What's New at CDAS
October 2, 2009:
Prescription Opioid Abuse and Diversion in an Urban Community: The Results of an Ultra- Rapid Assessment
James A. Inciardi, Ph.D.,Hilary L. Surratt, Ph.D., Theodore J. Cicero, Ph.D., and Ronald A. Beard, M.H.S.
Both national and state-level monitoring systems are documenting the widespread abuse of prescription drugs by a variety of populations in the United States, and numerous scientific papers have discussed the issue of prescription drug diversion -- the transfer of a prescription drug from a lawful to an unlawful channel of distribution or use. Nevertheless, diversion is a topic about which comparatively little is known, and systematic information garnered from prescription drug abusers and dealers on the specific mechanisms of diversion is limited. Within this context, a pilot ultra-rapid assessment was carried out in Wilmington, Delaware, during December 2006. The primary goal of this investigation was to gather timely descriptive information from multiple sources (police, prescription drug abusers, prescription drug dealers) in order to better understand the scope and dynamics of prescription drug abuse and diversion in the Wilmington area. The results suggest that the abuse and diversion of prescription medications in Wilmington are significant problems. For many individuals, the abuse of prescription opioids served as a gateway to heroin use. Sources of prescription drugs on the street were the elderly, pain patients, and doctor shoppers, as well as pill brokers and dealers who work with all of the former. It would appear that the diversion of prescription opioids in the Wilmington area might be reduced through physician education focusing on: 1) recognizing that a patient is misusing and/or diverting prescribed medications; 2) considering a patient’s risk for opioid misuse before initiating opioid therapy; and, 3) understanding the variation in the abuse potential of different opioids currently on the market. Patient education also appears appropriate in the areas of safeguarding medications, disposal of unused medications, and understanding the consequences of manipulating physicians and selling their medications.