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April 17, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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April 17, 2013 (PDF Version)

Featured Report
National Poll: Chronic Pain and Drug Addiction
April 2013

In a new public opinion poll, 52 percent of Americans said there should be limits on the amount and dosage of pain medication doctors are allowed to prescribe. Almost 50 percent of those surveyed said prescription drug addiction is a major U.S. health problem and 85 percent expressed concern about misuse. The survey sample size was 1,016.

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Journal Articles

D.J. Mastropietro and H. Omidian. 2013. "Current Approaches in Tamper-Resistant and Abuse-Deterrent Formulations." Informa Healthcare 39(5):611-24. doi:10.3109/03639045.2012.680468.
Researchers conducted a comprehensive literature search within Embase™ and Medline using the key words "abuse deterrent" and "tamper resistant" to identify relevant technologies. Only issued patents were examined using the phrase "abuse deterrent composition" searched through PatFT from the U.S. Patent and Trademark Office. Information from press releases and product innovator Web sites was obtained for additional data. Identified formulation approaches were separated into two categories: physical approaches and chemical approaches. Physical approaches were subcategorized into solids, gels, and non-intentionals, while chemical approaches were further broken down into agonists/antagonists, aversives, and metabolics. Among issued patents specifying an abuse-deterrent method, nine diverse approaches were found. Most formulations under development combined approaches and used proprietary technologies from pharmaceutical manufacturers. Prodrug and agonist/antagonist formulations are popular in marketed products, while solid and gel approaches are more recent additions. However, inclusion of aversive agents or enzyme inhibitors in a product is proving to be more difficult to develop.

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A. Rosenau. 2013. "Guidelines for Opioid Prescription: The Devil Is in the Details." Annals of Internal Medicine.

The president-elect of the American College of Emergency Physicians says restricting opioid prescription by emergency physicians will not resolve opioid misuse, which can be better addressed by closing corrupt pain centers and improving access to high-quality non-emergency care.

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News and Reports

In Drawdown, More Troops Booted for Rx Drug Offenses
Army Times
April 10, 2013

A naval nurse became addicted to prescription drugs and started stealing them from work. The case highlights a shift in the way military commanders are handling prescription drug abuse. They have increased screening and added new rules designed to deter, reduce, and punish illegitimate use. The Army also imposed a rule that limits prescription drug use to 6 months after the date of the prescription. Many military lawyers say commanders are ratcheting up enforcement of prescription drug rules to pare down force levels.

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Don't Punish People Who Really Need Painkillers
Los Angeles Times
April 9, 2013

Proposed limits on pain relievers shouldn't hurt people who need them, writes the author of this article. She explains the Food and Drug Administration's recommendations to reduce pills per prescription and make prescriptions harder to refill.

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OPINION: Employers Can and Should Take Actions to Stem Opioid Abuse
Business Insurance
April 7, 2013

Employers and workers' compensation managers can take action to reduce opioid abuse in the workplace. Ensuring patients are treated early and effectively, as well as implementing drug testing and screening procedures, are two parts of a risk-management plan that can prevent and address abuse. Nonmedical use of prescription pain relievers costs health insurers more than $70 billion each year.

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'Half' of the NFL Takes Adderall, Says Seahawks Cornerback Richard Sherman
Medical Daily
April 10, 2013

Fifty percent of NFL players take Adderall, according to Seattle Seahawks' cornerback Richard Sherman. A certified internist and addiction specialist questioned Sherman's statement, but suspects considerable misuse among athletes nonetheless. Players use the drug to increase energy and focus.

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'Sizzurp' Abuse on the Rise, Health Officials Warn
Canada TV News
April 8, 2013

Canadian health officials are concerned that youth are misusing over-the-counter (OTC) cough syrup to create a drink that mimics "Sizzurp," another highly abused concoction. Sizzurp consists of prescription cough syrup with codeine and promethazine, which is mixed with fruit juice or soda and sometimes sugary candy like Jolly Ranchers. The drink is also known as "purple drank" or "syrup." Because teens don't have access to prescription cough medicine, they use OTC cough medicine without realizing the active ingredient is not the same. Dextromethorphan, known as DXM and found in OTC cough remedies, can cause feelings of euphoria, blurred vision, numbness, and muscle spasms. Over time it can also lead to liver damage, hallucinations, and anxiety.

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First Do No Harm: Responding to Canada's Prescription Drug Crisis
Canadian Centre on Substance Abuse and National Advisory Council on Prescription Drug Misuse
March 2013
This report attempts to define the scope of Canada's prescription drug abuse crisis. It provides 10-year guidelines to reduce harms associated with such abuse in 58 comprehensive short- and long-term recommendations.

