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April 10, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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April 10, 2013 (PDF version)
Featured Report
Prescription Drug Misuse in America: A Report on Marijuana and Prescription Drugs
Quest Diagnostics Health Trends
Accessed April 4, 2013

This report analyzed 227,402 de-identified urine specimen results of patients tested by Quest Diagnostics' clinical laboratories in 2011 and 2012. The study assessed results of male and female patients, age 10 and up, in the United States. Tests covered a range of drugs, including opioid pain medications such as oxycodone, central nervous system depressants such as alprazolam (including Xanax), and the stimulant amphetamine (Adderall is an example). Administered tests included those conducted by physicians monitoring targeted high-dose users and random tests conducted by employers. Quest did not distinguish what proportion of those tested fall into which category. Presumably all testing by Medicaid and Medicare was patient monitoring. The number of tests rose from 75,997 in 2011 to 151,405 in 2012. Sixty percent of patients tested in 2012 misused their medications--a slight improvement over the 63 percent inconsistency rate of 2011. Among misusers, 33 percent tested positive for the prescribed drug and at least one additional drug; 25 percent had substituted a different drug; and 42 percent had no drugs on board. There was little inconsistency in use by gender: men and women misused prescription drugs equally. Inconsistency rates were 70 percent for Medicaid recipients and 58-59 percent for those with Medicare or private health insurance.

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Journal Articles and Monitoring Reports
A. Barsdorf, J. Mardekian, J. Vietri, and A. Joshi. 2013. "Prescription Opioid Tampering and Abuse in the U.S." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S58.

This Pfizer-funded study estimated the prevalence of prescription opioid abuse and tampering. Participants from Kantar Health's National Health and Wellness Survey were invited to complete an online survey assessing use, misuse, and abuse of prescription opioid medications. A total of 25,864 adults were screened. Prevalence was calculated using weights based on age, gender, race, and education. Prescription opioid abuse in the 3 months before the survey was estimated to affect 1.31 percent of U.S. adults, with approximately half of that percentage tampering to get high. Opioids were most commonly abused in their original form, but snorting, chewing, and taking medication with alcohol were also reported by more than 40 percent of those abusing prescription opioids. Most commonly abused drugs were acetaminophen-opioid combinations and oxycodone. Opioid abuse was associated with younger age, male sex, minority race, psychiatric illness, alcoholism, cigarette smoking, being employed, and higher household income. Those who tampered also abused more frequently and were likelier to use an opioid for pain.

R. Dart, S. Severtson, J. Patrick, and L. Webster. 2013. "Abuse, Misuse, and Diversion of Hydromorphone Since the Introduction of the Extended-Release Formulation (EXALGO®)." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S80.

Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System's Poison Center, Opioid Treatment, Survey of Key Informants' Patients, College Survey, and Drug Diversion programs were examined for changes in rates of hydromorphone abuse, misuse, and diversion. The quarterly exponentiated values of the slopes per 100,000 population (POP) and per 1,000 unique recipients of dispensed drug (URDD) from Q3 2006 or program inception through Q2 2012 were compared before and after the release of EXALGO, an extended-release tablet formulation of hydromorphone, using negative binomial regression. Before the release of EXALGO, the mean rate of change in hydromorphone abuse rates among individuals in the opioid treatment program significantly increased by 11.9 percent (POP) and 7.6 percent (URDD) per quarter; after the release of EXALGO, these rates showed a nonsignificant decline of 1.4 percent (POP) and 4.4 percent (URDD). The positive slopes of the rates of change before release of EXALGO were significantly different from the negative slopes after release of EXALGO for both POP and URDD. Similar patterns occurred in rates measured by each of the other four programs. Although hydromorphone abuse, misuse, and diversion rates have increased over time, release of EXALGO corresponded with slowing or decreasing rates across all five programs. The release of EXALGO did not increase overall rates of nonmedical hydromorphone use; whether it mitigated the increasing rate or reflects changes in overall patterns of nonmedical prescription opioid use awaits further research.

T. Frohe, L. Strong, M. McEntee, D. van der Goes, and K. Vowles. 2013. "Systematic Review of Opioid Dependence in Chronic Pain." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S10.

