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April 23, 2015

PAW Weekly Update

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 119  |  April 23, 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 Journal Articles and Reports PROFESSIONAL EDUCATION AND OPINIONS National International Medical Marijuana Northeast/Mid-Atlantic News South News Midwest News West News Other Resources Upcoming Webinars Grant Announcements Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

WEBINAR: MARK YOUR CALENDAR

Responding to the Prescription Misuse Epidemic: Promising Prevention Programs and Useful Resources
Substance Abuse and Mental Health Services Administration (SAMHSA)
May 20, 2015, 2 p.m. EDT

This National Prevention Week Webinar will describe the relationship between prescription opiates and heroin, discuss alternatives to opiates for acute and chronic pain treatment, explain how to determine when an individual might have an opiate problem, review the problems of prescription drugs in the workplace and community, mention medical marijuana, and describe the youth "study drug" epidemic. The Webinar will close with a review of promising prevention efforts focused on community-based prescription misuse, and SAMHSA fact sheets and tools that support those efforts.

The presenters are Deborah Galvin, Ph.D., SAMHSA; Georgia Karuntzos, Ph.D., RTI International; Sandra Lapham, M.D., Behavioral Health Research Center; Ted Miller, Ph.D., PIRE; and Christopher Ringwalt, Ph.D., University of North Carolina Injury Prevention Research Center.

Registration details to follow.


FEATURED

Congressman Richard Neal Introduces Bill to Limit Lawsuits in the Administration of Opioid Overdose Drugs
Anne–Gerard Flynn
April 17, 2015

Bipartisan legislation introduced in the U.S. House and Senate would exempt prescribers and people prescribed naloxone from civil liability for administering the drug during an emergency. Senators Edward Markey (D–Mass.), Kelly Ayotte (R–N.H.), and Tim Kaine (D–Va.) are sponsors of S. 707, the Opioid Overdose Reduction Act of 2015. House sponsors are Richard Neal (D–Mass.), Barbara Comstock (R–Va.), and Frank Guinta (R–N.H.). Among others, the bill is endorsed by Trust for America's Health, the American Medical Association, the American Psychiatric Association, the Association of State and Territorial Health Officials, the Community Anti-Drug Coalitions of America, the American Society of Addiction Medicine, the Harm Reduction Coalition, the New Hampshire Association of Chiefs of Police, the Massachusetts Sheriff's Association, the American Medical Response (America's largest ambulance provider), and the American Ambulance Association.

Read more:
http://www.masslive.com/news/index.ssf/2015/04/congressman_richard_neal_intro.html

M. Soledad Cepeda, D. Fife, J. Berwaerts, A. Friedman, Y. Yuan, and G. Mastrogiovanni. 2015. "Doctor Shopping for Medications Used in the Treatment of Attention Deficit Hyperactivity Disorder: Shoppers Often Pay in Cash and Cross State Lines." The American Journal of Drug and Alcohol Abuse, doi:10.3109/00952990.2014.945591.

Analysis of the LRx U.S. retail prescription database identified 4,402,464 people with attention deficit hyperactivity disorder (ADHD) medication that was dispensed in 2011 or 2012 for 18 months. Of that group, 0.4 percent (18,000 people) began doctor shopping. Women were more likely to become doctor shoppers. To fill ADHD prescriptions, shoppers traveled a median of 91.9 miles; non-shoppers traveled 0.2 mile. Almost 28 percent of doctor shoppers filled prescriptions in more than one state, compared with 4.3 percent of non-shoppers. (Editor's note: These findings may simply mean doctor shopping is more common among college students who do not live at home.) Of shoppers, 27.3 percent paid for at least one prescription with cash, compared with 14.4 percent of non-shoppers.

Read more:
http://informahealthcare.com/doi/abs/10.3109/00952990.2014.945591

Journal Articles and Reports

E.A. Austic. 2015. "Peak Ages of Risk for Starting Nonmedical Use of Prescription Stimulants." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.03.034.

Consistent with other studies, analysis of 2004–12 National Survey on Drug Use and Health data showed risk of initiating nonmedical use of prescription stimulants was highest between ages 16 and 19, when 0.7 to 0.8 percent of young people begin using annually. Females were more likely than males to be nonmedical users (odds ratio = 1.35).

