Drug diversion

In the terminology of the United States Drug Enforcement Administration, diversion is the use of prescription drugs for recreational purposes. The term comes from the "diverting" of the drugs from their original purposes. The Drug Enforcement Administration employs Diversion Investigators to address these problems.

Drug diversion may also refer to programs available to first time drug law offenders, which "divert" offenders from the criminal justice system to a program of education and rehabilitation.

Drugs that are diverted

• Opioids (including opium alkaloids) such as morphine, hydrocodone, oxycodone (OxyContin) and codeine.
• Pseudoephedrine or ephedrine, used in illicit production of methamphetamine or methcathinone. Ephedrine is also abused itself.
• Dextromethorphan (DXM), the active ingredient of cough medications like Robitussin DM, is abused for its effects which are similar to ketamine and PCP.
• Non-opioid depressants, mainly benzodiazepines such as diazepam, temazepam, clonazepam, and alprazolam.
• Stimulants such as amphetamine and methylphenidate. These have similar effects to cocaine and methamphetamine.
• Less commonly: benzydamine, dimenhydrinate, diphenhydramine, modafinil.

The Drug Enforcement Administration has implemented various measures against drug diversion in the United States. For example, retail sales of pseudoephedrine are limited in certain stores to specified amounts. In addition, several states have passed legislation requiring proof of identification and a written record of all pseudoephdrine sales.

Critics of the current policy on drug diversion claim that the problem is exacerbated by a lack of public knowledge regarding the abuse of prescription pharmaceuticals. In the recent Florida case of Rush Limbaugh, who was accused of painkiller abuse, critics also argued that the line between pharmaceutical opiates and street opiate remains vague in current law. Prescription painkillers can be stronger than the opiates, mostly heroin, which are sold as part of the illegal drug trade. While the purity of illegal opiates can vary widely, pharmaceutical manufacturing results in a uniform potency and benefits from government oversight, a factor which decreases the perceived danger of prescription pharmaceuticals.

Registration of drug suppliers and dispensers

21 U.S.C. § 823 of the Controlled Substances Act provides for registration of manufacturers and distributors of controlled substances. The criteria for registering manufacturers of Schedule I and II drugs are particularly strict and call for "limiting the importation and bulk manufacture of such controlled substances to a number of establishments which can produce an adequate and uninterrupted supply of these substances under adequately competitive conditions for legitimate medical, scientific, research, and industrial purposes." The Attorney General must make a positive determination that the registration would be "consistent with the public interest."

For manufacturers of other drugs, and for drug distributors, the regulations are substantially less strict: "The Attorney General shall register an applicant… unless he determines that the issuance of such registration is inconsistent with the public interest." The criteria for both manufacture and distribution is somewhat biased in favor of established industries, favoring "past experience" and a record of compliance with drug laws .

The Controlled Substances Act also provides for the registration of medical practitioners (i.e., physicians, dentists, veterinarians, etc.), pharmacies and hospitals that prescribe, administer, or dispense controlled substances directly to patients, as well as individuals conducting approved research involving controlled substances. This category also includes narcotic treatment programs that administer and dispense primarily Methadone for narcotic addiction treatment.

Examples of how, when and why it occurs

This activity can occur in many venues; and it

occurs in a variety of ways, by all segments of our population, in all neighborhoods, and in all workplaces. Its abuse is often overlooked by the thinking that if a doctor prescribes the drug, and a pharmacist dispenses the medication, it can’t be abused. Understanding that the top prescription drugs of abuse are every bit as addictive, abused, and valuable as illicit drugs, is sometimes difficult to comprehend.

—RxDiversion.com web page

The Cincinnati Post has reported on its frequency. John Burke, a leading expert on the issue, was quoted as saying, "Pharmaceutical diversion is kind of funny because it's going on in every community, but it appears not to exist unless you go after it purposely," ^[1]

Pharmaceutical diversion

Is the practice of obtaining drugs at a pharmaceutical level. Singer points out that when illegal drugs become expensive at the consumer's level (like heroin), they look for alternative ways of acquiring alternate drugs. For example, in India, when the street price of heroin rises it is replaced with over-the-counter drugs like buprenorphine (Tidigesic), dextropropoxyphene (Proxyvon), and diazepam (Valium). Pharmaceutical diversion is not only happening in developed countries " (it is) being experienced in developing countries (as well) where poverty and ready access to drugs of addiction collide." ^[2]

According to the United States Department of Justice, "Most pharmaceuticals abused in the United States are diverted by doctor shopping, forged prescriptions, theft and, increasingly, via the Internet." ^[3]

"To reduce the occurrence of pharmaceutical diversion by doctor shopping and prescription fraud," the US Department of Justice and "21 states have established prescription monitoring programs (PMPs) that facilitate the collection, analysis, and reporting of information regarding pharmaceutical drug prescriptions." ^[3]

CVS oxycodone diversion

DEA investigation into Oxycodone diversion

According to the US Justice Department, in 2011 CVS pharmacies in Sanford, Florida, ordered enough painkillers to supply a population eight times its size. Sanford has a population of 53,000 but the supply would support 400,000.^[4] According to the Drug Enforcement Administration, in 2010 a single CVS pharmacy in Sanford ordered 1.8 million Oxycodone pills, an average of 137,994 pills a month. Other pharmacy customers in Florida averaged 5,364 oxycodone pills a month. DEA investigators serving a warrant to a CVS pharmacy in Sanford on Oct. 18 2011 noted that "approximately every third car that came through the drive-thru lane had prescriptions for oxycodone or hydrocodone." According to the DEA, a pharmacist at that location stated to investigators that "her customers often requested certain brands of oxycodone using street slang," an indicator that the drugs were being diverted and not used for legitimate pain management. In response, CVS in a statement issued February 17 in response to opioid trafficking questions from USA Today said the company is committed to working with the DEA and had taken "significant actions to ensure appropriate dispensing of painkillers in Florida." ^[5]

See also

• Diversion (disambiguation)

Look up diversion in Wiktionary, the free dictionary.

• Oxycodone
• Pharmaceuticals in India
• Steroids

References

References

• Controlled Substances Act - U.S. Drug Enforcement Administration