Survey of forged prescriptions to investigate risk of psychoactive medications abuse in France - Results of OSIAP survey

Objective: To describe patterns of drug diversion from 2001 to 2004 in France and to define different profiles of forged prescriptions. Methods: Data from a national cross sectional survey carried out each year since 2001 were analysed. A national network of community pharmacies is requested to collect suspect prescriptions during two periods each year in May and November. Data included were date, age and sex of the patient, type of prescription form, drugs and criteria of suspicion. Results: Between 2001 and 2004, a sample of 1710 abnormal prescription forms were analysed. These concerned women in 54% of cases. The average age of those sampled was 47 years. Sixty-one percent of the 597 varieties of medication belonged to the anatomic therapeutic chemical (ATC) nervous system class. The most frequently involved drugs were benzodiazepines and benzodiazepine analogues (flunitrazepam, zolpidem) or opioids (buprenorphine, morphine). Multiple correspondence analysis underlined two opposite profiles for suspicious prescriptions: (i) specific prescription forms for scheduled drugs presented by men aged < 45 years involving drugs for the nervous system and presenting the criteria of stolen, falsified and abnormal prescriptions; and (ii) prescription forms presented by women aged > 45 years involving cardiovascular and muscular-skeletal system drugs, presenting the criteria of alteration to the prescription. Conclusion: Analysis of data collected from community pharmacies in the OSIAP (Ordonnances Suspectes Indicateur d'Abus et de Phartnacodependance) survey gives information about patterns of diversion of medication in France. This system is able to evaluate the impact of measures implemented in order to decrease the misuse of drugs and able to identify new patterns of drug diversion. Identification of profiles of suspicious 'prescription forms' could help pharmacists to better identify abnormal prescriptions. A European project has recently been implemented to extend this kind of survey to other countries in Europe.