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February 5, 2015

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 108  |  February 5, 2015
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports Professional Education National News International News Northeast/Mid-Atlantic News South News Midwest News West News Other Resources Grant Announcements Grants Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured

Editor's note: We could have featured almost everything in National News this week.

G. Franklin, J. Sabel, C.M. Jones, J. Mai, C. Baumgartner, C.J. Banta–Green, D. Neven, and D.J. Tauben. 2015. "A Comprehensive Approach to Address the Prescription Opioid Epidemic in Washington State: Milestones and Lessons Learned." American Journal of Public Health, doi:10.2105/AJPH.2014.302367.

The authors describe how strong collaborations between public health agencies and leaders in the pain field helped reverse Washington's prescription opioid epidemic. Strategies included tighter dosing guidelines, establishing a prescription drug monitoring program accessible to state Medicaid and workers' compensation oversight agencies, free physician educational consultations with pain experts, prescription drug take-back programs starting in 2003, and a naloxone-related Samaritan law passed in 2010. Prescription opioid overdose death rates declined 27 percent from 2008 to 2012, and overdose hospitalization rates decreased for the first time in 2012. Among workers' compensation patients, the percentage with new opioid use that became chronic users dropped from 26 percent in 2004 to 11 percent in 2010. The average daily dose declined by 27 percent; those reaching 120 milligrams per day went from 6.3 percent to 4.7 percent; and the rate of opioid poisonings and adverse effects remained stable between 2004 and 2010. Within Medicaid, average opioid doses have decreased since 2007. Prescription opioid–involved deaths reached a high of 300 Medicaid clients in 2007, and declined to 198 in 2012. Among Washington's 10th graders, the percentage using prescription pain relievers to "get high" dropped from 10 percent in 2006 to 6 percent in 2012.

Read more:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302367

Coalition of Physicians, Hospitals and Health Care Authority Getting National Attention for 'ER Is for Emergencies Campaign' to Reduce Preventable Emergency Room Visits
Washington State Medical Association
January 28, 2015

Washington's "ER Is for Emergencies Coalition" addresses emergency room overuse by focusing on frequent users, targeted strategies such as improving access to primary care, and encouraging physician participation in the prescription drug monitoring program (PDMP). It is the first state to integrate PDMP information into the electronic medical records of an emergency department. In fiscal year 2013, the rate of emergency department visits decreased by 9.9 percent, and the rate of visits resulting in a scheduled drug prescription fell by 24 percent.

Read more:
http://www.wsma.org/wcm/News_and_Events/Press_Room_Articles/
Physicians__hospitals_and_HCA_getting_national_attention_for_
campaign_to_reduce_ER_visits.aspx

Journal Articles and Reports

S.M. Bagley, J. Peterson, D.M. Cheng, C. Jose, E. Quinn, P.G. O'Connor, and A.Y. Walley. 2015. "Overdose Education and Naloxone Rescue Kits for Family Members of Opioid Users: Characteristics, Motivations, and Naloxone Use." Substance Abuse, doi:10.1080/08897077.2014.989352.

This eight-site Massachusetts study surveyed 126 participants of community support groups for opioid users' family members. Sessions included optional training on naloxone rescue kit use (79 percent took the training). Ninety-five percent of attendees were white; 78 percent were female; 74 percent were married or partnered; and 85 percent were parents of an opioid user, with 52 percent providing financial support for their son or daughter. Trainees were more likely than other attendees to be parents of an opioid user (91 percent vs. 65 percent), provide financial support to an opioid user (58 percent vs. 30 percent), and to have witnessed an overdose (35 percent vs. 12 percent). Some declined training because they had already received it, including five people who had successfully used naloxone during an overdose rescue. Major motivations for training were wanting a kit in the home (72 percent), education provided at the meeting (60 percent), and hearing about benefits from others (57 percent).

Read more:
http://www.tandfonline.com/doi/full/10.1080/08897077.2014.989352#.VMvR22nwsgA

G. Campbell, S. Nielsen, R. Bruno, N. Lintzeris, M. Cohen, W. Hall, B. Larance, R.P. Mattick, and L. Degenhardt. 2015. "The Pain and Opioids in Treatment Study: Characteristics of a Cohort Using Opioids to Manage Chronic Non-Cancer Pain." Pain 156(2):231–42, doi:10.1097/01.j.pain.0000460303.63948.8e.

An Australia-wide study recruited 1,514 people who take prescribed opioids to treat chronic pain. At baseline, participants had been in pain for an average of 10 years and had used prescription opioids for 4 years, with 10 percent taking a daily morphine equivalent dose of ≥ 200 mg. Employment and income levels were low, and two thirds of the sample reported that pain had affected their employment status. Half screened positive for current moderate-to-severe depression, and one fifth had made a lifetime suicide attempt. Younger participants reported higher levels of pain and pain interference with functioning, more mental health and substance use issues, and more barriers to treatment.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25599444

C.D. Donaldson, B. Nakawaki, and W.D. Crano. 2015. "Variations in Parental Monitoring and Predictions of Adolescent Prescription Opioid and Stimulant Misuse." Addictive Behaviors 45:14–21, doi:10.1016/j.addbeh.2015.01.022.

