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January 7, 2015

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 104  |  January 7, 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 News International News Northeast/Mid-Atlantic News South News West News Grants Received Abstracts From the 2014 Annual Meeting of the College on Problems of Drug Dependence Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured

EM Docs and Opioid Prescribing: How Often, How Much?
Robert Glatter, Medscape
December 29, 2014

A study presented at the November 2014 American College of Emergency Physicians Scientific Assembly showed emergency department (ED) visits generate fewer prescriptions for opioid analgesics than standard office-based visits. One in every 400 prescriptions originating in the ED was high-dose compared with 1 in 39 originating from office-based practices. Prescriptions from EDs also contained 44 percent fewer doses than ones from office-based practices. The study analyzed 1997–2011 prescription data from the Medical Expenditure Panel Survey.

Read more:
http://www.medscape.com/viewarticle/836711

J.A. Hoppe, H. Kim, and K. Heard. 2014. "Association of Emergency Department Opioid Initiation With Recurrent Opioid Use." Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2014.11.015.

Researchers linked clinical information on 4,801 patients discharged from an urban academic emergency department (ED) with an acute painful condition to data from Colorado's prescription drug monitoring program. Of the patients, 52 percent were opioid naïve. Thirty-one percent of this group received and filled an opioid prescription, and 12 percent filled at least one other opioid prescription in the next year (defined as recurrent use). Among the opioid- naïve patients in pain, relative to those who left the ED without a prescription, the adjusted odds ratio for recurrent use was 1.8 for those who filled a prescription and 0.8 for those who received a prescription but did not fill it.

Read more:
http://www.annemergmed.com/article/S0196-0644(14)01513-3/abstract

Journal Articles and Reports

F.L. Beaudoin, R.C. Merchant, A. Janicki, D.M. McKaig, and K.M. Babu. 2014. "Preventing Iatrogenic Overdose: A Review of In–Emergency Department Opioid-Related Adverse Drug Events and Medication Errors." Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2014.11.015.

Medical record review at two urban academic emergency departments (EDs) in Providence, R.I., identified 73 ED patients with in-ED opioid-related adverse events requiring naloxone. Most (59 percent) needed treatment because of a medication error. Factors that may have contributed to the events included chronic health conditions that could predispose individuals to an opioid-related adverse event, failure to adjust opioid dosing in the elderly and for hepatic or renal impairment, multiple doses and routes of opioid administration, coadministration of opioids with other sedating medications, and systems-based problems with patient handoffs and pharmacy oversight.

Read more:
http://www.annemergmed.com/article/S0196-0644(14)01514-5/abstract

E. Behar, G.–M. Santos, E. Wheeler, C. Rowe, and P.O. Coffin. 2014. "Brief Overdose Education Is Sufficient for Naloxone Distribution to Opioid Users." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.12.009.

To better understand the amount of education needed to ensure adequate knowledge of naloxone indications and administration, the authors surveyed a sample of opioid users receiving naloxone for the first time (n=60) and returning for a refill (n=54) at San Francisco community distribution programs. Participants completed the instruments prior to receiving naloxone; first-time recipients repeated the instruments immediately after receiving standardized 5- to 10-minute education. First-time recipients (before and after education) and refillers demonstrated a high level of knowledge on the Brief Overdose Recognition and Response Assessment—correctly identifying a mean of 13.7 out of 16 overdose scenarios. Facility with naloxone administration was high across all assessments, and significantly increased for intranasal administration after education for first-time recipients. Comfort with recognition of, response to, and administration of naloxone for an overdose significantly increased after brief education among first-time recipients. Knowledge of appropriate responses to opioid overdose was high across all assessments.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01988-7/abstract

S.C. Bunce, J.D. Harris, E.O. Bixler, M. Taylor, E. Muelly, E. Deneke, K.W. Thompson, and R.E. Meyer. 2014. "Possible Evidence for Reregulation of HPA Axis and Brain Reward Systems Over Time in Treatment in Prescription Opioid–Dependent Patients." Journal of Addiction Medicine, doi:10.1097/ADM.0000000000000087.

Researchers assessed changes in the brain's reward system among patients in residential treatment for opioid pain medication addiction. One group (n=7) had gone through medically assisted opioid withdrawal within the previous 1 to 2 weeks. The second group (n=7) had been drug free for 2 to 3 months. Healthy controls (n=7) served as a comparison group. A few months into recovery, patients who had successfully stopped taking prescription opioids showed signs that their brains' natural reward systems were starting to normalize. Assessment tests included drug cue reactivity, affect-modulated startle response tasks, salivary cortisol, and 8 days of sleep actigraphy.

Read more:
http://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/
Possible_Evidence_for_Re_regulation_of_HPA_Axis.99719.aspx

http://psychcentral.com/news/2014/12/23/brains-reward-system-begins-
normalizing-a-few-months-into-opioid-remission/79013.html


B.C. Kelly, J. Trimarco, A. LeClair, M. Pawson, J.T. Parsons, and S.A. Golub. 2014. "Symbolic Boundaries, Subcultural Capital and Prescription Drug Misuse Across Youth Cultures." Sociology of Health and Illness, doi:10.1111/1467-9566.12193.