The authors perform a comprehensive review of opioid dependence literature in chronic pain, including a method for evaluating quality of reviewed studies to allow for appropriate weighting of individual studies. This poster will present the results of the review, including an estimate of opioid dependence in those who are prescribed opioids for chronic pain, confidence intervals around this estimate, risk factors for misuse, and guidelines for future study that may help increase sensitivity and specificity in accurate identification.

L.D. Johnston, P.M. O'Malley, J.G. Bachman, and J.E. Schulenberg. 2013. Monitoring the Future National Results on Drug Use: 2012 Overview, Key Findings on Adolescent Drug Use. Ann Arbor: Institute for Social Research, The University of Michigan.

Monitoring the Future used a sample size of about 15,700, 15,400, and 14,300 students in 8th, 10th, and 12th grades, respectively. In all, about 45,400 students in 395 secondary schools participated. The use of narcotic drugs other than heroin (most of which are prescription analgesics) increased sharply in recent years, as have emergency room admissions involving these drugs, making this drug class particularly concerning. The two major components of this class--Vicodin and OxyContin--declined in all three grades. For the three grades combined, declines for Vicodin and OxyContin were significant in 2012. Use of illicit drugs, inhalants, and tranquilizers also decreased in 2012. Adderall showed some sign of increasing use, but only among 12th graders and not significantly. While Adderall use outside of medical supervision may still be rising at grade 12-possibly because of its use to enhance academic performance-misuse in grades 8 and 10 held steady in 2012.

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D. Kalauokalani and P. Cowan. 2013. "A Novel Approach to Public Education About Opioid Safety." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S35.

A brief video public service announcement (PSA) was produced and studied to measure recall, likeability, future consideration, and other metrics representing impact of exposure. The PSA was tested in eight national CineMedia movie theaters in the Cincinnati, Nashville, Washington, D.C., and Charleston-Huntington demographic market areas. Three hundred adults exposed to the PSA were interviewed on six selected days of the month. Respondents were required to be 25-54 years of age, attending a PG-, PG-13-, or R-rated film, and in their seats at least 20 minutes before the previews began. In terms of total recall, 61 percent of moviegoers recalled the ad either aided or unaided. Eighty six percent of those who recalled the ad positively rated likeability. All (100 percent) of those who recalled the ad agreed with the statement "The main message of the ad was to properly manage, store, and dispose of opioid pain medication"; 98 percent agreed with the statement "The ad makes me more aware of the dangers of sharing prescription pain medications"; 97 percent agreed with the statement "The ad makes me more aware of the dangers of taking someone else's prescription pain medications"; and 97 percent agreed with the statement "The ad makes me think about proper prescription pain medication storage." Eighty five percent of moviegoers who recalled the ad said they would be more careful with their pain medication in the future.

E. Lavonas, B. Bucher-Bartelson, S. Severtson, J. Davis, G. Baker, G. Vorsanger, and R. Dart. 2013. "Abuse and Diversion of Immediate-Release Prescription Opioids: 30 Months of Data From the RADARS® System." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-13, 2013. The Journal of Pain 14(4):S58.

Researchers used data from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System Poison Center, Drug Diversion, Opioid Treatment Program, Survey of Key Informants' Patients, and College Survey programs (Jan 2010 to June 2012) to measure rates of diversion and abuse for immediate release formulations of hydrocodone, morphine, oxycodone, oxymorphone, and tapentadol. Poison Center program "intentional abuse" cases were analyzed. Average rates were calculated using population (events per 100,000 people) and unique recipients of a dispensed drug (events per 1,000 unique recipients of dispensed drug [URDD]). Population rates estimate the public health burden associated with the abuse or diversion of each drug. URDD rates estimate the risk for individuals by taking into account the number of patients who had filled a prescription. Negative binomial regression was used to estimate average rates, confidence intervals, and trends over time. Abuse and diversion rates were generally stable over time. On a population basis, hydrocodone had the highest rates in all programs. Tapentadol had the lowest population rates in all programs except the Poison Center program, in which tapentadol and oxymorphone rates were indistinguishable. When compared with the number of patients filling prescriptions (URDD), oxymorphone had the highest rates in all programs. URDD rates were lowest for morphine in the Poison Center program, tapentadol in the Drug Diversion program, oxycodone in the Opioid Treatment and Survey of Key Informants' Patients programs, and hydrocodone in the College Survey program. Population-level indicators of abuse and diversion show the greatest public health impact from hydrocodone and the least for tapentadol.

