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August 11, 2016

PAW Weekly Update

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 186  |  August 11, 2016
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.

Webinar

Employee-Targeted Webinar: A Workplace Wellness Approach for Prescription Abuse Prevention
SAMHSA
Wednesday, Sept. 7, 2016 | 2 p.m. – 3:15 p.m. (ET)

This interactive webinar, facilitated by Joel Bennett, Ph.D., of Organizational Wellness & Learning Solutions, is geared toward workplace staff and best experienced in a group setting. Participants will learn about the role health consciousness plays in preventing prescription drug misuse; the risk factors associated with the increase in prescription drug misuse and healthy alternatives that can diminish those risks; action steps to implement healthy options; and how to reduce prescription drug misuse and abuse in their work setting. Those who plan on organizing a group to watch the webinar should contact Michael Neeper at MNeeper@OrganizationalWellness.com for materials to help with the session, including handouts and anonymous forms to assess changes in attitudes and behaviors resulting from the webinar. The webinar will also be archived on the SAMHSA YouTube site for later viewing.

Register:
https://join.onstreammedia.com/register/22396317/paw.
Index
Featured
Journal Articles and Reports
Professional Development
National
Marijuana
International
Northeast/Mid-Atlantic News
South News
Midwest News
West News
Other Resources
Video
Webinars
Grant Announcements
National Take-Back Initiative
Take-Back Events & Drop Boxes
Upcoming Events, Conferences & Workshops

Featured

Fair Health. July 2016. The Opioid Crisis among the Privately Insured: A White Paper.

This study analyzed U.S. private health insurance claims for 150 million patients. It excludes Medicare and Medicaid patients and, therefore, includes few people over age 65. From 2007 to 2014, claims that included a Diagnostic and Statistical Manual of Mental Disorders (Fourth Ed.) opioid-dependence code increased 3,203 percent; claims with an opioid-abuse code increased 317 percent; and pregnancy claims complicated by drug dependence increased 511 percent. From 2009 to 2014, heroin-overdose claims increased 510 percent. From 2007 to 2014, 69 percent of claims for opioid dependence and 50 percent of claims for opioid abuse were for people ages 19–35. Opioid dependence appears more common in men, but the gap narrows at ages 46–55. Conversely, opioid abuse is more common among women. From 2002–04 to 2011–13, claims related to heroin use increased by 100 percent among women and 50 percent among men. The report also shows the state-by-state distribution of opioid-dependence diagnoses compared to other substance abuse and dependence diagnoses in the period 2007–14. The South and West seem to be struggling the most with opioid dependence.

Read more:
http://www.beckershospitalreview.com/quality/6-statistics-about-the-national-opioid-epidemic.html
http://www.fairhealth.org/servlet/servlet.FileDownload?file=01532000001nwD2

Journal Articles and Reports

C.A. Bautista, A.M. Iosif, B.L. Wilsey, J.A. Melnikow, A. Crichlow, and S.G. Henry. 2016. “Factors Associated with Opioid Dose Increases: A Chart Review of Patients’ First Year on Long-Term Opioids.” Pain Medicine, doi:10.1093/pm/pnw185.

At a northern California medical center, 22 patients with chronic pain escalated their opioid dose by 30 mg morphine equivalents during their first year after opioid initiation. The authors matched these cases with 44 control patients who initiated opioids but did not escalate doses. over the 1-year period; controls did not experience overall dose escalation. Of all 674 encounters associated with opioid prescriptions during the year, 53 percent were by telephone; 13 percent by email; and 34 percent face-to-face. No prescribing rationale was documented for 43 percent of all opioid prescriptions and 25 percent of dose increases. Likelihood of dose increase and documentation of prescribing rationale did not significantly differ for cases versus controls, although controls by definition had smaller increases. Dose increases were significantly less likely for telephone (odds ratio [OR] = 0.2) and email (OR = 0.2) than face-to-face encounters. Documentation of prescribing rationale was significantly more likely for email (OR = 5.1) and less likely for telephone (OR = 0.3) encounters.

Read more:
http://painmedicine.oxfordjournals.org/content/early/2016/07/29/pm.pnw185

C.J. Blum, L.S. Nelson, and R.S. Hoffman. 2016. “A Survey of Physicians’ Perspectives on the New York State Mandatory Prescription Monitoring Program (ISTOP).” Journal of Substance Abuse Treatment, doi:10.1016/j.jsat.2016.07.013.

An electronic survey in 2014 of the 1,000 attending physicians on the faculty of the New York University medical school drew 207 responses. Of respondents, 89 percent had heard of the state’s prescription drug monitoring program (PDMP). Of them, 81 percent were registered users and 46 percent used the system once a week or more. There was significant negative feedback, with 40 percent describing the PDMP system as “rarely” or “never helpful,” and 39 percent describing it as “difficult” or “very difficult” to use. Physicians expressed frustration with the login process, the complexity of querying patients, and the lack of integration with electronic medical records. Only 83 percent knew that PDMP use is mandated in most cases when prescribing controlled substances, and only 44 percent agreed with this mandate. Surgeons, males, and those who prescribe controlled substances at least once per week had significantly lower rates of agreement (23 percent, 36 percent, and 33 percent, respectively). The most common reasons for disagreement were: time burden, concerns about helpfulness, potential for under-treatment, and erosion of physician autonomy. Emergency physicians, who are largely exempt from the mandate, were the most likely to believe the most was helpful, yet the least likely to be registered users. Of non-emergency physicians, 48 percent reported perfect compliance with the mandate. Surgeons and males reported the lowest rates of perfect compliance (18 percent and 37 percent, respectively).

Read more:
http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(16)30083-6/fulltext

C.E. Cauley, G. Anderson, A.B. Geoffrey, A.B. Haynes, M. Menendez, B.T. Bateman, K. Ladha. 2016. “Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations: A Nationally Representative Cohort Study.” Annals of Surgery, doi:10.1097/SLA.0000000000001945.

