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AIMS Public Health

2015, Volume 2, Issue 4: 762-783. doi: 10.3934/publichealth.2015.4.762
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Research article

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas

  • 1.
    Department of Anthropology, University of Central Florida, 4000 Central Florida Boulevard, Howard Phillips Hall 309, Orlando, FL 32816-1361, USA;
  • 2.
    Psychology Department, Queens College, City University of New York, 6530 Kissena Boulevard, SB A344, Queens, NY 11367-1597, USA;
  • 3.
    Social Science Department, LaGuardia Community College, City University of New York, 31-10 Thomson Avenue, Long Island City, NY 11101, USA;
  • 4.
    School of Social Work, Rutgers University, 536 George Street, New Brunswick, NJ 08901, USA;
  • 5.
    National Development and Research Institutes, 71 West 23rd Street, 4th Floor, New York, NY 10010, USA;
  • 6.
    Department of Social Work, Binghamton University, P.O. Box 6000, Binghamton, NY 13902-6000;
  • 7.
    Science Department, Berkeley College, 3 East 43 Street New York, NY 10017, USA;
  • 8.
    Graduate School of Education, University of Pennsylvania, 3700 Walnut Street Philadelphia, PA 19104, USA;
  • 9.
    Sociology and Criminology Department, Cabrini College, 610 King of Prussia Road, Radnor, PA 19087-3698, USA;
  • 10.
    Department of Pediatrics, Harlem Hospital Center, 506 Malcolm X Boulevard, New York, NY 10037, USA;
  • 11.
    Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY 10013, USA
  • Received: 27 July 2015 Accepted: 16 November 2015 Published: 02 December 2015

  • Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.

    Citation: Shana Harris, Valentina Nikulina, Camila Gelpí-Acosta, Cory Morton, Valerie Newsome, Alana Gunn, Heidi Hoefinger, Ross Aikins, Vivian Smith, Victoria Barry, Martin J. Downing Jr.. Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas[J]. AIMS Public Health, 2015, 2(4): 762-783. doi: 10.3934/publichealth.2015.4.762

    Related Papers:

  • Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.


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    [1] [ Hernandez SH, Nelson LS, (2010) Prescription drug abuse: Insight into the epidemic. Clin Pharmacol Ther 88: 307-317.
    [2] [ Arria AM, DuPont RL, (2010) Nonmedical prescription stimulant use among college students: Why we need to do something and what we need to do. J Addict Dis 29: 417-426.
    [3] [ Kroutil LA, Van Brunt DL, Herman-Stahl MA, et al. (2006) Nonmedical use of prescription stimulants in the United States. Drug Alcohol Depend 84: 135-143.
    [4] [ McCabe SE, Teter CJ, Boyd CJ, et al. (2005) Nonmedical use of prescription opioids among U.S. college students: Prevalence and correlates from a national survey. Addict Behav 30: 789-805.
    [5] [ National Drug Intelligence Center, National Prescription Drug Threat Assessment. Johnstown: National Drug Intelligence Center, 2009. Available from: http://www.justice/gov/archive/ndic /pubs33/33775/33775p.pdf
    [6] [ Novak SP, Kroutil LA, Williams RL, et al. (2007) The nonmedical use of prescription ADHD medications: Results from a national Internet panel. Subst Abuse Treat Prev Policy 2: 32.
    [7] [ Substance Abuse and Mental Health Services Administration, (2013) Results from the 2012 National Survey on Drug Use and Health: Summary of national findings. Rockville: Substance Abuse and Mental Health Services Administration.
    [8] [ Compton WM, Volkow ND, (2006) Abuse of prescription drugs and the risk of addiction. Drug Alcohol Depend 83S: S4-S7.
    [9] [ Levi J, Segal LM, Miller AF, (2013) Prescription drug abuse: Strategies to stop the epidemic 2013. Washington, D.C.: Trust for America's Health.
    [10] [ Yu HE, (2012) The prescription drug abuse epidemic. Clin Lab Med 32: 361-377.
    [11] [ Zacny J, Bigelow G, Compton P, et al. (2003) College on problems of drug dependence taskforce on prescription opioid non-medical use and abuse: Position statement. Drug Alcohol Depend 69: 215-232.
    [12] [ Substance Abuse and Mental Health Services Administration, (2008) National estimates of drug related emergency department visits. Rockville: Substance Abuse and Mental Health Services Administration.
