Diversion of prescribed drugs by drug users in treatment: analysis of the UK market and new data from London

Aims. To review the available knowledge about the diversion to the illicit market of drugs prescribed to drug users in treatment in the United Kingdom , and to identify aspects of the London marker in more derail. Method. An a nalysis of the literature and new data in terms of the extent and nature of the marker, the practicalities of trade, motives for selling, reasons for demand and the influence of variations in prescribing practice on diversion . Prices of diverted prescription drugs and derails of their availability i n London are presented Findings. The size of the market is substantial and appears to involve a large number of individuals, each diverting small amou nts of their own prescribed drugs. Major motives for selling prescribed dru gs are to raise funds to buy other, preferred, drugs and/or to pay for a pr ivate prescription. Buyers in treatment appear to be motivated by a desire to supplement their own prescriptions because they are dissatisfied with th e particular drug prescribed, dosage and formulation. Drug users in treatme nt can exploit the variations in prescribing practice-such as how much 'tak e-home' medication they are allowed and whether tests are conducted to asce rtain if they are using it themselves-and divert their prescribed drugs. Pr ices of prescription drugs on the illicit market can fluctuate on a daily b asis according to supply and demand. Conclusions. The results suggest that, to be effective, diversion control must simultaneously involve deterrents from prescribers, drug treatment services, law enforcement agencies and dis pensing pharmacists. Finally, some suggestions for further research on this under-studied issue are suggested.