G.M. Reisfield, T. Shults, J. Demery, and R. DuPont. 2013. "Protocol to Evaluate Drug-Related Workplace Impairment." Informa Healthcare (1):43-8. doi:10.3109/15360288.2012.753975.

Researchers proposed a protocol for evaluation of workplace impairment, based on comprehensive drug and alcohol testing at the time of suspected impairment and followed expeditiously by a comprehensive physician evaluation, including a focused medical history with an emphasis on controlled substance use, physical and mental status examinations, evaluation of employee adherence to prescription medication instructions, additional drug testing if indicated, use of collateral sources of information, and querying of state prescription monitoring databases. They also made suggestions for optimizing the evaluation of drug-related workplace impairment.

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B. Setnik, C. Roland, K. Sommerville, V. Goli, G. Pixton, R. Berke, and A. Calkins. 2013. "A Primary Care-Based, Open-Label Study Assessing the Success of Converting Opioid Experienced Patients With Chronic Pain to EMBEDA Using a Standardized Conversion Guide, and to Identify Behaviors Related to Prescription Opioid Abuse, Misuse, and Diversion." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S76.

Researchers used an open-label, single-arm, multicenter, primary care-based study to assess the utility of a standardized conversion guide in converting opioid-experienced adults with chronic, moderate-to-severe pain from various prescription opioids to EMBEDA® (extended-release morphine sulfate with sequestered naltrexone hydrochloride). The primary endpoint was the percentage of patients who achieved a stable dose of EMBEDA within 6 weeks. Secondary endpoints included time to stable dose, number of titration steps, rescue medication use, adverse events, and conversion guide utility. Patient behaviors related to prescription opioid misuse, abuse, and diversion (MAD) were evaluated by patient- and investigator-completed questionnaires and assessments. Approximately half of patients (51.3 percent) were successfully converted to a stable dose of EMBEDA in a mean of 20 days and a mean of 2.4 titration steps using the conversion guide. Most patients (95.4 percent) achieving a stable dose cited use of rescue medications during titration. Brief Pain Inventory scores improved during titration and investigators were generally satisfied with the conversion guide. Adverse events were consistent with opioid therapy. At baseline, most patients were assigned by the investigator as low risk for abuse (89.3 percent), misuse (84.2 percent), and diversion (94.3 percent). Overall, 79 percent of patients returned the baseline Patient Experience and Concerns with Prescription Opioids Questionnaire. Sixty percent indicated taking more than prescribed and 10.9 percent reported chewing or crushing their opioids in the past. Overall, 40.6 percent of patients who completed the Current Opioid Misuse Measure® (COMM) at the second visit were classified as having aberrant behaviors. One third of patients (33.8 percent) had greater than or equal to 1 abnormal urine drug test result during the study. Conversion to EMBEDA using the standardized conversion guide was an attainable goal in approximately 50 percent of opioid-experienced adults with chronic, moderate-to-severe pain in less than 30 days. Although most patients were assigned as low risk for MAD by the investigator, 41 percent displayed aberrant behaviors according to the COMM.

S. Severtson, J. Davis, M. Le Lait, B. Bucher-Bartelson, and R. Dart. 2013. "Use of Both Individuals Filling Prescriptions and Population Rates in Assessing Abuse Potential of Prescription Opioids." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S14. doi:10.1016/j.jpain.2013.01.065.

This study examines differences in rates per population and per unique recipient of dispensed drug (URDD) across different prescription opioid classes. Using two Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System programs (Poison Center and Drug Diversion), rates of product mentions by intentional exposure cases and diversion incident reports from the first quarter of 2010 through the second quarter of 2012 were calculated by year/quarter. Rates were calculated per population and URDD for seven prescription drug classes: hydrocodone, oxycodone, fentanyl, oxymorphone, buprenorphine, hydromorphone, and morphine. Negative binomial regression models revealed the average hydrocodone rate was more than seven times higher than the average rate of other products (with the exception of oxycodone) per population. However, findings reversed when rates were calculated per URDD, with other substance rates being at least 2.5 times likelier than hydrocodone. Oxymorphone showed low population rates but the highest rates in both programs per URDD. Oxycodone has relatively high rates per URDD and per population.