This study probed predictors of youth prescription opioid and stimulant misuse. Path analytic models using data from 12- to 17-year-olds in the 2012 National Survey on Drug Use and Health (NSDUH) found girls reported higher levels of parental warmth, as did youth from wealthier families. Adolescents from wealthier and intact families reported greater parental monitoring. Parental monitoring and parental warmth predicted adolescents' social ties and individual factors associated with drug use (a composite of 22 items related to parental and youth substance use beliefs, academic performance, delinquency, and sensation seeking). Social ties and individual factors in turn predicted prescription opioid and stimulant misuse. Contrary to findings of parallel path analyses probing alcohol, cigarette, and marijuana use (Hemovich, Lac, and Crano 2011), for adolescents ages 12 to 14, high levels of parental monitoring with low levels of parental warmth—while positively associated with attitudes and social ties—also predicted higher rates of prescription stimulant misuse. The analysis used separate models at ages 12 to 14 and 15 to 17, and results were validated with 2011 NSDUH data.

Read more:
http://www.sciencedirect.com/science/article/pii/S0306460315000234

E.L. Garland, B. Froeliger, and M.O. Howard. 2015. "Allostatic Dysregulation of Natural Reward Processing in Prescription Opioid Misuse: Autonomic and Attentional Evidence." Biological Psychology, doi:10.1016/j.biopsycho.2015.01.005.

In laboratory experiments on people in chronic pain, prescription opioid misusers (n = 72) evidenced significantly more attenuated heart rate variability responses to opioid, pain, and natural reward cues presented during a dot probe task than non-misusers (n = 26). Differences in heart rate variability were largest in response to natural reward cues, but appeared to be explained by differences in opioid dosing.

Read more:
http://www.sciencedirect.com/science/article/pii/S0301051115000150

T. Gupta, M. Mujib, P. Agarwal, P. Prakash, A. Garg, N. Sharma, W. Aronow, S. Wilbert, and C. Nabors. 2015. "Association Between Opioid Abuse/Dependence and Outcomes in Hospitalized Heart Failure Patients." American Journal of Therapeutics, doi:10.1097/MJT.0000000000000190.

In 2002–10 Healthcare Cost and Utilization Project Nationwide Inpatient Sample data, among 9,993,240 patients age 18 and older admitted with a primary diagnosis of heart failure, 29,014 had a history of opioid abuse or dependence. Opioid abusers/dependents were likely to be younger men of poor socioeconomic background, with self-pay or Medicaid as their primary payer. They had a lower prevalence of dyslipidemia, diabetes mellitus, coronary artery disease, prior myocardial infarction, and peripheral vascular disease, and were more likely to be smokers and have chronic pulmonary disease, depression, liver disease, and obesity. Multivariate logistic regression showed they had lower incidence of hospital-acquired conditions (14.8 percent vs. 16.5 percent) and lower in-hospital mortality (1.3 percent vs. 3.6 percent).

Read more:
http://journals.lww.com/americantherapeutics/Abstract/publishahead/
Association_Between_Opioid_Abuse_Dependence_and.99148.aspx


A. Lange, K.E. Lasser, Z. Xuan, L. Khalid, D. Beers, O.D. Heymann, C.W. Shanahan, J. Crosson, and J.M. Liebschutz. 2015. "Variability in Opioid Prescription Monitoring and Evidence of Aberrant Medication Taking Behaviors in Urban Safety-Net Clinics." Pain 156(2):335–40, doi:10.1097/01.j.pain.0000460314.73358.ff.

From September 2011 to August 2012, 67 primary care providers prescribed opioids to 1,546 patients of three Boston-area primary care clinics. Overall, 48 percent of patients had an opioid treatment agreement documented in their electronic health record (in a range of 9 percent to 84 percent); 56 percent had at least one past-year urine drug screen (in a range of 7 percent to 91 percent); and 36 percent had received early refills (≥ two opioid prescriptions written 7–25 days after the previous prescription, in a range of 19 percent to 60 percent). In regression, daily opioid medication dose above 50 mg increased odds of an agreement (1.93), urine screen (2.65), and early refill (2.92). Primary care providers varied significantly in adherence to opioid prescription guidelines.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25599455

J.D. Lee, P.D. Friedmann, T.Y. Boney, R.A. Hoskinson, R. McDonald, M. Gordon, M. Fishman, D.T. Chen, R.J. Bonnie, T.W. Kinlock, E.V. Nunes, J.W. Cornish, and C.P. O'Brien. 2015. "Extended-Release Naltrexone to Prevent Relapse Among Opioid Dependent, Criminal Justice System Involved Adults: Rationale and Design of a Randomized Controlled Effectiveness Trial." Contemporary Clinical Trials, doi:10.1016/j.cct.2015.01.005.

