Prescription Drug Abuse and Diversion in Clinical Practice: What can be Learned from Regulatory Sanction Data

Medications prescribed to treat pain and psychiatric distress, such as opioids, sedatives, and hypnotics, are drugs of widespread abuse in the US. Prescription of these medications are monitored and controlled by federal (Drug Enforcement Agency) and state narcotics control bureaus; in addition, practitioners licensed to prescribe these drugs are supervised by their state licensing entities. This article summarizes recent findings from a unique database identifying physicians charged with prescribing-related violations, and uses case studies to illustrate the types of cases most frequently prosecuted or sanctioned for misprescribing, diverting, or causing patient harm. Based upon analyses of the database, guidelines intended to help clinicians avoid regulatory sanctions and unwittingly contribute to prescription drug abuse and diversion are provided. It is suggested that nurses working in the field of addiction should be aware of and understand prescriber-supported pathways to the development and progression of substance use disorders, so that interventions for the treatment of prescription drug abuse can be knowledgeably implemented.</.