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Prescribed medication abuse: Limitless creativity 

Prescribed medication abuse: Limitless creativity
Chapter:
Prescribed medication abuse: Limitless creativity
Author(s):

Anthony C. Tamburello

DOI:
10.1093/med/9780199360574.003.0031
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date: 17 January 2020

Community abuse of prescription medication is typically limited to overuse or inappropriate sharing of medication. In jails and prisons, the demand characteristics are dramatically altered, creating an elaborate laboratory for medication alteration, diversion, and abuse. While prescription medications are sometimes used to achieve a ‘high,’ they may also be sought to ease discomforts commonly experienced in a jail or prison. Some may seek stimulating medications to counteract the effects of prescribed sedatives to allow them to be ready to respond to real or perceived dangers. Thus, inmates may feign or exaggerate mood, anxiety, psychotic, or somatic symptoms with the goal of being prescribed medications with the desired effects. More insidious is the diversion of prescribed medications to a third party. Many prescribed medicines have a ‘street value’ in correctional settings. A patient with a legitimate need for medication, who may already have poor illness insight, may be enticed or coerced into transferring their medication to a peer. This creates several dangerous problems. The source inmate may worsen or fail to improve, which may lead to dose escalation, an incorrect conclusion about a treatment failure, poor functioning, and behavioral sequelae including disruptive or violent conduct. Meanwhile, the recipient is exposed to medication risks without the benefits of informed consent or medical supervision. This chapter presents data on specific classes of prescribed medication abuses, methods of abuse, and approaches to minimize abuse or diversion of prescribed medications.

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