West Virginia University Logo

August 28, 2013

If you are having difficulty viewing the Weekly Update, please click here.

    SAMHSA Prescription Drug Abuse Weekly Update

    ISSUE 34  |  AUGUST 2013

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.

Featured Report

Full Report and Key


Findings: 2012 Partnership Attitude Tracking Study, Sponsored by MetLife Foundation: Hispanic Teen Drug Use
The Partnership at Drugfree.org
August 20, 2013
According to a 2012 national survey that tracks teen drug and alcohol use, Hispanic teens are more likely to abuse prescription drugs when compared with teens from other ethnic groups. The survey found 30 percent of Hispanic teens misused or abused a prescription medicine at least once in their lifetime compared with 17 percent in 2010--a 76 percent increase over 2 years. In 2012, more than one fourth of Hispanic teens (26 percent) reported abusing or misusing a prescription drug in the past year, compared with 15 percent for white and African American teens. One in seven Hispanic teens (16 percent) reported they engaged in the risky behavior of mixing alcohol with prescription drugs (without a prescription), compared with 11 percent for white teens and 6 percent for African American teens. One in ten Hispanic teens abused over-the-counter cough medicine in the past year, compared with 5 percent for white and African American teens. (See May 1, 2013, issue for a description of other findings from this report.)

Read more:

Journal Articles

S. Ando, T. Matsumoto, S. Kanata, A.  Hojo, D. Yasugi, N. Eto, C. Kawanishi, N. Asukai, and K. Kasai. 2013. "One-Year Follow Up After Admission to an Emergency Department for Drug Overdose in Japan." Psychiatry and Clinical Neurosciences. doi:10.1111/pcn.12079.

This study aimed to investigate incidence of and risk factors for repetition of suicidal behavior in Japan within 1 year after admission for drug overdose. Researchers followed up with patients who were admitted to the emergency department of a general public hospital in Tokyo for overdose of prescribed medicine and/or over-the-counter drugs between March 2008 and February 2009. Demographic characteristics, previous suicide attempts, and mental health state were examined with a self-report questionnaire and interview at recovery from the initial attempt. Information about suicidal behavior during the follow-up period was obtained from outpatient psychiatrists by postal questionnaire 1 year after discharge. Of 190 patients admitted to the emergency department, 132 completed the questionnaire and interview. Information about the follow-up period for 66 patients was obtained. Of these patients, 28 attempted suicide again and two patients committed suicide during the 1-year follow-up period. Psychiatric diagnosis of personality disorder and denial of suicidal intent at the time of recovery were associated with increased risk for another suicide attempt. Lethality levels of suicidal behaviors before and after admission were associated with each other. The authors suggest clinicians should pay attention to the means of previous suicide attempts, even if the patient denies suicidal intent at recovery.

Read more:

M. Ford and A. Rouse Dulaney. 2013. "Prescription Drug Overdose and Misuse: Data from Carolinas Poison Center." North Carolina Medical Journal 74(3):244.

U.S. poison control centers collect self-reported information from the public and medical information from healthcare providers on substances involved in poisonings, their clinical effects, and management of these cases. In 2011 and 2012, Carolinas Poison Center handled 98,115 calls involving people who were exposed to prescription or nonprescription pharmaceutical substances. The top five categories of such agents were analgesics; sedatives, hypnotics, and antipsychotics; cardiovascular drugs; antidepressants; and antihistamines. Prescription pain medications containing opioids, either alone or in combination with acetaminophen or salicylates, accounted for 6,137 of these calls, representing 29.8 percent of all calls related to human exposure to analgesic medications. The top three opioids implicated in these cases were (in rank order) hydrocodone, oxycodone, and tramadol. In the majority of prescription pain medication cases, the individual underwent treatment in a healthcare facility; naloxone was administered in 22.0 percent of cases. Of the cases managed in a healthcare facility that involved opioids only (without acetaminophen or aspirin), 7.6 percent had an outcome of death and/or major effects. Only 32.5 percent of prescription pain medication cases were managed at the site of the caller, outside a healthcare facility.

Read more:

News and Reports

@ISSUE: Why Are Death Rates Soaring from Prescription Drug Abuse by Women?
Asbury Park Press
August 18, 2013

This article discusses several reasons why women may be dependent on prescription pain relievers. Some women may be dealing with stress due to multiple roles--parenting teenagers, managing a household, working, or taking care of aging parents. In addition, doctors are untrained in pain management so they may overprescribe opiate-based drugs. Some blame pharmaceutical companies for aggressively marketing the drugs. Women abusing prescription drugs may have a family history of addiction, putting them at greater risk. They may be dealing with mental problems such as anxiety and depression. Also, gender-specific factors such as hormonal influences may make women more prone to using prescription pain relievers in combination with anti-anxiety and antidepressant drugs.