This article describes (but does not report) a five-site, open-label randomized controlled effectiveness trial comparing extended-release naltrexone treatment for opioid relapse with treatment as usual (TAU) among community dwelling, non-incarcerated volunteers with current or recent criminal justice system involvement. The naltrexone arm receives six monthly injections at medical management visits; the TAU receives referrals to available community treatment. (Editor's note: This is a weak design with patients aware of which group they are in and, inexcusably, no attempt to enroll TAU members in treatment at first contact.) Assessments occur every 2 weeks during a 24-week treatment phase and at 12- and 18-month follow-ups.

Read more:
http://www.contemporaryclinicaltrials.com/article/S1551-7144(15)00006-3/abstract

H.J. Mosher, E.E. Krebs, M. Carrel, P.J. Kaboli, M.W. Weg, and B.C. Lund. 2014. "Trends in Prevalent and Incident Opioid Receipt: An Observational Study in Veterans Health Administration 2004–2012." Journal of General Internal Medicine, doi:10.1007/s11606-014-3143-z.

Among patients receiving primary care at the 137 Veterans Health Administration clinics, opioid receipt increased from 19 percent in fiscal year (FY) 2004 to 33 percent in FY 2012. Prescribing rates rose in all regions in the United States. In FY 2012, rates ranged from 13 to 51 percent. The same year, opioid receipt was more likely among women than men (42 percent vs. 33 percent), and among 18–34-year-old veterans than veterans over 80 (48 percent vs. 18 percent).

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25519224

A. Pulver, C. Davison, and W. Pickett. 2015. "Time-Use Patterns and the Recreational Use of Prescription Medications Among Rural and Small Town Youth." The Journal of Rural Health, doi:10.1111/jrh.12103.

Multivariate analysis of 2009 and 2010 Canadian Health Behaviour in School-Aged Children survey data on rural students in grades 9 and 10 (n = 2,393) found peer time outside school hours and nonparticipation in extracurricular activities were significantly associated with recreational use of prescription drugs. Peer drug use, unhappy homes, and frequent binge drinking largely explained these associations.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/jrh.12103/abstract

J.M. Stogner, A. Sanders, and B.L. Miller. 2014. "Deception for Drugs: Self-Reported 'Doctor Shopping' Among Young Adults." Journal of the American Board of Family Medicine 27(5):583–93, doi:10.3122/jabfm.2014.05.140107.

Among 2,349 undergraduates responding to a paper-and-pencil survey with an 80 percent response rate at Georgia Southern University, 93 said they had attempted to deceive a physician to obtain a pharmaceutical. Most reported being at least partially motivated by their own abuse, and half said selling part of the prescription was a motivating factor. Alcohol use, marijuana use, and pharmaceutical misuse were risk factors associated with attempted deception. Rare-event logistic regression models suggested past substance use; full-time employment; being a student athlete; and self-identification as lesbian, gay, bisexual, or transgender raised the likelihood of attempted deception.

Read more:
http://www.jabfm.org/content/27/5/583.full

Professional Education

R.L. Haffajee, A.B. Jena, and S.G. Weiner. 2015. "Mandatory Use of Prescription Drug Monitoring Programs." JAMA, doi:10.1001/jama.2014.18514.

The authors share their views about mandatory use of prescription drug monitoring programs (PDMPs), their effectiveness, and prescribing outcomes. Twenty-two of the 49 states with PDMPs now require prescribers to query the system before writing prescriptions for a controlled substance. This paper urges a balance between addressing legitimate practitioner concerns and retaining features fundamental to mandate efficacy. The authors suggest automatically enrolling prescribers in the PDMP and implementing mandates only for clinically appropriate circumstances.

Read more:
http://jama.jamanetwork.com/article.aspx?articleid=2107540

National News

Study Finds Decreasing Number of Pill Mills and Drug Overdose Deaths in Florida
G. Ochoa, Pain Medicine News
January 2015

A study presented at PAINWeek revealed Florida's successful actions to reverse the growing prescription opioid abuse and overdose deaths trend. In 2010, pain clinics were required to register with the state; Schedule II or III substances could be prescribed but no longer dispensed from offices; Florida initiated a prescription drug monitoring program with mandatory dispenser reporting; and pill mills were raided and assets seized. For the next 3 years, all 98 high-volume oxycodone-dispensing clinics were shut down, and 250 pill mills were closed. Prescription drug overdose deaths decreased from 2,722 in 2010 to 2,116 in 2012.

Read more:
http://www.painmedicinenews.com/ViewArticle.aspx?d=Policy%2B%26%2
BManagement&d_id=83&i=January+2015&i_id=1139&a_id=29251


How Physicians Are Taking on Rx Drug Use in 2015
American Medical Association
January 26, 2015

The American Medical Association (AMA) wants all states to have legislation increasing naloxone availability by the end of 2015. At the AMA State Legislative Strategy Conference, acting Office of National Drug Control Policy Director Michael Botticelli outlined goals to reduce opioid misuse and increase overdose prevention and treatment efforts. These included addressing substance use disorders earlier in the disease process, improving and supporting prescription drug monitoring programs, expanding access to naloxone and enacting Good Samaritan provisions, expanding treatment access, and addressing the stigma associated with substance use disorders.

