5. TOP RX DRUGS OF ABUSE
• HYDROCODONE ( VICODIN, LORTAB ) $.50 PER MG
• OXYCODONE ( PERCOCET ) $1.00 PER MG
• METHADONE ( $10-$30 PER PILL )
• ALPRAZOLAM ( XANAX ) $1.00 PER MG
• FENTANYL PATCHES $40-$100 PER PATCH
6. HIPAA RULES 164.512 (a)
• A covered entity may use or disclose protected health
information to the extent that such use or disclosure is
required by law and the use or disclosure complies with and is
limited to the relevant requirements of such law.
7. STATE LAW: BUCHMAN vs STOKES
• Physician-patient privilege only attaches to communications
that are made within physician-patient relationship: if
communication by patient is fraudulent, relationship is not
established and privilege does not attach.
8. SOURCE OF DIVERTED DRUGS
• Forged and Altered Prescriptions
• “Doctor Shoppers”
• Theft (Health Facility and Other)
• Internet
• Pharmacy Robbery & Burglary
• International Smuggling
9. FORGED AND ALTERED PRESCRIPTIONS
• Alteration of script is a felony in many states
• Changing doses, refills or strength
• White out
10. HEALTH CARE FRAUD
• $100 billion a year
• Patient fraud
–Fraudulent identification
–Doctor shopping
12. DECEPTIONS
• Employee of Health Professionals
• Phony call-ins
• After hours “patient” scam
• Doctor Shopping
• ER Shopping
13. HEALTH PROFESSIONAL INVESTIGATIONS
• Falsify drug documents
• Nurses do not sell their drugs
• Impaired and use while working
• Drug substitution and compromises can be life
threatening to patients
16. RITALIN ADDERALL
• BOTH ARE CENTRAL NERVOUS SYSTEM
STIMULANTS
• TYPICALLY DIVERTED FROM LEGIT SOURCES
• CAN BE TAKEN ORALLY OR SNORTED
• COLLEGE STUDENTS ARE TWICE AS LIKELY TO
ABUSE
• BOTH ARE HABIT FORMING
• OVERDOSES CAN ALTER BRAIN CHEMISTRY
PERMANENTLY
• SCHEDULE II
• IN 2006 AN ESTIMATED 7 MILLION AMERICANS
ADMITTED TO ABUSING THESE DRUGS
17. ADDERALL ABUSE IN COLLEGE
•ACCORDING TO THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES,
90 PERCENT OF COLLEGE STUDENTS WHO INGESTED ADDERALL WITHOUT A
PRESCRIPTION ALSO BINGE DRANK OR QUALIFIED AS “HEAVY DRINKERS”.
•THIS STATISTIC APPLIES TO BOTH OF-AGE AND UNDERAGE RESPONDENTS
18. FENTANYL
•HUNDRED TIMES AS STRONG AS
MORPHINE
•OFTEN CUT INTO PIECES AND CHEWED
•HIGH RATE OF OVERDOSE
•WORKS OFF OF SKIN TEMPERATURE
19. OXYCODONE
PERC’S
. OXYCONTIN IS AVAILABLE IN
TABLET FORM IN 5 DOSES: 10, 20,
40, 80, AND 160MG. (HOWEVER, THE
MANUFACTURER IS NO LONGER
SHIPPING 160MG).
.NEW FORMULATION REDUCES
ABUSE
.
OXY’S
20. HYDROCODONE
•9 BILLION PILLS CONTAINING
HYDROCODONE ARE PRODUCED
ANNUALLY
•RESCHEDULING WILL TAKE PLACE
IN THE NEAR FUTURE
21. ZOHYDRO
• FDA APPROVED
• CONTAINS AS MUCH AS 50 MG OF PURE
HYDROCODONE
• MANUFACTURED AS A POWDER/BEADIN
CAPSULE FORM
• ER BEADS
23. SUBOXONE
•ONE ACTIVE INGREDIENT IS NALOXONE ( NARCAN )
•USED TO TREAT PATIENTS ADDICTED TO OPIATE BASED DRUGS
• NOT USED TO TREAT PAIN
•HIGH POTENTIAL FOR ABUSE
39. Guidelines for Rx drug disposal
FEDERAL GUIDELINES
Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.
Do not flush down toilet or drain unless label or accompanying patient information
specifically instructs you to do so.
Dispose of Rx drugs not labeled to be flushed through community drug take-back
programs. If a program is not available, dispose of medications appropriately:
1. Take medication out of its original packaging and place it into a disposable
container with a lid or into a sealable bag.
2. Mix drugs with an undesirable substance (e.g., cat litter or used coffee
grounds).
3. Place sealed container with the mixture and original packaging (be sure to
remove all personal information from the packaging) in the trash.
SAFEGUARD
Office of National Drug Control Policy. Proper Disposal of Prescription Drugs. 2009.
Available at: www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf
RX ABUSE PREVENTION TOOLKIT - from awareness to action
