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January 8, 2014


SAMHSA Prescription Drug Abuse Weekly Update
Issue 53  |  January 8, 2014
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Journal Articles and Reports News Other State and Local News Other Resources Videos Grant Announcements Grant Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


SAMHSA's Opioid Overdose Prevention Toolkit and Prescription Drug Abuse Webinar
January 16, 2014
2–3:30 p.m.

Dr. H. Westley Clark, director of the Center for Substance Abuse Treatment, will provide an overview of SAMHSA's Opioid Overdose Prevention Toolkit and discuss aspects of the prescription drug abuse problem. The Webinar will be hosted by the Addiction Technology Transfer Center Network.

Read more:

Journal Articles and Reports

J. Kim, D. Ji, S. Kang, M. Park, W. Yang, E. Kim, H. Choi, and S. Lee. 2014. "Simultaneous Determination of 18 Abused Opioids and Metabolites in Human Hair Using LC–MS/MS and Illegal Opioids Abuse Proven by Hair Analysis." Journal of Pharmaceutical and Biomedical Analysis 89:99–105.

An analytical method for simultaneous detection in hair of 18 opioids and metabolites considered to have a high abuse risk based on urine drug screening results was established and validated using liquid chromatography–tandem mass spectrometry (LC–MS/MS) for the purpose of clinical and forensic applications. Drugs and metabolites were extracted from hair using methanol, and analyzed using LC–MS/MS. The validation results proved the method was selective, accurate, and precise with acceptable linearity within calibration ranges. No significant variation was observed by different sources of matrices. The limits of detection and quantification ranged from 0.05 to 0.25 ng/10 mg hair and from 0.05 to 0.5 ng/10 mg hair, respectively. The developed method was successfully applied to 15 hair samples police obtained from opioid users (six from natural opiate users and nine from synthetic opiate users). The authors assert that this method will be very useful for monitoring inappropriate opioid drug use.

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K.M. Bohnert, M.A. Walton, S. Resko, K.T. Barry, S.T. Chermack, R.A. Zucker, M.A. Zimmerman, B.M. Booth, and F.C. Blow. 2014. "Latent Class Analysis of Substance Use Among Adolescents Presenting to Urban Primary Care Clinics." The American Journal of Drug and Alcohol Abuse 40(1):44–50. doi:10.3109/00952990.2013.844821.

This study used an empirical method to classify adolescents for substance use groups and examined correlates of the empirically defined groups. Data came from 12- to 18-year-old patients presenting to urban primary care community health clinics (Federally Qualified Health Centers) that primarily serve low-income families in two Midwestern cities (n = 1,664). Latent class analysis (LCA) was used to identify classes of substance users, and multinomial logistic regression was used to examine variables associated with class membership. LCA identified three classes: class 1 (64.5 percent) exhibited low probabilities of all types of substance use; class 2 (24.6 percent) was characterized by high probabilities of cannabis use and consequences; and class 3 (10.9 percent) had the highest probabilities of substance use, including heavy episodic drinking and prescription drug misuse. Those in classes 2 and 3 were more likely to be older and have poorer grades, poorer health, higher levels of psychological distress, and more sexual partners than those in class 1. Individuals in class 3 were also less likely to be African American than those in class 1.

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T.A. Cassidy, P. DasMahapatra, R.A. Black, M.S. Wieman, and S.F. Butler. 2013. "Changes in Prevalence of Prescription Opioid Abuse After Introduction of an Abuse-Deterrent Opioid Formulation." Pain Medicine. doi:10.1111/pme.12295.

