Signs of such behaviors include: Aggressive demands for more opioids Asking for opioids by name Behaviors suggesting opioid use disorder Forged prescriptions Increased alcohol use Increasing medication dose without the providers permission Injecting oral medications Obtaining medications from nonmedical sources Obtaining opioids from multiple providers Prescription loss or theft Reluctance to decrease opioid dosing Resisting medication change Requesting early refills Selling prescriptions Sharing or borrowing similar medications Stockpiling medications Unsanctioned dose escalation Using illegal drugs Using pain medications to treat other symptoms Prescribers and dispensers can take several precautions to evade drug diversion, such as communication among providers and pharmacies, educating patients on opioid sharing dangers, encouraging patients to keep opioid medications private, and reporting patient prescribing to the state central database, if available

Plamboeck A, Veedfald S, Deacon CF, Hartmann B, Wettergren A, Svendsen LB, et al
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