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December 11, 2013

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
ISSUE 49 | DECEMBER 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.
Table of Content Featured Article Journal Articles and Reports News Other State and Local News Other Resources Call Video Audio Grant Announcement Grant Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Article

G. Biondo and H.D. Chilcoat. 2013. "Discrepancies in Prevalence Estimates in Two National Surveys for Nonmedical Use of a Specific Opioid Product Versus Any Prescription Pain Reliever." Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.10.005.

Trends in past-year use of marijuana, cocaine, and nonmedical use of prescription pain relievers were estimated from the Monitoring the Future (MTF) survey and National Survey on Drug Use and Health (NSDUH) using 2005–10 data for adolescents in 12th grade. The proportion of nonmedical pain reliever users who misused OxyContin was also estimated for each survey. NSDUH provides a show card with pictures of pain relievers and specifically asks about four groups of pills. The group containing OxyContin is last and begins with a screener that instructs respondents to look at a group of pill pictures (one set is labeled OxyContin) but (unlike in earlier groups) does not read the respondent any pill names. If the respondent reports misusing a pill in the fourth group, a specific follow-up question asks about taking "OxyContin that was not prescribed for you or that you took only for the experience or feeling [it] caused," then probes whether that use was in the past 12 months. The 12-month probe is not used with other pain relievers. MTF reads the respondent a list of eight "narcotics other than heroin" (methadone, opium, morphine, codeine, Demerol, Vicodin, OxyContin, Percocet), then asks only a generic question about using narcotics other than heroin and follows up a "Yes" response with specific questions about the eight categories, including taking "OxyContin (without a doctor's orders)." All questions are restricted to use in the past 12 months.

Prevalence of past-year OxyContin nonmedical use was 2.5–3 times higher each year in MTF compared with NSDUH (4.3–5.5 percent versus 1.4–2.1 percent). Conversely, prevalence estimates for nonmedical prescription pain reliever use were 15 percent lower in MTF, on average, compared with NSDUH (8 percent versus 10–12 percent). The proportion of nonmedical prescription pain reliever users who reported using OxyContin was 42 percent in MTF versus 19 percent in NSDUH. Analysis of 8th and 10th graders yielded similar findings: past-year OxyContin prevalence was three times higher in MTF than in NSDUH. Usage rates were steady over time for both surveys. These findings are consistent with the Substance Abuse and Mental Health Services Administration's 2011 comparison report for imperfectly age-matched youth in roughly the 12–17-year age range. They suggest that measurement of nonmedical prescription pain reliever use is quite sensitive to survey methodology (setting, sample, method of administration, and question structure). That message underlines the need for thoughtful attention to instrument design/item selection in randomized trials and needs assessment surveys on prescription drug misuse. Editor's view: The NSDUH question set appears to be more accurate/specific than the MTF question set, but adopters should probably read example pill names in all four NSDUH pill groups, not just the first two.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24210422 (NB: open access)

Journal Articles and Reports


A.A. Al–Tayyib, E. Rice, H. Rhoades, and P. Riggs. 2013. "Association Between Prescription Drug Misuse and Injection Among Runaway and Homeless Youth." Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.10.027.

This short communication examined the association between current prescription drug misuse (PDM) and injection among runaway and homeless youth. Homeless youth were surveyed between October 2011 and February 2012 at two Los Angeles, California, drop-in service agencies. The outcome of interest was use of a needle to inject any illegal drug into the body during the past 30 days. Of 380 homeless youth (median age 21; IQR 17–25; 72 percent male), 84 (22 percent) reported current PDM and 48 (13 percent) reported currently injecting. PDM during the past 30 days was associated with a 7.7-fold (95 percent CI: 4.4, 13.5) increase in the risk of injecting during that time period. Among those reporting current PDM with concurrent heroin, cocaine, and methamphetamine use, the risk of injecting was 15.1 (95 percent CI: 8.5, 26.8).

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871613004651

J. Ahlner, A. Holmgren, and A.W. Jones. 2013. "Prevalence of Alcohol and Other Drugs and the Concentrations in Blood of Drivers Killed in Road Traffic Crashes in Sweden." Scandinavian Journal of Public Health. doi:10.1177/1403494813510792.

