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July 14, 2016

PAW Weekly Update

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 182  |  July 14, 2016
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.
Index
Featured
Journal Articles and Reports
Professional Development
National
Marijuana
International
Northeast/Mid-Atlantic News
South News
Midwest News
West News
Grant Award
Grant Announcements
Take-Back Events & Drop Boxes
Upcoming Events, Conferences & Workshops

Featured

Feds Announce New Actions to Combat Opioid Epidemic
U.S. Department Health and Human Services
July 6, 2016

The U.S. Department of Health and Human Services (HHS) has proposed removing a patient satisfaction survey question about pain management from Medicare hospital payment scoring to eliminate a potential financial incentive to prescribe opioids. It also ordered Indian Health Service prescribers and pharmacists to check state prescription drug monitoring program databases before prescribing or dispensing opioids for pain; expanded access to buprenorphine by raising the patient limit per provider from 100 to 275; and announced a Drug Enforcement Administration prescription drug take-back day in October. HHS is launching more than a dozen scientific studies on opioid misuse and pain treatment. It also invites feedback on ways to improve and expand prescriber education and training programs.

Read more:
http://www.hhs.gov/about/news/2016/07/06/hhs-announces-new-actions-combat-opioid-epidemic.html

C.M. Jones, G.T. Baldwin, T. Manocchio, J.O. White, and K.A. Mack. 2016. “Trends in Methadone Distribution for Pain Treatment, Methadone Diversion, and Overdose Deaths — United States, 2002–2014.” Morbidity and Mortality Weekly Report (MMWR) 65(26);667–71, July 8, 2016.

National methadone sales between 2002 and 2006 annually increased 25 percent, methadone-involved drug overdose deaths increased 22 percent, and methadone diversion increased 24 percent. After 2006, methadone sales annually declined 3 percent and methadone-involved overdose deaths declined 6.5 percent. Rates of methadone diversion continued to increase during 2006–09 but substantially more slowly and then declined an average of 13 percent per year beginning in 2010. By sex, most age groups, race/ethnicity, and U.S. Census region, the methadone overdose death rate peaked during 2005–07. People ages 25–54 had the highest overdose death rates. The overdose death rate was stable from 2002 to 2014 among people ages 65 and older, who also had the lowest overdose death rate. Among persons ages 55–64, the methadone overdose death rate continued to increase through 2014.

Read more:
http://www.cdc.gov/mmwr/volumes/65/wr/mm6526a2.htm?s_cid=mm6526a2_w

Journal Articles and Reports

L. Ashrafioun. 2016. “Prescription Opioid Craving: Relationship with Pain and Substance Use-Related Characteristics.” Substance Use & Misuse, doi:10.1080/10826084.2016.1188948.

A convenience sample of 106 opioid-dependent patients (as defined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition) treated at three centers in Detroit, northwest Ohio, and western New York during December 2012 to April 2013 completed the Desire for Drugs Questionnaire and other assessments. Multivariate analysis found both desire-and-intention and negative-reinforcement scores were positively associated with obsessive thoughts and compulsive behaviors about prescription opioids. Positive associations also existed between desire-and-intention scores and pain severity, and between negative-reinforcement scores and expected pain reduction.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/10826084.2016.1188948

B.E. Bride, S.A. Macmasterb, S.A. Morse, C.M. Watson, S. Choi, and J. Seiters. 2016. “A Comparison of Opioid and Nonopioid Substance Users in Residential Treatment for Co-Occurring Substance Use and Mental Disorders.” Social Work in Public Health, doi:10.1080/19371918.2016.1188738.

In 2009–11, 3 private residential treatment centers in Tennessee and California collected longitudinal data from 1,972 patients who had both mental health and substance use disorders. Patients misusing prescription opioids did not differ from patients using other substances on addiction severity, mental health, other baseline characteristics, treatment motivation, length of stay, or relapse.

Read more:
http://www.tandfonline.com/doi/full/10.1080/19371918.2016.1188738

E. Chiarello. 2016. “Nonprescription Syringe Sales: Resistant Pharmacists’ Attitudes and Practices.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.06.023.

