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February 20, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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February 20, 2013 (PDF version)
Featured Article

Richard L. Spoth, Linda Trudeau, Chungyeol Shin, Ekatarina Ralston, Cleve Redmond, Mark Greenberg, and Mark Feinberg. 2013. "Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three Randomized Controlled Trials With Late Adolescents and Young Adults." American Journal of Public Health: e1-8. doi:10.2105/AJPH.2012.301209.
Researchers examined the impact of three interrelated brief universal preventive interventions conducted in middle schools on long-term prescription drug misuse. The three randomized controlled trials evaluated 1) the Iowa Strengthening Families Program (ISFP); 2) the revised ISFP called Strengthening Families Program: For Parents and Youth 10-14, plus school-based Life Skills Training (SFP 10-14 + LST); and 3) the SFP 10-14, plus school-based LST or Project ALERT or All-Stars. Outcomes were based on self-reported prescription opioid misuse (POM) and lifetime prescription drug misuse overall (PDMO). Relative reduction rates measured the program's impact on POM and PDMO within the intervention group, relative to a control group. The analysis further examined the impact on higher-risk students (those who had already initiated alcohol, cigarette, or drug use at baseline) versus the impact on lower-risk subgroups. In Study 1, ISFP reduced POM and PDMO by 65 percent at age 25 compared with the control group. In Study 2, SFP 10-14 + LST showed significant or marginally significant reductions among the intervention group of 30 percent in POM and 60 percent in PDMO at age 25. In Study 3 (a more recent cohort), high school seniors showed a 20 percent to 21 percent reduction in POM and PDMO. All three studies found similar reductions for high- and low-risk subgroups. The authors concluded that brief universal interventions have the potential to affect public health by reducing prescription drug misuse among adolescents and young adults.

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Journal Articles
Lisa M. Cook. 2013. "Can Nurses Trust Nurses in Recovery Reentering the Workplace?" Nursing 43(3):21-24. doi:10.1097/01.NURSE.0000427092.87990.86.
The author examined the ability of working direct care nurses to trust nurses recovering from substance misuse disorders who are reentering the workplace. She used a researcher-designed quantitative survey to gather data. Nurses are willing to trust their recovering colleagues and strongly agree nurses in recovery should be allowed to return to the healthcare profession. Many nurses don't know how to provide help or where to locate support such as assistance programs or alternative-to-discipline programs for their colleagues.

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Richard A. Deyo, Jessica M. Irvine, Lisa M. Millet, Todd Beran, Nicole O'Kane, Dagan A. Wright, and Dennis McCarty. 2013. "Measures Such as Interstate Cooperation Would Improve the Efficacy of Programs to Track Controlled Drug Prescriptions." Health Affairs. doi:10.1377/hlthaff.2012.0945.
Researchers reviewed government documents, expert white papers, articles from peer-reviewed medical literature, and reports of local health officials' experiences. They concluded that prescription drug monitoring programs benefit law enforcement and health care delivery. However, the programs have strengths and weaknesses, and their overall impact on drug abuse and illegal activity remains unclear.

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Related Article
Rx Drug Tracking Could Have QA Use, Review Finds
Medpage Today
February 15, 2013
Prescription drug monitoring programs could help healthcare providers improve their quality of care. Healthcare providers increasingly looked to these programs as a tool for improving patient safety and care. A 2008 Ohio study found emergency department doctors who accessed prescription drug data changed their prescribing practices in 41 percent of cases. Nearly two thirds of those changes resulted in prescribing less or no opioid medication, but more than one third resulted in prescribing more opioid medication than was originally planned.

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Traci C. Green, Sarah E. Bowman, Madeline Ray, Nickolas Zaller, Robert Heimer, and Patricia Case. 2012. "Collaboration or Coercion? Partnering to Divert Prescription Opioid Medications." Journal of Urban Health. doi:10.1007/s11524-012-9784-5.
Researchers used qualitative data collected in a 12-week Rapid Assessment and Response study on prescription opioid overdose and abuse conducted in three New England communities. They reviewed and thematically coded 195 interviews and examined partnering of patients--with other "patients" and "caregivers"--to obtain prescription opioids. Motivation for partnering included fear of violence, financial benefit, or for transportation or other services. Partnering for prescription opioids exhibited a range of power differentials, from collaboration to coercion, and tended to involve vulnerable populations such as the elderly, disabled, or destitute.

