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January 22, 2014


SAMHSA Prescription Drug Abuse Weekly Update
Issue 55  |  January 22, 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.

Preventing Prescription Drug Abuse Among Adolescents: The Role of Poison Control Centers
Children's Safety Network
Tuesday, February 4, 2014
2:00–3:00 p.m. EST

This Webinar will explore the local poison control center as a resource to prevent and treat drug overdoses among adolescent populations. It will also introduce participants to the work poison centers are undertaking to educate teens and their families about prescription drug misuse.

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Table of Content Featured Article Journal Articles and Reports News Other State and Local News Grant Announcement Grant Awards Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


Richard Saitz, Debbie M. Cheng, Donald Allensworth–Davies, Michael R. Winter, and Peter C. Smith. 2014. "The Ability of Single Screening Questions for Unhealthy Alcohol and Other Drug Use to Identify Substance Dependence in Primary Care." Journal of Studies on Alcohol and Drugs 75(1).

Researchers assessed single screening question (SSQ) accuracy for identifying dependence. In a cross-sectional study, 286 primary care patients were administered SSQs for alcohol and for other drugs, the Alcohol Use Disorders Identification Test–Consumption (AUDIT–C), the Drug Abuse Screening Test (DAST), and a diagnostic interview reference standard for dependence. For alcohol use, the participants were asked how many times in the past year they had consumed in a day five or more drinks (for men), or four or more drinks (for women). For other substance use, they were asked, "How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?" For each test, researchers calculated area under the receiver operating characteristic (ROC) curve and the ability to discriminate dependence at an optimal cutoff. The prevalence of alcohol and other drug dependence was 9 percent and 12 percent, respectively. Optimal cut points were eight or more times for the alcohol SSQ, a score of three or more for AUDIT–C, three or more times for the other drug SSQ, and a score of four or more for the DAST. The areas under the ROC curve ranged from 0.87 to 0.96. Sensitivity, specificity, and positive and negative likelihood ratios at optimal cut points for the alcohol SSQs were 88 percent, 84 percent, 5.6 percent, and 0.1 percent, respectively; for the other drug SSQs were 97 percent, 79 percent, 4.6 percent, 0.04 percent, respectively; for the AUDIT–C were 92 percent, 71 percent, 3.2 percent, and 0.1 percent, respectively; and for the DAST were 100 percent, 84 percent, 6.3 percent, and 0, respectively. Alcohol SSQ and AUDIT–C positive likelihood ratio 95 percent confidence intervals did not overlap.

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Catherine Q. Howe and Mark D. Sullivan. 2014. "The Missing 'P' in Pain Management: How the Current Opioid Epidemic Highlights the Need for Psychiatric Services in Chronic Pain Care." General Hospital Psychiatry 36(1):99–104.

Researchers reviewed epidemiological and clinical data that point to the important roles psychiatric disorders have in the use and abuse of opioids in patients with chronic pain. They conducted literature searches on PubMed with the key phrases "chronic pain" and "opioid therapy" and selected articles on epidemiology of comorbidity between chronic pain and psychiatric disorders, trends in long-term opioid therapy, and clinical trials that involved using opioid therapy for chronic pain or for mental health disorders. They reviewed the bibliography of all relevant articles to identify additional papers to review. Chronic pain is highly comorbid with common psychiatric disorders. Patients with mental health and substance abuse disorders are more likely to receive long-term opioid therapy for chronic pain and more likely to have adverse outcomes from this therapy. Although opioids may exert brief antidepressant and anxiolytic effects in some patients with depression or anxiety, there is scant evidence for long-term benefit from opioid treatment of psychiatric disorders.

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Journal Articles and Reports

Ethan O. Bryson. 2014. "Substance Abuse Recognition and Prevention Through Education." Comprehensive Guide to Education in Anesthesia, 229–41.

The specter of addiction still remains a major issue in the anesthesia workplace. Each year between 1 percent and 2 percent of anesthesia care providers (ACPs) become addicted to the anesthetic agents they are tasked with administering to patients. Reports suggest that 10 percent to 15 percent of ACPs will abuse drugs or alcohol at some point in their career. Education regarding identification and effective treatment of the drug-impaired ACP is an essential part of the effort to reduce these numbers.

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Mance E. Buttram, Steven P. Kurtz, Hilary L. Surratt, and Maria A. Levi–Minzi. 2014. "Health and Social Problems Associated With Prescription Opioid Misuse Among a Diverse Sample of Substance-Using MSM." Substance Use and Misuse 49(3):277–84, doi: 10.3109/10826084.2013.828754.

