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August 20, 2014

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 85  |  August 20, 2014
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports Professional Education News Other State and Local News Other Resources Audio Grants Awarded Request for Proposal National Take-Back Event Take-Back Events and Drop Boxes Save the Date Upcoming Conferences and Workshops

Featured

A. Valdez. 2014. "Rx for Injury: Adolescent Prescription Drug Misuse." Journal of Emergency Nursing. Doi: 10.1016/j.jen.2014.05.011.

This review describes frequency of prescription drug misuse in adolescents, availability and access to prescription drugs, awareness and attitude about prescription drug misuse, and prevention strategies open to nurses. Strategies mentioned include educating patients and parents about risks, in particular a) that prescription opioids are not less risky than taking "street" or illicit drugs, b) proper storage and disposal is imperative, c) consulting a prescription drug monitoring program before an emergency department (ED) physician writes an opioid prescription, and d) getting involved in developing and encouraging prescribing colleagues to use ED controlled-substance prescribing guidelines. ED prescribing guidelines include not replacing controlled substances reported as being lost, stolen, or destroyed; not prescribing long-acting or controlled-released opioids in the ED; and performing screening, brief interventions, and treatment referrals for patients with suspected prescription abuse problems. The author suggests "a number of excellent resources available to parents and emergency nurses, including the PEERx program from the National Institute on Drug Abuse and the 'Not in My House' Web page from the Partnership for Drug-Free Kids."

Read more:
http://www.sciencedirect.com/science/article/pii/S0099176714002128

S. Jain. 2014. "A Diverted or Stolen Prescription Has Been Signed in Your Name. What Do You Do Now?" Current Psychiatry 13(7):63.

This article discusses ways to keep prescription pads secure and recommends actions to report and record fraudulent charges. The author suggests that EDs and doctors invest in tamper-resistant prescription pads and use a gel pen to write prescriptions.

Read more:
http://www.currentpsychiatry.com/articles/pearls/article/a-diverted-or-stolen-prescription-has-been-signed-in-your-name-what-do-you-do-now/020ddfe0bd2c98fc7c4894c73b5367f0.html

Journal Articles and Reports

A. Abdelkarim, H. Salama, S. Abdel Latif, and O. Abou El Magd. 2014. "Stimulant Abuse in Patients With Comorbid Adult Attention-Deficit Hyperactivity Disorder 'ADHD' and Substance Use Disorders 'SUD.'" European Psychiatry 29(S):1, doi: 10.1016/S0924–9338(14)77843–5.

Among 102 adult male substance abusers treated for addiction at El Maamoura psychiatric hospital in Alexandria, Egypt, retrospective assessment showed 35.3 percent had ADHD. Four ADHD patients (11.1 percent) but no one without ADHD was using cocaine.

Read more:
http://www.sciencedirect.com/science/article/pii/S0924933814778435

S.A. Brandt, E.C. Taverna, and R.M. Hallock. 2014. "A Survey of Nonmedical Use of Tranquilizers, Stimulants, and Pain Relievers Among College Students: Patterns of Use Among Users and Factors Related to Abstinence in Nonusers." Drug and Alcohol Dependence. Doi: 10.1016/j.drugalcdep.2014.07.034.

Researchers administered an Internet-based survey to one third of the student body at a small northeastern liberal arts college, and 303 students completed the survey. Of respondents, 36.8 percent reported using prescription drugs for nonmedical purposes. First-year students were less likely to have used the drugs than those in other class years. Of those reporting use, 72.8 percent reported using stimulants, 48.0 percent reported nonmedical use of pain relievers, and 39.8 percent reported using antianxiety medication. When nonusers were asked what factors influenced their choice not to abuse prescription drugs, 82.0 percent cited a lack of interest, 61.0 percent responded it was due to a fear of damaging their physical health, and 60.1 percent responded fear of damaging their mental health.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871614010230

S. Djezzar, M.A. Courné, and N. Richard. 2014. "Methylphenidate Abuse: Results of a French Survey." European Psychiatry 29(S1):1, doi: 10.1016/S0924–9338(14)78097–6.

Researchers analyzed cases of abuse and off-label use of methylphenidate (e.g., Ritalin) in France between 2000 and 2011 recorded in the NotS, Oppidum and Opema databases (tools for monitoring psychoactive substance misuse). In the Oppidum and Opema databases that track adult drug addiction treatment, 61 percent got methylphenidate by medical prescription and 36 percent got it on the black market. Abuse and misuse were identified in 245 patients (168 in NotS, 68 in Oppidum, and 9 in Opema). In databases where this information was recorded, 83 percent used the sustained release form, 77 percent involved polydrug use, 65 percent of cases were males, 20 percent injected methylphenidate, and 4 percent snorted the drug.