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Christopher O. Hoyte, Donald Albert, and Kennon J. Heard. 2013. "The Use of Energy Drinks, Dietary Supplements, and Prescription Medications by United States College Students to Enhance Athletic Performance." Journal of Community Health. doi:10.1007/s10900-013-9653-5.
Researchers explored the use of energy drinks, dietary supplements, and prescription medications by college students to enhance athletic performance. Using an ongoing survey system, they conducted a multiround questionnaire, collecting data from self-identified students at 2-year colleges, 4-year colleges, enrolled in online courses, and in technical schools during the specified sampling period. Of the 462 college students who reported sports participation at various levels, 397 (85.9 percent) had used energy drinks, dietary supplements, or prescription medications within the last year to enhance athletic performance. Energy drinks had the highest prevalence (80.1 percent), followed by dietary supplements (64.1 percent) and prescription medications (53.3 percent).

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William D. Voss, Erin Kaufman, Stephen S. O'Connor, Katherine Anne Comtois, Kenneth R. Conner, and Richard K. Ries. 2013. "Preventing Addiction Related Suicide: A Pilot Study." Journal of Substance Abuse Treatment. doi:10.1016/j.jsat.2012.10.006.
Researchers developed the Preventing Addiction Related Suicide module to address the need for improved suicide prevention strategies among persons addicted to drugs and alcohol. A pilot test with 78 patients demonstrated significant posttreatment changes in knowledge and attitudes toward suicide prevention issues. These significant gains were maintained at the 1-month follow-up. Changes in positive help-seeking behaviors to deal with suicidal issues among friends, family, and patients were also observed.

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News and Reports
Cowlitz County Struggling to Reverse Rise in Overdose Deaths
Longview Daily News
February 9, 2013
This article discusses the increase in heroin overdoses in Cowlitz County, Wash. In 2012, county deaths from prescription drug overdoses were at a 6-year high. Statewide, prescription drug deaths are declining, while heroin deaths are on the rise. Drug abusers are shifting to heroin as the cost of prescription medicine grows and public awareness and disposal programs limit availability of pills.

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Anti-Overdose Medication to Help Combat Opiate Prescription Drug Abuse
February 14, 2013
This article and video (2:12 minutes) briefly discuss the new legislation sponsored by Rep. Michael Stinziano (D-Ohio) that would make Narcan, a medication used to reverse opiate overdoses, more accessible. The legislation would extend Project DAWN--Deaths Avoided With Naloxone (a variation of Narcan)--a pilot program that distributes Narcan in Scioto County, Ohio.

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Fish Exposed to Anxiety Medication Show Altered Behavior, Study Finds
Washington Post
February 15, 2013
Laboratory experiments show European perch that are exposed to anti-anxiety medication become antisocial. They wander away from their school and devour food faster than fish of the same species. Researchers examined how perch behaved when exposed to oxazepam, a drug commonly used to treat anxiety disorders in humans. The scientists exposed the fish to oxazepam concentrations similar to those found in waters near densely populated areas of Sweden. Those who swam in oxazepam became bolder and lost interest in being with the school. The article reports that the Food and Drug Administration has issued guidelines for safely disposing of prescription drugs, urging consumers to avoid flushing them down the toilet and to participate in community take-back programs that allow people to return unused drugs for proper disposal.

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Students, Doctors Are at Fault for Growing Adderall Misuse
Collegiate Times
February 11, 2013
The author accuses students of faking attention deficit-hyperactivity disorder (ADHD) symptoms to get Adderall prescriptions, and faults doctors for overprescribing the drug. He suggests doctors have failed to inspect the real severity of a patient, instead taking the patient's word without obtaining evidence of ADHD.

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The Deadly Rise of Prescription Drug Abuse in the Military
February 14, 2013
Over the past decade, the military has spent $1.6 billion on painkillers, $2.7 billion on antidepressants, and more than $507 million on sleep medications. Prescription drug abuse--mostly the use of painkillers--has tripled since 2002. Since 2006, the number of soldiers enrolled in the Army's substance abuse program jumped 40 percent, with 23,000 enrolled in 2010. Military physicians writing pain reliever prescriptions to soldiers quadrupled to nearly 3.8 million scripts from 2001 to 2009.

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No Pain, Please, We're British
February 8, 2013
This article discusses the reluctance of doctors in the United Kingdom to prescribe painkillers. Doctors speculate that by prescribing fewer opioids, they have helped their country avoid the prescription drug abuse crisis confronting the United States. Practices such as physiotherapy, acupuncture, and massage are widely used to treat pain in the UK.