This study described correlations between prescription opioid misuse and demographics, substance use, sexual behavior, and related health and social problems in a sample of substance-abusing men who have high-risk sex with men. The study analyzed baseline data collected in 2008–10 from 515 men ages 18–55 who entered a risk reduction trial in the Miami–Fort Lauderdale metropolitan area. All participants reported unprotected anal intercourse with a nonmonogamous partner in the past 90 days and met one or more of three substance use inclusion criteria: binge drinking, heavy marijuana use, or other drug misuse/abuse. Prescription opioid misuse was positively associated with other substance use, drug injection, substance dependence, and history of arrest.

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Robert G. Carlson, Ramzi W. Nahhas, Raminta Daniulaityte, Silvia S. Martins, Linna Li, and Russel Falck. 2014. "Latent Class Analysis of Nonopioid-Dependent Illegal Pharmaceutical Opioid Users in Ohio." Drug and Alcohol Dependence 134:259–66, doi: 10.1016/j.drugalcdep.2013.10.004.

Researchers characterized heterogeneity in opioid use patterns among a community-based sample of 18- to 23-year-olds who use nonmedical pharmaceutical opioids, yet are not opioid dependent. Respondent-driven sampling recruited 390 participants. Latent class analysis stratified by racial/ethnic group identified subgroups of nonmedical opioid users based on six-month frequency of use, number of opioid disorder criteria, oral versus non-oral administration, number of types of opioids used, use of CNS depressants while using opioids, and reason for opioid use. Multinomial logistic regression estimated the significance of covariates in predicting class membership. Within both white and nonwhite groups, three classes emerged that were, generally, hierarchically ordered with respect to negative characteristics associated with nonmedical opioid use. The class with the least negative characteristics had the highest proportion of individuals who use opioids only to self-medicate a health problem. The group with a larger proportion who had ≥2 opioid abuse and dependence disorder criteria also were more likely to use opioids ≥3 days per week and use CNS depressants while under the influence of opioids, but were less likely to use opioids only to self-medicate.

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George Christopher Dertadian and Lisa Maher. 2014. "From Oxycodone to Heroin: Two Cases of Transitioning Opioid Use in Young Australians." Drug and Alcohol Review 33(1):102–4. doi: 10.1111/dar.12093.

This brief report presented two cases of transitions from recreational or nonmedical pharmaceutical opioid use to intravenous heroin use by young adults in Australia. Although this study was not designed to assess whether recreational oxycodone use is causally linked to transitions to intravenous use, polyopioid use places individuals at high risk for progression to heroin and injecting. In the first case, Jake used a range of analgesics before he transitioned to intravenous use, and the first drug he injected was methadone. In the second case, Emma engaged in a broad spectrum of polydrug use involving a range of opioid preparations as well as benzodiazepines, cannabis, and alcohol. Both cases transitioned from oral to intravenous pharmaceutical opioid use and subsequent intravenous heroin use. These cases represented the first documented reports of transitions from the nonmedical or recreational use of oxycodone to intravenous heroin use in Australia.

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Arif Duran, Osman Yıldırım, Tarık Ocak, and Ümit Y. Tekelioğlu. 2014. "Respiratory Arrest Caused by Abuse of Fentanyl Patch: A Case Report." National Journal of Physiology, Pharmacy and Pharmacology 4(1):89–91, doi: 10.5455/njppp.2013.3.23513.

Transdermal fentanyl patch has been increasingly used recently for the management of chronic pain. Used as prescribed, the transdermal route is considered safe, since the plasma concentration of fentanyl is maintained at a steady and efficacious level. If misused, transdermal fentanyl patch may produce respiratory arrest as all other opioids do. Researchers described a woman with meperidine dependence who developed respiratory arrest after cutaneous application of four transdermal fentanyl patches.

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Huijun Han, Philip H. Kass, Barth L. Wilsey, and Chin–Shang Li. 2014. "Increasing Trends in Schedule 2 Opioid Use and Doctor Shopping During 1999–2007 in California." Pharmacoepidemiology and Drug Safety 23(1):26–35, doi: 10.1002/pds.3496.