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871615001908

P. Dietze, S. Cogger, D. Malandkar, A. Olsen, and S. Lenton. 2015. "Knowledge of Naloxone and Take-Home Naloxone Programs Among a Sample of People Who Inject Drugs in Australia." Illicit Drug Reporting System: Drug Trend Bulletin.

According to 2013 and 2014 Illicit Drug Reporting System surveys of urban Australians who inject drugs, 85 percent know about naloxone and correctly report its function. Some have used the drug for more than 40 years. Thirty-seven percent—mainly residents of jurisdictions with current programs—were familiar with take-home naloxone programs. Of 1,523 respondents, 175 (11.5 percent) had been revived with naloxone. Respondents with naloxone prescriptions and training rose from 7 percent in 2013 to 12 percent in 2014. The 61 respondents with naloxone training in 2013 had revived 17 people. Ninety-six respondents with naloxone training in 2014 had revived 36 people.

Read more:
http://ndarc.med.unsw.edu.au/resource/knowledge-naloxone-and-take-home-naloxone-programs-among-sample-people-who-inject-drugs

S.W. Patrick, J. Dudley, P.R. Martin, F.E. Harrell, M.D. Warren, K.E. Hartmann, E. Wesley Ely, C.G. Grijalva, and W.O. Cooper. 2015. "Prescription Opioid Epidemic and Infant Outcomes." Pediatrics, doi:10.1542/peds.2014-3299.

Linking Tennessee Medicaid prescription and administrative data for 2009–2011 to vital statistics birth data revealed that 31,354 of 112,029 pregnant women (28 percent) filled at least one opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3 percent vs. 2.7 percent), to have anxiety (4.3 percent vs. 1.6 percent), and to smoke tobacco (41.8 percent vs. 25.8 percent). The study reviewed medical records to validate a random sample of neonatal abstinence syndrome (NAS) cases. In multivariate regression, NAS risk rose with higher cumulative opioid exposure for short-acting preparations, selected opioid types, number of cigarettes smoked daily, and selective serotonin reuptake inhibitor use. Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2 percent vs. 11.8 percent vs. 9.9 percent).

Read more:
http://pediatrics.aappublications.org/content/early/2015/04/08/peds.2014-3299.abstract

M.J. Sharp and T.A. Melnik. 2015. "Poisoning Deaths Involving Opioid Analgesics—New York State, 2003–2012." Morbidity and Mortality Weekly Report 64(14):377–80.

Analyzing 2003–12 New York multiple-cause-of-death data and Medicaid enrollment data showed deaths involving opioid analgesics increased both in number and as a percentage of all drug-poisoning deaths. Rates were highest among men, whites, people ages 45–64, those residing outside of New York City, and Medicaid enrollees. In 2012, 70.7 percent of deaths involving opioid analgesics also involved at least one other drug—most frequently a benzodiazepine.

Read more:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a2.htm?s_cid=mm6414a2_w

T.A. Simpatico. 2015. "Vermont Responds to Its Opioid Crisis." Preventive Medicine, doi:10.1016/j.ypmed.2015.04.002.

This article describes how Vermont is addressing its opiate crisis. The state has embraced long-term medication-assisted therapy, but it sees a need for cost–benefit analysis of this strategy. Vermont believes added treatment costs are offset by reductions in other healthcare costs.

Read more:
http://www.sciencedirect.com/science/article/pii/S0091743515001024

R.J. Smith, K. Rhodes, B. Paciotti, S. Kelly, J. Perrone, and Z.F. Meisel. 2015. "Patient Perspectives of Acute Pain Management in the Era of the Opioid Epidemic." Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2015.03.025.

This article reports on semi-structured, open-ended telephone interviews with 23 patients (mostly women) discharged from a Philadelphia academic emergency department after presenting with acute pain related to fracture, renal colic, or musculoskeletal back injury. From the patients' perspective, emergency physicians typically did not present alternative pain management options or discuss risks of opioid dependence. Patients with negative experiences related to pain management described deficiencies in patient–provider communication, which led to misunderstanding of clinical diagnoses, fragmentation of care among their healthcare providers, and a desire to be involved in the decision-making process for pain management. Patients with positive experiences commented on regular communication with their care team, rapid pain management, and the empathetic nature of their care providers. The patients communicated their fears about opioid addiction risks, their beliefs that following a prescribed opioid regimen would prevent opioid dependence, and their understanding of the broader tensions providers face related to opioid therapy.

