West Virginia University Logo

December 17, 2015

PAW Weekly Update

    

                                          
          READ ARCHIVED ISSUES                     SUBSCRIBE TO THE WEEKLY UPDATE
   

 

 
         
                                    
         
SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
Issue 153  |  December 17, 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.                      
               
                                                                                                                 
                                                                                                                                                                     
                            Index                            
Featured                            
Journal Articles and Reports                            
Professional Education and Policy Debate                            
National                            
Marijuana                            
International                            
Northeast/Mid-Atlantic News                            
South News                            
Midwest News                            
West News                            
Other Resources                            
Grant Awarded                            
Grant Announcements                            
Take-Back Events and Drop Boxes                            
Upcoming Conferences and Workshops                            
                       

                        Featured

Survey: Prescription Drug Abuse Impacts 80 Percent of Indiana Workplaces                        
National Safety Council                        
December 7, 2015                        

Eighty percent of employers in Indiana have been affected by prescription drug misuse in their workplaces, according to a National Safety Council poll of more than 200 employers. Almost two thirds of employers believe prescription opioid use is a bigger problem than illegal drugs. Although 76 percent of employers say misusing prescription drugs is a justifiable reason for termination, and 80 percent have experienced an issue, only 53 percent have a written policy concerning prescription drug use at work, and less than 30 percent offer training about workplace use of prescription drugs. Among the 87 percent who say they conduct drug testing, only 52 percent test for synthetic opioids. More than 60 percent are not confident their staff can recognize the signs and symptoms of prescription drug misuse or abuse. The poll will serve as a model for other states interested in assessing prescription drug misuse in the workplace.                        

Read more:                        
http://www.nsc.org/Connect/NSCNewsReleases/Lists/Posts/Post.aspx?ID=87                                                  

Drug Epidemic Handicaps Workforce in Tennessee                        
O.J. Early, Greenville Sun                        
December 5, 2015                        

Tennessee employers are having problems finding applicants who can pass drug tests. They sometimes rely on staffing agencies to fill the gap, but those agencies face the same challenge. Melinda Kelsey, spokesperson for the Tennessee Department of Labor and Workforce Development, affirmed that finding individuals who can pass a drug test is “an issue.” She added that employers tell the department “prescription drugs [have] become a problem in the work place.”                        

Read more:                        
http://www.greenevillesun.com/news/local_news/drug-epidemic-handicaps-workforce/article_c4e5a996-284b-5b21-9335-f7914a84031d.html                                                  

Colorado Police: Bus Driver Allegedly on Six Medications at Time of Crash                        
CBC Denver                        
December 8, 2015                        

A school bus driver was arrested on suspicion of driving under the influence of drugs after her bus crashed in Colorado last week, injuring several students. The driver admitted to being on six different prescribed medications. She appeared to be drug impaired and did not perform voluntary roadside maneuvers as instructed. She was charged with child abuse resulting in serious bodily injury, vehicular assault while driving under the influence of alcohol or drugs (or both), and careless driving causing bodily injury. (Includes video: 2:11 minutes)                        

Read more:                        
http://denver.cbslocal.com/2015/12/08/police-bus-driver-had-6-different-medications-in-system-at-time-of-crash/                      
               
               

Journal Articles and Reports

B.J. Arterberry, S.R. Horbal, A. Buu, and H. Lin. 2015. “The Effects of Alcohol, Cannabis, and Cigarette Use on the Initiation, Reinitiation and Persistence of Non-Medical Use of Opioids, Sedatives, and Tranquilizers in Adults.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.11.029.                

People who use alcohol, cigarettes, and cannabis are more likely to misuse prescription drugs, according to multivariate analysis of data from waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions. Early onset of cigarette and alcohol use was associated with increased odds of opioid use initiation. Early onset of cannabis, cigarette, and alcohol use was associated with increased odds of sedative/tranquilizer use initiation and opioid reinitiation/persistence. Early onset of cannabis use was associated with increased odds of sedative/tranquilizer reinitiation/persistence. Frequent cannabis and cigarette use was associated with opioid use and initiation/reinitiation of sedative/tranquilizer use. Frequent cannabis use was associated with sedative/tranquilizer persistence.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(15)01783-4/abstract                                  

W. Guan, T. Liu, J.R. Baird, and R.C. Merchant. 2015. “Evaluation of a Brief Intervention to Reduce the Negative Consequences of Drug Misuse Among Adult Emergency Department Patients.” Drug and Alcohol Dependence 157:44–53, doi:10.1016/j.drugalcdep.2015.10.007.                

A randomized controlled trial subjected 1,026 emergency department (ED) patients who misused drugs to a brief intervention or treatment as usual. Patients who received the intervention did not experience fewer negative consequences of drug misuse than patients in the control group. The researchers suggest that future ED drug misuse interventions should account for the fact that participants who were successful in stopping their drug misuse or receiving drug treatment experienced fewer negative consequences of drug use/misuse.                 