Drawing on ethnographic data collected over 12 months from different youth cultural scenes in New York City, the authors describe the subcultural bases of prescription drug misuse. Findings highlight the role of symbolic boundaries and subcultural capital in shaping routine practices of drug use among young adults. The data suggest prescription drug misuse education campaigns should account for variability in youth cultural scenes to maximize the efficacy of their messages.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12193/abstract;
jsessionid=3528DE1471B84B9EA70901F0B524B350.f04t01


S. Larney, A.S.B. Bohnert, D. Ganoczy, M.A. Ilgen, M. Hickman, F.C. Blow, and L. Degenhardt. 2014. "Mortality Among Older Adults With Opioid Use Disorders in the Veteran's Health Administration, 2000–2011." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.12.019.

Analysis of 2000–11 data from the Veterans Health Administration National Patient Care Database showed that among adults with opioid-use disorders, the drug-related mortality rate did not vary with age.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01999-1/abstract

M.J. Worley, S.J. Shoptaw, W.K. Bickel, and W. Ling. 2014. "Using Behavioral Economics to Predict Opioid Use During Prescription Opioid Dependence Treatment." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.12.018.

Researchers surveyed 353 people with prescription-opioid dependence who received 12 weeks of buprenorphine–naloxone and counseling in a multisite clinical trial. Obtaining opioids from doctors was associated with lower pretreatment drug spending than obtaining opioids from dealers or patients. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount and a greater proportion of their income on drugs were more likely to use opioids during treatment.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01998-X/abstract

News

Hospira's Non-Opioid Painkiller Gets FDA Approval
Reuters
December 30, 2014

The Food and Drug Administration has approved Hospira Inc.'s non-opioid injection pain reliever, Dyloject. Dyloject is a nonsteroidal anti-inflammatory drug that can be used alone or in combination with other non-opioid pain relievers. Other injectable non-opioid pain relievers require dilution prior to administration and typically call for an infusion of 15 to 30 minutes for a full dose, but Dyloject can be administered within 15 seconds.

Read more:
http://www.reuters.com/article/2014/12/30/us-hospira-fda-idUSKBN0K810E20141230

Painkiller Abuse, a Cyclical Challenge
The New York Times
December 22, 2014

This slide show depicts three eras since the late 19th century when opioid abuse reached problematic levels and provoked policy responses. Opioids now cause more deaths than any other drug: more than 16,000 in 2010. Patients in the United States have consumed 99 percent of the world's hydrocodone, 80 percent of the world's oxycodone, and 65 percent of the world's hydromorphone. Throughout the country, policy makers are wrestling with ways to address problems caused by high opioid prescribing rates, while not restricting access to medications for patients who need it. The most recent wave of opioid overuse can be traced back to at least the 1980s, when some doctors began reporting that addiction to the drugs was rare, and drug companies vigorously promoted them as safe for a broad range of painful conditions. In a 1980 letter in The New England Journal of Medicine, Dr. Jane Porter reported that out of nearly 12,000 patients who had received a narcotic pain reliever, only four became addicted. Six years later, a study published in the journal Pain reported that only 2 of 24 patients treated with narcotics for years had exhibited problems managing the medication.

Read more:
http://www.nytimes.com/2014/12/23/upshot/painkiller-abuse-a-cyclical-challenge.html?abt=0002&abg=1

Panel: Quashing Prescription Drug Abuse Demands Community Effort
American Academy of Family Physicians
December 2, 2014

In a panel discussion at the November 14–15, 2014, American Academy of Family Physicians State Legislative Conference, speakers addressed aspects of the prescription drug abuse problem that affect their states. They agreed the best ways to battle the problem involve cooperation among physicians, pharmacists, and law enforcement officers. Panel members highlighted innovative tools being used to combat prescription drug abuse, including the use of technology to identify prescription recipients—often combined with legislation aimed at controlling prescription use.

Read more:
http://www.aafp.org/news/practice-professional-issues/20141202statelegopioids.html

International News

ADHD Children Over-Prescribed Ritalin, Adelaide Professor Says
Brett Williamson, ABC
December 15, 2014

An Adelaide, Australia, professor is speaking out against doctors prescribing Ritalin to young children. Professor Jon Jureidini, head of the Department of Psychiatry at the University of Adelaide, warned that Ritalin prescribing to children ages 4 to 7 recently rose by 300 percent. He said children taking Ritalin would benefit from alternative interventions, noting the drugs are just "dampening down behavior" without addressing the root problem.

Read more:
http://www.abc.net.au/news/2014-12-16/adhd-children-over-prescribed-ritalin-adelaide-professor-says/5968338

Northeast/Mid-Atlantic News

Overdose Patients End Up Repeatedly in Hospital
Andrea K. McDaniels, The Baltimore Sun
December 29, 2014

The Maryland Department of Health and Mental Hygiene plans to offer rehab services and drug education to patients admitted for overdoses who survived. Almost 60 percent of Maryland patients who died from an overdose in 2013 had at least one hospital or emergency room visit for an overdose in the previous 12 months. Many patients had suffered multiple overdoses.

