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January 29, 2015


SAMHSA Prescription Drug Abuse Weekly Update
Issue 107  |  January 29, 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 Webinar Archive Video Grant Announcements Grants Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


FDA Eyes Drug Risks for Drivers
Go By Truck News
January 20, 2015

The Food and Drug Administration released draft guidance to help drug manufacturers assess the risks of psychoactive medications for drivers. This guidance suggests a systematic approach for manufacturers to use in assessing such risks.

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Rules Expand Options for Getting Rid of Unwanted Meds
John Hogan, WZZM
January 22, 2015

The Drug Enforcement Administration ended its National Drug Take-Back program last year, when rules changed allowing pharmacies to take back prescription drugs. But several national drug store chains are not accepting tightly controlled narcotics, and independent stores such as Kay Pharmacy in Grand Rapids, Mich., also balked, saying the return of Schedule II narcotics involved too much red tape. Some police departments provide permanent drop boxes for all types of prescription drugs. (Includes video: 2:01 minutes)

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Prescription Drug Abuse Epidemic Costing TN Taxpayers
Becca Habeggar, WBIR
January 22, 2015

On average, every taxpayer dollar spent on prescription drug abuse prevention programs in Tennessee saves taxpayers more than four times as much in future costs, according to a report produced by anti-drug advocates. In some counties, cost savings is even higher. Roane County's ratio, for example, is 14 to 1. Researchers—anti-drug advocates and an economist in East Tennessee—will present the report at a conference in Washington, D.C. (Includes video: 2:51 minutes)

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Journal Articles and Reports

E.C. Ailes, A.L. Dawson, J.N. Lind, S.M. Gilboa, M.T. Frey, C.S. Broussard, and M.A. Honein. 2015. "Opioid Prescription Claims Among Women of Reproductive Age—United States, 2008–2012." Morbidity and Mortality Weekly Report 64(02):37–41.

Analyses of 2008–12 MarketScan Commercial Claims and Encounters and Medicaid data showed opioid prescription claims were consistently higher among Medicaid-enrolled women ages 15–44 compared with privately insured women (39.4 percent versus 27.7 percent). The most frequently prescribed opioids to women in both groups were hydrocodone, codeine, and oxycodone.

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R.A. Breslow, C. Dong, and A. White. 2015. "Prevalence of Alcohol-Interactive Prescription Medication Use Among Current Drinkers: United States, 1999 to 2010." Alcoholism: Clinical and Experimental Research, doi:10.1111/acer.12633.

The authors pooled and analyzed 1999–2010 National Health and Nutrition Examination Survey data on past-year alcohol consumption and past-month prescription medication use. Controlling for age, race/ethnicity, education, marital status, and smoking, among those using alcohol-interactive prescription medication in the past month, 41.5 percent of survey respondents who were current-year drinkers took alcohol-interactive drugs. Of respondents age 65 and older, 78.6 percent used alcohol-interactive medications. Adjusting for demographic and smoking factors, 77.8 percent of current-year drinkers took alcohol-interactive medications. The alcohol-interactive medications most commonly used by current-year drinkers were cardiovascular agents, central nervous system agents, and metabolic agents.

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K. Devarakonda, K. Kostenbader, Y. Zheng, J.B. Montgomery, T. Barrett, J.L. Young, and L.R. Webster. 2015. "Human Abuse Potential of Immediate-Release/Extended-Release Versus Immediate-Release Hydrocodone Bitartrate/Acetaminophen: A Randomized Controlled Trial in Recreational Users of Prescription Opioids." Postgraduate Medicine 127(1):13–21.

This study compared positive, subjective drug effects of single, equal doses of biphasic immediate release (IR)/extended release (ER) hydrocodone bitartrate/acetaminophen (H/A) tablets with IR H/A tablets and a placebo. All tablets were 325 mg and contained 7.5 morphine-mg equivalents if not the placebo. In random sequences, over time, healthy adult recreational users of prescription opioids took single total doses of three and six tablets of the three drugs, as well as six-tablet doses that were crushed and encapsulated. Among 52 completers, opiate-bearing IR/ER products produced delayed and lower peak effects compared with equal doses of IR products. Comparing intact tablets, the drug-liking maximum was significantly lower for IR/ER than IR tablets. Crushing IR/ER tablets delayed these effects compared with an equal dose of crushed IR or intact IR/ER tablets.