Analysis of 2002–11 U.S. Nationwide Inpatient Sample hospital discharge data on 11,317,958 patients who underwent any of 6 major elective inpatient operations showed 9,458 had a postoperative opioid overdose before discharge. [Editor’s Note: The authors assume these overdoses were postoperative, but some instead may have been presenting conditions that caused discovery in the emergency department of a condition leading to emergency surgery. The discharge abstract does not record event sequence.] The postoperative overdose rate doubled over the study period from 0.6 to 1.1 overdoses per 1,000 cases. Patients with postoperative opioid overdose died more frequently during their hospitalization (1.7 percent vs. 0.4 percent). In multivariate regression, substance abuse history was the strongest predictor of postoperative overdose (odds ratio = 14.8). [Editor’s Note: Again, this risk factor suggests some overdoses were presenting conditions.] Gender, age, income, geographic location, operation type, and certain comorbid diseases also predicted overdose. Hospital teaching status, size, and urban/rural location did not predict overdose.

Read more:
http://journals.lww.com/annalsofsurgery/Abstract/publishahead/
Predictors_of_In_hospital_Postoperative_Opioid.96481.aspx


E. Colell, A. Sanchez-Niubo, M. Ferrer, and A. Domingo-Salvany. 2016. “Gender Differences in the Use of Alcohol and Prescription Drugs in Relation to Job Insecurity. Testing a Model of Mediating Factors.” International Journal of Drug Policy, doi:10.1016/j.drugpo.2016.07.002.

Path analysis on pooled data on 5,315 primary household wage earners ages 16–64 from the 2010–14 Catalan Health Surveys showed job insecurity (odds ratio [OR] = 1.35) was positively associated with poor mental health, with no significant interactions with gender. Poor mental health, in turn, was significantly associated with use of hypnotics/sedatives (OR=1.7).

Read more:
http://www.ijdp.org/article/S0955-3959(16)30217-1/fulltext

R.A. Deyo, S.E. Hallvik, C. Hildebran, M. Marino, E. Dexter, J.M. Irvine, N. O’Kane, J.V. Otterloo, D.A. Wright, G. Leichtling, and L.M. Millet. 2016. “Association Between Initial Opioid Prescribing Patterns and Subsequent Long-Term Use Among Opioid-Naïve Patients: A Statewide Retrospective Cohort Study.” Journal of General Internal Medicine, doi:10.1007/s11606-016-3810-3.

Analysis of data from Oregon’s mandatory-report prescription drug monitoring program showed that of 871,611 patients prescribed opioids during October 2012 to September 2013, 334,844 (38.5 percent) had been prescribed opioids or experienced an overdose in the prior year and 536,767 were essentially opioid-naïve. Of the opioid-naïve patients, 26,785 (5.0 percent) became long-term users in the year following their first prescription. Among 243,427 patients under age 45 using short-acting opioids who did not die in the follow-up year—a group that excludes most cancer patients, the odds for long-term use among those receiving two fills versus one was 2.25. The proportion of the under-45 patients who became long-term opioid users increased with increasing morphine milligram equivalents (MME) initially dispensed. Among those receiving under 120 MMEs during the initiation month, 2 percent became long-term opioid users. This proportion increased consistently with MMEs initially dispensed, exceeding 40 percent among patients receiving 1,600 or more MMEs in the initiation month. Patients initiating with long-acting opioids had a 24.5 percent chance of becoming long-term users compared to 3.5 percent of those initially prescribed short-acting opioids. These differences may simply reflect the initial prescribing patterns when physicians prescribe opioids for acute versus chronic, long-term pain control.

Read more:
http://link.springer.com/article/10.1007/s11606-016-3810-3

B. Levy, B. Spelke, L.J. Paulozzi, J.M. Bell, K.B. Nolte, S. Lathrop, D.E. Sugerman, and M. Landen. 2016. “Recognition and Response to Opioid Overdose Deaths—New Mexico, 2012.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.07.011.

Of the 489 overdose deaths in New Mexico in 2012, 49 percent involved prescription opioids only, 22 percent involved heroin only, 5 percent involved both, and 24 percent involved only non-opioid substances. Most deaths involving prescription opioids occurred in non-Hispanic white people (57 percent), men (58 percent), persons ages 40–59 (55 percent), and people with chronic medical conditions (89 percent). Most overdose deaths occurred in the home (69 percent) and in the presence of bystanders (68 percent). Prescription opioid and heroin deaths did not differ with respect to paramedic dispatch and attempts to resuscitate the victim, but heroin overdoses received naloxone twice as often (21 percent vs. 10 percent).

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30208-3/fulltext

J. Monárrez-Espino, L. Laflamme, C. Rausch, B. Elling, and J. Möller. 2016. “New Opioid Analgesic Use and the Risk of Injurious Single-Vehicle Crashes in Drivers Aged 50–80 Years: A Population-Based Matched Case–Control Study.” Age Ageing, doi:10.1093/ageing/afw115.

Swedish researchers conducted a matched case–control study using data from population registers. Cases were the 4,445 drivers ages 50–80 responsible for a single vehicle crash with at least one injured occupant between July 2005 and December 2009. Four controls with a valid driving license and no crashes were randomly matched to each case by sex, birth month/year, and residence area. Logistic regression adjusting for benzodiazepine use, co-morbidity, marital/partner status and occupation showed that those first prescribed opioids in the last 30 days had a two-fold higher crash risk than drivers using non-opioid analgesics, while crash risk was 1.7 times higher for long-term opioid users.

Read more:
http://ageing.oxfordjournals.org/content/early/2016/07/26/ageing.afw115.abstract

S.P. Novak, A. Håkansson, J. Martinez-Raga, J. Reimer, K. Krotki, and S. Varughese. 2016. “Nonmedical Use of Prescription Drugs in the European Union.” BMC Psychiatry 16:274, doi:10.1186/s12888-016-0909-3

A 2014 survey drew 22,070 responses from non-institutionalized people ages 12–49 in Denmark, Germany, Great Britain, Spain, and Sweden. Lifetime and past-year prevalence of nonmedical prescription drug use for opioids was 13.5 and 5.0 percent, for sedatives was 10.9 and 5.8 percent, and for stimulants was 7.0 and 2.8 percent. Germany had the lowest level of nonmedical use, while Spain, followed by Great Britain, had the highest levels. Mental and sexual health risk factors were associated with an increased likelihood of past-year nonmedical use. Among past-year users, 32, 28, and 52 percent of opioid, sedative, and stimulant nonmedical users, respectively, consumed illicit drugs. Social sources (sharing by friends/family) were the most commonly endorsed methods of acquisition, ranging from 44 percent (opioids) to 62 percent (sedatives). Internet pharmacies were a source of opioids (4 percent), stimulants (8 percent), and sedatives (3 percent).