Read more:

Should Miguel Tejada Suspension Mean More Education on Prescription Drug Abuse?
Bleacher Report
August 18, 2013

This article discusses the need for more education on prescription drug use among professional athletes. Recently, several players have been suspended for the use of performance enhancement drugs or Adderall. The drugs have become a focus on the playing field at college campuses and in classrooms. An added emphasis on prescription drugs should be integrated into preexisting programs for professional athletes and amateur athletes hoping to become professionals.

Read more:

Opioid Contracts for Injured Workers Help Prevent Improper Use of Pain Medications
Business Insurance
August 11, 2013

Experts say opioid contracts that require injured workers to give informed consent for long-term narcotic prescriptions are useful in preventing improper use of pain medications. It is not known if these contracts have a direct effect in preventing opioid dependency or overdoses. They are, however, helpful in informing patients and providers about the risks of narcotic prescriptions, and allow physicians to set boundaries for prescribing such drugs. Minnesota passed legislation that requires injured workers to sign written contracts with their providers when receiving long-term prescriptions for opioids or other controlled substances. Washington State's opioid contract includes a section that says doctors will verify patients' opioid prescription history with the prescription monitoring program. It also includes language that the patient will take opioids "only at the dose and frequency prescribed," and won't "ask for opioids or any other pain medicine from another provider."

Read more:

CVS Cuts Off Docs Who Prescribe Too Many Narcotics
NBC News
August 22, 2013

CVS Caremark Corporation suspended store and mail-order pharmacy access to pain relievers for more than 36 doctors and other healthcare providers who were prescribing the drugs at an alarmingly high rate. CVS began revoking the dispensing privileges of certain providers in late 2012. It has not yet discussed its findings about the providers with the Drug Enforcement Administration or others. CVS said the suspensions followed an analysis of prescriptions brought to its drugstores from March 2010 through January 2012 for hydrocodone, oxycodone, alprazolam, methadone, and carisoprodol. To identify doctors with suspicious practices, CVS analyzed prescription rates of providers in the same specialty and geographic region, ages of the patients, and the number of patients paying for the drugs with cash.

Read more:

Curbing the Claim-Related Opioid Abuse Epidemic
Property Casualty 360˚
August 16, 2013

This article discusses five components of an effective claims-based opioid monitoring program. They include assessing the prevalence and incidence of potential opioid abuse within the insured population; developing a method to score claims in a dynamic fashion; implementing a workflow to apply the most appropriate action to the claim (given the current phase of the claim and assessed risk); monitoring providers to understand where risk is greatest; and measuring cost and health outcomes, including prescription costs, emergency room visits, readmissions, lost work time, and claimant satisfaction. Insurers can take a leading role by managing risk at the point of the claim.

Read more:

Nevada State Senator Joins Call to List Oxycontin Over-Prescribers
Los Angeles Times
August 16, 2013

Senator Richard Segerblom sent a letter to Purdue Pharma requesting names of Nevada doctors suspected of prescribing pills to drug dealers and addicts. Segerblom, chairman of Nevada's Senate Judiciary Committee, believes the contents of Purdue's database could provide leads for medical investigators in his state.

Read more:

DEA Warns of Extortion Scam
NBC 5 Chicago
August 19, 2013

This article and video (2:27 minutes) discuss the Drug Enforcement Administration's (DEA's) warning about scammers who tell their victims that purchasing drugs over the Internet or by telephone is illegal, but that they will not be arrested if they pay a fine. Callers identify themselves as DEA agents. The DEA is urging consumers to use caution when purchasing controlled substance pharmaceuticals by telephone or through the Internet. If people receive calls, they should hang up and contact local police. People are also urged to report any suspicious calls to the DEA.

Read more:

Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States
CBHSQ Data Review, Substance Abuse and Mental Health Services Administration
August 2013

This study examines recent trends in heroin initiation, including nonmedical prescription pain reliever use among people aged 12 to 49. Pooling data from the National Survey on Drug Use and Health (conducted annually from 2002 through 2011), the study found the recent (12 months preceding interview) heroin use incidence rate was 19 times higher among those who reported prior nonmedical pain reliever (NMPR) use than among those who did not (0.39 vs. 0.02 percent). In contrast, the recent NMPR incidence rate was almost two times higher among those who reported prior heroin use than among those who did not (2.8 vs. 1.6 percent). Four out of five recent heroin initiates (79.5 percent) were previous NMPR users, but only 1.0 percent of recent NMPR initiates had already used heroin. Moreover, the vast majority of NMPR users had not progressed to heroin use. Only 3.6 percent of NMPR initiates started heroin use within the 5-year
period following first NMPR use.