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R.A. Rosenblatt, C.H.A. Andrilla, M. Catlin, and E.H. Larson. 2015. "Geographic and Specialty Distribution of U.S. Physicians Trained to Treat Opioid Use Disorder." Annals of Family Medicine 13(1):23–26, doi:10.1370/afm.1735.

Physicians authorized to prescribe buprenorphine on the July 2012 Drug Addiction Treatment Act (DATA) list of waived physicians were linked to the American Medical Association Physician Masterfile to determine their age, specialty, rural or urban status, and location. Sixteen percent of psychiatrists had received a DATA waiver (41.6 percent of all physicians with waivers), and practiced primarily in urban areas. Only 3.0 percent of primary care physicians had received waivers. In most counties, physicians had not obtained waivers to prescribe buprenorphine–naloxone. More than 30 million people live in counties without access to buprenorphine treatment.

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Professional Education

M. Brabant, S. Brissette, P. Lauzon, S. Marsan, C. Ouellet–Plamondon, and M.C. Pelletier. 2014. "Opioid Use Disorder in Patients with Chronic Non-Cancer Pain." Santé Mentale au Québec 39(2):117–32, doi:10.7202/1027835ar.

Canada now has the second highest number of opioid prescriptions per capita in the world. The rate of prescriptions has increased over the last decade—most notably in adults over 55. Recognizing the importance of pain treatment has influenced this increase, but higher opioid prescribing rates have produced undesirable outcomes, including medication misuse and a greater number of opioid-attributed deaths and emergency department visits. Diverse psychiatric conditions also occur in 40 percent of people with an opioid use disorder. Most physicians are ill-equipped to diagnose and manage opioid use disorder patients.

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National News

How About Informed Consent for All Medication?
Allen Frances, The Huffington Post
January 21, 2015

Allen Frances, professor emeritus at Duke University, believes doctors prescribe too many medicines for patients who do not really need them—particularly "off label" prescription drugs. Frances recommends requiring doctors to get written informed consent from patients for all medication use. This would make for more informed consumers and reduce over-prescribing, he says. Frances thinks the Food and Drug Administration will open the gates to more unscrupulous drug marketing if it finalizes its proposed policies on distributing reprints of medical and scientific journal articles.

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International News

Star Investigation: Canada's Invisible Codeine Problem
Jennifer Yang and Diana Zlomislic, The Star
January 17, 2015

In Canada, codeine pain relievers are widely available without a prescription. The Toronto Star purchased 1,000 tablets from five pharmacies in little more than an hour in Niagara Falls, Ontario. An expert panel warned the Canadian government about the ineffectiveness and addictive potential of low-dose codeine more than 30 years ago. Doctors and policymakers do not know how many Canadians are taking low-dose codeine. Data from the Centre for Addiction and Mental Health revealed more than 500 people in Ontario alone have entered methadone treatments over the past 3 years for addictions to "over-the-counter codeine preparations."

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Northeast/Mid-Atlantic News

Maine Drug Agency Seeks to Have Acetylfentanyl Outlawed
Mal Leary, MPBN
January 16, 2015

The Maine Drug Enforcement Agency is asking lawmakers to add acetylfentanyl to the state's list of outlawed drugs. Acetylfentanyl is illegal under federal law, but not Maine law. The drug is 15 times more potent than heroin.

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Saving Opiate Crisis's Tiniest Victims
Yvonne Abraham, The Boston Globe
January 18, 2015

In Massachusetts, an estimated 1,300 babies (or 17 per 1,000 births) suffered symptoms of opiate withdrawal in 2013. U.S. Representative Katherine Clark has introduced legislation that would require the Department of Health and Human Services to collect reliable data on the problem's magnitude.

