Drug Diversion: An Increasing Issue
By: Suzan Miller-Hoover, DNP, RN,CCNS
Abuse and misuse of prescription opioid medications is a major public health problem in the United States.
The National Institute on Drug Abuse (NIDA) defines:
• Prescription drug misuse/non-medical use: Taking a medication in a manner other than that prescribed, taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (National Institute on Drug Abuse (NIDA), 2018).
The category of medications most often misused are:
• Opioids: Usually prescribed to treat pain
• Central nervous system [CNS] depressants: Used to treat anxiety and sleep disorders; this category includes tranquilizers, sedatives, and hypnotics)
• Stimulants: Most often prescribed to treat attention-deficit hyperactivity disorder (ADHD)
Annually the National Survey on Drug Use and Health is completed. In 2017 it was estimated that:
• 18 million people (6% of those 12 years of age or older) misused prescription drugs in the past year
• 2 million people misused drugs for the first time within the past year
o 5,480 new drug misusers per day
Stimulants: More than 1 million
Tranquilizers: 1.5 million
• Overdose deaths are five times higher than 1999
• The populations at highest risk are adolescents and older adults
This increase in the prevalence of prescription drug misuse may be because of the ease of access and the dramatic rise in the number of prescriptions written since 1999. Additionally, in the past, prescription medications were thought NOT to be as addictive as street drugs (NIDA, 2018).
Did you know that common chronic pain disorders are inversely related to income and education (socio-economic status), thus, those in greater need have more chronic pain disorders.
Another interesting fact to think about: The amount of opioid analgesic contained in an extended release tablet can be much more than the amount of opioid analgesic contained in an immediate release tablet because ER tablets are designed to release the opioid analgesic over a longer period. Misuse of long-acting opioids magnifies the risk of overdose and death.
To learn more about drug diversion prevention and management, review the RN.com courses: West Virginia Best Practice Prescribing and Drug Diversion Training and Recognizing Impairment in the Workplace.
By adhering to the principles of best practice prescribing and having an awareness of drug diversion practices, the healthcare professional can ensure a safe environment of care for the patient. This will ensure that patients in chronic pain will be able to legitimately obtain the pain relief they require, and diversion of drugs into the illegal market will be controlled. Healthcare professionals have an ethical and legal responsibility to prevent drug diversion and to comply with current legal requirements, without compromising patient care.
National Institute of Drug Abuse (NIDA). (2018). Misuse of prescription Drug. Retrieved from: https://www.drugabuse.gov/publications/misuse-prescription-drugs/overview
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