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February 5, 2014

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SAMHSA Prescription Drug Abuse Weekly Update
Issue 57  |  February 5, 2014
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports News Other State and Local News Other Resources Webinar Archive Grant Announcements Grant Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


Michael W. Varner, Robert M. Silver, Carol J. Rowland Hogue, Marian Willinger, Corette B. Parker, Vanessa R. Thorsten, Robert L. Goldenberg, George R. Saade, Donald J. Dudley, Donald Coustan, Barbara Stoll, Radek Bukowski, Matthew A. Koch, Deborah L. Conway, Halit Pinar, Uma M. Reddy, and Eunice Kennedy Shriver National Institute of Child Health and Human Development Stillbirth Collaborative Research Network. 2014. "Association Between Stillbirth and Illicit Drug Use and Smoking During Pregnancy." Obstetrics and Gynecology 123(1):113–25, doi: 10.1097/AOG.000000000000005

To examine the association between stillbirth and maternal illicit drug use and smoking, the Stillbirth Collaborative Research Network conducted a case-control study from March 2006 to September 2008, covering more than 90 percent of deliveries to residents of five a priori–defined geographically diverse regions. The study attempted to include all stillbirths and representative live-born controls. Umbilical cord samples from cases and controls were collected and frozen for subsequent batch analysis. Maternal serum was collected at delivery and batch analyzed for cotinine. For 663 stillbirth deliveries, 418 (63 percent) had cord homogenate toxicology and 579 (87 percent) had maternal cotinine assays performed. For 1,932 live birth deliveries, 1,050 (54 percent) had cord homogenate toxicology and 1,545 (80 percent) had maternal cotinine assays performed. A positive cord homogenate test for any illicit drug was associated with stillbirth (OR 1.94, p = .012, 95 percent CI 1.16–3.27). The most common individual drug was cannabis (OR 2.34, p = .021, 95 percent CI 1.13–4.81), although the effect was partially confounded by smoking. Both maternal self-reported smoking history and maternal serum cotinine levels were associated in a dose-response relationship with stillbirth. A proxy for passive smoke exposure (positive serum cotinine less than 3 ng/mL and no history of smoking) also was associated with stillbirth (OR 2.06, p < .001, 95 percent CI 1.24–3.41). In conclusion, cannabis use, smoking, illicit drug use, and apparent exposure to secondhand smoke, separately or in combination, during pregnancy were associated with an increased risk of stillbirth. Because cannabis use may be increasing with increased legalization, the relevance of these findings may increase as well. Although numbers were small, use of hydrocodone (OR 152.57, p < .001, 95 percent CI 13.73–1695.65) or morphine (OR 3.46, p = .080, 95 percent CI 0.86–13.90) also trended toward association with increased odds of stillbirth.


Journal Articles and Reports

Nicholas G. Castle, Steven M. Handler, and Laura M. Wagner. 2014. "Potential Prescription Drug Misuse in Assisted Living." Research in Gerontology Nursing 7(1):25–32, doi: 10.3928/19404921–20130910–01.

Researchers examined prescription drug misuse in assisted living settings as reported by direct care workers (DCWs). Data came from DCWs in 45 assisted living settings located in Pennsylvania. A total of 944 DCWs completed a questionnaire on their opinions of prescription drug misuse. DCWs believed that most assisted living residents take prescription medications. In addition, 10 percent of DCWs observed or had evidence that residents used unnecessarily high doses, 30 percent were preoccupied with the cost of prescription drugs, and 26 percent had problems understanding the complexity of their drug treatment regimen. Prescription drug misuse may be a problem of importance in assisted living settings.

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Hendrée E. Jones, Erin Dengler, Anna Garrison, Kevin E. O'Grady, Carl Seashore, E. Horton, Kim Andringa, Lauren M. Jansson, and John Thorp. 2014. "Neonatal Outcomes and Their Relationship to Maternal Buprenorphine Dose During Pregnancy." Drug and Alcohol Dependence 134(1):414–17.

