DOCSLIB.ORG

Drug Diversion Training

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Drug Diversion Training DRUG DIVERSION TRAINING Jassin M. Jouria, MD Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serves as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. ABSTRACT As prescription drug misuse becomes more common, medical professionals are being forced into the role of detective, evaluating every patient — and coworker — for their potential for drug diversion. Clinicians must be able to identify characteristics of drug diverters and provided with tools to help them prevent diversion. Strategies to address the problem of drug diversion are discussed. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. Continuing Education Credit Designation This educational activity is credited for 3 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Statement of Learning Need Increasingly, health team members are required to update their knowledge and practices to recognize and prevent drug diversion. The rise in public access to information about disease cures and, in particular, by drug diverters, has led to heightened challenges and surveillance measures. Current federal and state laws require health administrators to develop drug diversion prevention programs that include mandatory training by all employees to recognize and report a substance use disorder in the workplace. Course Purpose To provide knowledge for clinicians expected to be compliant with the regulation of controlled substances, and to recognize and report the signs of drug diversion. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 2 Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC - all have no disclosures Acknowledgement of Commercial Support There is no commercial support for this course. Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 3 1. Most drug diverters will divert drugs from some of the following categories: a. Opiates b. Stimulants, Pseudoephedrine and Ephedrine c. Central Nervous System Depressants d. All of the above 2. True or False: Dextromethorphan is part of a classification of drugs called antitussives that are found in less than 10 products. a. True b. False 3. Prescription Drug Monitoring Programs utilize databases that do the following except: a. collect and store information regarding the prescription, dispensing, and use of prescription drugs b. collect information regarding the patient, practitioner, and pharmacy used c. consistently collect information from prescribers d. include gaps in process that can cause drug diversion to go undetected 4. A prescription for a controlled substance must: a. be dated and signed by the prescriber on the date issued b. include one patient identifier c. include only the drug name, strength and number prescribed d. none of the above 5. In the past decade, there has been an increase of _____ in the number of cases related to prescription painkillers. a. 40% b. 200% c. 400% d. 100% nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 4 Introduction As prescription drug misuse becomes more common, medical professionals are being forced into the role of detective, evaluating every patient - and co- worker - for their potential for drug diversion. Drug diversion can take many forms, but the most common types of drug diversion include theft from family and friends, doctor shopping, and theft from healthcare facilities.1 It is important for medical clinicians and pharmacists to be aware of the different strategies for drug diversion as well as the common characteristics of individuals with a substance use disorder, as this information will help reduce the incidence of drug diversion. Drug Diversion And Scope Of The Problem The National Association of Drug Diversion Investigators provides the following definition for drug diversion:2 Drug diversion can be defined as any criminal act or deviation that removes a prescription drug from its intended path from the manufacturer to the patient. This can include the outright theft of the drugs, or it can take the form of a variety of deceptions such as doctor shopping, forged prescriptions, counterfeit drugs and international smuggling. Prescription drug misuse and drug diversion is a significant problem that affects numerous individuals. As the availability and scope of prescription drugs have expanded to include a range of opiates, non-opiate depressants, stimulants, and potent cold medicines, so too have the misuse of these substances and the tendency to use them recreationally. Prescription drug use is a growing problem that can be difficult to identify. In the past decade, there has been an increase of 400% in the number of treatment admissions nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 5 related to prescription painkillers, and a significant number or prescription drug related deaths.3 Approximately seven million Americans misuse prescription drugs, which is more than the number of individuals addicted to all forms of illegal drugs.4 This study focuses on the jurisdiction of West Virginia as an example of regional efforts to improve regulation of controlled substances. In West Virginia, it is reported that the number of individuals that died from overdosing on prescription drugs is higher than the number of individuals who have died from overdosing on illicit drugs.5 In fact, prescription drug misuse is considered a significant problem in West Virginia, as a large percentage of the population is affected.6 Other state jurisdictions report outcomes, which more or less compare with those of West Virginia and may be found at the U.S. department of Substance Abuse