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处方药滥用的广泛和不断升级，许多科学论文讨论了与药物转移相关的问题。然而，关于各种机制、每种来源的转移规模以及与特定滥用药物和（或）不同的风险亚群有关的转移模式的经验数据尚不具备。在此背景下，这个为期4年的项目的总体目标是检查和描述复杂的机制和球员，连接处方药的非法供应（转移），以滥用者在南佛罗里达从三个Vantage位置：1）处方药滥用者，2）处方药经销商，和3）执法。抽样计划旨在最大限度地扩大样本的多样性，并收集关于尽可能广泛的转用活动的数据。具体目标是：1）招募1200名治疗客户的样本（300名公共支持，300名私人支付; 300名美沙酮维持客户和300名60岁及以上的老年人），300名街头吸毒者和300名男同性恋甲基苯丙胺滥用者，所有人都有处方药滥用问题; 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）评估获得和获取处方药的机制; 4）评估人口统计学、社会文化和心理社会特征，这些特征被假设为将处方药滥用者与其非法供应来源联系起来; 5）对每个亚组的30名受访者进行深入访谈; 6.从不同的网络中招募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，向谁销售，数量;价格以及如何获得;第七章）从布劳沃德县治安部门分流部门的300名处方药贩运者的逮捕档案中提取数据，以检查处方药的来源和机制贩卖人口;八是深入采访20名大型警察机构的转移调查人员，了解被转移处方药的来源。与公共卫生相关。更充分地了解处方药滥用和转移的机制和程度，以及它们在用户人群中的差异，对于医疗保健和监管机构以及行业至关重要，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.