In-depth interviews followed up with 17 community pharmacists in California, Kansas, Mississippi, and New Jersey who expressed ethical concerns about providing syringes when polled in a 71-pharmacist survey about ethical decision-making. The 17 pharmacists were ambivalent about providing syringes to people who inject drugs. They were concerned about balancing harm reduction against moral concerns about facilitating drug injection. Their views were shaped in part by law and pharmacy policy. Many allayed their concerns by “engaging in deterrence practices designed to dissuade people who inject drugs from coming to the pharmacy.”

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30170-3/abstract

D. Feingold, I. Goor-Aryeh, S. Bril, Y. Delayahu, and S. Lev-Ran. 2016. “Problematic Use of Prescription Opioids and Medicinal Cannabis Among Patients Suffering from Chronic Pain.” Pain Medicine, doi:10.1093/pm/pnw134.

Of 888 individuals treated for chronic pain at 2 Israeli pain clinics, 99.4 percent received prescription opioids or medicinal cannabis. Problematic use was assessed using Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria, Portenoy’s Criteria, and the Current Opioid Misuse Measure, with respective problem rates among individuals treated with opioids of 53 percent, 17 percent, and 29 percent. Among those treated with medicinal cannabis, problematic use rates on the first two criteria were 21 percent and 11 percent. Problematic use of opioids and cannabis was more common in individuals using medications for longer periods of time, reporting higher levels of depression and anxiety, and using alcohol or drugs. Problematic use of opioids was associated with higher self-reported levels of pain, and problematic use of cannabis was more common among individuals using larger amounts of medicinal cannabis.

Read more:
http://painmedicine.oxfordjournals.org/content/early/2016/06/24/pm.pnw134.abstract

N.D. Pope, K.L. Slovak, and J.T. Giger. 2016. “Development of the Older Adult Prescription Drug Assessment Questionnaire for Case Workers.” Journal of Applied Gerontology, doi:10.1177/0733464816655437.

The authors pilot-tested a 22-item questionnaire for people over age 65 that captured perceptions of prescription drug misuse and assessed respondent misuse. They pilot-tested it on 161 clients of a Midwestern older adult services agency. Exploratory factor analysis suggested a final 11-item, 3-factor instrument that included misuse assessment, views about appropriate use, and beliefs about problem scope.

Read more:
http://jag.sagepub.com/content/early/2016/06/25/0733464816655437.abstract

A.L. Schaffer, N.A. Buckley, R. Cairns, and S-A. Pearson. 2016. “Interrupted Time Series Analysis of the Effect of Rescheduling Alprazolam in Australia: Taking Control of Prescription Drug Use.” JAMA Internal Medicine, doi:10.1001/jamainternmed.2016.2992.

In 2014, Australia’s Therapeutic Goods Administration rescheduled alprazolam (Xanax) from prescription only under Schedule 4 to a Schedule 8 controlled drug. In the first year after rescheduling, prescriptions fell by 22 percent and the number of alprazolam related calls to the Poisons Information Centre decreased by 50 percent. In contrast, poisoning rates for other sedatives and benzodiazepines were unchanged.

Read more:
http://archinte.jamanetwork.com/article.aspx?articleid=2530900
http://www.msn.com/en-au/news/other/xanax-abuse-curbed-in-australia/ar-AAi8vjY

B. Zippel-Schultz, M. Speck, K. Cimander, T. Eschenhagen, J. Gölz, M. Maryschok, M. Nowak, T. Poehlke, H. Stöver, T.M. Helms, and N. Scherbaum. 2016. “Outcomes of Patients in Long-Term Opioid Maintenance Treatment.” Substance Use & Misuse, doi:10.1080/10826084.2016.1188946.