    [13] [ Johnston LD, O'Malley PM, Bachman JG, et al. (2010) Monitoring the Future: National results on adolescent drug use. Bethesda: National Institute on Drug Abuse.
    [14] [ Office of National Drug Control Policy, Epidemic: Responding to America's Prescription Drug Abuse Crisis. Washington, D.C.: Office of National Drug Control Policy, 2011.Available from: http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/prescription-drugs /rx_abuse_plan.pdf
    [15] [ Inciardi JA, Surratt HL, Lugo Y, et al. (2007) The diversion of prescription opioid analgesics. Law Enforc Exec Forum 7: 127-141.
    [16] [ Inciardi JA, Surratt HL, Cicero TJ, et al. (2009) The “black box” of prescription drug diversion. J Addict Dis 28: 332-347.
    [17] [ Cummings SM, Merlo L, Cottler LB, (2011) Mechanisms of prescription drug diversion among impaired physicians. J Addict Dis 30: 195-202.
    [18] [ Inciardi JA, Surratt HL, Kurtz SP, et al. (2007) Mechanisms of prescription drug diversion among drug-involved club- and street-based populations. Pain Med 8: 71-183.
    [19] [ Chandra A, Ozturk A, (2004) Health professionals beware of prescription pain medication abuse. Hosp Top 82: 34-37.
    [20] [ Inciardi JA, Surratt HL, Kurtz SP, et al. (2006) The diversion of prescription drugs by health care workers in Cincinnati, Ohio. Subst Use Misuse 41: 255-264.
    [21] [ Ibañez GE, Levi-Minzi MA, Rigg KK, et al. (2013) Diversion of benzodiazepines through healthcare sources. J Psychoactive Drugs 45: 48-56.
    [22] [ Rigg KK, March SJ, Inciardi JA, (2010) Prescription drug abuse and diversion: Role of the pain clinic. J Drug Issues 40: 681-702.
    [23] [ Beyene KA, Sheridan J, Aspden T, (2014) Prescription medication sharing: A systematic review. Am J Public Health 104: e15-e26.
    [24] [ Darredeau C, Barrett SP, Jardin B, et al. (2007) Patterns and predictors of medication compliance, diversion, and misuse in adult prescribed methylphenidate users. Hum Psychopharmacol 22: 529-536.
    [25] [ Hurwitz W, (2005) The challenge of prescription drug misuse: A review and commentary. Pain Med 6: 152-161.
    [26] [ Inciardi JA, Surratt HL, Cicero TJ, et al. (2009) Prescription opioid abuse and diversion in an urban community: The results of an ultrarapid assessment. Pain Med 10: 537-548.
    [27] [ McCabe SE, Teter CJ, Boyd CJ, (2006) Medical use, illicit use and diversion of prescription stimulant medication. J Psychoactive Drugs 38: 43-56.
    [28] [ Vrecko S, (2015) Everyday drug diversions: A qualitative study of the illicit exchange and Non-medical use of prescription stimulants on a university campus. Soc Sci Med 131: 297-304.
    [29] [ Davis WR, Johnson B, (2008) Prescription opioid use, misuse, and diversion among street drug users in New York City. Drug Alcohol Depend 92: 267-276.
    [30] [ Inciardi JA, Surratt HL, Cicero TJ, et al. (2010) Prescription drugs purchased through the Internet: Who are the end users? Drug Alcohol Depend 110: 21-29.
    [31] [ Jena AB, Goldman DP, Foster SE, et al. (2011) Prescription medication abuse and illegitimate Internet-based pharmacies. Ann Intern Med 155: 848-850.
    [32] [ Cicero TJ, Inciardi JA, (2005) Diversion and abuse of methadone prescribed for pain management. JAMA 293: 297-298.
    [33] [ Garnier LM, Arria AM, Caldeira KM, et al. (2010) Sharing and selling of prescription medications in a college student sample. J Clin Psychiatry 71: 262-269.
    [34] [ Rigg KK, Kurtz SP, Surratt HL, (2012) Patterns of prescription medication diversion among drug dealers. Drugs (Abingdon Engl) 19: 145-155.
    [35] [ Inciardi JA, Cicero TJ, (2009) Black beauties, gorilla pills, footballs, and hillbilly heroin: Some reflections on prescription drug abuse and diversion research over the past 40 years. J Drug Issues 39: 101-114.