Read more:
http://www.baltimoresun.com/health/bs-hs-overdose-reporting-20141229-story.html

Groups Unite Against Curbing Painkillers
Christopher Rowland, Boston Globe
December 29, 2014

Massachusetts state senators faced opposition last year when they tried to turn the tide of prescription pain pill abuse and overdose deaths. To residents like Cindy Steinberg, an advocate for patients who depend on prescription opiates to manage pain, no one has a right to withhold relief from millions of legitimate pain patients. Steinberg's reaction to the Massachusetts Senate bill captured the emotional core of lobbying campaigns against strict limitations on opiate prescribing—both nationally and in state capitals. Those campaigns are funded in part by drug makers. The industry is working to protect its U.S. market for oxycodone, hydrocodone, and similar drugs, which reached $8.3 billion in 2013. Steinberg has teamed with another powerful organization against some of the strictest narcotic prescribing proposals—the Massachusetts Medical Society—which represents the state's physicians.

Read more:
http://www.bostonglobe.com/news/nation/2014/12/29/opiate-prescribing-crackdown-massachusetts-opposed-industry-backed-patient-group/aAjGBp2NTHkfPfTSZrhF9N/story.html

Letter: Get Naloxone in the Hands of Peers and Loved Ones
NJ.com
December 25, 2014

This opinion piece lauds a recent article on community naloxone training and points out where naloxone is most effective: with the peers and loved ones of people who use opioids. In their hands, says Amanda Bent, a policy associate for the New Jersey Drug Policy Alliance, naloxone can be quickly, safely, and easily administered while waiting for professional help to arrive. Bent goes on to explain that promoting and funding expansion of community naloxone access is one of the best ways to fully implement the Overdose Prevention Act. She also notes that free intranasal naloxone training sessions are available in multiple locations through the state's Division of Mental Health and Addiction Services.

Read more:
http://www.nj.com/opinion/index.ssf/2014/12/letter_get_naloxone_
in_the_hands_of_peers_and_loved_ones.html


Dr. Stan Li Sentenced to Prison in Prescription Drug Deaths Case
CBS New York
December 19, 2014

In New York's first manslaughter case against a doctor in an overdose death, Queens physician Stan Li was sentenced for the deaths of two patients after selling prescription drugs at his pain management clinic. Judge Michael Sonberg spoke of Dr. Li's incredible intellect and training, then blasted him for greed and gave the 61-year-old doctor a maximum of 30 years behind bars.

Read more:
http://newyork.cbslocal.com/2014/12/19/dr-stan-li-sentenced-to-prison-in-prescription-drug-deaths-case

Massachusetts May Sue Drug Makers over Painkiller Marketing
Ed Silverman, The Wall Street Journal
January 2, 2015

Maura Healey, Massachusetts attorney general-elect, may take legal action against drug manufacturers to hamper the abuse and misuse of opioid pain relievers. Healey said she wouldn't hesitate to confront pharmaceutical companies engaged in unfair or deceptive marketing practices. Last year, the city of Chicago and two California counties filed lawsuits alleging various drug makers used deceptive marketing practices that downplayed their pain medications' risks and improperly encouraged physician prescribing, which caused some patients to become addicts. The manufacturers denied the allegations.

Read more:
http://blogs.wsj.com/pharmalot/2015/01/02/massachusetts-may-sue-drug-makers-over-painkiller-marketing

Head of Butler Co. Prescription Drug Ring Sentenced to 24 Years
CBS Pittsburgh
December 16, 2014

The head of one of the allegedly biggest prescription drug rings in Beaver County, Pa., has been sentenced to 24 years in prison. According to prosecutors, 28-year-old David Best was addicted—forging prescriptions and stealing to maintain his supply. Jurors convicted Best in April 2014 on conspiracy, drug, burglary, and firearm charges. Prosecutors say he broke into a Baden pharmacy and stole fentanyl, Ritalin, oxycodone, and other drugs, and convinced a pharmacy employee to steal prescription pads.

Read more:
http://pittsburgh.cbslocal.com/2014/12/16/head-of-butler-co-prescription-drug-ring-sentenced-to-24-years

Smart Talk: Top Story of 2014—Heroin and Prescription Drug Use Grow
Scott LaMar, Smart Talk
Dec 29, 2014

Heroin's resurgence in Central Pennsylvania made headlines in 2014, but it wasn't the only drug being abused. Most users started with prescription drugs. A report issued by the Center for Rural Pennsylvania estimated that 34,000 teenagers try heroin each year. That same report found 80 percent of those addicted to heroin used prescription drugs first. OxyContin and Vicodin were usually the drugs of choice. One reason teens use heroin is cost—a small bag is often $10 or less. More than 50 people died from heroin overdoses in York County in 2014, up from 17 in 2013.

Read more:
http://www.witf.org/smart-talk/2014/12/smart-talk-top-story-of-2014----heroin-and-prescription-drug-use-grows.php

Haloti Ngata Apologizes for Failed Adderall Test
NBCSports.com
January 1, 2015

Defensive tackle Haloti Ngata rejoined the Ravens this week, after apologizing to his teammates for violating the league's policy on performance-enhancing substances by taking Adderall. Ngata was suspended for four games—losing $2 million—when he tested positive for the drug.