Read more:
http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0909-3

Related Infographic

Infographic: Prescription Drug Abuse in Europe
RTI International
Accessed August 5, 2016

This infographic shows data on nonmedical prescription drug use in five European countries—Denmark, Germany, Spain, Sweden, and the United Kingdom. Rates of opioid misuse in the Europe may be catching up to rates in the United States.

Read more:
https://www.rti.org/infographic/prescription-drug-abuse-europe


D. Tang, P. Li, L. Guo, Y. Xu, X. Gao, J. Deng, J. Huang, G. Huang, H. Wu, Y. Yue, and C. Lu. 2016. “The Prevalences of and Association Between Nonmedical Prescription Opioid Use and Poor Sleep Among Chinese High School Students.” Scientific Reports, doi:10.1038/srep30411.

Survey responses from 18,686 Chongqing high school students in 2012 showed prevalence of lifetime, past-year and past-month nonmedical prescription opioid use were 14.6 percent, 4.6 percent, and 2.8 percent, respectively. The most commonly misused opiate was licorice tablets with morphine (9.1 percent, 2.5 percent,and 1.5 percent for lifetime, past-year and past-month, respectively), followed by cough syrup with codeine, Percocet, diphenoxylate and tramadol. Eighteen percent or respondents were poor sleepers including 27.4 percent of nonmedical users. Multivariate analysis found the odds of poor sleep for nonmedical users was 1.5 times the odds for nonusers.

Read more:
http://www.nature.com/articles/srep30411

B.J.H. Yarborough, S.P. Stumbo, S.L. Janoff, M.T. Yarborough, D. McCarty, H.D. Chilcoat, P.M. Coplan, C.A. Green. 2016. “Understanding Opioid Overdose Characteristics Involving Prescription and Illicit Opioids: A Mixed Methods Analysis.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.07.024.

Researchers interviewed 87 survivors of opioid overdoses or family members of decedents. Individuals who overdosed either abused and misused multiple drugs; experienced dose-related miscommunications or medication-taking errors; had mental health and/or substance use conditions; reported chronic pain; or had unstable resources or family/social support. Most events involved polysubstance use, often including benzodiazepines. Accidental overdoses were commonly the result of abuse or misuse, some in response to inadequately treated chronic pain or, less commonly, medication-related mistakes. Suicide attempts were frequently triggered by consecutive negative life events.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30221-6/fulltext

Professional Development

H. Ansari and L. Kouti. 2016. “Drug Interaction and Serotonin Toxicity with Opioid Use: Another Reason to Avoid Opioids in Headache and Migraine Treatment.” Current Pain and Headache Reports 20:50.

Read more:
http://link.springer.com/article/10.1007/s11916-016-0579-3

P. Armenian, A. Olson, A. Anaya, A. Kurtz, R. Ruegner, and R.R. Gerona. 2016. “Fentanyl and a Novel Synthetic Opioid U-47700 Masquerading as Street ‘Norco’ in Central California: A Case Report.” Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2016.06.014.

Read more:
http://www.annemergmed.com/article/S0196-0644(16)30292-X/abstract

R. Jain and J.G. Stark. 2016. “Safety and Efficacy Considerations Due to Misuse of Extended-Release Formulations of Stimulant Medications.” Postgraduate Medicine, doi:10.1080/00325481.2016.1218259.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/00325481.2016.1218259

M.A. Schuckit. 2016. “Treatment of Opioid-Use Disorders.” New England Journal of Medicine 375:357-368, doi:10.1056/NEJMra1604339

Read more:
http://www.nejm.org/doi/full/10.1056/NEJMra1604339#t=article

National

Navy Seeks Feedback on Alcohol and Prescription Drug Abuse Prevention Efforts
MilitarySpot.com
August 4, 2016

The U.S. Navy is using a survey to seek feedback on its alcohol and prescription drug abuse prevention efforts. The Navy Alcohol and Drug Abuse Prevention Survey measures participants’ attitudes and perceptions of alcohol and prescription drug abuse. Findings will be used to develop and enhance prevention programs and increase readiness of the fleet.

Read more:
http://www.militaryspot.com/news/navy-seeks-feedback-alcohol-prescription-drug-abuse-prevention-efforts

Group Urges Lawmakers to Address Opioid Crisis by Ending Anonymous Shell Companies
Naomi Jagoda, The Hill
August 1, 2016

The Fair Share Education Fund is urging lawmakers to end the use of anonymous shell companies to make it easier for law enforcement to curb the drug trafficking behind the opioid crisis. No state requires people forming companies to disclose the identities of the people who actually own or control them. The Fund released a report that describes 10 anonymous shell companies linked to opioid trafficking.

Read more:
http://thehill.com/policy/finance/290026-group-address-opioid-crisis-by-ending-anonymous-shell-companies

Report: Counterfeit Pills Fueling U.S. Fentanyl and Opioid Crisis
U.S. Drug Enforcement Administration
July 22, 2016

A U.S. Drug Enforcement Administration (DEA) intelligence brief reports that hundreds of thousands of counterfeit prescription pills, many containing deadly amounts of fentanyl and fentanyl-related compounds, have made their way into the U.S. drug market. Fentanyl and fentanyl-related compounds also are being mixed into or sold as heroin, oftentimes without the customer’s knowledge. Fentanyl traffickers have been successful at expanding the fentanyl market and introducing new fentanyl-laced drug products to the U.S. drug market. The rise of counterfeit pills that contain fentanyl in the illicit drug market has increased overdoses and deaths.