Read more:
http://www.europsy-journal.com/article/S0924-9338(14)78097-6/abstract

D.T. Hackman, M.S. Greene, T.J. Fernandes, A.M. Brown, E.R. Wright, and R.A. Chambers. 2014. "Prescription Drug Monitoring Program Inquiry in Psychiatric Assessment: Detection of High Rates of Opioid Prescribing to a Dual Diagnosis Population." Journal of Clinical Psychiatry 75(7):750–56, doi: 10.4088/JCP.14m09020.

An Indiana community mental health center examined prescription drug monitoring program data for 201 dual diagnosis patients. More than 80 percent of these patients had substance use disorders and psychotic, mood, or anxiety disorders. Cases were 51 percent female, 56 percent white, and two thirds uninsured. Nicotine and alcohol disorders were identified in most, with about one third diagnosed with cannabis, cocaine, or opioid disorders. A majority of patients (n=115) had been prescribed opioids in the prior year, with nearly 1 in 5 prescribed an opioid and benzodiazepine simultaneously. Patients were dispensed a mean of 4 opioid prescriptions and 213 opioid pills. More opioid prescriptions correlated with opioid dependence (OR=1.08), and more prescribers correlated with personality disorder diagnoses (OR=1.112). Higher rates and riskier patterns of controlled substance prescribing were identified in patients with Medicaid/Medicare insurance, compared with uninsured patients.

Read more:
http://europepmc.org/abstract/med/25093472

W.P. Jayawardene and A.H. YoussefAgha. 2014. "Multiple and Substitute Addictions Involving Prescription Drugs Misuse Among 12th Graders: Gateway Theory Revisited With Market Basket Analysis." Journal of Addiction Medicine 8(2):102–10, doi: 10.1097/ADM.0000000000000012.

This study of data from 2007 to 2009 Annual Surveys of Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents found that lifetime prevalence of prescription drugs misuse among 12th graders was 19.2 percent. The analysis treats responses from different age cohorts as if they were a longitudinal snapshot.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24440894

A. Looby, D.L. Beyer, and L. Zimmerman. 2014. "Nonmedical Prescription Stimulant Use: Investigating Modifiable Risk Factors." Addiction Research and Theory. Doi:10.3109/16066359.2014.946411.

A survey of 154 undergraduate students in North Dakota found that strong cognitive enhancement expectancies and low grades predicted intention to engage in prescription stimulant use. These expectancy and self-efficacy effects should be alterable through intervention.

Read more:
http://informahealthcare.com/doi/abs/10.3109/16066359.2014.946411

M.E. Mackesy–Amiti, G.R. Donenberg, and L.J. Ouellet. 2014. "Prescription Opioid Misuse and Mental Health Among Young Injection Drug Users." American Journal of Drug and Alcohol Abuse. Doi: 10.3109/00952990.2014.940424.

Researchers conducted semistructured psychiatric interviews with 570 Chicago, Ill.–area drug injectors ages 18 to 25 who were recruited through outreach and respondent-driven sampling. Most were injecting heroin. Estimated rates of lifetime prescription opioid abuse and dependence were 19 percent and 17 percent, respectively. Past-year prescription opioid misuse was significantly associated with antisocial personality disorder (OR=2.15), past-year substance-induced major depression (OR=1.81), and prior posttraumatic stress disorder (OR=2.45).

Read more:
http://informahealthcare.com/doi/abs/10.3109/00952990.2014.940424

J. McCarthy and L.E. Porter. 2014. "Prescription Fraud: A Comparison of Pharmacists' and Laypersons' Perceptions of Suspicious Prescription Presentation Behavior." International Journal of Law, Crime, and Justice. Doi: 10.1016/j.ijlcj.2014.07.002.

An online survey completed by 43 pharmacists and 110 laypersons in Australia investigated how pharmacists detect deception in the context of prescription fraud, and whether their experience affects their levels of suspicion compared with nonexperienced laypersons. Pharmacists were generally more suspicious than laypersons when they rated indicators of drug use and both reliable and unreliable indicators of deception (with reliability determined from the literature), and also when they rated a hypothetical person displaying "true" indicators of deception. Both groups were misled by unreliable deception cues. Laypersons rated deception cues more accurately than pharmacists did.

Read more:
http://www.sciencedirect.com/science/article/pii/S1756061614000494

H. Newville, J. Roley, and J.L. Sorensen. 2014. "Prescription Medication Misuse Among HIV–Infected Individuals Taking Antiretroviral Therapy." Journal of Substance Abuse Treatment. Doi: 10.1016/j.jsat.2014.07.013.

In a survey of 295 HIV–infected patients receiving antiretroviral therapy, 11 percent self-reported prescription medication misuse. In regression analysis, prescription medication misusers were more likely to report any drinking to intoxication (OR=4.31, p=0.013), greater severity of antiretroviral therapy side effects (OR=1.05, p=0.041), and poorer cognitive functioning (OR=0.97, p=0.048), compared with those who did not misuse prescription medications.