    [36] [ Cai R, Crane E, Poneleit K, et al. (2010) Emergency department visits involving nonmedical use of selected prescription drugs in the United States, 2004-2008. J Pain Palliat Care Pharmacother 24: 293-297.
    [37] [ Centers for Disease Control and Prevention, (2011) Vital signs: overdoses of prescription opioid pain relievers: United States, 1999-2008. MMWR Morb Mortal Wkly Rep 60: 1487-1492.
    [38] [ Gilson AM, Ryan KM, Joranson DE, et al. (2004) A reassessment of trends in the medical use and abuse of opioid analgesics and implications for diversion control: 1997-2002. J Pain Symptom Manage 28: 176-188.
    [39] [ Mack KA, Jones CM, Paulozzi LJ, (2013) Vital signs: Overdoses of prescription opioid pain relievers and other drugs among women — United States, 1999-2010. MMWR Morb Mortal Wkly Rep 62: 537-542.
    [40] [ Joranson DE, Gilson AM, (2005) Drug crime is a source of abused pain medications in the United States. J Pain Symptom Manage 30: 299-301.
    [41] [ Berge KH, Dillon KR, Sikkink KM, et al. (2012) Diversion of drugs within health care facilities, a multiple victim crime: Patterns of diversion, scope, consequences, detection, and prevention. Mayo Clin Proc 87: 674-682.
    [42] [ Office of National Drug Control Policy, The economic costs of drug abuse in the United States, 1992-1998. Washington, D.C.: Office of National Drug Control Policy, 2001. Available from: http://www.whitehousedrugpolicy.gov/publications/pdf/economic_costs98.pdf
    [43] [ Joranson DE, Gilson AM, (2006) Wanted: A public health approach to prescription opioid abuse and diversion. Pharmacoepidemiol Drug Saf 15: 632-634.
    [44] [ McCabe SE, Boyd CJ, (2005) Sources of prescription drugs for illicit use. Addict Behav 30: 1342-1350.
    [45] [ McCabe SE, Cranford JA, Boyd CJ, et al. (2007) Motives, diversion and routes of administration associated with nonmedical use of prescription opioids. Addict Behav 32: 562-575.
    [46] [ Rabiner DL, Anastopoulos AD, Costello EJ, et al. (2009) The misuse and diversion of prescribed ADHD medications by college students. J Atten Disord 13: 144-153.
    [47] [ Upadhyaya HP, Rose K, Wang W, et al. (2005) Attention-Deficit/Hyperactivity Disorder, medication treatment, and substance use patterns among adolescents and young adults. J Child Adolesc Psychopharmacol 15: 799-809.
    [48] [ Arria AM, Garnier-Dykstra LM, Caldeira KM, et al. (2011) Prescription analgesic use among young adults: Adherence to physician instructions and diversion. Pain Med 12: 898-903.
    [49] [ Walker MJ, Webster LR, (2012) Risk factors for drug diversion in a pain clinic patient population. J Opioid Manag 8: 351-362.
    [50] [ Cicero TJ, Kurtz SP, Surratt HL, et al. (2011) Multiple determinants of specific modes of prescription opioid diversion. J Drug Issues 41: 283-304.
    [51] [ Inciardi JA, Cicero TJ, Munoz A, et al. (2006) The diversion of Ultram, Ultracet, and generic tramadol HCl. J Addict Dis 25: 53-58.
    [52] [ Monte AA, Mandell T, Wilford BB, et al. (2009) Diversion of buprenorphine/naloxone coformulated tablets in a region with high prescribing prevalence. J Addict Dis 28: 226-231.
    [53] [ McCabe SE, Teter CJ, Boyd CJ, (2004) The use, misuse and diversion of prescription stimulants among middle and high school students. Subst Use Misuse 39: 1095-1116.
    [54] [ Wilens TE, Adler LA, Adams J, et al. (2008) Misuse and diversion of stimulants prescribed for ADHD: A systematic review of the literature. J Am Acad Child Adolesc Psychiatry 47: 21-31.
    [55] [ Ali SE, Ibrahim MM, Palaian S, (2010) Medication storage and self-medication behaviour amongst female students in Malaysia. Pharm Pract 8: 226-232.
    [56] [ Petersen EE, Rasmussen SA, Daniel KL, et al. (2008) Prescription borrowing and sharing among women is fraught with potential health consequences. J Womens Health (Larchmt) 17: 1073-1080.