Read more:
https://www.dea.gov/divisions/hq/2016/hq072216.shtml

Aetna is Notifying Some Doctors About Their Drug-Dispensing Habits
Lenny Bernstein, Washington Post
August 3, 2016

Aetna insurance has written letters to 931 physicians who fell within the top 1 percent of opioid prescribers within their specialty but were not high-volume opioid prescribers. These physicians had an average refill rate of 4.5 per opioid prescription compared to an overall average of 0.3. Only doctors who prescribed opioid pain relievers at least 12 times were included in the data examined, which represented more than 8.6 million claims. Aetna found that family medicine doctors (58 percent) and internists (31 percent) were the top refill prescribers. Pennsylvania had 136 “superprescribers,” followed by Missouri (87), Florida (78), North Carolina (52) and Utah (45). None of the doctors contacted was on Aetna’s list of doctors suspected of fraud or deliberately facilitating opioid misuse and diversion.

Read more:
https://www.washingtonpost.com/news/to-your-health/wp/2016/08/03/aetna-is-notifying-some-doctors-about-their-drug-dispensing-habits

Big Business Has Its Eye on State Responses to Opioid Crisis
Eric Rosenbaum, CNBC
August 5, 2016

The Missouri Chamber of Commerce and Industry said it believes the addiction crisis is raising costs for businesses since companies are the predominant payers of private insurance. Quality of life for employees and quality of workforce also concern large businesses, with many employees unable to pass a drug test. The Chamber is worried about the state’s future business attractiveness due to lack of a prescription drug monitoring program. The National Safety Council recently graded all 50 states on how they are handling the opioid crisis. Twenty-eight states were graded as “failing” and 19 more as “needing improvement.” Missouri, Michigan, and Nebraska received the lowest grade possible. Only Vermont, New Mexico, Kentucky, Maine, and Tennessee—many of them states with the highest heroin or prescription opioid overdose rates—met at least five of six indicators for an adequate control and response system. Vermont is also one of the few states with enough treatment capacity to handle its residents suffering from addiction.

Read more:
http://www.cnbc.com/2016/08/05/jobs-battle-affected-by-the-big-drug-addiction-issue.html

Addiction in the Workplace: Tips for Employers
Robert Yagoda, U.S. News & World Report
August 4, 2016

Employers need a written substance abuse policies prohibiting drug and alcohol use at work. They should ask all employees to read and sign an agreement stating they understand those policies. Employers and supervisors also should look for signs of drug and alcohol misuse. Employers should promptly and properly deal with employees they suspect of misusing. This article describes signs an employee is misusing drugs or alcohol; how to deal with addiction in the workplace; and what to do if an employee is under the influence on the job.

Read more:
http://health.usnews.com/health-news/patient-advice/articles/2016-08-04/addiction-in-the-workplace-tips-for-employers

Study: One in Five Opioid Users Also Might Be Abusing Seizure Drug
HealthDay News
August 1, 2016

Researchers presented a study at the American Association for Clinical Chemistry’s annual meeting that looked at test results of 323 patients who were prescribed opioid pain medications. The patients were being treated at pain or rehabilitation clinics, primarily in Arizona, Indiana, and Massachusetts. About one in five tested positive for gabapentin (Neurontin), but did not have a prescription for the drug. Of the patients taking gabapentin illicitly, 56 percent were taking it with an opioid, 27 percent with both an opioid and muscle relaxant or anxiety medication, and the rest with other substances.

Read more:
https://consumer.healthday.com/general-health-information-16/prescription-drug-news-551/1-in-5-opioid-users-also-may-be-abusing-seizure-drug-gabapentin-study-713372.html

Report: Illegal Purchases of Controlled Substances Made Easier Via Rogue Internet Sites
National Association of Boards of Pharmacy
July 29, 2016

The National Association of Boards of Pharmacy (NABP) released its “Internet Drug Outlet Identification Program Progress Report for State and Federal Regulators: July 2016.” The report showed that one-third of websites identified as not recommended in the second quarter are illegally selling controlled substances. It explores the connection between the dangers of rogue internet drug outlets and the risk of overdose from illegally dispensed prescription controlled substances and possibly tainted counterfeit drugs. Currently, of 11,299 online prescription drug outlets reviewed by NABP, they have classified 95.8 percent as Not Recommended because the websites sell prescription medications in ways that do not comply with state and federal laws or with Association patient safety and pharmacy practice standards. The report also details the findings of a study by researchers at Fisher College in Boston about opioid availability online and points out government agency warnings about counterfeit opioids.

Read more:
http://www.prnewswire.com/news-releases/illegal-purchases-of-controlled-substances-are-made-easier-via-rogue-internet-drug-outlets-reports-nabp-300306463.html

Marijuana

J. Metrik, E.R. Aston, C.W. Kahler, D.J. Rohsenow, J.E. McGeary, V.S. Knopik, and J. MacKillop. 2016. “Cue-Elicited Increases in Incentive Salience for Marijuana: Craving, Demand, and Attentional Bias.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.07.027.

This study, which lacked a control group, exposed 93 frequent marijuana users to neutral cues, then to lit marijuana cigarettes. Relative to neutral cues, marijuana cues significantly increased subjective craving. In a marijuana purchase task, they increased demand intensity (i.e., amount consumed at $0) and peak drug expenditure, with price elasticity significantly decreased following marijuana cues. Marijuana users displayed significant attentional bias for cannabis-related words after marijuana cues. Cue-elicited increases in craving were associated with greater attentional bias for marijuana words.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30239-3/fulltext

X. Wang, R. Derakhshandeh, J. Liu, S. Narayan, P. Nabavizadeh, S. Le, BA2, O.M. Danforth, K. Pinnamaneni, H.J. Rodriguez, E. Luu, R.E. Sievers, S.F. Schick, S.A. Glantz, and M.L. Springer. 2016. “One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function.” Journal of the American Heart Association, doi:10.1161/JAHA.116.003858.

In rats, 1 minute of exposure to secondhand marijuana smoke impaired femoral artery flow‐mediated dilation to a comparable extent as impairment from equal concentrations of tobacco secondhand smoke, but recovery was considerably slower for marijuana. Exposure to marijuana secondhand smoke directly caused cannabinoid‐independent vasodilation that subsided within 25 minutes, whereas femoral artery dilation remained impaired for at least 90 minutes. Impairment occurred even when marijuana lacked cannabinoids and rolling paper was omitted.

