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Impact of Prescription Drug Diversion Control Systems on Medical Practice and Patient Care



NIDA Research Monograph, Number 131 [Printed in 1993]

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Table of Contents

Preface-----iii

The Impact of Prescription Drug Control Systems on Medical Practice and Patient Care: A Summary of the NIDA Technical Review-----1

Guiding Principles of International and Federal Laws Pertaining to Medical Use and Diversion of Controlled Substances-----18
David E. Joranson

Session: Medical Use, Therapeutic Rationale-Prescribing and Control Issues

Therapeutic Use of Opioids: Prescribing and Control Issues-----35
Russell K. Portenoy

Anxiolytics: Indications, Benefits, and Risks of Short, and Long-Term Benzodiazepine Therapy Current Research Data-----51
Karl Rickels and Edward Schweizer

Issues and Controversies Regarding Benzodiazepine Use-----68
Carl Salzman

Stimulant Drugs-Medical Needs, Alternative Indications and Related Problems-----89
Jonathan O. Cole, Lenore A. BolIing, and Barbara J. Peake

Session: Abuse and Diversion

The Nonmedical Use of Prescription Drugs in the United States-----109
Edgar H. Adams and Andrva Kopstein

Drug Diversion Control Systems, Medical Practice, and Patient Care-----120
Gene R. Haislip

Session: Diversion Control Methods

Existing Methods to Identify Retail Drug Diversion-----132
G. Thomas Gitchel

PADS Approach to Preventing Prescription Drug Diversion-----141
John J. Ambre

Diversion Investigation Units-Methods, Utilities, and Limitations-----145
R. Keith Bulla

OSTAR-Oklahoma Schedule Two Abuse Reduction: An Electronic Point of Sale Diversion Control System-----151
Elaine Dodd

The Illinois Experience in Achieving the Medical/Regulatory Balance Required to Control Prescription Drug Diversion-----159
Mark T. Bishop and Ronald J. Vlasty

New York State's Triplicate Prescription Program-----176
John L. Eadie

Triplicate Prescriptions in Washington State-----194
Donald H. Williams

The Medicaid Prescription Drug Initiative-----200
Thomas Roslewicz

Summary and Conclusions of a Review of Prescription Drug Diversion Control Methods-----206
Constance Horgan, Jeffrey Prottas, Christopher Tompkins, Linda Wastila, and Melissa Bowden

Session: Impact on Medical Practice and Patient Care

Professional Association Responses

An American Medical Association Perspective on Preventing Prescription Drug Diversion-----224
John J. Ambre

Prescription Drug Regulation: Implications for Nursing and Health Care Delivery-Response of the American Nurses' Association-----228
Madeline A. Naegle

Perspective of the American Pharmaceutical Association-----235 C. Edwin Webb

Perspective of the Empire State Medical Association of the National Medical Association-----239
Gerald Deas

Prescribing Practices and Drug Abuse-Perspective of the American Society of Addiction Medicine . . . . . . . . . . . . . . . . . . . 242 Anne Geller

Response of the American Academy of Child and Adolescent Psychiatry-----246
Nicholas Rock

Advocacy Groups

Impact of Drug Regulation and Diversion Control System on Legitimate Narcolepsy Patients Response of American Narcolepsy Association-----249
Joseph A. Piscopo

State Cancer Pain Initiatives-----260
June L. Dahl

Benzodiazepine Dependence-A Treatment Program Perspective-----266
Robert D. O'Connor

A Public Citizen Health Research Group Perspective on Federal Triplicate Prescription Requirements for Controlled Substance Prescription Drugs-----270
Sidney Wolfe

Session: Evaluation of the Impact on Medical Practice and Medical Care

Consequences of the 1989 New York State Triplicate Benzodiazepine Prescription Regulations-----279
Michael Weintraub, Satesh Singh, Louise Byrne, Kumar Maharaj, and Laurence Guttmacher

Changes in Prescribing Patterns in Long-Term Care Facilities and Impact on Incidence of Adverse Events-----294
Sergio I. Zullich, Thaddeus H. Grasela, Jill B. Fiedler-Kelley, and Francis M. Gengo

Future Research Directions

A Research Agenda for Prescription Drug Diversion Control-----309
Constance Horgan, Jeffrey Prottas, Christopher Tompkins, Linda Wastila, and Melissa Bowden

The Impact of Prescription Drug Control Systems on Medical Practice and Patient Care-A Summary of Research Recommendations-----325
Dorynne Czechowicz

Appendix

List of May 30-June 1, 1991 Technical Review Participants-----331

List of October 3-4, 1991 Research Advisory Panel Participants-----334




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