Read more:
http://www.sciencedirect.com/science/article/pii/S0740547214001639

P.L. Owens, M.L. Barrett, A.J. Weiss, R.E. Washington, and R. Kronick. 2014. "Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993–2012." HCUP Statistical Brief #177. Agency for Healthcare Research and Quality, Rockville, Md., August.

This HCUP Statistical Brief presents data on adult inpatient hospitalizations involving overuse of prescription opioids, including opioid dependence, abuse, poisoning, and adverse effects. The rate of hospital stays involving opioid overuse among adults increased more than 150 percent between 1993 and 2012, with 709,500 stays in 2012. The largest rates of increase were among subgroups with lower rates in 1993 (women, persons 85 years and older, and persons living in the Midwest). In 2012, rates varied much less among age groups, the Northeast was no longer a notable high-rate outlier, and male and female rates were nearly equal. Medicaid covered 43 percent of opioid overuse stays in 1993. By 2012, Medicaid and Medicare each covered about one third of the stays.

Read more:
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb177-Hospitalizations-for-Opioid-Overuse.pdf

J.G. Ray, S. Hollands, T. Gomes, M.L. Urquia, E.M. Macdonald, P. Li, M.M. Mamdani, and D.N. Juurlink. 2014. "Risk of Overdose and Death Following Codeine Prescription Among Immigrants." Journal of Epidemiology Community Health. Doi: 10.1136/jech–2014–204489.

Researchers used administrative databases to analyze the risk of drug overdose or all-cause mortality within 30 days of codeine prescription in the Canadian province of Ontario between 2002 and 2012. They identified 553.504 persons newly prescribed codeine and 673,740 persons newly prescribed a nonopioid NSAID. The rate of overdose or death was 57.1/100,000 person-days exposed among Canadian-born recipients, which was equal to or higher than rates among recipients who migrated from various world regions (controlling for potential confounders such as age, sex, income and physician visits). Patients prescribed codeine who were unable to speak English or French were at a lower risk of overdose or death relative than people proficient in either language (hazard ratio=0.63).

Read more:
http://jech.bmj.com/content/early/2014/07/29/jech-2014-204489.abstract

S. Rönkä, K. Karjalainen, E. Vuori, and P. Mäkelä. 2014. "Personally Prescribed Psychoactive Drugs in Overdose Deaths Among Drug Abusers: A Retrospective Register Study." Drug and Alcohol Review. Doi: 10.1111/dar.12182.

This register linkage study included all 243 persons who had died of psychoactive prescription drug overdose in Finland in 2000 through 2008. Thirty-six percent of the deceased had legally purchased a similarly acting drug within 3 years of death, with the proportion rising from 20 percent in 2000 to 49 percent in 2008. The proportion with legal purchases within 1 year of death rose from 10 percent to more than 30 percent. Eighty-three percent of the deceased had received income support, but only 13 percent to 14 percent were long-term unemployed or on disability pension. Disability pension recipients had significantly more prescribed psychoactive drug purchases than nonrecipients had.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/dar.12182/abstract;
jsessionid=AF861617071552773C7807B4162E4DCD.f02t03


T. Shimane, T. Matsumoto, and K. Wada. 2014. "The Clinical Behavior of Japanese Community Pharmacists for Preventing Prescription Drug Overdose." Psychiatry and Clinical Neurosciences. Doi: 10.1111/pcn.12232.

This study examined Japanese community pharmacists' clinical behavior regarding patients who overdose on prescribed drugs. Researchers mailed surveys to all registered community pharmacies with dispensing functions (n=1,867) in the Saitama Pharmaceutical Association. Among respondents, 26 percent reported working with patients who overdosed on prescribed drugs in the previous year. Half evaluated their practices such as medication counseling and prescriber referral as good. A poor self-evaluation of prescriber referral was associated with "insufficient confidence in communication with prescribers" (OR=2.7) and "to avoid trouble with prescribers" (OR=1.7).

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/pcn.12232/abstract

D.J. Snipes, A.J. Jeffers, E.G. Benotsch, J. McCauley, D. Bannerman, C. Granger, and A.M. Martin. 2014. "Religiosity in the Nonmedical Use of Prescription Medication in College Students." American Journal of Drug and Alcohol Abuse. Doi: 10.3109/00952990.2014.939755.

Continuing their analysis of an online survey of 767 Virginia Commonwealth University students, researchers found greater religiosity scores were associated with lower odds of engaging in nonmedical use of prescription drugs in the past 3 months. These associations were partially mediated by the personality characteristics of conscientiousness and openness to experience as well as perceived risk of nonmedical use of prescription drugs. Among fraternity and sorority members, religiosity had no effect on nonmedical use.

