West Virginia University Logo

April 16, 2015

PAW Weekly Update

SAMHSA Prescription Drug Abuse Weekly Update
Issue 118  |  April 16, 2015
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports National News International News Medical Marijuana Northeast/Mid-Atlantic News South News Midwest News West News Upcoming Webinars Grant Announcements Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


C.S. Davis, A.Y. Walley, and C.M. Bridger. 2015. "Lessons Learned from the Expansion of Naloxone Access in Massachusetts and North Carolina." The Journal of Law, Medicine and Ethics 43(s1):19–22, doi:10.1111/jlme.12208.

Legislative action was a key factor in the evolution of naloxone access in Massachusetts and North Carolina. But usage barriers remain in both states. First, healthcare providers often do not see prescribing and provision of naloxone as part of their duty to patients and families. Second, existing naloxone formulations require assembly (intranasal), pose a risk of needle stick injury (intramuscular), or come with a high cost (Evzio autoinjector). There is an urgent need for affordable and easily accessible formulations that require little training. Third, although naloxone kits are highly cost effective, they largely lack insurance coverage. Finally, naloxone's status as a prescription medication reduces access. The likely benefits of making it available over the counter warrant consideration.

Read more:

Colorado Marijuana Study Finds Legal Weed Contains Potent THC Levels
Bill Briggs, NBC News
March 23, 2015

Andy LaFrate, president of Charas Scientific, warned that Colorado's commercial marijuana generally contains little or no cannabidiol (CBD)—the compound that makes medical marijuana "medical." The average CBD level in commercial products is an astonishingly low 0.1 percent. LaFrate alerted parents that CBD levels in these products are too low to help control pediatric epilepsy. Worse, unusually high tetrahydrocannabinol (THC) levels in commercial products could trigger seizures. (Editor's note: The medical marijuana strain called Charlotte's Web claims its ratio is 30 CBD to 1 THC.) Among 600-plus samples provided by certified growers and sellers, the level of THC—the marijuana ingredient that produces a high—averaged 18.7 percent, compared with levels below 10 percent in traditional pot. THC potency in the high 20s is common, with some retail pot above 30 percent. The more than 600 samples were also often laced with contaminants. Some green buds were covered in fungi, and several marijuana flowers were "crawling," with up to 1 million fungal spores. "It's a natural product," LaFrate said. "There's going to be microbial growth on it no matter what you do. So the questions become, what's a safe threshold? And which contaminants do we need to be concerned about?" Testing of 200-plus pot extracts or "concentrates" revealed some contained solvents like butane. Charas Scientific is licensed by the state and paid by marijuana growers to measure THC strength before products go to market.

Read more:

Journal Articles and Reports

J.E. Brady, C.J. DiMaggio, K. Keyes, J.J. Doyle, L.D. Richardson, and G. Li. 2015. "Emergency Department Utilization and Subsequent Prescription Drug Overdose Death." Annals of Epidemiology, doi:10.1016/j.annepidem.2015.03.018.

This study compared 2,732 New York patients ages 18–64 who died from prescription drug overdoses during 2006–10 with 2,732 patients selected through incidence density sampling of emergency department (ED) discharge data. Adjusting for demographic characteristics and diagnoses of pain, substance abuse, and psychiatric disorders, the odds of prescription drug overdose death compared with patients who did not visit the ED or visited the ED once in the previous year were 4.9 for those who visited the ER twice, 16.6 for those who visited the ER three times, and 48.2 for those who visited the ER four or more times.

Read more:

A.A. Cavaiola, B.A. Fulmer, and D. Stout. 2015. "The Impact of Social Support and Attachment Style on Quality of Life and Readiness to Change in a Sample of Individuals Receiving Medication-Assisted Treatment for Opioid Dependence." Substance Abuse, doi:10.1080/08897077.2015.1019662.

Among 159 opioid-dependent survey respondents recruited from a New Jersey methadone-assisted opioid treatment program, social support predicted perceived improvement in health, family and social relationships, and abstinence. Attachment style did not predict improvement or readiness to change.