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(15)01689-0/abstract                                  

S. Harris, V. Nikulina, C. Gelpí–Acosta, C. Morton, V. Newsome, A. Gunn, H. Hoefinger, R. Aikins, V. Smith, V. Barry, and M.J. Downing Jr. 2015. “Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas.” AIMS Public Health 2(4):762–83, doi:10.3934/publichealth.2015.4.762.                

Among a convenience sample of 846 people, 325 had diverted prescription drugs in the past year. Diverters were younger and more likely to have a valid prescription for the drugs they diverted. People who both acquired and redistributed diverted drugs were more likely to live in New York City, not have prescription insurance coverage, and perceive few legal risks of prescription drug diversion. Respondents to the Internet survey were recruited from ads in the volunteer section of Craigslist in New York City, South Florida, and Washington, D.C., between May 2013 and April 2014.                

Read more:                
http://www.aimspress.com/article/10.3934/publichealth.2015.4.762                                  

E. Kim, S. Kim, Y. Hyun, Y. Noh, H. Jung, S. Han, C. Park, B. Moon Choi, and G. Noh. 2015. “Clinical and Psychological Characteristics of Propofol Abusers in Korea: A Survey of Propofol Abuse in 38, Non-Healthcare Professionals.” Korean Journal Anesthesiology 68(6):586–93, doi:10.4097/kjae.2015.68.6.586.                

Among 38 police-identified misusers of injected propofol, a strong anesthetic, 31 had misused the drug for more than a year, and 34 injected at least 2–3 times a week. Stress relief and maintenance of a sense of well-being were the most common reasons cited for first-time administration of propofol and continuing misuse, with almost everyone reporting euphoria at the time of injection. Withdrawal symptoms occurred in 5 users, and 13 reported disruptions in their work life.                 

Read more:                
http://synapse.koreamed.org/search.php?where=aview&id=10.4097/kjae.2015.68.6.586&code=0011KJAE&vmode=FULL                                  

S.P. Stumbo, B.J.H. Yarborough, S.L. Janoff, M.T. Yarborough, D. McCarty, and C.A. Green. 2015. “A Qualitative Analysis of Family Involvement in Prescribed Opioid Medication Monitoring Among Individuals Who Have Experienced Opioid Overdoses.” Substance Abuse, doi:10.1080/08897077.2015.1124479.                

Patients and family members report better pain management outcomes when the patient, caregiver, and clinician develop a shared treatment plan, according to in-depth interviews with a convenience sample of 87 Kaiser Permanente Northwest patients who experienced an opioid-related overdose or were family members of patients who died from an overdose. Negative outcomes included relationship stress, particularly when patients and caregivers had differing perspectives about what constituted effective pain management versus misuse and abuse. When family members were involved in monitoring and managing opioid medications, clinicians were often unaware of their involvement.                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/08897077.2015.1124479                                  

X. Tao, R.A. Lavin, L. Yuspeh, V.M. Weaver, and E.J. Bernacki. 2015. “Is Early Prescribing of Opioid and Psychotropic Medications Associated with Delayed Return to Work and Increased Final Workers’ Compensation Cost?” Journal of Occupational and Environmental Medicine 57(12):1315–18, doi:10.1097/JOM.0000000000000557.                

Prescriptions for psychotropic medications within 60 days of a workers’ compensation claim is significantly associated with a final claim cost of at least $100,000, according to an analysis of 11,394 claimants who were involved in lost-time injuries between 1999 and 2002 and followed through December 31, 2009. Odds ratios were 1.9 if prescribed short-acting opioids; 2.1 for hypnotics, antianxiety agents, or antidepressants; and 3.9 for long-acting opioids. These findings do not account for the seriousness of incidents, for which more serious incidents may require stronger prescription drugs.                

Read more:                
http://journals.lww.com/joem/Abstract/2015/12000/Is_Early_
Prescribing_of_Opioid_and_Psychotropic.10.aspx
                                  

E. Tiffany, C.M. Wilder, S.C. Miller, and T. Winhusen. 2015. “Knowledge of and Interest in Opioid Overdose Education and Naloxone Distribution Among US Veterans on Chronic Opioids for Addiction or Pain.” Drugs: Education, Prevention and Policy, doi:10.3109/09687637.2015.1106442.                

Fifty-two percent of patients at an opioid substitution clinic and 21 percent of patients at a pain management clinic experienced an opioid overdose, according to a survey of patients at a Veterans Health Administration hospital where naloxone kits were not yet available. Less than half of patients had heard of naloxone and none owned a naloxone kit. After a brief explanation, 73 percent of the opioid substitution clinic patients and 55 percent of the pain management clinic patients said they wanted a kit. Patients were more likely to want one if they had witnessed or experienced an opioid overdose or had ever used intravenous drugs. The survey was conducted between July 2013 and January 2014.                 

