National surveillance systems are documenting widespread, escalating abuse of prescription drugs, and numerous scientific papers have discussed problems associated with pharmaceutical diversion. However, empirical data on the full range of mechanisms, the magnitude of diversion from each source, and the patterns of diversion associated with specific drugs of abuse and/or different at-risk subpopulations are unavailable. Within this context, the overall goal of this 4-year project is to examine and describe the complex of mechanisms and players that connect illicit supplies of prescription drugs (diversion) to abusers in South Florida from three vantage points: 1) prescription drug abusers, 2) prescription drug dealers, and 3) law enforcement. The sampling plan is designed to maximize the diversity of the sample and collect data on the fullest possible range of diversion activities.
The specific aims are to:1) recruit samples of 1200 treatment clients (300 publicly-supported, 300 private pay;300 methadone maintenance clients, and 300 elderly persons ages 60 and above), 300 street drug users, and 300 gay male methamphetamine abusers, all with prescription drug abuse problems;2) assess life histories of drug abuse, including current alcohol, illicit, and prescription drugs;3) assess mechanisms of access to and acquisition of prescription drugs;4) assess demographic, sociocultural, and psychosocial characteristics that are hypothesized to connect prescription drug abusers to their illicit sources of supply;5) conduct in-depth interviews with sub-samples of 30 respondents from each subgroup;6) recruit 50 prescription drug sellers from diverse networks and conduct in-depth interviews to determine which prescription drugs they sell, to whom, in what quantities;at what prices, and how they are obtained;7) extract data from the arrest files of 300 prescription drug traffickers from the diversion unit of the Broward County Sheriff's Department to examine the sources and mechanisms of prescription drug trafficking;and, 8) conduct in-depth interviews with 20 diversion investigators in large police agencies to obtain information about the sources of diverted prescription drugs. Relevance to Public Health. A fuller understanding of the mechanisms and magnitude of prescription drug abuse and diversion, and how they vary across user populations, is critical for health care and regulatory agencies, and industry in order to develop appropriate prevention, risk management, treatment, policy, and enforcement initiatives.
| O'Grady, Catherine L; Surratt, Hilary L; Kurtz, Steven P et al. (2014) Nonmedical prescription drug users in private vs. public substance abuse treatment: a cross sectional comparison of demographic and HIV risk behavior profiles. Subst Abuse Treat Prev Policy 9:9 |
| Ibanez, Gladys E; Levi-Minzi, Maria A; Rigg, Khary K et al. (2013) Diversion of Benzodiazepines through Healthcare Sources. J Psychoactive Drugs 45:48-56 |
| Levi-Minzi, Maria A; Surratt, Hilary L; Kurtz, Steven P et al. (2013) Under treatment of pain: a prescription for opioid misuse among the elderly? Pain Med 14:1719-29 |
| Ibanez, Gladys E; Levi-Minzi, Maria A; Rigg, Khary K et al. (2013) Diversion of benzodiazepines through healthcare sources. J Psychoactive Drugs 45:48-56 |
| Rigg, Khary K; Murphy, John W (2013) Understanding the etiology of prescription opioid abuse: implications for prevention and treatment. Qual Health Res 23:963-75 |
| Cicero, Theodore J; Surratt, Hilary L; Kurtz, Steven et al. (2012) Patterns of prescription opioid abuse and comorbidity in an aging treatment population. J Subst Abuse Treat 42:87-94 |
| Rigg, Khary K; Kurtz, Steven P; Surratt, Hilary L (2012) Patterns of prescription medication diversion among drug dealers. Drugs (Abingdon Engl) 19:144-155 |
| Cicero, Theodore J; Ellis, Matthew S; Paradis, Alethea et al. (2011) Role of key informants and direct patient interviews in epidemiological studies of substance abuse. Pharmacoepidemiol Drug Saf 20:308-12 |
| Surratt, Hilary; Kurtz, Steven P; Cicero, Theodore J (2011) Alternate routes of administration and risk for HIV among prescription opioid abusers. J Addict Dis 30:334-41 |
| Cicero, Theodore J; Kurtz, Steven P; Surratt, Hilary L et al. (2011) Multiple Determinants of Specific Modes of Prescription Opioid Diversion. J Drug Issues 41:283-304 |
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