H. Surratt, S. Kurtz, T. Cicero, R. Dart, G. Baker, and G. Vorsanger. 2013. "Street Prices of Prescription Opioids Diverted to the Illicit Market: Data From a National Surveillance Program." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 8-11, 2013. The Journal of Pain 14(4):S40.

Researchers implemented a national surveillance program to monitor prescription opioid street price trends as an indicator of availability, demand, and abuse potential. They examined street prices of diverted prescription opioids using surveillance data collected as part of the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System, which measures U.S. rates of prescription opioid abuse and diversion. The RADARS® Drug Diversion Program comprises 250 prescription drug diversion investigators from law enforcement and regulatory agencies that complete quarterly questionnaires on new diversion cases in their jurisdictions. Street price data were obtained from 687 questionnaires collected during seven quarters in 2010 and 2011. Street prices of diverted prescription opioids were computed (mean and median prices/mg) to make standardized price comparisons across drug classes. Street price trends were also examined. Street price per mg ranked as follows: hydromorphone (mean= $5.57; median=$5.00); buprenorphine ($2.93; $1.88); oxymorphone ($2.04; $1.50); methadone ($1.26; $1.00); IR oxycodone ($1.05; $1.00); hydrocodone ($0.99; $1.00); ER oxycodone ($0.85; $0.88); morphine ($0.74; $0.67); tramadol ($0.14; $0.10); and tapentadol ($0.10; $0.10). Although minor street price fluctuations were observed between quarters, street prices were consistent over time with the exception of ER oxycodone, which experienced a street price decline after the tamper-deterrent formulation launch in August 2010. Analyses yielded substantial differences in street prices for each opioid monitored. Higher street prices appear to reflect greater drug desirability/demand among abuser populations and limited illicit market availability.

R. Weiler, T. Barnett, L. Pealer, and J. Haddox. 2013. "Youth Health Risk Behaviors Associated With the Nonmedical Use of Prescription Pain Relievers." Abstracts Presented at the 32nd Annual Scientific Meeting of the American Pain Society, May 08-11, 2013. The Journal of Pain 14(4):S23.

This investigation examined associations between nonmedical use of prescription pain relievers (NMUPPR) and risk behaviors related to injury, violence, tobacco, alcohol, illicit drug use, risky sexual behaviors, and physical activity. Self-report data were collected from 4,178 9th to 12th grade students enrolled in five schools in five states using a modified version of the 2011 Youth Risk Behavior Survey (YRBS). Logistic regression (controlling for sex, race/ethnicity, and grade covariates) was used to assess independent associations with lifetime and 30-day NMUPPR and the other risk behaviors. Prevalence of lifetime and past 30 day NMUPPR were 19 percent and 10 percent, respectively. Students reporting NMUPPR during the past 30 days were likelier to report other problem behaviors that during that same period. Relative to those not reporting NMUPPR, odds they reported other problem behaviors were 7 for cigarette use, 6 for marijuana use, 6 for binge drinking, 6 for driving after drinking, and 4 for carrying a weapon. They were 9 times likelier to report using cocaine, 12 times likelier to report using methamphetamine, and 18 times likelier to report using heroin during their lifetime. Findings suggest that NMUPPR is a salient drug-use behavior among adolescents. Furthermore, it clusters with other activities, suggesting NMUPPR may be part of a syndrome of risk behaviors. To better inform policy, prevention, and treatment activities, the authors recommend NMUPPR items should become part of the YRBS.

News and Reports

CVS Pays $11 Million in Drug-Records Settlement
The Wall Street Journal
April 3, 2013

CVS Caremark Corporation has agreed to pay $11 million to settle civil allegations by the Justice Department that the company failed to keep proper records of pharmacy drug sales in Oklahoma. Federal investigators say CVS pharmacies used "dummy" registration numbers for prescriptions from 2005 to 2011 and filled prescriptions written by doctors who were no longer registered with the Drug Enforcement Administration. CVS did not admit liability.

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Clover Schools Crack Down on Pill Sales, Abuse
The Herald
March 29, 2013

During the 2012-13 school year, Clover schools reported 32 incidents involving drug abuse--including over-the-counter drugs, Ritalin, Adderall, oxycodone, hydrocodone, and marijuana. The Clover School District of South Carolina conducted sweeps with drug-sniffing dogs at schools and hosted awareness sessions for parents to talk about the problem. The District plans to invite guest speakers to talk to students about prescription drug dangers. The arrest of four Clover High students who sold prescription drugs has led to greater awareness about the scope of the problem.