Read more:                
http://www.tandfonline.com/doi/abs/10.3109/09687637.2015.1106442                                  

S.K. Vosburg, T.A. Eaton, M. Sokolowska, E.D. Osgood, J.B. Ashworth, J.J. Trudeau, M. Muffett–Lipinski, and N.P. Katz. 2015. “Prescription Opioid Abuse, Prescription Opioid Addiction, and Heroin Abuse Among Adolescents in a Recovery High School: A Pilot Study.” Journal of Child and Adolescent Substance Abuse, doi:10.1080/1067828X.2014.918005.                

This 2010 pilot study of 31 former prescription opioid abusers at two Massachusetts recovery high schools (schools specifically designed for adolescent students who are recovering from a substance use disorder) found most teens started misusing prescription opioids out of curiosity. Eighteen became addicted to prescription opioids. Many were polydrug users whose addiction stemmed from stress and difficult life situations. Five abused heroin.                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/1067828X.2014.918005                 
               

Professional Education and Policy Debate

M. Kraus, N. Lintzeris, C. Maier, and S. Savage. 2015. “Recommendations for the Prevention, Detection, Treatment and Management of Prescription Opioid Analgesic Dependence: Outcomes from the Opioid Analgesic Dependence Education Nexus (OPEN) Meeting.” International Journal of Mental Health and Addiction, doi:10.1007/s11469-015-9590-x.                

An international panel of experts met in Berlin in September 2014 to develop a best-practice approach to opioid analgesic dependence European practitioners can adopt. The panel crafted 14 strategies they said “highlight the importance of multidisciplinary care and the utilization of additional expertise rather than practicing in isolation and emphasize the need to manage all aspects of a patient’s wellbeing.”                

Read more:                
http://link.springer.com/article/10.1007/s11469-015-9590-x                                  

L.P. McLafferty, M. Becker, N. Dresner, S. Meltzer–Brody, P. Gopalan, J. Glance, G. St. Victor, L. Mittal, P. Marshalek, L. Lander, and L.L.M. Worley. 2015. “Guidelines for the Management of Pregnant Women with Substance Use Disorders.” Psychosomatics, doi:10.1016/j.psym.2015.12.001.                

This review provides clinicians with guidance on managing the care of pregnant women with substance use disorders, who “present many clinical challenges to health care providers, including comorbid psychiatric disorders, a history of trauma and abuse, avoidance of or poor access to prenatal care, fear of legal consequences and countertransference reactions.”                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0033318215002066                                  

L.R. Webster, M.J. Brennan, L.M. Kwong, R. Levandowski, and J.A. Gudin. 2015. “Opioid Abuse-Deterrent Strategies: Role of Clinicians in Acute Pain Management.” Postgraduate Medicine:1–9.                

The federal government, states, and other stakeholders continue to pursue strategies to mitigate risk of opioid misuse while maintaining access. Federal agency efforts have included required licensure and documentation for prescribing opioids, implementation of risk evaluation and mitigation strategies, and guidance on assessment and labeling of opioid abuse–deterrent formulations. State governments and insurance companies have enacted monitoring programs. Pharmaceutical companies continue to develop abuse-deterrent opioid formulations. And clinicians’ efforts to mitigate opioid misuse include comprehensive patient assessment and universal precautions (e.g., use of multimodal analgesia and abuse-deterrent opioid formulations, urine toxicology screening, participation in prescription drug monitoring and risk evaluation, and mitigation strategy programs).                

Read more:                
http://www.ncbi.nlm.nih.gov/pubmed/26631936                 
               

National

Congress Member Asks Defense Department to Address Drug Abuse in Military                
U.S. Rep. Jackie Walorski                
December 7, 2015                

Rep. Jackie Walorski (R–Ind.), a member of the House Armed Services Committee, has asked the Department of Defense how it plans to minimize drug abuse by current and former service members, their families, and in the communities that surround military installations. She posed a series of questions, including, “What safeguards does the military have in place to address over prescription of opioids? What kind of training does the military have regarding the appropriate methods of prescribing prescription painkillers?”                

Read more:                
http://walorski.house.gov/media-center/press-releases/walorski-requests-defense-department-address-drug-abuse-in-military                                  

Preventing Ambulatory Surgical Center Drug Diversion and Employee Abuse                
Regent Surgical Health                
December 3, 2015                

This article provides signs and symptoms of drug theft and employee addiction within ambulatory surgery centers (ASC), which may be particularly susceptible to acts of drug diversion. “Unlike hospitals,” Regent Surgical Health said, “ASCs do not house a pharmacy department to track medications, and consulting pharmacists may not always audit facility charts against narcotics records. There is often one ASC staff member in charge of ordering and restocking drugs, which could lead to a dangerous lack of accountability within the organization.”                

Read more:                
http://regentsurgicalhealth.com/eletters/preventing-asc-drug-diversion-and-employee-abuse/                 
                 

 Marijuana

A. Azofeifa, M.E. Mattson, and R. Lyerla. 2015. “Driving Under the Influence of Alcohol, Marijuana, and Alcohol and Marijuana Combined Among Persons Aged 16–25 Years—United States, 2002–2014.” Morbidity and Mortality Weekly Report 64(48):1325–9.                  