Read more:
http://informahealthcare.com/doi/abs/10.3109/00952990.2014.939755

Substance Abuse and Mental Health Services Administration (SAMHSA). 2014. The DAWN Report: Emergency Department Visits Attributed to Overmedication That Involved the Insomnia Medication Zolpidem. Rockville, Md.: SAMHSA, Center for Behavioral Health Statistics and Quality.

Emergency department visits involving overmedication with Zolpidem/Ambien increased for both males and females between 2005–06 and 2009–10. In 2010, females accounted for 68 percent of the overdoses, with patients most often ages 45 to 54. Of 2010 overdoses, 47 percent also included other pharmaceuticals. Nearly half resulted in a hospital admission or transfer, with 26 percent admitted to a critical or intensive care unit.

Read more:
http://samhsa.gov/data/2K14/DAWN150/sr150-zolpidem-2014.htm

U. Varshney. 2014. "Mobile Health: Medication Abuse and Addiction." MobiHoc'14—The 15th Association for Computing Machinery International Symposium on Mobile Ad Hoc Networking and Computing, Philadelphia, Pa., Aug. 11–14, doi: 10.1145/2633651.2633656.

Medication behavior can be monitored using smart medication systems, specialized wearable sensors, or mobile devices with patient-entered consumption data. The goal is to design and develop an advance warning system. This paper presents a preliminary design of a system that analyzes usage pattern and alerts healthcare professionals or family members about possible abuse. System inputs include patient's condition, usage history, current use, and a built-in database on abuse and addiction potential of medications.

Read more:
http://dl.acm.org/citation.cfm?id=2633656

P. Wajantri, M.M. Angadi, K.A. Masali, K.J. Shashank, S. Bhat, and A.P. Jose. 2014. "A Study on Knowledge, Attitude, and Practice About Self Medication Among College Students." International Journal of Health Sciences and Research 4(7):11–14.

A survey of 167 college students in India showed that 94 percent practiced self-medication. Their rationales were to save money when treating minor illnesses (66 percent), to save time (35 percent), and to get relief (24 percent). Antipyretics (76 percent) were most commonly used for self-medication. Symptoms most often self-medicated were fever (59 percent) and cough/cold/sore throat (49 percent). Books (67 percent) were the major source of knowledge regarding self-medication, and 69 percent were aware that self-medicating could be harmful.

Read more:
http://www.scopemed.org/?jft=107&ft=107-1406610429#cite

Professional Education

D. McCarty, R. Bovett, T. Burns, J. Cushing, M.E. Glynn, J. Kruse, L.M. Millet, and J. Shames. 2014. "Oregon's Strategy to Confront Prescription Opioid Misuse: A Case Study." Journal of Substance Abuse Treatment. Doi: http://dx.doi.org/10.1016/j.jsat.2014.07.012.

This case study reviews the Oregon Prescription Drug Taskforce's participation in the National Governors Association State Policy Academy on Reducing Prescription Drug Abuse. The taskforce developed a strategy for practice change, community education, and enhanced access to safe opioid disposal that relies on stakeholder meetings, consensus development, and five action steps: 1) reduce pills in circulation, 2) educate prescribers and the public on the risks of opioid use, 3) foster safe disposal of unused medication, 4) provide treatment for opioid dependence, and 5) continue leadership from the governor, health plans, and health professionals.

Read more:
http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(14)00149-4/abstract

R. Nimroozi, D.J. Mastropietro, and H. Omidian. 2014. "Opioid Abuse and Deterrence: Buprenorphine Products." Journal of Developing Drugs 3:117, doi: 10.4172/2329–6631.1000117.

The economic burden from abuse of opioid-based prescription drugs led to the development of treatment programs and the use of methadone maintenance in clinics. Yet, methadone itself had abuse liability and was misused in ways such as crushed for nasal insufflation or dissolved for subsequent intravenous injection. Later, buprenorphine, a synthetic opioid working as a partial agonist at the mu-opioid receptor, became available for outpatient use. It restricts euphoria, decreases withdrawal symptoms, and can prevent displacement when the user takes illicit opioids. To reduce its potential for abuse, it now only is available as a combination (Suboxone) with the opioid antagonist naloxone. If users abuse the combination product by injecting it, the naloxone cancels the euphoric effects.

Read more:
http://omicsgroup.org/journals/opioid-abuse-and-deterrence-buprenorphine-products-2329-6631.1000117.php?aid=28042

H. Omidian and D.J. Mastropietro. 2014. "Drug Tampering and Abuse Deterrence." Journal of Developing Drugs 3:119, doi: 10.4172/2329–6631.1000119.

This paper summarizes the types of tampering commonly performed during abuse of prescription drugs. This information can assist those developing dosage forms more resistant to multiple abuses.