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In Search of a 'Wonder Drug'? Why Students Are Misusing Adderall and Other Stimulants
April 4, 2013

This brief article and video (5:05 minutes) discuss safety and risks associated with the attention deficit hyperactivity disorder drug Adderall, when used to enhance performance.

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Aglukkaq Asks for U.S. Help to Control Oxycodone
Canadian Medical Association Journal
April 3, 2013

Last month, Canadian Federal Health Minister Leona Aglukkaq sent a letter to Gil Kerlikowske of the U.S. Office of National Drug Policy and Margaret Hamburg, M.D., U.S. Food and Drug Administration Commissioner, asking for their assistance to control oxycodone use. In November 2012, Minister Aglukkaq approved a generic version of oxycodone after ignoring expert advice against doing so. In the letter, she wrote, "Preventing the abuse and diversion of pharmaceutical drugs is an area where cooperation between our two countries would be valuable in helping to achieve our common objectives. To this end, I propose that our officials work together to develop joint evidence-based guidance on abuse deterrence that could be used on both sides of the border."

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Community View: Millions Have Pharma Drugs in Water; Better Disposal Needed
The Journal News
March 29, 2013

This opinion piece reports growing concerns about prescription drugs in drinking water, with trace amounts of pharmaceuticals detected in water sources for an estimated 41 million Americans. It recommends allowing grocery stores with pharmacies to voluntarily install collection boxes and requiring long-term care facilities, nursing homes, and hospitals to submit an annual plan to the Westchester County Health Department detailing their safe drug disposal plans.

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Vivitrol Helps Patients Beat Opioid Addictions
March 29, 2013

This article and video (2:36 minutes) discuss how Vivitrol helped a former drug user overcome an OxyContin addiction. Vivitrol is an injectable extended-release form of naltrexone, a drug that can help prevent relapse. In a Food and Drug Administration trial, 36 percent of Vivitrol patients stayed in treatment for 6 months without relapsing, compared with 23 percent in the placebo group. Researchers recommend staying on Vivitrol for 6 to 12 months.

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How Prescription Drug Abuse Became a Workplace Problem ... and What Employers Can Do About It
Update Newsletter, Partnership for a Drug-Free New Jersey
Winter 2013

The author, an attorney, discusses prescription drug abuse by providing general information, statistics on pain medication deaths, and employers' pain medication costs. She mentions several things employers can do to minimize substance use in the workplace, such as drug testing beyond the five-panel test and offering safety education programs for workers on the risks of prescription medication abuse.

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http://www.drugfreenj.org/HowRxAbuseBecameWorkpplaceProblem or

LCO Tribe Battles Prescription Drug Abuse
March 30, 2013

This article and video (2:10 minutes) highlight a panel discussion about prescription drug abuse among the Lac Courte Oreilles Tribe. In the past year, its community had 10 deaths related to prescription drug use. The tribe hopes to take part in the Wisconsin Prescription Drug Monitoring Program, which is set to launch in June.

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Get Prescription Drugs? Your Name Could Now Be in a State Database
April 2, 2013

Patients receiving controlled substances such as morphine, OxyContin, and Vicodin will now have their information entered into the Wisconsin Prescription Drug Monitoring (PDMP) database. The PDMP will help reduce prescription drug abuse and assist law enforcement officers to investigate people who use them illegally.

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Lockport Sees Success With Drug Drop Off Program
The Buffalo News
March 31, 2013

After its success with Drug Enforcement Administration National Take Back Days, the City of Lockport, New York, decided to install a permanent drop box available 24 hours a day at the Lockport Police Department. Thus far, more than 500 pounds of unwanted prescription pills have been deposited.

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More Than 3 Tons of Unwanted Medicine Collected Via Drop Boxes
Edina Patch
April 1, 2013

In one year, Hennepin County, Minnesota, collected more than 6,700 pounds of unwanted medications with only six drop boxes. The county's goal was to encourage residents to properly dispose of unused and unwanted medicines.

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Montco Seeks to End Teen 'Pharm' Parties
April 5, 2013

Montgomery County, Pennsylvania, has mobilized to reduce teenagers' "pharm parties" by installing 10 permanent prescription drug collection boxes and raising community awareness about the problem.