Using data from the California Prescription Drug Monitoring Program, researchers examined age and gender-specific trends of Schedule 2 opioid use during calendar years 1999–2007. Specifically, they analyzed the following: 1) the prevalence of Schedule 2 opioid users among California's population and 2) the proportion of these opioid users who were doctor shoppers (defined as an individual who used more than five different prescribers for all Schedule 2 opioids he or she obtained in a calendar year). Among all age and gender groups, the prevalence of Schedule 2 opioid users in California increased by at least 150 percent and up to 280 percent and the prevalence of doctor shoppers among users increased by at least 111 and up to 213 percent over nine years. The prevalence of opioid users was lowest among 18- to 44-year-old men (1.25 percent) and highest among 65-year-old and older women (5.31 percent) by 2007. The prevalence of doctor shoppers was approximately 1.4 percent among those up to age 64 years and 0.5 percent among those 65 years and older. The gender difference in doctor shoppers among all age groups was negligible. On average, the cumulative morphine-equivalent amount of Schedule 2 opioid per individual obtained per year was threefold to sixfold higher for doctor shoppers than for the general population across different age and gender groups.

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S.A. Handley and R.J. Flanagan. 2014. "Drugs and Other Chemicals Involved in Fatal Poisoning in England and Wales During 2000–2011." Clinical Toxicology 52(1):1–12,

Researchers searched mortality statistics—injury and poisoning, Series DH4 (2000–2005), mortality statistics—for deaths registered in England and Wales, Series DR (2006–11), and the Office for National Statistics drug poisoning database for information on fatal poisoning during 2000–2011. They also searched the PubMed database for "fatal" and "poisoning" and "England" and "Wales." This search yielded seven papers that gave relevant information on deaths reported during 2000–2011 that were not superseded by later publications. The annual number of deaths from poisoning fell from 3,092 in 2000 to 2,749 in 2010, before increasing to 3,341 in 2011. This increase was due in part to a change in the ICD coding relating to alcohol poisoning, suggesting that such deaths had been underrecorded previously. Although fatalities from dextropropoxyphene declined (287 in 2004 and 18 in 2011) following the withdrawal of co-proxamol (paracetamol [acetaminophen] and dextropropoxyphene [propoxyphene] mixture) during 2005–07, deaths involving codeine and most notably tramadol (836 deaths during 2000–2011) increased. Deaths from paracetamol poisoning either alone or with alcohol reached 89 in 2011, the lowest annual figure since 1974. However, there really has been no marked downward trend since 1999 despite reductions in pack size, continued publicity as to the dangers of paracetamol overdose, and improved liver failure treatment, including transplantation. The annual number of deaths from antidepressants remained relatively stable (median: 397, range: 335–469). Although the number of deaths from dosulepin [dothiepin] decreased (186 in 2000 and 49 in 2011), the number of deaths involving selective serotonin reuptake inhibitors increased (from 50 in 2000 to 127 in 2011). Although annual numbers of deaths involving diamorphine/ morphine (88 percent unintentional) declined, deaths involving methadone (89 percent unintentional) increased and the annual number of deaths from these drugs showed little change (2000: 1,061, 2011: 995). Deaths involving amphetamine/methamphetamine remained relatively constant at about 50 annually. During 2008–11, cocaine-related deaths fell by 48 percent, deaths involving MDMA and related compounds fell by 69 percent, and deaths involving "legal highs," notably γ-hydroxybutrate/γ-butyrolactone and ketamine, increased.

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L. Hewlett, and D.P. Wermeling. 2013. "Survey of Naloxone Legal Status in Opioid Overdose Prevention and Treatment." Journal of Opioid Management 9(5):369–77. doi: 10.5055/jom.2013.0179.

Researchers surveyed the federal and state-by-state legal status for prescribing, dispensing, and administering naloxone injection. The survey analyzed current and proposed laws regarding naloxone's role in opioid overdose prevention and treatment. Aspects of the legislation studied included Food and Drug Administration regulatory status, prescriber authorization, prescription requirements, defining the patient, authority to administer naloxone, status of lay person administration, and provisions for Good Samaritan protections from criminal and civil liability. To date, 10 states have legislation implementing opioid overdose prevention programs including naloxone. Several states with high opioid overdose burdens are in the legislative process. Reasons for hesitation to initiate such programs include fear of liability, a proxy endorsement for drug abuse, and apprehension of increasing drug usage.

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R. Jacobson. 2014. "Bitter Medicine." Scientific American Mind 25:15, doi:10.1038/scientificamericanmind0114–15.

This article discussed steps taken at various levels to curb prescription opioid addiction and overdose in the United States. It also provided experts' recommendations for future intervention.