Read more:
http://omicsgroup.org/journals/drug-tampering-and-abuse-deterrence-2329-6631.1000119.php?aid=28038

News

Consumer Watchdog Campaign: Proposition 46 Requiring Physicians to Check Statewide Prescription Drug Database Can Save Up to $406 Million Annually
Consumer Watchdog
August 11, 2014

Consumer Watchdog estimates that Proposition 46 can save California taxpayers up to $406 million annually by requiring doctors to check the prescription drug monitoring program (PDMP) database before prescribing narcotics to first-time patients. This includes $299 million annually by reducing the numbers of doctor-shoppers on Medi–Cal, $95 million in reduced criminal justice costs, and $12 million in savings from lost productivity. Several states recently required physicians to use PDMP databases. In Tennessee, the number of prescriptions decreased 7 percent while the number of doctor-shoppers decreased 36 percent in the first year. In Virginia, doctor-shoppers declined 73 percent.

Read more:
http://www.consumerwatchdog.org/newsrelease/consumer-watchdog-campaign-prop-46-requiring-physicians-check-statewide-prescription-dru

Canada Slow to Respond to Opioid Addiction Crisis
David Juurlink, (Toronto, Ontario) Globe and Mail
August 14, 2014

Dr. David Juurlink, an expert adviser with EvidenceNetwork.ca and professor and head of the Division of Clinical Pharmacology and Toxicology at the University of Toronto, compares the prevention of prescription drug abuse efforts in Canada with the United States. He suggests prescribing opioids more cautiously and conducting a national assessment of the toll exacted by opioids. Dr. Juurlink said every doctor and pharmacist should have real-time access to a patient's full medication profile, drug companies should be compelled to conduct large-scale evaluations of the benefits and risks of their drugs, and patient and physician registries should be implemented for high-dose opioids. He feels better treatments are needed for pain. He said everyone should collectively lower their expectations of what pills can do for patients with chronic pain.

Read more:
http://www.theglobeandmail.com/globe-debate/canada-slow-to-respond-to-prescription-opiod-crisis/article20058291/

Merck Wins U.S. Approval of New Type of Sleeping Pill
Anna Edney, Bloomberg
August 14, 2014

Merck received approval from the Food and Drug Administration to sell Belsomra (chemical name Suvorexant), a new sleeping pill claimed to have fewer side effects than Ambien. The Drug Enforcement Administration, which must determine prescribing restrictions before the drug enters the market, proposed to class it as having a low potential for abuse.

Read more:
http://www.bloomberg.com/news/2014-08-13/merck-wins-u-s-approval-of-new-type-of-sleeping-pill.html

Treating College Students for Opioid Dependence
Celia Vimont, Partnership for Drug-Free Kids
August 13, 2014

This article discusses treating college students who are dependent on prescription pain relievers with buprenorphine/naloxone or sustained-release naltrexone. Joshua Hersh, staff psychiatrist at Miami University, said students may mix drugs or use higher doses of their own medication which facilitates addiction. When he treats students for prescription drug abuse, he has them sign a release form that allows him to speak with their treating doctor and pharmacist. He also checks the Ohio prescription drug monitoring program database to see where students are getting their medication. He tries to treat students on an outpatient basis whenever possible. At Miami University, buprenorphine/naloxone has been administered to students by a school nurse to prevent diversion. When using naltrexone, a person must detox from opioids about 1 week before he or she can start treatment. Dr. Hersh urges all colleges to provide their safety officers with naloxone nasal spray.

Read more:
http://www.drugfree.org/join-together/treating-college-students-opioid-dependence/

Other State and Local News

Cal Poly's Drug Policy Calls for Random Testing for NCAA–Banned Drugs
Nick Wilson, Tribune News
August 12, 2014

This article discusses California Polytechnic State University's drug policy, the kinds of substances banned for its student–athletes, and the punishments for violations. All student–athletes who participate in NCAA sports may be selected by the university's medical review officer for random drug testing. Drugs banned under NCAA regulations that the university tests for include stimulants such as Adderall, cocaine, ephedrine, and bath salts; street drugs including heroin, marijuana, and THC; and performance enhancers including testosterone, androstenedione, and human growth hormone. The policy includes sanctions for nonsteroid and steroid offenses.

Read more:
http://www.sanluisobispo.com/2014/08/12/3193403/cal-polys-drug-policy-calls-for.html?sp=/99/177/183/

The Challenges of Bottling Up Prescription Drug Abuse
Tom Lutey, Billings (Mont.) Gazette
August 10, 2014

This article discusses Montana's prescription drug monitoring program. The state requires that all prescriptions for pain relievers be registered with the board of pharmacy. The list has 5 million prescriptions on it and 620,000 patients. Montana doctors and pharmacists are required to report prescriptions to the registry but are not required to check a patient's name against the registry before writing a prescription. Only 24 percent of health care providers eligible to use the list actually do. Since the registry went live in October 2012, prosecutors have received responses to 264 subpoenas, and healthcare licensing boards have requested information for 18 investigations of care providers. More than 56 percent of the state's pharmacists are registered to check patient names against the list. The board is working to increase the number of professionals using the list, and plans to link the database with registries from other states to track prescription fraud across state lines.