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Massive Drug Bust Spans 44 Pa. Counties, Including Erie
Emily Welsh, WICU
January 21, 2015

Attorney General Kathleen Kane announced a massive drug bust in Pennsylvania shut down a prescription drug ring spanning 44 counties, including Erie. The operation trafficked nearly $2,000,000 in illegal pills. Twenty-two people have been charged and accused of forging prescriptions for oxycodone and stealing information from doctors. Around 550 fraudulent prescriptions were filled over a 22-month period.

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VT Sees Drop in Alcohol and Drug Abuse Rates Among Young Adults
The Bennington Banner
January 21, 2015

Between 2011 and 2012 and 2012 and 2013, past-year prescription pain reliever misuse fell from 12 percent to 9 percent among Vermonters ages 18 to 25, according to the National Survey on Drug Use and Health.

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Martha's Vineyard Youth Task Force Drug Use Study Yields Mostly Promising Results
Barry Stringfellow, Martha's Vineyard Times
January 22, 2015

The 2014 Youth Risk Behavior Survey (YRBS) found 9 percent of high school students in Martha's Vineyard abuse prescription drugs—more than double the 2009 YRBS figure. Among middle school students, prescription drug misuse increased from 2.7 percent to 3.3 percent.

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New Pa. Law Offers Tool to Fight Drug Overdoses
Stacy M. Brown, Pocono Record
January 18, 2015

Unintentional drug poisoning has surpassed auto accidents as the primary cause of accidental death among Pennsylvanians 25 to 64 years old. Last year, the governor signed Act 139, which allows first responders and loved ones to administer naloxone to those experiencing an overdose. Family members can also receive a naloxone prescription. The law provides immunity from criminal and civil prosecutions for those who respond to and report an overdose and administer the medication. The Monroe County Sheriff's Department said deputies will not be carrying naloxone. Likewise, the Pocono Township Police Department and Pocono and Jackson Townships Volunteer Fire Departments have not shown interest in participating.

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South News

Gov. McAuliffe's Task Force Recommends Six Drug Abuse Bills
Elizabeth O'Roark and Grayson Kemper, The Cavalier Daily
January 23, 2015

Following task force recommendations, Governor McAuliffe will propose six bills to address opiate and heroin abuse regulations in the Virginia General Assembly's 2015 session. The bills range from granting first responders better naloxone access to significantly increasing the penalty for drug dealers directly implicated in a fatal overdose.

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Realtor Allegedly Stole Prescription Drugs from Client's Home
ABC News
January 22, 2015

Virginia Realtor Sarah Reeves was caught on tape stealing prescription drugs from a homeowner. (Video: 2:12 minutes)


Survey: Middle Schoolers Experiment with Alcohol, Drugs
Jennifer Waugh, WJXT
January 19, 2015

In the 2014 Florida Youth Substance Abuse Survey, 8 percent of youth reported misusing prescription opioids, despite a drop in other substance abuse. (Includes video: 5:20 minutes)

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Heroin ODs Spike After Pill Mill Crackdown
Abe Aboraya, Health News Florida
January 22, 2015

In 2010, 98 of the country's top 100 oxycodone-prescribing physicians were in Florida. Huge reforms were put in place, including a prescription drug–tracking database and crackdown on pill mills. Experts said a spike in heroin overdoses and deaths resulted.

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Expanded Focus on Drug Issues Planned
Jule Hubbard, Wilkes Journal Patriot
January 19, 2015

Community leaders met to establish a more formal Project Lazarus public health model addressing prescription drug abuse in Wilkes County, N.C. Fred Brason, president and chief executive officer of Project Lazarus, said he hopes to see a big turnout at the community-wide prescription drug forum and workshop scheduled on Feb. 19. Brason's organization will provide a $10,000 grant to get the effort started. Project Lazarus emphasizes education, proper disposal of unwanted or old medication, and physicians' participation in a prescription monitoring program.