Researchers designed an observational, cross-sectional study with a sentinel sample of adults assessed for substance abuse treatment within the NAVIPPRO® surveillance system. The study included 232,874 adults at 437 facilities from January 1, 2008 through December 31, 2011. A time-series analysis using logistic regression was conducted to estimate quarterly prevalence of past 30-day abuse (adjusted for covariates and prescription volume) and changes in abuse pre- and post-abuse-deterrent formulation (ADF) introduction. They discovered increases in abuse prevalence occurred for all prescription opioids as a class and for extended-release (ER) opioids. Significantly greater abuse of ER oxymorphone and buprenorphine occurred in the post-ADF period (relative risk [RR] = 2.91, 95 percent confidence interval [CI] = 2.59–3.27 and RR = 1.85, 95 percent CI = 1.74–1.96). Increases in abuse for these two compounds were significant among groups that reported abuse via preferential routes of administration (oral only, snorting only, injection only) post-ADF introduction. Replacement of a widely prescribed opioid formulation known for its abuse potential alone may have had little impact on overall rates of prescription opioids as a class. However, changes in abuse levels of certain opioids coinciding with ADF introduction suggest possible switching of abuse among the study sample to specific long-acting opioid analgesics.

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J.M. Davis, S.G. Severtson, B. Bucher–Bartelson, and R.C. Dart. 2013. "Using Poison Center Exposure Calls to Predict Prescription Opioid Abuse and Misuse-Related Emergency Department Visits." Pharmacoepidemiology Drug Safety. doi:10.1002/pds.3533.

Researchers compared data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System with data from the Drug Abuse Warning Network (DAWN) from 2004 through 2010. Population rates of poison center call mentions regarding prescription opioid abuse and misuse were compared with population rates of emergency department visit mentions of the same using linear regression. Buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone were included in the analysis. The strength of association between RADARS and DAWN data regarding all opioids in aggregate was strong (R2 = 0.81, p < 0.001). Correlations between the two programs at the drug class level were also strong for buprenorphine, hydrocodone, hydromorphone, methadone, and oxycodone (all R2 > 0.70, all p < 0.01), significant for fentanyl (p = 0.05), and moderate for morphine (p = 0.09).

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E.L. Garland and M.O. Howard. 2014. "Randomized Controlled Trial of Mindfulness-Oriented Recovery Enhancement for Chronic Pain and Prescription Opioid Misuse: Clinical Outcomes and Mechanisms." The Society for Social Work and Research 2014 Annual Conference, San Antonio, Texas, January 18, 2014.

Chronic pain patients (n = 115) were randomized to either an MSW–led Mindfulness-Oriented Recovery Enhancement (MORE) group (n = 57) or a support group (SG) (n = 58). MORE intervention sessions involved mindfulness training, cognitive restructuring, and techniques for positive emotion regulation. Standardized measures of pain severity, pain-related functional interference, opioid craving, and opioid misuse were collected pre- and post-intervention, as well as at the 3-month follow-up. To explore therapeutic mechanisms, measures of reinterpretation of pain sensations, nonreactivity, positive reappraisal, and heart rate variability (HRV) to pain-, opioid-, and pleasure-related visual stimuli were monitored before and after treatment. The MORE group demonstrated significantly greater decreases in pain severity (p = .04), functional interference (p < .001), and opioid craving (p = .005) than the SG; effects on pain severity and interference persisted for 3 months. Compared with the SG, a greater proportion of individuals in the MORE group who met criteria for opioid misuse at pre-treatment no longer met opioid misuse criteria at post-treatment (p = .05). Increases in reinterpretation of pain sensations, nonreactivity, and positive reappraisal were associated with decreases in pain severity, functional interference, and opioid craving/misuse, respectively. HRV responses were associated with reduced opioid craving and misuse.

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M.T. Hall and S. Golder. 2014. "The Non-Medical Use of Prescription Drugs Among Criminal Justice–Involved Women: The Role of Trauma and Inter-Personal Violence." The Society for Social Work and Research 2014 Annual Conference, San Antonio, Texas, January 18, 2014.