Read more:

Other State and Local News

Medication Drop Box Popular
Albuquerque Journal News
August 19, 2013

In April 2012, the New Mexico Department of Public Safety launched a prescription drug drop box for residents living in Duke City. The box is checked every 3 months. The first collection resulted in 30 pounds of pills--3 months later, 60 to 70 pounds were dropped off by residents. In 16 months, the police department disposed of more than 250 pounds of pills. The popularity has caught the interest of other law enforcement officials in the area.

Read more:

Arizona Honored for Efforts to Curb Prescription Drug Abuse
August 22, 2013

The National Criminal Justice Association honored Arizona's prescription drug initiative as the best in the Western region in terms of innovation and delivery of concrete results. The Arizona Prescription Drug Misuse and Abuse Initiative reflects a multisystemic, multiagency effort to reduce prescription drug misuse and its associated consequences. Since June 2012, the initiative has been responsible for the collection of more than 5,000 pounds of unused prescriptions, the education of nearly 9,000 Arizonans through a research-based awareness curriculum, and a total media reach of more than 395,000 people.

Read more:

Prescription Drug Related DWIs Are on the Rise
August 23, 2013

This article and video (2:49 minutes) discuss drugged driving in Jefferson Parish, Louisiana. Half of driving while intoxicated (DWI) cases are related to prescription or illicit drugs. The Director of Felony DWI and Traffic Safety Outreach for Jefferson Parish works with the state to try to reduce all DWIs. In February, the director proposed a research project to look at drugged driving--a statewide problem. The project is now under way. It is funded by Louisiana State University's Highway Safety Research Group and run by the Louisiana Transportation Research Center. Once researchers determine how big the dilemma is, officials will look at control strategies.

Read more:

Group Fighting Against Rx Abuse
Fox 45
August 23, 2013

This article and video (2:25 minutes) discuss a group's mission to stop prescription drug abuse among young people. Hope Blooms speaks to students about the dangers of abusing prescription drugs. The educational program is only in Southeast Ohio, but may expand to cover every high school in the state. The founder lost her 21-year-old daughter to a mix of oxycodone and alcohol.

Read more:

Coalitions in Action: County Coalition Incinerates Their Rx Problems
Community Anti-Drug Coalitions of America
August 22, 2013

Almost 1 year ago, the Jackson County Anti-Drug Coalition based in Ripley, West Virginia, purchased an incinerator to help reduce prescription drug abuse. The sheriff's department holds the license and the county commission assists. By reducing access and increasing perception of harm, Jackson County's overdose deaths have dramatically decreased, and the community has not lost a teenager to abuse since 2009, according to the coalition's project director.

Read more:

The Rx Drug Wars: A New Hope
The Chattanoogan.com
August 16, 2013

Alix C. Michel and David J. Ward, lawyers with a combined 50 years of experience in medical and professional malpractice, share their views on two efforts that provide hope for winning the war on prescription drugs. The Tennessee Medical Association, Tennessee Department of Health, and other healthcare provider associations/agencies developed a brochure that educates patients on Tennessee's new Prescription Safety Law. The brochure describes aspects of the drug epidemic and explains why physicians will be asking patients more questions about prescription drug use. It also provides tips regarding responsible use of prescription drugs. The East Tennessee Children's Hospital is hosting a conference entitled, "The Hidden Epidemic, Living with Neonatal Abstinence Syndrome and What the Future Holds" on September 13. Due to the overwhelming response from the community, the conference will now be simulcast live via the Web.

Read more:

Prescription Drugs Take Deadly Toll on Roads
The Chicago Tribune
August 17, 2013

This article discusses drivers impaired by lawfully prescribed medications. Such was the case in Illinois when a retired construction worker crashed his vehicle into the side of a school bus. Some children suffered minor injuries; the construction worker died at the scene. A blood test determined he had taken a sedative and narcotic pain reliever. If an individual drives with a prescribed medication in his or her system, prosecutors have to prove impairment. A National Highway Traffic Safety Administration study named a range of drugs that are "potentially driver-impairing medications," but people still drive after taking these medications. There is no easy way to know the dosage or drug interactions that make driving unsafe. A recent study showed high doses of pain relievers may increase a driver's chances of being involved in a crash. Another study found motorists taking certain medications are more likely to perform "unsafe driving actions" that make them responsible for roughly 150 fatal crashes in the United States each year. James Zacny, a University of Chicago anesthesiology professor who has studied the effects of opioid pain relievers on driving, said the problem worsens when opioids are combined with other drugs. Some experts note doctors rarely discuss safe driving when prescribing pain relievers or other medications.