Read more:
http://jaha.ahajournals.org/content/5/8/e003858.abstract?sid=8fa366ef-fc64-40fd-92cb-cc51c32da6b0

Report: More American High School Students Smoke Pot than Binge Drink
Perry Stein, Washington Post
August 1, 2016

Marijuana has passed alcohol as the leading substance misused by youth. In the 2014 National Survey on Drug Use and Health, 7.4 percent of youth ages 12–17 reported past-month marijuana use and 6.1 percent reported past-month binge alcohol use. Similarly, in 2015 Youth Risk Behavior Survey, 21.7 percent of high school students reported past-month marijuana use and 17.7 percent reported past-month binge drinking. The highest high school use rate for marijuana is in the District of Columbia, 32 percent. The District had the second-lowest binge-drinking rate (12 percent), and the lowest rate for prescription drug misuse, at 7.3 percent. Arkansas had the highest rate of prescription drug usage, 21.5 percent. States along the coasts and some Southwest and Midwest states generally had higher marijuana use rates than binge-drinking rates. Project Know has compiled a report detailing state rate comparisons and comparing U.S. and European rates. Only France and Spain had marijuana use rates as high as U.S. rates. Most countries had binge drinking rates that were double U.S. rates.

Read more:
https://www.washingtonpost.com/news/local/wp/2016/08/01/more-american-high-school-students-smoke-pot-than-binge-drink-report-says
http://www.projectknow.com/discover/high-school-drug-use

Employers Explore Medical Marijuana Concerns
Chris Balusik, Chillicothe Gazette
July 31, 2016

Karen Pierce spoke to the Ross County Safety Council, Ohio, about handling medical marijuana in the workplace when legalization takes effect in September. Pierce, whose firm provides drug-free workplace programs and consulting services, told employers and business owners that they do not have to accommodate medical use. They are not required to permit use or possession or distribution. They are not prohibited from refusing to hire someone who tests positive for marijuana and they are not prohibited from firing or taking adverse action. Employers can drug test and have a drug-free workplace program that includes a zero-tolerance policy if employees test positive for marijuana. The law also states an employer cannot be sued for refusing to hire someone, firing someone or taking disciplinary action against someone who tests positive. A worker who is dismissed from a job for a positive marijuana test will be ineligible to collect on unemployment or worker’s compensation claims. Pierce advises employers to put policies in place that are clear in their definitions and scope, including addressing marijuana use of an employee when off the job. Employee and supervisor training should follow, explaining the law and company policies fully, and drug testing programs may be implemented. Companies should know where they can turn for assistance to deal with difficult situations or confusion once the law goes into effect.

Read more:
http://www.chillicothegazette.com/story/news/local/2016/07/31/employers-explore-medical-marijuana-concerns/87679258

Posttraumatic Stress Disorder Marijuana Study Recruiting Veteran Volunteers
Jon Anderson, Military Times
August 2, 2016

John Hopkins University and Scottsdale Research Institute are looking for veteran volunteers to smoke up to two marijuana joints a day in a study designed to find out if pot helps relieve symptoms of posttraumatic stress disorder. They will test 76 combat veterans over 12 weeks. The study, approved by the U.S. Drug Enforcement Administration, is expected to take 2 years to complete.

Read more:
http://www.militarytimes.com/story/veterans/2016/08/02/ptsd-marijuana-study-now-recruiting-veteran-volunteers/87945004

Pain Patients Can Now Buy Medical Marijuana in Minnesota
Heidi Wigdahl, KARE
August 1, 2016

Pain patients can now purchase medical marijuana in Minnesota, implementing the medical cannabis law that went into effect July 1, 2015. (Includes video: 1:41 minutes)

Read more:
http://www.kare11.com/news/health/pain-patients-can-now-buy-medical-marijuana-in-mn/285569062

California Initiative Opens Door to TV Ads that Promote Pot Smoking
Patrick McGreevy, Los Angeles Times
July 31, 2016

California’s Proposition 64 on the November ballot includes a provision that would allow cannabis sellers to advertise their products in print ads and on digital sites and radio and television stations, but would “prohibit the marketing and advertising of non-medical marijuana to persons younger than 21 years old or near schools or other places where children are present.” Television ads are unlikely to appear soon because the federal government considers marijuana illegal. Health officials also are concerned. The American Heart Association of Greater Los Angeles has not yet taken a position on the initiative, but its board president said it would be “tragic” if television was opened to ads for smoking marijuana. Proponents of Proposition 64 argue that it includes rules to make sure the ads are not seen by minors, and prohibit the use of marketing techniques that are appealing to young people, such as the use of symbols, music or cartoons. About 10 radio stations in Medford, Bend, and Eugene in Oregon have run marijuana ads. Sacramento FOX affiliate KTXL-TV ran ads for a medical marijuana dispensary some years ago, but has since adopted a policy of not accepting such advertising. An Arizona TV station has aired ads for a physician who refers patients to marijuana dispensaries. Representatives of the Alaska and Colorado broadcasters associations said they are not aware of any television stations in their states that have run marijuana ads, and they have recommended that members not accept such ads.

Read more:
http://www.latimes.com/politics/la-pol-ca-california-pot-ads-20160731-snap-story.html

High Stakes: Marijuana in the Workplace
Jason F. Meyer and Jeffrey S. Herman, California Lawyer
August 1, 2016

Forty-two states and three U.S. territories permit some form of marijuana use, with the majority supporting legalized marijuana for medicinal purposes. This article discusses marijuana’s impact on employment law and drug testing. The authors advise employers to implement a clear and comprehensive drug testing policy that fully complies with applicable laws. As laws continue to develop and evolve, so too should employment policies and practices. The authors are under the impression that each state determines whether employers are able to penalize employees for engaging in state-sanctioned marijuana use. [Editor’s note: Weekly Update has not verified the accuracy of the legal opinions stated in this article, including the veracity of the last sentence, which seems inconsistent with a series of recent court rulings.]

Read more:
http://www.callawyer.com/2016/08/the-stakes-have-never-been-higher-marijuana-in-the-workplace

A Look at How Professional Sports Leagues Test for Marijuana
New York Daily News
July 30, 2016

The National Football League tests players once for marijuana between mid-April and early August. National Basketball Association players are subject to four random drug tests throughout the season, but they are not subject to testing during the off-season. Major League Baseball does not test players for marijuana unless there is reasonable cause to suspect they are using it. The National Hockey League randomly tests one-third of its players each season for street drugs. Hockey players who test positive for marijuana are not disciplined, although they could be referred to a substance abuse program.

