Prescription Drug Diversion: What It Is and How to Avoid It

Prescription drug diversion is a growing problem. It refers to the transfer of prescription drugs from the person for whom they were prescribed to another person for illicit use. Diversion can occur in many ways – sharing or selling prescription drugs, “doctor shopping” to get multiple prescriptions, theft, and fraudulent prescriptions. Understanding prescription drug diversion, why it occurs, and how to prevent it is important for patients, healthcare providers, and society as a whole.

What is Prescription Drug Diversion

Prescription drug diversion occurs when prescription drugs are transferred from the person for whom they were prescribed to another person for illicit use. This includes:

• Sharing or selling prescription drugs
• “Doctor shopping” to get prescriptions from multiple providers
• Prescription forgery or alteration
• Prescription theft from pharmacies, hospitals, or patient homes
• Illegal online pharmacies selling without prescriptions

Many people participate in prescription diversion because prescription drugs are often easier to obtain than illicit drugs. Some reasons people divert prescriptions include:

• To self-medicate physical or mental health issues
• To get high or feed an addiction
• To lose weight or enhance performance
• To make money selling drugs

Prescription drug diversion fuels substance misuse and overdoses. It is important to understand why it occurs and how to prevent it.

Contributing Factors to Diversion

Many societal factors contribute to the growing problem of prescription diversion including:

• Overprescribing – Prescriptions for opioids, stimulants, and sedatives have risen dramatically since the 1990s. Wider availability makes diversion more likely.
• Drug shortages – Shortages of prescription pain medications lead some patients to divert drugs out of desperation.
• High costs – The high out-of-pocket costs of some prescriptions motivates patients to sell diverted medications.
• Pill mills – Unethical clinics prescribing excessive controlled medications for profit fuels diversion.
• Social influences – Having friends or family members who abuse prescription medications increases personal risk of misuse.

Understanding patient motivations for diversion is important for preventing prescription misuse. Patients struggling with untreated addiction or mental health issues may be diverting medications without malicious intent. While diversion is illegal and risky, a judgemental or punitive approach could discourage patients from seeking help. An empathetic, harm reduction approach focused on connecting patients with treatment resources may be more constructive.

Dangers of Prescription Diversion

Prescription drug diversion comes with many risks including:

• Inaccurate dosing – Taking medications not as prescribed can lead to overdose or dangerous side effects.
• Adverse interactions – Diverted medications taken with alcohol, other medications, or street drugs can cause harm.
• Tampering and contamination – Diversion through illegal distribution exposes pills to unsafe handling and additions like fentanyl.
• Inadequate medical care – Those using diverted prescriptions may not seek appropriate healthcare for their medical needs.
• Addiction – Nonmedical use of prescription medications leads many people to develop substance use disorders.
• Legal consequences – Selling or distributing prescription medications carries stiff legal penalties.

Prescription drug diversion also causes broader societal harm. It contributes to higher healthcare costs, fuels the opioid crisis, spreads infectious disease, and depletes resources that could help patients with legitimate needs. Preventing diversion protects public health and safety.

Preventing Prescription Drug Diversion

Prescription drug diversion involves many players – patients, prescribers, pharmacists, drug manufacturers, and regulatory agencies. Preventing diversion requires coordinated efforts across healthcare and law enforcement. Some strategies include:

• Prescription drug monitoring programs (PDMPs) – State-run databases track controlled medication prescriptions to detect overprescribing and doctor shopping.
• Tighter prescription regulations – Requiring physician review of PDMP data and restricting refills can reduce diversion.
• Patient education – Teaching patients to properly store and dispose of medications helps prevent diversion through theft.
• Drug take-back programs – Providing safe medication disposal options reduces the supply of unused drugs that could be diverted.</li
• Law enforcement monitoring – Investigating “pill mills”, illegal online pharmacies, and distribution networks can disrupt diversion channels.
• Addiction treatment expansion – Broadening access to substance abuse counseling and medications for opioid use disorder lessens the demand side of diversion.

While technology and regulation can help address diversion, changing social attitudes is also key. Reducing stigma around addiction and mental illness may allow more patients to get appropriate treatment rather than self-medicating with diverted drugs. A compassionate, public health approach focused on harm reduction and connecting people to care could transform the prescription drug epidemic.

What to Do About Prescription Drug Diversion

While the prescription drug diversion problem seems overwhelming, there are things individuals can do to help. Some constructive actions include:

• Learn the signs of substance misuse and connect loved ones to treatment if needed.
• Set clear rules with teens and young adults about not sharing medications.
• Secure prescriptions properly in a lockbox and clean out unused medicines.
• Safely dispose of unneeded medications through a drug take-back program.
• Report suspected “pill mill” clinics or doctors overprescribing.
• Advocate for increased addiction treatment funding and reduced stigma.

Prescription drug diversion causes too much preventable harm. But each of us has power to shift attitudes and policies for the better. Small, thoughtful actions to spread awareness and promote healing over punishment can help create meaningful change.