This secondary analysis study examined the relationship between maternal buprenorphine dose at delivery and neonatal abstinence syndrome (NAS) peak score, estimated gestational age at delivery, Apgar scores at one and five minutes, neonatal head circumference, length, and weight at birth, amount of morphine needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital stay and compared neonates who required pharmacotherapy for NAS to neonates who did not require such pharmacotherapy on these same outcomes, in 58 opioid-dependent pregnant women receiving buprenorphine as participants in a randomized clinical trial. Analyses failed to provide evidence of a relationship between maternal buprenorphine dose at delivery and any of the 10 outcomes (all p–values > .48) and significant mean differences between the untreated (n=31) and treated (n=27) for NAS groups were found for duration of neonatal hospital stay and NAS peak score (both p–values < .001). Findings failed to support the existence of a dose–response relationship between maternal buprenorphine dose at delivery and any of 10 neonatal clinical outcomes, including NAS severity and whether infants treated for NAS had a higher mean NAS peak score or spent a longer time in the hospital than did the group not treated for NAS is unsurprising. The sample size in this study was too small to detect differences unless they were quite large.

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Marc O. Martel, Andrew J. Dolman, Robert R. Edwards, Robert N. Jamison, and Ajay D. Wasan. 2014. "The Association Between Negative Affect and Prescription Opioid Misuse in Patients With Chronic Pain: The Mediating Role of Opioid Craving." Journal of Pain 15(1):90–100.

Researchers examined the factors that underlie the association between negative affect (NA) and prescription opioid misuse among patients with chronic pain. In this study, 82 patients with chronic musculoskeletal pain being prescribed opioid medication completed the Current Opioid Misuse Measure, a well-validated self-report questionnaire designed to assess prescription opioid misuse. Patients were also asked to complete self-report measures of pain intensity, NA, and opioid craving. A bootstrapped multiple mediation analysis examined the mediating role of patients' pain intensity and opioid craving in the association between negative affect and prescription opioid misuse. Consistent with previous research, researchers found a significant association between negative affect and misuse. Opioid craving, but not pain intensity, mediated that association. The discussion suggested potential psychological and neurobiological factors that might contribute to the interrelationships.

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Laura McGlone, Ruth Hamilton, Daphne L. McCulloch, Jane R. Mackinnon, Michael S. Bradnam, and Helen Mactier. 2014. "Visual Outcome in Infants Born to Drug-Misusing Mothers Prescribed Methadone in Pregnancy." British Journal of Ophthalmology 98(2):238–45, doi: 10.1136/bjophthalmol–2013–303967.

Flash visual evoked potentials (VEPs) were abnormal in a cohort of 100 neonates exposed to maintenance methadone in utero. This prospective cohort study described clinical visual and electrophysiological outcomes at 6 months. Visual assessment included modified Atkinson test battery. Strabismus, nystagmus, reduced visual acuity, delayed visual maturation or refractive error (>3 dioptres) defined a fail on that assessment. Pattern-onset VEPs were recorded to 120', 60', and 15' checks. The study assessed 81 drug-exposed and 26 comparison infants (79 percent and 52 percent of the original cohorts) at a median age of 27 weeks (range 26–30). In utero, 90 percent of drug-exposed infants had been additionally exposed to illicit drugs and 41 percent to excess alcohol. Forty percent of the drug-exposed cohort failed clinical visual assessment: the relative risk of abnormal assessment was 5.1 (95 percent CI 1.3 to 20; p=0.02). Nystagmus was particularly common. VEP peak times were slower and amplitudes smaller in drug-exposed infants, of whom 70 percent had one or more abnormal VEP parameter. Abnormal visual outcome at 6 months was not associated with the pattern of additional drug exposure or a history of neonatal abstinence. Abnormal visual electrophysiology in infants born to drug-misusing mothers prescribed maintenance methadone persists to 6 months of age, and is associated with abnormal clinical visual assessment.

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Milad Nazarzadeh, Zeinab Bidel, and Kristin V. Carson. 2014. "The Association Between Tramadol Hydrochloride Misuse and Other Substances Use in an Adolescent Population: Phase 1 of A Prospective Survey." Addictive Behaviors 39(1):333–37, doi: 10.1016/j.addbeh.2013.09.013.

This investigation estimated the prevalence of tramadol misuse in a sample of Iranian adolescents and assessed the relationship between tramadol misuse and other substance use. This is the first phase of a prospective survey examining the prevalence of adolescent smoking status, substances use and related factors in Ilam city, Iran. Grade 10 male and female students (n=2000) were recruited using multistage sampling. Self-administered multiple-choice questionnaires were conducted with data analyzed using cross tabulations and logistic regression models. The prevalence of lifetime tramadol misuse was 4.8 percent (7.6 percent males; 1.8 percent females). Adjusted odds ratios and confidence intervals for lifetime tramadol misusers reporting substance use during the past month were 2.2 (1.1–4.4) for alcohol, 5.0 (1.5–21.9) for cannabis, 8.9 (2.7–29.4) for ecstasy, 0.5 (0.03–7.0) for methamphetamine, and 2.3 (0.7–7.4) for opium.