Read more:

K.R. Kerley, H. Copes, and O.H. Griffin. 2015. "Middle-Class Motives for Non-Medical Prescription Stimulant Use Among College Students." Deviant Behavior 36(7):589–603, doi:10.1080/01639625.2014.951573.

In semi-structured interviews, 22 college students who misused prescription stimulants reported they draw on what the authors label "conventional middle-class beliefs (e.g., success and moderation)" to make sense of their drug use. They use excuses and justifications rooted in "middle-class values" to create symbolic boundaries between themselves (as legitimate users) and others (as hedonistic users). This allows students to continue their illegal behavior while maintaining an identity as conventional citizens.

Read more:

R. Liccardo Pacula, D. Powell, and E. Taylor. 2015. "Does Prescription Drug Coverage Increase Opioid Abuse? Evidence from Medicare Part D." National Bureau of Economic Research Working Paper, No. 21072.

Medicare Prescription Drug Coverage (Medicare Part D) began in 2006. The Drug Enforcement Administration's Automation of Reports and Consolidated Orders System data indicate that prescription-opioid distribution increased faster thereafter in states with a larger fraction of people affected by Part D. Opioid-related substance abuse treatment admissions also increased. (Editor's note: These correlations are probably spurious, because the authors found the same states experienced significant growth in opioid abuse among the under-65 population.)

Read more:

S.S. Martins, J. Santaella–Tenorioa, B.D.L. Marshall, A. Maldonado, and M. Cerdá. 2015. "Racial/Ethnic Differences in Trends in Heroin Use and Heroin-Related Risk Behaviors Among Nonmedical Prescription Opioid Users." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.03.020.

National Survey on Drug Use and Health data from 2002 to 2005 and 2008 to 2011 indicate that people who used prescription opiates nonmedically in the past 6 months were twice as likely to report using heroin in 2008–11 as in 2002–05, with larger risk increases among non-Hispanic whites and Hispanics. During 2008–11, perceived heroin availability and risks of past-year heroin use, ever injecting heroin, and past-year heroin abuse or dependence rose as frequency of nonmedical use of prescription opiates increased.

Read more:


Proove Biosciences Launches World's First Test to Predict Responders to Opioid Pain Medications
April 7, 2015

Proove Biosciences launched Proove Opioid Response, the world's first clinical laboratory test claiming to predict responses to opioid pain medications. It assesses 49 genetic variations to give physicians information about the safety and effectiveness of five specific opioids: hydrocodone, oxycodone, morphine, tramadol, and hydromorphone. Proove says the test will improve clinical outcomes because patients will only be prescribed medications likely to work. The company also believes the test will improve economic outcomes, by avoiding expensive treatment failures and adverse drug events.

Read more:

New Rules Make It Easier to Dispose of Potentially Dangerous Painkillers
Consumer Report
April 6, 2015

Recent Drug Enforcement Administration (DEA) rules allow people to take prescription pain relievers and other medications to drop-offs at pharmacies, hospitals, clinics, and long-term care centers throughout the year. Consumer Reports suggests calling the DEA to find a drop-off location or checking its website. The new regulations also allow individuals to mail opioids and other medications to authorized collection centers. Pharmacies and other designated locations have approved packaging for mailing. This article provides information for an alternative: safely throwing away medications.

Read more:


OPP and Timmins Pharmacies and Organizations Launch Program to Keep Fentanyl off the Streets
Timmins Press
April 6, 2015

The Ontario Provincial Police's Drug Enforcement Unit launched the "Patch 4 Patch Initiative" in partnership with pharmacies and healthcare agencies in Timmins, Iroquois Falls, and Cochrane. The new program asks patients who have been prescribed fentanyl patches to return used patches to the pharmacy before receiving more.

Read more:


ASU Develops App to Determine Drug Impairment
Lindsey Reiser, KPHO/KTVK
April 7, 2015

Arizona State University (ASU) developed an app to measure marijuana impairment. The app, which will also be available on smart phones, assesses micro involuntary saccadic eye movement to reveal whether a particular portion of the brain is impaired. ASU plans to expand the program to test for heroin and prescription drugs.