This descriptive study examined the correlates of recent nonmedical use of prescription drugs (NMUPD) by women in the criminal justice system. Researchers interviewed a convenience sample of 406 women (41.6 percent African American, 50.5 percent white, 7.6 percent of other races) on probation and/or parole in the largest metropolitan city of a Midwestern state. They used face-to-face recruitment at all probation and parole offices within the county; direct mailings to women on probation and parole; print, TV, and Web-based advertisements; and flyers posted in a variety of public locations, community-based organizations, government agencies, and healthcare facilities. All interviews were administered in person by trained female staff using an audio computer-assisted interviewing method. Interpersonal violence was measured by items from the Victimization Survey of the National Crime Victimization Survey, posttraumatic stress disorder (PTSD) by the Posttraumatic Stress Diagnostic Scale (PDS), and psychiatric distress by the Brief Symptom Inventory (BSI). NMUPD was conceptualized as use of prescription opioids, sedatives, benzodiazepines, or barbiturates within the past year. Bivariate and adjusted comparisons were conducted using chi-square tests and logistic regression for categorical variables and t tests and multiple regression for continuous variables. Multiple logistic regression was used to identify correlates of NMUPD among the offender population. Past-year NMUPD was reported by 26.8 percent (n = 109) of the overall sample. With regard to demographics, female offenders who reported NMUPD tended to be younger and were more likely to be white. Women who endorsed NMUPD reported higher rates of psychiatric problems in all nine symptom domains of the BSI; those who reported NMUPD were also more likely to participate in drug treatment and use medications for detoxification or opioid replacement therapy than women who did not engage in past-year NMUPD. Though women who reported NMUPD were just as likely as those who did not to experience a traumatic event during their lifetime, those who endorsed NMUPD were more likely to experience persistent problems and meet diagnostic criteria as a result. In the multiple logistic regression model, younger age, white race, chronic pain, psychological intimate partner violence, and a diagnosis of PTSD were significant correlates of NMUPD. Criminal justice–involved women who did not meet criteria for PTSD were 40 percent less likely to engage in past-year NMUPD.

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G. Liebetrau, D. Prasa, H. Hentschel, and M. Deters. 2013. "Poisonings Due to Substance Abuse Reported to the Poisons Information Centre Erfurt from 2002 to 2011." Gesundheitswesen. doi:10.1055/s-0033-1355368.

This study only touches on prescription abuse peripherally. Researchers conducted a retrospective analysis of all substance exposures of humans (including suicide acts) (n = 125,130) from the beginning of 2002 to the end of 2011, according to substance classes, reasons of exposures, symptom severity, age groups, and gender. Substance abuse cases (3,760, 3.0 percent of all exposures) continuously increased from 252 (92 with one and 160 with multiple substances) in 2002 to 507 in 2011 (239 with one and 268 with multiple substances). In relation to all exposures, only the abuse of multiple substances rose significantly (p < 0.001). Compared with all substances of exposure, ethanol, amphetamine-type stimulants, benzodiazepines/analogues, and liquid ecstasy abuse significantly increased (p < 0.005), while cannabis and Brugmansia/Datura species abuse significantly decreased (p < 0.05). Substance abuse significantly more often (p < 0.001) caused moderate (23.7 percent) and severe (6.1 percent) symptoms than in suicide attempts (9.6 percent; 4.4 percent). First legal high exposures were registered in 2010 and led significantly more often (p < 0.001) to moderate symptoms (50 percent) than cannabis exposures (19.4 percent). The clinical significance of substance abuse is shown by the fact that it resulted more often in moderate and severe symptoms than suicide attempts.

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N. Sehgal, J. Colson, and H.S. Smith. 2013. "Chronic Pain Treatment with Opioid Analgesics: Benefits Versus Harms of Long-Term Therapy." Expert Review of Neurotherapeutics 13(11):1201–20. doi:10.1586/14737175.2013.846517.

This paper reviews current evidence on opioid effectiveness and the benefits and harms of long-term therapy for chronic noncancer pain (CNCP). Opioids are routinely prescribed for chronic pain (CP) treatment. Over two decades, the number of opioid prescriptions, prescribed daily opioid doses, overall opioid availability, and opioid-related adverse effects has risen dramatically. Yet CP and related disability rates remain high, and the majority of patients with CNCP are dissatisfied with their treatment. This pattern raises questions about the relevance of opioid therapy in CNCP treatment.

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E.R. Wright and M.S. Greene. 2013. "How Does Availability of Prescription Opioids Affect Pain Reliever Abuse at the County Level? An Ecological Study in Indiana." Abstract, American Public Health Association, 141st Annual Meeting and Expo, Boston, Massachusetts, November 5, 2013.