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Prescription Drug-Related Deaths Continue to Rise in U.S.
Los Angeles Times
March 29, 2013

Drug fatalities increased 3 percent in 2010 and preliminary data for 2011 indicate the trend has continued, according to new analyses by the Centers for Disease Control and Prevention. The figures reflect all drug deaths, but the increase was propelled largely by prescription pain medications such as OxyContin and Vicodin. Overdose deaths involving these medications rose to 16,651 in 2010, accounting for 43 percent of fatal overdoses.

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Bill Takes Aim at Drug Overdose Deaths in California
April 4, 2013

California state legislators introduced a bill to convene a statewide task force on drug overdoses and develop recommendations to address the problem. The bill also would create a $500,000 grant program to encourage communities to set up overdose prevention efforts.

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One TN Bill Would Treat Drug-Using Moms; the Other Would Punish Them
The Tennessean
March 31, 2013

Tennessee lawmakers continue to debate how to decrease the number of children born addicted to drugs. One approach is to advance the "Safe Harbor Act," which forces drug-addicted pregnant women into treatment programs while preventing the Department of Children's Services from taking away their infants solely for prescription drug abuse. The other approach is to allow prosecution of women whose drug use harms their newborns. The latter approach is the leading contender.

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Growing Danger of Prescription Drug Abuse
Keloland TV
March 29, 2013

This article and video (2:54 minutes) discuss the dangers of prescription drugs, including being aware of side effects, using drugs responsibly, and disposing of leftover medication.

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Bill Aims at Studying Prescription Drug Abuse in High School and College Students
Port City Daily
March 31, 2013

North Carolina House Bill 351 would establish a 15-member Joint Legislative Commission on Prescription Drug Abuse by Students. The commission would study prescription drug abuse among high school and college students, its effects, and appropriate response strategies.

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Phoenix Sees Increase in Drug-Related DUI Offenses
Ahwatukee Foothills News
March 31, 2013

The Phoenix Police Department has seen an increase in driving-under-the-influence arrests after training officers to detect drivers abusing illegal and prescription drugs. Arrests included driving under the influence of medical marijuana, illegal drugs, and prescription drugs, including cases where pills were dispensed legally.

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ER Key to Curb Painkiller Abuse: Column
USA Today
March 31, 2013

The author, a primary care physician, discusses the need for tighter controls in emergency rooms. He recommends expanding the New York City approach to other hospitals throughout the country. Its New York City emergency room physicians no longer prescribe long-acting opioid pain relievers, fentanyl, or methadone, and patients receive no more than 3 days' worth of shorter-acting drugs. Also, doctors will not refill prescriptions that have been lost, stolen, or destroyed.

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Judge's Arrest Shines Light on Utah's Prescription Drug Abuse Problem
Deseret News
April 2, 2013

The Drug Enforcement Administration arrested a Salt Lake City Justice Court Judge for drug distribution after she received 338 oxycodone pills from Las Vegas via the U.S. Postal Service. Allegedly, she was planning to deliver the pills to someone else. The Utah Division of Substance Abuse and Mental Health's 2012 annual report shows an average of 23 Utahns die each month from prescription opioid abuse. Since 2000, the number of deaths due to pain medication overdoses has risen more than 400 percent.

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Police: Woman Used Her Dead Dog's Name to Fill Prescriptions in Palm Beach County
The Palm Beach Post
April 3, 2013

A 41-year-old Palm Beach woman was arrested for writing her dog's name on the prescriptions she had stolen from her former employer, a veterinarian. In total, 240 pills of hydrocodone/ acetaminophen mix were filled. When she tried to refill a prescription, the pharmacy sent a confirmation to the veterinarian's office. The doctor informed the pharmacy that the prescription was forged. The woman admitted wrongdoing and said she couldn't afford health insurance and needed the pills to treat her back injury.

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Give Health Canada Power to Require Post-Market Monitoring of Drug Safety: Senate Report
Toronto Star
April 3, 2013

Health Canada should be able to require better monitoring of prescription drugs and be more transparent about dangerous side effects, according to a Canadian Senate social affairs committee study. The report highlighted a number of problems, including how Health Canada collects and analyzes reports of adverse drug reactions and secrecy surrounding what the regulator learns (whether drugs are harmful, fatal, or ineffective for some patients). The report notes the limited amount of data on side effects that drug manufacturers can glean from a pre-market clinical trial given the small sample size compared with the general population. The report's recommendations include linking electronic health records to an adverse drug reaction reporting system and better public communication of agency knowledge about potential side effects.