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New Program to Curb Opioid Prescription Drug Overdoses
February 13, 2013
The Colorado School of Public Health is offering a new training program to help stem the epidemic of opioid prescription-related overdoses and unintentional deaths. Their online course offers guidelines to Colorado healthcare providers for managing patients with chronic, non-cancer-related pain. The article reports that The Opioid Crisis: Guidelines and Tools for Improving Chronic Pain Management is the first course of its kind in Colorado to offer online training and tools that target the opioid abuse epidemic. The course was developed by the school's Center for Worker Health and Environment in partnership with chronic pain experts and members of Colorado's insurance community. 
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Illinois Poison Center Sees Increase in Calls for Prescription Drug Poisoning
February 1, 2013
The Illinois Poison Center reported that more people in the state are hospitalized for poisoning than for injuries from guns and car crashes combined. Poisoning calls about prescription medications--especially painkillers--are rising. Of more than 80,000 calls in 2012, 10,975 related to analgesics; 6,581 related to sedatives/hypnotics/antipsychotics; 4,033 related to antidepressants; 3,390 related to cardiovascular drugs; and 3,059 related to antihistamines. The percentage of calls about child exposures fell from 70 percent to 48 percent in 2003.

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Clamping Down on Prescription Painkiller Abuse
CBS Evening News
February 8, 2013
This article and video (2:10 minutes) probe prescription drug addiction by interviewing a woman who almost died from abusing narcotic painkillers that were prescribed after a car accident.

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Prescription Drugs: Available and Deadly
The Southern
February 10, 2013
This article discusses the prescription drug abuse and crime problem in Illinois--highlighting national and state statistics. Illinois saw a 49 percent increase in unintentional drug overdoses from 1999 to 2007--prescription drugs being the cause in most cases.

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Programs in Place to Help Curb Growing Problem of Prescription Drug Abuse
The Southern
February 10, 2013
This article discusses Illinois' prescription drug monitoring program (PMP) and a state hospital's Care Plan and Prevention program. Recently, the PMP partnered with the National Association of Boards of Pharmacy data-sharing network to improve handling of prescription drugs and help identify when patients have been issued duplicate prescriptions for controlled substances across state lines. The Care Plan and Prevention program will alert prescribers and dispensers when patients exceed recommended limits on controlled substances, which may help prevent prescription drug abuse. The program identifies people suspected of coming to the emergency room in an attempt to secure drugs. Staff bring in social workers and case managers to develop a plan to help the person with substance abuse. The hospital also limits the amount of narcotics prescribed, and prescriptions are not written for long-term use. (Editor's note: This program appears to be patterned after Project Lazarus in North Carolina.)

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Prescription Drugs a Big Problem in the NRL
The Roar
February 14, 2013
This article discusses prescription drug use and abuse in the Australian National Rugby League. When players try to manage pain from injuries, some get into the habit of self-medicating with stronger prescription drugs or more-than-prescribed dosages. In addition, they may ignore the harmful effects of the drug if consumed with alcohol. The author reports that in the past, certain doctors may have been unaware of potential problems associated with players' misuse and lack of understanding of prescription drug dangers. Now, with increased awareness, clubs have changed the way they handle players' medical requirements.

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Substance Use Among 12th Grade Aged Youths by Dropout Status
NSDUH Report, Substance Abuse and Mental Health Services Administration
February 12, 2013
Based on 2002-10 data, one in seven 12th grade youths dropped out of high school. Twelfth grade dropouts had higher rates of substance use (e.g., cigarettes, alcohol, binge alcohol, marijuana, nonmedical use of psychotherapeutic drugs, and any illicit drugs) than peers of a similar age who were still in school. Past-month misuse of prescription drugs among 12th grade youths by dropout status was 9.5 percent for dropouts, compared with 5.1 percent for those in school.

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Emergency Department Visits Involving Attention Deficit/Hyperactivity Disorder Stimulant Medications
The DAWN Report, Substance Abuse and Mental Health Services Administration
January 24, 2013
The number of emergency department (ED) visits involving attention deficit/hyperactivity disorder (ADHD) stimulant medications increased from 13,379 to 31,244 between 2005 and 2010. The number of ED visits involving these medications increased significantly for adults 18 and older between 2005 and 2010, but no significant increases were seen among children younger than 18. During the same time period, the number of ED visits related to nonmedical use of ADHD stimulant medications increased from 5,212 to 15,585; those involving adverse reactions increased from 5,085 to 9,181. Among ED visits involving these medications, 45 percent involved other pharmaceutical drugs; 21 percent involved illicit drugs; and 19 percent involved alcohol.

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Adderall Abuse on Cal Poly's Campus
February 8, 2013
In this article and video (2:23 minutes), a reporter interviews a student about abusing Adderall on campus. The student, who uses Adderall to help her study, admits that 75 percent of her friends also use it and says she feels the benefits outweigh the risks.

