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What Is Opioid Diversion?

Table of Contents

Opioid diversion involves stealing, selling, or giving away prescription medications for use by an individual who does not have the prescription.

Opioids are controlled substances, meaning you must have a prescription to take them. People who divert them do so for a number of reasons, but it is important to remember that diversion is illegal and can be extremely dangerous.

Unfortunately, opioid diversion is common. About 82% of clinicians and health care workers know someone who has diverted medications.[1] You may also have friends, family members, or coworkers who have used prescription painkillers without a prescription.

Anyone, including you, can make drug diversion less common. You can stop giving away painkillers, dispose of your pills properly, and encourage others who may be buying or obtaining illicit opioids to get help.

4 Common Types of Opioid Diversion

Anytime someone takes a painkiller without a prescription, they're participating in opioid diversion. These four main pathways result in pills landing in the wrong hands:

1. Healthcare Workplace Theft

Doctors, nurses, and aides can access strong medications to relieve patient pain. While regulations should keep those drugs safe, some professionals steal. Some steal to misuse the medications themselves while others may diver them to friends or family. About 10% of health care workers report misusing drugs.[2] This can include diverting. 

2. Direct Patient Theft

Sometimes individuals can have their prescriptions stolen from them from friends, family, home health aids, etc. About 31% of hospice agencies report opioid diversion, and in those cases, close to 40% of the theft was perpetrated by family caregivers.[3]

3. Gifts From Friends & Family

Up to 75% of people who misuse painkillers get their pills from friends or relatives.[4] Sometimes, those pills are gifts. This can often be well intentioned: a family member knows that a medication they have might make their loved one feel better. Regardless of intention, individuals should never share opioids medications with a friend or loved one without encouraging them to first be medically evaluated.

4. Purchases From Dealers 

Prescription painkillers can be a lucrative source of income. One hydromorphone dose, for example, costs between $5-20 on the street.[5] For this reason, some individuals sell their prescriptions instead of using them. 

Why Not Share Your Medication?

About half of all people misusing painkillers got their pills for free from a friend or family member.[6]

If you've been handing out your painkillers for free, you're putting your loved ones at risk. About 80% of people who use heroin started with prescription painkillers.[7] While presumably well intentioned, the pill you hand out to a friend or family member could be the trigger that starts a lifetime of addiction or dependency.

You could also cause an overdose. Every day, 100 people die from drug overdoses, and about 75% of those overdoses involve painkillers.[8]

Giving away your pills is illegal at both the state and federal levels.[9] If you're caught, you could be fined or even face jail time.

Keep all of your painkillers in a safe, secure location. And if someone asks you for pills, always refuse. It's the kindest and safest thing you can do. 

Preventing Opioid Diversion 

Reducing overdose deaths and drug diversion is a joint effort. We all as individual citizens have a role to play, as do officials. [10]

As a painkiller consumer, you can prevent opioid diversion. Don't hand out medications you're using, and get rid of any extras in a safe place: Dispose of your pills properly when you don't need them anymore by flushing them down the toilet or by returning them to a healthcare office or drug takeback center .[11]

If we all work together, we can reduce opioid diversion rates and ensure that fewer people die of overdoses each year.

Sources

  1. The Opioid Crisis Continues: Have You Bolstered Your Health System's Drug Diversion Defenses Yet? PSQH. https://www.psqh.com/analysis/the-opioid-crisis-continues-have-you-bolstered-your-health-systems-drug-diversion-defenses-yet/. January 2022. Accessed June 2022.
  2. Drug Diversion and Impaired Health Care Workers. Quick Safety. https://www.jointcommission.org/-/media/tjc/newsletters/quick_safety_drug_diversion_final2pdf.pdf. April 2019. Accessed June 2022.
  3. Estimates of Medication Diversion in Hospice. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2760728. February 2020. Accessed June 2022.
  4. Primary Prevention of Prescription Opioid Diversion: A Systematic Review of Medication Disposal Interventions. Northwestern University. https://www.scholars.northwestern.edu/en/publications/primary-prevention-of-prescription-opioid-diversion-a-systematic-. 2021. Accessed June 2022.
  5. Street Prices of Prescription Opioids Diverted to the Illicit Market: Data From a National Surveillance Program. Journal of Pain. https://www.jpain.org/article/S1526-5900(13)00492-6/fulltext. April 2013. Accessed June 2022.
  6. How People Obtain the Prescription Pain Relievers They Misuse. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/report_2686/ShortReport-2686.html. January 2017. Accessed June 2022.
  7. Opioid Overdose Crisis. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids/opioid-overdose-crisis. March 2021. Accessed June 2022.
  8. The High Cost of Drug Diversion. Pharmacy Times. https://www.pharmacytimes.com/view/the-high-cost-of-drug-diversion. January 2016. Accessed June 2022.
  9. Don't Share Prescription Drugs. Commonwealth Prevention Alliance. https://pastop.org/prevention-professionals/initiatives/care/. Accessed June 2022.
  10. Drug Diversion and Loss Prevention: A Changing Landscape. Security Management. https://www.asisonline.org/security-management-magazine/articles/2020/09/drug-diversion-and-loss-prevention-a-changing-landscape/. September 2020. Accessed June 2022.
  11. Drug Disposal: Drug Take Back Locations. U.S. Food and Drug Administration. https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-drug-take-back-locations. October 2020. Accessed June 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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