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Alexandra Nielsen and Wayne Wakeland. 2014. "Dynamic Simulation of the Effect of Tamper Resistance on Opioid Misuse Outcomes." Simulation and Modeling Methodologies, Technologies and Applications Advances in Intelligent Systems and Computing 256:169–81.

This study developed a system dynamics model of the medical use of pharmaceutical opioids, and the associated diversion and nonmedical use of these drugs. The model was used to test the impact of a tamper resistance intervention in this complex system. The study relied on secondary data obtained from the literature and from other public sources for the period 1995 to 2008. In addition, an expert panel provided recommendations regarding model parameters and model structure. The behavior of the resulting systems-level model compared favorably with reference behavior data. After the base model was tested, logic to simulate the replacement of all opioids with tamper resistant formulations was added and the impact on overdose deaths was evaluated over a seven-year period, 2008–15. Principal findings were that the introduction of tamper resistant formulations unexpectedly increased total overdose deaths. This was due to increased prescribing which counteracted the drop in the death rate.

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Amanda Phillips. 2014. "Prescribing in Prison: Complexities and Considerations." Nursing Standards 22;28(21):46–50, doi: 10.7748/ns2014.

Prescribing in prison is challenging because of environmental constraints, drug-seeking behavior, and the potential for drug trafficking. Risk management is, therefore, a fundamental part of the nonmedical prescriber's role as she or he attempts to balance health needs with security requirements. This article highlights the need for an insightful, yet impartial, approach to prescribing for offenders. It also emphasizes the importance of keeping abreast of emerging trends to safeguard patients from the effects of prescription drug misuse.

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Jeffrey H. Samet and Judith I. Tsui. 2014. "Variations in Prescription Opioids and Related Harms: A Key to Understanding and Effective Policy." Addiction 109(2):183–85, doi: 10.1111/add.12308.

Referring to the Fisher and colleagues (2014) article (see last week's [Jan. 29] Weekly Update), the authors agree that while Fischer and colleagues present a substantive and thought-provoking descriptive review of differences in health systems, policy, regulations and culture between North America and other high-income countries which may explain the disparity in nonmedical use of prescription opioids (POs) and subsequent harms, more evidence is needed linking those factors to harms. The researchers recommend pursuing the path that these authors initiated, by applying the methodology of studying small area variations in the nonmedical use of POs and their related harms. Then, circle back to North America to examine what is happening in different regions within the United States and Canada. Researchers also recommend comparing states with and without more strict regulatory policies for opioid prescribing or that have enacted Physician Monitoring Programs. Another example could compare regions that require continuing medical education on safe opioid prescribing to be recredentialed by the jurisdiction's medical board to those that have no comparable stipulation. Finally, they suggest mapping healthcare teams that follow recommended safe opioid prescribing practices and comparing such geographic regions to those that do not use such consensus guidelines might reveal differences in key outcomes.

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Anne Siegler, Ellenie Tuazon, Daniella Bradley O'Brien, and Denise Paone. 2014. "Unintentional Opioid Overdose Deaths in New York City, 2005–10: A Place-Based Approach to Reduce Risk." International Journal on Drug Policy, doi: 10.1016/j.drugpo.2013.10.015.

Researchers conducted a cross-sectional analysis of unintentional opioid poisoning deaths in New York City (NYC) from 2005 to 2010 (n=2649). Bivariate and multivariate analyses were performed to identify factors associated with settings of fatal opioid overdose. Three fourths of the sample overdosed in a home; one tenth in an institution, and the remainder in a public indoor setting, the outdoors or another nonhome setting. Factors associated with overdosing at home included female gender, college degree, residence in the borough of Staten Island, and combined use of opioid analgesics and benzodiazepines. Factors associated with overdosing outside of the home included ages 35–64, residence in Manhattan, and use of heroin. The sample represents a near census of unintentional opioid overdose deaths in NYC during the study period, and allows for the identification of demographic and drug-using patterns by setting of overdose. Because most opioid overdoses occur inside the home, opioid overdose response programs can most efficiently address the epidemic by both reducing the risk of overdose in the home and targeting those who may be in the home at the time of an overdose for overdose response training.

