rx diversion

“THE ADDICTIONS”

SCHEDULE II SUBSTANCES

•MUST BE WRITTEN

• NO REFILLS

• OXYCODONE

•METHADONE

• FENTANYL

• RITALIN/ADDERALL

SCHEDULE III SUBSTANCES

•MOST ABUSED CLASS OF NARCOTICS

•WRITTEN OR CALL INS

•REFILLS AVAILABLE

•HYDROCODONE

TOP RX DRUGS OF ABUSE

• HYDROCODONE ( VICODIN, LORTAB ) $.50 PER MG

• OXYCODONE ( PERCOCET ) $1.00 PER MG

• METHADONE ( $10-$30 PER PILL )

• ALPRAZOLAM ( XANAX ) $1.00 PER MG

• FENTANYL PATCHES $40-$100 PER PATCH

HIPAA RULES 164.512 ( a)

• A covered entity may use or disclose protected health information to the extent that such use or disclosure is required by law and the use or disclosure complies with and is limited to the relevant requirements of such law.

STATE LAW: BUCHMAN vs STOKES

• Physician-patient privilege only attaches to communications that are made within physician-patient relationship: if communication by patient is fraudulent, relationship is not established and privilege does not attach.

SOURCE OF DIVERTED DRUGS

• Forged and Altered Prescriptions

• “Doctor Shoppers”

• Theft (Health Facility and Other)

• Internet

• Pharmacy Robbery & Burglary

• International Smuggling

FORGED AND ALTERED PRESCRIPTIONS

• Alteration of script is a felony in many states

• Changing doses, refills or strength

• White out

HEALTH CARE FRAUD

• $100 billion a year

• Patient fraud

– Fraudulent identification

–Doctor shopping

HEALTH CARE FRAUD

• Provider Fraud

– False insurance billings

• up-coding

• brand/generic scam

– Illegal diet clinics

– Illegal pain clinics

DECEPTIONS

• Employee of Health Professionals

• Phony call-ins

• After hours “patient” scam

• Doctor Shopping

• ER Shopping

HEALTH PROFESSIONAL INVESTIGATIONS

• Falsify drug documents

• Nurses do not sell their drugs

• Impaired and use while working

• Drug substitution and compromises can be life threatening to patients

RITALIN ADDERALL

RITALIN ADDERALL

• BOTH ARE CENTRAL NERVOUS SYSTEM

STIMULANTS

• TYPICALLY DIVERTED FROM LEGIT SOURCES

• CAN BE TAKEN ORALLY OR SNORTED

• COLLEGE STUDENTS ARE TWICE AS LIKELY TO

ABUSE

• BOTH ARE HABIT FORMING

• OVERDOSES CAN ALTER BRAIN CHEMISTRY

PERMANENTLY

• SCHEDULE II

• IN 2006 AN ESTIMATED 7 MILLION AMERICANS

ADMITTED TO ABUSING THESE DRUGS

ADDERALL ABUSE IN COLLEGE

•ACCORDING TO THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES,

90 PERCENT OF COLLEGE STUDENTS WHO INGESTED ADDERALL WITHOUT A

PRESCRIPTION ALSO BINGE DRANK OR QUALIFIED AS “HEAVY DRINKERS”.

•THIS STATISTIC APPLIES TO BOTH OF-AGE AND UNDERAGE RESPONDENTS

FENTANYL

•HUNDRED TIMES AS STRONG AS

MORPHINE

•OFTEN CUT INTO PIECES AND CHEWED

•HIGH RATE OF OVERDOSE

•WORKS OFF OF SKIN TEMPERATURE

OXYCODONE

PERC’S

. OXYCONTIN IS AVAILABLE IN

TABLET FORM IN 5 DOSES: 10, 20,

40, 80, AND 160MG. (HOWEVER, THE

MANUFACTURER IS NO LONGER

SHIPPING 160MG).

.NEW FORMULATION REDUCES

ABUSE

.

OXY’S

HYDROCODONE

•9 BILLION PILLS CONTAINING

HYDROCODONE ARE PRODUCED

ANNUALLY

•RESCHEDULING WILL TAKE PLACE

IN THE NEAR FUTURE

ZOHYDRO • FDA APPROVED

• CONTAINS AS MUCH AS 50 MG OF PURE

HYDROCODONE

• MANUFACTURED AS A POWDER/BEAD IN

CAPSULE FORM

• ER BEADS

SUBOXONE

SUBOXONE

•ONE ACTIVE INGREDIENT IS NALOXONE ( NARCAN )

•USED TO TREAT PATIENTS ADDICTED TO OPIATE BASED DRUGS

• NOT USED TO TREAT PAIN

•HIGH POTENTIAL FOR ABUSE

XANAX

XANAX • BENZODIAZEPINE FAMILY

• WORKS BY SLOWING DOWN THE MOVEMENT OF

CHEMICALS IN THE BRAIN THAT BECOME

UNBALANCED

• TREATS ANXIETY

JUVENILES VS RX MEDICATION

•BELIEVE RX DRUGS ARE SAFER

•SEE PARENTS USING

•FAMOUS PEOPLE/ATHLETES USING

•EASY ACCESS TO IN HOUSE PHARMACY

OARRS •OHIO AUTOMATED RX REPORTING SYSTEM

•EFFECTIVE TOOL FOR LAW ENFORCEMENT/MEDICAL PROFESSIONALS

•REDUCES “DOCTOR SHOPPING”

•FIGHTS INSURANCE FRAUD

CELEBRITY DEATHS

ADDICTION ALCOHOL/XANAX BARBITUATES, PAINKILLERS

MORE CELEBRITIES

XANAX/WITHDRAWS OXYCODONE/HYDROCODONE/XANAX BARBITUATES

METHAMPHETAMINE

HITTING THE BUBBLE

METH HEADS

MORE METH HEADS

Guidelines for Rx drug disposal

FEDERAL GUIDELINES

Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.

Do not flush down toilet or drain unless label or accompanying patient information

specifically instructs you to do so.

Dispose of Rx drugs not labeled to be flushed through community drug take-back

programs. If a program is not available, dispose of medications appropriately:

1. Take medication out of its original packaging and place it into a disposable container with a lid or into a sealable bag.

2. Mix drugs with an undesirable substance (e.g., cat litter or used coffee grounds).

3. Place sealed container with the mixture and original packaging (be sure to remove all personal information from the packaging) in the trash.

SAFEGUARD

Office of National Drug Control Policy. Proper Disposal of Prescription Drugs. 2009.

Available at: www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf

RX ABUSE PREVENTION TOOLKIT - from awareness to action

HISTORICALLY

•“ILLEGITIMATE PATIENTS” ARE OVER PRESCRIBED

AND LEGITIMATE PATIENTS ARE UNDER PRESCRIBED.

QUESTIONS?

KKIMBLE@CODETF.COM

740-404-0157