This retrospective 4-year study (2008–11) used a forensic toxicology database (TOXBASE) to evaluate concentrations of alcohol and other drugs in blood samples from drivers killed in road traffic crashes. The mean age of all victims (N = 895) was 48 ± 20 years (SD), and the majority was male (86 percent). In 504 drivers (56 percent), the results of toxicological analysis were negative. These victims were older (mean age 47 ± 20 years) than alcohol-positive cases (35 ± 14 years) and illicit drug users (34 ± 15 years). In 21 percent of fatalities, blood alcohol concentration (BAC) was above the statutory limit for driving (0.2 g/L), although the median BAC was appreciably higher (1.72 g/L). Illicit drugs (mainly amphetamine and cannabis) were identified in 7 percent of victims—either alone (2.5 percent), together with alcohol (1.8 percent), or with a prescription drug (2 percent). Identified psychoactive prescription drugs were mainly benzodiazepines, z-hypnotics, and tramadol, which were found in the blood of 7.6 percent of crash victims. Compared with alcohol, prevalence of illicit and psychoactive prescription drugs was fairly low, despite a dramatic increase in the number of drug-impaired drivers arrested by police after a zero-tolerance law was introduced in 1999.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24265165

J. Guydish, B.K. Campbell, J.K. Manuel, K.L. Delucchi, T. Lea, K.M. Peavy, and D. McCarty. 2013. "Does Treatment Fidelity Predict Client Outcomes in 12-Step Facilitation for Stimulant Abuse?" Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.10.020.

This study examined relationships between treatment fidelity and outcomes in a community-based trial of a Twelve-Step Facilitation (TSF) intervention for stimulant abuse. In a prior multisite randomized clinical trial, 234 participants in 10 outpatient drug treatment clinics were assigned to receive the Stimulant Abuser Groups to Engage in 12-Step (STAGE-12) intervention. A secondary analysis reviewed and coded all STAGE-12 sessions for fidelity to the protocol, using the Twelve-Step Facilitation Adherence Competence Empathy Scale (TSF ACES). Linear mixed-effects models tested the relationship between three fidelity measures (adherence, competence, empathy) and six treatment outcomes (number of days of drug use and five Addiction Severity Index [ASI] composite scores) measured at 3 months post-baseline. Adherence, competence, and empathy were robustly associated with improved employment status at follow-up. Empathy was inversely associated with drug use, as was competence in a nonsignificant trend (p = .06). Testing individual ASI drug composite score items suggested that greater competence was associated with fewer days of drug use and, at the same time, with an increased sense of being troubled or bothered by drug use. Greater competence and empathy in the delivery of a TSF intervention were associated with better drug use and employment outcomes, while adherence was associated with employment outcomes only. Higher therapist competence was associated with lower self-reported drug use and greater self-reported concern about drug use.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871613004584

B.S. Jonas, Q. Gu, and J.R. Albertorio–Diaz. 2013. "Psychotropic Medication Use Among Adolescents: United States, 2005–2010." National Center for Health Statistics Data Brief, Number 135.

This report estimated past-month psychotropic medication use among U.S. noninstitutionalized adolescents aged 12–19 during 2005–10, based on National Health and Nutrition Examination Survey data. The specific psychotropic drug types addressed were antidepressants; medications for attention deficit hyperactivity disorder (ADHD); anxiolytics, sedatives, and hypnotics; antimanics; and antipsychotics. Adolescents using psychotropic drugs were further examined by sex, race, and Hispanic origin and mental health professional consultation. Males (4.2 percent) were more likely than females (2.2 percent) to use ADHD drugs. Females (4.5 percent) were more likely than males (2.0 percent) to use antidepressants. Psychotropic drug use was higher among non-Hispanic white adolescents (8.2 percent) than non-Hispanic black adolescents (3.1 percent) or Mexican–American adolescents (2.9 percent). About one half of U.S. adolescents who used psychotropic drugs in the past month had seen a mental health professional in the past year (53.3 percent). The report does not distinguish misuse from prescribed use.

Read more:
http://www.cdc.gov/nchs/data/databriefs/db135.pdf
http://www.cdc.gov/nchs/data/databriefs/db135.htm

C. Lions, M.P. Carrieri, L. Michel, M. Mora, F. Marcellin, A. Morel, B. Spire, and P. Roux. "Predictors of Non-Prescribed Opioid Use After One Year of Methadone Treatment: An Attributable-Risk Approach (ANRS-Methaville Trial)." Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.10.018.

At 12 months of treatment (M12), 158 subjects had available data on opioid use, measured using the Opiate Treatment Index. Researchers identified variables associated with nonprescribed opioid use at M12 using a univariate logistic regression and two multivariate models: one incorporating only pretreatment variables, the second adding in-treatment variables. At M12, 32.3 percent of patients had used nonprescribed opioids during the previous month. A good patient–physician relationship was the most influential factor associated with not using nonprescribed opioids after 1 year. Living with a heroin user at M12, using cocaine during treatment, and hazardous alcohol consumption at enrollment were all associated with increased risk of nonprescribed opioid use at M12. Analysis of attributable fractions indicated that living with a heroin user at M12 accounted for 21 percent of patients reporting nonprescribed opioid use at M12, while lack of a good relationship with the physician accounted for 26 percent (Editor's note: possibly because of continued abuse). The attributable risk approach suggests continued nonprescribed opioid use by a considerable proportion of individuals could potentially be reduced by enhancing care for co-dependent patients and encouraging patients to modify their social networks.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24268548

K.A. Mack. 2013. "Drug-Induced Deaths—United States, 1999–2010." Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report [Supplements] 62(03):161–63.