and Mental Health Services Administration (SAMHSA) website: http://www.samhsa.gov/data/2k12/NSDUH115/sr115-nonmedical- use-pain-relievers.htm. For the purposes of this brief self-study, the focus will be on West Virginia as a case example within a much broader and growing national concern about the problem of drug diversion within and across state borders. While any type of prescription drug can be diverted, it is most common for individuals to divert those that are classified as controlled substances as they tend to have a physical or psychological effect on the body.7 Drug diversion occurs when patients are addicted to the drugs, which is most common with those classified as controlled substances. Most drug diverters will divert drugs from the following categories:8 Opiates nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 6 Pseudoephedrine and Ephedrine Dextromethorphan Central Nervous System Depressants Stimulants Drug diverters do not fall into one specific category. In fact, drug diverters are categorized based upon the ways in which they divert drugs. The following is a list of the different types of drug diverters.9 Individual Drug Diverters Patients Healthcare workers Drug Dealers Drug Addicts Organizational Drug Diverters An Organization with a defined hierarchy (Managers, Supervisors, Recruiters, Runners) Pharmacy Employee Pharmacist Pharmacy Technicians Physicians Wholesale Distributors The list above provides examples of all the types of drug diverters. However, the most common drug diverters are individuals, healthcare nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 7 workers and pharmacy technicians.10 Therefore, this course will focus primarily on those
Load more

Recommended publications
  • Effects of Drug Diversion
    Drug abuse is not just a problem con- Determining when pain relieving medica- fined to our streets and our schools. It can tions have been diverted from the rightful recip- happen anywhere a person has a problem ients is often problematic. Long term care facili- related to drug addiction. Frequently it can ties use forms to record which medications have occur in places that may not readily come to been given to residents according to the proper mind for most people – our long term care schedule. When the resident, due to his/her ex- facilities such as nursing homes and assisted isting physical or mental disabilities, is unable to living facilities. When caregivers in long term report that medications have not been admin- care facilities steal medications that were law- istered, facility administrators may have to rely fully prescribed for the residents in their care, on the medication administration records alone. it is called drug diversion. The person completing those records may be the same individual who is diverting the drugs for Drug diversion is a criminal act in- his/her own unlawful use. Occasionally the per- volving the unlawful obtaining and posses- son diverting the medications prescribed for the sion of regulated drugs known as Controlled resident will substitute some other type of med- Dangerous Substances (“CDS”) such as ication in order to attempt to make the proper opioids or narcotics. recipient think that he/she was given dosage that is rightfully due (e.g., giving the resident an ac- Effects of Drug Diversion: etaminophen tablet in place of the more effec- tive, prescribed pain medication.) • It endangers the health of patients who do not receive the prescribed medications they need.
    [Show full text]
  • In Brief, Prescription Drug Monitoring Programs: a Guide for Healthcare Providers
    In Brief Winter 2017 • Volume 10 • Issue 1 Prescription Drug Monitoring Programs: A Guide for Healthcare Providers Since the 1990s, a dramatic increase in prescriptions The Evolution of PDMPs for controlled medications—particularly for opioid pain PDMPs are state-operated databases that collect relievers such as oxycodone and hydrocodone—has information on dispensed medications. The first PDMP been paralleled by an increase in their misuse1 and by was established in 1939 in California, and by 1990 another an escalation of overdose deaths related to opioid pain eight state programs had been established.4 PDMPs would relievers.2 The number of state-run prescription drug periodically send reports to law enforcement, regulatory, monitoring programs (PDMPs) has also increased during or licensing agencies as part of efforts to control diversion this timeframe. Currently, 49 states, the District of of medication by prescribers, pharmacies, and organized Columbia, and 1 U.S. territory (Guam) have criminals. Such diversion can occur through medication or operational PDMPs. prescription theft or illicit selling, prescription forgery or The first state PDMPs provided law enforcement and other counterfeiting, nonmedical prescribing, and other means, public agencies with surveillance data to identify providers including diversion schemes associated with sleep clinics inappropriately prescribing controlled medications. The (sedative-hypnotics and barbiturates), weight clinics objective was to minimize harmful and illegal use and (stimulants), and pain
    [Show full text]
  • Legal Authorities Under the Controlled Substances Act to Combat the Opioid Crisis