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Brian D. Sites, Michael L. Beach, and Matthew A. Davis. 2014. "Increases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users." Regional Anesthesia & Pain Medicine 39(1):6–12, doi: 10.1097/AAP.0000000000000022.

Researchers used the nationally representative Medical Expenditure Panel Survey to examine trends in prescription oral opioid analgesic use from 2000 to 2010. They made national estimates of adults (18 years and older) who reported receiving an opioid analgesic prescription (referred to as opioid users) and used logistic regression to examine predictors of opioid analgesic use. The primary outcome measures were national estimates of total users of prescription opioid analgesics and total number of prescriptions. The secondary outcome was that of observing changes in the disability and health of the users. The estimated total number of opioid analgesic prescriptions in the United States increased by 104 percent, from 43.8 million in 2000 to 89.2 million in 2010. In 2000, an estimated 7.4 percent (95 percent CI 6.9–7.9) of adult Americans were prescription opioid users compared with 11.8 percent (95 percent CI 11.2–12.4) in 2010. On the basis of estimates adjusted for changes in the general population, each year was associated with a 6 percent increase in the likelihood of receiving an opioid prescription from 2000 to 2010. Despite the apparent increase in use, there were no demonstrable improvements in the age- or sex-adjusted disability and health status measures of opioid users. The authors did compare the health status of opioid users to people in pain who did not use opioids.

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Carla Smith Stover and Thomas J. McMahon, 2014. "Opioid Dependence and Intimate Partner Violence: Associations With the Current Parenting Behavior of Fathers." Advances in Dual Diagnosis 7(1).

This study was designed to document differences in parenting behavior in fathers associated with a history of drug abuse versus a history of intimate partner violence (IPV). An ethnically diverse sample of 91 opioid-dependent fathers receiving methadone maintenance treatment and a demographically similar group of 111 fathers living in the same community with no history of alcohol or drug abuse since the birth of their first child were interviewed using a set of standard research measures. Multivariate analysis of covariance revealed that, after allowance for demographic covariates, a history of either minor or severe IPV, but not a history of drug abuse, was associated with a report of more negative parenting behavior. A history of minor IPV was associated primarily with a lack of warmth and affection in parenting behavior. A history of severe IPV was associated with more aggressive and more neglectful parenting behavior.

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Sunita S. Patil and Sunil K.Patil. 2013. "Critical Eye Toward Storage and Disposal of Prescribed Medicine." Global Journal of Medicine and Public Health 2(6).

Drug therapy is the most often used intervention for treatment and prevention of disease. Many patients do not finish these medications. They store leftovers in the medicine cabinet or throw them away. If these drugs are not properly stored and not properly disposed, they can have a direct impact on public safety, the environment, and health care services. Also this excess of medication in the home creates significant opportunities for unintentional poisoning, illegal distribution, substance misuse, and environmental contamination. Many steps have been taken by the U.S government for proper storage and disposal of prescribed medicines. Federal guidelines recommend different ways to dispose the prescription drugs when they are no longer needed. In India, however, there is no awareness of proper storage and disposal of prescribed medicines. Thus, the author believes that more societal awareness is needed and suggests the Government of India pursue educational and law enforcement strategies to increase proper storage and disposal of prescribed medicines.

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Dennis C. Turk, Elizabeth J. Dansie, Hilary D. Wilson, Bruce Moskovitz, and Myoung Kim. 2014. "Physicians' Beliefs and Likelihood of Prescribing Opioid Tamper-Resistant Formulations for Chronic Noncancer Pain Patients." Pain Medicine Jan. 21, doi:10.1111/pme.12352.

Researchers conducted a cross-sectional survey of clinicians' attitudes and opinions about opioids using the Clinicians' Attitudes about Opioids Scale (CNCP). The survey explored beliefs about and likelihood of prescribing tamper-resistant opioid formulations (TRFs). They selected a nationally representative sample of 1,535 practicing physicians throughout the United States. A stepwise hierarchical multiple linear regression analysis was conducted to estimate if physician characteristics, opinions, or geographic region categorized according to state rates of mortality by drug overdose and milligrams of opioids prescribed by state were predictive of the likelihood of prescribing TRFs. Physicians who were board certified in pain medicine or prescribed opioids to a higher volume of CNCP patients were significantly more likely to report TRFs. These factors plus 1) concerns about possible misuse and abuse of opioids, 2) beliefs about the effectiveness of opioids for CNCP, and 3) satisfaction with education and training in pain management, together accounted explained 21 percent of variance in TRF prescribing. Rates of mortality by drug overdose and opioid prescription volume by location were not predictive of TRF usage.