Read more:
http://www.nydailynews.com/sports/i-team/nfl-nba-mlb-nhl-test-marijuana-article-1.2732129

Doctors in New South Wales (Australia) Can Now Prescribe Cannabis
Simon Thomsen, Business Insider Australia
August 1, 2016

Doctors in New South Wales, Australia, can now prescribe cannabis-based medicines to seriously ill people who have exhausted existing treatment options. Prescriptions will be reviewed by the Commonwealth Therapeutic Goods Administration and by a committee of medical experts before they can be used.

Read more:
http://www.businessinsider.com.au/doctors-in-nsw-can-prescribe-cannabis-from-today-2016-8

International

Northern Ireland Health Minister Outlines Progress Tackling Alcohol- and Drug-Related Harm
Northern Ireland Executive
August 1, 2016

Northern Ireland’s health ministry has released its fourth annual progress report, “The New Strategic Direction for Alcohol and Drugs Phase 2.” Prescription drug misuse and the misuse of new psychoactive substances remain health risks. The government needs to do more to raise awareness of these issues, and to provide treatment and support for those who need help.

Read more:
https://www.northernireland.gov.uk/news/health-minister-michelle-oneill-outlines-progress-tackling-alcohol-and-drug-related-harm

United Kingdon Prescription Drug Abuse Among the ‘Highest in Europe’
Lisa Baker, HR & Charity News
August 4, 2016

Fadi Sfeir, associate at Capstan Avocats in France, examines the legal complications that surround taking psychoactive prescription drugs in European workplaces. He discusses how employers can provide a safe work environment without interfering with the employee’s privacy as it relates to the recruitment process. Sfeir also discusses whether an employer can test an employee for prescription drugs to ensure work safely. To deal with misuse of prescription drugs in the workplace, Sfeir advises employers to take preventive action.

Read more:
http://hrnews.co.uk/uk-prescription-drug-abuse-among-highest-europe-can-employers

The Philippines Airport Police Undergo Drug Test
Benjie Vergara, Manila Times
August 3, 2016

Manila International Airport Authority, Philippines, reported that at least 496 members of the airport police department were subjected to urine drug testing in compliance with its drug-free workplace policy. Random testing ensures the airports are run by non-drug users. The testing was performed by an outside third party accredited by the Department of Health and the results will be known within the week.

Read more:
http://www.manilatimes.net/airport-police-undergo-drug-test/277760

Northeast/Mid-Atlantic News

Opioid Overdose Deaths Continue to Rise in Massachusetts
Amy Phillips, WWLP
August 3, 2016

The Massachusetts Department of Public Health reported that opioid related overdose deaths have not declined, despite efforts to increase treatment programs. In 2016, 66 percent of opioid related deaths to date tested positive for fentanyl, up from 57 percent in 2015. Rates for heroin and prescription drug deaths are decreasing at around the same rate that fentanyl is increasing. Naloxone use is steadily increasing. (Includes video: 0:47 minute)

Read more:
http://wwlp.com/investigative-story/opioid-overdose-deaths-continue-to-rise-in-massachusetts

Sanford (Maine) Drug Overdoses at All-Time High
Tammy Wells, Journal Tribune
July 30, 2016

Sanford, Maine, has recorded 23 drug-related overdoses and five drug-related deaths since January, 2016. Both statistics are the most ever recorded in this city of 22,000 people. In June, first responders handled six overdoses within one 24-hour period, one of them fatal.

Read More:
http://www.journaltribune.com/news/2016-07-30/Front_Page/
Sanford_drug_overdoses_at_alltime_high.html


John Gotti’s Grandson Busted for Allegedly Trafficking Prescription Drugs in New York
NY1 News
August 4, 2016

The grandson of the late mob boss John Gotti has been arrested and charged for allegedly leading a crew of drug traffickers. The 23-year-old headed a seven-person crew charged for allegedly selling pain reliever drugs and other pharmaceutical controlled substances in New York. He and six other defendants are accused of peddling the drugs in Howard Beach and Ozone Park over the last year. If convicted, he faces up to 25 years in prison. (Includes video: 1:21 minutes)

Read more:
http://www.ny1.com/nyc/all-boroughs/news/2016/08/4/grandson-of-john-gotti-busted-for-trafficking-prescription-drugs.html

South News

West Virginia Launches Effort to Tackle Opioid Use in High School Sports
WHSV
August 1, 2016

The West Virginia attorney general’s office has teamed up with several groups to address opioid use in high school athletics. The initiative will feature educational fliers, public service announcements, and speaking events statewide. It also will promote alternative pain management including physical therapy, non-opioid pain relievers, acupuncture, massage therapy and over-the-counter medication.

Read more:
http://www.whsv.com/content/news/West-Virginia-launches-effort-to-tackle-opioid-use-in-high-school-sports-388688912.html

Georgia Nurse Practitioner Accused of Illegally Searching Prescriptions
Stacey Readout, WJXT
August 1, 2016

The Georgia Bureau of Investigation has arrested a nurse practitioner for researching prescription drug history of two former employees. She illegally accessed and disseminated sensitive information stored within the prescription drug monitoring program database. Although she was authorized to access the database as a nurse practitioner, the Bureau says her searches did not fall within the boundaries of proper usage. She has no criminal history and intends to plead not guilty and vigorously fight the charge. The disclosure law has come under much criticism due to its vagueness and the way it was written.

Read more:
http://www.news4jax.com/news/georgia/gbi-nurse-practitioner-illegally-searched-prescriptions

Healthcare Professionals Accused In Little Rock (Ark.) ‘Pill Mill’ Case Go On Trial
Linda Satter, Arkansas Democrat-Gazette
August 2, 2016

A trial began in Little Rock, Ark., for physician Felicie Wyatt, nurse Kristen Raines, and physician’s assistant Aaron Paul Borengasser. Each is accused of conspiring to distribute hydrocodone, Xanax, and a muscle relaxer without a legitimate medical purpose through a “pill mill.”

