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).