Indiana's past-year prevalence rate for nonmedical pain reliever use was highest among young adults ages 18 to 25 (14.4 percent; 95 percent confidence interval [CI]: 11.9–17.3), and surpassed the nation's rate (10.4 percent; 95 percent CI: 10.0–10.8). Research indicates substance use may be linked to drug availability and social–environmental characteristics of the community. An 87-county ecological study assessed the impact of opioid availability and demographic characteristics on pain reliever abuse in Indiana. Researchers examined census information on gender, race, and age; INSPECT data (Indiana's prescription drug monitoring program) on the number of opioid prescriptions dispensed; and the Treatment Episode Data Set for prescription opioid abuse reported at treatment admission. The multiple linear regression analysis explained more than 40 percent of the variance in pain reliever abuse.

Read more:


False Positive—The Reality of Workplace Drugs in America
The Fix
December 12, 2013
Reprinted by The Huffington Post, December 31, 2013

This article chided media outlets for failing to check the validity of data reported in a press release by Quest Diagnostics, "Drug Use Among American Workers Declined 74% Over Past 25 Years, Finds Unprecedented Analysis of More Than 125 Million Workplace Urine Drug Tests." The press release, which received widespread media coverage, including a November 18, 2013, article in The Wall Street Journal, stated there was a 74 percent decline in drug use among American workers over the past 25 years. Some limitations to its findings were noted, warning that estimates were restricted to employers who perform drug testing and that substances for which employers test vary. The Wall Street Journal also cautioned that three fourths of tests included in the estimates were conducted for pre-employment screening, with the rest administered following accidents, after employers suspected drug use, or as part of regular testing regimens (Editor's note: The Fix incorrectly states this information was in the press release.) When The Fix conducted a separate analysis and interviewed Quest representatives, they concluded that upon careful inspection, the reported 74 percent reduction was a "false positive." Because few workplaces test for abusable prescription drugs and tests are not available for many designer drugs, use of those drugs is largely excluded from the Quest data. But other sources, like the National Survey on Drug Use and Health, show that use of those drugs has jumped in the past 25 years, partially displacing the drugs commonly used 25 years ago. Thus, drug use would be underestimated in Quest data much more today than it was at that time. Moreover, Quest assumed the drug use trend among employees whose employers test for drugs applied to the many people working at firms without a drug testing program. The literature, however, suggests drug users are more likely to work for firms without testing programs. Even for those firms included in the Quest data, drugs are not tested at uniform sensitivity levels across employers, and federal sensitivity guidelines have changed. Therefore, comparing results over time from a time-variant pool of employers is not an apples-to-apples comparison. Finally, the Quest analysis excluded all test results submitted by employers who use a mix of instant results tests and standard urine collection devices. Quest acknowledged that its data did not provide a complete picture of the drugs being used by the U.S workforce. Editor's note: Only some of these limitations apply to Quest's analysis of trends by drug, summarized in the November 27, 2013, Weekly Update.

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Maryland HIE Connects to State Drug Database to Cut Overdoses
January 2, 2013

The Chesapeake Regional Information System for our Patients (CRISP) has integrated with Maryland's prescription drug monitoring program through its Web-based query portal. The link between health information systems will help providers access data on patients with potential drug abuse habits and connect them to treatment. CRISP's care coordination catalogue already includes admission, transfer, and discharge notifications as well as population health management tools to track and help the uninsured. The system combines geographic information and data on hospital service use to develop a picture of community needs and areas of public health concern.

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A State Plan: Reducing Prescription Drug Abuse in Oklahoma
Oklahoma Department of Mental Health and Substance Abuse Services

In September 2012, the Oklahoma Prevention Leadership Collaborative commissioned the Prescription Drug Planning Workgroup to develop a prescription drug abuse response plan. The plan recommends action items in community and public education, provider and prescriber education, disposal and storage, tracking and monitoring, regulations and enforcement, and treatment and prevention. The workgroup hopes to reduce unintentional opioid overdose deaths in Oklahoma from 11 per 100,000 to 9.4 per 100,000 by 2017 (baseline data from 2011 Medical Examiner data).

