Lawful Prescribing and the Prevention of Diversion

Abstract

Concern about controlled substance diversion and overview of prescribers by legal and regulatory officials is growing. The article is designed to increase health professionals' awareness of the methods of diversion and to provide guidance on how diversion can be foiled. This paper also should help healthcare practitioners to better understand the regulations governing prescribing of controlled substances. Examples of unlawful prescribing of controlled substances are presented. Some behaviors of persons illegitimately seeking controlled substances from prescribers are described. Strategies to lessen the possibility of prescriptions being altered are discussed. Federal and state laws and regulations pertaining to controlled substances are described.

Key Words:

• Diversion
• opioids
• law
• prescribing
• controlled substances

Additional information

Notes on contributors

J. David Haddox

Cherokee Layson-Wolf, PharmD, is Assistant Professor at the University of Maryland School of Pharmacy. At the time that this review was conducted, she was a Community Care Pharmacy Practice Resident at Virginia Commonwealth University.

Perry G. Fine, MD, is Professor of Anesthesiology, School of Medicine and Associate Medical Director, Pain Management Center at the University of Utah Health Sciences Center, Salt Lake City; and National Medical Director, VistaCare, based in Scottsdale, AZ. This commentary is based on an article in Dr. Fine's VistaCare Palliative Medicine Monitor.

Jonathan R. Gavrin, MD, is the Internet editor for the Journal. He is Associate Professor of Anesthesiology and Adjunct Associate Professor of Medicine at the University of Washington School of Medicine; Associate Member, Fred Hutchinson Cancer Research Center; and Associate Director for Clinical Anesthesia Services, Harborview Medical Center.

Philip J. Wiffen, is the Regional Pharmaceutical and Prescribing Adviser, Anglia & Oxford Region of the National Health Service Executive, a member of the Oxford Regional Pain Relief Unit and Coordinating Editor of the Cochrane Collaboration Pain Palliative and Supportive Care Collaborative Review Group.

Philip J. Wiffen, BPharm, MRPharmS, MFPHM (Hon) is Regional Pharmaceutical and Prescribing Adviser, Anglia & Oxford Region of the National Health Service Executive, a member of the Pain Relief Unit, Churchill Hospital, and Coordinating Editor, Cochrane Collaboration Pain Palliative and Supportive Care Collaborative Review Group.