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Related Journal Article

A. Miller. 2013. "New National Strategy on Prescription Drug Abuse." Canadian Medical Association Journal. doi:10.1503/cmaj.109-4458.
This article briefly discusses First Do No Harm: Responding to Canada's Prescription Drug Crisis, a comprehensive report compiled by 46 members of a national advisory council, including pain and addiction specialists, researchers, pharmacists, and medical professionals. The strategy focuses on five areas: education, prevention, treatment, enforcement, and patient and physician monitoring.
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Bill Approved to Create Overdose-Review Team
April 10, 2013

West Virginia Senate Bill 108 establishes a team of professionals to track and analyze fatal prescription drug overdoses and other suspicious deaths. The review team will also document trends and patterns related to illegal sales and distribution of prescription drugs. Their findings will be compiled in an annual report issued to the governor.

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Wars on Drugs
The New York Times
April 6, 2013

The author, a psychiatrist and psychopharmacologist, discusses Tricare Management Activity--the Department of Defense division that manages healthcare services for the military--which shows a 682 percent increase in the number of psychoactive drugs prescribed to troops between 2005 and 2011. Data suggest military doctors may prescribe psychoactive drugs for off-label uses, without knowing whether such uses are effective or safe.

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Opioid Testing Helps Curb Workers Comp Claims
Business Insurance
April 10, 2013

Employers are concerned about growing numbers of workers impaired by prescription drugs. Experts say opioid testing is becoming more common among employers aiming to increase job safety and reduce workers' compensation costs, particularly in industries where heavy machinery is used.

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Bills Could Aid Drug Abuse Fight
April 5, 2013

West Virginia's Senate Bill 10 would allow more flexibility among the state's boards of medicine, osteopathy, and dental examiners to initiate disciplinary proceedings based on information received from physicians, hospital administrators, professional societies, and others about possible pill mills and rogue physicians. Senate Bill 11 would reclassify hydrocodone pain relievers sold under brand names Lortab and Vicodin, from a Schedule III to Schedule II controlled substance. The reclassification limits physicians to writing three 30-day prescriptions for the drug before requiring a patient to schedule a follow-up appointment.

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Using Study Drugs to Get Better Grades: Why You Should Think Twice
Huffington Post
April 9, 2013

This article describes study drugs--prescription stimulants such as Adderall and Ritalin used to treat attention deficit disorder and attention deficit hyperactivity disorder. College students take them to increase mental focus and productivity while studying. The article also discusses the drugs' long-term effects and risks of addiction and overdose death.

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New Survey Reveals Troops' Drinking, Drug Use
Marine Times
April 1, 2013

A new worldwide survey of active-duty troops showed fewer harmful behaviors than reports from 2008, with declining incidents of binge drinking, smoking, illegal drug use, and suicide attempts. About 25 percent of troops said they use prescription drugs, but only 1.3 percent reported misusing them in the past year compared with 2 percent in 2008. Respondents said steroids and stimulants are the most commonly abused medications.

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Students Seek Adderall for Academic Boost
The California Aggie
April 11, 2013

Adderall use and abuse among students at University of California, Davis are on the rise. Students admit using the drug to compensate for poor study habits and procrastination. Many get Adderall from friends and some are not worried about long-term effects.

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Update on Prescription Drug Misuse and Abuse: How We Are Making a Difference in Collier County
Naples News
April 7, 2013

This article provides facts on Florida's prescription drug misuse and abuse problems. There are warning signs to heed when someone is misusing prescription medication and steps to prevent abuse.

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When Your M.D. Is an Algorithm
The Wall Street Journal
April 11, 2013

Analytic companies that attended the National Rx Drug Abuse Summit in Orlando, Florida, are taking a data-driven approach to combat prescription drug abuse--combining medical research and guidelines with a computer algorithm to guide doctors in administering drugs to certain patients. The companies say their method will help lower healthcare costs, communicate principles of safe use, and identify potential pain medicine abuse before addiction begins. Some physicians are leery of the analysis programs and questioned whether the companies are more interested in lowering costs than in patient well-being.

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Painkillers Paved Way for New Addicts
Cape Cod Times
April 9, 2013

One man became addicted to prescription drugs after a motorcycle crash; another after suffering from a slipped disc more than 20 years ago. The video (4:50 minutes) provides a real-life depiction of prescription opioid dependency.