    [57] [ Daniel KL, Honein MA, Moore CA, (2003) Sharing prescription medication among teenage girls: Potential danger to unplanned/undiagnosed pregnancies. Pediatrics 111: 1167-1170.
    [58] [ Goldsworthy RC, Schwartz NC, Mayhorn CB, (2008) Beyond abuse and exposure: Framing the impact of prescription-medication sharing. Am J Public Health, 98(6), 1115-1121.
    [59] [ Hogan DJ, Moreland A, Lane P, et al. (1990) Exchange of prescription medications by dermatology outpatients. J Am Acad Dermatol 23: 953.
    [60] [ Goldsworthy RC, Mayhorn C, (2009) Prescription medication sharing among adolescents: Prevalence, risks, and outcomes. J Adolesc Health 45: 634-637.
    [61] [ Ellis J, Mullan J, (2009) Prescription medication borrowing and sharing — Risk factors and management. Aust Fam Physician 38: 816-819.
    [62] [ Ward L, Patel NM, Hanlon A, et al. (2011) Prescription medication borrowing among adult patients at an urban medical center. J Urban Health 88: 997-1014.
    [63] [ Altschuler DM, Brounstein PJ, (1991) Patterns of drug use, drug trafficking, and other delinquency among inner-city adolescent males in Washington, D.C. Criminology 29: 589-622.
    [64] [ Centers N, Weist M, (1998) Inner city youth and drug dealing: A review of the problem. J Youth Adolesc 27: 395-411.
    [65] [ Cicero TJ, Kuehn BM, (2014) Driven by prescription drug abuse, heroin use increases among suburban and rural whites. JAMA 312: 118-9.
    [66] [ Parker H, (2005) Normalization as a barometer: Recreational drug use and the consumption of leisure by younger Britons. Addict Res Theory 3: 205-215.
    [67] [ Alexa, Top sites in United States, 2014. Available from: http://www.alexa.com/topsites/countries /US
    [68] [ Grov C, (2012) HIV risk and substance use in men who have sex with men surveyed in bathhouses, bars/clubs, and on Craigslist.org: Venue of recruitment matters. AIDS Behav 16: 807-817.
    [69] [ Hughes JR, Fingar JR, Budney AJ, et al. (2014) Marijuana use and intoxication among daily users: An intensive longitudinal study. Addict Behav 39: 1464-1470.
    [70] [ Ramo DE, Hall SM, Prochaska JJ, (2010) Reaching young adult smokers through the Internet: Comparison of three recruitment mechanisms. Nicotine Tob Res 12: 768-775.
    [71] [ Siegel M, DiLoreto J, Johnson A, et al. (2011) Development and testing of an Internet-based survey instrument to measure the alcohol brand preferences of U.S. youth. Alcohol Clin Exp Res 35: 765-772.
    [72] [ Stueve A, O'Donnell L, Duran R, et al. (2001) Time-space sampling in minority communities: Results with young Latino men who have sex with men. Am J Public Health 91: 922-926.
    [73] [ Downing MJ Jr, Antebi N, Schrimshaw EW, (2014) Compulsive use of Internet-based sexually explicit media: Adaptation and validation of the Compulsive Internet Use Scale (CIUS). Addict Behav 39: 1126-1130.
    [74] [ Barchard KA, Williams J, (2008) Practical advice for conducting ethical online experiments and questionnaires for United States psychologists. Behav Res Methods 40: 1111-1128.
    [75] [ Birnbaum MH, (2004) Human research and data collection via the Internet. Annual Rev Psychol 55: 803-832.
    [76] [ Nosek BA, Banaji MR, Greenwald AG, (2002) E-research: Ethics, security, design, and control in psychological research on the Internet. J Soc Issues 58: 161-176.
    [77] [ Baum, S, (2000) Drink driving as a social problem: Comparing the attitudes and knowledge of drink driving offenders and the general community. Accid Anal Prev 32: 689-694.
    [78] [ Johnston LD, O'Malley PM, Bachman JG, et al. (2005) Monitoring the future national survey results on drug use, 1975-2004: Volume II, College students and adults ages 19-45. Bethesda: National Institute on Drug Abuse.
    [79] [ Lord S, Brevard J, Budman S, (2011) Connecting to young adults: An online social network survey of beliefs and attitudes associated with prescription opioid misuse among college students. Subst Use Misuse 46: 66-76.
    [80] [ Kilmer B, Everingham SS, Caulkins JP, et al. (2014) How big is the US market for illegal drugs? Santa Monica: RAND.
