A Much-Needed Window on Opioid Diversion

Abstract

A recent report attributed increasing opioid analgesic mortality to “aggressive” pain management [1]. While there is no question that increases in adverse and tragic health consequences are associated with rising nonmedical use of prescription pain medications, we questioned the validity of asserting, absent direct evidence, that it resulted from treating pain patients [2]. We also pointed out that illicit-drug users create a powerful demand that will be satisfied by those who divert prescription drugs from the supply chain. We called for research that would tell us more about the users, their motivations, and methods of diversion, including use of targeted ethnographic studies in high-incidence areas. In this issue, Inciardi et al. make an excellent contribution to better understanding the abuse and diversion of prescription drugs, including opioids. A useful summary of the meager literature and an extensive bibliography about sources of diversion is provided. They also report their own ethnographic studies of several populations in the Miami area who use diverted prescription opioid analgesics. This qualitative research provides a much-needed and revealing window on user populations, why they use opioid analgesics, and how the drugs are diverted. Although it is not …