Role of the Pain Management Clinic in Prescription Drug Diversion

Introduction: National surveillance systems are documenting widespread, escalating abuse of prescription drugs, however little is known about the scope of prescription drug abuse and the wide array of diversion sources. It is important to understand the practices of healthcare professionals and patients that may be knowingly or unknowingly facilitating the diversion of prescription drugs. Within this context, the goal of this research is to describe and examine the role that pain management clinics may play in the diversion of prescription drugs.

Methods: Audio-taped, individual interviews were conducted with a sub-sample of 25 prescription drug abusers drawn from a larger NIDA funded study sample. Each interview usually lasted between 60 to 90 minutes, after which each participant was paid a $30 stipend to compensate for his/her time. The interview transcripts were qualitatively analyzed by extracting themes from the text that were later categorized.

Findings: Preliminary findings suggest that some pain management clinics may be playing a central role in the diversion process for many prescription drug abusers. Participants cited the convenience of clinics' on-site pharmacies, the vast amount of available clinics in the South Florida area and the minimal amount of documentation needed to receive pain medication as appealing attributes. A greater willingness among pain physicians to prescribe “stronger” medications (schedule II) to treat symptoms was also a reoccurring theme.

Significance: These findings should provide much needed data to regulatory agencies and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices.