Detecting Potential
Diversion and Misuse with the Oklahoma Prescription Monitoring Program (PMP)
Selling prescription drugs and visiting multiple providers for prescriptions (i.e., “doctor shopping”) are common types of drug diversion. The following drug classes have been identified to have a high potential for diversion and misuse:
Anabolic steroids
Central nervous system depressants
Hallucinogens
Opioids
Stimulants
Signs of medication diversion can include:
patient requests specific medications patient has a history of lost medications patient is not interested in diagnostic tests
past medical records are unable to be obtained patient recietes textbook symptoms
The PMP is a tool that be used to inform clinical decision making and reduce prescription drug diversion and misuse. The following factors in a patient's PMP report may be a cause for concern:
Multiple prescriptions
Multiple providers or pharmacies
Early refills
Extended duration opioid prescriptions for acute pain
High daily doses
Dangerous medication combinations (e.g. overlapping benzodiazepine and opioid prescriptions)
The Center for Disease Control and Prevention (CDC) does not recommend discharging patients from care based on information in the PMP. Concerns with the PMP and patient behavior are opportunities to increase patient safety and health by:
listening empathically and avoiding judgement, providing potentially lifesaving information (e.g. overdose risks), and applying evidence-based interventions (e.g. naloxone prescriptions, substance use disorder treatment referrals, nonopioid pain treatment, etc).