Among a convenience sample of 160 patients from 15 opioid maintenance therapy offices across Germany, mean age was 44. During one year of follow up, 23 percent showed indications of an alcohol problem, 56 percent used cannabis, 28 percent used heroin (usually infrequently), 48 percent had a non-substance-related affective or anxiety disorders and 61 percent a somatic diagnosis (most often hepatitis C, HIV, or cardiovascular disease). Unemployment was 43 percent at baseline and follow up. No arrests or incarcerations were reported.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/10826084.2016.1188946

Professional Development & Opinion

C. Davidson. 2016. “Developing Treatments for Stimulant Abuse: A Brief Overview.” East Asian Archives of Psychiatry 26(2): 52–9.
Read more:
http://easap.asia/abstracts/v26n2/1602_V26N2_p52a.html

B. Fischer, Y. Murphy, P. Kurdyak, and E.M. Goldner. 2016. “Depression–A Major But Neglected Consequence Contributing to the Health Toll from Prescription Opioids?” Psychiatry Research, doi:10.1016/j.psychres.2016.06.053.

Read more:
http://www.psy-journal.com/article/S0165-1781(16)30318-3/abstract

National

Change in Drug Monitoring Provision a Possible Sticking Point in Passing Opioid Bill
Steven Ross Johnson, Modern Healthcare
July 6, 2016

A conference committee version of the Comprehensive Addiction and Recovery Act eliminated a mandate for physicians to check a prescription drug monitoring program database before writing prescription for opioids. That change is controversial.

Read more:
http://www.modernhealthcare.com/article/20160706/NEWS/160709975

Calvin Johnson Says Opioids Handed Out ‘Like Candy’ to NFL Players
Des Bieler, Washington Post
July 7, 2016

Calvin Johnson, a former National Football League (NFL) player with the Detroit Lions, has said that the team’s medical staff handed out addictive opioids “like candy.” More than 1,500 former NFL players, not including Johnson, have filed a class-action lawsuit against the NFL. The suit names each of the league’s 32 teams, alleging that doctors and trainers often distributed pain relievers without examinations or prescriptions, and that players were deliberately misled about dangerous side effects.

Read more:
https://www.washingtonpost.com/news/early-lead/wp/2016/07/06/calvin-johnson-says-painkillers-were-handed-out-like-candy-to-nfl-players

Pfizer Agrees to Truth in Opioid Marketing
Lenny Bernstein, Washington Post
July 5, 2016

Pfizer has reached an agreement with the city of Chicago to use a written code of conduct for marketing opioids. Pfizer will disclose in its promotional material that narcotic pain relievers carry serious risk of addiction even when used properly and promised not to promote opioids for unapproved “off-label” uses. The company also will acknowledge there is no good research on opioids’ effectiveness beyond 12 weeks. Opioids are not among Pfizer’s leading products, and it is not a major opioid provider.

Read more:
https://www.washingtonpost.com/national/health-science/pfizer-agrees-to-truth-in-opioid-marketing/2016/07/05/784223cc-42c6-11e6-88d0-6adee48be8bc_story.html

New Effort at Veterans Affairs to Halt Doctor Shopping for Pain Meds
Patricia Kime, Military Times
July 6, 2016

President Obama has called on Congress to support a Department of Veterans Affairs (VA) policy requiring doctors to check state prescription drug monitoring program databases before prescribing a controlled substance at least once a year, and at each refill. Since the VA launched an opioid safety initiative in 2013, the number of prescriptions decreased by more than 110,000.

Read more:
http://www.militarytimes.com/story/veterans/2016/07/06/new-effort-va-halt-doctor-shopping-pain-meds/86729506

Dentistry’s Role in Preventing Prescription Opioid Abuse
Carol Gomez Summerhays, New Dentist Now
July 6, 2016

The president of the American Dental Association (ADA) is encouraging dentists to (1) register for an ADA Continuing Education Recognition Program webinar on model opioid prescribing in the context of modern drug-seeking behavior, (2) use their prescription drug monitoring program, (3) review the ADA’s Practical Guide to Substance Use Disorders and Safe Prescribing, (4) visit the ADA Center for Professional Success to review ADA resources and previous webinars on opioid prescribing and abuse prevention topics, (5) tell patients to visit MouthHealthy.org/meds where they can learn about the dangers of using opioid pain medications for non-medical purposes, (6) urge patients to sign the Medicine Abuse Project pledge to safeguard their medicines and talk with their families about medicine abuse, and (7) participate in or host a National Recovery Month event in September.