Read more:
http://billingsgazette.com/news/local/the-challenges-of-bottling-up-prescription-drug-abuse/article_e57699be-b465-53fd-8417-6eacd144f584.html?comment_form=true

Pennsylvania Adopts New Guidelines for Pain Treatment in Emergency Rooms
WFMZ
August 13, 2014

The Pennsylvania Departments of Drug and Alcohol Programs and Health and the Pennsylvania Medical Society announced adoption of the Emergency Department Pain Treatment Guidelines. The guidelines recommend appropriate treatment to relieve pain and to identify individuals who may be abusing or are addicted to prescription opioids so they can be referred to treatment.

Read more:
http://www.wfmz.com/news/pennsylvania-adopts-new-guidelines-for-pain-treatment-in-emergency-rooms/27456326

Hennepin Sheriff's Deputies Now Carry Heroin Antidote
Shannon Prather, Star–Tribune
August 12, 2014

The Hennepin County Sheriff Department became the first law enforcement agency in Minnesota to carry Naloxone. Sheriff Rich Stanek said 24 patrol deputies have been trained to administer Narcan and kits have been placed in squad cars.

Read more:
http://www.startribune.com/local/north/270931661.html

Lawmaker: First Responders Need to Carry Overdose Drug
Megan Reust, WANE–TV
August 14, 2014

This article and video (2 minutes 51 seconds) discuss first responders using Narcan. Indiana's law now allows all first responders, police officers, and fire departments to carry Narcan without having any liability. Three Rivers Ambulance Authority is one of the few that carries the drug. Last year alone, it used Narcan 140 times. Although many law enforcement agencies and firefighters do not carry Narcan, Rep. McMillen says lawmakers will be working to make this a mandate soon.

Read more:
http://wane.com/2014/08/13/lawmaker-first-responders-need-to-carry-overdose-drug/

Naperville Attempts to Tackle Growing Heroin Problem
Carol Marin and Don Moseley, NBC Chicago
August 12, 2014

This article (3 minutes 51 seconds) and two videos (2 minutes 6 seconds and 2 minutes 45 seconds) discuss a report by a legislative task force stating that heroin use among high school students in Illinois is a growing problem. Heroin use touches kids as young as the eighth grade. Heroin-related deaths in DuPage County increased from 26 in 2011 to 42 to 2012; in Will County from 30 to 53; in McHenry County from 9 to 16; and in Kane County from 9 to 27. The report recommends more education among high school students as to the addictive nature of the drug and the proper disposal of prescription drugs that can lead to heroin addiction.

Read more:
http://www.nbcchicago.com/investigations/Naperville-Attempts-to-Tackle-Growing-Heroin-Problem-270848591.html

Report: Drug Overdose Deaths Remain High in Eastern Kentucky but Showing Improvements
Hillary Thornton, WYMT
August 13, 2014

This article and video (2 minutes 6 seconds) discuss a report by Kentucky Office of Drug Control Policy that revealed the Eastern Kentucky region leads the state with five of the top six counties for overdose deaths in 2013. Pike County showed improvement, with 12 fewer overdoses in 2013 than the previous year.

Read more:
http://www.wkyt.com/wymt/home/headlines/REPORT-Drug-overdose-deaths-remain-high-in-Eastern-Kentucky-but-showing-improvements-271148651.html

Price of Addiction: Oregon Prescribers Should Consider 'Smart Pills' To Stem Opioid Abuse (Guest Column)
David Russo, Portland Business Journal
August 13, 2014

David Russo, a doctor of osteopathic medicine and a pain management specialist, suggests that health leaders, prescribing providers, and Oregon policymakers examine prescribing practices to better control the possibility of abuse and overprescribing. He thinks the best way to help those who are addicted or abuse prescription drugs is to reduce abuse opportunities and increase the use of smart pills. If altered or abused, smart pills have unpleasant side effects, alter the timed release, or become ineffective.

Read more:
http://www.bizjournals.com/portland/blog/health-care-inc/2014/08/price-of-addiction-oregon-prescribers-should.html?page=all

Other Resources

2014 CADCA 50 Challenge
Community Anti-Drug Coalitions of America
Accessed August 13, 2014

The CADCA 50 Challenge is an effort to get prescription drug abuse and over-the-counter cough medicine abuse on the radar screens of families across the country. To participate in the challenge, host a town hall meeting or another type of educational event about prescription drug abuse and over-the-counter cough medicine abuse during October, National Medicine Abuse Awareness Month. The Community Anti-Drug Coalitions of America offer helpful tools to assist communities in hosting and planning their events, including PowerPoint presentations, videos, brochures, and fact sheets.

