rx diversion
TRANSCRIPT
“THE ADDICTIONS”
SCHEDULE II SUBSTANCES
•MUST BE WRITTEN
• NO REFILLS
• OXYCODONE
•METHADONE
• FENTANYL
• RITALIN/ADDERALL
SCHEDULE III SUBSTANCES
•MOST ABUSED CLASS OF NARCOTICS
•WRITTEN OR CALL INS
•REFILLS AVAILABLE
•HYDROCODONE
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
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.
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.
SOURCE OF DIVERTED DRUGS
• Forged and Altered Prescriptions
• “Doctor Shoppers”
• Theft (Health Facility and Other)
• Internet
• Pharmacy Robbery & Burglary
• International Smuggling
FORGED AND ALTERED PRESCRIPTIONS
• Alteration of script is a felony in many states
• Changing doses, refills or strength
• White out
HEALTH CARE FRAUD
• $100 billion a year
• Patient fraud
– Fraudulent identification
–Doctor shopping
HEALTH CARE FRAUD
• Provider Fraud
– False insurance billings
• up-coding
• brand/generic scam
– Illegal diet clinics
– Illegal pain clinics
DECEPTIONS
• Employee of Health Professionals
• Phony call-ins
• After hours “patient” scam
• Doctor Shopping
• ER Shopping
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
RITALIN ADDERALL
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
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
FENTANYL
•HUNDRED TIMES AS STRONG AS
MORPHINE
•OFTEN CUT INTO PIECES AND CHEWED
•HIGH RATE OF OVERDOSE
•WORKS OFF OF SKIN TEMPERATURE
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
HYDROCODONE
•9 BILLION PILLS CONTAINING
HYDROCODONE ARE PRODUCED
ANNUALLY
•RESCHEDULING WILL TAKE PLACE
IN THE NEAR FUTURE
ZOHYDRO • FDA APPROVED
• CONTAINS AS MUCH AS 50 MG OF PURE
HYDROCODONE
• MANUFACTURED AS A POWDER/BEAD IN
CAPSULE FORM
• ER BEADS
SUBOXONE
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
XANAX
XANAX • BENZODIAZEPINE FAMILY
• WORKS BY SLOWING DOWN THE MOVEMENT OF
CHEMICALS IN THE BRAIN THAT BECOME
UNBALANCED
• TREATS ANXIETY
JUVENILES VS RX MEDICATION
•BELIEVE RX DRUGS ARE SAFER
•SEE PARENTS USING
•FAMOUS PEOPLE/ATHLETES USING
•EASY ACCESS TO IN HOUSE PHARMACY
OARRS •OHIO AUTOMATED RX REPORTING SYSTEM
•EFFECTIVE TOOL FOR LAW ENFORCEMENT/MEDICAL PROFESSIONALS
•REDUCES “DOCTOR SHOPPING”
•FIGHTS INSURANCE FRAUD
CELEBRITY DEATHS
ADDICTION ALCOHOL/XANAX BARBITUATES, PAINKILLERS
MORE CELEBRITIES
XANAX/WITHDRAWS OXYCODONE/HYDROCODONE/XANAX BARBITUATES
METHAMPHETAMINE
HITTING THE BUBBLE
METH HEADS
MORE METH HEADS
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
HISTORICALLY
•“ILLEGITIMATE PATIENTS” ARE OVER PRESCRIBED
AND LEGITIMATE PATIENTS ARE UNDER PRESCRIBED.