Read more:
http://www.annemergmed.com/article/S0196-0644(15)00232-2/abstract

PROFESSIONAL EDUCATION AND OPINIONS

C.M. Farmer, D. Lindsay, J. Williams, A. Ayers, J. Schuster, A. Cilia, M.T. Flaherty, T. Mandell, A.J. Gordon, and B.D. Stein. 2015. "Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process." Substance Abuse, doi:10.1080/08897077.2015.1012613.

An expert panel developed and updated 65 guideline statements for treating opioid use disorders with buprenorphine. Panel members disagreed about appropriate buprenorphine dosing by patient type.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25844527

P.A. O'Malley. 2015. "Opioid Abuse, Misuse, and Death: The Promises and Limitations of Drug Barrier Technology Now and in the Future." Clinical Nurse Specialist 29(3):139–42, doi:10.1097/NUR.0000000000000130.

The Food and Drug Administration recently approved explored drug barrier technology and extended-release formulations of single-entity hydrocodone—a drug with a history of abuse and misuse dating back to the 1940s.

Read more:
http://journals.lww.com/cns-journal/Citation/2015/05000/Opioid_Abuse,_Misuse,_and_Death__The_Promises_and.6.aspx

A.M. Orkin, K. Bingham, M. Klaiman, P. Leece, J.E. Buick, F. Kouyoumdjian, L.J. Morrison, and H. Hu. 2015. "An Agenda for Naloxone Distribution Research and Practice: Meeting Report of the Surviving Opioid Overdose with Naloxone (SOON) International Working Group." Addiction Research and Therapy 6:1, doi:10.4172/2155-6105.1000212.

The Surviving Opioid Overdose with Naloxone International Working Group identified key steps and challenges for developing rigorous, pragmatic trials of naloxone distribution in various clinical settings. The working group discussed emerging naloxone delivery devices and technologies and described how these devices may alter standards of care for overdose prevention research and practice. They also developed bystander resuscitation protocols for opioid-associated resuscitative emergencies, identified strategies to overcome knowledge translation barriers for patients and providers, and suggested elements essential for effective educational tools and program implementation.

Read more:
http://omicsonline.org/open-access/an-agenda-for-naloxone-distribution-research-and-practice-meeting-report-ofthe-surviving-opioid-overdose-with-naloxone-soon-international-workinggroup-2155-6105-1000212.php?aid=42019

M.T. Schechter. 2015. "Drug Users Should Be Able to Get Heroin from the Health System." BMJ 350:h1753, doi:10.1136/bmj.h1753.

Dr. Martin Schechter was principal investigator of the North American Opiate Medication Initiative (NAOMI) trial conducted in British Columbia. The trial randomly assigned persistent addicts to receive either prescribed heroin or standard treatment. Dr. Schechter argues that a small subset of heroin addicts, who have not had success with traditional methods, should be prescribed heroin. Six randomized controlled trials in Europe and Canada have shown heroin-assisted treatment is more effective for this group of addicts than conventional therapies. The NAOMI trial, for example, found people taking prescribed heroin used fewer illicit drugs and were involved in less criminal activity. Although direct treatment cost is about four times higher than conventional therapies, the NAOMI study discovered that heroin-assisted therapy led to better outcomes at an overall lower societal cost than methadone maintenance. The Randomised Injectable Opiate Treatment Trial in Britain also found heroin-assisted therapy was more cost effective than oral methadone.

Read more:
http://www.bmj.com/content/350/bmj.h1753

National

Kaine Urges Funding to Combat Prescription Drug Abuse Crisis
Political News
April 11, 2015

Eighteen U.S. senators sent a letter to Senate appropriators, urging them to increase funding in fiscal year 2016 for prescription drug abuse prevention, treatment, and research programs at the Department of Health and Human Services.

Read more:
http://politicalnews.me/?id=33171&keys=HHS-DRUG-OVERDOSE-PREVENTION

International

Funding for Addictions Prevention and Treatment Services in First Nations Communities Across Canada
Health Canada
April 14, 2015

The Canadian government plans to invest $13.5 million over the next 5 years to enhance prevention and treatment for prescription drug abuse within First Nations communities. The Saskatchewan First Nations and its partners will receive more than $2.6 million for existing treatment centers to tailor effective interventions and enhance support for people struggling with prescription drug addiction.