Read more:

Medical Marijuana Still Polls Well in Florida After Amendment 2 Loss
Kevin Derby, Sunshine State News
April 6, 2015

Quinnipiac University released a poll showing 84 percent of Florida voters support patients' legal use of marijuana for medical purposes if prescribed by a doctor, while 14 percent oppose use. When asked if they support legalization of medical marijuana for recreational use, 55 percent said yes; 42 percent said no. Only 17 percent said they would "probably" or "definitely" use marijuana if it was legalized for recreational use. Quinnipiac found similar support for both recreational and medical marijuana in Ohio and Pennsylvania.

Read more:

Northeast/Mid-Atlantic News

Life-Saving Narcan Kits, Training Coming to Schools
Rachel Shapiro, Staten Island Advance
April 8, 2015

State funding of $272,000 will be used to provide New York school personnel with naloxone kits and training on their use.

Read more:

Pa. Drug Tracker Database Behind Schedule
Mary Wilson, NewsWorks
April 6, 2015

Pennsylvania's Department of Health said the new prescription drug monitoring program is delayed because funds were not appropriated to pay for it.

Read more:

Heroin Making Comeback in New York City, with Fatal Overdoses Outnumbering Homicides
Thomas Tracy, New York Daily News
April 4, 2015

Heroin deaths outpaced murders in New York for the second straight year in 2014—420 versus 335. The five neighborhoods with the most heroin deaths in 2013 were Fordham, Tremont, and Mott Haven in the Bronx, and Tottenville and Willowbrook in Staten Island.

Read more:

Pennsylvania Acting Secretary of Health Convenes First Achieving Better Care by Monitoring the All Prescriptions Program (ABC-MAP) Board Meeting
April 8, 2015

Pennsylvania Acting Secretary of Health Karen Murphy convened the first meeting of the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) Board. The board will help develop policies and procedures that expand the state's prescription drug monitoring program. Its next meeting is in May.

Read more:

Pennsylvania State Police to Carry Medication for Opioid Drug Overdoses
Karen Langley, Pittsburgh Post Gazette
April 7, 2015

After receiving training, Pennsylvania State Police will begin carrying naloxone kits in patrol cars. Insurance company grants provided the kits at no cost to police.

Read more:

County Sees Spike in Deaths from Overdoses, Suicides
Chauncey Ross, The Indiana Gazette
April 10, 2015

The number of 911 calls reporting suicide attempts and overdoses spiked in Indiana County, Pennsylvania.

Read more:

Medford Responds to Opioid Crisis as Overdoses Increase
Alex Ruppenthal, Medford Transcript
April 8, 2015

Massachusetts's Medford Board of Health is preparing a manual to send to area hospitals and doctors on safe prescribing practices. The manual includes information on how prescribers can refer patients for treatment. The board is training coaches on substance abuse and pain management—teaching strategies to help identify athletes who might be abusing medication. It is working with hospital officials to establish positions for case managers who would check in with patients following an overdose. Finally, it is developing social media and other marketing campaigns to address the stigma of addiction and promote the use of Narcan®.

Read more

South News

Growing Hepatitis Rates a Concern in W.Va.
Erin Beck and Lydia Nuzum, The Charleston Gazette
April 4, 2015

West Virginia has the highest rate of Hepatitis B and C infections in the nation. Hepatitis B tripled between 2013 and 2014 in six counties in the state's northwestern region. An estimated two thirds of individuals in those cases identified themselves as drug users.

Read more:

Fulton County Government Sues Multiple Drug Companies for Supplying and Distributing Prescription Drugs in GA at the Alleged Disregard of State Laws and Citizens' Welfare
April 6, 2015

Fulton County, Ga., is suing a conglomerate of companies that supply and distribute prescription drugs, for allegedly causing injuries and engaging in a course of conduct that violates state law. This civil action requests temporary and permanent injunctions mandating defendants to inform the Georgia State Board of Pharmacy about all suspicious orders for controlled substances, directing defendants to submit their system of determining suspicious drug orders, and enjoining defendants from distributing any controlled substance for an illegitimate medical purpose. The county also asked for reimbursement of litigation costs, a trial by jury, and to recover costs, losses, and damages.