Read more:
http://www.arkansasonline.com/news/2016/aug/02/3-accused-in-lr-pill-mill-case-go-on-tr

Deaths from Prescription Drugs Down in Oklahoma
Grant Hermes, News 9
August 4, 2016

Oklahoma Bureau of Narcotics reported that overdose deaths may be leveling off after a 139 percent increase between 2001 and 2010. Deaths topped out at 870 in 2014, and declined to 823 in 2015. Last year, overdoses caused by prescription pain relievers accounted for 59 percent of all overdose deaths, down from 72 percent in 2011. Doctors and law enforcement agencies are crediting new laws and public awareness campaigns with the decline. Last year, 31 Oklahomans died from heroin overdoses, the most in the last five years and 2016 is on track to hit 40. Deaths from Methamphetamines are increasing too. In 2015, they accounted for one third of all drug deaths in the state. (Includes video: 2:05 minutes)

Read more:
http://www.news9.com/story/32689517/deaths-from-prescription-drugs-down-in-oklahoma

Midwest News

Wisconsin Board Adopts Guidelines for Prescribing Opioids
Associated Press, Journal-Sentinel
July 31, 2016

The Wisconsin Medical Examining Board has adopted guidelines for prescribing opioids. They include prescribing opioids sparingly, telling patients they could become addicted, and avoiding opioids as the first option to treat pain.

Read more:
http://www.jsonline.com/story/news/health/2016/07/31/wisconsin-board-adopts-guidelines-prescribing-opioids/87899200

Illicit Fentanyl is Amplifying Indiana’s Overdose Epidemic
Leigh DeNoon, WFYI
August 1, 2016

This year, opioid overdose 911 calls are on track to set a new record in Indianapolis, Ind., due in part to fentanyl. The drug is also fueling overdose deaths. Coroner’s office records showed deaths from fentanyl alone more than doubled between 2014 and 2015, while Indiana’s prescription drug database shows doctors were scaling back. First responders have used naloxone on over 900 people so far this year in Indianapolis. June was a record month, with 152 people treated. The city is on pace to treat over 1,500 overdoses this year. (Includes audio: 3:45 minutes)

Read more:
http://www.wfyi.org/news/articles/illicit-fentanyl-and-heroin-fueling-indys-overdose-epidemic

South Dakota Medical Association Publishes Journal on Prescription Drug Abuse
Yankton Daily Press & Dakotan
July 31, 2016

The South Dakota State Medical Association has published “Addressing the Challenges of Prescribing Controlled Drugs,” a special issue of the association’s peer-reviewed medical journal, South Dakota Medicine. This issue aims to be a resource for physicians and other health care providers and to help educate patients about the dangers of prescription drug misuse. The SDSMA also published a white paper, “Opiate Analgesics for Chronic, Non-Cancer Pain,” that provides guidelines for opioid prescribing and serves as a resource for physician practices.

Read more:
http://www.yankton.net/healthlines/article_dc4d5022-5788-11e6-9fb7-677db4c7f833.html

Media Campaign to Fight Drug Abuse Among Teens Launched In Michigan
M. Lapham, Detroit Unspun
August 4, 2016

The Michigan Department of Health and Human Services has launched a statewide media campaign that targets all drug abuse. The purpose of this campaign is to illustrate the harmful effects of drug use so teens better understand the seriousness of what may seem like a momentary decision. The campaign message: “Don’t let drugs ruin your story. Don’t let drugs determine your future.” (Includes video: 0:30 minutes)

Read more:
http://blog.thedetroithub.com/2016/08/04/media-campaign-to-fight-drug-abuse-among-teens-launched-in-michigan

West News

Nevada Among Top 15 States for Drug Overdoses
Mike Murphy, Anthem Blue Cross and Blue Shield
July 31, 2016

Nevada is ranked among the top 15 states for lethal overdoses with 18.4 deaths per 100,000 residents. Anthem Blue Cross and Blue Shield has launched a comprehensive suite of programs and resources to assist members and their physicians in managing opioid misuse and abuse-related conditions. The Pharmacy Home Program helps establish one home pharmacy to more effectively coordinate care for at-risk members. This pharmacy program focuses on members who either are on large amounts of opioid medicines or have been getting narcotic prescriptions from three or more doctors. The program also focuses on use of prescription medications, both controlled and non-controlled, to help decrease the risk of adverse drug interactions.

Read more:
https://vegasinc.com/news/2016/jul/31/nevada-is-in-the-top-15-states-for-drug-overdoses

New Laws Help Reduce Overdose Deaths in New Mexico
Shauna Harley, Albuquerque Journal
July 30, 2016

Earlier this year, New Mexico’s governor signed two bills to help reduce overdose deaths. One expands access and availability of naloxone through standing orders. The other requires doctors to check the state’s prescription drug monitoring program before prescribing an opioid to patients for the first time, and then at least every three months after that for people who are chronically prescribed opioids. Turquoise Lodge Hospital, operated by the health department, is expanding its medical detoxification and social rehabilitation services. It also is working to provide an intensive outpatient program for adults where patients can attend 12–15 hours of group programming to address their addiction issue.

Read more:
http://www.abqjournal.com/817670/new-laws-help-reduce-overdose-deaths.html

Seattle Police Have Saved 10 People with Overdose Drug
KIRO
August 1, 2016

Seattle’s police department has administered naloxone to 10 people since officers started carrying the antidote in mid-March. The department is considering having all officers carry the drug.

Read more:
http://www.kiro7.com/news/local/seattle-police-have-saved-10-people-with-overdose-drug/415295387

Other Resources

August 31 is International Overdose Awareness Day
Penington Institute
Accessed August 1, 2016

This global event aims to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have met with death or permanent injury as a result of drug overdose.