Read more:
http://profootballtalk.nbcsports.com/2015/01/01/haloti-ngata-apologizes-for-failed-adderall-test

Teaching Friends and Family How to Reverse a Drug Overdose
NPR
December 29, 2014

When Patricia Graham–Farmer, a caseworker employed at a drug treatment center in New York City, witnessed a man in the throes of overdose, she brought out her naloxone kit. Almost immediately after she administered the spray, the man resumed breathing. All staff and clients at the treatment center have been trained to use Narcan and carry a rescue kit containing two doses. (Includes audio: 7:17)

Read more:
http://www.npr.org/blogs/health/2014/12/29/371770229/teaching-friends-and-family-how-to-reverse-a-drug-overdose

In Wake of Chris Davis Exemption, MLB's Adderall Policy Needs to Be Modified
Peter Schmuck, The Baltimore Sun
December 16, 2014

In this opinion piece, Baltimore Sun writer Peter Schmuck says Major League Baseball and the Major League Baseball Players Association should carefully supervise prescription drug use as part of baseball's Joint Drug Policy, but that the process leading to the late-season suspension of Orioles' first baseman Chris Davis needs to be re-examined. Schmuck agrees that Davis violated the policy by taking Adderall without the appropriate clearance from the league, but is troubled by the suspension's effect on the rest of the team at a critical time. He says the fact that Davis could apply for and secure permission (while suspended) to use Adderall in the future discredits the process used to determine who gets to use the drug and who doesn't.

http://www.baltimoresun.com/sports/schmuck-blog/bal-chris-davis-adderall-policy-needs-to-be-modified-20141216-story.html

South News

Lawsuit Seeks to Make Drugmaker Pay for OxyContin Abuse
Laura Ungar, USA Today
December 29, 2014

Prescription drug and heroin abuse continues to plague Kentucky's Appalachians, where officials say aggressive OxyContin marketing is responsible. For 7 years, the state has pursued a civil lawsuit against drug maker Purdue Pharma. The suit alleges that a deceptive marketing campaign misled doctors, consumers, and the government about OxyContin's addiction risk—ultimately encumbering taxpayers with millions of dollars in social, healthcare, and other costs. Purdue's lawyers say similar cases against the drug manufacturer have been dismissed due to weak evidence.

Read more:
http://www.usatoday.com/story/news/nation/2014/12/29/kentucky-battles-purdue-pharma-in-court-over-oxycontin-abuse/20803459

Two Men Accused of Stealing Drugs Meant for Disposal
My Fox Memphis
December 18, 2014

Two employees at a drug disposal waste facility in Shelby County, Tenn., stole large amounts of prescription drugs. James Duffie and Kelvin Threat were arrested in August at the facility, where police confiscated five large plastic bags of drugs from the defendants' vehicles. Inside the bags were thousands of pills—mostly opioids. The drugs came from hospitals and nursing homes that disposed of them after patients died.

Read more:
http://www.myfoxmemphis.com/story/27662103/two-men-accused-of-stealing-drugs-meant-for-disposal

Pharmacy Techs Part of Prescription Drug Abuse
Washington Times
December 29, 2014

John A. Foust, executive director of the Oklahoma State Board of Pharmacy, said pharmacy technicians stealing narcotics is one of the board's biggest problems. One example is Ms. Walters, who confessed to diverting between 3,000 and 4,000 hydrocodone pills while working at a Walmart in Sequoyah County. Walters had been in trouble with the law before, but she lied on her pharmacy technician application form and was able to begin working in close proximity to thousands of doses of highly addictive narcotic drugs. Though Walters was fired from her job, a search of Oklahoma's criminal records databases indicates she has not been charged with any crime related to the diversion of the hydrocodone tablets.

Read more:
http://www.washingtontimes.com/news/2014/dec/29/pharmacy-techs-part-of-prescription-drug-abuse

Lawmakers Look to Curb Prescription Drug Abuse
The Telegraph
January 1, 2015

Texas House and Senate committees that examined ways to limit prescription drug abuse agree the state should interactively share its prescription monitoring program (PMP) database with other states. The House Public Health Committee's chair said their report recommends many other strategies for curbing prescription drug abuse, including improving the state's PMP database and incentivizing doctors to use the system. Other lawmakers want to mandate PMP use. Less than a third of doctors punished by the Texas Medical Board over a 3-year period for prescribing violations involving two or more patients were prosecuted, according to a Statesman story.

Read more:
http://www.macon.com/2015/01/01/3508086/lawmakers-look-to-curb-prescription.html

West News

United States: Counties Seek to Implement Drug Disposal Ordinances
Mondaq
December 29, 2014

Alameda County, California, has begun to seek payment from select pharmaceutical manufacturers under the Alameda County Safe Drug Disposal Ordinance. The ordinance requires pharmaceutical manufacturers to establish or participate in a Product Stewardship Plan to collect unwanted prescription pharmaceuticals at secured disposal kiosks. The regulations require manufacturers to accept all drugs—not just the ones they produce.