This drug-induced deaths analysis and discussion are part of the second Centers for Disease Control and Prevention Health Disparities and Inequalities Report. The purpose of the analysis is to raise awareness of disparities by age, gender, racial/ethnic, and/or geographic differences and to prompt actions to reduce disparities. During 2010, a total of 40,393 drug-induced deaths occurred in the United States. The majority of these deaths were unintentional (74.3 percent); 13.1 percent resulted from suicidal drug poisoning; 7.3 percent were due to drug poisoning of undetermined intent; 5.1 percent were due to mental and behavioral disorders from drug use; and less than 1 percent was due to homicide or medical conditions from chronic drug use. Drug-induced mortality was highest among persons aged 40–49.

Read more:
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a27.htm
http://www.cdc.gov/minorityhealth/CHDIReport.html#CHDIR

D.O. Warner, K. Berge, H. Sun, A. Harman, A. Hanson, and D.R. Schroeder. 2013. "Substance Use Disorder Among Anesthesiology Residents, 1975–2009." JAMA 310(21):2289–296. doi:10.1001/jama.2013.281954.

This study has very narrow limits. Researchers studied all physicians who began training in U.S. anesthesiology residency programs from July 1, 1975, to July 1, 2009, including 44,612 residents contributing 177,848 resident-years to the analysis. They ascertained cases of substance use disorder (SUD) during training that were detected by authorities during or after training. Data sources included American Board of Anesthesiology (ABA) records with training problem reports, reports of civil or criminal legal actions, and lifetime flag set if the anesthesiologist was detected with a SUD or inappropriately prescribed drugs for profit; the Disciplinary Action Notification Service (DANS) of the Federation of State Medical Boards; and the National Death Index, including cause-of-death information. The study excluded 69 trainees caught inappropriately prescribing, even though some of them may have had SUDs. Of the remaining residents, 338 were detected with SUDs during residency training, with 46 more SUD cases active during training that were discovered during post-residency disciplinary actions. The overall rate of known SUDs was 2.16 per 1,000 resident-years (2.68 men and 0.65 women per 1,000 resident-years). This rate includes 228 cases residency supervisors reported to central authorities and 110 cases they chose not to report that other sources (notably DANS) did. It excludes undetected SUDs and an unknown portion of SUDs residency directors did not report. It also excludes 122 cases with the SUD flag set but no confirmatory or contradictory evidence, and 512 physicians known to have SUDs but with no evidence that their disorder began during residency. The reported annual SUD rate for residents increased from 1975 until 1995 and declined in 1996–2002, but has peaked since 2003 (2.87 per 1,000 resident-years). Twenty-eight individuals (7.3 percent of known abusers) died from SUDs during residency training; two had SUDs during training that were not detected and died from these disorders shortly after completing training; and seven died of a relapse SUD after training. Another 10 residents with substance abuse flags in their training records died of unknown causes before completing training, and 26 residents who did not complete training and had no SUD code died of a SUD within 4 years of starting training. Some deaths may have been suicides rather than unintentional SUD deaths.

Median time from first use during residency to detection was 4 months. In 66 percent of nonfatal episodes, the substances initially abused were identified. The most common substance category was opioids—primarily intravenous—followed by alcohol, marijuana or cocaine, and anesthetics/hypnotics.

Follow-up for relapse of those with SUDs was to December 31, 2010. Relapse data sources were restricted to the Death Index, ABA, and DANS. The 46 individuals who DANS data subsequently revealed had SUDs during training were also excluded from the relapse analysis. Of the 310 remaining survivors with SUDs, 173 (56 percent) completed residency and 135 (44 percent) achieved ABA certification. It appears the relapse study denominator was not restricted to this subset, even though nonfatal relapse data were not available for the remainder. Kaplan–Meier estimates of the cumulative proportion of survivors experiencing at least one relapse reported to the Medical Board were 23 percent at 5 years after the initial episode, 38 percent at 15 years, 42.5 percent at 20 years, and 43 percent at 30 years. Rates of relapse and death did not vary with the category of substance used; relapse rates did not change over the study period. This study did not examine SUD rates for those who were not reported to have SUDs during residency.

