title: Pill counts and pill rental: unintended entrepreneurial opportunities.
abstract: BACKGROUND
  Prescription opioid diversion and abuse are becoming increasingly prevalent in many regions of the world, particularly the United States. One method advocated to assess compliance with opioid prescriptions is occasional "pill counts." Shortly before a scheduled appointment, a patient is notified that they must bring in the unused portion of their opioid prescription. It has been assumed that if a patient has the correct number and strength of pills that should be present for that point in a prescription interval that they are unlikely to be selling or abusing their opioids.
  
  
  METHODS
  Two cases are presented where patients describe short term rental of opioids from illicit opioid dealers in order to circumvent pill counts.
  
  
  RESULTS
  Pill renting appears to be an established method of circumventing pill counts.
  
  
  CONCLUSIONS
  Pill counts do not assure non-diversion of opioids and provide additional cash flow to illicit opioid dealers.
authors: Department of Anesthesiology, College of Medicine, University of Vermont, Burlington, VT 05401, USA. christopher.viscomi@vtmednet.org
authors: Christopher M
authors: CM
authors: Viscomi
authors: Melissa
authors: M
authors: Covington
authors: Catherine
authors: C
authors: Christenson
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D016520:Entrepreneurship; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D064226:Prescription Drug Diversion / Q000517:prevention & control*; D055656:Prescriptions; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid