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February 25, 2016

 PAW Weekly Update

    

                                          
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SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
          Issue 162  |  February 25, 2016          
   
                                                               
                                                                                                                                                       
                                                                                                                   
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 Development                            
National                            
Marijuana                            
International                            
Northeast/Mid-Atlantic News                            
South News                            
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Upcoming Conferences and Workshops                                                         
                       

Featured

M.A. Bachhuber, S. Hennessy, C.O. Cunningham, and J.L. Starrels. 2016. “Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013.” American Journal of Public Health, doi:10.2105/AJPH.2016.303061.                        

Between 1996 and 2013, the percentage of U.S. adults who filled a benzodiazepine prescription each year increased steadily from 4.1 percent to 5.6 percent. The quantity of benzodiazepines filled increased from 1.1 to 3.6 kilogram-lorazepam-equivalents per 100,000 adults (an annual increase of 9 percent). The benzodiazepine overdose death rate increased from 0.6 to 3.1 per 100,000 adults, hitting a plateau after 2010.                        

Read more:                        
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303061                                                  

L.Y. Chen, R.M. Crum, E.C. Strain, G.C. Alexander, C. Kaufmann, and R. Mojtabai. 2016. “Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants.” Journal of Clinical Psychiatry, doi:10.4088/JCP.14m09291.                        

Adolescent treatment visits to hospital emergency departments that involved dextroamphetamine-amphetamine and methylphenidate decreased over time between 2006 and 2011, according to data from three national surveys. Nonmedical dextroamphetamine-amphetamine use remained stable, nonmedical methylphenidate use declined by 54 percent, and visits involving either medication remained stable. Among adults, treatment visits that involved dextroamphetamine-amphetamine remained unchanged, nonmedical use increased 67 percent, and emergency department visits increased 156 percent. All three indicators remained unchanged for methylphenidate. Both youth and adults said the major source of these medications for nonmedical use was a friend or relative. Two-thirds of friends and relatives obtained the medication from a physician.                        

Read more:                        
http://www.psychiatrist.com/JCP/article/Pages/2016/aheadofprint/14m09291.aspx                       
               
               

Journal Articles and Reports

H. Angoorani and F. Halabchi. 2015. “The Misuse of Anabolic-Androgenic Steroids Among Iranian Recreational Male Body-Builders and Their Related Psycho-Socio-Demographic Factors.” Iranian Journal of Public Health 44(12):1662–9.                

A 2011 survey of 906 male recreational body-builders in Tehran, Iran, found that 150 misused anabolic-androgenic steroids. Misuse was lower among respondents with high family income or team sports experience.                

Read more:                
http://www.ncbi.nlm.nih.gov/pubmed/26811817                                  

J.N. Booth, M. Behring, R.S. Cantor, L.D. Colantonio, S. Davidson, J.P. Donnelly, E. Johnson, K. Jordan, C. Singleton, F. Xie, and G. McGwin. 2015. “Zolpidem Use and Motor Vehicle Collisions in Older Drivers.” Sleep Medicine, doi:10.1016/j.sleep.2015.12.004.                

For a study of vision and driving among people age 70 and older in north-central Alabama, researchers interviewed 2,000 drivers (mean age 77) and ascertained their zolpidem sleep medication use by pill bottle review. They also looked at a 5-year count of police-reported road crashes. In multivariate analysis, relative risk (RR) of a crash was 1.4 times as high for current zolpidem users as nonusers, but the difference was not statistically significant. Significant risk elevation was observed for current zolpidem users among female drivers (RR = 1.6) and drivers age 80 and over (RR = 2.4).                

Read more:                
http://www.sleep-journal.com/article/S1389-9457(15)02081-X/abstract                                  

M.M. Butler, R.M. Ancona, G.A. Beauchamp, C.K. Yamin, E.L. Winstanley, K.W. Hart, A.H. Ruffner, S.W. Ryan, R.J. Ryan, C.J. Lindsell, and M.S. Lyons. 2016. “Emergency Department Prescription Opioids as an Initial Exposure Preceding Addiction.” Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2015.11.033.                

Among 59 patients who reported heroin or nonmedical opioid use at a hospital emergency department in Cincinnati, 35 (59 percent) were first exposed to opioids by a legitimate medical prescription. Ten received the prescription from an emergency department. Eighty percent who previously started use medically had used illicit drugs or had been treated for substance use disorders. Median time from medical exposure to onset of nonmedical use was 6 months for first use to get high, 12 months for regular use to get high, 18 months for use to avoid withdrawal, and 24 months for regular use to avoid withdrawal. Eleven patients began nonmedical use within 2 months of medical use.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S019606441501567X                                  

T. Carne, J. Wells, M. Bergin, S. Dada, M. Foley, P. McGuiness, A. Rapca, E. Rich, and M. Claire Van Hout. 2016. “A Comparative Exploration of Community Pharmacists’ Views on the Nature and Management of Over-the-Counter and Prescription Codeine Misuse in Three Regulatory Regimes: Ireland, South Africa and the United Kingdom.” International Journal of Mental Health and Addiction, doi:10.1007/s11469-016-9640-z.                

Six focus groups with 45 pharmacists in Ireland, the United Kingdom, and South Africa focused on popular products that contain codeine. One striking result of this study is the ineffectiveness of information provision models that currently exist for customers at the point of sale or dispensing. A lack of recipient interest in current sources of information (such information leaflets in product packages) is ubiquitous across countries, and purchasers generally perceive over-the-counter codeine as safe. Participants also discussed how they identified customers who were potentially misusing codeine and difficulties in relationships between pharmacists and prescribers.                

Read more:                
http://link.springer.com/article/10.1007/s11469-016-9640-z                                  

C.M. Jones, P.G. Lurie, and W.M. Compton. 2016. “Increase in Naloxone Prescriptions Dispensed in US Retail Pharmacies Since 2013.” American Journal of Public Health, doi:10.2105/AJPH.2016.303062.                

Naloxone dispensing from U.S. retail pharmacies increased 1,170 percent between the fourth quarter of 2013 and the second quarter of 2015. These findings suggest that prescribing naloxone in the outpatient setting complements traditional community-based naloxone programs.                                 

Read more:                
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303062                                  

A.K. Matusiewicz, M.A. Ilgen, E.E. Bonar, A. Price, and A.S.B. Bohnert. 2016. “The Relationship between Non-Medical Use of Prescription Opioids and Sex Work Among Adults in Residential Substance Use Treatment.” Journal of Substance Abuse Treatment, doi:10.1016/j.jsat.2016.01.010.                

A survey of 588 adults who were treated at a residential substance use disorder treatment center in Michigan revealed that 14 percent were sex workers in the month prior to treatment. Non-medical use of prescription opioids was more common among those with a history of sex work (95 percent vs. 74 percent of other respondents), an association that remained significant after controlling for demographic factors, other substance use, and psychiatric symptom severity (odds ratio = 3.4).                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0740547216000428                                  

L.J. Merlo, M.D. Campbell, G.E. Skipper, C.L. Shea, and R.L. DuPont. 2016. “Outcomes For Physicians With Opioid Dependence Treated Without Agonist Pharmacotherapy In Physician Health Programs.” Journal of Substance Abuse Treatment, doi:10.1016/j.jsat.2016.02.004.                

Of 702 physicians admitted to 16 physician health programs over a 5-year period, 85 percent were male. Chart review indicated 339 were treated for opioid misuse, 159 for other drug misuse, and 204 only for alcohol misuse. In random drug and alcohol testing during extended care management, excluding those receiving opioid substitution therapy, 78 percent never tested positive, 14 tested positive once, and 8 percent repeatedly tested positive.                 

Read more:                
http://www.sciencedirect.com/science/article/pii/S0740547216000453                                  

T.H. Nassif, J.C. Chapman, F. Sandbrink, D.O. Norris, K.L. Soltes, M.J. Reinhard, and M. Blackman. 2016. “Mindfulness Meditation and Chronic Pain Management in Iraq and Afghanistan Veterans with Traumatic Brain Injury: A Pilot Study.” Military Behavioral Health 4(1):82–9, doi:10.1080/21635781.2015.1119772.                

This nine-patient pilot study randomly assigned four veterans with traumatic brain injury to mindful meditation and five to treatment as usual for eight weeks. The meditation group reported clinically meaningful reductions in pain intensity (between 23 percent and 42 percent) and pain interference with functioning (between 34 percent and 41percent).                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/21635781.2015.1119772#abstract                                  

S. Nielsen and M.C. Van Hout. 2016. “What Is Known About Community Pharmacy Supply of Naloxone: A Scoping Review.” International Journal of Drug Policy, doi:10.1016/j.drugpo.2016.02.006.                

For this review, researchers identified 16 articles related to pharmacy supply of naloxone. They concluded that using community pharmacies to distribute take-home naloxone warrants further consideration and development. Strengths include a range of established supply models and training curricula; few direct concerns regarding legal liability of pharmacists in the supply of naloxone (once legal supply systems have been established); and access to target patient populations, including pain patients who may not be in contact with existing naloxone supply programs.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0955395916300147                                  

L.J. Paulozzi, C. Zhou, C.M. Jones, L. Xu, and C.S. Florence. 2016. “Changes in the Medical Management of Patients on Opioid Analgesics Following a Diagnosis of Substance Abuse.” Pharmacoepidemiology and Drug Safety, doi:10.1002/pds.3980.                

Analysis of Market Scan commercial healthcare claims data for January 2010 to June 2011, which included 1.85 million people ages 18–64 who were prescribed opioid analgesics, identified 9,009 patients with misuse disorder diagnoses in July–December 2010 but no prior misuse diagnoses. Daily opioid dosage did not decline in the misuse group following diagnosis. During the 6 months after diagnosis, 5.8 percent of the misuse group and 0.14 percent of the no-misuse group overdosed. In months 7–12 post-diagnosis, the overdose rate of misusers declined to 2.1 percent, with their opioid prescribing rate down 13.5 percent, and their benzodiazepine prescription rate down 12.3 percent. Roughly half of misusers received antidepressants and a quarter of them received gabapentin before, during, and after their misuse episode.                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1002/pds.3980/abstract                                  

A.N. Sanders, J.M. Eassey, J.M. Stogner, and B.L. Miller. 2016. “Deception and Drug Acquisition: Correlates of ‘Success’ Among Drug-Seeking Patients.” Journal of Primary Care and Community Health, doi:10.1177/2150131916628462.                

Ninety-three (4.0 percent) of 2,349 students surveyed at a public university in Georgia reported attempting to deceive a physician to get a medication, with 64 (3 percent) successful, according to a survey administered in a stratified random sample of classes. Among those 64, 24 (38 percent) sought medications for their own use only, 9 (14 percent) for financial gain only, and 31 (48 percent) for both reasons. Respondents who reported recreationally using pharmaceuticals in the past were more likely to report successful attempts than respondents without a history of misuse.                

Read more:                
http://www.ncbi.nlm.nih.gov/pubmed/26846509                 
               

Professional Development

 R. Choul, D.B. Gordon, O.A. de Leon-Casasola, J.M. Rosenberg, S. Bickler, T. Brennan, Todd Carter, C.L. Cassidy, E. Hall Chittenden, E. Degenhardt, S. Griffith, R. Manworren, B. McCarberg, R. Montgomery, J. Murphy, M.F. Perkal, S. Suresh, K. Sluka, S. Strassels, R. Thirlby, E. Viscusi, G.A. Walco, L. Warner, S.J. Weisman, and C.L. Wu. 2016. “Management of Postoperative Pain: A Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council.” Journal of Pain 17(2):131–57, doi:10.1016/j.jpain.2015.12.008.                

