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December 10, 2015

PAW Weekly Update

                                          
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SAMHSA Prescription Drug Abuse Weekly Update
         
         
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 Issue 152  |  December 10, 2015          
   
                                                               
          
                                                                                                                   
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.                      
               
                                                                                                                 
                                                                                                                                                                     
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                        Featured

Court Sides with Employer over Workplace Rx Drug Policy Violation                        
Kathryn J. Russo, Jackson Lewis P.C.                        
November 25, 2015                        

A federal court in Utah has upheld the termination of an employee who did not disclose his use of prescription medication, per his employer’s policy. About 2 months after starting as a haul truck driver for the Lisbon Valley Mining Company, Kevin Lee Angel tested positive for oxycodone. Angel had been taking the drug for about a month while continuing to work, without notifying human resources or obtaining a work release from the company’s physician—all in violation of the prescription drug policy. Russo said this case highlights the importance of employers having a written policy that requires “safety-sensitive” employees to report use of prescription medications that may impair their ability to safely perform their jobs. She also recommended that employers not apply zero-tolerance policies to non-safety-sensitive employees unless a business justification exists.                         

Read more:                        
http://www.natlawreview.com/article/employee-termination-upheld-due-to-failure-to-comply-employer-s-prescription                       
               
               

  Journal Articles and Reports

K.R. Fingar, C. Stocks, A.J. Weiss, and P.L. Owens. 2015. Statistical Brief #193: “Neonatal and Maternal Hospital Stays Related to Substance Use, 2006–2012.” Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality: Rockville, Maryland.                

In 2012, hospitals in 38 states spent $594.6 million for substance-related neonatal stays and $349.3 million for substance-related maternal stays, according to an analysis of 2006–12 Healthcare Cost and Utilization Project data on hospital discharge censuses from 38 states. The authors identified discharges of neonates and pregnant and postpartum women that included an alcohol or other drug use/misuse diagnosis. Inflation-adjusted costs for substance-related neonatal stays increased 135 percent between 2006 and 2012, while costs for maternal stays increased 35 percent. Of the 30,653 neonatal hospital stays related to substance use in 2012, 83 percent involved neonatal drug withdrawal or unspecified narcotics. Of the 65,855 maternal hospital stays, 33.9 percent involved cannabis, and 23 percent involved opiates.                

Read more:                
https://www.hcup-us.ahrq.gov/reports/statbriefs/sb193-Neonatal-Maternal-Hospitalizations-Substance-Use.jsp                                  

E. Gladstone, K. Smolina, S.G. Morgan, K.A. Fernandes, D. Martins, and T. Gomes. 2015. “Sensitivity and Specificity of Administrative Mortality Data for Identifying Prescription Opioid–Related Deaths.” Canadian Medical Association Journal, doi:10.1503/cmaj.150349.                

Vital statistics administrative mortality data in Canada (and elsewhere) imperfectly identify deaths involving prescription opioids. Ontario coroners’ data including drug test results definitively identified 3,549 prescription opioid deaths from 2003 to 2010. Comparing that information with deaths identified with different combinations of International Classification of Diseases codes showed the best estimate of prescription opioid deaths resulted from selecting deaths with both an underlying cause of death of poisoning and a further multiple cause of death code for poisoning by prescription opioids or other unspecified narcotics (diagnosis codes T402, T403, T404, or T406). In 2010, this algorithm had a positive predictive value of 0.90, a specificity of 0.99, and a sensitivity of 0.75. Its sensitivity was lower in earlier years.                

Read more:                
http://www.cmaj.ca/content/early/2015/11/30/cmaj.150349                                  

B. Han, S. Polydorou, R. Ferris, C.S. Blaum, S. Ross, and J. McNeely. 2015. “Demographic Trends of Adults in New York City Opioid Treatment Programs—An Aging Population.” Substance Use and Misuse, doi:10.3109/10826084.2015.1027929.                

From 1996 to 2012, use of opioid treatment programs increased substantially among older adults in New York City. Most of those treated were ages 50–59.                

Read more:                
http://www.tandfonline.com/doi/full/10.3109/10826084.2015.1027929                                  

W. Jiraporncharoen, S. Likhitsathian, C. Lerssrimongkol, S. Jiraniramai, L. Siriluck, and C. Angkurawaranon. 2015. “Sedative Use: Its Association with Harmful Alcohol Use, Harmful Tobacco Use, and Quality of Life Among Health Care Workers in Thailand.” Journal of Substance Use, doi:10.3109/14659891.2015.1042081.                

A little more than 4 percent of healthcare workers at an urban university hospital in Thailand reported harmful sedative use in the past 3 months, according to a 2013 survey. Those involved with prescribing or dispensing medication were at higher risk of misuse (odds ratio [OR] = 1.8) than other workers. In multivariate analysis, harmful use was associated with harmful alcohol use (OR = 3.4) but not with tobacco use. Mean quality-of-life scores of misusers were 7.78 points lower than nonusers for the physical component and 5.52 for the mental component.                

Read more:                
http://www.tandfonline.com/doi/abs/10.3109/14659891.2015.1042081                                  

H.E. Jones and A. Fielder. 2015. “Neonatal Abstinence Syndrome: Historical Perspective, Current Focus, Future Directions.” Preventive Medicine 80:12–17, doi:10.1016/j.ypmed.2015.07.017.                

From the late 19th century to the middle of the last, estimated mortality rates for neonatal abstinence syndrome (NAS) exceeded 33 percent with treatment and 90 percent without treatment. Over the past 50 years, NAS increased because methadone pharmacotherapy for heroin misuse disorders led to women in methadone maintenance programs delivering babies with NAS. A critical milestone in successful NAS treatment was development of a measure of neonatal withdrawal: the Neonatal Abstinence Scoring System, which allowed systematic tailoring of treatment protocols.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0091743515002339                                  

E.E. McGinty, A. Kennedy–Hendricks, J. Baller, J. Niederdeppe, S. Gollust, and C.L. Barry. 2015. “Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998–2012.” Psychiatric Services, doi:10.1176/appi.ps.201500065.                

A search of 1998–2012 online indexing services and archives yielded 4,625 newspaper stories and 654 television stories about opioid analgesic abuse and addiction. A review of the TV stories and a 40 percent random sample of the newspaper stories yielded an analysis sample of 437 newspaper stories and 236 television transcripts focused on opioid analgesic abuse. The most frequently mentioned cause of the problem was illegal drug dealing, and the most frequently mentioned solutions were law enforcement solutions designed to arrest and prosecute the individuals responsible for diverting opioid analgesics onto the illegal market. Forty percent mentioned prevention-oriented approaches such as prescription drug–monitoring programs, with mentions increasing in the latter years of the study period. Less than 5 percent of news stories mentioned expanding substance abuse treatment.                

Read more:                
http://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201500065?journalCode=ps                                  

G.K. Tzilos, C.M. Caviness, B.J. Anderson, and M.D. Stein. 2015. “Stimulant Use and Associated Health Risks Among Student and Non-Student Emerging Adults.” Emerging Adulthood, doi:10.1177/2167696815617077.                

Twelve percent of students and 17 percent of non-students reported using stimulants in the past month, according to responses to a screener for a study by a self-selected, non-representative Rhode Island community sample of 929 students and 1,009 non-students ages 18–25. The screener did not differentiate between prescribed use and misuse. Stimulant use was correlated with alcohol use, illicit drug use, sleep difficulties, and psychological distress.                

Read more:                
http://eax.sagepub.com/content/early/2015/11/25/2167696815617077.abstract                
               

Professional Education and Policy Debate

M.B. Greenwood–Ericksen, S.J. Poon, L.S. Nelson, S.G. Weiner, and J.D. Schuur. 2015. “Best Practices for Prescription Drug Monitoring Programs in the Emergency Department Setting: Results of an Expert Panel.” Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2015.10.019.                

An expert panel made 18 recommendations to improve the design of the prescription drug monitoring program (PDMP) to increase use in hospital emergency departments. The main themes of the recommendations were 1) enrollment should be mandatory, with an automatic process to mitigate the workload; 2) registration should be open to all prescribers; 3) delegates should have access to the PDMP to alleviate work flow burdens; 4) PDMP data should be pushed into hospital electronic health records; 5) PDMP review based on objective criteria should be mandatory for patients receiving opioid prescriptions; 6) PDMP content should be standardized and updated in a timely manner; and 7) states should encourage interstate data sharing.                 

Read more:                
http://www.annemergmed.com/article/S0196-0644(15)01415-8/abstract                                  

Network for Excellence in Health Innovation. 2015. “Issue Brief: Physicians and PDMPs: Improving the Use of Prescription Drug Monitoring Programs.”                

A 2015 Network for Excellence in Health Innovation expert forum focused on challenges and opportunities related to use of prescription drug monitoring programs (PDMPs). Participants included strong representation from prescribers and dispensers. The forum’s key themes and policy recommendations include improving access and usability; ensuring PDMPs are easy to use if mandating use; enhancing the frequency, integrity, and timeliness of PDMP data; providing proactive alerts and dashboards; and complementing PDMP systems with other clinical data.                

Read more:                
http://www.nehi.net/publications/67-physicians-and-pdmps-improving-the-use-of-prescription-drug-monitoring-programs/view                                  

V. Nguyen, R.B. Raffa, R. Taylor, and J.V. Pergolizzi Jr. 2015. “The Role of Abuse-Deterrent Formulations in Countering Opioid Misuse and Abuse.” Journal of Clinical Pharmacy and Therapeutics, doi:10.1111/jcpt.12337.                

Current opioid abuse–deterrent formulations involve one or more of four approaches: a physical barrier; incorporation of an opioid receptor antagonist that self-limits opioid action when taken in excess; inclusion of a noxious agent that is released during inappropriate use; or a prodrug.                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1111/jcpt.12337/full                                  

E.A. Salsitz. 2015. “Chronic Pain, Chronic Opioid Addiction: a Complex Nexus.” Journal of Medical Toxicology, doi:10.1007/s13181-015-0521-9.                

This article reviews evidence on the effectiveness and risk of developing an opioid use disorder in patients treated with chronic opioid therapy for chronic non-cancer pain.                

Read more:                
http://link.springer.com/article/10.1007/s13181-015-0521-9                 
               

 National

 Court Dismisses Bias Claim by Deaf Employee Fired for Positive Drug Test                
Kathryn J. Russo, Drug and Alcohol Testing Law Advisor                
November 30, 2015                

A federal court in Alabama has ruled that a deaf employee was not discriminated against based on his disability when his employer fired him after testing positive for hydrocodone. Edward Phillips was employed as a finisher in a PPG Industries manufacturing facility, whose drug testing policy provided that employees who tested positive for drugs would be required to enter into a rehabilitation agreement to remain employed and to participate in follow-up drug testing after completion of a treatment program. Any subsequent positive drug test results would lead to termination. Phillips failed a drug test in 2000, signed a rehabilitation agreement, and in 2013 tested positive for hydrocodone. He did not have a prescription for the drug, and he was terminated. Phillips asserted he was discriminated against in violation of the Americans with Disabilities Act because he was subjected to drug testing more frequently than other employees and was terminated for failing the drug test when other employees were not—claims the judge found lacked merit.                 

Read more:                
http://www.drugtestlawadvisor.com/2015/11/deaf-employee-who-was-fired-for-positive-drug-test-result-could-not-show-disability-discrimination/                                  

Tackling the Taboo of Substance Abuse Among Nurses                
Katherine Leverence, ONS Connect                
December 1, 2015                

This article discusses substance abuse among oncology nurses; recognizing substance abuse in the workplace; and how to help someone with a problem.                 

Read more:                
http://connect.ons.org/issue/december-2015/straight-talk/tackling-the-taboo-of-substance-abuse-among-nurses                                  

Law to Spur Drug Enforcement Administration Action on New Prescription Drugs                
Brian Broderick, Bloomberg Bureau of National Affairs                
November 27, 2015                

President Obama has signed into law the Improving Regulatory Transparency for New Medical Therapies Act, which establishes a 90-day time limit for Drug Enforcement Administration (DEA) determination of the proper category or schedule for drugs based on their potential for abuse. Currently, the DEA has no deadline for when it must make a scheduling decision.                

Read more:                
http://www.bna.com/law-signed-spur-n57982064051/                                  

Heroin, Opioid Overdoses Top Concern for Drug Czar                
Peter Urban, Taunton Daily Gazette                
December 2, 2015                

Michael Botticelli, director of the Office of National Drug Control Policy, told the House Oversight and Government Reform Committee that his agency’s chief concern is overdoses from heroin and prescription opioids. He expects the latest statistics released later this month will show a substantial increase in heroin overdoses, even with nationwide efforts making headway against misuse of prescription pain relievers.                

Read more:                
http://www.tauntongazette.com/article/20151202/NEWS/151208726                                  

FDA Rejects Indivior’s Nasal Spray for Opioid Overdose                
Reuters                
November 24, 2015                

The U.S. Food and Drug Administration (FDA) has rejected Indivior’s naloxone nasal spray for the treatment of opioid overdose. The pharmaceutical company said the FDA found the early stage uptake of naloxone nasal spray did not fully meet its threshold. Last week, the agency approved the first-ever nasal spray formulation of the drug made by privately held Adapt Pharma.                

Read more:                
http://www.reuters.com/article/2015/11/24/us-indivior-fda-idUSKBN0TD2CS20151124#hM8T5TCHhUBmi5dr.97                                  

Over 70 College Campuses to Receive Safe Drug Disposal Systems                
PRNewswire                
December 2, 2015                

Mallinckrodt Pharmaceuticals, in partnership with the JED Foundation, will donate 30,000 medication deactivation pouches to over 70 college campuses to promote safe and convenient disposal of unused prescription drugs.                

Read more:                
http://www.prnewswire.com/news-releases/the-jed-foundation-and-mallinckrodt-pharmaceuticals-partner-to-provide-safe-drug-disposal-systems-to-college-campuses-300186492.html                
                 

Marijuana

F.R. Levin, J.J. Mariani, M. Pavlicova, D. Brooks, A. Glass, A. Mahony, E.V. Nunes, A. Bisaga, E. Dakwar, and K.M. Carpenter, M.A. Sullivan, and J.C. Choi. 2015. “Dronabinol and Lofexidine for Cannabis Use Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.11.025.                  

A randomized controlled trial found dronabinol (a synthetic form of delta-9-tetrahydrocannabinol, a naturally occurring pharmacologically active component of marijuana) and lofexidine (an alpha-2 agonist) ineffective in the treatment of cannabis use disorder. Currently, there are no federally approved medications for cannabis use disorder.                   

Read more:                  
http://www.drugandalcoholdependence.com/article/S0376-8716(15)01778-0/abstract                                      

S. Rigucci, T.R. Marques, M. Di Forti, H. Taylor, F. Dell’Acqua, V. Mondelli, S. Bonaccorso, A. Simmons, A.S. David, P. Girardi, C.M. Pariante, R.M. Murray, and P. Dazzan. 2015. “Effect of High-Potency Cannabis on Corpus Callosum Microstructure.” Psychological Medicine, doi:10.1017/S0033291715002342.                  

Brain imaging showed users of high-potency cannabis have higher corpus callosum mean diffusivity and higher corpus callosum axial diffusivity than either low-potency users and those who never used. Daily users also have higher mean and axial diffusivity than occasional users and those who never used.                  

Read more:                  
http://www.ncbi.nlm.nih.gov/pubmed/26610039                                      

C.K. Roth, L.A. Satran, and S.M. Smith. 2015. “Marijuana Use in Pregnancy.” Nursing for Women’s Health 19(5):431–37, doi:10.1111/1751-486X.12235.                  

This column describes the prevalence of cannabis use among women; the effect cannabis has on the body; and the potential maternal, fetal, and neonatal effects of marijuana use during pregnancy. The authors suggest best practices for nurses and other clinicians providing care to pregnant women who use cannabis. They recommend nurses screen pregnant women for marijuana use at the first prenatal visit. Marijuana can cross the placenta to reach the fetus. Repeated marijuana use also can alter receptors in the brain during fetal development as early as 2 weeks after conception.                   

Read more:                  
http://onlinelibrary.wiley.com/doi/10.1111/1751-486X.12235/abstract                                      

Pain Added to List of Conditions for Medical Cannabis in Minnesota                  
Tim Boltz, Fox 9                  
December 2, 2015                  

Starting August 1, 2016, patients certified as having intractable pain will be eligible to receive medical cannabis from Minnesota’s two medical cannabis manufacturers.                  

Read more:                  
http://www.fox9.com/news/55198610-story                                      

A Weed Breathalyzer Could Be on the Way                  
Reuters                  
December 2, 2015                  

Hound Labs, Inc., and the University of California, Berkeley have developed a roadside marijuana breathalyzer to measure tetrahydrocannabinol (THC) levels. The device is not yet certified for police evidentiary use, but the company has started a clinical trial and hopes to have the device ready for market by the end of 2016. Other companies and universities are developing similar devices, which do not provide evidence of impairment. And insufficient data currently exist to establish which level of THC impairs people. Some states set arbitrary limits. For example, Washington and Montana have set a limit of 5 nanograms/milliliter (ng/mL); Pennsylvania has a 1 ng/mL limit.                  

Read more:                  
http://fortune.com/2015/12/02/marijuana-breathalyzer/                                      

After Being Fired for Smoking Pot, What Do I tell Potential Employers?                  
Nick Corcodilos, PBS                  
December 1, 2015                  

Nick Corcodilos, a headhunter since 1979, shares advice about a question he received from a reader. A woman was fired after her estranged husband sent her employer a video of her smoking marijuana. She wants to know what she should tell her potential employer. Cordodilos thinks if something has a material effect on the job, the employer has a right to know. If not, do not discuss it. If an individual decides to discuss it, he suggests being brief and moving on to talk about how being an employee will boost the company’s bottom line. Corcodilos also consulted an attorney about the reader being fired and included the feedback.                   

Read more:                  
http://www.pbs.org/newshour/making-sense/ask-the-headhunter-after-being-fired-for-smoking-pot-what-do-i-tell-potential-employers/                                     

Employers Struggle with Fine Print of Medical Marijuana Law                  
Joseph Bednar, Business West                  
December 1, 2015                  

A Massachusetts statute that legalizes medical marijuana is causing confusion in the workplace. The law states any person who meets the requirements for medical marijuana may not be penalized or “denied any right or privilege” for such activity. But employers are not required to accommodate marijuana use in the workplace. Employers are unsure of whether they can fire employees who fail drug tests. Cases making their way through the courts soon may provide some clarity.                   

Read more:
                 
http://businesswest.com/blog/employers-struggle-with-fine-print-of-medical-marijuana-law/                                     

Pennsylvania House to Vote on Medical Marijuana Bill                  
Chris Goldstein, Philly420                  
November 25, 2015                  

The Pennsylvania House is expected to vote on a senate-passed medical cannabis bill that has more than 100 tacked-on amendments. New language being considered includes a 10 percent cap on tetrahydrocannabinol (THC); a ban on smoking medical marijuana; an advisory group to oversee the medical cannabis program; a 5 percent excise tax imposed on the sale of cannabis between growers and dispensaries; and allowing employers to fire workers if they fail a drug test for THC or deem that the worker is under the influence of marijuana in the workplace.                  

Read more:                  
http://www.philly.com/philly/columnists/philly420/Philly420_A_
vote_on_Pa_medical_marijuana_bill_.html
                                    

Medical Marijuana May Go Mobile in Vermont                  
Kyle Midura, WCAX                  
November 30, 2015                  

Vermont’s medical marijuana dispensaries have begun delivering products. Burlington and Brattleboro’s dispensaries are still figuring out how to make deliveries work. Patient and driver safety are a concern; contingencies for snowy roads must be put in place; and patients must understand they are placing a specific order. (Includes video: 2:44 minutes)                  

Read more:                  
http://www.wcax.com/story/30617754/medical-marijuana-may-go-mobile-in-vermont                                      

Ontario Medical Marijuana Exemption Under Review a Day After Announced                  
CBC News                  
November 26, 2015                  

Ontario’s government will re-examine whether to allow medical marijuana users to smoke and vape anywhere in the province, just 1 day after announcing the change. Some worry about secondhand smoke. No scientific evidence exists evaluating whether secondhand marijuana vapor produced from an electronic cigarette has any health effects on bystanders. The exemptions were drafted with the advice of legal counsel, and not providing an exemption for medical marijuana users could raise constitutional issues. Under the exemption, employers or restaurant owners could still ban medical marijuana users from smoking on the premises.                   

Read more:                  
http://www.cbc.ca/news/canada/toronto/med-marijuana-1.3338413                   
               

International

What Is Your Christmas Drug and Alcohol Policy?                
Bartier Perry, Lexology                
November 30, 2015                

This article looks at the annual Christmas party and other festive behavior affecting work and concludes by exploring the benefit of a comprehensive drug and alcohol policy.                

Read more:                
http://www.lexology.com/library/detail.aspx?g=760ba0f6-ba4b-4565-b100-b232c9eacf7a                 
               

Northeast/Mid-Atlantic News

Mass. Medical Residents Seek to Access Prescription Data                
Felice J. Freyer, Boston Globe                
November 30, 2015                

Massachusetts medical residents can prescribe controlled substances but cannot check the prescription drug monitoring program database. State Representative Nick Collins filed legislation that would enable medical residents to do just that. The Department of Public Health has the authority to make the change without legislation, and a union that represents doctors-in-training at Boston Medical Center and Cambridge Health Alliance is collecting signatures on a letter that asks the state’s governor to expand access.                 

Read more:                
https://www.bostonglobe.com/metro/2015/11/29/medical-residents-seek-access-prescription-database/tNz2Cz4bdPbTY4nYlvsLNN/story.html                 
               

South News

Prison Workers in Florida Among Those Charged in Prescription Drug Ring                
Cindy Swirko, Gainesville Sun                
November 25, 2015                

Several prison workers in Bradford County, Fla., and one woman in neighboring Alachua County have been charged with participating in a prescription narcotics drug ring—the largest in Bradford County in terms of suppliers. Drugs were allegedly sold to inmates and users in the community. The Florida Department of Corrections fired the employees who were arrested.                 

Read more:                
http://www.gainesville.com/article/20151125/ARTICLES/151129806?tc=ar                 
               

 Midwest News

Ohio Program Bolsters Drug-Free Workplace Effort                
Chris Balusik, Chillicothe Gazette                
December 2, 2015                

Working Partners; the Pain Valley Alcohol, Drug Addiction, and Mental Health Services Board; the Chillicothe–Ross Chamber of Commerce; and the Gannett Foundation/Chillicothe Gazette collaborated to offer a three-workshop series that focuses on creating and maintaining drug-free workplace policies in Ohio. The three classes included basic drug information such as trends, marijuana legalization, and prescription drug issues. They also included legal and operational issues such as complying with federal and Bureau of Workers' Compensation mandates, addiction issues, and policy creation. Some company drug policies are not specific enough or not enforced consistently. A session for second group of employers is planned for the spring.                

Read more:                
http://www.chillicothegazette.com/story/news/local/2015/12/01/program-bolsters-drug-free-workplace-effort/76610656/?from=global&sessionKey=&autologin=                                 

Large Purchases of Rx Pills at Marion (Ohio) Veterans Hospital Trigger Inspection                
Charlie D Mar, Fox 59                
November 30, 2015                

The Drug Enforcement Administration (DEA) searched the Veterans Affairs Medical Center in Marion, Ohio. The center purchased more addictive prescription pills than any other facility in the northern district, and the DEA wants to know why. In 2014, it bought 832,310 tablets of hydrocodone and 638,000 tablets of oxycodone. Through the first three quarters of 2015, it bought more than one million hydrocodone pills and 526,000 tablets of oxycodone. The center treats 26,442 unique patients. Doctors and employees are the focus of this inspection, not the patients. (Includes video: 2:28 minutes)                

Read more:                
http://fox59.com/2015/11/30/large-purchases-of-prescription-pills-at-marion-va-trigger-dea-inspection/                                  

Doctor Shopping of Prescription Drugs Remains a Scourge in Missouri                
Ben Kleine, Southeast Missourian                
November 29, 2015                

In Missouri, doctor shopping remains the most common way for people to acquire prescription drugs because the state does not have a PDMP. Undercover buys are used to address the illegal activity. Illegal possession can be prosecuted if a dealer moves the pills to some other type of package, but it is difficult to prove intent to distribute. Some Missouri doctors try to establish their own protocols to reduce doctor shopping. For example, one doctor requires patients to bring pain medications to appointments to verify they have not sold any of their pills.                

Read more:                
http://www.semissourian.com/story/2254508.html                
               

West News

Feds Step Up Drug Enforcement of Pharmacies in California                
Kristina Davis, San Diego Union-Tribune                
November 25, 2015                

On July 13, 2012, a pharmacy technician ordered 1,000 hydrocodone pills through San Diego's Medical Center Pharmacy, where he was employed. The order was either meant for his consumption or to restock the supply of pills he had already stolen. His license was revoked after being convicted of prescription forgery and burglary. This incident sparked a Drug Enforcement Administration (DEA) investigation into Medical Center Pharmacy. The DEA has also increased the amount of surprise inspections on businesses in recent years. California is considering making it mandatory for pharmacies to inventory their drug supplies quarterly. Pharmacies are already required to report missing drugs.                

Read more:                
http://www.sandiegouniontribune.com/news/2015/nov/25/policing-pharmacies-prescription-drugs/                                  

Central Oregon Health Care Providers Tackle Prescription Drug Abuse                
KTVZ                
December 2, 2015                

The Pain Standards Task Force, a division of the Central Oregon Health Council’s Provider Engagement Panel, will soon formally adopt safer prescribing guidelines for chronic non-cancer pain management.                

Read more:                
http://www.ktvz.com/news/C-O-health-care-providers-tackle-prescription-drug-abuse/36765650                                  

Oregon Attorney General: Settlement to Fund Prescription Drug Abuse Fight                
KTVZ                
December 1, 2015                

The Oregon Coalition for Responsible Use of Meds and Oregon Health and Science University will receive $567,000 to prevent opioid misuse in the state. The funding comes from the $1.1 million settlement reached between the Oregon Department of Justice and Insys, a pharmaceutical company that unlawfully promoted the opioid Subsys in the state.                 

Read more:                
http://www.ktvz.com/news/Oregon-AG-Settlement-to-fund-prescription-drug-abuse-fight/36737778                 
               

Grant Announcements

National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for That                
U.S. Department of Health and Human Services                
Submission period begins November 3, 2015, 9 a.m., EST.                
Submission period ends April 29, 2016, 11:59 p.m., EST.                
http://nida.ideascale.com/a/pages/addiction-research-theres-an-app-for-that                                  

New Jersey Health Initiative 2016: Building a Culture of Health in New Jersey–Communities Moving to Action, Round 2                
Robert Wood Johnson Foundation                
Deadline: January 14, 2016                
http://www.rwjf.org/en/library/funding-opportunities/2015/njhi-2016--building-a-culture-of-health-in-new-jersey---communiti.html                                  

Research on Prescription Opioid Use, Opioid Prescribing, and Associated Heroin Risk (RFA-CE-16-003)                
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention                
Deadline: February 18, 2016                
http://www.grants.gov/view-opportunity.html?oppId=280151                 
               

Take-Back Events and Drop Boxes

Prescription Drug Drop Off (April 11, 2016)                
Georgia Southern University                
Accessed December 2, 2015                
http://calendar.georgiasouthern.edu/event?id=55306                                  

Palo Alto Police Department Installs Drug Disposal Container                
Palo Alto Online (California)                
December 2, 2015                
http://www.paloaltoonline.com/news/2015/12/02/palo-alto-police-department-installs-drug-disposal-container                                  

Egg Harbor City Police Station Installs Permanent Medicine Drop Box                
Shore News Today (New Jersey)                
November 27, 2015                
http://www.shorenewstoday.com/galloway_township/egg-harbor-city-police-station-installs-permanent-medicine-drop-box/article_5eebbcfc-947b-11e5-aea1-8399cfefeac6.html                                  

Autumn Lake Helps Save Lives with Project Medicine Drop                
Cape May County Herald (New Jersey)                
November 30, 2015                
http://www.capemaycountyherald.com/lifestyle/health_and_wellness/article_2960c626-977e-11e5-94f0-270c7c80f1cb.html                                  

Lincoln County Installs Free Medication Drop-Off Box                
Katie Nelson, Argus Leader (South Dakota)                
December 2, 2015                
http://www.argusleader.com/story/news/crime/2015/12/02/lincoln-county-installs-free-medication-drop-off-box/76686002/?from=global&sessionKey=&autologin=                                  

Prescription Drug Collection Bin Installed in Pasco Police Department Lobby                
Tri-City Herald (Washington)                
November 30, 2015                
http://www.tri-cityherald.com/news/local/article47258750.html                 
               

Upcoming Conferences and Workshops

 Pharmacy Diversion Awareness Conference                
U.S. Drug and Enforcement Administration                
January 9 and 10, 2016                
Jackson, Mississippi                
February 27 and 28, 2016                
Charleston, West Virginia                

The Pharmacy Diversion Awareness Conference is designed to assist pharmacy personnel in identifying and preventing diversion activity.                

Read more:                
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/                                  

26th National Leadership Forum and SAMHSA’s 12th Prevention Day                
Community Anti-Drug Coalitions of America and SAMHSA                
February 1–4, 2016                
Gaylord National Hotel and Convention Center                
201 Waterfront Street                
National Harbor, Maryland 20745                

The Community Anti-Drug Coalitions of America Forum is the premier and largest training conference for community-based substance use prevention professionals, coalition leaders, and prevention and addiction researchers.                

Read more:                
http://www.cadca.org/forum2016                 

Register:                
http://www.cadca.org/events/26th-national-leadership-forum-including-samhsas-12th-prevention-day/registration                                  

Ensuring Access to Pain Care: Engaging Pain Medicine and Primary Care Teams                
American Academy of Pain Medicine                
February 18–21, 2016                
Palm Springs, California                
http://www.painmed.org/annualmeeting                                 

2016 National Rx Drug and Heroin Summit                
March 28–31, 2016                
Atlanta                
http://nationalrxdrugabusesummit.org                                 

Third Annual Smart Approaches to Marijuana Education Summit                
March 31, 2016                
Atlanta                
http://nationalrxdrugabusesummit.org/sam-summit-2/                                  

Register:                
https://www.123contactform.com/form-1486587/2016-National-Rx-Drug-Abuse-Summit                
         
                                 
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.