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广泛的、不断升级的处方药滥用，许多科学论文讨论了与药物转移相关的问题。但是，关于各种机制的经验数据、从每个来源转移的程度以及与特定滥用药物和/或不同危险亚群有关的转移模式尚无法获得。在此背景下，这个为期4年的项目的总体目标是从三个有利角度检查和描述将南佛罗里达州非法处方药供应（转移）与滥用者联系起来的复杂机制和参与者：1)处方药滥用者，2)处方药经销商和3)执法部门。抽样计划的设计是为了最大限度地提高样本的多样性，并收集尽可能广泛的导流活动的数据。具体目标是：1)招募1200名有处方药物滥用问题的治疗对象（300名公费治疗对象、300名自费治疗对象、300名美沙酮维持治疗对象和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；2)评估药物滥用的生活史，包括目前的酒精、非法药物和处方药；3)评估处方药获取和获取机制；4)评估假定将处方药滥用者与其非法供应来源联系起来的人口统计学、社会文化和社会心理特征；5)对每个子组的30名受访者进行深度访谈；6)从不同网络中招募50名处方药销售商，进行深度访谈，确定他们销售哪些处方药、卖给谁、卖多少；价格是多少，如何获得；7)从布劳沃德县治安部门分流部门300名处方药走私犯的逮捕档案中提取数据，考察处方药走私的来源和机制；8)与20名大型警察机构的调剂调查员进行深度访谈，获取调剂处方药来源的信息。与公共卫生相关。为了制定适当的预防、风险管理、治疗、政策和执法举措，更全面地了解处方药滥用和转移的机制和程度，以及它们在不同用户群体之间的差异，对卫生保健、监管机构和产业界至关重要。

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.