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Review
. 2017 Apr 11:11:1178221817696077.
doi: 10.1177/1178221817696077. eCollection 2017.

Doctor Shopping Behavior and the Diversion of Prescription Opioids

Ronald Simeone  1
Affiliations
Review

Doctor Shopping Behavior and the Diversion of Prescription Opioids

Ronald Simeone. Subst Abuse. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Subst Abuse. 2018 Apr 11;11:1178221817724034. doi: 10.1177/1178221817724034. eCollection 2017. Subst Abuse. 2018. PMID: 35173436 Free PMC article.

Abstract

Objectives: "Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012.

Methods: Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency.

Results: A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012.

Conclusions: Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

Keywords: Doctor shopping; prescription diversion; prescription opioid diversion; prescription opioids.

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Conflict of interest statement

DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Event generation.
Figure 2.
Figure 2.
Projected Trends (Prescriptions and Milligrams per Year).
Figure 3.
Figure 3.
Percent total morphine-equivalent milligrams diverted by state and percent change in percent morphine-equivalent milligrams diverted by state over the period 2008-2012.
See this image and copyright information in PMC

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