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Workers' Comp Changes Drug Program
Sidney Daily News
January 27, 2014

The Ohio Bureau of Workers' Compensation (BWC) made changes to its pharmacy program, including a reduction in prescriptions and more than a $20 million savings since 2011. The BWC wanted to improve injured worker care while finding ways to reduce prescription drug abuse. Opiate doses have decreased by 10.9 million since 2010, before the introduction of BWC's first-ever outpatient medication formulary in 2011. The changes also resulted in a 27.8 percent decrease in opioid prescriptions and a 72.9 percent decrease in skeletal muscle relaxant prescriptions in 2013 compared to 2010. The formulary is updated regularly and includes guidelines for coverage of various drugs. As of January 1, Ohio providers must enroll in the Ohio Automated Rx Reporting System to write controlled substance prescriptions for chronic care for BWC to cover these prescriptions. Chronic care is defined as writing three or more prescriptions for controlled substances for the same injured worker during a 12-week period. Other pharmacy program controls implemented by BWC included a lock-in program that limits the practice of doctor and pharmacy shopping; and standardized Drug Utilization Reviews to evaluate the necessity and appropriateness of prescription drug treatment and identify overuse or danger.

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Menu of State Prescription Drug Identification Laws
Centers for Disease Control and Prevention, Office for State, Tribal, Local and Territorial Support
Accessed January 31, 2014

This inventory provides a collection of prescription drug identification laws along with statutory and regulatory language enacted across states. It does not contain a full assessment of all relevant prescription drug laws. This assessment accomplishes the first step in evaluating the effectiveness of prescription drug identification laws. This menu includes laws enacted through June 30, 2013.

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RIA Helps Shatter Myths on Prescription and OTC Drugs
University at Buffalo Research Institute on Addictions
January 24, 2014

The University at Buffalo Research Institute on Addictions (RIA) supports National Drug Facts Week aimed at "Shatter the Myths" about teen drug use and abuse. The RIA Director said that the organization is engaged in a number of efforts to better understand the dangers and consequences of these drugs. Currently, Kathleen Parks, a senior research scientist, is leading a two-year study on college students' perceptions of the positive and negative consequences of using prescription drugs for nonmedical reasons. RIA has reached out to the public about prescription and OTC drug abuse through its Expert Summary series. They provide information on addictions and substance abuse topics, with overviews of problem areas as well as research-based suggestions on how to address them. One Expert Summary summarized the effects of opioids, depressants and stimulants, and outlined New York's I–STOP (Internet System for Tracking Over-Prescribing) legislation. Another warned of the dangers of OTC cough medicine abuse and suggested ways for parents, physicians, and pharmacists to spot abuse.

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Other State and Local News

What's in Your Medicine Cabinet?
January 30, 2014

The Valley Stream Wellness Committee, N.Y., a partnership of four school districts, will participate in the national Medicine Abuse Project in an effort to raise awareness about prescription drug abuse. The Medicine Abuse Project asks parents to lock up their prescription drugs, dispose of unused drugs, and talk to their children about the risks involved in taking prescription and over-the-counter medications. The committee arranged with Home Depot to have locked medicine cabinet boxes available for parents to purchase at cost along with free shipping. The committee plans to contact village and Town of Hempstead officials to discuss the possibility of modifying local building codes to require any new construction to have a lockable medicine cabinet. The Wellness Committee will reach out to the parents at Valley Stream's 14 public schools to spread the word about the importance of locking up medications.

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Program Helps Montana Nurses Battling Prescription Drug Abuse
January 29, 2014

The Montana Nurses Assistance Program is helping nurses with prescription drug abuse. In the past, nurses have had licenses suspended or revoked for stealing drugs used after surgery and diverting drugs from patients. Now, they can get help with treatment, testing, and on-the-job supervision to prove to the board they can tackle their problems and keep their licenses. About 80 nurses currently are using the program. (Video included.)