Read more:

Sheriff, Congresswoman Announce Regional Heroin Initiative
Chris Gaudet, Leesburg Patch
April 6, 2015

Federal and local law enforcement agencies announced the assembly of a regional Heroin Operations Team (HOT) in Northern Virginia. HOT will address rising heroin use and related overdoses in and around Loudoun County. It will involve local, state, and federal law enforcement; County Public Schools; and the County Department of Mental Health, Substance Abuse and Developmental Services, among others.

Read more:

Ranks of Drug-Addicted Babies Growing in SW Florida
Frank Gluck, The News-Press
April 5, 2015

Neonatal abstinence syndrome cases at Lee County hospitals rose 24 percent between 2013 and 2014—affecting 114 babies. Cases have increased 1,325 percent since 2005, and about half of mothers were on methadone maintenance.

Read more:

Midwest News

Nearly 90 HIV Cases Reported in Scott County as Concerns About Outbreak Grow
Matt Adams, WTTV
April 7, 2015

Indiana health officials reported the HIV outbreak in southeastern Indiana is up to 89 cases. The outbreak has been linked to injection abuse of the prescription drug Opana. Indiana's health department started a needle exchange as part of its response, and has provided 168 needles thus far. An estimated 300 needles have been returned since March 30.

Read more:

Indiana House to Vote on Expanding Access to Narcan
Katie Heinz, RTV6
April 8, 2015

The Indiana House will vote on a bill to expand Narcan® access to family, friends, and others who know someone struggling with addiction. The bill would also allow these individuals to administer the drug. (Includes video: 2:24 minutes)

Read more:

New Federal Drug Czar Talks About Tackling Northern Kentucky's Heroin Epidemic
Tana Weingartner, WVXU/WMUB
April 9, 2015

At a Chamber of Commerce luncheon, National Drug Control Policy Director Michael Botticelli blamed Northern Kentucky's high heroin addiction numbers on pain medications being vastly overprescribed. He encouraged companies to help employees with opioid addiction and stressed the importance of developing community-based solutions. (Includes audio: 1:31 minutes)

Read more:

SIGCO Offers Free Drug Test Kits
Middlesboro Daily News
April 6, 2015

The Stand In the Gap Coalition (SIGCO) in Cumberland Gap, Tenn., is sponsoring a youth drug identification and testing program called Give Me A Reason (GMAR) in the tristate area. GMAR provides free saliva-based drug testing kits to parents for voluntary home use. Each kit contains a stamped envelope self-addressed to Operation UNITE and a form requesting test results (for positive tests, drugs will be specified). Parents of youths with positive tests are encouraged to contact their family doctor, family resource center, area hospital, health department, or other professional to discuss next steps.

Read more:

Lock Up Your Meds: Prescription Drug Abuse Sky High in West Michigan Community
April 6, 2015

Local officials urged a West Michigan community to lock up its prescription medications or dispose of them at the Branch County Sheriff's Department. Based on a 2012 study, Branch County had the highest rate of pain reliever abuse in Southwest Michigan. Pines Behavioral Health is working with the Branch County Substance Abuse Task Force to raise awareness about the problem. The organizers distributed 12,000 flyers describing the best ways to keep medications away from children. (Includes video: 2:23 minutes)

Read more:

West News

Bill Seeks to Reduce Prescription Drug-Related Deaths in California
Monica Luhar, KCET
April 7, 2015

California Assembly Bill 623 (AB623) would limit opioid access. Where an abuse-deterrent opioid analgesic drug product is available, AB623 would prohibit a healthcare service plan or insurer from requiring use of a formulation without abuse-deterrent properties. The bill would require a healthcare service plan or insurer to allow a provider to prescribe and, if otherwise covered, to provide coverage for, a less than 30-day supply of an opioid analgesic drug product. Finally, it would require pharmacists to inform patients prescribed opioids about proper storage and medicine disposal. (Includes video: 3:52 minutes)

Read more:

Upcoming Webinars

Nevada's Prescription Monitoring Program (PMP): Clinical Utility of Patient and Prescriber Reports
University of Nevada School of Medicine
May 13, 2015, 12 to 1 p.m.

This session will teach participants how to access and query Nevada's prescription drug monitoring program (PDMP), review national PDMP use trends and innovations, and determine the clinical utility of PDMP patient and prescriber reports.