Read more:
http://jama.jamanetwork.com/article.aspx?articleid=1787405

News


Protect Your Teen from Dangerous Dark Net Drugs
The Huffington Post
December 2, 2013

This article discusses teens using the Dark Net to purchase drugs, which are typically delivered to their family's mailbox. The Dark Net is a group of anonymous Web sites hosted by a group of computers. Sites block indexing from search engines such as Google and Yahoo, making them unsearchable by the general public. Users who access these sites must download special browsers to hide their Web activity. Tor (The Onion Router), which uses several layers of encryption, is a popular browser among teens. Tor makes it impossible to trace sites visited, Internet activity, instant messages, and online posts. Once teens install Tor, they are able to view sites such as the Hidden Wikki, which indexes links to some of the most horrific sites on the Dark Net. The author provides helpful tips to prevent teens from accessing and obtaining drugs from the Dark Net.

Read more:
http://www.huffingtonpost.com/sedgrid-lewis/protect-your-teen-from-dangerous-dark-net-drugs_b_4350523.html

Instagram Helps Prevent Drug Sales by Blocking Some Hashtags
Business 2 Community
December 2, 2013

Instagram, a popular photo and video sharing social media site, has become a black market for illegal drug sales using hashtags. Drug dealers use Instagram to share photos of drugs and drug paraphernalia to promote black market offers advertising illegal and prescription drugs. Hashtags are not cryptic. Photos marked with #marijuana and other similar tags have resulted in searchable lists that make it easy to find online deals. Instagram's 150 million members are informed about its policy prohibiting illegal activities. The site has blocked many hashtags used for drug trafficking.

Read more:
http://www.business2community.com/instagram/instagram-helps-prevent-drug-sales-blocking-hashtags-0700411#!oT4Zt

Managing the Risks of Taking Adderall to Enhance Work Performance
Forbes
December 6, 2013

Todd Essig, a clinical psychologist and psychoanalyst, discusses how individuals might manage the significant risks of "brain doping" or taking Adderall for work. Dr. Essig provides strategies for avoiding addiction and dependency and describes the downsides of using Adderall for work enhancement.

Read more:
http://www.forbes.com/sites/toddessig/2013/12/06/managing-the-risks-of-taking-adderall-to-
enhance-work-performance


Holiday Drinking: How 8 Common Medications Interact with Alcohol
Fox News
November 29, 2013

This article lists eight common medication classes that may interact negatively with alcohol: antidepressants, birth control pills, blood pressure and heart medications, cholesterol-lowering medications, diabetes medications, gastroesophageal reflux and ulcer drugs, pain relievers, and sleeping pills. The side effects of drug–alcohol interactions are described.

Read more:
http://www.foxnews.com/health/2013/11/29/holiday-drinking-how-8-common-medications-
interact-with-alcohol


ADD Drug Use Continues to Rise Among MLB Players
Los Angeles Times
November 29, 2103

The Major League Baseball Players Association released a report showing authorized use of attention deficit disorder (ADD) drugs increased to 119 exemptions last season. Exemptions rose slowly: 106 in 2008, 108 in 2009, 105 in 2010 and 2011, 116 in 2012, and 119 in 2013. Last season, an additional seven players were disciplined for unauthorized Adderall use. The results indicate 1 in 10 players have been diagnosed with ADD.

Read more:
http://www.latimes.com/sports/sportsnow/la-sp-sn-add-drug-use-rise-mlb-players-carlos-ruiz-20131129,0,190317.story#axzz2m8UTzKLE

Commentary: Medication-Assisted Treatment for Opioid Dependence
Partnership at Drugfree.org
December 6, 2013

John Knight, a pediatrician at Harvard Medical School, and Melissa Weiksnar, program coordinator for the Center for Adolescent Substance Abuse Research at Boston Children's Hospital, share their views about Medication-Assisted Treatment for teens and young adults. At Boston Children's Hospital, about one third of children in the program remain completely free of alcohol and drug use with buprenorphine therapy; about another third remain free of opioid use (but might occasionally slip up by using alcohol or marijuana). The remaining third try opioids once or twice but show dramatic improvement over time. Dr. Knight and Weiksnar believe the best treatment occurs in the least restrictive environment. Their clinical program is outpatient based and they empower parents to supervise prescriptions. Adolescents and parents also participate in a 13-week education and support group.

Read more:
http://www.drugfree.org/join-together/addiction/medication-assisted-treatment-for-opioid-
dependence?utm_source=Join percent20Together percent20Daily&utm_campaign=b28a877faf-
JT_Daily_News_Medication_Assisted&utm_medium=email&utm_term=0_97f4d27738-b28a877faf-221990529


10 Strategies to Combat the Rx Abuse Epidemic—An Insurer's Perspective
Property Casualty 360
December 2, 2013

This article provides a recap of strategies from the Trust for America's Health report, "Prescription Drug Abuse: Strategies to Stop the Epidemic," (see report in the October 16, 2013, Weekly Update) and shares thoughts from an insurer's perspective.

Read more:
http://www.propertycasualty360.com/2013/12/02/10-strategies-to-combat-the-rx-abuse-
epidemic---an?t=workers-compensation

Other State and Local News


U of Arkansas Has 4th Most Drug Arrests in SEC
The Arkansas Traveler
December 4, 2013

The University of Arkansas Police Department made 333 arrests for illicit drugs and paraphernalia between 2010 and 2012—ranking the university fourth among the 14 Southeastern Conference (SEC) schools for drug use. Overall, 4,223 drug and related arrests were made among SEC schools from 2010 to 2012. The University of Missouri had the most arrests (982) in the past 3 years; University of Florida had 408 arrests; Vanderbilt University had 341. The most common arrest at every school was for marijuana, according to SEC school police reports. Sergeant Stout, public information officer for the Fayetteville Police Department, said there have been several planned drug busts since classes began on August 26. Besides marijuana, drugs most often found at the busts are laboratory pills such as Ecstasy and prescription pills such as Oxycodone.

Read more:
http://www.uatrav.com/news/article_4cdfb3a8-5baf-11e3-9e7c-0019bb30f31a.html

Pinal's Rx Drug Abuse Program Touts Successes
Casa Grande Valley Newspaper
December 4, 2013

The Arizona Prescription Drug Misuse and Abuse Initiative in Pinal County celebrated its first year by sharing statistics about the program. This multiagency collaborative, which aims to reduce prescription drug abuse, has set up 16 prescription drop boxes throughout the county and collected 1,800 pounds of prescription medication. Other accomplishments include reaching more than 175,749 people via public messaging and media methods, distributing the Rx Crimes curriculum to 201 law enforcement officers, and implementing emergency department guidelines at area hospitals.

Read more:
http://www.trivalleycentral.com/arizona_city_independent/people/pinal-s-rx-drug-abuse-
program-touts-successes/article_8c714d82-5c64-11e3-bf68-0019bb2963f4.html


'Drugged Driving' Focus of National Safe Driving Week
CBC News
December 2, 2013

The Canada Safety Council (CSC) is raising awareness during National Safe Driving Week, Dec. 1–7, about the dangers of driving while impaired by illegal drugs, prescription medication, and over-the-counter products. CSC said the number of young drivers, ages 16 to 24, who die in crashes while impaired by drugs is nearly identical to the number of people impaired by alcohol. More drivers over age 55 are killed while impaired by drugs than by alcohol.

Read more:
http://www.cbc.ca/news/canada/ottawa/drugged-driving-focus-of-national-safe-driving-week-1.2447247

Audio: Wellbutrin Abuse Vexes Sudbury Police, Outreach Workers
CBC News
December 4, 2013

Camille Lavoix, a Hepatitis C nurse, said intravenous drug users have discovered they can pulverize Wellbutrin and inject it for a short-lived high. The pill is used to treat depression and help people quit smoking. When injected, it causes weeping abscesses that resemble lunar craters. Wellbutrin is more popular locally than OxyContin, according to Lavoix. Sudbury Police encountered the drug about 12 times in the past year. (Audio: 6:21 minutes)

Read more:
http://www.cbc.ca/news/canada/sudbury/wellbutrin-abuse-vexes-sudbury-police-outreach-
workers-1.2450457


Ontario Opioid Deaths Drop for First Time in Years—But Some Painkiller Prescriptions Skyrocket
Global News
November 28, 2013

This article and three videos (2:19 minutes, 3:40 minutes, and 3:54 minutes) discuss the decrease in opioid deaths among Ontarians in 2012 for the first time in years. The number of people killed by pain relievers dropped from 541 in 2011 to 469 in 2012. Dave Juurlink, doctor and addiction specialist, credits new rules for OxyNEO (the OxyContin replacement), the narcotics monitoring system, and awareness among doctors prescribing pills for the decline.

Read more:
http://globalnews.ca/news/997204/ontario-opioid-deaths-drop-for-first-time-in-years-but-
prescriptions-for-some-drugs-skyrocket


SHSU Program Focuses on Impaired Driving
The Huntsville Item
November 29, 2013

The Impaired Driving Initiatives at Sam Houston State University has developed a new program, funded by the Texas Department of Transportation, to assist probation and parole officers in recognizing signs and systems of drug impairment among clients and families. The 6- to 8-hour course will be offered in 2014.

Read more:
http://www.itemonline.com/local/x868304649/SHSU-program-focuses-on-impaired-driving

Free Kits Available at Police Station to Test for Drugs
The Jamestown Press
December 5, 2013

Rhode Island's Jamestown Police Department is now offering free drug testing kits for residents. The tests can detect marijuana, cocaine, methamphetamine, and opiates. Each kit contains test sticks with urine samples to determine if the subject has been using drugs. Tests are completely anonymous and available at the police station.

Read more:
http://www.jamestownpress.com/news/2013-12-05/News/Free_kits_available_at_police_station_to_test_for_.html

Kentucky's Response to Drug Epidemic Is Yielding Some Good News
Kentucky.com
November 30, 2013

Kentucky's drug overdose deaths declined from 1,023 in 2011 to 1,004 in 2012. One survey showed drug use decreased among Kentucky teens. Another indicated the state no longer led the nation in one key measure of prescription drug abuse: in 2010, the number of state residents 12 and older who reported nonmedical use of prescription pain relievers, at 4.48 percent, was slightly below the national average of 4.57 percent, according to estimates from the Substance Abuse and Mental Health Services Administration. The rate of Kentucky residents who said they were dependent on illicit drugs in 2010–11 remained slightly above the national rate. Deaths attributed to heroin increased from 22 in 2011 to 143 in 2012, according to the Justice and Public Safety Cabinet; deaths involving heroin accounted for 19.56 percent of overdose cases handled by state medical examiners in 2012.

Read more:
http://www.kentucky.com/2013/11/30/2963173/kentuckys-response-to-drug-epidemic.html

Drug Trial Treats Austin Opioid Addicts
KXAN
December 5, 2013

Carlos Tirado, clinical director of Chemical Dependency Services at Seton Shoal Creek Hospital, is leading a clinical trial with Seton Mind Institute that targets prescription pain reliever abuse. The trial will study a medication under development called lofexidine hydrochloride, which treats acute withdrawal from short-acting opioids. The goal is to sign up 60 people by September 2014. Seton Mind Institute is one of just 10 sites selected to participate in the drug trial sanctioned by the National Institutes of Health.

Read more:
http://www.kxan.com/news/local/austin/drug-trial-treats-austin-opioid-addicts

Prescription Drug Abuse: An Illinois Public Health Crisis
Metropolitan Chicago Healthcare Council, Illinois Poison Center, Illinois Department of Public Health
Accessed December 5, 2013

The Metropolitan Chicago Healthcare Council, Illinois Poison Center, and Illinois Department of Public Health released a report that shows an increase in prescription drug overdoses throughout the country and outlines strategies to reduce abuse in Illinois. The state's prescription opioid death rate is 10.5 for every 100,000 people.

Read more:
http://www.mchc.com/eweb/upload/IPC_PrescriptionDrugReport_2013.pdf

Health Department Releases Powerful New Television Ads Highlighting the Risks of Prescription Painkiller Abuse
The New York City Department of Health and Mental Hygiene
December 4, 2013

The New York City Department of Health and Mental Hygiene debuted two television ads raising awareness about prescription pain reliever abuse. The first features a Staten Island parent whose 22-year-old son died from an opioid analgesic overdose. The second features a personal account of a New Yorker who received treatment for opioid analgesic addiction. In New York City, the opioid analgesic overdose death rate increased 267 percent between 2000 and 2011, followed by a slight decrease in 2012. In 2012, Staten Islanders had the highest rate of opioid analgesic overdose deaths (10.1 per 100,000)—more than three times as high as all other boroughs.

Read more:
http://www.nyc.gov/html/doh/html/pr2013/pr046-13.shtml
Related Videos
Prescription Painkillers—Ann Marie
The New York City Department of Health and Mental Hygiene
December 4, 2013

Watch:
https://www.youtube.com/watch?v=-tmS2pbewUM

Prescription Painkillers—Mike
The New York City Department of Health and Mental Hygiene
December 4, 2013

Watch:
https://www.youtube.com/watch?v=1WsOd7RjAmo
Drug Companies Sue King County over 'Take-Back' Law
NWCN.com
November 29, 2013

Major drug makers filed a lawsuit against King County, claiming its "drug take-back" program violates federal law, would not keep drugs from children, and would place an unfair financial burden on patients. In its lawsuit, the drug companies said "in-home disposal" remains the best way to keep children and teenagers from accessing prescription drugs. Health board officials said they expected litigation, but also believe the law will hold up in court. The plan is expected to cost two cents per prescription and take effect in 2015. (Video: 1:35 minutes)

Read more:
http://www.nwcn.com/video/featured-videos/Drug-companies-sue-King-Co-over-take-back-
law-233886121.html


State Lawmakers: Close Gaps in Rx Monitoring Program
Rhode Island Public Radio
December 3, 2013

