In recent years, attention to the increasing and tragic consequences of abuse of opioid analgesics has led some to suggest that the main source of the problem is physicians' prescribing to pain patients, rekindling fears about regulatory scrutiny and doubts about the use of these important medications. Such assertions need to be examined in light of evidence that there are many sources of diversion, including theft of large quantities from pharmacies before they are prescribed. We need to assess the sources of the problem and address them without interfering in legitimate medicine and pain care.
Before coming to the pain field in the mid 1980s, I had more than a decade of experience in designing and administering a state diversion prevention and control program, and I founded a national association of state controlled substances authorities. Drawing on this as well as recent experience, I would like to contribute a piece that I think is missing from the current national discussion about diversion and abuse, i.e., what is diversion, how does it occur, what information is available to study it, and what are key research and policy questions. If this is of interest, I invite you to view the short 15 slide presentation titled "Diversion of Prescription Opioids."
By: David E. Joranson, MSSW
- Joranson DE, Gilson AM. A much-needed window on opioid diversion (Editorial). Pain Med 2007;8:128-129.
- Joranson DE, Gilson AM. Wanted: A public health approach to prescription opioid abuse and diversion (Editorial). Pharmacoepidemiology and Drug Safety. 2006;15:632-634.
- Joranson DE, Gilson AM. Drug crime is a source of abused pain medications in the United States. J Pain Symptom Manage. 2005; 30(4):299-301.