From the first pilot initiatives in the early 1990s to the national OSIAP survey in the 2020s: More than 30years of insight in medication diversion phenomenon in France.

Abstract

This article proposes to trace back the timeline of the monitoring of falsified medical prescriptions in France as part of the French Addictovigilance System's toolbox. It examines the genesis of the OSIAP survey (Suspect Prescriptions Indicator of Possible Abuse), which has been held at the national level since 2001 but was created in the early 1990s, and its development until the current situation with a continuously confirmed yearly increasing trend. Understanding the birth and development of OSIAP and some other Addictovigilance tools that continue to be useful after more than 30 years of existence requires to review key historical benchmarks including the principles and missions of the former French National Commission on Narcotic and Psychotropic Drugs. Even though the OSIAP survey is part of a specific toolbox developed and routinely explored by the Addictovigilance network in a multidimensional approach, it has also been the sole data source, which identified some problematic drug uses, such as the early detection of tropicamide eye drop misuse in France or the diversion of codeine cough syrups after July 2017. Nevertheless, findings obtained from this data source should be checked against other complementary sources. Close monitoring of falsified prescriptions should be maintained in France, and the recent evolutions are plaid for supporting this survey. It is still being determined whether the constant increase of false prescription forms recorded in the OSIAP survey results from an increase in the absolute number of falsified prescriptions or whether pharmacists have become more vigilant with time. Still, the acceleration of these falsifications is also in line with the deployment of teleconsultations and the democratisation of digital techniques such as copying prescriptions or generating false QR codes. The forging techniques will likely evolve again in the future, possibly by adapting to stricter requirements such as the implementation of dematerialised prescriptions.