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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.

Researchers used a prospective survey to examine the prevalence of adolescent smoking status, substance 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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Diana Raketić, Branka Stamatović Gajić, Tomislav Gajic, and Mirjana Jovanović. 2013. "Women and Addiction (Alcohol and Opiates): Comparative Analysis of Psychosocial Aspects." Srpski Arhiv za Celokupno Lekarstvo 141(9–10):648–52.

This Serbian study aimed to assess and compare psychosocial aspects, including sociodemographic characteristics as well as specific aspects of functioning of family and interpersonal relationships of women ages 19–45 and addicted to opiates versus alcohol. There were two substance addict groups (32 and 30 treatment center patients addicted to drugs and alcohol, respectively) and a convenience sample "control group" of 30 subjects with no substance addiction. A sociodemographic data questionnaire and semistructured Addiction Severity Index interview were used. Statistically significant differences between the groups included mean age (opiate abusers youngest, alcohol abusers oldest), family history of addiction disorders (positively correlated), education (abusers less likely to be college graduates), and employment work status (opiate abusers much less likely to be employed). Observed differences in marital status and child-bearing may have resulted from the cohort age differences. The subjects addicted to opiates differed significantly with respect to manifestation of aggressive, delinquent behavior, infectious diseases, and presence of addicts-partnerships, but there were no significant differences related to physical abuse, sexual abuse, or self-assessment of depression.

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Ana Sarasa–Renedo, Albert Espelt, Cinta Folch, Carmen Vecino, Xavier Majó, Yolanda Castellano, Jordi Casabona, M. Teresa Brugal, and Redan Study Group. 2014. "Overdose Prevention in Injecting Opioid Users: The Role of Substance Abuse Treatment and Training Programs." Gaceta Sanitaria, doi:10.1016/j.gaceta.2013.10.012.

This study identified factors associated with limited knowledge of overdose prevention and assessed the possible effect of treatment and training programs on overdose prevention. From October 2008 to March 2009, current injecting opioid users attending harm reduction centers in Catalonia, Spain, were interviewed. Crude and adjusted prevalence ratios of limited knowledge about overdose prevention were calculated by adjusting Poisson regression models with a robust variance. Among the sample of opioid users, 28.7 percent had limited knowledge of overdose prevention. Factors associated with limited knowledge were country of origin, never having received treatment for drug dependency, having a low educational level, and never having experienced an overdose. In contrast, treatment at the time of the interview was not associated with a lower prevalence of limited knowledge about overdose prevention.

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Hanna Uosukaine, Jenni Ilomäki, Jussi Kauhanen, Ulrich Tacke, Jaana Föhr, Jari Tiihonen, and J. Simon Bell. 2014. "Factors Associated With Buprenorphine Compared With Amphetamine Abuse Among Clients Seeking Treatment in Finland." Journal of Substance Abuse Treatment, doi: (10.1016/j.jsat.2014.01.004).

This study compared social, health, and treatment-related factors associated with buprenorphine and amphetamine abuse in Finland. Structured clinical interviews were conducted with clients seeking treatment for buprenorphine (n=670) or amphetamine (n=557) abuse in Helsinki from January 2001 to August 2008. In multivariate analyses, buprenorphine abuse was associated with male gender (OR 1.57, 95 percent CI 1.17–2.09), daily abuse (OR 5.45, 95 percent CI 4.14–7.18), no drug-free months during the last year (OR 1.68, 95 percent CI 1.23–2.29), and inversely associated with increasing age (OR 0.95, 95 percent CI 0.93–0.97 per year) and psychotic symptoms (OR 0.33, 95 percent CI 0.24–0.45). Despite more intense abuse patterns, clients seeking treatment for buprenorphine abuse shared similar characteristics with amphetamine clients. These characteristics were different from characteristics of those who abuse prescription opioids in North America.

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Kate Walsh, Heidi S. Resnick, Carla Kmett Danielson, Jenna L. McCauley, Benjamin Edward Saunders, and Dean G. Kilpatrick. 2014. "Patterns of Drug and Alcohol Use Associated With Lifetime Sexual Revictimization and Current Posttraumatic Stress Disorder Among Three National Samples of Adolescent, College, and Household-Residing Women." Addictive Behaviors 39(3):684–89.