    Legal Authorities Under the Controlled Substances Act to Combat the Opioid Crisis Updated December 18, 2018 Congressional Research Service https://crsreports.congress.gov R45164 Legal Authorities Under the Controlled Substances Act to Combat the Opioid Crisis Summary According to the Centers for Disease Control and Prevention, the annual number of drug overdose deaths involving prescription opioids (such as hydrocodone, oxycodone, and methadone) and illicit opioids (such as heroin and nonpharmaceutical fentanyl) has more than quadrupled since 1999. A November 2017 report issued by the President’s Commission on Combating Drug Addiction and the Opioid Crisis also observed that “[t]he crisis in opioid overdose deaths has reached epidemic proportions in the United States ... and currently exceeds all other drug-related deaths or traffic fatalities.” How the current opioid epidemic happened, and who may be responsible for fueling it, are complicated questions, though reports suggest that several parties likely played contributing roles, including pharmaceutical manufacturers and distributors, doctors, health insurance companies, rogue pharmacies, and drug dealers and addicts. Many federal departments and agencies are involved in efforts to combat opioid abuse and addiction, including a law enforcement agency within the U.S. Department of Justice, the Drug Enforcement Administration (DEA), which is the focus of this report. The primary federal law governing the manufacture, distribution, and use of prescription and illicit opioids is the Controlled Substances Act (CSA), a statute that the DEA is principally responsible for administering and enforcing. The CSA and DEA regulations promulgated thereunder establish a framework through which the federal government regulates the manufacture, distribution, importation, exportation, and use of certain substances which have the potential for abuse or psychological or physical dependence, including opioids.
    [Show full text]
  • Review of the Drug Enforcement Administration's Regulatory And
    Office of the Inspector General U.S. Department of Justice OVERSIGHT INTEGRITY GUIDANCE Review of the Drug Enforcement Administration’s Regulatory and Enforcement Efforts to Control the Diversion of Opioids Evaluation and Inspections Division 19-05 September 2019 (Revised) Executive Summary Review of the Drug Enforcement Administration’s Regulatory and Enforcement Efforts to Control the Diversion of Opioids Introduction Results in Brief In this review, the Office of the Inspector General (OIG) We found that DEA was slow to respond to the examined the regulatory activities and enforcement significant increase in the use and diversion of opioids efforts of the Drug Enforcement Administration (DEA) since 2000. We also found that DEA did not use its from fiscal year (FY) 2010 through FY 2017 to combat available resources, including its data systems and the diversion of opioids to unauthorized users. strongest administrative enforcement tools, to detect According to the Centers for Disease Control and and regulate diversion effectively. Further, we found Prevention (CDC), as of 2017 in the United States more that DEA policies and regulations did not adequately than 130 people die every day from opioid overdose. hold registrants accountable or prevent the diversion of Since 2000, more than 300,000 Americans have lost pharmaceutical opioids. Lastly, we found that while the their lives to an opioid overdose. The misuse of and Department and DEA have recently taken steps to addiction to opioids, including prescription pain address the crisis, more work is needed. relievers, heroin, and synthetic opioids such as fentanyl, DEA Was Slow to Respond to the Dramatic Increase in has led to a national crisis that affects not only public Opioid Abuse and Needs to More Fully Utilize Its health, but also the social and economic welfare of the Regulatory Authorities and Enforcement Resources to country.
    [Show full text]
  • Methods, Trends and Solutions for Drug Diversion by Tina Kristof
    Methods, Trends and Solutions for Drug Diversion by Tina Kristof IAHSS-F RS-18-01 February 8, 2018 Evidence Based Healthcare Security Research Series IAHSS Foundation The International Association for Healthcare Security and Safety - Foundation (IAHSS Foundation) was established to foster and promote the welfare of the public through educational and research and development of healthcare security and safety body of knowledge. The IAHSS Foundation promotes and develops educational research into the maintenance and improvement of healthcare security and safety management as well as develops and conducts educational programs for the public. For more information, please visit: www.iahssf.org. The IAHSS Foundation creates value and positive impact on our profession and our industry…..and we are completely dependent on the charitable donations of individuals, corporations and organizations. Please realize the value of the Foundation’s research – and help us continue our mission and our support to the healthcare industry and the security and safety professionals that serve our institutions, staff and most importantly – our patients. To make a donation or to request assistance from the IAHSS Foundation, please contact Nancy Felesena at (888) 353-0990. Thank You for our continued support. Karim H. Vellani, CPP, CSC Committee Chair IAHSS Foundation IAHSS Foundation’s Evidence Based Healthcare Security Research Committee KARIM H. VELLANI, CPP, CSC BRYAN WARREN, MBA, CHPA, CPO-I Threat Analysis Group, LLC Carolinas HealthCare System RON HAWKINS THOMAS TAGGART Security Industry Association Paladin Security MAUREEN MCMAHON RN, BSN, MS STEPHEN A. TARANTO, Jr., J.D. Boston Medical Center Boston University Medical Center BONNIE MICHELMAN, CPP, CHPA KEN WHEATLEY, MA, CPP Massachusetts General Hospital/Partners Royal Security Group, LLC Healthcare P a g e | 1 Introduction Drug abuse in the United States has reached epidemic proportions.