The American Pain Society has released an evidence-based clinical practice guideline with 32 recommendations to help clinicians achieve optimal pain management following surgery. The key recommendation, based on high-quality evidence, is wider use of a variety of analgesic medications and techniques. The guideline strongly advises use of multimodal anesthesia that target different mechanisms of actions in the peripheral and central nervous systems. Evidence also indicates that non-pharmacological therapies can be effective adjuncts to pharmacological therapies. The recommendations are rated as strong, moderate or weak based on scientific evidence quality.                

Read more:                
http://www.jpain.org/article/S1526-5900(15)00995-5/abstract                 
http://www.news-medical.net/news/20160218/American-Pain-Society-releases-new-post-surgical-pain-management-guideline.aspx                                  

D. Herzberg, H. Guarino, P. Mateu-Gelabert, and A.S. Bennett. 2016. “Recurring Epidemics of Pharmaceutical Drug Abuse in America: Time for an All-Drug Strategy.” American Journal of Public Health 106(3):408–10, doi:10.2105/AJPH.2015.302982.                

Although some consider the prescription drug misuse epidemic a recent phenomenon, it actually is the third wave stretching back more than a century, the authors contend. During each wave, policies followed a similar pattern: voluntary educational campaigns, supply-side policing, and public health responses or “harm reduction.” These experiences suggest that only broad-based application of all three approaches to users of all drugs can produce a reduction in drug-related harm rather than merely shifting it from one type of drug to another. The authors also believe this has rarely happened because policy has been shaped by “racially charged division of drug users into deserving and morally salvageable victims, or fearsome and morally repugnant criminals.”                

Read more:                
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302982                 
               

National

FDA’s Science Board to Discuss Opioid Abuse                
Bronwyn Mixter, Bloomberg                
February 18, 2016                

The FDA’s Science Board will hold a public meeting on March 1, 2016, to discuss the role that the agency plays in providing appropriate pain treatment while reducing opioid misuse. Other topics include the role of opioids in pain management; scientific challenges facing the FDA in supporting the development of pain medications and in seeking to understand the real-world use of opioids to treat pain; the role that the FDA plays as a part of a larger federal, state, and local response to the challenges of providing appropriate pain treatment while reducing opioid misuse; and post-market surveillance activities related to opioids.                

Read more:                
http://www.bna.com/fdas-science-board-n57982067487                                  

Blue Cross Blue Shield Announces New Initiatives to Fight Opioid Epidemic                
Blue Cross Blue Shield Association                
February 18, 2016                

A new Blue Cross Blue Shield (BCBS) steering committee will develop recommendations on how BCBS companies can collaborate with healthcare professionals, government officials, and communities across the country to combat opioid misuse and prevent addiction. The BCBS Association will also use BCBS data to investigate the prevalence of opioid addiction in the United States and its impact on the nation’s healthcare system. BCBS will help educate Americans on opioid misuse and how to prevent it and will produce a documentary about the opioid struggles of individuals and families. The documentary will explain how to spot the signs of pain reliever addiction and how to get help.                

Read more:                
http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=153621#.VseOlWkUXoZ                                  

How Prescription Drug Abuse Unleashed Heroin Epidemic                
Kevin D. Williamson, National Review                
February 18, 2016                

This article shares perspectives from addicts and experts in Louisiana and Alabama on how prescription drug misuse led to the heroin epidemic. Some addicts got their prescription drugs from pharmacies such as Walgreens. In some instances, Walgreens contributed to the problem by enabling more than 1 million oxycodone pills to reach the black market in a year. Many states have also seen an increase in pharmacy robberies. Once officials started paying attention to opioid addiction, addicts switched to heroin, also known as “diesel” or “dogfood.” Some call heroin “911” or “killa” because the potency can send people to the emergency department or kill them. When that happens, dealers consider it great for marketing. In New Orleans, the University Medical Center recently saw a 250 percent increase in opiate-overdose cases in 1 month. Officials believe it is due to the heroin supply chain moving from Asia to South America. Once the drug reaches New Orleans, it is adulterated and less pure. Some dealers mix the heroin with fentanyl. If the blend is wrong, medical personnel refer to it as a “clean kill.”                

Read more:                
http://www.nationalreview.com/article/431486/heroin-prescription-painkillers-new-drug-epidemic                                  

The Few Bad Doctors May Need to Be Prosecuted for Drug Overdose Deaths                
Alan G. Santos, New York Times                
February 17, 2016                

Alan Santos, a former associate deputy assistant administrator of the U.S. Drug Enforcement Administration’s Office of Diversion Control, believes physicians should be prosecuted if they are involved and culpable for someone’s death. Prescribers have legal responsibilities to ensure prescription drugs do not get diverted for illicit purposes.                

Read more:                
http://www.nytimes.com/roomfordebate/2016/02/17/prosecuting-doctors-in-prescription-drug-overdose-deaths/the-few-bad-doctors-may-need-to-be-prosecuted-for-drug-overdose-deaths                                  

Five Tips to Combat Prescription Drug Abuse in Your Pharmacy                
Elements Magazine                
February 18, 2016                

This article discusses five ways to prevent prescription drug misuse in independent community pharmacies. They include: 1) look for red flags; 2) verify prescription information; 3) recognize the signs of addiction; 4) work with organizations fighting the epidemic; and 5) communicate and educate patients.                

Read more:                
https://www.pbahealth.com/5-tips-to-combat-prescription-drug-abuse-in-your-pharmacy                 
                 

Marijuana

C. Blanco, D.S. Hasin, M.M. Wall, L. Flórez-Salamanca, N. Hoertel, S. Wang, B.T. Kerridge, and M. Olfson. 2016. “Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence from a US National Longitudinal Study.” JAMA Psychiatry, doi:10.1001/jamapsychiatry.2015.3229.                  