    [81] [ National Institute on Drug Abuse, Nationwide Trends. Bethesda: National Institute on Drug Abuse, 2015. Available from: https://d14rmgtrwzf5a.cloudfront.net/sites/default/files /drugfacts_nationtrends_6_15.pdf
    [82] [ Garson GD, (2013) Missing values analysis and data imputation. Ashelboro: Statistical Associates Publishers.
    [83] [ Schafer JL, Graham JW, (2002) Missing data: Our view of the state of the art. Psychol Methods 7: 147-177.
    [84] [ Sinharay S, Stern HS, Russell D, (2001) The use of multiple imputation for the analysis of missing data. Psychol Methods 6: 317-329.
    [85] [ Caviness CM, Anderson BJ, de Dios MA, et al. (2013) Prescription medication exchange patterns among methadone maintenance patients. Drug Alcohol Depend 127: 232-238.
    [86] [ Steinberg L, (2007) Risk taking in adolescence: New perspectives from brain and behavioral science. Curr Dir Psychol Sci 16: 55-59. [87] Back SE, Payne RL, Simpson AN, et al. (2010) Gender and prescription opioids: Findings from the National Survey on Drug Use and Health. Addict Behav 35: 1001-1007.
    [87] [88] Boyd CJ, McCabe SE, Cranford JA, et al. (2007) Prescription drug abuse and diversion among adolescents in a southeast Michigan school district. Arch Pediatr Adolesc Med 161: 276-281.
    [88] [89] Rhodes SD, Bowie DA, Hergenrather KC, (2003) Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 57: 68-73.
    [89] [90] Mustanski BS, (2001) Getting wired: Exploiting the Internet for the collection of valid sexuality data. J Sex Res 38: 292-301.
    [90] [91] National Institute on Drug Abuse, Trends in Prescription Drug Abuse. Bethesda: National Institute on Drug Abuse, 2014. Available from: http://www.drugabuse.gov/publications/research-reports-prescription-drugs/trends-in-prescription-drug-abuse
    [91] [92] Jansen BJ, (2010) Use of the Internet in higher-income households. Washington, D.C.: Pew Research Center.
    [92] [93] Korgen K, Odell P, Schumacher P, (2001) Internet use among college students: Are there differences by race/ethnicity? Electronic Journal of Sociology 5.
    [93] [94] Perrin A, Duggan M, Americans' internet access: 2000-2015. Washington, D.C.: Pew Research Center, 2015. Available from: http://www.pewinternet.org/2015/06/26/americans-internet-access-2000-2015
    [94] [95] Zickuhr K, Smith A, Digital differences. Washington, D.C.: Pew Research Center, 2012. Available from: htpp://www.pewinternet.org/2012/04/13/digital-differences
    [95] [96] Dykema J, Jones NR, Piché T, et al. (2013) Surveying clinicians by web: Current issues in design and administration. Eval Health Prof 36: 352-381.
    [96] [97] Chiasson MA, Parsons JT, Tesoriero JM, et al. (2006) HIV behavioral research online. J Urban Health 83: 73-85.
    [97] [98] Grey JA, Kontan J, Iantaffi A, et al. (2015) An updated protocol to detect invalid entries in an online survey of men who have sex with men (MSM): How do valid and invalid submissions compare? AIDS Behav 19: 1928-1937.
    [98] [99] Hirshfield S, Schrimshaw EW, Stall RD, et al. (2015) Drug use, sexual risk, and syndemic production among MSM who engage in group sex encounters. Am J Public Health 105: 1849-1858.
    [99] [100] McCabe SE, Couper MP, Cranford JA, et al. (2006) Comparison of web and mail surveys for studying secondary consequences associated with substance use: Evidence for minimal mode effects. Addict Behav 32: 162-168.
    [100] [101] McCabe SE, (2008) Misperceptions of non-medical prescription drug use: A web survey of college students. Addict Behav 33: 713-724.
    [101] [102] Fleming CM, Bowden M, (2009) Web-based surveys as an alternative to traditional mail methods. J Environ Manage 90: 284-292.
    [102] [103] Shih T-H, Fan X, (2008) Comparing response rates from Web and mail surveys: A meta-analysis. Field Methods 20: 249-271.
    [103] [104] Link MW, Mokdad AH, (2005) Alternative modes for health surveillance surveys: An experiment with web, mail, and telephone. Epidemiology 16: 701-70.
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