The development of a comprehensive risk-management program for prescription opioid analgesics: researched abuse, diversion and addiction-related surveillance (RADARS).
OBJECTIVE. Beginning in the late 1990's a marked increase in abuse of OxyContin emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS) System. The main goal of RADARS was to develop proactive, timely and geographically sensitive methods to assess the abuse and diversion of OxyContin, along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of abuse of OxyContin and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems.


METHODS
The detection systems selected were: (1) Quarterly-surveys of drug abuse experts who are knowledgeable about cases of prescription drug abuse; (2) Surveys of law enforcement agencies that detect diversion of prescription drugs; and (3) Poison Control Center reports of intentional misuse or abuse of prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes.


RESULTS
Preliminary results indicate that prescription drug abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely abused drugs in the country, but the abuse of all prescription opioids seems to have grown over the 14 quarters since the inception of RADARS.


CONCLUSIONS
The next step in these studies is to develop regionally specific, risk-minimization-strategies, which is the goal of all risk-management programs. If successful, RADARS will serve as a prototype of such programs for any new drug approved that has measurable abuse potential.
Cicero
Theodore J
TJ
Washington University School of Medicine, St. Louis, Missouri 63110, USA. cicerot@wustl.edu
Dart
Richard C
RC
Inciardi
James A
JA
Woody
George E
GE
Schnoll
Sidney
S
Muñoz
Alvaro
A
D000701:Analgesics, Opioid; D003625:Data Collection; D003692:Delayed-Action Preparations; D011307:Drug Prescriptions; D006801:Humans; D006853:Hydrocodone; D007196:Indiana / Q000453:epidemiology; D009316:National Institutes of Health (U.S.); D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D010098:Oxycodone; D011039:Poison Control Centers / Q000706:statistics & numerical data; D016495:Police; D018570:Risk Assessment; D012308:Risk Management / Q000458:organization & administration*; D040242:Risk Reduction Behavior; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D014481:United States
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D006853:Hydrocodone; D010098:Oxycodone