Risk factors for drug diversion in a pain clinic patient population

J Opioid Manag. Nov-Dec 2012;8(6):351-62. doi: 10.5055/jom.2012.0135.


Background: Prescription drug abuse and drug diversion have soared at the same time prescribing practices have increased, prompting the pain medicine community to seek more accurate knowledge of the sources of prescription drugs used non medically.

Objective: To determine the extent of drug diversion and its risk factors in patients treated in a pain clinic.

Methods: An anonymous patient survey was developed based on factors examined for their association with diversion identified from a literature search. Patients were asked to participate as they arrived for appointments at six chronic pain management clinics. Questions ascertained whether patients had experienced drug loss, theft, or diversion and, if so, the number of episodes. Data were analyzed to determine associations between identified risk factors and the following four identified ways of diverting prescription medications: stolen medications, lost medications, sharing of medications, and selling of medications. Data were also analyzed to determine the extent of drug diversion within the studied population.

Results: Respondents had experienced a 45 percent incidence of some form of drug diversion on at least one occasion. The most common type of drug diversion was loss due to theft, reported by 30 percent of the respondents. Findings suggest family history of drug abuse and a history of criminal behavior can increase likelihood of drug diversion.

Conclusions: Drug diversion in a pain clinic population was common in this brief survey. Such diversion may contribute to the problems of nonmedical use of prescription drugs.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Crime / statistics & numerical data*
  • Data Collection
  • Drug and Narcotic Control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Clinics
  • Prescription Drugs / supply & distribution*
  • Risk Factors
  • Substance-Related Disorders / epidemiology*
  • Theft / statistics & numerical data
  • Young Adult


  • Prescription Drugs