This study examined associations between sexual revictimization, posttraumatic stress disorder (PTSD), and past-year substance use by using three national female samples (adolescent participants from the 2005 National Survey of Adolescents-Replication, and college and household-residing participants from the 2006 National Women's Study-Replication). Participants were 1,763 adolescent girls, 2,000 college women, and 3,001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and nonmedical prescription drugs were assessed through structured telephone interviews of U.S. households and colleges in 2005–6. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and nonvictims: revictimized adolescents and household-residing women reported more other illicit and nonmedical prescription drug use, while revictimized college women reported more other illicit drug use. Past six-month PTSD was associated with increased odds of drug use for adolescents, nonmedical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms.

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Prescription Drug Abuse Cited as a Growing School Problem
CBC News
January 16, 2014

The School Climate Survey found that almost 10 percent of students in high school in Newfoundland and Labrador have abused prescription drugs. The education department survey covered students in second to fifth grades, junior high, and high school for the 2012–13 school year. It asked questions categorized by school safety, expectations, bullying, drugs and alcohol, and student satisfaction. Nathan Whalen, president of the Newfoundland and Labrador Federation of School Councils, said the research found students do not believe the educators are taking the problem seriously enough. He called on the education system to do more to address the problems.

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The Battle Over Oregon's Prescription Drug Monitoring Program
Oregon Public Broadcasting
January 13, 2014

This article and audio discussed the state of Oregon and the American Civil Liberties Union (ACLU) upcoming hearing in U.S. District Court against the DEA. In January 2012, the DEA attempted to subpoena records from Oregon's Prescription Drug Monitoring Program as part of an agency investigation. The state denied the DEA access because it needed a warrant to obtain the records from the program. Subsequently, a U.S. Circuit Court Magistrate found that federal law trumped state law in this case and ordered the state to turn over the records. The DEA subpoenaed additional records. The state of Oregon and the ACLU filed a suit that contends that without a warrant from the DEA turning over personal records would not only violate state law, but also privacy protections guaranteed by the Fourth Amendment.

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Learn More About RxArmory and Prescription Drug Abuse
ABC 15
January 17, 2014

This article and video (3 minutes 49 seconds) discussed the RxArmory, a medicine cabinet safe that is used to prevent prescription drug abuse. It requires no tools for installation and fits into most medicine cabinets, vanities, or storage cabinets. RxArmory adheres to cabinet surfaces with two included strips of industrial grade adhesive. It features a heavy duty mechanical cam lock with a four-digit combination and solid brass key.

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Prescription Drug Abuse Continues to Climb, Especially Usage of Painkillers
Chicago Tribune
January 15, 2014

Larry Myers, Vice President–Marketing and Editorial Content for What Doctors Know magazine, defined general terms used when discussing prescription drug abuse. He explained what opioids are and why prescription drug abuse has increased in the United States. He discussed treatment options and the signs of addiction to pain relievers.

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Fifty Qantas and Virgin Airline and Alcohol Drug Testing
Daily Telegraph
January 13, 2014

In Australia, random alcohol and drug tests by the Civil Aviation Safety Authority recorded seven positives for alcohol and two for drugs out of 11,252 samples during the 2012–13 year. Airlines also conducted pre-employment, random, and for-cause tests focused on safety-sensitive positions. Almost 50 airline tests by Qantas and Virgin were positive for drugs or alcohol between March 2012 and February 2013. A few of these positive readings were reversed on medical review. Qantas tests revealed 20 positives for drugs and a further 16 for alcohol. (The airline employs 35,000 people). The employment of three workers caught by the tests was terminated and three resigned. Eleven Virgin tests were positive—seven for alcohol and four for drugs—with nine employees losing their jobs and one resigning. None of the airline's pilots tested positive. No positive results were recorded by Jetstar. Those tested included pilots, cabin crew, engineers, refuellers, pit crew, and baggage handlers with access to aircraft. Last year a survey of more than 300 pilot members of the Australian and International Pilots' Association revealed a culture of heavy drinking. One in seven respondents was at risk of significant life problems because of excessive alcohol consumption, although only eight pilots (about 2.5 percent) scored above the cut-off for alcohol dependence. The report compiled by former Alcohol and Other Drugs Council of Australia chief executive Dr. Donna Bull found that three fourths of responding international pilots reported drinking at hazardous levels. Forty percent admitted to imbibing six or more drinks in a single occasion at least once a month.