Read more:

PADD Places New Drug-Disposal Box at Newbern Police Dept.
Dyersburg State Gazette
August 17, 2013

The Prevention Alliance of Dyersburg and Dyer County installed a prescription drug drop box at the Newbern Police Department and Dyer County Sheriff's Office in Tennessee. Residents can dispose of all types of medications 24 hours a day, 7 days a week.

Read more:

Measures Would Target Abuse of Painkillers in Indiana
The Indiana Star
August 21, 2013

The Indiana Medical Licensing Board is considering guidelines that would require doctors to take additional steps when prescribing pain relievers. Patients would sign an agreement in which they consent to toxicology screening, promise not to share the drugs, take them as prescribed, and allow the doctor to conduct random pill counts. Physicians must tell patients about some of the potential serious side effects, and explore alternatives. In addition, doctors will be expected to see patients who are taking these medicines at least every 4 months, and conduct annual saliva or urine tests to ensure the person is taking the drug. Doctors would run the patient's name at least once a year through the state's prescription drug monitoring database.

Read more:

Illegal Prescription Drugs Seized in 'Operation Rx'
KGBT Television
August 15, 2013

This article and video (1:20 minutes) discuss the arrest of nine people who were caught illegally selling prescription medications. The Hidalgo County Sheriff's Department in Texas launched a month-long investigation after receiving a report that abortion pills were being sold at flea markets. Undercover deputies found flea market vendors selling Viagra, Cialis, Redotex, and Xanax without a license. The pills were brought from Mexico and some were coated with lead. One vendor was making about $5,000 a day.

Read more:

Doctor: Prescription Drug Abuse Poses a Widespread Problem
August 18, 2013

This article and video (3:10 minutes) discuss prescription drug abuse with the medical director at Jackson Recovery Center in Iowa who has seen an increase in prescription medications because doctors are overprescribing them. The risk increases when narcotics are combined with other medications or alcohol, according to the director.

Read more:

Program Would Attack Substance Abuse Through Workplace
The Lima News
August 21, 2013

The Mental Health and Recovery Services Board of Allen, Auglaize, and Hardin Counties gave a briefing to businesses interested in comprehensive drug-free workplace policies, providing help to employees, and helping potential employees. The board wants five Ohio companies to sign up for a pilot program to address challenges and develop solutions for recreational marijuana use, prescription drug abuse, and alcohol abuse and addictions. The executive director hopes businesses embrace the idea because it will help their bottom line--an employee with a substance abuse issue costs his or her employer $7,000 a year.

Read more:

Salisbury Doctor Accused of Faking Prescriptions, Aiding Illegal Drug Sales in 8 Counties
The Morning Call
August 20, 2013

A Salisbury Township doctor was charged with 48 counts of unlawfully prescribing a controlled substance, 48 counts of acquiring a controlled substance by misrepresentation, two counts of conspiracy, and one count of identity theft. He conspired to write fraudulent prescriptions for more than 10,000 oxycodone pills with an estimated street value of $300,000. Most of the illegally prescribed drugs were purchased at Northeast Pharmacy in Lehighton and Mauch Chunk Pharmacy in Jim Thorpe, Pennsylvania. They were then resold without prescriptions in Lehigh, Northampton, Carbon, Monroe, Bucks, Montgomery, Schuylkill, and Luzerne counties.

Read more:

Cuyahoga County Law Enforcement to Hold Summit on Prescription Drug Abuse, Trafficking
The Morning Journal
August 19, 2013

The Cleveland Police Department is hosting a prescription drug abuse and trafficking summit put on by Purdue Pharma. Police officers within Cuyahoga County, Ohio, will be trained on drug diversion issues, including prescription drug identification, lawful prescribing, diversion prevention, pharmacy theft, and pharmaceutical counterfeiting. Those officers will then train other officers within their department. Purdue Pharma will also present its RxPATROL program--a Web-based information clearinghouse developed to collect, analyze, and disseminate information on pharmacy crime, assisting law enforcement efforts to apprehend suspects and help pharmacists guard against robberies and burglaries.