Read more:
http://www.preventrxabuse.org/facts-tools/the-cadca-50-challenge/

New Distracted and Impaired Driving Community of Practice
Children Safety Network
Application Due: August 29, 2014

The Children's Safety Network announced a new Community of Practice (CoP) on the prevention of distracted and impaired driving. Using the principles of quality improvement, this CoP aims to improve participants' knowledge of and ability to implement best practices related to innovative technologies, policies, laws, partnerships, and programs that reduce the burden of distracted and impaired driving, especially as it relates to teen drivers and their parents. This CoP will explore the prevention of motor vehicle crashes that affect children and youth through strategies, programs, research, and legislation related to distraction by passengers; drowsy driving; drunk driving; eating, drinking, and grooming while driving; impaired driving from illicit drugs; impaired driving from marijuana; impaired driving from prescription/over the counter drugs; and technology/cell phone use while driving.

Read more:
http://www.childrenssafetynetwork.org/news/new-distracted-and-impaired-driving-community-practice

Safe Drug Disposal Announces the Availability of Hospital-Grade In-Home Medicine Destruction for Consumers Through Amazon.com
Digital Journal
August 12, 2014

This press release announces that Drug Dispose All is now available to consumers in 8-oz. and 128-oz options on Amazon.com. Drug Dispose All is an in-home narcotic disposal to safely destroy old or unused prescription medication.

Read more:
http://www.digitaljournal.com/pr/2117468

Audio

Prescription Drug Overdose in North Carolina
Frank Stasio, Western North Carolina Public Radio
August 14, 2014

Host Frank Stasio talks with Fred Brason, founder of Project Lazarus, an organization working on prescription overdose issues in North Carolina. He also talks with David McAdams, author of Game Changer: Game Theory and the Art of Transforming Strategic Situations and associate professor at Duke Fuqua School of Business, and Chris Atack, patrol captain for the Carrboro Police Department. [Duration: 31 minutes 15 seconds]

Read more:
http://wcqs.org/post/prescription-drug-overdose-north-carolina

Grants Awarded

CDC Awards More Than $1 Million to Oklahoma to Advance Prescription Drug Overdose Prevention
Oklahoman
August 14, 2014

This article announces that the Centers for Disease Control and Prevention awarded Oklahoma more than $1 million to help prevent prescription drug overdoses and to address patient and prescribing behaviors. The funding will help the state enhance and maximize its prescription drug monitoring program and leverage prescribing data to protect patients in Oklahoma's Medicaid program from overdose.

Read more:
http://newsok.com/cdc-awards-more-than-1-million-to-oklahoma-to-advance-prescription-drug-overdose-prevention/article/5210473

Quality Health Foundation Awards Grants
Star–Democrat
August 13, 2014

Quality Health Foundation awarded grants totaling $395,000 to 12 organizations across Maryland and in the District of Columbia that support local healthcare-related quality improvement efforts. A $20,000 grant was awarded to the Talbot Partnership for Alcohol and Other Drug Abuse Prevention for its Heroin, Prescription, and Synthetic Drug Prevention Program. The program concentrates on prevention and early intervention for heroin, prescription drug abuse, and synthetic drug risks.

Read more:
http://www.stardem.com/business/article_7474ef37-5802-5da2-b79f-40b8892f42f5.html

Request for Proposal

Prescription Drug Abuse: Reducing Prescriptions for Opioids
Health Canada
Deadline: August 29, 2014, 4 p.m. EDT
http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/dscif-ficsa/index-eng.php

Chronic Pain Management Research Grant
Milbank Foundation
Postmarked by November 1, 2014
http://foundationforpmr.org/milbank-foundation-chronic-pain-management-research-grant-application-criteria-and-conditions

Interventions for Youth Who Misuse/Abuse Prescription Stimulant Medications in High School and/or College-Attending Youth (U01)
National Institutes of Health
Deadline: November 13, 2014, 5 p.m.
https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-15-010.html

National Take-Back Event

National Take-Back Initiative
Drug Enforcement Administration
September 27, 2014
http://www.deadiversion.usdoj.gov/drug_disposal/takeback/

Take-Back Events and Drop Boxes

Muscogee Sheriff's Office Collects Thousand More Pounds of Expired Pills
Tiffany Stevens, Ledger–Enquirer (Georgia)
August 13, 2014
http://www.ledger-enquirer.com/2014/08/13/3246432/muscogee-sheriffs-office-collects.html?sp=/99/100/&ihp=1