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Bill Proposed to Curb Trafficking of Prescription Medication
January 29, 2014

Oklahoma's state representative recently highlighted House Bill 2589 during the Ardmore Personnel Roundtable Legislative Luncheon. The bill would allow authorities to file drug trafficking charges against individuals carrying large quantities of prescription medication. The bill would add morphine, oxycodone, hydrocodone, and alprazolam to drugs listed in the current drug trafficking law. Carrying 1,000 grams of a morphine mixture, 400 grams of an oxycodone mixture, 50 grams of an oxycodone substance, or 15 grams of an alprazolam mixture would carry a penalty of a $100,000 to $500,000 fine and prison time. The Oklahoma Bureau of Narcotics and Dangerous Drugs supports the legislation.

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Vermont Faces Opiate Drug Abuse Crisis
CBS Evening News
January 28, 2014

This article and video (2 minutes 48 seconds) discuss prescription drug abuse and heroin use in Vermont.

A reporter talks to a 27-year-old female about her struggle with drug addiction. She started with marijuana, and then she moved on to prescription drugs and heroin. Since 2000, Vermont has seen nearly an 800 percent increase in opiate drug abuse. Most (80 percent) of Vermont's prisoners are in prison on drug-related charges; serious crimes are up 46 percent over the past five years; and last year, heroin overdose deaths almost doubled. The governor wants harsher penalties for dealers and help for addicts by putting them in treatment instead of jail.

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Overdose Deaths From Prescription Pain Meds Drop 27 Percent
Washington State Department of Health
January 28, 2014

The Washington Department of Health announced that the overdose death rate decreased by 27 percent and the number of deaths went from 512 in 2008 to 388 in 2012. Offsetting this decline, heroin deaths increased from 146 in 2008 to 231 in 2012. Overall, the state rate of deaths from both heroin and prescription drugs decreased only slightly over the last three years, from 8.7 per 100,000 to 8.5 per 100,000. In the past three years, the Department of Health used pain management rules for health care providers and the Prescription Monitoring Program as prevention tools. This year, the state health department will work on expanding access to naloxone.

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Cowlitz County, Wash., Overdose Fatality Rate Remains Among State's Highest
Longview Daily News
January 30, 2014

The state of Washington is seeing a decrease in deaths from prescription drug abuse except for in Cowlitz County. The Department of Health reported that it had the state's second-highest rate of deaths due to heroin or prescription drug abuse, at 17.1 deaths per 100,000 people between 2010 and 2012. The local rate is more than double the state rate. Pend Oreille County leads the state with 19.7 heroin and prescription medication deaths per 100,000.

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Marin Voice: What We Don't Know Can Hurt Us
Marin News
January 25, 2014

Dr. Matthew Willis, Marin County's Public Health Officer, shares his views about prescription drug abuse among young people. Marin's 11th graders reported misusing prescription pain killers, sedatives, and barbiturates at the same rate as their California peers. The rate of stimulant misuse among 11th graders is 25 percent greater than the state average. In Marin, more people die from misusing prescription drugs than from motor vehicle crashes. Dr. Willis suggests locking up medications, keeping track of medication quantities, and learning how to properly dispose of unused medications. He also encourages parents to use "teachable moments" with their children while watching television or when taking medications to talk about how these drugs can be harmful or dangerous. The Marin County Department of Health and Human Services is convening a group of key community stakeholders to gain a clearer understanding of the issue and to create a comprehensive plan for reducing prescription drug misuse and abuse in the community.

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Prescription Drugs Lead to Growing Problem of Infant Addiction
News Star
January 25, 2014

This article discusses babies born addicted to narcotics in the United States, particularly Louisiana. Recent legislation supported by the Fourth District Attorney's Office allows pregnant women who become incarcerated to get substance abuse treatment from the Northeast Delta Human Services Authority. A St. Francis Medical Center neonatologist said the majority of drug-addicted babies delivered at St. Francis are born addicted to marijuana, methadone, or prescription drugs. University Health Conway Nursery said all mothers who deliver at Conway are screened, and if they test positive, the infant is screened. If an infant is positive on a toxicology screen or if the newborn shows signs and symptoms of withdrawal, the child is monitored and every two hours nurses collect an abstinence score. The Nursery comforts the infant by using low lighting, decreasing activity around the infant, and decreasing stimulation. In extreme situations, physicians give medications like morphine and methadone in small doses. Ten of 80 newborns at Conway tested positive in December, and 6 of 70 did in January.