Read more:
http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/physicians-taking-rx-drug-use-2015

Purdue's New Rx Opioid Hits Market
Deborah Weinstein, Medical Marketing and Media
January 27, 2015

Purdue Pharma's prescription opioid medication Hysingla ER (hydrocodone bitartrate) is now on sale. The drug is the first acetaminophen-free hydrocodone product with abuse-deterrent properties.

Read more:
http://www.mmm-online.com/purdues-new-rx-opioid-hits-market/article/394737

Best Ways to Get Rid of Medication
Consumer Reports
January 2015

This article describes safe drug disposal options and explains why flushing medication or tossing it in the trash isn't ideal. It also provides tips on safe storage of opioids.

Read more:
http://www.consumerreports.org/cro/2015/01/best-ways-to-get-rid-of-medication/index.htm

Treatment of Overdose Will Cost Cities Less
Sabrina Tavernis, The New York Times
January 26, 2015

The Clinton Foundation Health Matters Initiative has negotiated a stable "low" price for Evzio, a handheld auto injector that delivers a single dose of naloxone. Daniel Raymond, policy director of the Harm Reduction Coalition, said auto-injector devices are not widely used because they are significantly more expensive than administering naloxone as a nasal spray or regular injection. Although the new price was not disclosed, it will be available to any institution that can more broadly distribute the medication, such as a police department or university.

Read more:
http://www.nytimes.com/2015/01/27/science/treatment-of-overdose-will-cost-cities-less.html

NACDS Emphasizes Collaboration in Curbing Prescription Drug Diversion, Abuse
Pharmacy Times
January 27, 2015

At a U.S. House Energy and Commerce Subcommittee on Health hearing, "Examining Public Health Legislation to Help Patients and Local Communities," the National Association of Chain Drug Stores (NACDS) testified that chain pharmacies are committed to partnering with government on strategies to prevent prescription drug abuse. NACDS stressed the importance of prescription drug monitoring programs to identify and prevent drug abuse, misuse, and diversion. It reiterated its support for reauthorization of the National All-Schedules Prescription Electronic Reporting Act.

Read more:
http://bit.ly/15GxY3n

International News

"Driving Home the Message." 2015. The Pharmaceutical Journal 294(7847).

Effective March 2, 2015, new rules on taking drugs and driving will be enforced in England and Wales. This means police can stop drivers to test their blood levels for 16 substances, including medicines. The United Kingdom Department of Transport estimates this will affect around 19 million prescriptions per year. Patients taking medicines affected by new drug driving laws will need timely and accurate advice from pharmacists.

Read more:
http://www.pharmaceutical-journal.com/opinion/editorial/drug-driving-law-must-not-be-a-burden-for-patients/20067698.article

Deadly Painkiller Linked to Rising Number of Alberta Deaths
Reid Southwick, Calgary Herald
January 27, 2015

The rise in fentanyl abuse linked to OxyNeo, often sold as "oxycodone," has caused more fatal overdoses in Alberta. As Canadian doctors began prescribing OxyNeo, fentanyl-related deaths rose from 29 in 2012 to 66 in 2013 to 61 in 2014. Heroin overdoses are also increasing.

Read more:
http://calgaryherald.com/news/crime/deadly-painkiller-linked-to-rising-number-of-alberta-deaths

Northeast/Mid-Atlantic News

Bennett Bill Would Make Narcan Available in Schools
Mark Schieldrop, Cranston Patch
January 29, 2015

Rhode Island Representative David A. Bennet has introduced legislation 2015-H5047, which would require public schools to be equipped with naloxone kits. The bill would also provide immunity from penalty or civil action to school personnel who administer the drug. Some school nurses may already own a kit because Rhode Islanders can get naloxone without a prescription at 26 Walgreens stores.

Read more:
http://patch.com/rhode-island/cranston/bennett-bill-would-make-narcan-available-schools-0

Senators Seek One-Year Delay of New York's Electronic Prescribing Mandate
James T. Mulder, Syracuse Media Group
January 28, 2015

Senator David Valesky co-sponsored legislation that would delay the March 27 deadline mandating all drug prescriptions in New York to be issued electronically. The Rhode Island Medical Society asked the state's health department to delay the mandate because many doctors are not yet ready. Doctors can only use e-prescribing software that meets regulations established by the Drug Enforcement Administration.

Read more:
http://www.syracuse.com/news/index.ssf/2015/01/senators_seek_one-
year_delay_of_new_yorks_electronic_prescribing_mandate.html


Surge in Heroin Overdoses Puzzles Health Workers
Brian MacQuarrie, The Boston Globe
January 29, 2015

A surge in overdose deaths has stunned addiction treatment and prevention workers. Massachusetts State Police recorded 114 suspected opioid fatalities in December—up from 60 the previous month. In Essex County, 33 suspected opioid-related deaths were recorded in November and December, compared with 13 in July and August. In Franklin County, 21 overdoses were reported in November and December, compared with 3 in October. In Taunton, where overdoses plunged to almost zero last summer, 37 overdoses and three deaths occurred in November and December. Emergency workers in Boston used naloxone to reverse 138 opioid overdoses in December. In November and October, there were 92 and 69 opioid overdose reversals, respectively.