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The 'Other Drug Problem,' in Our Own Medicine Cabinets
The Denver Post
December 25, 2013

Colorado's governor, attorney general, and a professor of pharmacy at the University of Colorado support the state's efforts to reduce prescription drug abuse. Colorado has created collaborations and initiatives in several key areas: public awareness, healthcare provider education, treatment, safe medication disposal, and improved data systems for monitoring controlled substances. In addition, the governor's office developed the Colorado Plan to Reduce Prescription Drug Abuse with the goal of preventing 92,000 Coloradans from abusing opioids by 2016, and formed the Colorado Consortium for Prescription Drug Abuse Prevention.

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Kiwis Look into Possible Prescription Drug Misuse at World Cup
The Guardian
December 28, 2013

The Kiwis are under review by the New Zealand Rugby League (NZRL) for possible prescription drug misuse and player "recovery practices." Chief Executive Phil Holden said concerns surfaced from team management's observations, including whether energy drinks were consumed in combination with prescription sleeping pills—a practice that is not banned under anti-doping regulations. Holden hopes to establish a think tank with other chief executives of New Zealand sporting organizations and engage closely with the NRL on the issue. The review will be complete by mid-February.

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Other State and Local News

Death Rates Soar Among Women Using Prescription Drugs
The Billings Gazette
December 29, 2013

According to the Montana Department of Public Health and Human Services, 352 women died from a drug overdose between January 2008 and August 2013. This includes overdoses from prescription drugs, heroin, and cocaine. Women are more likely than men to be prescribed pain relievers, use them chronically, and acquire them in higher doses. Women are also more likely to be prescribed drugs for depression and anxiety, which can interfere with other medications.

Read more:

County Report Addresses Prescription Drug Misuse
Dutchess County Government (New York)
December 23, 2013

The Dutchess County Health and Human Services Cabinet issued a special report, "Confronting Prescription Drug Abuse in Dutchess County, New York: Existing and Proposed Strategies to Address the Public Health Crisis," which covers prescription drug use, misuse, and abuse in the county. The report identifies key factors driving prescription drug abuse and outlines initiatives under way in several county departments and community agencies to lessen the problem. It also provides recommendations for greater coordination and enhancement of Dutchess County Government efforts and a proposed work plan to move the recommendations forward. In 2012, 50 deaths resulted from accidental overdoses; nearly 60 percent (33) involved prescription drugs. Thus far this year, 31 of 63 overdose deaths in the county have involved prescription drugs. The county's Drug Task Force reported more than 30 nonfatal heroin overdoses during the past month and the Medical Examiner's office reported five heroin deaths in the past 2 weeks.

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Frederick County Officials to Announce Drug Awareness Efforts for 2014
The Frederick News-Post
December 31, 2013

The Frederick County school board, sheriff's office, state attorney's office, public health agency, and municipalities are planning to launch an anti-drug campaign. The effort will include town hall meetings, pamphlets listing available county resources, and a contest to raise awareness about increased prescription drug and heroin use.

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GIPD No Longer Taking Prescription Drugs
Nebraska TV
December 29, 2013

This article and video (1:30 minutes) discuss Grand Island Police Department's discontinued prescription drug drop-off program. The local incinerator discovered that a license is needed to destroy the drugs and police are working with the Grand Island Substance Abuse Coalition to find a solution. Authorities told residents to keep their prescription medications in a safe place until they can dispose of them properly.

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200 Staten Island Cops Authorized to Give Shots for Prescription Drug Overdose
New York Daily News
December 29, 2013

Nearly 200 cops in one Staten Island precinct have been authorized to administer naloxone to prescription drug overdose victims. The pilot program began following a surge of pain reliever overdoses. Officers are trained to watch for symptoms such as unconsciousness, lethargy, confusion, and shallow or no breathing. When administered properly, the person should resume normal breathing within 10 minutes.

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Oklahoma Doctor Held for Nine Deaths Linked to Prescription Drugs
December 30, 2013

Texas police arrested William Valuck, a former Oklahoma doctor, on nine counts of homicide and 43 counts of illegal drug distribution. Valuck prescribed large doses of addictive medicines such as oxycodone to patients he hardly knew in return for bribes. Oklahoma court documents showed the 71-year-old was previously convicted in 2001 and sentenced to 70 months in prison on charges of money laundering and defrauding investors.