Driving under the influence of alcohol significantly declined from 16 percent to 7 percent among people ages 16–20 and from 29 percent to 18 percent among people ages 21–25, according to an analysis of data from the 2002–14 National Survey on Drug Use and Health. Driving under the influence of marijuana declined from 3.8 percent to 3.1 percent among people ages 16–20 but did not change among people ages 21–25. Driving under the influence of alcohol and marijuana combined declined from 2.3 percent to 1.4 percent among people ages 16–20 and from 3.1 percent to 1.9 percent among people ages 21–25.                   

Read more:                  
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6448a1.htm?s_cid=mm6448a1_w                                      

O. Devinsky, E. Thiele, L. Laux, D. Friedman, A. Patel, J. Bluvstein, M. Chez, C. Joshi, R. Cilio, F. Filloux, E. Fertig, A. Wilfong, P.D. Lyons, Y. Park, R. Flamini, M. Wong, I. Miller,  and E. Marsh. 2015. “Efficacy and Safety of Epidiolex (Cannabidiol) in Children and Young Adults with Treatment-Resistant Epilepsy: Update from the Expanded Access Program.” Abstract from the American Epilepsy Society, 69th Annual Meeting, December 4–8, 2015. Philadelphia, Pa.                  

In a low-quality study without a comparison group, 261 children and young adults with treatment-resistant epilepsy received at least 3 months of cannabidiol treatment. After 3 months of therapy, median seizure frequency reduction was 45 percent in all patients, 63 percent in Dravet syndrome patients, and 71 percent for atonic seizures in Lennox–Gastaut syndrome patients. Among all patients, 47 percent had a 50 percent or greater reduction in seizures. Seizure freedom at 3 months occurred in 9 percent of patients, including 13 percent of Dravet syndrome patients. Clobazam co-therapy was associated with a higher rate of treatment response: 57 percent convulsive seizure reduction versus 39 percent. Adverse events in 10 percent or more of patients included somnolence (23 percent), diarrhea (23 percent), fatigue (17 percent), decreased appetite (17 percent), convulsions (17 percent), and vomiting (10 percent). Fourteen patients (4 percent) had an adverse event that led to discontinuation of treatment, and 36 patients withdrew primarily due to lack of efficacy. Serious adverse events were reported in 106 patients (34 percent), including 7 deaths, none of them treatment related.                   

Read more:                  
https://www.aesnet.org/meetings_events/annual_meeting_abstracts/view/2414222                                      

B. Murnion. 2015. “Medicinal Cannabis.” Australian Prescriber 38:212–15.                  

Controversies exist in how to produce, supply, and administer cannabinoid products in Australia. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimizes risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014, under consideration in Australia’s parliament, would address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion as a Schedule 4 drug, which includes prescription-only medicine.                  

Read more:                  
http://www.australianprescriber.com/magazine/38/6/212/5                                      

G.L. Schauer, B.A. King, R.E. Bunnell, G. Promoff, and T.A. McAfee. 2015. “Toking, Vaping, and Eating for Health or Fun.” American Journal of Preventive Medicine, doi:10.1016/j.amepre.2015.05.027.                  

Seven percent of adults said they currently use marijuana, and 34 percent reported ever using the drug, according to a 2014 nationally representative consumer panel survey of 4,269 adults age 18 and older. Among current users, 10 percent reported medicinal use, 53 percent reported recreational use, and 36 percent reported using marijuana for both. Most current users said they consumed marijuana using a bowl or pipe (50 percent) and joint (49 percent). Fewer reported using a bong, water pipe, or hookah (22 percent); blunts (20 percent); edibles/drinks (16 percent); and vaporizers (8 percent).                  

Read more:                  
http://www.ajpmonline.org/article/S0749-3797(15)00320-7/abstract                                      

B. Wilsey, J.H. Atkinson, T.D. Marcotte, and I. Grant. 2015. “The Medicinal Cannabis Treatment Agreement: Providing Information to Chronic Pain Patients Through a Written Document.” Clinical Journal of Pain 31(12):1087–96, doi:10.1097/AJP.0000000000000145.                  

Based on a review of the scientific literature and available guidance, the authors suggest that pain management practitioners ask patients prescribed medicinal cannabis for chronic pain to review and acknowledge via signature certain tenets, including potential benefits and harms.                  

