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Rx diversion

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Prescription abuse diversion.

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Rx diversion

  1. 1. “THE ADDICTIONS”
  2. 2. SCHEDULE II SUBSTANCES •MUST BE WRITTEN •NO REFILLS •OXYCODONE •METHADONE •FENTANYL •RITALIN/ADDERALL
  3. 3. SCHEDULE III SUBSTANCES •MOST ABUSED CLASS OF NARCOTICS •WRITTEN OR CALL INS •REFILLS AVAILABLE •HYDROCODONE
  4. 4. 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
  5. 5. 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.
  6. 6. 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.
  7. 7. SOURCE OF DIVERTED DRUGS • Forged and Altered Prescriptions • “Doctor Shoppers” • Theft (Health Facility and Other) • Internet • Pharmacy Robbery & Burglary • International Smuggling
  8. 8. FORGED AND ALTERED PRESCRIPTIONS • Alteration of script is a felony in many states • Changing doses, refills or strength • White out
  9. 9. HEALTH CARE FRAUD • $100 billion a year • Patient fraud –Fraudulent identification –Doctor shopping
  10. 10. HEALTH CARE FRAUD • Provider Fraud – False insurance billings • up-coding • brand/generic scam – Illegal diet clinics – Illegal pain clinics
  11. 11. DECEPTIONS • Employee of Health Professionals • Phony call-ins • After hours “patient” scam • Doctor Shopping • ER Shopping
  12. 12. 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
  13. 13. RITALIN ADDERALL
  14. 14. 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
  15. 15. 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
  16. 16. FENTANYL •HUNDRED TIMES AS STRONG AS MORPHINE •OFTEN CUT INTO PIECES AND CHEWED •HIGH RATE OF OVERDOSE •WORKS OFF OF SKIN TEMPERATURE
  17. 17. 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
  18. 18. HYDROCODONE •9 BILLION PILLS CONTAINING HYDROCODONE ARE PRODUCED ANNUALLY •RESCHEDULING WILL TAKE PLACE IN THE NEAR FUTURE
  19. 19. ZOHYDRO • FDA APPROVED • CONTAINS AS MUCH AS 50 MG OF PURE HYDROCODONE • MANUFACTURED AS A POWDER/BEADIN CAPSULE FORM • ER BEADS
  20. 20. SUBOXONE
  21. 21. 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
  22. 22. XANAX
  23. 23. XANAX • BENZODIAZEPINE FAMILY • WORKS BY SLOWING DOWN THE MOVEMENT OF CHEMICALS IN THE BRAIN THAT BECOME UNBALANCED • TREATS ANXIETY
  24. 24. JUVENILES VS RX MEDICATION •BELIEVE RX DRUGS ARE SAFER •SEE PARENTS USING •FAMOUS PEOPLE/ATHLETES USING •EASY ACCESS TO IN HOUSE PHARMACY
  25. 25. OARRS •OHIO AUTOMATED RX REPORTING SYSTEM •EFFECTIVE TOOL FOR LAW ENFORCEMENT/MEDICAL PROFESSIONALS •REDUCES “DOCTOR SHOPPING” •FIGHTS INSURANCE FRAUD
  26. 26. CELEBRITY DEATHS ADDICTION ALCOHOL/XANAX BARBITUATES, PAINKILLERS
  27. 27. MORE CELEBRITIES XANAX/WITHDRAWS OXYCODONE/HYDROCODONE/XANAX BARBITUATES
  28. 28. METHAMPHETAMINE
  29. 29. HITTING THE BUBBLE
  30. 30. METH HEADS
  31. 31. MORE METH HEADS
  32. 32. 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
  33. 33. HISTORICALLY •“ILLEGITIMATE PATIENTS” ARE OVER PRESCRIBED AND LEGITIMATE PATIENTS ARE UNDER PRESCRIBED.
  34. 34. QUESTIONS? KKIMBLE@CODETF.COM 740-404-0157

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