Multivariate and propensity score-matched analyses of National Epidemiologic Survey on Alcohol and Related Conditions data from 34,653 people interviewed in both 2001–2 and 2004–5 showed that the 1,279 people who used cannabis in the first wave were more likely than nonusers to have substance use disorders in the second wave (any disorder, odds ratio [OR] = 6.2; any alcohol use disorder, OR = 2.7; any cannabis use disorder, OR = 9.5; any other drug use disorder, OR = 2.6; and nicotine dependence, OR = 1.7), but not mood disorder (OR = 1.1) or anxiety disorder (OR = 0.9). The same general pattern of results was observed in the multiple regression analyses of wave 2 prevalent psychiatric disorders and in the analysis of incident and prevalent psychiatric disorders. The results do not establish causation.                  

Read more:                  
http://archpsyc.jamanetwork.com/article.aspx?articleid=2491944                                      

Oregon House Spends Hours Reading Aloud Marijuana Bill Before Vote                  
Noelle Crombie, The Oregonian                  
February 15, 2016                   

Oregon’s house of representatives has approved a bill that removes a 2-year residency requirement for recreational marijuana producers, processors, and retailers. Other provisions include reducing annual medical marijuana card registration fees for veterans from $200 to $20; treating medical marijuana the same as prescription drugs when setting conditions for people on pretrial release, diversion unrelated to impaired driving, and probation or post-prison supervision; and allowing medical marijuana patients to use completed application receipts as a registry card when shopping at dispensaries for up to 30 days.                   

Read more:                  
http://www.oregonlive.com/marijuana/index.ssf/2016/02/oregon_house_passes_bill_that.html                                      

Medical Marijuana Workplace Discrimination Bill Filed in New Jersey                  
Emily Gray Brosious, Sun Times                  
February 15, 2016                  

A New Jersey lawmaker has filed a bill to create workplace protections for medical marijuana patients. It would prohibit employers from punishing employees who test positive for marijuana if they are registered medical marijuana patients. The bill would also apply to prospective employees. The bill would not require employers to permit on-duty workplace marijuana consumption. Eight states have medical cannabis laws that contain antidiscrimination or reasonable accommodation provisions addressed to employers. Arizona, Delaware, and Minnesota are the only states with laws that currently address workplace drug testing, and none of these laws require employers to permit on-duty marijuana use by employees.                  

Read more:                  
http://extract.suntimes.com/news/10/153/15592/new-jersey-worplace-discrimination-bill-medical-marijuana                                      

New Hampshire Kills Bill that Would Have Legalized Marijuana                  
Garry Rayno, Union Leader                  
February 11, 2016                  

New Hampshire lawmakers have rejected a bill that would have legalized recreational marijuana for those age 21 and older and allowed individuals to grow up to six plants.                  

Read more:                  
http://www.unionleader.com/NH-House-kills-bill-that-would-have-legalized-marijuana                                      

Marijuana-Infused Cookie Sends Oregon Boy to Hospital                  
Noelle Crombie, The Oregonian                  
February 17, 2016                   

An 8-year-old boy in Oregon recently ate a marijuana-infused cookie that he found on the ground. He had chest and stomach pains and trouble staying awake. The boy’s mother contacted poison control and then took him to the hospital. He was treated for symptoms related to marijuana ingestion and released 5 hours later. The cookie was infused with an estimated 50 milligrams, according to the packaging.                   

Read more:                  
http://www.oregonlive.com/marijuana/index.ssf/2016/02/klamath_falls_boy_sickened_tak.html                                      

Medical Marijuana Fast Fact: Medical Marijuana in Canada’s Workplaces                  
Public Services Health and Safety Association                  
Accessed February 18, 2016                  

This Public Services Health and Safety Association Fast Fact provides employers, supervisors, and workers in Ontario, Canada, with basic information on cannabis, the history of medical marijuana in Canada, applicable legislation, considerations for accommodation, and suggested control measures for the workplace.                  

Read more:                  
http://www.pshsa.ca/products/fast-facts/medical-marijuana-fast-fact                                      

Pot Smoking on the Job? Colorado Cannabis Companies Experiment with Marijuana Policies                  
Jackie Salo, International Business Times                  
February 12, 2016                  

While some Colorado cannabis companies allow employees to use marijuana in the workplace, O.penVAPE, a licensed cannabis retailer, does not. It has a policy inclusive of its entire 150-person staff. The policy attempts to address the issue of drug use at work through guidelines about impairment, instead of singling out cannabis. Its workplace impairment policy includes sleep deprivation and impairment. Employees identified as potentially impaired are asked to take an online test that would measure functionality. If the test shows reason for concern, the employee is asked to meet with a counselor to determine an appropriate course of action, but the company has yet to reach this point with any of its workers. Colorado Harvest Company, a group of growers and dispensaries, also prohibits cannabis use at the licensed retailer’s offices.                  

Read more:                  
http://www.ibtimes.com/pot-smoking-job-colorado-cannabis-companies-experiment-marijuana-policies-2300607                                      

Veterans Forced to Look Beyond VA for Medical Marijuana                  
WBUR                  
February 17, 2016                  

For this story, Here & Now’s Lisa Mullins talked with two veterans, Scott Murphy and Kenneth MacIntosh, who find that medical marijuana helps control their pain and symptoms of posttraumatic stress disorder. They get medical marijuana from private clinics. Now, they have a nonprofit called Veterans for Safe Access and Compassionate Care. (Includes audio: 9:20 minutes)                  

Read more:                  
http://hereandnow.wbur.org/2016/02/17/veterans-medical-marijuana                                      

State Senator Describes Protocol to Obtain Medical Marijuana in New York                  
Gracelyn Santos, D.D.S., SI Live                  
February 18, 2016                  

New York State Senator Diane Savino describes the process to obtain medical marijuana in her state. This article also includes who qualifies for medical marijuana and registration facts.                   

Read more:                  
http://blog.silive.com/gracelyns_chronicles/2016/02/post_25.html                                      

U.S. Senator Thinks Legalizing Marijuana Could Help End America’s Opioid Addiction Crisis                  
Christopher Ingraham, Washington Post                  
February 13, 2016                  

U.S. Sen. Elizabeth Warren (D-Mass.) has sent a letter to the Centers for Disease Control and Prevention, asking the agency to explore the use of medical marijuana as an alternative to opioid pain relievers. Sen. Warren also asked the agency to look into the impact of the legalization of medical and recreational marijuana on opioid overdose deaths. This article highlights what the research has shown.                  

Read more:                  
https://www.washingtonpost.com/news/wonk/wp/2016/02/13/why-elizabeth-warren-thinks-legalizing-marijuana-could-help-end-americas-opioid-addiction-crisis                                      

Former Postal Employee Pleads Guilty to Distributing Pot                  
Federal Soup                  
February 19, 2016                  

A former postal employee from New York has pleaded guilty to bribery, distribution of marijuana, and delay of mail. The woman accepted bribes to help deliver drug shipments. She also opened some of them and sold the drugs. The woman admitted that she used some of the proceeds from the marijuana sales to pay court-ordered restitution resulting from a larceny conviction. After her arrest, agents found more than 1,500 pieces of mail in her vehicle that had not been delivered. She faces a maximum penalty of 25 years in prison and a $250,000 fine.                  

Read more:                  
https://federalsoup.com/articles/2016/02/19/former-postal-employee-pleads-guilty-to-distributing-pot.aspx                 
               

International

Fact Sheet–Prescription Drug Abuse Research                
Government of Canada                
February 16, 2016                

This fact sheet highlights Canada’s national study optimizing patient centered-care: a pragmatic randomized control trial comparing models of care in the management of prescription opioid misuse. It also lists $4,440,000 in funding for regional prescription drug abuse operating grants.                

Read more:                
http://news.gc.ca/web/article-en.do?nid=1034359                                 

Australian Officials Reveal Rigorous Anti-Doping Program Ahead of Rio Olympics                
ABC                
February 15, 2016                

The Australian Olympic Committee and the Australian Sports Anti-Doping Authority (ASADA) began testing athletes 8 months ago, under an anti-doping program. Australia also conducts online and face-to-face education programs as a preventive measure. All Australian Olympic athletes and support personnel will need to sign agreements to assist ASADA and attend an interview to “fully and truthfully” answer questions. They will also be required to provide information and documents in any ASADA investigation. ASADA also plans to store selected samples for future testing. Australia’s Olympic athletes agreed last year to have their bags and other possessions searched by team officials following a new ban on sleeping drugs.                

Read more:                
http://www.abc.net.au/news/2016-02-15/aoc-and-asada-reveal-rigorous-anti-doping-program/7169514                
               

Northeast/Mid-Atlantic News

Maine Labor Dept. Pushing for Changes to State Drug Testing Law                
Gillian Graham, Portland Press Herald                
February 18, 2016                

Maine’s department of labor is recommending that lawmakers help companies deal with substance misuse by streamlining the approval process for employer drug-testing policies. It also recommends implementing a program to train supervisors to spot drug-related impairment in the workplace. The recommendations came from a working group report that examined issues including substance use and misuse in the workplace, legalization of medical marijuana, and the potential statewide legalization of recreational marijuana use. Under the proposed law change, the labor department would develop a uniform substance abuse testing policy that employers could simply implement after notifying the department.                 

Read more:                
http://www.pressherald.com/2016/02/17/maine-department-of-labor-pushing-for-changes-to-state-drug-testing-law                                  

Senior Opioid Addiction a Growing Problem in Saugus (Mass.)                
Jeannette Hinkle, Saugus Advertiser                
February 18, 2016                

Prescription opioid addiction among seniors is a growing concern. The addiction specialist for Greater Lynn Senior Services in Massachusetts has a caseload of around 30 older adults suffering from addiction of prescription opioid medications. Seniors who have dealt with emotional trauma or abuse are more likely to become addicted to prescription medications. Opioid addiction in seniors can lead to more falls that result in concussions, injuries, and mental health issues. Older adults who misuse prescription pain medication usually obtain the pills from doctors, other seniors, or emergency rooms. Seniors are less likely to seek help for their addiction. When they do, it is because addiction starts to affect their lives. For example, they may fall more frequently or have financial difficulties. Loved ones should look for signs of misuse such as the elder being focused on getting a medication refill, going to different doctors, using medication at off times, and running out of medication early.                 

Read more:                
http://saugus.wickedlocal.com/article/20160218/NEWS/160216757                                  

New Bedford (Mass.) Saw Five Overdoses in Five Hours                
Gintautas Dumcius, Mass Live                
February 12, 2016                

Five heroin overdoses in 5 hours recently occurred in New Bedford, Massachusetts. Five people—four men and one woman—were taken to St. Luke’s Hospital after getting Narcan.                

Read more:                
http://www.masslive.com/news/boston/index.ssf/2016/02/this_massachusetts_city_saw_fi.html                                  

Heroin-Related Overdose Deaths Soar in Connecticut                
Dave Altimari, Hartford Courant                
February 14, 2016                

In Connecticut, 723 people died from a heroin, cocaine, or other drug overdose in 2015, up from 357 in 2012. From 2014, heroin-related deaths increased 27 percent to 415 and fentanyl deaths increased 148 percent to 107. Most fentanyl overdoses involved illicit fentanyl. Naloxone, carried by state police since fall 2014, was used successfully to revive 63 people.                

Read more:                
http://www.courant.com/news/connecticut/hc-2015-heroin-deaths-increase-20160214-story.html                                  

Connecticut Governor’s Narcan Proposal Receives Support                
Andrew Ragali, Record-Journal                
February 17, 2016                 

A committee in Connecticut’s legislature recently heard support for the governor’s proposal to require every municipality in Connecticut to carry naloxone. The state’s lobbying group for cities and towns is on board even though it is already a municipal mandate.                

Read more:                
http://www.myrecordjournal.com/meriden/meridennews/8452089-129/ccm-backs-governors-proposal-on-narcan.html                                 

Narcan Has Saved Lives in New Jersey’s Verona and Cedar Grove                
P.J. Candido, Verona-Cedar Grove Times                
February 15, 2016                

Cedar Grove and Verona police departments in New Jersey have revived eight people with Narcan since 2015.                 

