Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings (Detailed Tables). Rockville, MD: Department of Health and Human Services; 2015. HHS Publication No. (SMA) 13-4795, NSDUH Series H-46.
    1. Substance Abuse and Mental Health Services Administration Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Department of Health and Human Services; 2015. HHS Publication No. (SMA) 15-4927, NSDUH Series H-50.
    1. Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Department of Health and Human Services; 2013. HHS Publication No. (SMA) 13-4760, DAWN Series D-39.
    1. Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set—Admissions (TEDS-A)—Concatenated, 1992 to 2012. Ann Arbor, MI: Inter-University Consortium for Political and Social Research; 2015. ICPSR 25221.
    1. Substance Abuse and Mental Health Services Administration. National Admissions to Substance Abuse Treatment Services. Rockville, MD: Department of Health and Human Services; 2015. HHS Publication No. (SMA) XX-XXXX, BHSIS Series X-XX.

LinkOut - more resources