Read more:

Pennsylvania Doctor Accused of Setting Up 'Commune' for Drugs and Sex With Patients
August 20, 2013

A Clarion County psychiatrist was charged with 13 counts of prescribing outside accepted treatment principles, four counts of provider prohibited acts, two counts of corrupt organizations, one count of criminal conspiracy, one count of dealing in unlawful proceeds, one count of theft by deception, and one count of insurance fraud. Investigators said he is the country's one-time largest purchaser and distributor of the pain reliever Subutex, and Pennsylvania's largest purchaser and distributor of Adderall and Ritalin. They estimated that in 2011 and 2012 he bought and distributed more than 183,000 doses of Subutex, 19,000 doses of Adderall, and 28,000 doses of Ritalin.

Read more:

Prescription Drug Abuse Difficult to Police
Seacoast Media Group
August 18, 2013

New Hampshire signed a law in 2012 to implement the prescription drug monitoring program, attempting to track prescription drug use and misuse. The state was the 48th to adopt the program; however, it remains unfunded and inoperable. Federal grant money is available to fund the program, but the state's application was rejected because the program is only authorized through 2015.

Read more:

Prescription Drug Abuse Message Spreads
The Star Press
August 16, 2013

Volunteers and staff at Indiana University Health Ball Memorial Hospital, the Delaware County chapter of Prevent Child Abuse (PCA), medical professionals, and child care advocates organized a conference to address the increase in babies born with Neonatal Abstinence System. A toolkit was created for community presentations on babies who are exposed to drugs in utero. Educational presentations have been conducted throughout East Central Indiana to medical communities, church groups, Purdue Extension programs, and educational institutions. PCA members and supporters are now researching treatment options for mothers and children exposed to drugs during pregnancy.

Read more:

Wisconsin Looks to Join Neighboring States in Monitoring Prescription Drugs
Wisconsin Public Radio
August 19, 2013

This audio (1:11 minutes) and transcript mention Wisconsin's plans to expand the prescription monitoring program by sharing information with bordering states. The Wisconsin Pharmacy Examining Board is expected to discuss the issue next month.

Read more:

Other Resources

PARENT TALK KIT: Tips for Talking and What to Say to Prevent Drug and Alcohol Abuse
The Medicine Abuse Project and The Partnership at Drugfree.org
Accessed August 22, 2013

This kit gives parents ideas for talking to their kids about drugs and alcohol, scripts for what to say, and tips for answering tough questions.

Read more:

Grant received

$280K Grant Targets Student Substance Abuse in Portsmouth
August 22, 2013

The New Hampshire Department of Health and Human Services is giving the School Department $280,000 in federal funds to combat underage drinking and prescription drug abuse. The money will fund two new full-time positions: a student assistance counselor at the high school and a wellness coordinator at the middle school. The wellness coordinator will review the health curriculum and propose ways to expand it, as well as help implement other evidence-based programs and strategies to reduce underage drinking and prescription drug abuse. The student assistance counselor will focus on providing treatment to students who are already at risk.

Read more:


Exploring the Link: Drugs and Mental Health
Webcast: August 29, 2013

Read more:

Insights from a National Epidemic: The Medicine Abuse Project--Free Resources for States and Communities
September 5, 2013

Read more:

Save the Date

DEA's National Take-Back Initiative
October 26, 2013

Upcoming Conferences and Workshops

PAINWeek National Conference
September 4-7, 2013
Las Vegas, Nevada

Educational Forum on Prescription Drug Abuse for Healthcare Providers
September 14, 2013
8-11:30 a.m.
Sheraton Park South Hotel
9901 Midlothian Turnpike
North Chesterfield, VA 23235

The Substance Abuse Free Environment, Virginia Department of Health, Medical Society of Virginia, and One Care of Southwest Virginia are hosting a forum that will educate healthcare providers, prescribers, and pharmacy professionals on current practices for preventing, identifying, and treating prescription drug abuse.

Read more:

Pharmacy Diversion Awareness Conference
September 21 and 22
Boston, Massachusetts

National Conference on Addiction Disorders 2013
September 21-25, 2013
Anaheim, California

Harold Rogers Prescription Drug Monitoring Program National Meeting
September 25-27, 2013
Washington, District of Columbia

2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2, 2013
Chicago, Illinois

4th Annual Executive Forum on Creating a Culture of Health and Wellness
October 7-8, 2013 
Chicago, Illinois

2013 American Association for Treatment of Opioid Dependence Conference
November 9-13, 2013
Philadelphia, Pennsylvania

11th Annual World Health Care Congress
April 7-9, 2014
National Harbor, Maryland
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.