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Painkiller-Spiked Heroin Kills at Least 17 in Pittsburgh Region
New York Daily News
January 27, 2014

This article and video (2 minutes 31 seconds) discussed heroin tainted with fentanyl and sold in a baggie stamped with the words "Theraflu" that led to 17 deaths in western Pennsylvania over seven days. At least 14 overdose cases occurred in Allegheny County, two in Westmoreland County, and one in Armstrong County. Pittsburgh's mayor, the Allegheny County medical examiner, and other officials have warned users about the deadly batch of heroin.

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Heroin Epidemic Eclipses Prescription Drug Abuse in Front Royal
Northern Virginia Daily
January 27, 2014

The Office of Police Chief Norman Shiflett released 2013 figures that showed heroin replaced prescription drug abuse as the most serious drug problem confronting law enforcement in Front Royal, Virginia. The Northwest Regional Drug Task Force for Front Royal and Warren County seized 242 grams of heroin and 444 dose units of pills last year. Sergeant Kevin Coffman said in 2013, heroin surpassed pills as the drug of choice in the Shenandoah Valley. Law enforcement filed a total of 343 drug-related charges.

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Program Aims to Reduce Drug Overdoses
Poynette Press
January 28, 2014

The Wisconsin Department of Health Services is launching a pilot program to allow all Emergency Medical Technicians (EMTs) to administer Naloxone. This pilot program aligns with the Association of State and Territorial Health Officials 15" x 15" challenge to reduce the rate of nonmedical use by 15 percent by 2015, and the number of unintentional overdose deaths involving controlled prescription drugs. The one-year pilot includes education and training to EMTs. A report on the pilot's outcomes will be released in early 2015.

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Lawmakers Hope Bills Help Tackle Wisconsin's Growing Heroin Problem
January 29, 2014

This article and audio (3 minutes 57 seconds) discuss heroin use and prescription drug abuse in Wisconsin. A state senate committee will soon review and vote on a package of bills that the assembly has already approved. One bill would provide immunity to anyone who helps a person who has overdosed. Also, the bill would provide immunity for possessing and administering Narcan (Naloxone). Another bill targets the abuse of opiate-based prescription pain relievers by allowing more medicine collection sites for pill disposal. Wisconsin has seen an increase in heroin use since it is cheaper than prescription drugs. A state representative recently introduced measures to create regional treatment centers to address this problem.

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Heroin Abuse at 'Epidemic' Level in South Florida Drug Report
January 30, 2014

The National Institute on Drug Abuse reported that deaths from heroin rose 89 percent in Florida from 62 in 2011 to 117 in 2012, hitting South Florida the hardest. In Miami–Dade County, deaths increased 120 percent, from 15 in 2011 to 33 in 2012. Experts said the spike in heroin use and deaths is among young adults, ages 18 to 29.

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Bill to Combat Prescription Drug Abuse Wins Senate Approval
State of Delaware
January 30, 2014

The Delaware State Senate approved House Bill 154 and Senate Bill 119. HB 154 would create a new criminal offense of "Medication Diversion" that applies to anyone who intentionally diverts prescription narcotics from patients who are under the care of a healthcare program in medical or other 24-hour facilities. Senate Bill 119 would enhance Delaware's prescription monitoring efforts by limiting all medical facilities except licensed pharmacies from dispending more than a 72-hour supply of a controlled substance to patients and requiring all dispensers to enter any prescription of a controlled substance into the state's Prescription Monitoring Program.

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Bill Proposed to Curb Trafficking of Prescription Medication
Staten Island Advance
January 28, 2014

Staten Island lawmakers sent a letter to state health officials asking them to link the prescription drug monitoring database, "I–STOP," with other states, to prevent doctor and pharmacy shopping across state lines. They said drug dealers and substance abusers know the current database will not track what they do in other states. The letter urged the state to "pursue all available options seeking to establish individual information-sharing agreements with other states, or a regional agreement, to close this interstate loophole."

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Other Resources

Half of Us Campaign Videos
mtvU and The Jed Foundation
Accessed January 31, 2014

The Half of Us campaign has launched a new initiative to help college students learn about prescription drug abuse. The campaign includes a series of videos available on its website and Tumblr.