Read more:
http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=112813#.VS5o1mnwvoY

A Pill for Work and Play
The Economist Newspaper Limited
April 18, 2015

Tramadol has become Egypt's favorite recreational drug. Taxi drivers take it to stay awake, men take it to improve their sexual prowess, petty officials readily accept it as a bribe, and wedding guests receive it as a favor. Until recently, tramadol was selling for one or two Egyptian pounds a pill ($0.15–$0.30). A rehabilitation center in Cairo said at least 40 percent of its clients are addicted, and the problem is getting worse.

Read more:
http://www.economist.com/news/middle-east-and-africa/21648690-painkiller-becomes-egypts-favourite-recreational-drug-pill-work-and-play

MEDICAL MARIJUANA

O. Marie and U. Zölitz. 2015. "'High' Achievers? Cannabis Access and Academic Performance." IZA Discussion Paper No. 8900.

This robust study found cannabis lowers college grades. From October 1, 2011, to May 1, 2012, the association of cannabis shop owners in the Dutch university town of Maastricht (under pressure from local authorities) only sold to Dutch, German, and Belgian customers. Sales restrictions primarily targeted drug tourists from France and Luxembourg, but as a byproduct, stopped sales to more than 1,000 Maastricht University students. Researchers applied a difference-in-difference approach using administrative panel data on more than 57,000 course grades of students enrolled at the university before and during the partial cannabis prohibition. Academic performance of students who were no longer legally permitted to buy cannabis increased significantly. Their grades rose by about 2 percent, and their course failure rate decreased 16 percent. Grade improvements were driven by younger students, and effects were stronger for women and low performers. In line with how THC consumption affects cognitive functioning, performance gains were larger for courses that required more numerical/mathematical skills. Based on students' course evaluations, performance gains appear to be driven by improved understanding of material, not changes in study efforts.

Read more:
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2582535

No Clarity on Conflicting Laws as Judge Keeps Marijuana on List of Harmful Drugs
Alan Schwarz, The New York Times
April 15, 2015

Judge Kimberly Mueller of the U.S. District Court in Sacramento declined to remove marijuana from the Drug Enforcement Administration's Schedule I list—substances classified as having no currently accepted medical use and a high potential for abuse. Judge Mueller ruled that adjustments to the law were better left to Congress. Her decision to hold the hearing was in response to a pretrial defense motion in a federal case against alleged marijuana growers. She will continue to preside over the case.

Read more:
http://www.nytimes.com/2015/04/16/us/federal-judge-keeps-marijuana-on-list-of-most-dangerous-drugs.html?ref=us&_r=0

Colorado Moving to Allow Pot Use by People on Probation
Kristen Wyatt, Associated Press
April 10, 2015

Colorado's House Judiciary Committee approved a proposal that would allow people on probation or parole to use medical marijuana. The change would not apply to probationers whose crime was related to marijuana. In 2012, Colorado's Court of Appeals ruled that people on probation should not be allowed to use medical marijuana. Recently, Arizona's highest court ruled marijuana patients in Arizona should be allowed to use the drug while on probation or parole. Rhode Island and the Virgin Islands also allow probationers to use medical marijuana. California law specifies that anyone on parole can ask the courts for permission to smoke medical marijuana after being released from jail or prison.

Read more:
http://abcnews.go.com/US/wireStory/colorado-considers-marijuana-people-probation-30201522

House Passes Marijuana Revisions
Jim Camden, The Spokesman-Review
April 10, 2015

The Washington House passed the Cannabis Patient Protection Act, which requires medical marijuana patients to register in the state's database and pay taxes on products they purchase from state-licensed stores. The bill eliminates medical marijuana dispensaries, shifting their products into the state's recreational dispensaries. It allows individuals to grow and process pot or form small collectives to share it. The House passed a separate bill permitting medical users to buy marijuana without paying the excise taxes on pot sold in state-licensed stores. To avoid taxes, medical users can also grow it themselves. The bill replaces excise taxes on growers and processors with a single excise tax paid by recreational purchasers at the store. It gives local governments a small portion of tax revenues each year (based on sales), but limits their ability to restrict marijuana businesses. Any local ban would have to be approved by voters. Both bills head to the Senate.