Read more:
http://www.mondaq.com/unitedstates/x/362888/food+drugs+
law/Counties+Seek+To+Implement+Drug+Disposal+Ordinances


Local Doctor, 82, Accused of Taking Part in Prescription-Drug Ring
CBS Los Angeles
December 22, 2014

A doctor and five others have been indicted in a widespread prescription drug ring. Eighty-two-year-old Clyde Arnold provided illegal prescriptions for narcotics as part of the ring, which included three other senior citizens. Arnold pleaded not guilty, claiming other people stole his prescription pads and attempted to sell them on the black market. Prosecutors say people went to Arnold's clinic in the Crenshaw district for multiple prescriptions of maximum opioid doses and resold the drugs.

http://losangeles.cbslocal.com/2014/12/22/local-doctor-82-accused-of-taking-part-in-prescription-drug-ring

Grants Received

Barnstable County Receives $550K Grant to Fight Opioid Abuse
CapeCodToday.com
December 29, 2014

The Barnstable County Department of Human Services received a 5-year, $550,000 grant from the Massachusetts Department of Health's Bureau of Substance Abuse Services. The grant will support an opioid abuse collaborative.

Read more:
http://www.capecodtoday.com/article/2014/12/29/28318-barnstable-county-receives-550k-grant-fight-opioid-abuse

Carroll County Sheriff's Office Receives Grant for Drug Collection Unit
TheCarrollNews.com
January 1, 2015

The Carroll County Sheriff's Office in Virginia was awarded a grant from CVS Pharmacy to install an unused prescription drug collection unit. It is 1 of 1,000 units CVS Pharmacy and the Medicine Abuse Project are providing throughout the country—part of a 5-year initiative of the Partnership for Drug-Free Kids.

Read more:
http://www.thecarrollnews.com/news/home_top-news/151026477/Carroll-County-Sheriffs-Office-receives-grant-for-Drug-Collection-Unit

Abstracts From the 2014 Annual Meeting of the College on Problems of Drug Dependence

Drug and Alcohol Dependence, 146, Online Supplement, January 2015. (Editor's note: Because these voluminous conference papers represent preliminary findings that have not yet been peer reviewed, we are only listing them with links to the abstracts. Unfortunately, only the specific "aims" section of each abstract is currently available without a subscription.)

D.T. Barry, C.J. Cutter, M. Beitel, C. Liong, and R.S. Schottenfeld. 2014. "Cognitive–Behavioral Therapy and Educational Counseling for Chronic Pain and Opioid Dependence."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01124-7/abstract


W. Becker, D. Ganoczy, D. Fiellin, and A.S. Bohnert. 2014. "Dose and Other Factors Associated With Decreased Pain Intensity Among Patients Initiating Buprenorphine/Naloxone."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01130-2/abstract


C.L. Bergeria, D. Hand, M. Meyer, S.T. Higgins, S.C. Sigmon, and S.H. Heil. 2014. "Characterizing Interpregnancy Intervals of Opioid-Maintained Women."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01134-X/abstract


D. Blum, N. Levy–Cooperman, C. Hailong, B. Chakaraborty, T. Hopyan, J. Faulkner, and K. Schoedel. 2014. "Abuse Potential of Eslicarbazepine Acetate in Recreational Sedative Users."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01139-9/abstract


C.J. Boyd, E.A. Meier, P.T. Veliz, Q. Epstein–Ngo, and S.E. McCabe. 2014. "A Prospective Study of Youths' Nonmedical Use of Opioids, Anxiolytics and Sedatives."
http://www.drugandalcoholdependence.com/article/S0376-8716%2814%2901150-8/abstract


L. Brandt, S. Fischberger, R. Jagsch, and G. Fischer. 2014. "Effects of Maternal Opioid Maintenance Therapy on Neonatal Outcomes: Methadone Versus Buprenorphine."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01155-7/abstract


L.S. Brown, S. Kritz, M. Lin, B. Louie, and R. Zavala. 2014. "Evaluation of an Electronic Information System to Enhance Practice at a Medication-Assisted Opioid Treatment Program."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01159-4/abstract


S.F. Butler, T.A. Cassidy, and P. Coplan. 2014. "Comparing Abuse of Extended-Release Versus Immediate-Release Opioid Analgesics Adjusted for Number of Prescriptions and Morphine-Equivalent Dose."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01169-7/abstract


D.R. Camenga, J.R. Gaither, J. Leventhal, and S. Ryan. 2014. "Increasing Incidence of Hospital Admissions for Opioid Poisonings in Adolescents and Young Adults: 2000–2009."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01173-9/abstract


P. Coplan, A. DeVeaugh–Geiss, A. Kadakia, and G. Stiles. 2014. "Comparison of the Risk of Opioid Overdose Among Patients Prescribed Immediate-Release and Extended-Release Opioid Analgesics."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01211-3/abstract