Read more:
http://www.bostonglobe.com/metro/2015/01/29/new-surge-heroin-overdoses-puzzles-mass-health-workers/0vKpDx3UsPUP5D6GYKJtLM/story.html

Keene Hospital Starts New Program Aimed at Helping to Combat Prescription Drug Abuse
Ella Nilsen, SentinelSource.com
January 29, 2015

Officials at Cheshire Medical Center/Dartmouth–Hitchcock Keene in New Hampshire are establishing a system to track how much pain medication healthcare providers at Keene Hospital are prescribing, and to whom. They have implemented a risk assessment tool for each patient with a condition requiring opioid treatment. Those prescribed opioids are required to undergo pain assessments and drug screenings before they receive prescription pain pills. Staff can monitor patients and try to limit the amount of pain medications they receive. Patients who have substance abuse problems may be designated "high risk" and asked to schedule more frequent follow-up appointments, including drug screenings. Providers may also suggest other pain management methods, such as acupuncture or physical therapy. The center received a federal planning grant to examine the drug problem and develop an action plan.

Read more:
http://www.sentinelsource.com/news/local/keene-hospital-starts-new-program-aimed-at-helping-to-combat/article_3e41d416-7f5d-50ee-84c1-d5ec2b78bff8.html

Overdose Deaths from Heroin Galvanizing Leaders in Maryland and Virginia
Jenna Johnson and Rachel Weiner, The Washington Post
January 24, 2015

Maryland and Virginia had more heroin-related deaths in 2013 than in any other year since 2007. The states' governors have made heroin and prescription drug abuse reduction a priority. In 2013, Maryland lawmakers passed legislation that allowed medics and other first responders to administer naloxone. Virginia lawmakers will consider a similar law this session.

Read more:
http://www.washingtonpost.com/local/md-politics/overdose-deaths-from-heroin-galvanizing-leaders-in-maryland-and-virginia/2015/01/24/ef0c19fc-a305-11e4-9f89-561284a573f8_story.html

Anne Arundel County Executive Declares Heroin Public Health Emergency
Saliqa Khan, WBAL
January 27, 2015

Anne Arundel County, Md., Executive Steve Schuh announced an executive order declaring a countywide heroin public health emergency and directing county agencies to use "all best efforts" to eradicate heroin use. (Includes video: 2:40 minutes)

Read more:
http://www.wbaltv.com/news/anne-arundel-county-official-declares-heroin-public-health-emergency/30949248

Drug Deaths on the Rise in Lancaster and York Counties
Susan Baldridge, Lancasteronline.com
January 24, 2015

In 2014, the number of morphine overdose deaths in Lancaster County, Pa., more than tripled the six deaths in 2013. York County's coroner said it had 100 drug-related deaths, including 54 from heroin.

Read more:
http://lancasteronline.com/news/local/drug-deaths-on-the-rise-in-lancaster-and-york-counties/article_e4793a7c-a32f-11e4-93ce-4b1290f5461a.html

Heroin and Fentanyl Abuse on the Rise
NMS Labs
Accessed January 26, 2015

This chart shows the number of all postmortem cases that tested positive for heroin and fentanyl at Pennsylvania's NMS Labs. It also includes a U.S. map from the Centers for Disease Control and Prevention with drug-poisoning deaths involving heroin and other opioid drugs by county.

Read more:
http://www.nmslabs.com/uploads/PDF/Heroin-Fentanyl_Positvity_Trends_Data.pdf

Reports of Drug-Affected Newborns Rise Again
Lindsay Tice, Lewiston-Auburn Sun Journal
January 29, 2015

The number of Maine newborns reportedly affected by drugs increased 17 percent in 2014, from 835 to 977. That number was 135 in 2005. It is unclear how many children in Maine are born exposed to drugs because doctors and other healthcare providers report differently. The Neonatal Intensive Care Unit medical director and chief of pediatrics at Eastern Maine Medical Center said numbers were down in 2013. He estimated that about 10 percent of mothers took illicit drugs, 15 percent took prescription drugs, and 75 percent took drugs such as Subutex or methadone.

Read more:
http://www.sunjournal.com/news/lewiston-auburn/0001/11/30/reports-drug-affected-newborns-rise-again/1648968

Docs, Hospitals, State Health Officials Endorse Opioid Painkiller Guidelines
Don Michak, Journal Inquirer
January 29, 2015

The Connecticut Hospital Association, Connecticut State Medical Society, state chapter of the American College of Emergency Physicians, and Department of Public Health have endorsed opioid pain reliever guidelines that focus on treating chronic pain patients who frequent emergency departments.