Rhode Island's State Representative William O'Brien convened a commission that will examine ways to strengthen the prescription drug monitoring program (PDMP). Currently, the program does not include data from enough sources, and misses prescriptions people might pay for in cash. Also, data are delayed for 2 weeks before the system registers a prescription. Rhode Island's PDMP continues to operate even though it has run out of money. Lawmakers have not yet identified a long-term source of funding. (Audio: 51 seconds)

Read more:
http://ripr.org/post/state-lawmakers-close-gaps-rx-monitoring-program

Utah May Try to Cut OD Deaths with 'Good Samaritan' Law
The Salt Lake Tribune
December 2, 2013

Utah State Representative Carol Spackman Moss is sponsoring legislation that would grant limited criminal immunity to people who notify police or other emergency responders in the event of an overdose. With support from the treatment community, prosecutors, and lawmakers, the Law Enforcement and Criminal Justice Interim Committee unanimously endorsed the bill last month and sent it on for consideration by the full legislature in January.

Read more:
http://www.sltrib.com/sltrib/politics/57197085-90/bill-utah-drug-moss.html.csp

'Good Samaritan' Policy Encourages Students to Dial 911
USA Today
December 2, 2013

The University of Miami has implemented a new "Good Samaritan" rule, which states anyone who calls campus police or other emergency services for a student with an alcohol- or drug-related medical issue will not face legal consequences. Thirty cases have been reported this semester on Miami's campus. More than 11 states nationwide have medical amnesty policies, but colleges are taking steps to customize their requirements.

Read more:
http://www.usatoday.com/story/news/nation/2013/12/02/good-samaritan-college/3809373

System Helps via Christi Track Prescription Abuse
The Wichita Eagle
December 5, 2013

Via Christi hospitals use a new computer system to track patients and prescriptions in their emergency departments. The system is integrated into Via Christi's electronic medical records and uses a "stoplight" procedure with green, yellow, and red color coding that can alert physicians about the number of prescriptions a patient has been given in the past 100 days. It incorporates state data from Kansas Tracking and Reporting of Controlled Substances and makes it easier for physicians to identify patients and their prescriptions. Via Christi's pharmacy board will work to educate other hospitals, clinics, and doctors' offices about the system. The program has an open-source application so others will be able to use it statewide.

Read more:
http://www.kansas.com/2013/12/05/3158755/system-helps-via-christi-track.html

Other Resources


Are You AWARxE? Proper Disposal of Unused Medications Helps Prevent Misuse and Abuse
AWARErx.org
Accessed December 5, 2013

This one-page fact sheet lists three options for residents to safely and legally dispose of unwanted, expired, or unneeded medications. It also provides instructions for safe disposal of syringes, sharps, and lancets.

Read more:
https://awarerx.s3.amazonaws.com/system/redactor_assets/documents/189/Drug_disposal_
for_consumers_3-18-13A.pdf


Saving Lives and Protecting People: Preventing Prescription Painkiller Overdose
Centers for Disease Control and Prevention
Accessed December 6, 2013

The Centers for Disease Control and Prevention's Injury Center focuses one of its efforts on preventing prescription pain reliever overdose. The Center provides a two-page fact sheet with a few examples of how it is addressing this problem.

Read more:
http://www.cdc.gov/injury/pdfs/NCIPC_Overview_FactSheet_PPO-a.pdf
http://www.cdc.gov/injury/about/focus-rx.html

Teen Drugged Driving: Parent, Coalition and Community Activity Guide
The White House Office of National Drug Control Policy
Accessed December 6, 2013

This Toolkit includes facts about the dangers and extent of teen and young adult drugged driving, parent and community activities for effective prevention, and other prevention resources.

Read more:
http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/drugged_driving_toolkit.pdf

Call to Action


Join the Movement! Participate in CADCA's Annual Survey of Coalitions!
Community Anti-Drug Coalitions of America
December 5, 2013

The 2014 Community Anti-Drug Coalitions of America (CADCA) Annual Survey of Coalitions is now open for participation. It aims to identify coalitions throughout the country and learn more about their community actions to address substance abuse problems. CADCA uses survey data to advocate for coalition funding in Congress and promote community anti-drug coalitions as vehicles for comprehensive community change. The survey provides a single source where coalitions, policymakers, researchers, and practitioners can access up-to-date information.