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The Jed Foundation Announces New Partnership With the Clinton Foundation to Support Health and Safety of College Students
Digital Journal
January 14, 2014

During the Health Matters Conference, the Jed Foundation and the Clinton Health Matters Initiative (CHMI) announced a joint program, the Jed and Clinton Foundation Health Matters Campus Program, to help colleges and universities create healthier and safer campus environments. The program is designed to help colleges and universities promote emotional wellbeing and mental health programming, reduce substance abuse, and prevent suicide among 18- to 26-year-olds. Participating schools take a confidential, online self-assessment about their current mental health, suicide prevention, and substance abuse programming. Upon completion, the school's responses are compared to recommended practices developed by national experts in college mental health and substance abuse prevention. Then, the Jed Foundation and CHMI provide a confidential feedback report and phone consultation with recommendations for enhancement. Schools are recognized with a Jed and Clinton Foundation Health Matters Campus Program seal. The seal represents a school's commitment to student mental health and substance abuse prevention and showcases that the school employs a comprehensive, campus-wide approach to mental health, substance abuse, and suicide prevention programming. MtvU's Half of Us campaign and Facebook also announced partnerships with the Jed Foundation and the Clinton Foundation to help prevent prescription drug misuse among college students and to help college students identify potential warning signs that a friend is in emotional distress and may need help.

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Every Pill Has Two Sides: What You Need to Know About Adderall and Oxycontin Abuse
Music Television (MTV)
January 14, 2014
This article and three videos discussed prescription drug abuse, specifically Adderall and Oxycontin. Interviews were conducted with college students who shared their personal stories about prescription drug abuse. In addition, MTV spoke to Dr. Victor Schwartz of the Jed Foundation about the proper use of prescription drugs, and the specific dangers that can come from improper use. Dr. Schwartz also talked about what constitutes abuse, what the warning signs are, and how to get help or help a friend who might be struggling.

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Withdrawal Ease Launches in Canada and Australia
Digital Journal
January 13, 2014

Withdrawal Ease announced its launch into Canada and Australia. The nutritional supplement system was designed specifically for opiate/pain reliever withdrawal symptoms. Each system includes two formulations containing a proprietary blend of 16 vitamins, herbs, and amino acids to help reduce the acuity of opiate withdrawal symptoms. The manufacturer hopes sales will launch in United Kingdom, Europe, and South America later in 2014. No evidence of effectiveness was presented for this unregulated product.

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Why Is Heroin Abuse Rising While Other Drug Abuse Is Falling?
January 14, 2014

This article discusses why the drop in nonmedical prescription opiate abuse overlapped with an increase in heroin abuse. It explains that illegally obtained prescription pain relievers have become more expensive and harder to get, while the price and difficulty in obtaining heroin have decreased. An 80 mg Oxycontin costs $60 to $100 on the street. Heroin costs about $9 a dose. Also, laws cracking down on non-medical prescription pain relievers have played a role. Many cities are reporting that previous non-medical abusers of prescription pain relievers have turned to heroin as a cheaper alternative.

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Commentary: Interstate PMP Data-Sharing Technologies Assist States, Health Care Providers in Protecting Patient Health
The Partnership at Drugfree.org
January 15, 2014

Carmen A. Catizone, Executive Director/Secretary for the National Association of Boards of Pharmacy, discussed how its prescription monitoring program (PMP), InterConnect Program, is helping states to protect patient health and lower rates of prescription drug abuse and diversion. Currently, 21 states are sharing data. This commentary shared some of the successes and the challenges.

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New Generation Rx Online Game Teaches Teens About Prescription Drug Abuse
PR Newswire
January 15, 2014

Cardinal Health Foundation launched online video games under the Generation Rx Initiative to promote learning about prescription drug misuse and abuse. The game "Trauma" targets students from middle school to college. They will learn how the abuse of prescription medications played a role in a car crash involving two high school students. The game is free to play and takes 15 to 20 minutes to complete.

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Other State and Local News

New Colorado Campaign Targets Teen Prescription Drug Abuse
Denver Post
January 14, 2014

Colorado will soon unveil the "Rise Above Colorado" campaign to address teens abusing prescription drugs. It will include educational programs and outreach efforts. Colorado has the second worst rate of pain pill abuse in the United States. Colorado youths reported in a survey that prescription medications are easier to get than beer; and more than 29 percent of Colorado 12th graders admitted to taking prescription medication without a doctor's prescription.