Read more:
http://www.journalinquirer.com/connecticut_and_region/docs-hospitals-state-health-officials-endorse-opioid-painkiller-guidelines/article_f64a3dc6-a7d2-11e4-8ede-1fd21ff4babb.html

Antidote Drug Sought for Heroin Addicts
Kevin Kearney, Wayne Independent
January 26, 2015

The Wayne County district attorney's office will soon issue naloxone kits to its detectives. District Attorney Janine Edwards said her office will request 20 doses of Narcan® from the Pennsylvania Department of Drug and Alcohol Programs.

Read more:
http://www.wayneindependent.com/article/20150126/NEWS/150129838/-1/news

South News

'Good Samaritan' Overdose Bill Clears Committee
Daily Press
January 26, 2015

Senate Bill 892 cleared the Virginia Senate Committee and will be sent to the Senate floor. The legislation would grant immunity for misdemeanor drug and alcohol offenses to people who report overdoses. It would also require reporters to cooperate with any subsequent investigation. Reporters would not be exempt from prosecution for felonies they may have committed, including drug dealing.

Read more:
http://www.dailypress.com/news/politics/dp-nws-ga-overdoses-20150126-story.html

Heroin Deaths Spike in County
Curtis Johnson, The Herald-Dispatch
January 23, 2015

Huntington, W.Va., authorities are concerned about a recent increase in suspected heroin overdoses, which may have led to nine deaths in January. Cabell County paramedics already recorded 41 drug overdoses in 2015.

Read more:
http://www.herald-dispatch.com/x984736947/Heroin-deaths-spike-in-county

Florida Doctors Learn How to Combat the Prescription Pill Epidemic
Kelly Baumgarten, WJHG
January 24, 2015

The Emerald Coast Medical Association's annual Winter Beach Retreat educated doctors on how to resolve the prescription drug abuse problem. Former head of the New York City Drug Enforcement Administration Bob Stutman said the most important thing doctors can do is ensure patients are taking their medication. Local doctors are looking to establish a program educating fellow physicians on appropriate prescribing and opioid monitoring. (Includes video: 2:31 minutes)

Read more:
http://www.wjhg.com/home/headlines/Florida-Doctors-Learn-How-To-Combat-the-Prescription-Pill-Epidemic-289690351.html

Midwest News

Kancare MCOs Gain Access to State's Drug Monitoring System
Andy Marso, Hays Post
January 28, 2015

The three insurance companies administering Kansas Medicaid (KanCare) now have direct access to the state's prescription drug monitoring program. Company officials told legislators this will enhance patient care by allowing them to quickly identify prescription drug abuse. The companies will get reports on how many opiate prescriptions consumers are getting, and from how many doctors.

Read more:
http://www.hayspost.com/2015/01/28/kancare-mcos-gain-access-to-states-drug-monitoring-system

Secretary McDonald Calls for Comprehensive Review of Medication Practices in Tomah
WEAU
January 26, 2015

In response to allegations of opiate overuse and retaliation against employees, Secretary of Veterans Affairs Robert A. McDonald called for a review of medication practices at the VA medical center in Tomah, Wis. A clinical team will report back in 30 days. The VA has temporarily reassigned the chief of staff to a position outside of the medical center.

Read more:
http://www.weau.com/home/headlines/Secretary-McDonald-calls-for-comprehensive-review-of-medication-practices-in-Tomah-289832361.html

Northeast Ohio Continues Heroin Battle in 2015
Matt Skrajner, The News-Herald
January 26, 2015

In 2015, Lake County, Ohio, will start using Vivitrol to treat opiate addiction. A new 16-bed facility in Painesville will house women with young children. The current women's facility will be repurposed into a men's facility, increasing the spots for men by 50 percent. The men's house will transition into a recovery house.

Read more:
http://www.news-herald.com/general-news/20150126/northeast-ohio-continues-heroin-battle-in-2015

County Heroin Deaths Up; $1M in Drugs Seized in 2014
Nathan Phelps, Press-Gazette Media
January 23, 2015

In Brown County, Wis., drug investigators seized more than $1.1 million worth of drugs last year. The death toll from heroin rose to 10 in 2014—up from six the year before.

Read more:
http://www.greenbaypressgazette.com/story/news/local/2015/01/23/county-heroin-deaths-drugs-seized-last-year/22214957/

West News

Price of Addiction: Oregon Explores New Painkiller Abuse-Deterrent Rules
Elizabeth Hayes, Portland Business Journal
January 26, 2015

Supported by a coalition of pain and addiction specialists, proposed Oregon legislation would require insurers to cover abuse-deterrent opioids as preferred drugs on their formulary and prohibit an increase in patient cost sharing.

Read more:
http://www.bizjournals.com/portland/blog/health-care-inc/2015/01/price-of-addiction-oregon-explores-new-painkiller.html

Lawmaker Seeks More Participation in State Prescription Database
Mackenzie Concepcion, Cronkite News
January 28, 2015

Senator Kelli Ward, who works in an emergency department, will focus on ways to encourage use of Arizona's prescription drug monitoring program without legislation. If improvements are not made, Sen. Ward will introduce a bill requiring prescribers to check the database.