Read more:                
http://www.northjersey.com/news/health-news/narcan-an-anti-overdose-drug-has-saved-lives-in-verona-and-cedar-grove-1.1512270                                  

Pennsylvania Signs Contract for Prescription Drug Registry                
Ford Turner, Reading Eagle                
February 17, 2016                

Pennsylvania’s governor has signed a 3-year contract with Appriss to provide a prescription drug-monitoring program. The database will incorporate existing Schedule II records from the attorney general’s office and will interchange with other states. The system could be fully operational by August.                 

Read more:                
http://www.readingeagle.com/news/article/pennsylvania-signs-contract-for-prescription-drug-registry                                  

Pharmacists Working to Combat Opioid Overdose                
David Bauman, University of Connecticut                
February 15, 2016                

The University Of Connecticut School of Pharmacy is collaborating with the state pharmacists association and the state government to train pharmacists on how to prescribe naloxone.                 

Read more:                
http://today.uconn.edu/2016/02/pharmacists-working-to-combat-opioid-overdose                                  

Drug Czar Announces Expansion of ‘Yale Child Study’ Program on Substance Abuse                
Mark Davis, WTNH                
February 16, 2016                

Michael Botticelli, the White House director of drug policy, has announced an expansion of the Yale Child Study to help families who have a parent with a substance misuse problem. The program currently serves 250. The expansion will add 500 more Connecticut families with children under age 6. (Includes video: 2:30 minutes)                

Read more:                
http://wtnh.com/2016/02/16/drug-czar-announces-expansion-of-yale-child-study-program-on-substance-abuse                                  

Senator Seeks $660 Million in Congressional Funding to Battle New York Drug Epidemic                
Christine Corrado, FiOS1                
February 16, 2016                                 

U.S. Sen. Charles Schumer (D-N.Y.) is seeking congressional support for $660 million dollars in emergency funding to address the prescription drug, opioid, and heroin problem in the Lower Hudson Valley. Overdose-related deaths increased by 115 percent between 2010 and 2013 in Westchester County. (Includes video: 1:44 minutes)                

Read more:                
http://www.fios1news.com/lowerhudsonvalley/sen-schumer-calls-emergency-funding-battle-lhv-drug-epidemic#.VsdKKmkUXoZ                                  

Officials Call for Expansion of N.Y. Police Department Drug Disposal Program                
CBS New York                
February 16, 2016                

New York legislators want the N.Y. Police Department to expand its prescription drug drop-off program to every precinct in the city. The program was introduced in five police precincts in Staten Island and Brooklyn in 2014. In 18 months, the department collected 500 gallons of pills. (Includes 45 second video)                

Read more:                
http://newyork.cbslocal.com/2016/02/16/nypd-prescription-drug-disposal-program                                  

Health System with Penn., N.Y. Locations Introduces Measures to Prevent Prescription Drug Abuse                
Megan Zhang, Warner Cable News                
February 18, 2016                

Guthrie Healthcare System, which operates hospitals in Pennsylvania and New York, has introduced a drug disposal unit in two of its hospitals to help prevent drug misuse. The health system is also trying to get doctors to prescribe abuse-deterrent opioids that have a tiny capsule of naloxone inside the pill. Guthrie is gradually introducing both measures to more of its facilities. (Includes video: 1:48 minutes)                

Read more:                
http://www.twcnews.com/nys/binghamton/news/2016/02/18/guthrie-introduces-new-measures-to-prevent-prescription-drug-abuse.html                
               

South News

Physician Pleads Guilty to Illegally Prescribing Pain Medication                
KLTV                
February 17, 2016                

Sameer Andoni Fino, M.D., an East Texas pain management physician, has pleaded guilty for dispensing controlled substances outside the usual course of professional practice and not for a legitimate medical purpose. During an investigation, Dr. Fino wrote an undercover agent a prescription for 60 units of Norco after meeting with the agent for approximately 6 minutes. Fino agreed to voluntarily surrender his privileges to prescribe controlled substances. He could get up to 10 years in federal prison. In a related civil action, he has agreed to forfeit $3,936,704 that was seized during the execution of federal seizure warrants.                  

Read more:                
http://www.kltv.com/story/31247068/physician-pleads-guilty-to-illegally-prescribing-pain-medication                                  

Mississippi Attorney General: Use $216 Million to Stop Drug Overdoses                
Zac Carlisle, WTVA                
February 18, 2016                

Mississippi Attorney General Jim Hood is encouraging legislators to use some of the $216 million his office collected to reduce the misuse and overdose of prescription pain relievers, heroin, and synthetic drugs. Pursuant to statute, the attorney general is required to make recommendations to the legislature regarding appropriation of recoveries by his office. Some of Hood’s recommendations include: $3,802,400 to the state’s department of mental health for the expansion of regional adolescent residential treatment centers, an increase in the availability of adolescent intensive outpatient programs, expanded drug treatment for those who cannot afford to pay and for outreach programs to prevent prescription and synthetic drug abuse by teenagers; $1 million to the state’s pharmacy board in partnership with its bureau of narcotics to implement a public outreach initiative to prevent overdoses and abuse of heroin, opioids, and synthetic drugs; and $75,000 to the state’s department of health for physician education on the appropriate use of prescription pain relievers.                

Read more:                
http://www.wtva.com/news/Attorney_General_Use_.html                                  

Opioid Abuse on the Rise in Texas; Advocates Say State Needs to Act Fast                
Ashley Lopez, KUT                
February 18, 2016                

Texas advocates claim the state is moving too slowly to address opioid misuse. The state legislature passed a bill to expand the availability of naloxone. However, the Texas Overdose Naloxone Initiative claims it has been doing the brunt of the work that the state should be doing. It has distributed over 10,000 doses of naloxone that has reversed over 400 overdoses. The law has been in effect for 5 months. (Includes audio: 6:21 minutes)                

Read more:                
http://kut.org/post/opioid-abuse-rise-texas-and-advocates-say-state-needs-act-fast                 
               

Midwest News

Nebraska Lawmakers Vote to End Easy ‘Doctor Shopping’                
Jeremy Maskel, KETV                
February 18, 2016                

Nebraska lawmakers have approved a bill that requires pharmacies to report the distribution of all controlled substances to the state’s prescription drug monitoring program. State Sen. Sara Howard of Omaha lost her sister to a prescription drug overdose when she became addicted to pain relievers after being injured in a car accident. Once signed by the governor, the law will immediately take effect.                

Read more:                
http://www.ketv.com/news/nebraska-lawmakers-vote-to-end-easy-doctor-shopping/38064792                                  

Kentucky Named Among States Hit Hard By Heroin, Prescription Opioid Epidemic                
Ashley Sanchez and Randall Barnes, WPSD                
February 19, 2016                

President Barack Obama has named Kentucky as one of five states hit hard by the prescription drug misuse epidemic. The Centerpoint Recovery Center for men has over 100 people on its waiting list to get help. Federal funding would help expand services and make them more affordable. It also would improve access to naloxone. Pharmacies already prescribe the drug, but some people are not aware of it. (Includes video: 2:21 minutes)                

Read more:                
http://www.wpsdlocal6.com/story/31268258/kentucky-singled-out-as-problem-spot-for-heroin-and-prescription-opioid-abuse                                  

Kroger to Offer Anti-Overdose Drug without Prescription in Ohio, Northern Kentucky                
Dan Sewell, Associated Press                
February 12, 2016                

Ohio-based grocery chain Kroger will make naloxone available without a prescription in 200 pharmacies across Ohio and northern Kentucky within a week.                                 

Read more:                
http://wdtn.com/2016/02/12/kroger-to-offer-anti-overdose-drug-without-prescription                                  

Chicago-Area Pharmacy Workers Accused of Selling Prescription Drugs on the Street                
Pam Zekman, CBS Chicago                
February 17, 2016                

A drug addict describes how she supported her addiction by getting pain relievers from a pharmacy worker. All she had to do was call, place an order, and pick up the drugs the next day at the pharmacy where he worked. The Illinois Department of Professional Regulation has disciplined 33 pharmacists and 163 pharmacy technicians over the last 5 years for diverting drugs for their use or to sell on the street. The state does not check the criminal history of applicants before issuing pharmacy technician licenses.                

Read more:                
http://chicago.cbslocal.com/2016/02/17/2-investigators-pharmacy-workers-selling-prescription-drugs-on-the-street                                  

Indiana University Student Charged with Dealing Xanax-Laced Gummy Candy                
Jill Clavan, WTTV                
February 17, 2016                

An Indiana University (IU) student has been charged with selling Xanax-laced gummy candy from his off-campus apartment. This is the second Xanax case involving an IU student this semester. In January, campus police arrested a first-year student for selling the drug out of his dorm room. (Includes video: 1:37 minutes)                

Read more:                
http://cbs4indy.com/2016/02/17/iu-student-charged-with-dealing-xanax-laced-gummy-candy                                  

The Fight Against Prescription Drug Abuse                
Attorney General Marty Jackley, Butte County Post                
February 20, 2016                

South Dakota Attorney General Marty Jackley discusses prescription drug misuse and statewide efforts to address this issue. Officials are still concerned about easy access to prescription drugs, particularly among families, friends, and healthcare providers. Enforcement statewide continues to allocate resources toward prescription drug diversion, including to its prescription drug monitoring program and take-back drop-off programs. Drug courts and alternative sentencing are options used to keep offenders out of prison and jails so that they can get the help they need. Addressing addiction has a long term impact on the user’s lives, their families, and their employers.                

Read more:                
http://rapidcityjournal.com/news/local/communities/belle_fourche/the-fight-against-prescription-drug-abuse/article_304f3a63-9f0a-5f08-abcd-085efb77aa2f.html                 
               

Other Resources

Course: Impairment in the Workplace                
CEUFast                
February 4, 2016                

This course will help nurses in Florida to identify and support colleagues who may be afflicted with workplace impairment.                

Read more:                
https://ceufast.com/course/recognizing-impairment-in-the-workplace-                 
               

Audio

Radio: National Governors Association Forum on Prescription Drug Abuse                
C-SPAN                
February 20, 2016                

The National Governors Association’s Health and Human Services Committee met to discuss federal and state efforts to combat opioid addiction as part of its winter meeting. (Duration: 1:30:15) [Editor’s Note: First 10:26 minutes discusses presidential campaign.]                 

Listen:                
http://www.c-span.org/video/?405041-1/radio-nga-forum-prescription-drug-abuse                 
               

Webinars

Drugged Driving Data and How to Use it at the Community Level                
Community Anti-Drug Coalitions of America                
Tuesday, March 1, 2016                
1:00 p.m. – 2:30 p.m. (ET)                

Laura Liddicoat, forensic toxicologist and chair of the National Safety Council’s Alcohol, Drugs and Impairment Division, and Dereece D. Smither, Ph.D., research psychologist in the National Highway Traffic Safety Administration’s Office of Behavioral Safety Research, will discuss fatal crashes and the information gathered from current reporting efforts. The presentation will define impairment related to drugged driving, and showcase evaluation strategies that have been developed to reduce impaired driving.                 

Read more:                
http://www.cadca.org/webinar/druggeddrivingdata                                  

Register:                
http://www.cadca.org/webform/drugged-driving-data-and-how-use-it-community-level                                  

Prescription Monitoring Programs: Capabilities and Benefits                
American Dental Association                
Wednesday, March 16, 2016                
2:00 p.m. – 3:00 p.m. (CT)                

Patrick Knue, program coordinator for the Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Program at Brandeis University, will discuss the prescription drug misuse problem and the history and purpose of PDMPs. He will also discuss how they operate and how dentists can access them.                