C.J. Cutter, B.A. Moore, D. Barry, L.E. Fiellin, R.S. Schottenfeld, D. Fiellin, and P. O'Connor. 2014. "Cognitive Behavioral Therapy Improves Treatment Outcome for Prescription Opioid Users in Primary Care Based Buprenorphine/Naloxone Treatment."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01222-8/abstract


R.C. Dart, H. Surratt, E.J. Lavonas, E.M. Martinez, S.G. Severtson, T. Cicero, S.P. Kurtz, A. Rosenblum, and J.L. Green. 2014. "Buprenorphine/Naloxone Abuse and Diversion: Film Rates Are Less than Tablet Rates."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01228-9/abstract


L. Degenhardt, S. Larney, J. Kimber, N. Gisev, M. Farrell, T. Dobbins, D.J. Weatherburn, A. Gibson, R. Mattick, T. Butler, and L. Burns. 2014. "The Impact of Opioid Substitution Therapy on Mortality Post-Release from Prison."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01235-6/abstract


C. Delcher, A. Wagenaar, B. Goldberger, and M. Maldonado–Molina. 2014 "Florida's Prescription Drug Monitoring Program and Oxycodone-Caused Mortality: A Monthly Time Series Analysis, 2003–2012."

http://www.drugandalcoholdependence.com/article/S0376-8716(14)01236-8/abstract


M.J. Dennis, M.L. Dennis, and R.R. Funk. 2014. "Opioid Use Disorders: Trends and Correlates."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01240-X/abstract


A. DeVeaugh–Geiss, P. Coplan, A. Kadakia, and H. Chilcoat. 2014. "Is Opioid Dose a Strong Predictor of the Risk of Opioid Overdose? Important Confounding Factors that Change the Dose–Overdose Relationship."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01248-4/abstract


M. Deutsch–Feldman, Y. Zhang, M. Buonora, A. Brownstein, K. Niikura, A. Ho, J. Ott, and M.J. Kreek. 2014. "Self-Administration of Oxycodone by Adolescent and Adult Mice Differentially Affects Hypothalamic Mitochondrial Metabolism Gene Expression."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01247-2/abstract


A. Dick, R. Pacula, A.J. Gordon, M. Sorbero, R.M. Burns, C. Farmer, D. Leslie, and B.D. Stein. 2014. "Increasing Access to Opioid Agonist Treatment in U.S. Treatment Shortage Areas."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01251-4/abstract


D. Fiellin, C.J. Cutter, B.A. Moore, D. Barry, P. O'Connor, and R.S. Schottenfeld. 2014. "Primary Care Buprenorphine Detoxification Versus Maintenance for Prescription Opioid Dependence."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01282-4/abstract


A.J. Gordon, W.H.L. Ciganic, G. Cochran, W.F. Gellad, and J.M. Donohue. 2014. "Characteristics of Buprenorphine Opioid Agonist Treatment in a Longitudinal U.S. Medicaid Population."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01322-2/abstract


M.K. Greenwald, L.H. Lundahl, and V. Diwadkar. 2014. "Effects of Yohimbine and Hydrocortisone Pretreatment on Opioid Seeking, Stress Biomarkers, and Learning in Heroin-Dependent Volunteers."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01333-7/abstract


A. Holtyn, M.N. Koffarnus, A. DeFulio, S.O. Sigurdsson, E.C. Strain, R.P. Schwartz, and K. Silverman. 2014. "Employment-Based Reinforcement of Opiate and Cocaine Abstinence in Out-of-Treatment Injection Drug Users."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01369-6/abstract


T. Kelley–Baker, J. Yao, and R. Pollini. 2014. "Prescription Drug Use in a National Sample of Female Drivers."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01400-8/abstract


N. Levy–Cooperman, K.A. Schoedel, J. Reiz, D. Thompson, B. Chakaraborty, P. Geoffroy, and K. Michalko. 2014. "Effect of Co-Administration of Naloxone on Intravenous Hydromorphone Abuse Potential in Non-Treatment-Seeking, Opioid-Dependent Drug Users."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01458-6/abstract


B. Lewis, L. Hoffman, and S.J. Nixon. 2014. "Characterizing Sex Differences Among Pain Medication Abusers."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01459-8/abstract


M.R. Lofwall, S. Babalonis, L. Bennett, P.A. Nuzzo, and S.L. Walsh. 2014. "Effects of Extended Release Tramadol on Cigarette Smoking During Opioid Withdrawal."
http://www.drugandalcoholdependence.com/article/S0376-8716%2814%2901475-6/abstract


D.C. Lott and J. Rhodes. 2014. "Implementing Opioid Overdose Education and Naloxone Distribution in an Outpatient Community Treatment Program."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01485-9/abstract


B.E. Lozano, D. Teer, and S.E. Back. 2014. "To Reduce or Abstain? Substance Use Goals in the Treatment of Veterans With Substance Use Disorders and Comorbid PTSD."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01487-2/abstract


D.R. Maguire, L.R. Gerak, and C.P. France. 2014. "Effect of Opioid Withdrawal on Delay Discounting of Food in Rhesus Monkeys."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01495-1/abstract


P. Mannelli, K.S. Peindl, and L.–T. Wu. 2014. "Feasibility of Very Low-Dose Naltrexone and Buprenorphine Transition from Opioid Use to Extended-Release Naltrexone."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01499-9/abstract