Read more:
http://www.overdoseday.com

Video

Navigating the Opioid Crisis: A Primary Care Perspective
Kenneth W. Lin, M.D., MPH; Charles P. Vega, M.D., Medscape
August 2, 2016

In this video commentary about prescribing opioids for pain, the speakers discuss setting reasonable patient expectations and incorporating naloxone prescriptions. They recommend selecting alternatives before prescribing opioids. If doctors prescribe opioids, the speakers recommend prescribing them for shorter durations and at the lowest dosage possible. (Duration: 13:32 minutes)

Watch:
http://www.medscape.com/viewarticle/866579

Webinars

Reducing Opioid Abuse by Incorporating Patient Management Strategies from Psychiatry and Behavioral Health
American Dental Association
Aug. 24, 2016 | 3–4 p.m. (ET)
http://pcss-o.org/event/reducing-opioid-abuse-by-incorporating-patient-management-strategies-from-psychiatry-and-behavioral-health

Pain Management in Dentistry: A Changing and Challenging Landscape
American Dental Association
Sept. 2, 2016 | 3–4 p.m. (ET)
http://pcss-o.org/event/pain-management-in-dentistry-a-changing-and-challenging-landscape

Grant Announcements

Safety and Outcome Measures of Pain Medications Used in Children and Pregnant Women (R03) | (R01) | (R21)
National Institutes of Health
Due: Oct. 16, 2016 | Jan. 7, 2020 | Jan. 7, 2020
Read more (R03):
http://grants.nih.gov/grants/guide/pa-files/PA-16-313.html
Read more (R01):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284425
Read more (R21):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284428

Safety and Outcome Measures of Pain Medications Used in Children and Pregnant Women (R03) | (R01) | (R21)
National Institutes of Health
Due: Oct. 16, 2016 | Jan. 7, 2020 | Jan. 7, 2020
Read more (R03):
http://grants.nih.gov/grants/guide/pa-files/PA-16-313.html
Read more (R01):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284425
Read more (R21):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284428

Bottle Tracking Program
National Association of Drug Diversion Investigators
Due: None Specified
http://www.naddi.org/aws/NADDI/pt/sp/programs_grants
http://naddibottletracking.org/law-enforcement

National Take-Back Initiative

National Take-Back Initiative
Drug and Enforcement Administration
Saturday, Oct. 22, 2016
10 a.m. – 2 p.m.
http://www.deadiversion.usdoj.gov/drug_disposal/takeback

Take-Back Events & Drop Boxes

St. Charles (Mo.) Police Reveal Prescription Drug Drop-Off Vault
KTVI
August 3, 2016
http://fox2now.com/2016/08/03/st-charles-police-reveal-prescription-drug-drop-off-vault

Lowville (N.Y.) Hospital Joining Pilot Program to Take in Unwanted Drugs
Steve Virkler, Watertown Daily Times
August 2, 2016
http://www.watertowndailytimes.com/news04/lowville-hospital-joining-pilot-program-to-take-in-unwanted-drugs-20160802

New Medication Disposal Unit at Warwick (N.Y.) Police Department Well Received
Warwick Advertiser
August 4, 2016
http://www.warwickadvertiser.com/apps/pbcs.dll/article?AID=/20160804/NEWS01/160809964/New-medication-disposal-unit-at-Warwick-Police-Department-well-received

MedSafe Medication Disposal Box Now Available in Phoenix (N.Y.)
Mikayla Kemp, Oswego County Today
July 30, 2016
http://oswegocountytoday.com/medsafe-medication-disposal-box-now-available-in-phoenix

Walgreens Adds Local Medicine Disposal Drop Boxes in North Caroline
Eddie Fitzgerald, Sun Journal
August 4, 2016
http://www.newbernsj.com/business/20160804/walgreens-adds-local-medicine-disposal-dropoff

Belmont (N.C.) Gets Permanent Drug Drop Off Box
Vanessa Leon, Time Warner Cable
August 3, 2016
http://www.twcnews.com/nc/charlotte/news/2016/08/3/belmont-gets-permanent-drug-drop-off-box.html

New Prescription Drug Drop Box Available at Rock County (Wisc.) Sheriff’s Office
Caissa Casarez, WKOW
August 1, 2016
http://www.wkow.com/story/32590344/2016/08/01/new-prescription-drug-drop-box-available-at-rock-county-sheriffs-office

Upcoming Events, Conferences, & Workshops

The Harold Rogers Prescription Drug Monitoring Program National Meeting
Bureau of Justice Assistance, and Prescription Drug Monitoring Program Training and Technical Assistance Center at Brandeis University
Aug. 17–19, 2016
Washington, D.C.

Register:
http://www.pdmpassist.org/content/ttac-meeting-registration-form

National Conference on Addiction Disorders: Taking Recovery to New Heights
Vendome Healthcare Media
Aug. 18–21, 2016
Sheraton Denver Downtown Hotel
Denver, Colo.
https://vendome.swoogo.com/ncad-2016/home

Register:
https://vendome.swoogo.com/ncad-2016/begin

2016 Annual Conference
International Health Facility Diversion Association
Sept. 13–14, 2016
Cincinnati, Ohio
https://ihfda.org/2016-annual-conference

Register:
https://www.regonline.com/Register/Checkin.aspx?EventID=1803476

Twenty-Ninth Annual National Prevention Network Conference
National Prevention Network
Sept. 13-15, 2016
Buffalo, N.Y.
http://www.npnconference.org

Register:
http://www.npnconference.org/registration

2016 Conference: Saving Lives: Access to Improved Health & Recovery
American Association for the Treatment of Opioid Dependence
Oct. 29 – Nov. 2, 2016
Baltimore, Md.
http://www.aatod.org/national-conference/2016-aatod-conference-baltimore

Register:
http://www.aatod.org/national-conference/2016-aatod-conference-baltimore/register-now

2016 Fall Research Conference: The Role of Research in Making Government More Effective
Association for Public Policy Analysis & Management
Nov. 3–5, 2016
Washington, D.C.
http://www.appam.org/events/fall-research-conference/2016fall-research-conference-information

Bridging the Gaps: Reducing Prescription Drug and Opioid Abuse and Misuse Summit
National Association of Attorneys General and the Association of State and Territorial Health Officials
Nov. 14–16, 2016
Arlington, Va.
http://www.naag.org/nagtri/nagtri-courses/national/bridging-the-gaps-reducing-prescription-drug-and-opioid-abuse-and-misuse-summit.php

National Rx Drug Abuse & Heroin Summit
Operation Unite
April 17–20, 2017
Atlanta, Ga.
https://vendome.swoogo.com/2017-rx-summit/8082

Call for Presentations
Submission Deadline Date: Friday, Aug. 5, 2016
https://vendome.swoogo.com/2017-rx-summit/2017-CFP
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.