Read more:                
http://www.ada.org/en/publications/ada-news/2016-archive/february/webinar-monitoring-prescription-drug-use                 

Register:                
http://websurveys.ada.org/s/opioidwebinar                                  

Weed in Your Workplace: What You Need to Know                
National Safety Council                
Wednesday, April 20, 2016                
2:00 p.m. (ET)                
http://eventcallregistration.com/reg/index.jsp?cid=59487t11                 
               

Grant Announcements

SP-16-003: Strategic Prevention Framework - Partnerships for Success (SPF-PFS)                
SAMHSA                
Due: April 12, 2016                

The purpose of this grant program is to address two substance abuse prevention priorities: 1) underage drinking among persons aged 12 to 20; and 2) prescription drug misuse among persons ages 12–25. States/tribes may also use grant funds to target an additional, data-driven local substance abuse prevention priority (e.g., marijuana, heroin).                 

Read more:                
http://www.grants.gov/web/grants/search-grants.html                                  

NIJ-2016-9090: Research and Evaluation on Drugs and Crime                
National Institute of Justice                
Due April 20, 2016                

The National Institute of Justice (NIJ) is seeking investigator-initiated proposals to conduct research that examines criminal justice tools, protocols, and policies concerning drug trafficking, markets and use, and the effects of drug legalization and decriminalization on law enforcement, applicable to State, tribal and local jurisdictions. Proposals must address one of the following: drug intelligence and community surveillance, or criminal investigation and prosecution. In addition, NIJ has identified three drug research priorities: marijuana and cannabis products; heroin and other opioids (including diverted prescription drugs); and novel psychoactive substances (also known as synthetic drugs).                

Read more:                
http://www.grants.gov/web/grants/search-grants.html                                  

Increasing Access to Medication-Assisted Treatment in Rural Primary Care Practices (R18)                
Agency for Healthcare Research and Quality                
Due: March 4, 2016                
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-16-001.html                                  

Drug-Free Communities Support Program (SP-16-001)                
SAMHSA                
Due: March 18, 2016                
http://www.samhsa.gov/sites/default/files/grants/pdf/sp-15-001_0.pdf                                  

NIDA Challenge: Addiction Research: There’s an App for that                
U.S. Department of Health and Human Services, National Institute on Drug Abuse (NIDA)                
Submission Period begins November 3, 2015, 9:00 a.m. (ET)                
Submission Period ends April 29, 2016, 11:59 p.m. (ET)                
http://nida.ideascale.com/a/pages/addiction-research-theres-an-app-for-that                                  

Bottle Tracking Program                
National Association of Drug Diversion Investigators                
Due: None Specified                
http://www.naddi.org/aws/NADDI/pt/sp/programs_grants                 
http://naddibottletracking.org/law-enforcement                 
               

National Take-Back Initiative

National Prescription Drug Take-Back Day                
Drug Enforcement Administration                
Saturday, April 30, 2016                
10:00 a.m. – 2:00 p.m.                
http://www.deadiversion.usdoj.gov/drug_disposal/takeback                 
               

Take-Back Events & Drop Boxes

810 lbs. of Medication Collected by South Caroline Police                
Jim Fair, Greer Today                
February 12, 2016                
http://greertoday.com/greer-sc/810-pounds-of-medication-collected-by-police/2016/02/12              

Medsafe Disposal Box Now Available at Edwards Air Force Base (Calif.) Pharmacy                
Edwards Air Force Base                
February 17, 2016                
http://www.edwards.af.mil/news/story.asp?id=123469134                                  

Prescription Drug Drop-Off Box Now Open to Public at Lubbock (Texas) Police Station                
Ellysa Gonzalez, Lubbock Avalanche-Journal                
February 13, 2016                
http://lubbockonline.com/local-news/2016-02-12/prescription-drug-drop-box-now-open-public-lubbock-police-station#.VsIBzGkUXoY                                  

Drug Disposal Boxes Now Available in Suffolk (Va.)                
13 News Now                
February 18, 2016                
http://www.13newsnow.com/story/news/local/mycity/suffolk/2016/02/18/drug-disposal-boxes-now-available-suffolk/80560740                                  

Prescription Drug Disposal at Bridgeport (W.Va.) Family Pharmacy                
Tess Leonhardt, WDTV                
February 13, 2016                
http://www.wdtv.com/wdtv.cfm?func=view&section=5-News&item=Prescription-Drug-Disposal-at-Bridgeport-Family-Pharmacy-28695                 
               

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference                
U.S. Drug and Enforcement Administration                
February 27–28, 2016                 
Charleston, West Virginia                
March 19–20, 2016                 
Wilmington, Delaware                
April 17–18, 2016                 
Towson, Maryland                
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/                                 

Ohio Workers’ Compensation Medical & Health Symposium                
Bureau of Workers’ Compensation                
March 10–11, 2016                
Columbus, Ohio                
https://www.bwc.ohio.gov/provider/brochureware/PainSymposium/default.asp                                  

Marijuana and Cannabinoids: A Neuroscience Research Summit                
National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Center for Complementary and Integrative Health, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke                
March 22–23, 2016                
Bethesda, Maryland                
http://apps1.seiservices.com/nih/mj/2016                 

Register:                
http://apps1.seiservices.com/nih/mj/2016/Registration.aspx                                  

2016 National Rx Drug & Heroin Summit                
March 28–31, 2016                
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                                  

Medical Marijuana Seminar                
Private Motor Truck Council of Canada                
May 3, 2016                
Alberta, Canada                                 

Read more:                
http://www.todaystrucking.com/alberta-hosting-spring-talk-on-medical-marijuana-in-trucking                 
http://www.pmtc.ca/News.asp?a=view&id=113                                  

2016 Annual Conference                
International Health Facility Diversion Association                
September 13–14, 2016                
Duke Energy Convention Center                
Cincinnati, Ohio                 
https://ihfda.org/2016-annual-conference                 

Register:                
https://www.regonline.com/Register/Checkin.aspx?EventID=1803476                 
         
                                 
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.