Read more:
http://cronkitenewsonline.com/2015/01/lawmaker-seeks-more-participation-in-state-prescription-database-to-curb-opioid-abuse

Rx Safes Assigned Ticker Symbol, Ships First Orders of 2015
CNN
January 29, 2015

Rx Safes, Inc. shipped 500 Rx DrugSAFE prescription drug lock boxes to the Oklahoma Bureau of Narcotics and Drug Diversion. These fingerprint-secured steel lock boxes are designed to prevent unauthorized access to prescription medications. Oklahoma will distribute them to at-risk families.

Read more:
http://money.cnn.com/news/newsfeeds/articles/marketwire/1172032.htm

Accidental Deaths from Drug Use on the Rise in North Dakota
Archie Ingersoll, Inforum
January 28, 2015

North Dakota lacks a system counting fatal and nonfatal overdoses. Officials hope to create this system, using data from hospitals to track overdoses. In 2013, 32 North Dakotans died from an accidental overdose—up from 5 in 1999. State officials do not know if the deaths resulted from recreational use of heroin, prescription pain relievers, or other opiates. The state's human service centers have seen an increase in people seeking treatment for heroin and prescription pain reliever addictions.

Read more:
http://www.inforum.com/news/3666654-accidental-deaths-drug-use-rise-north-dakota

Charts: Colorado Among States with Growing Heroin, Prescription Drug Abuse Problem
Megan Arellano, Colorado Public Radio
January 28, 2015

Colorado's number of heroin overdose deaths increased from 42 in 1999 to 91 in 2012 to 118 in 2013. Several areas with high prescription drug overdoses also have growing rates of heroin overdose. Since 2008, the number of 18- to 24-year-old Coloradans using heroin has risen 27 percent.

Read more:
http://www.cpr.org/news/story/charts-colorado-among-states-growing-heroin-prescription-drug-abuse-problem

Report Shows Newborns Testing Positive for Drugs in Oklahoma
EnidNews.com
January 25, 2015

In Oklahoma, the number of newborns who tested positive for drugs or alcohol at birth rose 16.5 percent to 375. Ninety-six babies tested positive for prescription medications—nearly double the number in 2013.

Read more:
http://www.enidnews.com/news/report-shows-newborns-testing-positive-for-drugs-in-oklahoma/article_916f66aa-a4f9-11e4-a9d9-7fb13ee9160b.html

Other Resources

Warning: Take Only as Directed (Film)
Adventure Theatre Musical Theater Center
Accessed January 30, 2015

Adventure Theatre MTC launched a short film musical based on a personal tragedy that aims to reduce parent and teen prescription drug abuse. The film, WARNING: Take Only as Directed, is available to download for free on their website.

Read more:
http://www.warningshortfilm.com

Grant Announcements

Translational Avant-Garde Award for Development of Medication to Treat Substance Use Disorders
National Institutes of Health
Deadline: April 15, 2015

This award will support outstanding basic and/or clinical researchers with the vision and expertise to translate scientific discoveries into medications for substance use disorders stemming from tobacco, cannabis, cocaine, methamphetamine, heroin, or prescription opiate use.

Read more:
http://grants.nih.gov/grants/guide/rfa-files/RFA-DA-15-017.html

Prescription Monitoring Program Script Collection
Illinois Department of Human Services
Bid Date and Time: February 25, 2015, by 2 p.m.

Through this contract, prescription drug information will be collected from dispensers. The prescription drug monitoring program (PDMP) has used a vendor to collect these data since 2000, and intends to continue collection of more than 20,000,000 prescription records from retail pharmacies. The PDMP will also collect an estimated 20,000,000 prescription records dispensed to long-term care facilities.

Read more:
http://www.illinoisbids.com/bid-opportunities/2015/01/28/6094147-Prescription-
Monitoring-Program-Script-Collection.html


Comparison and Validation of Screening Tools for Substance Use Among Pregnant Women
Centers for Disease Control and Prevention
Deadline: February 24, 2015
http://www.grants.gov/web/grants/search-grants.html

Strategic Prevention Framework Partnerships for Success: State and Tribal Initiative
Substance Abuse and Mental Health Services Administration
Deadline: March 16, 2015
http://www.grants.gov/web/grants/search-grants.html

Drug-Free Communities Support Program
Substance Abuse and Mental Health Services Administration
Deadline: March 18, 2015
http://www.samhsa.gov/grants/grant-announcements/sp-15-001

Grants Received

$21.6 Million in Grant Money Awarded to Law Enforcement, Cities in Middle District of Alabama
Erin Edgemon, Alabama Media Group
January 26, 2015

The U.S. Department of Justice awarded a $21.6 million grant to Alabama agencies and cities in the Middle District of Alabama in 2014. This included a $400,000 award to the Department of Public Health to enhance prescription drug data collection.

Read more:
http://www.al.com/news/montgomery/index.ssf/2015/01/216_million_in_grant_money_awa.html

UAMS Researchers Get Grant to Study Opioid Dispensing
Arkansas Democrat-Gazette
January 26, 2015

The National Institute on Drug Abuse has awarded two University of Arkansas research scientists a 3-year, $538,781 grant to study the prescription and dispensation of opioid drugs.