Read more:
http://www.spokesman.com/stories/2015/apr/10/house-passes-marijuana-revisions

Nevadans, Dispensaries Face Longer Wait for Medical Pot
Eric Hartley, Las Vegas Review-Journal
April 10, 2015

Nevadans have to wait a little longer to purchase marijuana from legal dispensaries. It could take months before the Independent Laboratory Advisory Committee sets workable pesticide limits, and even longer before the first marijuana crops are ready. Nevada regulation requires marijuana tested in state-licensed labs must meet the "most stringent acceptable standard for an approved pesticide chemical residue in any food item" under federal rules. The delay affects the 9,000 Nevadans who already have patient cards. Almost 6,500 cardholders are in Clark County.

Read more:
http://www.reviewjournal.com/news/pot-news/nevadans-dispensaries-face-longer-wait-medical-pot

Marijuana Legalization Across U.S. May Hinge on 2016 California Vote
Alison Vekshin, Bloomberg
April 13, 2015

All eyes will be on California next year as residents vote whether to allow recreational marijuana use. California is among at least five states, including Massachusetts and Maine, where legalization measures are likely to appear on ballots in November 2016. Both advocates and opponents said California is the key battleground, where success or failure is likely to determine whether most of the country decriminalizes the drug for recreational use.

Read more:
http://www.bloomberg.com/politics/articles/2015-04-13/pot-legalization-across-u-s-may-hinge-on-2016-california-vote

Area Legislators Ready for Session
Zane Hill, The Daily Iberian
April 12, 2015

Louisiana State Senator Fred Mills introduced Senate Bill 143, which would facilitate development of a legal distribution system for medical marijuana. The bill would authorize the Louisiana Board of Pharmacy to develop rules "relating to the production and dispensing of prescribed marijuana for therapeutic use," and require the board to seek input from the Louisiana District Attorneys Association, the Louisiana Sheriff's Association, the Louisiana Commission on Law Enforcement and Administration of Criminal Justice, and the state Department of Agriculture and Forestry. The bill would also authorize the Louisiana State Board of Medical Examiners to promulgate rules authorizing physicians licensed in the state to prescribe marijuana. SB 143 includes language that bars smoking or inhaling marijuana.

Read more:
http://www.iberianet.com/news/area-legislators-ready-for-session/
article_f5ea7f0a-e0ce-11e4-8df0-7f151f472601.html


Senate Passes Medical Marijuana Expansion Bill
Marcus Macintosh, KCCI
April 16, 2015

The Iowa Senate passed an expansion of the medical marijuana law that would allow treatment of debilitating medical conditions other than epilepsy. SF484 defines debilitating medical conditions as cancer, multiple sclerosis, epilepsy, AIDS or HIV, glaucoma, hepatitis C, Crohn's disease or ulcerative colitis, amyotrophic lateral sclerosis, Ehlers–Danlos syndrome, post-traumatic stress disorder, and severe, chronic pain caused by an underlying medical condition that has not responded to conventional treatment. The bill also sets up a system for medical cannabis dispensaries in Iowa. Twelve dispensaries would be licensed by April 1, 2016. (Includes video: 2:15 minutes)

Read more:
http://www.kcci.com/news/senate-debating-medical-marijuana-expansion-right-now/32380786

Northeast/Mid-Atlantic News

10 Heroin Overdoses in 24 Hours; Pittsburgh Officials Fear Could Only Be Beginning
WPXI
April 16, 2015

Pittsburgh police responded to 10 heroin overdoses that resulted in two deaths within a 24-hour span. Five overdoses occurred within 5 hours. Three victims responded positively to Narcan®, but the other two were taken to the hospital and later died. Stamp bags with the word "predator" and a photo of a shark were found at several scenes. Narcotics agents are awaiting test results from the lab to determine what the heroin contained. (Includes video: 1:40 minutes)

Read more:
http://www.wpxi.com/news/news/local/pittsburgh-police-respond-4-heroin-overdoses-withi/nktR4

New App Allows Doctors, Pharmacists to Track Potential Prescription Drug Abuse
Stephanie Akin, The Record
April 13, 2015

New Jersey officials said doctors and pharmacists can now use smart phones to track patients who might be abusing prescription drugs. The new app allows registered users to access the state's Prescription Monitoring Program. The app—the first of its kind in the country—is available for free through iTunes. Android and Windows Mobile versions will be introduced this summer.