    [Show full text]
  • DRUG DIVERSION: ENFORCEMENT TRENDS, INVESTIGATION, & PREVENTION Regina F
    DRUG DIVERSION: ENFORCEMENT TRENDS, INVESTIGATION, & PREVENTION Regina F. Gurvich, MBA, CHC, CHPC Agenda ◦ Definitions, causes, and sources ◦ Regulations and enforcement trends ◦ Role of the Compliance Officer ◦ Investigating and preventing drug diversion ◦ Case study 1 The estimated cost of controlled prescription drug diversion and abuse to Federal, State, and private medical insurers is approximately $72.65 billion a year. "The President’s FY 2018 Budget Request supports $27.8 billion for drug control efforts spanning prevention, treatment, interdiction, international operations, and law enforcement across 14 Executive Branch departments, the Federal Judiciary, and the District of Columbia. This represents an increase of $279.7 million (1.0 percent) over the annualized Continuing Resolution (CR) level in FY 2017 of $27.5 billion. Within this total, the Budget supports $1.3 billion in investments authorized by the Comprehensive Addiction and Recovery Act (CARA) the 21st Century Cures Act, and other opioid-specific programs to help address the opioid epidemic." "National Drug Control Budget: FY 2018 Funding Highlights" (Washington, DC: Executive Office of the President, Office of National Drug Control Policy), May 2017, p. 2. National Drug Control Budget: FY 2018 Funding Highlights" (Washington, DC: Executive Office of the President, Office of National Drug Control Policy), May 2017, Table 1, p. 16; Table 2, p. 18; and Table 3, p. 19. 3 2 Definition Drug diversion is the illegal distribution or abuse of prescription drugs or their use for unintended or illicit purposes ◦ Often due to addiction or for financial gain ◦ Proliferation of pain clinics has led to an increase in the illegal distribution of expired or counterfeit medications ◦ High-value and Schedule II – V Controlled Substances frequently diverted: ◦ Opioids ◦ Performance enhancing drugs (e.g.