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Disclosures to Participate in State Prescription Drug Monitoring Programs
Federal Register
February 11, 2013
The Department of Veterans Affairs (VA) proposed to amend its regulations on sharing certain patient information to implement the VA's authority to participate in state Prescription Drug Monitoring Programs (PDMPs). PDMP participation will allow the VA patient population to benefit from reductions in negative health outcomes. Comments must be received on or before April 12, 2013.

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Prescription Drug Abuse Destroys Lives With Death and Crime
February 10, 2013
This article discusses the prescription drug abuse problem in Lackawanna County, Pa. Although Pennsylvania has a database to track patient prescriptions, it can be accessed only by the state attorney general's office. Many doctors and health professionals believe lawmakers should give doctors access to the database to limit doctor shopping.

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Other Resources
GenerationRx--Preventing the Misuse and Abuse of Prescription Medication
Cardinal Health
Accessed February 15, 2013
The Cardinal Health Foundation has teamed with the Ohio State University College of Pharmacy to develop GenerationRx Outreach--an initiative that promotes prevention of prescription drug abuse and misuse. They created a free, comprehensive suite of resources to increase awareness about this issue and encourage action in communities throughout the country. Their PowerPoint presentation, which addresses the growing prescription drug abuse epidemic among adolescents, is easy to follow, with instructions for educators below the slides. Embedded within the presentation is an interactive exercise in which audience members are asked to discuss a case report. Additional educational materials are available for all age groups.

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http://www.cardinal.com/us/en/generationrx#Card Health Gen Rx
Stop Rx Abuse Before It Starts
Kentucky Office of Attorney General
Accessed February 14, 2013
Information, resources, and video testimonials on the impact of prescription drug abuse in Kentucky.

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Talking to Your Kids About Prescription Drug Abuse: Not Worth the Risk Even If It's Legal
Substance Abuse and Mental Health Services Administration
Accessed February 14, 2013
This two-page brochure is a resource for parents who want to talk to their kids about prescription drug abuse.

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Drug Hazards: Medications (Over-the-Counter and Rx) and Illegal Drugs--Cautions and Guidelines for the Workplace
Facility Manager Association of New Mexico
Accessed February 15, 2013
These PowerPoint slides were presented in January by Dr. Megan E. Thompson, Associate Professor of Pharmacy Practice at the University of New Mexico College of Pharmacy, to Facility Manager Association of New Mexico members and guests. She discussed the impact of over-the-counter and prescription drugs in the workplace.

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Upcoming Webinar
Responding to the Nation's Prescription Drug Abuse Crisis
Webinar: Feb. 28, 2013, 2:00-3:30 p.m. EST
Please join SAMHSA and the Preventing Prescription Abuse in the Workplace (PAW) Technical Assistance (TA) Center for their second Prescription Abuse in the Workplace Webinar. The Webinar is aimed at SAMHSA grantees working at both the state and community levels. The presentation will provide information for prevention planners interested in developing and operating programs that respond to prescription drug abuse. It will concentrate on how the nation is responding to the prescription drug abuse crisis.
PAW TA Center Director Ted Miller, Ph.D., of the Pacific Institute for Research and Evaluation will classify current and conceptually appropriate responses. Then he will examine how selected workplaces and communities are structuring their response. He will identify evidence-based individual prevention programs with prescription drug abuse content as well as a wide range of environmental prevention approaches. Dr. Miller will discuss other approaches such as screening and brief/early intervention, treatment, and harm reduction through co-prescription of naloxone antidote to those with prescriptions for opioid painkillers. Finally, the Webinar will describe SAMHSA's PAW TA Center and the resources it offers.
SAMHSA and the PAW TA Center hope you will be able to join them Feb. 28.
For Participants
URL: https://www.mymeetings.com/nc/join
Conference number: PW4848524
Audience passcode: PRESCRIPTION

  1. Conference number: PW4848524.
  2. The Net portion audience passcode is "Prescription."
  3. Enter the required fields.
  4. Indicate that you have read the Privacy Policy.
  5. Click on "Proceed."
  6. To Access the Audio Portion: Dial the Toll-Free Number: 888.566.1821.
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Participants should access the Net portion 30 minutes before the scheduled start time to ensure they can log on. We will use Microsoft Live Meeting software. It should load onto your computer once you click on the link. However, if you have problems or need assistance, please contact the Product Help Desk at 800.857.8777, option 3.
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.

The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" 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 viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" 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 journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.
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