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'Rx123 Campaign' Created to Stop Rx Drug Abuse, Heroin Use
Merris Badcock, WHAG
January 16, 2015

CLEAN Inc., a nonprofit anti-drug organization in Winchester, Va., created Rx123 to raise awareness about prescription drug abuse. Rx123 supports a simple message: "Take your own prescription medications, secure your medications, and properly dispose of any unused or expired medications." CLEAN received a grant from the American Medical Association Foundation to market the three-part slogan throughout Northwestern Virginia.

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Midwest News

Doctor Charged with Prescribing Pain Medications That Resulted in Five Deaths
Erica Coghill, WLKY
January 22, 2015

A federal grand jury charged Dr. Jaime Guerrero with prescribing pain medications that resulted in the deaths of five patients, healthcare fraud, and unlawful distribution and dispensing of controlled substances. The 32-count indictment alleged that Guerrero, who still practices in Kentucky and Indiana, dispensed pain medication to 30 patients without legitimate medical reason between April 2009 and May 2014. If convicted, he could face up to life in prison and a $2.75 million fine. (Includes video: 2:16 minutes)

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U.S. Attorney: Heroin and Prescription Pills #1 Drug Problem in Southern Illinois
Matthew Nordin and Joseph Carr, WSILTV
January 22, 2015

U.S. Attorney Stephen Wigginton, who serves Southern Illinois, said prescription pills and heroin are the most abused drugs. Recovering heroin addict Sarah Wolfson knows firsthand about this problem. She became addicted to pain pills after sustaining an injury horseback riding. Wolfson's doctor prescribed Vicodin, but after 6 months, cut her off. She was introduced to heroin by a dealer who supplied her prescription medicine, but has now been sober for 3 months. (Includes video: 3:26 minutes)

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Oakland County Deputies Equipped with Kits to Reverse Heroin, Opiate Overdoses
Roberto Acosta, MLive Media Group
January 18, 2015

Oakland County, Mich., police have supplied approximately 25 deputies with naloxone kits.

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National Influx of Heroin Hitting Quad-Cities
Rachel Warmke, Quad-Cities Online
January 17, 2015

Iowa police officials have seen an influx of heroin over the past few years. But they don't know how much heroin is in the Quad Cities area. Rock Island County State's Attorney said his office filed 12 cases for heroin possession from January through November 2014—eight more than in 2013. Prosecutors also filed 16 cases for delivery or intent to deliver heroin last year—up from 10 cases in 2013. In 2013, five people died from overdoses in the county. As of mid-December 2014, nine people had died of the same cause.

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West News

Video Shows Prescott Valley Police Commander Taking Drugs
Christina O'Haver, KTVK-3TV
January 21, 2015

A Prescott Valley police commander resigned after being caught on video stealing prescription drugs from the police department's evidence room. Investigators also found more than 1,000 pills in his office. Askew, who served more than 20 years with the department, admitted to becoming addicted to Percocet after suffering two back injuries. When he was put in charge of the department's "Dump the Drugs" prescription drop-off program, the temptation became too great. (Includes video: 1:16 minutes)

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Five Percent of Colorado's Population Abuses Rx Painkillers
Kevin Torres, KUSA
January 16, 2015

The National Survey on Drug Use and Health showed roughly 5 percent of Colorado's population was abusing prescription pain relievers from 2012 to 2013. Laurie Lovedale, manager of the Prescription Drug Abuse Prevention Program, provides three helpful tips to prevent abuse.