    [Show full text]
  • GAO-01-1011 Attention Disorder Drugs: Few Incidents of Diversion
    United States General Accounting Office GAO Report to Congressional Requesters September 2001 ATTENTION DISORDER DRUGS Few Incidents of Diversion or Abuse Identified by Schools GAO-01-1011 Contents Letter 1 Results in Brief 2 Background 2 Few Incidents of Diversion or Abuse of Attention Disorder Drugs Identified by Schools 6 Most Schools Dispense Attention Disorder Medications and Follow Drug Security Procedures 10 Many States and Local School Districts Have Provisions for School Administration of Medications 15 Conclusions 19 Agency Comments 20 Appendix I Objectives, Scope and Methodology 21 Appendix II Survey of Public School Principals – Diversion/Abuse of Medication for Attention Disorders 26 Appendix III State Controls on Dispensing of Drugs in Public Schools 33 Appendix IV Anecdotal Accounts of School-Based Diversion or Abuse of Attention Disorder Medications 36 Appendix V Studies Related to Diversion or Abuse of Methylphenidate by School-Aged Children 38 Appendix VI State Statutes, Regulations, and Mandatory Policies Addressing the Administration of Medication to Students 40 Page i GAO-01-1011 Attention Disorder Drugs Appendix VII GAO Contacts and Staff Acknowledgments 46 Tables Table 1:Rise in Production Quota for Methylphenidate and Amphetamine 5 Table 2:Measures Taken by School Officials as a Consequence of Diversion or Abuse of Attention Disorder Drugs 9 Table 3: School Personnel Dispensing Attention Disorder Medication 13 Table 4: Sample of Schools in Our Study 23 Figures Figure 1: Brand Name Methylphenidate Pills 4 Figure
    [Show full text]
  • Investigation Report of the Special Demand Committee Board of Directors of Cardinal Health, Inc. April 12, 2013 Confidential
    Investigation Report of the Special Demand Committee Board of Directors of Cardinal Health, Inc. April 12, 2013 Confidential For Committee Use Only TABLE OF CONTENTS EXECUTIVE SUMMARY ........................................................................................................... 1 REPORT OF THE SPECIAL DEMAND COMMITTEE ............................................................. 4 I. THE DEMAND ................................................................................................................. 4 A. Allegations ............................................................................................................. 4 B. Formation of Special Demand Committee ............................................................ 5 II. RELEVANT LEGAL STANDARDS ............................................................................... 5 III. THE INVESTIGATION .................................................................................................... 6 A. Document Collection and Review ......................................................................... 6 B. Interviews ............................................................................................................... 6 IV. ANTI-DIVERSION POLICIES AND PROCEDURES .................................................... 7 A. Anti-Diversion Measures Before the 2007 ISOs ................................................... 7 B. Anti-Diversion Measures from the 2007 ISOs through the 2012 ISO ................... 8 1. Review of Potential New Customers ........................................................
    [Show full text]
  • Hearing Before the United States House of Representatives Committee on Energy and Commerce, Subcommittee on Oversight and Investigations
    Cardinal Health 7000 Cardinal Place Dublin, Ohio 43017 cardinalhealth.com HEARING BEFORE THE UNITED STATES HOUSE OF REPRESENTATIVES COMMITTEE ON ENERGY AND COMMERCE, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS May 8, 2018 Testimony of George S. Barrett Executive Chairman, Cardinal Health I. INTRODUCTION Chairman Harper, Ranking Member DeGette, and Members of the Subcommittee, Chairman Walden, Ranking Member Pallone, and other Members of the full Committee: thank you for the opportunity to be here for today’s hearing on “Combating the Opioid Epidemic: Examining Concerns About Distribution and Diversion.” My name is George Barrett, and from 2009 to 2017, I was privileged to serve as CEO and Chairman of Cardinal Health, which today is composed of more than 50,000 dedicated men and women. I have devoted a career to healthcare in a wide range of roles for over three decades, and I appreciate the opportunity to share my perspective with you today. The people of Cardinal Health are deeply committed to serving the American healthcare system. Although this hearing is focused on one aspect of our pharmaceutical wholesale distribution business, Cardinal Health is a global, integrated healthcare company, providing customized solutions for hospitals, healthcare systems, pharmacies, ambulatory surgery centers, clinical laboratories, and physician offices worldwide. Our pharmaceutical wholesale distribution business delivers thousands of products from hundreds of manufacturers and suppliers. Each year, we process in excess of 400 million orders. The overwhelming majority of medications we distribute are non-opiate medicines such as antibiotics, or treatments for cancer, heart disease, diabetes, and other chronic conditions. With respect to all our distribution, our objective is simple: to enable the healthcare providers we serve to use these products to bring health and healing to their patients.
