John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 40-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at , via the Web site www.rxdiversion.com, or by phone at 513-336-0070.
A media story out of Great Falls, Montana, about a prescription overdose death reminds me that many people still do not realize that sharing their prescription drugs with those to whom they were not prescribed can have tragic endings.
The story describes how a woman, who was legitimately prescribed fentanyl, gave her boyfriend some of the powerful drug for a headache, causing his death. The woman has been charged with negligent homicide, and in the meantime has lost a very close friend. There is no indication as to what form of fentanyl was prescribed and given to the boyfriend, but the drug-related death was documented through an autopsy.
I am sure that thousands of dosage units of prescription drugs change hands every day that are likely just as innocent and well-intended as this exchange began. This includes everything from antibiotics, blood pressure medicine, and controlled substances, to, remarkably, some Schedule II pharmaceuticals. The average individual has no idea that providing these medications to friends and/or family is likely a criminal offense in his or her state. In fact, in my home state of Ohio, a "gift" makes you guilty of trafficking in drugs, the same felony as if you had sold the drugs for a profit. Pursuing a mother who gives her daughter a tramadol pill because of some low-level pain, however, is not my idea of the good use of law enforcement resources in Ohio or any other state.
The much greater risk and problem is what happened in Montana, when a person becomes responsible for a friend or family member's death by allowing the individual to take some of the prescribed medication. I am sure in that individual's mind, the criminal charges are the least of his or her concerns, having to carry that mistake for the rest of his or her life.
Even more reckless behavior is the practice of some teenagers who engage in "pharming" parties. The teens find a variety of prescription drugs in their home medicine cabinets and take them to a party, where everyone empties their treasure into a large bowl. During the evening, partiers ingest handfuls of unknown pharmaceuticals and chase it down with copious amounts of alcohol. This is a true recipe for disaster, with the possibility of causing an unintended death during the festivities.
Pharmacists, prescribers, and law enforcement need to make it clear to the general public that the prescription drugs patients are prescribed are for them and them alone. The prescriber made a decision after examining the patient that he or she needed a certain drug, and the prescriber never intended for the patient to share that with a family member or a friend. Subsequently, the pharmacist had the same intention when he or she filled the prescription from the prescriber, and would not think that this would need to be part of the information provided to the patient.
There is no possible way that the practice of sharing pharmaceuticals will be eliminated in this country, but maybe stories like the one in Great Falls, will make individuals think twice before they engage in this illegal act, an act that could send a loved one to an untimely death. Better public education on this matter is likely needed before others make the same mistake as this woman from Montana.
Women with abnormal vaginal microbiota showed no difference in efficacy of daily oral PrEP compared to women with normal vaginal microbiota.
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