Understanding the Scope and Magnitude of Prescription Drug Diversion

描述(由申请人提供)：国家监测系统正在记录普遍存在的、不断升级的处方药滥用情况，许多科学论文讨论了与药物转移有关的问题。然而，没有关于各种机制的经验数据、从每个来源转移的数量以及与具体的滥用药物和/或不同的风险亚群有关的转移模式。在这一背景下，这个为期4年的项目的总体目标是从以下三个方面审查和描述将处方药非法供应(转移)与南佛罗里达州吸毒者联系起来的复杂机制和参与者：1)处方药滥用者，2)处方药经销商，3)执法。抽样计划的目的是最大限度地增加样本的多样性，并尽可能全面地收集有关转用活动的数据。具体目标是：1)招募1200名治疗客户(300名公共资助，300名私人支付；300名美沙酮维持服务客户，300名60岁及以上老年人)、300名街头吸毒者和300名男同性恋甲基苯丙胺滥用者的样本，他们都有处方药物滥用问题；2)评估药物滥用的生活史，包括目前的酒精、非法和处方药；3)评估获得和获得处方药的机制；4)评估假设将处方药滥用者与其非法供应来源联系起来的人口、社会文化和心理社会特征；5)深入访谈每个小组30名受访者的分样本；6)从不同网络招募50名处方药销售商，并进行深入访谈，以确定他们销售哪些处方药、卖给谁、数量多少；以什么价格出售、如何获得；7)从布罗沃德县警局分流股300名处方药贩毒者的抓捕档案中提取数据，以检查处方药贩运的来源和机制；8)与大型警察机构的20名分流调查员进行深入访谈，以获取分流处方药的来源信息。与公共卫生的相关性。更全面地了解处方药滥用和转移的机制和规模，以及它们在不同使用人群中的差异，对于卫生保健和监管机构以及行业来说至关重要，以便制定适当的预防、风险管理、治疗、政策和执法举措。

DESCRIPTION (provided by applicant): National surveillance systems are documenting widespread, escalating abuse of prescription drugs, and numerous scientific papers have discussed problems associated with pharmaceutical diversion. However, empirical data on the full range of mechanisms, the magnitude of diversion from each source, and the patterns of diversion associated with specific drugs of abuse and/or different at-risk subpopulations are unavailable. Within this context, the overall goal of this 4-year project is to examine and describe the complex of mechanisms and players that connect illicit supplies of prescription drugs (diversion) to abusers in South Florida from three vantage points: 1) prescription drug abusers, 2) prescription drug dealers, and 3) law enforcement. The sampling plan is designed to maximize the diversity of the sample and collect data on the fullest possible range of diversion activities. The specific aims are to:1) recruit samples of 1200 treatment clients (300 publicly-supported, 300 private pay; 300 methadone maintenance clients, and 300 elderly persons ages 60 and above), 300 street drug users, and 300 gay male methamphetamine abusers, all with prescription drug abuse problems; 2) assess life histories of drug abuse, including current alcohol, illicit, and prescription drugs; 3) assess mechanisms of access to and acquisition of prescription drugs; 4) assess demographic, sociocultural, and psychosocial characteristics that are hypothesized to connect prescription drug abusers to their illicit sources of supply; 5) conduct in-depth interviews with sub-samples of 30 respondents from each subgroup; 6) recruit 50 prescription drug sellers from diverse networks and conduct in-depth interviews to determine which prescription drugs they sell, to whom, in what quantities; at what prices, and how they are obtained; 7) extract data from the arrest files of 300 prescription drug traffickers from the diversion unit of the Broward County Sheriff's Department to examine the sources and mechanisms of prescription drug trafficking; and, 8) conduct in-depth interviews with 20 diversion investigators in large police agencies to obtain information about the sources of diverted prescription drugs. Relevance to Public Health. A fuller understanding of the mechanisms and magnitude of prescription drug abuse and diversion, and how they vary across user populations, is critical for health care and regulatory agencies, and industry in order to develop appropriate prevention, risk management, treatment, policy, and enforcement initiatives.