S.S. Martins, J. Santaella, B.D. Marshall, A. Maldonado, and M. Cerdá. 2014. "Trends in Racial/Ethnic Differences in Heroin Use and Heroin Risk Behaviors Among Nonmedical Users of Prescription Opioids from 2002 to 2011."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01507-5/abstract


J. Matejkowski, K.L. Dugosh, N. Clements, and D.S. Festinger. 2014. "Development and Pilot Testing of an Online Training to Raise Awareness Among Criminal Justice Professionals of Medications Used to Treat Opioid Addiction."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01511-7/abstract


P. Mateu–Gelabert and H. Guarino. 2014. "Initiation of Nonmedical Prescription Opioid Use and Development of Opioid Dependence Among Young Adults."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01512-9/abstract


J. Mays, D. Puttick, S. Russell, and E. Chartoff. 2014. "Sex Differences in Depressive-Like Effects of Kappa Opioid Receptor Activation in Rats."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01518-X/abstract


J.L. McCauley, M.A. Mercer, A. Teer, F. Beylotte, K.T. Brady, and S.E. Back. 2014. "Gender Differences in Laboratory Stress Response Among Prescription Opioid-Dependent Individuals."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01519-1/abstract


J. Mendelson, O. Clavier, D. Kynor, and G. Galloway. 2014. "Attitudes, Beliefs, and Barriers to Adopting an Automated Naloxone Delivery System to Overcome Opioid Overdose: Interviews of Opioid Injectors and Physicians."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01535-X/abstract


J. Naylor, T. Prisinzano, and K. Freeman. 2014. "Self-Administration of Oxycodone Alone or as a Mixture With the Kappa Agonist, Salvinorin A, by Monkeys Under a Progressive Ratio Schedule of Reinforcement."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01565-8/abstract


H. Newville, J. Roley, and J. Sorensen. 2014. "Nonmedical Use of Prescription Drugs Among HIV-Positive Individuals Taking Antiretroviral Therapy."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01569-5/abstract


S. Nielsen, R. Bruno, G. Campbell, M. Cohen, M. Farrell, W. Hall, B. Hoban, B. Larance, N. Lintzeris, R. Mattick, and L. Degenhardt. 2014. "Benzodiazepine Use Among a Sample of Chronic Pain Patients Prescribed Opioids."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01574-9/abstract


B. Nosyk, J.E. Min, G. Colley, V. Lima, B. Yip, M. Milloy, E. Wood, and J. Montaner. 2014. "The Causal Effect of Opioid Substitution Treatment on Highly Active Antiretroviral Treatment Adherence."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01578-6/abstract


S.P. Novak, L. Wenger, J. Lorvick, and A. Kral. 2014. "The Misuse, Abuse, and Diversion of Opioid Replacement Therapies Among Street Abusers."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01579-8/abstract


A. Opheim, K.S. Haase, L. Tanum, N. Kunøe, S. Nesvåg, L. Stavseth, H.Z. Latif, A.L. Mjølhus, and M. Møller. 2014. "Existential Anxiety in First-Time Recipients of XR-NTX for Opioid Addiction."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01588-9/abstract


T.W. Park, K. Nelson, Z. Xuan, K.E. Lasser, J.M. Liebschutz, and R. Saitz. 2014. "The Association Between Benzodiazepine Prescription and Aberrant Drug Behaviors in Primary Care Patients Receiving Chronic Opioid Therapy."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01598-1/abstract


M.A. Parker and J.C. Anthony. 2014. "Beyond an Adolescent's First Occasion of Using Prescription Pain Relievers Extra-Medically: Associations With Sex and With Alcohol Involvement."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01600-7/abstract


K.A. Parks, K. Levonyan–Radloff, S. Przybyla, and A. Hequembour. 2014. "College Student Opinions About the Use of Nonmedical Prescription Drugs."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01601-9/abstract


B. Rafat and B. Sproule. 2014. "Influence of Pharmacokinetics on the Abuse Liability of Controlled-Release Opioid Formulations: The Case of Oxycodone."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01634-2/abstract


M. Randesi, O. Levran, E. Butelman, V. Yuferov, J. Ott, P. Blanken, W. van den Brink, J.M. van Ree, and M.J. Kreek. 2014. "Gene Variants of the Opioid System—Relationship to Heroin Self-Exposure, Addiction, and Treatment."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01637-8/abstract


M. Romero–Gonzalez, G. DiGirolamo, and G. Gonzalez. 2014. "Differences Between Heroin and Non-Prescription Opioid Analgesics Users in Treatment-Seeking Opioid-Dependent Young Adults."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01656-1/abstract


P.L. Ross–Durow, P.T. Veliz, S.E. McCabe, and C.J. Boyd. 2014. "Comparison of Adolescent Self-Reports of the Nonmedical Use of Scheduled Prescription Medications in Self-Administered Surveys Versus Semistructured Interviews."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01658-5/abstract