Read more:                  
http://journals.lww.com/clinicalpain/Abstract/2015/12000/
The_Medicinal_Cannabis_Treatment_Agreement_.10.aspx
                                      

Federal Court Dismisses Medical Marijuana Claims Asserted by Employee                  
National Law Review                  
December 7, 2015                  

A federal district court in Washington has ruled that an employer may terminate an employee for using marijuana, even when that employee has a prescription and uses it off-duty. Safeway tested employee Michael Swaw for drugs following a workplace injury. Swaw, who was employed at one of the supermarket chain’s beverage plants, tested positive for marijuana, and Safeway terminated him, pursuant to its drug-free workplace policy. Swaw sued, alleging his former employer unlawfully discriminated against him on the basis of a disability because his medical marijuana use was pursuant to a valid prescription. He also argued he was treated more harshly than employees found to be intoxicated by alcohol. The court dismissed Swaw’s claims, holding that state law does not impose upon employers a duty to accommodate medical marijuana in drug-free workplaces. The court also noted that marijuana remains illegal under federal law.                   

Read more:                  
http://www.natlawreview.com/article/washington-court-dismisses-medical-marijuana-claims-asserted-employee                                      

Eight Tips for Approaching Your Employer About Medical Marijuana Use                  
Alison McMahon, Civilized                  
December 8, 2015                  

Alison McMahon—a workplace expert in Alberta, Canada, and founder of Cannabis at Work—suggests employees approach their employers about medical marijuana use if they hold a safety-sensitive job (meaning they have a duty to report potential hazards) or if they need to consume cannabis on a regular basis. McMahon provides eight tips for employees to follow: know your rights and responsibilities, have your documentation in order, be forthcoming, confirm confidentiality, be proactive and helpful, be prepared for an unexpected response from others, be professional, and be perseverant. McMahon said because medical cannabis is legal in Canada, employers have a duty to accommodate medical disability. She added that employees who do not hold safety-sensitive positions are not required to report their medical cannabis use to their employer.                   

Read more:                  
https://www.civilized.life/8-tips-for-approaching-your-employer-about-medical-marijuana-use-1496556031.html                   

Massachusetts Doctors’ Group Doubles Down on Pot Stance                  
Colin A. Young, Lowell Sun                  
December 8, 2015                  

The Massachusetts Medical Society has confirmed its opposition to legalized marijuana for recreational use. The group, which represents about 25,000 doctors, urged that any proposed legislation in support of marijuana legalization prohibit anyone under 21 from using or possessing the drug and include dedicated revenues for public education and prevention and treatment of adverse health consequences. Finally, they adopted a policy that women of reproductive age who report using marijuana should be counseled on potential adverse health effects.                  

Read more:                  
http://www.lowellsun.com/todaysheadlines/ci_29216855/doctors-group-doubles-down-pot-stance                                     

Task Force in Oregon Will Scrutinize Medicinal Properties of Pot                  
Elizabeth Hayes, Portland Business Journal                  
December 8, 2015                  

Oregon’s governor has appointed a task force to review research on the medicinal properties of marijuana and propose solutions to research limitations. The task force will also examine legal barriers to establishing research labs and using institutional review boards to monitor and review medical marijuana research.                   

Read more:                  
http://www.bizjournals.com/portland/blog/health-care-inc/2015/12/kate-brown-led-task-force-will-scrutinize.html                                      

A ‘Budding’ Industry: Asian Americans for Cannabis Education                  
Monica Luhar, NBC News                  
December 7, 2015                  

Tiffany Wu, a business attorney who specializes in the cannabis industry, and two of her friends have started Asian Americans for Cannabis Education. The group aims to expand the dialogue about marijuana among Asian Americans who are consumers of marijuana but less likely to be transparent about their use or about joining the industry. It hopes to break down the stigma associated with marijuana by having cross-generational dialogue. The group has addressed some stereotypes by using the media and photographs to change the conversation on cannabis.                   

Read more:                  
http://www.nbcnews.com/news/asian-america/budding-industry-asian-americans-cannabis-education-n472981                                      

Survey: Marijuana Has Huge Influence on Colorado Tourism                  
Jason Blevins, Denver Post                  
December 9, 2015                  

A Colorado Tourism Office survey of 3,254 tourists found legal weed is a growing motivator for trips to the state. Marijuana laws influenced vacation decisions nearly 49 percent of the time. The survey did not ask people if they opted out of Colorado travel because of legal pot. Only 8 percent of the Colorado tourists who responded to the survey said they visited a marijuana dispensary. Of the 8 percent who went pot shopping, 85 percent said marijuana was a primary motivator of their visit to Colorado, up from 29 percent last year. (Includes Video: 1:20 minutes)                  

Read more:                  
http://www.denverpost.com/business/ci_29225304/marijuana-has-huge-influence-colorado-tourism-state-survey                   
               

International

Fentanyl Patch-for-Patch Law Passes in Ontario, Canada                
CBC News                
December 8, 2015                

The Ontario (Canada) legislature has passed a bill aimed at combating fentanyl misuse. The bill incorporates a “Patch4Patch” program, which currently operates in many Ontario communities. People with a prescription for the opioid pain pill would only be given new patches with the drug when they turn in used patches. Ontario provincial police warn that as little as 100–150 micrograms of fentanyl powder can be deadly.                