Webinar Archive

ATTC iTraining: SAMHSA's Opioid Overdose Prevention Toolkit & Prescription Drug Abuse
January 16, 2014

H. Westley Clark, Director of the Center for Substance Abuse Treatment, gave an overview of SAMHSA's Opioid Overdose Prevention Toolkit and discussed other aspects of the prescription drug abuse problem. The presentation and slides are now available.


Grant Announcements

New Applicant Workshops Announced for the Drug-Free Communities Program
Community Anti-Drug Coalitions of America
Friday, February 7, 2014—Washington, D.C.
Tuesday, February 11, 2014—Denver, Colo.
Thursday, February 13, 2014—Atlanta, Ga.

2014 Drug-Free Communities Support Program Grants
White House Office of National Drug Control Policy and Substance Abuse and Mental Health Services Administration
Deadline: March 24, 2014

ONDCP and SAMHSA are now accepting applications for the 2014 Drug-Free Communities (DFC) Support Program grants. ONDCP expects to award approximately 182 new grants to community drug prevention coalitions throughout the United States. Grants awarded through the DFC Support Program are intended to support established community-based youth substance use prevention coalitions capable of effecting community-level change. Coalitions receiving DFC funds are expected to work with leaders within their communities to identify and address local youth substance use problems and create sustainable community-level change through the use of the Seven Strategies for Community Change.

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Medical Toxicology Foundation Research Award: Prescription Drug Abuse Prevention
American College of Medical Toxicology
Deadline: 11:59 p.m. EST, February 14, 2014

Research to Prevent Prescription Drug Overdoses
Centers for Disease Control and Prevention, Department of Health and Human Services
Letter of Intent Deadline: February 14, 2014
Proposal Deadline: 5:00 p.m. EST, March 19, 2014
http://www.grants.gov/search-grants.html?agencies percent3DHHS percent7CDepartment
percent20of percent20Health percent20and percent20Human percent20Services

Research on Integration of Injury Prevention in Health Systems
Centers for Disease Control and Prevention, Department of Health and Human Services
Letter of Intent Deadline: February 14, 2014
Proposal Deadline: 5:00 p.m. EST, March 19, 2014
http://www.grants.gov/search-grants.html?agencies percent3DHHS percent7CDepartment percent20of percent20Health percent20and percent20Human percent20Services

Grants Received

Four Cities Win Grants for Outstanding Prescription Drug Abuse Prevention Initiatives
United States Conference of Mayors
January 24, 2014

The United States Conference of Mayors announced the winners of the Safeguard My Meds Prescription Drug Abuse Prevention Recognition Program during its 82nd Winter Meeting. Awards were given to outstanding local initiatives that have the greatest potential to reduce the misuse and abuse of prescription drugs, particularly among young people. Grants were made to Mayoral-based initiatives in Columbus, Indiana; Fayetteville, Arkansas; Indianapolis, Indiana; and Philadelphia, Pa.

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Take-Back Events and Drop Boxes

National Take-Back Initiative
Drug Enforcement Administration
10:00 a.m. to 2:00 p.m.
Saturday, April 26, 2014

Responsible Drug Collection Offered by the Peoria Police
Arizona Newszap.com
January 30, 2014

Prescription Drug Disposal Unit Installed in Conewago Township
Evening Sun
January 27, 2014

Lebanon County, Pa., to Dispose of Old Medicines
Lebanon Daily News
January 29, 2014

169 Pounds of Prescriptions Turned in to New Castle County, Del.
January 24, 2014

Niagara Falls Cops Getting the Drop on Unwanted Prescription Medications
Niagara Gazette
January 27, 2014

Santa Clarita Valley, Calif., Safe Drop-Off Drug Box Fills Up
Santa Clarita Valley Signal
January 26, 2014

Laurel Sheriff's Office Offers Drug Drop Box
January 31, 2014

Franklin County Opening Four Drug Drop-Off Boxes
January 27, 2014

Upcoming Conferences and Workshops

Collaborative Perspectives on Addiction: 'Changing Addictive Behavior: Bench to Bedside and Back Again'
February 28 to March 1, 2014
Atlanta, Georgia

Pain Management Through a Wide Lens: Balancing Safety and Effectiveness
March 8, 2014
St. Louis, Missouri

Eleventh Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland

National Rx Drug Abuse Summit
April 22–24, 2014
Atlanta, Georgia
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.


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