Non-Medical Use of Prescription Drugs: Policy Change, Law Enforcement Activity, and Diversion Tactics

This grant is funded under NIJ's Research on Illegal Prescription Drug Market Interventions solicitation that supports the examination of the utility of policies, practices, and resources available to law enforcement for major crime deterrence, prosecution, and other market intervention--specifically under the objective Policy Analysis of Criminal Diversion of Prescription Medication Laws. The proposed policy analysis will research the impact of Florida House Bill 7095 (effective 7/2011) on diversion of psychoactive prescription drugs (PPDs). HB7095 changed wholesale distribution and reporting, pharmacy license regulations, physician standards of care, Department of Health (DOH) pharmacy inspections, and violation penalties, and banned physician dispensing. The project goals are to: determine whether HB7095 altered practices; establish baseline to examine future trends; and identify not/useful aspects of legislation. New HB7095 requirements adds wholesale distributors to DEA's Automation of Reports and Consolidated Orders System (bulk and dosage form controlled substance) data that will be access monthly by Florida Department of Law Enforcement (FDLE). FL DOH data on pharmacy permits and PPD dispensing will be analyzed for patterns suggesting pill mills; data on pharmacy loss and theft reports will be examined for diversion; and Board of Medicine charges, findings of guilt, and penalties against physicians will be examined. Researchers will: collect site information by applying systematic social observation procedures at pharmacies, and using crime incident data from local police/sheriffs; conduct 40 semi-structured interviews re the legislation with six Drug Enforcement Strike Force personnel (FLDE agents, police chiefs and sheriffs) who enforce HB7095 in each of the seven FDLE regions; and conduct 25 semi-structured interviews with physicians recently indicted and imprisoned for PPD offenses and referred by the States AG and Prosecutor. Analyses include: interrupted time series ARIMA models using GLM and MLE with Poisson regression or negative binomial analyses controlling for time to set baseline then adding intervention dummy variables pre/post HB7095; plus spatial analyses using cross-sectional geocoded data and HLM to examine within surrounding violent/property crime areas, and distance between pain clinics and pill mills expected to congregate. In addition to the data and written deliverables required by NIJ, anticipated work products include professional conference presentations, manuscripts for submission to professional journals, local stakeholder briefing materials; and a briefing to NIJ. This project has the potential to inform States considering similar legislation on the implementation, monitoring and impact assessment of new prescription drug policies.ca/ncf