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OSU, Cardinal Health Tackle Prescription-Drug Abuse
The Columbus Dispatch
April 10, 2013

Ohio State University's College of Pharmacy and the Cardinal Health Foundation have introduced the fourth in a series of online toolkits to reduce prescription drug abuse among college students nationwide. Generation Rx University was created by and for college students and includes skits and scripts to facilitate conversations about misconceptions, realities, and dangers of prescription drug abuse.

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Humane Society Vet Suspects Drug Fraud
River Falls Journal
April 10, 2013

A veterinarian for the Sheboygan County Humane Society of Wisconsin was suspended after his license was allegedly used by the group's director to purchase pain relievers.

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Lock Up Your Lethals Campaign Addresses Prescription Drug Abuse and More
Redwood Times
April 9, 2013

The Humboldt County, California, Department of Health and Human Services launched a new campaign, Lock Up Your Lethals, encouraging parents to keep alcohol out of reach and set good examples for children by never combining the substance with prescription or over-the-counter medications. The campaign includes radio and television ads as well as a brochure to raise awareness about various hazards and potential solutions.

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Student Charged With Using Social Media to Sell Drugs
Orlando Sentinel
April 9, 2013

In Massachusetts, a Pentucket High School student was arrested for selling citalopram (an antidepressant) and Ritalin, using the popular mobile photo messaging service Snapchat. When a student's mother saw the Snapchat message advertising the drug sale, she alerted high school officials. Snapchat allows people to take photos and send them to others over the Internet. Messages disappear after a maximum of 10 seconds. However, recent online reports show there are ways to circumvent a message's short life span and keep them        

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Savage: Affordable Care Act Offers Opportunity to Combat Pain and Drug Abuse
Roll Call
April 5, 2013

The author, a physician, says it is critical for Congress to fund programs within the Affordable Care Act to improve chronic pain treatment and reduce prescription opioid abuse through comprehensive pain management. He says Congress must maintain funding for medical research despite recent budget cuts.

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Georgia Prescription Tracking System May Shut Down Months After Launch
The Atlanta Journal-Constitution
April 10, 2013

Startup funding for the Georgia Prescription Monitoring Program will expire on September 30. State lawmakers did not appropriate any funding for the program when they passed legislation to create it in 2011.

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Bill Lays Out Criminal Charges for 'Doctor Shopping'
Pelham Reporter
April 10, 2013

An Alabama bill would allow law enforcement to prosecute people for "doctor shopping." The bill proposes that initial violations result in Class A misdemeanors with fourth convictions over a 5-year period classified as Class C felonies.

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Doctors Too Busy to Be Concerned With Patient Safety
April 10, 2013

The president and CEO of WorkersCompensation.com says doctors are a key part of the addiction problem. They overprescribe prescription medications and only 20 percent use the prescription drug monitoring database.

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Task Force Focused on Combating Prescription Abuse
The Chippewa Herald
April 6, 2013

The 12 investigators on the Wisconsin West Central Drug Task Force handle an average of 350 cases each year. Their investigations stem from outside tips and the work of confidential informants. They also investigate prescription medication theft from healthcare providers and pharmacies, as well as residential cases.

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Drug Scene: Prescription Meds Biggest Challenge
Price County Daily
April 6, 2013

In an overview of prescription drug abuse in Wisconsin, two authors discuss doctor shopping and how the state's prescription monitoring database can help reduce this problem. Another challenge is the drugs users seek, which can easily be found. The article focuses on rampant abuse and the importance of properly disposing medications.

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Other Resources
Mayor Bloomberg Delivers Keynote Address at National Rx Drug Abuse Summit
April 3, 2013

Text and video (19:19 minutes) of Mayor Bloomberg's remarks at the Omni Orlando Resort in Florida.

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2013 National Rx Drug Abuse Summit
United States Food and Drug Administration
April 2, 2013

Read remarks from Dr. Margaret A. Hamburg, Commissioner of the Food and Drug Administration, at the 2013 National Rx Drug Abuse Summit in Orlando, Florida.

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What Your Brain Looks Like on Prescription Meds
April 11, 2013

Most of us think prescription drugs are safer than illicit drugs, but that's only true when they are taken exactly as prescribed and for their intended purpose. NBC's Dr. Nancy Snyderman explains how prescription medications like sleeping pills and pain relievers affect the brain.

Pill Nation: Are We Too Reliant on Prescription Meds?
April 10, 2013

Leading medical ethicists ask whether we are taking too many pills. (4:57 minutes)

Grant Announcement
Harold Rogers Prescription Drug Monitoring Program FY 2013 Competitive Grant Announcement
Deadline: May 2, 2013
Upcoming Conferences and Workshops
2013 Symposium for Medical Professionals: Kentucky Medical Communities UNITEd
April 27, May 11, 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
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, 2013
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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