    [Show full text]
  • Controlled Substance Integrity—Documentation from Drop-Off to Pickup Content Summary
    Controlled Substance Integrity—Documentation From Drop-Off to Pickup Content Summary This booklet discusses procedures to ensure the appropriate handling and documentation of prescriptions for controlled substances. Methods the pharmacist or pharmacy technician may use to verify the identity of the patient, the validity of the prescription, and the scope of practice of the prescriber are provided. This booklet also reviews methods to record the quantity of drug dispensed and emphasizes proper documentation on the prescription blank. Finally, the booklet discusses the importance of making the offer to counsel the patient about the proper use of the medication, documenting the offer, and maintaining signature logs. 2 Introduction The abuse of controlled substances in the United States and their diversion to individuals for whom they were not prescribed is a seemingly uphill battle for health care professionals, law enforcement, and policymakers. The crisis extends beyond our country’s borders. The Global Burden of Disease Study 2010 is the first of its kind to assess the worldwide burden of disease attributable to illicit drug use and dependence. The study demonstrated that opioid dependence was the primary contributor to illicit drug-related deaths worldwide. In addition, the United States was one of the top four countries in the world with the highest rate of burden.[1] From 1999–2010, opioid-related deaths in the United States dramatically increased in number, according to the Centers for Disease Control and Prevention (CDC). The number of deaths parallels the 300 percent increase in sales of opioid prescriptions during that same time.[2] While pharmacists routinely use their professional judgment when determining whether to fill prescriptions for controlled substances, added scrutiny is required to prevent diversion to the illicit drug market.
    [Show full text]
  • Reducing Prescription Drug Diversion in Medicaid
    DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop 00-00-00 Baltimore, Maryland 21244-1850 CENTER FOR PROGRAM INTEGRITY Drug Diversion in the Medicaid Program State Strategies for Reducing Prescription Drug Diversion in Medicaid January 2012 Background “Drug diversion” is best defined as the diversion of licit drugs for illicit purposes. It involves the diversion of drugs from legal and medically necessary uses towards uses that are illegal and typically not medically authorized or necessary. While drug diversion is not a new phenomenon, States are reporting a significant increase in the problem. In fact, according to the 2010 National Drug Threat Assessment report, “The threat posed by the diversion and abuse of controlled prescription drugs (CPDs), primarily pain relievers, is increasing, as evidenced by the sharp rise in the percentage (4.6 percent in 2007, 9.8 percent in 2009) of state and local law enforcement agencies reporting CPDs as the greatest drug threat in their area.” Increased abuse of CPDs has led to elevated numbers of deaths related to prescription opioids, which increased 98 percent from 2002 to 2006.1 The National Drug Threat Assessment report further states that, “The most commonly diverted CPDs are opioid pain relievers, according to Drug Enforcement Administration (DEA) and the National Survey of Drug Use and Health (NSDUH) data.”2 Opioid pain relievers are popular among drug abusers because of the euphoria they induce. Opioid pain relievers include codeine,
    [Show full text]
  • Exploring the Relationship of GHB and Sleep FINAL
    Cover Page The handle http://hdl.handle.net/1887/68643 holds various files of this Leiden University dissertation. Author: Pardi, D.J. Title: Exploring the relationships of gamma-hydroxybutyrate and sleep on metabolism, physiology, and behavior in humans Issue Date: 2019-01-24 CHAPTER 5 Illicit gamma-Hydroxybutyrate (GHB) and Pharmaceutical Sodium Oxybate (Xyrem®): DifferenCes in CharaCteristiCs and Misuse. Drug and Alcohol Dependence (2009) 104(1-2):1-10. Authors: Lawrence P. Carter, Daniel Pardi, Jane Gorsline, Roland R. Griffiths - 91 - AbstraCt There are distinct differences in the accessibility, purity, dosing, and misuse associated with illicit gamma-hydroxybutyrate (GHB) compared to pharmaceutical sodium oxybate. Gamma-hydroxybutyrate sodium and sodium oxybate are the chemical and drug names, respectively, for the pharmaceutical product Xyrem® (sodium oxybate) oral solution. However, the acronym GHB is also used to refer to illicit formulations that are used for non-medical purposes. This review highlights important differences between illicit GHB and sodium oxybate with regard to their relative abuse liability, which includes the likelihood and consequences of abuse. Data are summarized from the scientific literature; from national surveillance systems in the U.S., Europe, and Australia (for illicit GHB); and from clinical trials and post-marketing surveillance with sodium oxybate (Xyrem). In the U.S., the prevalence of illicit GHB use, abuse, intoxication, and overdose has declined from 2000, the year that GHB was scheduled, to the present and is lower than that of most other licit and illicit drugs. Abuse and misuse of the pharmaceutical product, sodium oxybate, has been rare over the 5 years since its introduction to the market, which is likely due in part to the risk management program associated with this product.
    [Show full text]