Read more:
http://newdentistblog.ada.org/wordpress/a-message-from-the-ada-president-dentistrys-role-in-preventing-prescription-opioid-abuse/

Gingrich, Kennedy Take on Opioid Addiction
Shefali Luthra, Kaiser Health News (KHN)
July 7, 2016

During this question and answer segment, Patrick Kennedy, former member of congress from Rhode Island, and Newt Gingrich, former speaker of the House of Representatives, spoke about why the issue of opioid addiction is gaining traction and what is needed from Congress. They also discuss how efforts to treat the opioid epidemic could fit into broader efforts to improve mental health care.

Read more:
http://khn.org/news/gingrich-kennedy-take-on-opioid-addiction-the-khn-conversation

Marijuana

A.C. Bradford, and W.D. Bradford. 2016. “Medical Marijuana Laws Reduce Prescription Medication Use in Medicare Part D.” Health Affairs 35(7):1230–6, doi:10.1377/hlthaff.2015.1661.

Using data on all prescriptions filled by Medicare Part D enrollees from 2010 to 2013, researchers estimated that use of prescription drugs for which marijuana might serve as a clinical alternative fell significantly once a medical marijuana law was implemented. The authors claim Medicare program and enrollee spending was $165 million lower in 2013 because states implemented medical marijuana laws, but the analysis fails to establish cause and effect. [Editor’s note: this study included pain relievers in its assessment even in states that only allow marijuana use for narrow diagnoses, such as epilepsy, and only offer products with no claimed efficacy against pain. Also, since many marijuana laws became effective before 2010, the start date for this study also calls into question the essentially cross-sectional results.]

Read more:
http://content.healthaffairs.org/content/35/7/1230.abstract?sid=3971e9fc-c905-408e-a49d-dd911017325d

P.A. Cavazos-Rehg, S.J. Sowles, M.J. Krauss, V. Agbonavbare, R. Grucza, and L. Bierut. 2016. “A Content Analysis of Tweets About High-Potency Marijuana.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.06.034.

“Dabbing” involves heating extremely concentrated forms of marijuana to high temperatures and inhaling the resulting vapor. Tweets containing dabbing-related keywords were collected during January 2015 (n = 206,854). A crowdsourcing service coded a random sample of 5,000 tweets for content according to pre-determined categories about dabbing-related behaviors and effects experienced. Among the 5,000 tweets, 71 percent were related to dabbing marijuana concentrates. The most common themes included mentioning current use of concentrates (24 percent), the intense high or extreme effects from dabbing (22 percent) and excessive/heavy dabbing (15 percent). Extreme effects tended to physiological (n = 124/333; 37 percent) or psychological (17 percent). The most common physiologic effects, passing out (n = 46/333; 14 percent) and respiratory (9 percent), were further studied in the full sample. Coughing was the most common respiratory effect mentioned (n = 807), and tweets commonly mentioned dabbing with intentions to pass out (n = 416).

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30196-X/abstract

Pharmacists Open to Dispensing Medical Marijuana, Not Sold on Recreational
Paula McCooey, Ottawa Citizen
July 2, 2016

The Canadian Pharmacists Association welcomes the opportunity to dispense marijuana for medicinal purposes, but not for nonmedicinal purposes. It believes the best way to enhance patient safety, education, and appropriate access is through pharmacist dispensing and management of medical marijuana while promoting the use of non-smokable products. Currently, pharmacists can only dispense oral doses of cannabinoids based on a doctor’s prescription.