Drop Off Drugs at Blueclaws Stadium
Kirk Moore, Asbury Park (N.J.) Press
August 13, 2014
http://www.app.com/story/news/local/jackson-lakewood/lakewood/2014/08/12/drug-dropoff-blueclaws/13959613/

Safe Disposal of Unused Meds Helps Prevent Drug Abuse
Barbara C. Barrett, Luminary (Pennsylvania)
August 12, 2014
http://www.muncyluminary.com/page/content.detail/id/538420/Safe-disposal-of-unused-meds-helps-prevent-drug-abuse.html?nav=5007

Sen. Chapin and Rep. Case Welcome Pharmaceutical Drug Drop Box
Connecticut State Sen. Clark Chapin
August 9, 2014
http://ctsenaterepublicans.com/2014/08/sen-chapin-rep-case-welcome-pharmaceutical-drug-drop-box/#.U-qGAKNOXoY

New Prescription Drug Drop Box Available at Crestline PD
Krystal Smalley, Crawford County (Ohio)
August 14, 2014
http://crawfordcountynow.com/local/new-prescription-drug-drop-box-available-at-crestline-pd/

Prescription Drug Drop Box Now in Cardington
Marrow County Sentinel (Ohio)
August 12, 2014
http://morrowcountysentinel.com/news/news/50247913/Prescription-drug-drop-box-now-in-Cardington#.U-y8s6NOUgB

With Opiate Addiction on the Rise, Here's a Safe Way to Trash Meds
Natasha Haverty, North Country Public Radio (New York state)
August 13, 2014
http://www.northcountrypublicradio.org/news/story/25730/20140813/with-opiate-addiction-on-the-rise-here-s-a-safe-way-to-trash-meds

Dispose of Properly: Health Department Collects Record Amounts of Unwanted Medication
Susan Frick Carlman, Naperville (Ill.) Sun
August 14, 2014
http://napervillesun.suntimes.com/2014/08/14/health-department-medication-collection-record/

Teaching Moment: New Drop-Off Site a Chance to Reinforce Danger of Meds in Wrong Hands
Natalie Allison Janicello, Times–News (North Carolina)
August 14, 2014
http://www.thetimesnews.com/news/top-news/teaching-moment-new-dropoff-site-a-chance-to-reinforce-danger-of-meds-in-wrong-hands-1.359167

Residents Asked to Dispose of Unwanted Medications
Tri-Town News (New Jersey)
August 14, 2014
http://tri.gmnews.com/news/2014-08-14/Front_Page/Residents_asked_to_dispose_of_unwanted_medications.html

Prescription Drug Take-Back
Vashon Island Chamber of Commerce (Washington)
Accessed August 12, 2014
http://business.vashonchamber.com/events/details/prescription-drug-take-back-52205

Prescription Drop-Offs Planned at First Energy Park
Tom Mongelli, WOBM (New Jersey)
August 12, 2014
http://wobm.com/prescription-dropoffs-planned-at-first-energy-park/

Save the Date

Sixth Annual American Medicine Chest Challenge: National Day of Awareness and Safe Disposal of Prescription and Over-the-Counter Medicine
American Medicine Chest Challenge
November 8, 2014
http://www.americanmedicinechest.com

Upcoming Conferences and Workshops

Pills Kill: Prescription to Addiction Symposium
City of Santa Clarita, Calif.
August 27, 2014
Santa Clarita, California
http://www.santa-clarita.com/index.aspx?page=133&recordid=1735&returnURL=%2findex.aspx

2014 Arkansas Prescription Drug Abuse Summit
University of Arkansas, Criminal Justice Institute
September 10, 2014
Little Rock, Arkansas
http://www.cji.edu/2014-rx-drug-abuse-summit/

Twenty-Seventh Annual NPN Prevention Research Conference
National Prevention Network
September 15–18, 2014
Hartford, Connecticut
http://swpc.ou.edu/npn

2014 Harold Rogers PDMP National Meeting
Brandeis University, Prescription Drug Monitoring Program Training and Technical Assistance Center
September 22–24, 2014
Washington, District of Columbia
http://www.pdmpassist.org/content/events

Fifth Annual Prescription Drug Abuse Symposium: Reversing the Tide of Opioid Abuse
Office of the Indiana Attorney General
October 16–17, 2014
Westin Indianapolis
301 West Washington Street
Indianapolis, Indiana

The Prescription Drug Abuse Symposium will take a multidisciplinary approach to address prescription drug abuse in Indiana. It will bring together state and federal legislators, law enforcement, health officials, members of the medical community, pharmacists, state and local agencies, and education providers to share strategies on combating the issue.

Read more:
http://www.in.gov/bitterpill/symposium.html

142nd Annual Meeting and Exposition
American Public Health Association
November 15–19, 2014
New Orleans, Louisiana
http://www.apha.org/meetings/annual
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. TheWeekly 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.