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Whether Heroin or Prescription Drugs, Fatal Overdoses in Maine "A Waste of Life," Says Attorney General
Bangor Daily News
January 15, 2014

This article and video (1:14 minutes) discussed figures on drug-induced deaths released by Maine's attorney general and chief medical examiner and other prescription drug abuse statistics. Heroin overdoses increased from seven in 2011 to 28 in 2012. In all, drug overdoses killed 163 people in 2012 and 2,110 people between 1997 and 2012. In 2013, there were 927 drug-addicted babies, more than twice the number in 2009, an increase from 165 in 2005. Fatal overdoses decreased to 168 in 2010 and again to 156 in 2011, but increased to 163 during 2012. The deadliest drugs in 2012 were oxycodone, responsible for 29 percent of fatal overdoses; benzodiazepines at 24 percent; and methadone at 20 percent, according to an April 2013 Substance Abuse Trends report. Of the 163 overdose deaths in 2012, 101 involved pharmaceutical opioids.

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Florida Drug Database Changes on Life Support
Daytona Beach News–Journal
January 14, 2014

Florida Senate Health Policy Chairman Aaron Bean pulled from his committee's agenda a measure (SB 7016) that would make it harder for investigators to access the state prescription drug database. Under the proposed measure, investigators would have to get subpoenas to access records stored. Atty. Gen. Pam Bondi, other prosecutors, and law enforcement officials object to the changes. They believe requiring judges to sign off on the records requests would slow down the process of cracking down on prescription drug-related crimes.

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Duluth School Board Weighs Random Drug Testing
Duluth News Tribune
January 15, 2014

The Duluth (Minn.) School District presented its findings on random drug testing of students to the School Board's education committee. The district would drug test students involved in co-curricular activities, those who register to park in a high school lot, and those who are members of the "Pledge Makers." If approved, students and one parent must give consent for drug testing when signing up for any of these. The tests would check for drugs including methamphetamine, barbiturates, cocaine, codeine, morphine, alcohol, steroids, marijuana, and benzodiazepines. The district would follow its student conduct code and that of the Minnesota State High School League for consequences. Students and parents would have a chance to explain a reason for a positive result, such as a prescription, to a medical review officer. If the board approves moving forward, the district would fully develop a policy this year. It would start in the 2015-16 school year, making Duluth the first school district in the state to randomly test students for drugs.

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Group Takes Another Swipe at Painkiller OD Crisis
Gaston Gazette
January 12, 2014

Two years ago, the Chronic Pain Initiative in Gaston County, N.C., organized to optimize treatment of chronic pain while trying to prevent substance abuse. The goal of the collaboration never came to fruition and the group disbanded. Recently, officials gathered to reenergize the coalition with the help of Project Lazarus and funding from the Kate B. Reynolds Trust and the North Carolina Office of Rural Health. In 2010, Gaston County ranked third among counties with the most unintentional and undetermined overdose deaths in the state, with 45 overdose deaths.

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Juneau Drugs by the Numbers
January 16, 2014

The Juneau Police Department reported that the amount of heroin seized last year decreased, but seizures of Oxycontin and other prescription medicines increased, according to the Alaska Department of Public Safety. The report compared the numbers of drugs seized in 2013 with the previous two years. It showed that 970 Oxycodone pills worth more than $156,000 were confiscated, compared to 275 pills in 2012. Methamphetamine seizures nearly doubled. Police are seeing an increase in Oxycodone from Canada, but the main sources for all illegal drugs in Juneau are California, Oregon, and Washington state. Most narcotics come into Juneau by air and the United States Postal Service. Juneau police opened 137 narcotics cases in 2013, and 41 defendants were charged with 65 crimes.

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Heroin Deaths Surge at the Jersey Shore
NBC News
January 13, 2014

Ocean County, N.J., has the highest deaths from heroin and prescription drug overdose in the state per capita. Such deaths more than doubled in 2013 with 112. In 2012, 53 people died of heroin and prescription drug overdoses in Ocean County. Ocean County also has the highest number of heroin-related emergency room admissions. Of all New Jersey heroin-related admissions, 11 percent in 2011 and 11.4 percent in 2012 occurred in Ocean County. Ocean County prosecutors have distributed warning cards to funeral homes to get families to dispose of unused prescription medications that may be left behind by the deceased.

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In Bucolic Vermont, Rising Problem of Painkiller and Heroin Abuse Stirs a Battle Cry
Star Tribune
January 15, 2014

This article discusses prescription drug abuse and heroin use in Vermont. The state ranks among the top 10 states for the abuse of pain relievers and illicit drug use other than marijuana for people ages 18 to 25. It ranks second in the country for the rate of people being treated for opiate abuse. Last year, the number of heroin overdose deaths almost doubled from 9 to 17. Five times as many suspected heroin dealers were indicted in 2013 as in 2010.

