Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations

Abstract

While doctor shoppers, physicians and the Internet receive much of the attention regarding diversion, the data reported in this paper suggest that there are numerous active street markets involving patients, Medicaid recipients and pharmacies as well. In addition, there are other data which suggest that the contributions of residential burglaries, pharmacy robberies and thefts, and "sneak thefts" to the diversion problem may be understated.

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“…They described it as 'disorganized' because there are so many different players involved in the phenomenon, including physicians, pharmacists and other healthcare professionals; drug abusers, patients, students, street dealers and white collar criminals; and tourists, saloonkeepers and all types of service personnel, to name but a few. Federal agencies maintain that the diverted drugs enter the illegal market primarily through 'doctor shoppers', inappropriate prescribing practices by physicians and improper dispensing by pharmacists [132]. Incidardi et al in a study of the mechanisms of prescription drug diversion among druginvolved club-and street-based populations, concluded that while doctor shoppers and the internet receive much of the attention regarding diversion, the data showed there are numerous active street markets involving patients, Medicaid recipients and pharmacists as well [132].…”

“…However, it has been shown that the majority of the drugs come from a single physician's prescription and that family members share it [18]. Inciardi et al described diversion as a disorganized for-profit industry [132]. They described it as 'disorganized' because there are so many different players involved in the phenomenon, including physicians, pharmacists and other healthcare professionals; drug abusers, patients, students, street dealers and white collar criminals; and tourists, saloonkeepers and all types of service personnel, to name but a few.…”

“…The abuse of many different prescription drugs has been escalating since the early to mid-1990s [132][133][134][135]. Diversion can occur in many ways, including the illegal sale of prescriptions by physicians, patients and pharmacists, doctor shopping, forgery, robbery and theft.…”

“…Prescription drug 'diversion', defined as the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit market place, has been a topic of widespread commentary and is of interest to regulators and providers [132]. The abuse of many different prescription drugs has been escalating since the early to mid-1990s [132][133][134][135].…”

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“…Sale, theft, and forgery of either prescriptions or Drug Enforcement Agency (DEA) numbers are known components of drug diversion [3].…”