Read more:
http://www.arkansasonline.com/news/2015/jan/26/uams-researchers-get-grant-study-opioid-dispensing

Take-Back Events and Drop Boxes

More than 500 Pounds of Prescription Drugs Collected at State Police Box in Frederick
Jeremy Arias, The Frederick News-Post (Maryland)
January 29, 2015
http://www.fredericknewspost.com/z/content_type/briefs/more-than-pounds-of-prescription-drugs-
collected-at-state-police/article_f5205656-fa9d-55bf-82fe-614d8ca7b791.html


Somerset Sheriff Reports Increase in Amounts Dropped Off During 2014 Drug Collection Programs
Kimberly Redmond, NJ Advance Media (New Jersey)
January 25, 2015
http://www.nj.com/somerset/index.ssf/2015/01/somerset_sheriff_reports_increase_in_amounts_dropp.html

Prescription Drug Drop Boxes Installed at Memorial Hospital
Beacon Health System (Indiana)
Accessed January 27, 2015
https://beaconhealthsystem.org/news/presciption-drug-drop-boxes-installed-at-memorial-hospital

Halton Police Encouraging Proper Disposal of Potentially Harmful Medicines
Tim Whitenell, Burlington Post (Ontario, Canada)
January 23, 2015
http://www.insidehalton.com/news-story/5272948-halton-police-encouraging-proper-disposal-of-potentially-harmful-medicines

Ellis Co. Law Enforcement Taking Over Regional Drug Take-Back Days
Kari Blurton, Hays Post (Kansas)
January 29, 2015
http://www.hayspost.com/2015/01/29/ellis-co-law-enforcement-taking-over-regional-drug-take-back-days

Newberg Prescription Drug Disposal Site
City of Newberg (Oregon)
Accessed January 26, 2015
http://www.newbergoregon.gov/operations/page/drug-take-back-program

Disposing of Prescription Meds Properly
Covington-Maple Valley Reporter (Washington)
January 25, 2015
http://www.maplevalleyreporter.com/news/289748641.html

Rx Safe Marin Adds Drug Take-Back Site in Novato
Renee Schiavone, Novato Patch (California)
January 29, 2015
http://patch.com/california/novato/rx-safe-marin-adds-drug-take-back-site-novato-0

Sheriff Station Restarts Drug Drop Off at Lost Hills Station
Malibu Surfside News (California)
January 26, 2015
http://www.malibusurfsidenews.com/police/sheriff-station-restarts-drug-drop-lost-hills-station

MedReturn Boxes Offer Residents Safe Medication Disposal
Sharon Kingston, The Sentinel (Pennsylvania)
January 27, 2015
http://cumberlink.com/news/health/what-s-the-buzz-medreturn-boxes-offer-residents-safe-medication/article_8e2c59b3-f7c9-5986-b4af-e9565a64b90e.html

Permanent Prescription Box Added
Shepherdstown Chronicle (West Virginia)
January 26, 2015
http://www.shepherdstownchronicle.com/page/content.detail/id/512506/Permanent-Prescription-Box-Added.html?nav=5091

Navajo County Installs 5 New Medicine Return Boxes
White Mountain Independent (Arizona)
January 27, 2015
http://www.wmicentral.com/news/latest_news/navajo-county-installs-new-medicine-return-boxes/article_43e6696e-a5ae-11e4-9175-fb9da15be3cd.html

Drop Your Prescriptions in This Box When You're Done with Them
John Wright, KLPZ (Arizona)
January 29, 2015
http://www.parkerliveonline.com/2015/01/29/drop-prescriptions-box-youre-done

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conferences
Drug Enforcement Administration, Office of Diversion Control
February 7–8, 2015: Las Vegas, Nev.
March 28–29, 2015: Birmingham, Ala.
May 30–31, 2015: Norfolk, Va.
June 27–28, 2015: Oklahoma City, Okla.
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness

2015 AATOD Conference—Address a Public Health Crisis: Opioid Dependence
American Association for Treatment of Opioid Dependence, Inc. (AATOD)
March 28–April 1, 2015
Atlanta, Georgia
http://www.aatod.org/national-conference/2015-aatod-conference-atlanta

National Rx Drug Abuse Summit
April 6–9, 2015
Atlanta, Georgia
http://nationalrxdrugabusesummit.org

48th Annual Communicating Nursing Research Conference—Equity and Access: Nursing Research, Practice, and Education
Western Institute of Nursing
April 22–25, 2015
Albuquerque, New Mexico
http://www.winursing.org/?query=2015+WIN+Conference
https://win.confex.com/win/2015/webprogram/ataglance.html

Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio
http://www.pharmacy.ohio-state.edu/outreach/generation-rx-university-conference

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
http://injurycenter.umich.edu/events/university-michigan-injury-center-prescription-drug-overdose-summit/mon-2015-11-09-0830
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.