Multiple determinants of specific modes of prescription opioid diversion

Theodore J. Cicero, Steven P. Kurtz, Hilary L. Surratt, Gladys E. Ibanez, Matthew S. Ellis, Maria A. Levi-Minzi, James A. Inciardi

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Numerous national surveys and surveillance programs have shown a substantial rise in the abuse of prescription opioids over the past 15 years. Accessibility of these drugs to non-patients is the result of their unlawful channeling from legal sources to the illicit marketplace (diversion). Empirical data on diversion remain absent from the literature. This paper examines abusers' sources of diverted drugs from two large studies: 1) a national sample of opioid treatment clients (N=1983), and 2) a South Florida study targeting diverse populations of opioid abusers (N=782). The most common sources of diverted medications were dealers, sharing/trading, legitimate medical practice (e.g., unknowing medical providers), illegitimate medical practice (e.g., pill mills), and theft, in that order. Sources varied by users'age, gender, ethnicity, risk-aversiveness, primary opioid of abuse, injection drug use, physical health, drug dependence, and either access to health insurance or relative financial wealth. Implications for prescription drug control policy are discussed.

Original languageEnglish
Pages (from-to)283-304
Number of pages22
JournalJournal of Drug Issues
Issue number2
StatePublished - 2011

Bibliographical note

Funding Information:
Acknowledgements We are grateful to CNPQ, for providing financial support to this work CNPQ-FAPESP–465458/2014-9 and 2014/50891-1-INCT Translacional em Medicina (465458/2014-9).

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Medicine (miscellaneous)


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