Read more:


Be a Safe Prescriber: Illinois Prescription Monitoring Program (PMP) Update
Illinois Academy of Family Physicians, DuPage County Health Department
April 23, 2015, 12 to 1 p.m.


Grant Announcements

Comprehensive Media Campaign for Prescription Drug Abuse
State of Montana
Bid date and time: April 27, 2015, 2 p.m.

Prescription Drug Overdose Prevention for States
Centers for Disease Control and Prevention
Deadline: May 8, 2015

Harold Rogers Prescription Drug Monitoring Program FY 2015
United States Department of Justice
Deadline: May 28, 2015

Take-Back Events and Drop Boxes

TTU School of Pharmacy and Lubbock Co. VOICES Coalition to Host Medication Cleanout April 18
April 7, 2015

Household Hazardous Waste Event April 18
The Elk Valley Times (Tennessee)
April 3, 2015

Dump the Drugs Event Is April 25
The Daily Courier (Arizona)
April 9, 2015

Kentwood to Host Drug Take Back Day on April 25
Kristin Austin, MLive Media Group (Michigan)
April 10, 2015

Campaign Takes 43 Pounds of Unused Medication off the Streets
Christy Hart–Harris, The Daily Reporter (Michigan)
April 9, 2015

Arkansas Prescription Drug Take Back at UALR
Kelli Jacobi, University of Arkansas Little Rock
April 9, 2015

DPD Installs Prescription Take Back Unit
The Hartselle Enquirer (Alabama)
April 9, 2015

Record Setting Year for Take-Back Program
Ryan Delaney, WLFI (Indiana)
April 6, 2015

Orange Co. Sheriff's Dept. Has Dropbox for Unused Prescription and Over-the-Counter Drugs
WBIW (Indiana)
April 6, 2015

Agawam Offers Prescription Drug Drop Off Box at Police Station for Safe Disposal
Laura Newberry, MassLive (Massachusetts)
April 9, 2015

Rep. Levin in Royal Oak to Promote Safe Disposal of Rx Drugs to Combat Abuse
Michael P. McConnell, The Macomb Daily News (Michigan)
April 8, 2015

Wyoming and Metro Health Hospital to Hold Drug Take Back Day
Kristin Austin, MLive Media Group (Michigan)
April 9, 2015

Prescription Drug Take Back Event Planned
Brainerd Dispatch (Minnesota)
April 7, 2015

NEW Prescription Drug Drop-Off Box at Municipal Complex
Buena Vista Township (New Jersey)
April 8, 2015

Columbus Agency Organizes Medication Collection Day
Gary Seman Jr., ThisWeek Community News (Ohio)
April 6, 2015

Lancaster PD Holds Community Disposal Day
Logan Daily Press (Ohio)
April 8, 2015

Prescription Drug Receptacle Installed in East Ridge
The Chattanoogan (Tennessee)
April 6, 2015

Deer Park, Pasadena Police Collect Unused Prescriptions
The Pasadena Citizen (Texas)
April 6, 2015

Mission Police Post Prescription Drop-Off Box
Progress Times (Texas)
April 10, 2015

Community Joins in Prescription Drug Take Back Event
Heidi Baxley, Iron County Today (Utah)
April 8, 2015

Upcoming Conferences and Workshops

48th Annual Communicating Nursing Research Conference—Equity and Access: Nursing Research, Practice, and Education
Western Institute of Nursing
April 22–25, 2015
Albuquerque, New Mexico

Training: Engaging Youth in Rx Drug Abuse Prevention
Health Resources in Action and Blake Works
May 7–8, 2015
Boston, Massachusetts


Pharmacy Diversion Awareness Conferences
Drug Enforcement Administration, Office of Diversion Control
May 30–31, 2015: Norfolk, Virginia
June 27–28, 2015: Oklahoma City, Oklahoma

International Conference on Opioids
Harvard Medical School
June 7–9, 2015
Boston, Massachusetts


Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
The Weekly Update 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 viewpoint or opinion and are not assessed for validity, reliability or quality. The Weekly Update 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 of journal articles listed in the Weekly Update.