Read more:
http://www.northjersey.com/news/new-app-allows-doctors-pharmacists-to-track-potential-prescription-drug-abuse-1.1308083

Babies Born to Women Abusing Opioids on the Rise in R.I.
Linda Borg, The Providence Journal
April 12, 2015

Rhode Island's Annual Kids Count Factbook reported that in 2013, 76 babies in the state were diagnosed with neonatal drug abstinence or fetal alcohol syndrome—nearly double the rate in 2006. This is the first time Rhode Island Kids Count has covered the topic.

Read more:
http://www.providencejournal.com/article/20150412/NEWS/150419761

Exclusive: Staten Island Cops Will Not Count or Touch Prescription Pills Left in Borough's Anonymous Drop-Off Boxes
Reuven Blau, New York Daily News
April 15, 2015

The Staten Island Police Department said its officers will not tally or touch unwanted prescription medications discarded in anonymous drop-off boxes at the borough's four police stations. The department's property clerk will process the potentially dangerous drugs.

Read more:
http://www.nydailynews.com/new-york/s-cops-won-count-prescription-pills-drop-off-boxes-article-1.2185557

Stoneham Yet to Record Fatal Opiate Overdose in 2015
Patrick Blais, The Stoneham Independent
April 16, 2015

A total of 21 fatal opiate overdoses occurred in Stoneham, Mass., between 2003 and 2012. In fiscal year 2014, the state's Bureau of Substance Abuse Services provided treatment services to 250 Stonehamites, with 60 percent treated for opioid addiction. Stoneham sits in Middlesex County, where the fatal overdose trend has sharply increased. In 2013, 167 people in Middlesex died from opiate abuse—a 40 percent increase from 2003 and a threefold increase from 2000.

Read more:
http://homenewshere.com/stoneham_independent/news/article_bba6edcc-e44a-11e4-8e67-073d8c6107e5.html

Stoughton Shown as National Model to Prevent Overdoses
Stoughton Journal
April 14, 2015

The Prescription Drug Abuse Summit featured Stoughton, Mass., as a national model for overdose prevention. Stoughton was able to put Narcan® in every police cruiser by acquiring a medical director who would provide training and a standing order to resupply the drug. The Stoughton model was replicated by departments throughout Norfolk County. Money forfeited by drug dealers was used to purchase the 900 doses of naloxone given to 28 communities.

Read more:
http://stoughton.wickedlocal.com/article/20150414/NEWS/150418220

South News

Drug Infractions Among Miners Aren't Falling Despite Penalties
Chris Lawrence, West Virginia MetroNews Network
April 14, 2015

The West Virginia Office of Miners' Health, Safety, and Training reported that 724 coal miners have been decertified since January 1, 2013, with 330 decertifications in 2013, another 316 in 2014, and 78 to date in 2015. The protocol on a first offense includes offering a plea agreement in which the miner can seek treatment and regain certification after a suspension of 1 to 12 months. On the second positive test, individuals are permanently decertified, but they can appeal. Eugene White, the agency's director, said most problems involve prescription drug misuse. Under the original rule, miners covered by collective bargaining agreements with the United Mine Workers of America could take their cases before an arbitrator and possibly be reinstated, regardless of the law. Effective June 2, all miners, union and non-union, will be treated the same under the provisions set forth in the legislation.

Read more:
http://wvmetronews.com/2015/04/14/positive-drug-tests-among-miners-growing-workers-lose-certification

At Least 13 People in Richmond Area Hospitalized After Ingesting 'Bad' Heroin
Tammie Smith, Richmond Times-Dispatch
April 10, 2015

After ingesting heroin mixed with clenbuterol, a veterinary drug, at least 13 people in the Richmond area have been hospitalized. The Virginia Poison Center notified state health officials in March after receiving calls about patients who were hospitalized for unusually bad heroin reactions. The State Health Commissioner sent out an alert on March 26 asking healthcare providers to watch for cases.

Read more:
http://www.richmond.com/news/local/article_9145cda4-4642-
52c5-924e-fa8117441ceb.html


Orange and Osceola Drug Deaths Up by 26 Percent
Naseem S. Miller, Orlando Sentinel
April 16, 2015

Drug deaths in Florida's Orange and Osceola counties increased by 26 percent between 2013 and 2014, driven partly by heroin and fentanyl use. Accidental drug deaths in the two counties totaled 209 in 2014—increasing from 166 in 2013—and were nearly on par with the number of deaths associated with motor vehicle and pedestrian accidents. Most deaths occurred among 20- to 30-year-olds. The 34 deaths associated with fentanyl use almost doubled the 18 deaths in 2013. Heroin deaths increased to 89 from 49 deaths in 2013, 26 in 2012, and 19 in 2011. One hundred and twelve people died from prescription drug overdoses in 2014 compared with 103 in 2013.

