Managing psychopharmaceutical drugs under prescription regimes
There is extraordinary cross-national variation in the availability of prescription psychoactive drugs, with most prescription drug use being concentrated in developed countries. A variety of measures aim to prevent abuses such as ‘doctor shopping’ and diversion of psychopharmaceuticals from the medical and pharmacy systems. The evidence suggests that prescription regimes affect the prescribing practices of doctors, often resulting in substitution. Price can be used to channel demand between two drugs that are substitutes for each other, moving demand from a drug with more adverse consequences to a less risky alternative. Advice to physicians on prescribing, has limited effect unless it concerns a new and serious side effect and alternative medicines can be prescribed. The development of a strong pharmacy system can limit illicit diversion of prescription medications, but cannot always prevent periodic epidemics of prescription drug misuse.