Reasons for accumulating a large amount of drug:
(1) accidental
(2) intentional, for diversion
(3) hoarding, as a manifestation of anxiety or other psychiatric disorder
(4) living in a remote location or difficulty in getting to a pharmacy
(5) travel or multiple residences
Ways in which a patient may develop a large quantity of a drug:
(1) noncompliance
(2) filling a prescription with multiple refills
(3) duplicate prescriptions (lost, misplaced, etc)
(4) seeing multiple doctors
(5) use of multiple pharmacies (a single pharmacy might detect excessive amounts of drug)
(6) keeping supplies of unused medications
(7) borrowing or stealing the drug from a friend or family member
(8) asking for a medication that is not really needed
(9) misplacing drugs
Reasons accumulated drugs can be a problem:
(1) expense to the patient or payor
(2) risk for diversion if the drug has abuse potential
(3) lack of efficacy if the drug outdates