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Officials Give Tips to Prevent Medication Theft
Danielle Radin, KRCR
January 21, 2015

California officials say unmonitored medications can be subject to theft or misplaced by caretakers. The Anderson Police Department recommends installing cameras at a loved one's when caretakers are present. A pharmacist suggests checking the quantity listed on the bottle, and keeping track of it. (Includes video: 2:14 minutes)

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Webinar Archive

Learn About Effective Programs for Preventing Prescription Drug Misuse Among Youth
Substance Abuse and Mental Health Services Administration
January 22, 2015

The SAMHSA–funded Preventing Prescription Abuse in the Workplace (PAW) project hosted this Webinar, featuring "Effective Programs for Preventing Prescription Drug Misuse Among Youth." Program implementers and evaluators described content from four school- and community-based programs, and presented evidence on their effectiveness in preventing youth prescription drug misuse. (Duration: 1:22 minutes)


PowerPoint Slides:


Disposal of Unused Medicines
U.S. Food and Drug Administration
January 9, 2015

Food and Drug Administration Drug Info Rounds pharmacists discuss medication disposal options and special instructions for throwing out expired, unwanted, or unused medicines. (Duration: 5:01 minutes)



Drug-Free Communities Support Program
Substance Abuse and Mental Health Services Administration
Deadline: March 18, 2015

The Drug-Free Communities Support Program has two goals: 1) Establish and strengthen collaboration among communities; public and private nonprofit agencies; and federal, state, local, and tribal governments to support community coalitions working to prevent and reduce substance use among youth; and 2) Reduce substance use among youth and—over time—adults, by addressing risk factors.

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Comparison and Validation of Screening Tools for Substance Use Among Pregnant Women
Centers for Disease Control and Prevention
Deadline: February 24, 2015

Strategic Prevention Framework Partnerships for Success: State and Tribal Initiative
Substance Abuse and Mental Health Services Administration
Deadline: March 16, 2015

Grants Received

Grant to Help Fight Drug Abuse and Underage Drinking
Shore News Today
January 20, 2015

Cape Assist received a $126,740 grant from the New Jersey Division of Mental Health and Addiction Services to reduce prescription drug abuse in Cape May County.

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Ocean City Police Collect $15,000 Worth of Prescription Drugs
Charles Watson, WRDE (Maryland)
January 22, 2015

Police Department Changes Procedures for Medication Drop Off Box
Bryan Betts, Alamogordo News (New Mexico)
January 21, 2015

Chatham Police Offer Safe Disposal of Prescription Drugs
Emily Everson, Chatham Patch (New Jersey)
January 22, 2015

New Sharps and Prescription Drug Disposal Kiosks in Framingham
Framingham Online News (Massachusetts)
January 23, 2015

You Can Now Drop Off Your Unwanted, Expired Drugs at the Waukesha Police Department
Katie Delong, Fox6 News (Wisconsin)
January 22, 2015

Decatur Police Accept Unused Medications
Emily Steele, Herald-Review (Illinois)
January 16, 2015

Prescription Drug Drop Box Unveiled Today
Steve Cassling, KBHR (California)
January 22, 2015

Sheriff Station Now Accepting Illegal/Prescription Drugs and Sharps Containers
Malibu/Lost Hills Station, Los Angeles County Sheriff (California)
January 21, 2015

Ecorse, Melvindale Add Prescription Drug 'Take Back' Boxes
Ryan Dunn, The News-Herald (Michigan)
January 20, 2015

South Brunswick: Medicine Drop Box Available
South Brunswick Post (New Jersey)
January 19, 2015

Taylor County Installs Drug Drop-Off Box
Lauren Talotta, WBOY (West Virginia)
January 20, 2015

Upcoming Conferences and Workshops

SAMHSA's 11th Prevention Day
Substance Abuse and Mental Health Services Administration
February 2, 2015
National Harbor, Maryland

25th Anniversary National Leadership Forum
Community Anti-Drug Coalitions of America
February 2–5, 2015
National Harbor, Maryland

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.

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

National Rx Drug Abuse Summit
Operation UNITE
April 6–9, 2015
Atlanta, Georgia

48th Annual Communicating Nursing Research Conference—Equity and Access: Nursing Research, Practice, and Education
Western Institute of Nursing
April 22–25, 2015
Hotel Albuquerque at Old Town
800 Rio Grande Blvd. NW
Albuquerque, New Mexico

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Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
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.