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Police Get New Life-Saving Tool in Battle Against N.J. Heroin Epidemic
The Star-Ledger
December 27, 2013

Police in New Jersey's Ocean, Hunterdon, Camden, and Cape May Counties could soon be equipped with Narcan to reduce deaths from heroin abuse. Narcan will be supplied in police cars throughout Ocean County by February. Hunterdon County police officers will begin carrying the drug next year and Camden County police may start using it early next year.

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92 Drug Overdose Deaths in Westmoreland Shatter Last Year's Record
Trib Total Media
December 31, 2013

Westmoreland County recorded 92 deaths from drug overdoses in 2013—an increase from 78 in 2012. One third of those who overdosed used heroin and two thirds died from prescription drug overdoses. Most heroin deaths occurred among younger adults, while prescription drug overdoses ranged from ages 15 to 70. The Westmoreland County Drug Overdose Task Force hopes to find long-term solutions to reduce the death rate by 25 percent in 5 years.

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Prescription Drug Abuse on the Rise
December 30, 2013

Drug abuse continues to grow in Vilas County, according to the sheriff. While working with Wisconsin's Lac du Flambeau tribal police, his department identified unused and outdated prescriptions as primary sources for abused drugs.

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Other Resources

Prescription Drug Abuse in America
Infographic Journal
December 31, 2013

This PharmacyTechPrograms.org infographic provides prescription drug abuse statistics in America.

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Educational Resources: Misuse of Prescription Pain Relievers
United States Food and Drug Administration
Accessed January 3, 2014

These educational resources provide helpful information to prevent prescription pain reliever misuse. They consist of brochures, print public service announcements (PSAs), Internet PSA banners, posters, radio PSAs, and television PSAs.

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Pills Behind the Wheel May Mean Jail Time
Fox 31 News
December 24, 2013

This article and video (1:35 minutes) remind people not to use powerful prescription medications while driving. Oxycodone and hydrocodone are examples of pain relievers that can affect an individual's driving. Georgia police said unsafe and impaired drivers will be arrested.

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Thoughts on the Latest Long-Acting Opioid
December 31, 2013

Charles Argoff, neurology professor at Albany Medical College and Director of the Comprehensive Pain Management Center at Albany Medical Center, discusses a clinical scenario for those who take care of people with chronic pain. Dr. Argoff examines Zohydro, a new extended-release and long-acting opioid preparation. (Video duration: 8:14 minutes, includes transcript)

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Grant Received

City Up for Substance Abuse Prevention Grant
El Defensor Chieftain
December 25, 2013

Socorro County will receive a $400,000 grant from the New Mexico Human Services Department's Behavioral Health Division to promote substance abuse education within the county. The first year, funds will support various assessments, coalition development initiatives, and strategic prevention framework plans. Officials awarded the grant to Socorro based on data related to underage and adult drinking, alcohol-related motor vehicle deaths, and prescription drug abuse. San Miquel, Sierra, and Torrance Counties also received grants.

Read more:

Take-Back Events and Drop Boxes

Dispose of Unwanted Prescription Drugs at Drop Box in Readington Police Station
Hunterdon Democrat
January 2, 2013

Butler County Police Stations Add Drug Drop Boxes
Trib Total Media
December 28, 2013

Upcoming Conferences and Workshops

What Every Health Professional Should Know About Prescription Drug Abuse
January 22, 2014
Brea, California

Lecture: Prescription Drug Use—The Dos and the Don'ts
January 29, 2014
Huntley, Illinois

SAMHSA's 10th Prevention Day: The Power of Prevention: Strengthening Behavioral Health and Public Health for the Next Decade
February 3, 2014
National Harbor, Maryland

24th National Leadership Forum: The Power of Movement
February 3–6, 2014
National Harbor, Maryland

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

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

11th Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland

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

Prescription Drug Abuse and Diversion Crimes
June 10, 2014
Cottleville, Missouri
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.