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Is Your Loved One a Drug Addict?
Third Age
March 27, 2013

This article discusses prescription drug addiction among seniors. It lists signs to look for when individuals suspect their loved one is abusing prescription medication. The National Clearinghouse for Alcohol and Drug Information reports that 17 percent of adults age 60 and over abuse prescription drugs.

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New Definition of DUI Adds Tool for Law Enforcement
Trib Total Media
March 31, 2013

In 2004, when Pennsylvania changed its driving under the influence (DUI) laws to include the word "drug" (DUID), it allowed the prosecution of people impaired by any drug, including prescription medications. In 2012, about 15,000 of 50,000 DUI arrests were DUIDs, according to the Office of Pennsylvania Courts Now. A drug recognition expert and police officer train law enforcement officers to recognize classic signs and symptoms of drug-impaired drivers. They are seeing more prescription drug abuse, over-the-counter drug abuse, and designer drugs.

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VIDEO: Guam and CNMI Will Participate in Prescription Drug 'Take Back' Campaign April 27
Pacific News Center
April 2, 2013

Guam and the Commonwealth of Northern Mariana Islands (CNMI) will participate in the Drug Enforcement Administration's 2013 National Drug Take Back Campaign on April 27. Last year, Guam collected 82.5 pounds of unwanted prescription drugs; CNMI collected 87 pounds.

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UPS Agrees to Forfeit $40 Million in Payments From Illicit Online Pharmacies for Shipping Services
United States Attorney's Office, Northern District of California
March 29, 2013

This media release discusses a Non-Prosecution Agreement between UPS and the United States Attorney's Office for the Northern District of California. UPS agreed to forfeit $40 million in payments received from illicit online pharmacies and implement a compliance program designed to ensure illegal online pharmacies will not be able to use UPS's services to distribute drugs. From 2003-10, UPS was on notice, through some of its employees, that Internet pharmacies were using its services to distribute controlled substances and prescription drugs without valid prescriptions. Despite being notified, UPS did not implement procedures to close Internet pharmacy shipping accounts. UPS has already taken steps to prevent the problem from recurring.

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WAKE UP! Study Reveals 75 Percent of Teens Report Increased Knowledge From Prescription Drug Prevention Program
The Sacramento Bee
April 3, 2013

This press release from Touchstone Research Institute (TRI) says the WAKE UP! 2012 teen prescription drug abuse pilot program in five Florida and California schools is a success. TRI compared results with a benchmark survey of approximately 3,800 students, conducted prior to the program's launch. More than 75 percent of respondents were significantly more aware of the dangers of misusing and abusing prescription drugs. More than 90 percent of surveyed teens report understanding that people are at risk of harming themselves if they use others' prescription drugs. TRI's evaluation did not assess whether participants reduced initiation or 30-day prevalence of prescription abuse. WAKE UP! is a community educational campaign established by The Pain Truth to reduce prescription drug abuse among teenagers. The program uses science to educate teenagers about the effects and dangers of prescription drugs.

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National Rx Drug Abuse Summit: All That Is Missing Is You
April 2, 2013

The president and chief executive officer of WorkersCompensation.com discusses what his colleagues missed by not attending the National Rx Drug Abuse Summit, and the importance of joining the effort to help prevent prescription drug abuse.

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Putting a Face on Drug Abuse Death
April 2, 2013

This article shows a memory wall displayed at the National Rx Drug Abuse Summit as a reminder of those who lost their lives to prescription drugs and why attendees continue their efforts to reduce prescription drug abuse in their communities.

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Other Resources
2013 National Rx Drug Abuse Summit, April 2-4, 2013
Accessed April 9, 2013

PDF files of speaker presentations are available for the Summit. Printing instructions include creating a free account with Slide Share.

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Kentucky Permanent Prescription Drug Disposal Locations
Commonwealth of Kentucky
Accessed April 3, 2013

Kentucky listed 86 permanent prescription drug disposal locations in 53 counties as of March 20, 2013.