Read more:
http://www.orlandosentinel.com/health/os-central-florida-heroin-deaths-increase-20150416-story.html

Governor's Substance Abuse Regional Task Force Schedules Meetings May 4–12 Throughout West Virginia
The State Journal
April 13, 2015

Round 16 of the Governor's Substance Abuse Regional Task Force meetings will be held at locations throughout West Virginia starting May 4. The Round 16 learning session will focus on treatment approaches to the opioid epidemic, including abstinence-based treatment and medication assisted treatment.

Read more:
http://www.statejournal.com/story/28786258/governors-substance-abuse-regional-task-force-schedules-meetings-may-4-12-throughout-west-virginia-opioid

BNPD Assists with Passage of Revised Prescription Drug Monitoring Program
Benton Police Department
April 14, 2015

Benton police were part of a group that amended the Arkansas prescription monitoring program law to grant law enforcement limited access to data on cases related to prescription drug abuse. Act 901 of 2015 was signed into law on April 11, 2015.

Read more:
http://www.thv11.com/story/news/crime/2015/04/14/benton-police-prescription-drug-monitoring-program/25777683

Midwest News

Rural Outbreak of HIV Among Indiana Drug Users Hits 106
The Ohio Dispatch
April 11, 2015

Public health officials reported that an HIV outbreak in Scott County, Ind., related to intravenous prescription drug abuse has reached 106 confirmed and preliminary cases.

Read more:
http://www.dispatch.com/content/stories/national_world/2015/
04/11/Rural-outbreak-of-HIV-among-Indiana-drug-users-hits-106.html


Overdose Antidote Could Soon Be in Indiana Households
Gina Glaros, WTHI
April 14, 2015

The Indiana house has approved Aaron's Law, which would allow people to get a prescription and administer Narcan® at home. The bill heads back to the Senate for final approval. This measure would become effective immediately if signed by the governor. (Includes video: 1:54 minutes)

Read more:
http://wthitv.com/2015/04/14/overdose-antidote-could-soon-be-in-indiana-households

West News

OBN: Prescription Drugs Killing More Oklahomans Than Ever Before
Kim Passoth, KOCO
April 16, 2015

In 2014, 864 Oklahomans died from a drug-related overdose, making it the deadliest year on record. At least 72 percent of deaths were connected to prescription drug abuse. (Includes video: 1:39 minutes)

Read more:
http://www.koco.com/news/OBN-Prescription-drugs-killing-more-Oklahomans-than-ever-before/32411422

Survey Looks at Drug Use by Students
North County Outlook
April 15, 2015

The 2014 Healthy Youth Survey revealed that prescription drugs, heroin, and cocaine remain a problem among Snohomish County, Wash., students. About 9.6 percent of seniors reported using drugs not prescribed to them, and 5.7 percent admitted to trying heroin. Though one in four seniors said they use marijuana, the number has not increased since before legalization.

Read more:
http://www.northcountyoutlook.com/story/2015/04/15/news/survey-looks-at-drug-use-by-students/7852.html

Other Resources

Injury Prevention and Control: Prescription Drug Overdose
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention
April 3, 2015

The Centers for Disease Control and Prevention's Prescription Drug Overdose website is now live. This site helps spotlight the prescription abuse epidemic, and provides the public, healthcare providers, and states with data and promising strategies to reverse it.

Read more:
http://www.cdc.gov/drugoverdose/index.html

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.

http://medicine.nevada.edu/news/calendar/nevadas-prescription-monitoring-program-(pmp)-clinical-utility-of-patient-and-prescriber-reports

Register:
http://cmetracker.net/UNEV/Login?FormName=RegLoginLive&Eventid=2538

GRANT ANNOUNCEMENTS

Prescription Drug Overdose Prevention for States
Centers for Disease Control and Prevention
Deadline: May 8, 2015
http://www.grants.gov/web/grants/search-grants.html

Harold Rogers Prescription Drug Monitoring Program FY 2015
United States Department of Justice
Deadline: May 28, 2015
https://www.bja.gov/Funding/15PDMPsol.pdf