L.E. Sandstrom, P. Coplan, H. Chilcoat, F.W. Brason, C. Leukefeld, and L.A. Morris. 2014. "Brief Guide to Prevent Overdose Fatality for Prescription Opioid Abusers: A Harm Reduction Initiative."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01672-X/abstract


B. Setnik, A. Bass, K.W. Sommerville, K. Matschke, and L.R. Webster. 2014. "Abuse Potential Study of Intravenous Oxycodone Hydrochloride Alone or in Combination With Intravenous Naltrexone in Nondependent, Recreational Opioid Users."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01686-X/abstract


S.G. Severtson, E.M. Martinez, J.L. Green, R.C. Dart, and E.J. Lavonas. 2014. "Buprenorphine/Naloxone Pediatric Ingestion: Exposure Rates Differ Between Film and Tablet Formulations."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01688-3/abstract


B. Sproule, K–W. Liu, and J. Chundamala. 2014. "Early Evaluation of the Experiences and Opinions of Pharmacists Towards the Ontario Narcotics Monitoring System."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01717-7/abstract


M. Vuolo, B.C. Kelly, B.E. Wells, and J.T. Parsons. 2014. "Correlates of Prescription Drug Market Involvement."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01780-3/abstract


A. Wachholtz and G. Gonzalez. 2014. "Pain Sensitivity and Tolerance Among Individuals on Opioid Maintenance: Long-Term Effects."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01781-5/abstract


M. Weaver, G. Villalobos, T. Moore, P. Dillon, and D. Svikis. 2015. "Identifying Prescription Drug Misuse in Primary Care Patients: A Tale of Two Instruments."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01791-8/abstract


R. Weiss, K. McDermott, M.L. Griffin, E. Hilario, and H. Connery. 2014. "Does Early Response to Buprenorphine-Naloxone Predict Treatment Outcome in Prescription Opioid Dependence?"
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01795-5/abstract


L.K. Whiteside, R. Cunningham, E.E. Bonar, F.C. Blow, P. Ehrlich, and M. Walton. 2014. "Prevalence and Correlates of Prescription Stimulant Misuse Among Youth in the Emergency Department."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01802-X/abstract


C.M. Wilder, S.C. Miller, E. Tiffany, and T. Winhusen. 2014. "Opioid Overdose Risk Perception and Naloxone Acceptability Among Patients Maintained on Chronically Prescribed Opioids at the Cincinnati VA."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01805-5/abstract


E.L. Winstanley and A. Clark. 2014. "Risk Factors Associated With Overdose Among Patients Seeking Treatment for Opioid Dependence."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01810-9/abstract


M. Worley, K. Heinzerling, S. Shoptaw, and W. Ling. 2014. "Chronic Pain Volatility Predicts Outcomes of Buprenorphine-Naloxone for Prescription Opioid Dependence."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01814-6/abstract


H–H.H. Yeh and J.C. Anthony. 2014. "Female Opioid Users May Be at Excess Risk of Becoming Dependent Soon After Extra-Medical Prescription Pain Reliever Use in Adolescence but Not in Young Adulthood: Estimates for the United States, 2002–2011."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01820-1/abstract


M. Zhang and B. Sproule. 2014. "Publication Trends From 1950 to 2009: Opioids, Benzodiazepines, Barbiturates, and Amphetamines."
http://www.drugandalcoholdependence.com/article/S0376-8716(14)01825-0/abstract

Take-Back Events and Drop Boxes

Medication Disposal Provided in New Hanover
Port City Daily (Wilmington, N.C.)
January 3, 2015
http://portcitydaily.com/2015/01/03/medication-disposal-provided-in-new-hanover

New Spot to Drop Unwanted Pills
McDowellNews.com (North Carolina)
December 30, 2014
http://www.mcdowellnews.com/news/new-spot-to-drop-unwanted-pills/
article_14999c1e-903f-11e4-8dc1-db98723ac409.html


Robbinsville Police Department Installs Medicine Drop Box at Headquarters for Unused Prescriptions
NJ.com (New Jersey)
December 24, 2014
http://www.nj.com/mercer/index.ssf/2014/12/robbinsville_police_installs_
medicine_drop_box_at_headquarters_for_unused_prescriptions.html


Prescription Drug Disposal Box Installed at Police Services Center in Dalton
TheChattanoogan.com (Tennessee)
December 22, 2014
http://www.chattanoogan.com/2014/12/22/290761/Prescription-Drug-Disposal-Box.aspx

Decatur Drug Drop Box Considered Successful
WICS Newschannel 20 (Illinois)
December 22, 2014
http://www.wics.com/news/top-stories/stories/vid_20314.shtml

Year-Round Prescription Drug Disposal
WAND17 (Illinois)
December 19, 2014
http://www.wandtv.com/story/27674414/year-round-prescription-drug-disposal

Upcoming Conferences and Workshops

SAMHSA's 11th Prevention Day
Substance Abuse and Mental Health Services Administration
February 2, 2015
National Harbor, Maryland
http://forum.cadca.org/?q=node/59

25th Anniversary National Leadership Forum
Community Anti-Drug Coalitions of America
February 2–5, 2015
National Harbor, Maryland
http://forum.cadca.org

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