Read more:                
http://www.cbc.ca/news/canada/sudbury/fentanyl-patch-for-patch-law-1.3355177                 
               

Northeast/Mid-Atlantic News

Drug Scourge Hits Home for New York City Police and Fire Departments                
Frank Donnelly, Staten Island Advance                
December 10, 2015                 

This article describes prescription pain reliever misuse by a New York City police officer and the heroin overdose death of a firefighter. NYC’s police department has a zero-tolerance policy for illicit drug abuse, but treatment is available to officers who become addicted to drugs legally prescribed to them. The fire department’s counseling services unit provides mental health evaluations, direct treatment, and appropriate referrals for all employees.                

Read more:                
http://www.silive.com/news/index.ssf/2015/12/cops_firefighters_not_immune_t.html                                  

New Hampshire Overdose Deaths in 2015 to Top 400, Double 2013                
NECN                
December 8, 2015                

New Hampshire overdose deaths will exceed 400 this year. Most overdosed on heroin or fentanyl. In 2013, the state counted 192 opioid overdose deaths; 326 in 2014. The governor wants to create more drug courts, strengthen the prescription drug monitoring program, build up law enforcement, and improve access to treatment and recovery services for addicts.                 

Read more:                
http://www.necn.com/news/new-england/2015-New-Hampshire-Overdose-Deaths-to-Top-400-Double-2013-361040161.html                                  

Drug Prevention Curriculum Eyed for New Hampshire Schools                
Allie Morris, Concord Monitor                
December 10, 2015                

New Hampshire lawmakers have approved legislation that would require public schools to offer annual drug and alcohol prevention education to students from kindergarten through high school.                

Read more:                
https://politics.concordmonitor.com/2015/12/gov-state/drug-prevention-curriculum-eyed-for-new-hampshire-schools/                                  

Drug Cocktails Fuel Massachusetts’ Overdose Crisis                
Martha Bebinger, NPR                
December 10, 2015                

In the first 6 months of 2014, the vast majority of overdose deaths in Massachusetts were caused by heroin or a prescription opioid taken in combination with some other drug or alcohol. For this story, an NPR reporter spoke with users of illegal drugs about drug “cocktails” that intensify and lengthen a heroin high. Patients on methadone described a popular cocktail taken after their daily dose of methadone treatment: gabapentin (anti-seizure medication), Klonopin, clonidine (treats high blood pressure and attention deficit hyperactivity disorder), and an over-the-counter allergy medicine. Some heroin users said they doctor shop for anxiety or depression medication prescriptions. (Includes audio: 4:10 minutes)                

Read more:                
http://www.npr.org/sections/health-shots/2015/12/08/458280574/drug-cocktails-fuel-massachusetts-overdose-crisis                                  

Maine Plan to Attack Drug Crisis Spends Equally on Treatment, Enforcement                
Steve Mistler, Portland Press Herald                
December 9, 2015                

Maine unveiled a $4.8 million proposal to address the state’s drug crisis. It includes hiring 10 agents for the Maine Drug Enforcement Agency and a statewide coordinator to connect law enforcement and treatment providers, funding five police departments to implement the Operation Hope program adopted by Scarborough police, and providing $2.4 million for treatment and recovery programs.                

Read more:                
http://www.pressherald.com/2015/12/09/maine-lawmakers-release-4-8-million-plan-to-fight-drug-crisis                
               

 South News

Texas Doctor, Pharmacy Staff Accused in $17M Prescription Drug Sale Scheme                
Click2Houston.com                
December 8, 2015                

A Houston-area doctor and three pharmacy staff members have been charged in a $17 million health insurance fraud scheme that involved selling ketamine to patients without a valid prescription. The pharmacy paid the doctor to provide pre-signed prescriptions without examining patients, then sold compounded creams that contained prescription drugs and ketamine to customers—using the pre-signed prescriptions—and billed their insurance companies.                

Read more:                
http://www.click2houston.com/news/doctor-pharmacy-staff-accused-in-17m-scheme-involving-sale-of-prescription-drugs                 
               

Midwest News

Prescription Drug Abuse in the Illinois Workplace                
Beau Ebenezer, WEEK & WHOI                
December 8, 2015                

Prescription drug misuse could be slipping through the cracks at Illinois workplaces, this article warns. No study has assessed whether the state has a prescription drug problem in the workplace, and state law does not require employers to conduct drug tests. The Illinois Work Injury Resource Center tests thousands of employers throughout central Illinois for marijuana, cocaine, amphetamines, PCP, and opiates. Employers can upgrade the test to include six additional prescription medications. It can still be difficult to identify those who misuse drugs because opiates can clear an employee’s system in about a week. Also, many opiates sometimes go untested because employers are unaware of advanced testing options.                

Read more:                
http://www.cinewsnow.com/news/local/Prescription-drug-abuse-in-the-workplace-361088801.html                                  

Federal Appeals Court in Missouri Upholds College’s Drug Tests for Students                
Southwest Missourian                
December 10, 2015                

The St. Louis-based 8th U.S. Circuit Court of Appeals ruled that the State Technical College of Missouri can require all students to take drug tests. The court said the college’s 1,200 students “are primarily engaged in safety-sensitive and potentially dangerous curriculum due to the unique nature of this particular vocational and technical college and its limited focus.”                 