Take-Back Events and Drop Boxes

Drug Take Back Day Set for April 25
Sean Ingram, The Courier (Arkansas)
April 13, 2015
http://www.couriernews.com/view/full_story/26575209/article-Drug-Take-Back-Day-set-for-April-25

Dump the Drugs Event April 25 at Seven Locations
Chino Valley News (Arizona)
April 15, 2015
http://cvrnews.com/main.asp?SectionID=74&SubSectionID=114&ArticleID=60301

Prescription Drug Take-Back at Mall April 25
The Baytown Sun (Texas)
April 12, 2015
http://baytownsun.com/news/article_7015c0e0-e0da-11e4-97dd-13ba50043b2a.html

April 25 Set Aside as Drug Take-Back Day in Maine
Penobscot Bay Pilot (Maine)
April 16, 2015
http://www.penbaypilot.com/article/april-25-set-aside-drug-take-back-day-maine/51319

Kentwood to Host Drug Take Back Day on April 25
Kristin Austin, MLive Media Group (Michigan)
April 14, 2015
http://www.mlive.com/kentwood/index.ssf/2015/04/kentwood_to_host_drug_take_bac.html

2015 Spring Prescription Drug Drop-Off
Saginaw Chippewa Indian Tribe of Michigan
April 13, 2015
http://www.sagchip.org/news.aspx?newsID=358#.VS5ZomnwvoZ

Flint Police Department Now Accepting Unused, Unwanted Prescriptions
Amanda Emery, MLive Media Group (Michigan)
April 14, 2015
http://www.mlive.com/news/flint/index.ssf/2015/04/flint_
police_department_now_ac.html#incart_related_stories


Prescription Disposal Program Starts with Discussion on Drug Abuse
Victoria Mitchell, Royal Oak Review (Michigan)
April 15, 2015
http://www.candgnews.com/news/prescription-disposal-program-starts-discussion-drug-abuse-82747

MPD Receives Drug Collection Box
Marla Toncray, Ledger Independent (Kentucky)
April 16, 2015
http://www.maysville-online.com/news/local/mpd-receives-drug-collection-box/article_d6756c3f-9452-5434-9b9c-3926b21b352c.html

Free Prescription Drug Drop-Off Set for Incline Village
Tahoe Daily Tribune (Nevada)
April 15, 2015
http://www.tahoedailytribune.com/northshore/nnews/15916838-113/free-prescription-drug-drop-off-set-for-incline-village

Suffolk County Leg. Lindsay III Cosponsors Narcan Training Course and Drug Disposal Program in Sayville
Long Island Media (New York)
April 15, 2015
http://www.longisland.com/news/04-15-15/sayville-narcan-training-and-drug-disposal.html

Vienna Offers Location to Drop Off Unwanted Drugs
WFMJ (Ohio)
April 16, 2015
http://www.wfmj.com/story/28820190/vienna-offers-location-to-drop-off-unwanted-drugs

UMBC Prescription Drug Take Back Initiative
University of Maryland, Baltimore County
April 13, 2015
http://my.umbc.edu/events/32068

Manitowoc County Plans Drug Disposal Program
The Herald Times (Wisconsin)
April 12, 2015
http://www.htrnews.com/story/news/local/2015/04/12/manitowoc-county-ymca-plans-drug-disposal-program/25675837

Upcoming Conferences and Workshops

Training: Engaging Youth in Rx Drug Abuse Prevention
Health Resources in Action and Blake Works
May 7–8, 2015
Boston, Massachusetts
http://captus.samhsa.gov/news-and-events/engaging-youth-rx-drug-abuse-prevention

Register:
http://events.r20.constantcontact.com/register/event?
oeidk=a07eai0x62oca5f692b&llr=jcwvq5cab


Pharmacy Diversion Awareness Conferences
Drug Enforcement Administration, Office of Diversion Control
May 30–31, 2015: Norfolk, Virginia
June 27–28, 2015: Oklahoma City, Oklahoma
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness

International Conference on Opioids
Harvard Medical School
June 7–9, 2015
Boston, Massachusetts
http://www.opioidconference.org/Home_Page.html

Register:
http://www.opioidconference.org/Register.html

Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio
http://www.pharmacy.ohio-state.edu/outreach/generation-rx-university-conference

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
http://injurycenter.umich.edu/events/university-michigan-injury-center-prescription-drug-overdose-summit/mon-2015-11-09-0830
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.