The National Household Survey on Drug Abuse found that 1.4% of the general population acknowledged using prescription medication not legitimately prescribed for them.1 The following study was undertaken to explore the prevalence of prescription diversion (ie, redirection of one's medication to others) among patients in a family practice setting.
Study candidates were 220 patients, 18 years or older, seen for nonemergency medical care at a family medicine resident clinic. Exclusion criteria were medical debilitation and cognitive impairment. Participation rate was 100%, with 75% being female and 25% male. Mean (SD) age was 39.5 (16.2 years); data were missing for 22 patients. Most were African American (50%) or white (41%); the remainder were Hispanic or other (data missing for 11). Most were single (43%) or married (28%), while 15% were divorced, 11% were widowed, and 2% were separated (data missing for 1). Twenty percent had not completed high school, 33% had a high school diploma, and the remainder had attended some college or received a degree (data missing for 4).
Candidates were introduced to the project during registration by the receptionist (ie, convenience sample) and asked to drop the anonymous survey into a collection box in the waiting room. Respondents were not paid for participation. Survey completion (approximately 3 minutes) was accepted as informed consent.
The survey explored respondents' history of drug or alcohol abuse and whether respondents' had ever illegally sold drugs, been denied entry into a medical practice because of problems with prescription medications, or given or sold their medication to anyone else.
Of the 220 participants, 3 indicated past drug or alcohol problems; 2 had illegally sold drugs. No participant reported that they had ever been told by a physician office that they could not return because of selling, giving away, or taking too much of a prescribed medication.
Fifteen participants (7%) acknowledged prescription diversion: 14 reported giving medication to someone else and 1 reported selling the prescription (pain pills) on 1 occasion. Among the former, 7 gave medication to a friend, 6 to a spouse or significant other, and 7 to another family member; none reported giving prescribed medication to an acquaintance, stranger, or coworker. The majority (9 respondents) indicated diverting medication 5 times or less and 2 reported 6 times (data missing for 3). A prior history of substance abuse was reported by 1 prescription diverter. In comparing prescription diverters with nondiverters, group sizes were too divergent for analysis. These data suggest that in a family practice setting, a small minority of patients divert prescriptions, prescription diverters most often share prescriptions with a friend or family member, and few report selling prescriptions.
Limitations of this study include its self-report format (eg, fear of prosecution, threat to future care); sample of convenience; missing survey data; and population demographics and their potential impact, if any, on the ability to generalize these data.