Read more:
http://www.cadca.org/annual-survey

Video


Feds: Doctor, Son Sold Pills to Drug Dealers
USA Today
Accessed December 6, 2013

Dr. Andrew Larsen and his son have been accused of selling prescription pills to drug dealers. They also face allegations of abusing Larsen's medical license to sell prescription pain relievers, marijuana, and other drugs. (Duration: 1:16 minutes)

Watch:
http://www.usatoday.com/videos/news/2013/12/05/3886869

Teens Misusing, Abusing Drugs
WPLG
December 2, 2013

A new study illustrates the growing problem of prescription addiction among teens. (Duration: 2:27 minutes)

Watch:
http://www.local10.com/news/teens-misusing-abusing-drugs/-/1717324/23237402/-/cb7ct2/-/index.html

Audio


Prescription Drug Abuse on the Rise on College Campuses Across the Country
Rhode Island Public Radio
December 3, 2013

Elisabeth Harrison, Rhode Island Public Radio's education reporter, spoke with Dr. Lisa Weyandt, a University of Rhode Island psychology professor who studies effects of prescription drug abuse on college students. (Duration: 7:25 minutes)

Listen:
http://ripr.org/post/prescription-drug-abuse-rise-college-campuses-across-country

Grant Announcement


Medical Toxicology Foundation Research Award: Prescription Drug Abuse Prevention
American College of Medical Toxicology
Deadline: February 14, 2014, 11:59 p.m. ET
http://www.acmt.net/MTF_Prescription_Research_Award.html

Grant Received


American Medical Association Awards Grant
Santa Ynez Valley News
November 28, 2013

The American Medical Association awarded an $8,000 grant to California's Santa Ynez Valley Youth Coalition and Buellton Medical Center to reduce underage prescription drug abuse. The 1-year grant will provide funds for public service announcements and informational materials to be distributed throughout the community. Funding will also help support a local conference to offer information, intervention strategies, and referral resources for prevention and treatment of underage prescription drug abuse.

Read more:
http://syvnews.com/news/local/american-medical-association-awards-grant/article_bd8819d2-
570f-11e3-bd40-0019bb2963f4.html


Cardinal Health Foundation Helps Local Non-Profit Organizations Fight Prescription Drug Abuse, Misuse
The Wall Street Journal
December 4, 2013

Cardinal Health Foundation awarded more than $350,000 in grant funding to 29 nonprofit organizations dedicated to reducing prescription drug abuse. This is the 4th year the Foundation has offered funding through its Prescription Drug Abuse and Misuse Prevention Grant Program.

Read more:
http://online.wsj.com/article/PR-CO-20131204-906084.html?dsk=y

Take-Back Events and Drop Boxes


Nassau County Pilot Program: Don't Flush Away Unwanted Prescription Drugs
CBS New York
December 4, 2013
http://newyork.cbslocal.com/2013/12/04/nassau-county-pilot-program-dont-flush-away-unwanted-
prescription-drugs


Used Prescription Drop Box Installed at Bethel P.D.
Delco News Network
December 3, 2013
http://www.delconewsnetwork.com/articles/2013/12/03/garnet_valley_press/news/doc529e171c
ee74b371312859.txt


Delta Township Gets Prescription Drug Drop Box
Delta Township
December 2, 2013
http://www.deltami.gov/index.php/delta-township-gets-prescription-drug-drop-box

North Bergen Asks Residents to Drop Off Unwanted Medications
North Jersey Media Group
November 29, 2013
http://www.northjersey.com/news/233901631_North_Bergen_asks_residents_to_drop_
off_unwanted_ medications_for_safe_disposal_of_medicines.html

Upcoming Conferences and Workshops


Lecture: Prescription Drug Use—The Dos and the Don'ts
January 29, 2014
Huntley, Illinois
http://centegra.org/event/lecture-prescription-drug-use-dos-donts

SAMHSA's 10th Prevention Day
The Power of Prevention: Strengthening Behavioral Health and Public Health for the Next Decade
February 3, 2014
National Harbor, Maryland
http://forum.cadca.org/?q=node/59

24th National Leadership Forum: The Power of Movement
February 3–6, 2014
National Harbor, Maryland
http://forum.cadca.org

Collaborative Perspectives on Addiction: 'Changing Addictive Behavior: Bench to Bedside and Back Again'
February 28–March 1, 2014
Atlanta, Georgia
http://www.apadivisions.org/addiction-perspectives.aspx

Pain Management Through a Wide Lens: Balancing Safety and Effectiveness
March 8, 2014
St. Louis, Missouri
http://aspmnstlouisregional.org/2014-conference-information-and-registration.html

11th Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland
http://www.globalmedicalmeetings.com/events/hr14000

National Rx Drug Abuse Summit
April 22–24, 2014
Atlanta, Georgia
http://nationalrxdrugabusesummit.org

Prescription Drug Abuse and Diversion Crimes
June 10, 2014
Cottleville, Missouri
http://www.thepoliceacademy.org/2014.6.10. percent20Prescription.pdf
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.