Read more:                
http://www.semissourian.com/story/2257843.html                 

Tennessee Report Says Prescription Drug Abuse ‘Ravages People of All Ages’                
The Chattanoogan                
December 7, 2015                

Tennessee Department of Mental Health and Substance Abuse Services data show a 20-year trend of rising misuse of prescription medication in all age groups. Misuse is particularly increasing among those ages 50 and older.                 

Read more:                
http://www.chattanoogan.com/2015/12/7/313906/Report-Says-Prescription-Drug-Abuse.aspx                                  

Wisconsin Governor Signs Bill to Make Narcan More Readily Available                
Laurie Linder, USAW                
December 8, 2015                

Wisconsin Governor Scott Walker signed a bill expanding access to Narcan. Now anyone in the state will be able to buy the antidote without a prescription. (Includes video: 3:07 minutes)                

Read more:                
http://www.wsaw.com/home/headlines/Walker-signs-heroin-antidote-distribution-bill-360945221.html                                  

Michigan Legislature Passes Bill to Prevent Rx Overdose Deaths                
WILX                
December 9, 2015                

Michigan passed a Good Samaritan bill that exempts people under 21 from being charged with a crime when reporting a prescription drug overdose. The bill awaits the governor’s signature.                

Read more:                
http://www.wilx.com/home/headlines/Senate-Passes-Good-Samaritan-Bill-to-Prevent-Prescription-Drug-Overdose-Deaths-361254051.html?ref=051                                  

Wisconsin Medical School Developing Trauma Center Opioid Risk Screening Tool                
Maureen Fitzgerald, ATTC Messenger                
December 2015                

The University of Wisconsin School of Medicine and Public Health has launched a 3-year research project to develop and test an opioid risk screening tool in Wisconsin trauma centers. The tool could guide a framework for prevention and early intervention for opioid misuse and use disorders.                 

Read more:                
http://www.attcnetwork.org/find/news/attcnews/epubs/addmsg/December2015article.asp                                  

Oklahomans Warned to Secure Medications Around the Holidays                
Brooke McCuiston, Press-Leader                
December 3, 2015                

This article urges Oklahoma residents to secure medications during holiday parties. It offers three ways to reduce the availability of medications in the home. It also lists permanent drop box sites for Tillman County, which is southwest of Oklahoma City.                

Read more:                
http://press-leader.com/news/586/holiday-parties-at-your-house-make-sure-to-secure-your-meds                                  

Iowa’s Jones County Boosts Efforts to Keep Drug-Impaired Drivers off Roads                
Jill Kasparie, KCRG                
December 3, 2015                

The Jones County (Iowa) Sheriff’s Office has seen more Iowans driving impaired from a combination of alcohol and other drugs, a single drug, or a combination of many drugs. Some deputies in the county, which is east of Cedar Rapids, have been trained to recognize drug-impaired drivers and conduct tests to identify which drugs the driver has used. Prescription drugs are one of the biggest concerns because of the lack of officers trained to handle the problem.                

Read more:                
http://www.kcrg.com/content/news/Jones-County-steps-up-efforts-to-keep-drug-impaired-drivers-off-the-roads-360477981.html                 
               

West News

Indictment Says Utah Company Sold Black Market Medicine to Pharmacies                
Tom Harvey, Salt Lake Tribune                
December 9, 2015                

Randy Alan Crowell, owner of Green Valley Medical Distributors, was indicted for selling more than $100 million worth of medicines obtained on the black market to pharmacies that resold the drugs to unsuspecting customers. Crowell pocketed $16 million from the scheme while allegedly defrauding insurance companies and Medicare.                 

Read more:                
http://www.sltrib.com/news/3288194-155/new-york-indictment-says-utah-company                 

Calif. Hospital Sees More Patients Seeking Pain Meds, Prompts Policy Reminder                
Lacey Peterson, Union Democrat                
December 10, 2015                

Sonora Regional Medical Center, located about 100 miles southeast of Sacramento, is reminding the public about its policy on pain medication as part of its effort to reduce prescription drug addiction and overdose deaths. It also issued the reminder because it has seen an increase in patients seeking pain medications. Emergency physicians will not usually prescribe pain medication if a patient already receives the drug from another healthcare provider. Lost or stolen prescriptions will not be refilled, and certain medications (such as OxyContin, fentanyl, and Dilaudid) will not be filled at all. In addition, missing doses of Subutex, Suboxone, or methadone will not be replaced. The medical center uses California’s prescription drug monitoring program.                