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National Take Back Initiative Collection Site Search
Drug and Enforcement Administration
Accessed April 5, 2013

People can search this database to find drop-off locations for the Fifth National Prescription Drug Take Back Day, April 27, 2013, from 10 a.m. to 2 p.m.

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National Conference of State Legislatures
Prevention of Prescription Drug Overdose and Abuse
March 2013

The National Conference of State Legislatures provides a summary of state legislation introduced in 2013 concerning prescription drug abuse issues.

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10 Things Parents May Not Know About Prescription Drugs
Narconon International

In its booklet, "10 Things Parents May Not Know About Prescription Drugs," Narconon International provides parents with a tool to facilitate conversation with their children about prescription drug abuse.

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Prescription Drug Fraud and Misuse
Problem-Oriented Guides for Police Series, Center for Problem-Oriented Policing

This technical assistance document provides guidance for local police departments and community coalitions that want to launch or improve enforcement efforts to curb prescription fraud and misuse. The document describes fraud and misuse, reviews factors that increase their risks, identifies a series of questions to help analyze the local problem, and reviews responses to the problem.

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http://www.popcenter.org/problems/prescription_fraud or
Archived Webinar
Lessons Employers Can Learn From the Quest Diagnostics Drug Testing Index
March 27, 2013
1 p.m. Central Daylight Time




Illegal Adderall on Campuses
AOL News
April 1, 2013

Students are popping Adderall and other drugs to stay focused and get good grades. (1:59 minute)

Study Drugs
The National Canadian Broadcasting Corporation
April 2, 2013

Students are using prescription medication as study drugs on university campuses. (8:17 minutes)


Taking Acetaminophen Safely
Food and Drug Administration
February 26, 2013

"Taking Acetaminophen Safely" is the latest installment of the Medicines in My Home series. It provides background about acetaminophen, a common over-the-counter pain reliever and fever reducer, and the many different types of medications that may contain acetaminophen. The video addresses the danger of taking more acetaminophen than directed; how to use the drug facts label to determine if acetaminophen is in a medicine; and how to safely take acetaminophen. It also encourages consumers to contact their healthcare professionals if they have questions or concerns. (2:03 minutes)


Prescription Drug Use in Canada
The Loop
March 27, 2013

A reporter explains why Ottawa is planning to unveil a prescription drug abuse strategy. (3:12 minutes)


Healthy Kids Minute: Teen Prescription Drug Abuse
March 14, 2013

The Vice President of Behavioral Health for Crozer-Keystone Health System talks about the dangers of prescription drug abuse among teenagers. (2:37 minutes)


Grant Announcement

Harold Rogers Prescription Drug Monitoring Program FY 2013 Competitive Grant Announcement
Deadline: May 2, 2013

Upcoming Conferences and Workshops

Heroin and Prescription Drug Diversion
April 12, 2013
Franklin, Wisconsin

Maryland Workers' Comp Prescription Drug Abuse Summit
April 12, 2013
Linthicum, Maryland

2013 Symposium for Medical Professionals: Kentucky Medical Communities UNITEd
April 13-June 8, 2013
Various Cities; Kentucky

Drug Enforcement Administration's Sixth National Prescription Drug Take-Back Day
April 27, 2013
Various Locations Nationwide

Pharmacy Diversion Awareness Conference
May 4 and 5 in Detroit, Michigan
June 22 and 23 in Chicago, Illinois
July 13 and 14 in Portland, Oregon
August 3 and 4 in Baton Rouge, Louisiana
August 16 and 17 in San Diego, California
August 18 and 19 in San Jose, California
September 21 and 22 in Boston, Massachusetts

The Drug Enforcement Administration (DEA) will host regional 1-day Pharmacy Diversion Awareness Conferences (PDACs). PDACs are designed to assist pharmacy personnel in identifying and preventing diversion activity. Each 1-day conference is open to pharmacists, pharmacy technicians, and loss prevention personnel employed by pharmacies or hospitals/clinics registered with the DEA.

Read more:
National Prevention Week 2013
May 12-18, 2013
Various Locations Nationwide

Prescription Drug Training
May 23, 2013
Reading, Pennsylvania

The Generation Rx University Conference for Prescription Drug Abuse Prevention and Recovery
August 7-8, 2013
Columbus, Ohio

2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2
Chicago, Illinois
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.
The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full-text journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.
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