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Police Undergo Training to Identify Drug-Impaired Drivers
January 15, 2014

The Pennsylvania DUI Association, the Center County Alcohol Task Force, and the Center County District Attorney's Office hosted Advanced Roadside Impaired Driving Enforcement training in response to an increase in drivers operating a vehicle while under the influence of legal and illegal drugs. The goal is to put officers in a position to prevent DUI–related crashes, injuries, and fatalities. Pennsylvania's drunk driving law includes all drugs, from prescription drugs to inhalants.

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Plan Aims to Control Illegal Use of Prescribed Medications
Stillwater NewsPress
January 10, 2014

The Stillwater (Okla.) Police Department has created a database to record the names of any individual who reports the loss or theft of a prescription drug. The department will require the individual to take a polygraph test before the department will accept any subsequent report of a lost or stolen prescription drug. So they can complete their police report, officers responding to a report of lost or stolen prescriptions will ask the reporting parties to provide the names of their physicians. Police will contact the physicians to ensure they are aware a police report has been requested, and determine if the physician knows of previous prescription drug abuse or suspicions regarding the reporting party.

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OS Drafts First Random Drug Testing Policy for Two Schools
January 16, 2014

Ocean Springs School District in Mississippi is working on a drug testing policy that would affect Ocean Springs High School and the middle school. They will be testing for prescription and non-prescription drugs. Administrators will use a urine sample test on students who participate in extracurricular activities, take driver's education classes, or drive and park on campus. Students who initially test positive would have to undergo a follow-up test. If it is positive again, those students would be suspended from participation in extracurricular programs. To return to those activities, they will have to complete drug counseling or an education program at their parents' expense and another drug test must come back clean. The school board is expected to vote on the random drug testing in March. If it passes, it would start in the 2014–15 school year.

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Painkiller Abuse on the Rise in the Chattahoochee Valley
January 13, 2014

This article and video (2 minutes 40 minutes) discussed the rise in prescription drug abuse in Chattahoochee Valley, Ga., and a new outpatient treatment program for individuals battling prescription pain pill addiction and opiate addiction.

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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.

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

Grant Awards

Towns Partner to Address Opiates
Wakefield Observer
January 12, 2014

The Mystic Valley Public Health Coalition represents six health departments from the Massachusetts towns of Malden, Medford, Melrose, Reading, Stoneham, and Wakefield that have worked together for nine years. In 2013, the coalition was awarded a Massachusetts Opioid Abuse Prevention Collaborative grant. The purpose of the grant is to implement local policy, practice, systems, and ecological change to prevent opioid misuse/abuse; prevent/reduce unintentional opiate-related deaths and nonfatal hospital events; and increase both the number and capacity of municipalities across the state. The coalition is in the process of conducting a needs assessment of local conditions and building capacity. It will also develop a plan to address this issue and implement strategies. It will evaluate its progress and ensure that projects are sustainable and culturally competent.

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Drive-Thru Medicine Drop-Off Planned in Basking Ridge, N.J.
Bernardsville News
January 13, 2014

Department of Drug and Alcohol Programs Launches Interactive Map Showing Healthy Pennsylvania Drug Take-Back Box Locations
Digital Journal
January 13, 2014

Prescription Drug Drop Box Now Available in Todd County, Minn.
Osakis Review
January 15, 2014

Greensburg, Pa., Police Offer Community Alerts, Drug Disposal Bins
Trib Total Media
January 16, 2014


Towns Partner to Address Opiates
Wakefield Observer
January 12, 2014

The Mystic Valley Public Health Coalition represents six health departments from the Massachusetts towns of Malden, Medford, Melrose, Reading, Stoneham, and Wakefield that have worked together for nine years. In 2013, the coalition was awarded a Massachusetts Opioid Abuse Prevention Collaborative grant. The purpose of the grant is to implement local policy, practice, systems, and ecological change to prevent opioid misuse/abuse; prevent/reduce unintentional opiate-related deaths and nonfatal hospital events; and increase both the number and capacity of municipalities across the state. The coalition is in the process of conducting a needs assessment of local conditions and building capacity. It will also develop a plan to address this issue and implement strategies. It will evaluate its progress and ensure that projects are sustainable and culturally competent.

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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.