Read more:                
http://www.uniondemocrat.com/News/Local-News/Hospital-sees-increase-in-patients-seeking-pain-meds-prompts-policy-reminder                 
               

Other Resources

Applying the Strategic Prevention Framework to Prescription Drug Abuse                
Community Anti-Drug Coalitions of America                
Online Course                

This course addresses prescription and over-the-counter medicine misuse and addiction. The 10 modules apply the “problem statement” of youth prescription drug misuse to the major competencies of SAMHSA’s Strategic Prevention Framework. To build basic skills and gain significant knowledge to address this issue, participants should have a working understanding of the framework and have identified prescription misuse as a problem.                   

Read more:                
http://learning.cadca.org/products/1016/applying-the-strategic-prevention-framework-to-prescription-drug-abuse                 
               

Grant Awarded

Lilly Grant to Fund 100 New Rx Disposal Sites in Indiana                
Alex Brown, Inside Indiana Business                
December 8, 2015                

Pharmaceutical maker Eli Lilly and Co. has given a $30,000 grant to Great Lakes Clean Water/US Clean Water to support its Yellow Jug Old Drugs program, which allows residents to drop off medications. Funding will be used to establish 100 new prescription drug disposal sites at pharmacies across Indiana.                 

Read more:                
http://www.insideindianabusiness.com/story/30697632/lilly-grant-to-fund-100-new-rx-disposal-sites                 
               

Grant Announcements

Generation Rx Medication Disposal Grant Program                
Cardinal Health                
Due: January 22, 2016                

Cardinal Health is accepting grant applications from nonprofit organizations to support promotion and education efforts associated with community prescription drug disposal programs.                

Read more:                
http://www.cardinalhealth.com/en/about-us/community-relations/population-health/rx-drug-misuse-and-abuse.html                                 

Increasing Access to Medication-Assisted Treatment in Rural Primary Care Practices (R18)                
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality                
Due: March 4, 2016                

This initiative will fund demonstration research projects that implement medication-assisted treatment (MAT) for opioid use disorder in primary care practices in rural areas. It will also test methods to overcome known barriers to implementation of MAT in primary care and create training and implementation resources to support future efforts to expand MAT access.                 

Read more:                
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-16-001.html                                  

National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for That                
U.S. Department of Health and Human Services, National Institute on Drug Abuse                
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                
Due: 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                
Due: February 18, 2016                
http://www.grants.gov/view-opportunity.html?oppId=280151                 
               

Take-Back Events and Drop Boxes

St. Martin Parish (La.) Recycle Collection Day Scheduled for January 16, 2016                
Daily Advertiser                
December 10, 2015                
http://www.theadvertiser.com/story/news/2015/12/10/st-martin-parish-wide-recycle-collection-day-scheduled/77098500/                                  

Pima County (Ariz.) Sheriff Adds Permanent Prescription Drug Drop-Off Locations                
Michael Cooper, Tucson News Now                
December 9, 2015                
http://www.tucsonnewsnow.com/story/30709078/pima-sheriffs-department-adds-permanent-prescription-drug-drop-off-locations                                  

Angels Camp (Calif.) Police Department Prescription Drug Drop Box                
ThePineTree.net                
December 10, 2015                
http://new.thepinetree.net/news/angels-camp-police-department-prescription-drug-drop-box/                                  

Prescription Drug Drop Box in Marion County (Ind.) Jail Collecting Discarded Drugs                
Weekly View                
December 10, 2015                
http://weeklyview.net/2015/12/10/prescription-drug-drop-box-in-jail-collecting-discarded-drugs/                                  

Drug Lock Box Coming to Shen (Iowa) Police Department                
Mike Peterson, KMA Land                
December 11, 2015                
http://www.kmaland.com/news/drug-lock-box-coming-to-shen-pd/article_d9847b10-a016-11e5-ad70-6b82420c199b.html                                  

Neosho (Mo.) Has Second Drop Box for Drugs                
Neosho Daily News                
December 9, 2015                
http://www.neoshodailynews.com/article/20151209/NEWS/151208787                                  

Clarksville (Tenn.) Police Department ‘Count It, Lock It, Drop It’ Program Raises Awareness About Prescription Drug Abuse                
Clarksville Online                
December 9, 2015                
http://www.clarksvilleonline.com/2015/12/09/330428/                                  

Prescription Drug Drop Off in Weslaco, Texas                
KRGV                
December 8, 2015                
http://www.krgv.com/news/local-news/prescription-drug-drop-off-in-weslaco/36858562                 
               

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference                
U.S. Drug and Enforcement Administration                
January 9–10, 2016                
Jackson, Mississippi                
February 27–28, 2016                
Charleston, West Virginia                
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/                                  

Twenty-Sixth National Leadership Forum and SAMHSA’s 12th Prevention Day                
Community Anti-Drug Coalitions of America and Substance Abuse and Mental Health Services Administration                
February 1–4, 2016                
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                  
Atlanta, Georgia                
http://nationalrxdrugabusesummit.org                                  

Third Annual Smart Approaches to Marijuana Education Summit                
March 31, 2016                
Atlanta, Georgia                
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.