Read more:
http://ottawacitizen.com/news/local-news/pharmacists-open-to-dispensing-medical-marijuana-not-sold-on-recreational

International

How Canada’s Blood Tribe Brought Opiate Overdose Deaths Down to Zero
Dylan C. Robertson, Christian Science Monitor
July 5, 2016

After 35 of the 7,500 members of Canada’s Blood Tribe died from opiate overdoses in 2015, the community took action. In territory just north of Montana, deaths spiked in mid-2014 when a switch to abuse-resistant Oxycontin prompted dealers to substitute fentanyl. Deaths peaked every 2 weeks when welfare and pension checks arrived. Esther Tailfeathers, M.D., used funding from the tribe’s semi-autonomous, oil-rich government to put together 200 emergency naloxone kits, a CPR mask, and instructions on how to use them. Authorities distributed the kits to places where they suspected fentanyl was being used. The tribe launched two confidential hotlines: one to help addicts quit and the other to report traffickers. Every public building in town posted instructions on how to deal with an overdose. About 150 members of the Blood Tribe have suboxone prescriptions and government staff drive most addicts to the pharmacy daily for their dose. The police conduct weekly drug busts and have embraced harm reduction. During traffic stops, officers confiscate only used syringes, ignoring new ones because they are safer. Parents suspected of harboring traffickers in exchange for drugs are given multiple warnings before their homes are raided, in the hope of keeping families together. At the reserve’s social-services office, traditional Blackfoot “smudge boxes” are used to purify the mind with smoke from burning sweet grass, dirt, and charcoal. The tribe has experienced no deaths in the last 8 months and overdose treatment in the emergency department has fallen from a daily occurrence to an incident every few weeks.

Read more:
http://www.csmonitor.com/World/Americas/2016/0705/How-Canada-s-Blood-Tribe-brought-opiate-overdose-deaths-down-to-zero

Edmonton (Canada) Pharmacist Banned After Obtaining Pills Through False Records
Keith Gerein, Edmonton Journal
July 3, 2016

Calvin Boey—an Edmonton, Canada, pharmacist—diverted more than 7,500 pills from his employer during an eight-month period. He created fake patient profiles and prescription records to obtain sedatives. Boey was stripped of his permit to practice and fined $40,000. A hearing tribunal of the Alberta College of Pharmacists deemed the behavior unprofessional conduct and submitted the case to Alberta Justice as a possible criminal matter. The tribunal noted that a previous finding of unprofessional conduct had been levelled against Boey, stemming from his time working at the Shoppers Drug Mart in 2011–12. In that case, he diverted about 10,000 tablets of a sleep medication, and about 1,000 pills of an anti-anxiety drug to feed a personal addiction. Boey had been fined and his practice permit suspended until the end of 2013.

Read more:
http://edmontonjournal.com/news/local-news/edmonton-pharmacist-banned-from-practice-after-obtaining-7500-pills-through-false-records

Bedford (U.K.) Hospital Reports Highest Number of Babies Born Drug Dependent
Bedfordshire On Sunday
July 5, 2016

The British Broadcasting Corporation (BBC) has reported that one in 100 babies born at Bedford Hospital, United Kingdom, last year showed signs of being drug dependent. Of 72 National Health Service hospitals responding to a BBC freedom of information request, Bedford had the highest number. The figures included babies born with an addiction to alcohol or prescription drugs. Almost one in 500 babies in hospitals in England is born dependent on substances their mother took while pregnant.

Read more:
http://www.bedfordshire-news.co.uk/bedford-hospital-reports-highest-number-of-babies-born-drug-dependent/story-29476993-detail/story.html

Northeast/Mid-Atlantic News

Massachusetts Doctors Prescribing Fewer Opioids
Felice J. Freyer, Boston Globe
July 7, 2016

Athenahealth, a Massachusetts company that provides electronic medical records, said opioid prescriptions in the physician practices that use its software fell 25 percent since January 2015. Medical practices nationwide recorded a 13 percent decline. Athenahealth also found the decline in Massachusetts happened across many groups: patients younger and older than 65; those covered by Medicare, Medicaid, or commercial insurance, or paying on their own; and those being treated by primary care doctors or specialists. The decline was steepest among primary care doctors. The Athenahealth figures included 651 physicians, nurse practitioners, and physician assistants in large and small practices that have continuously used the company’s software since 2014. Together, they receive 600,000 patient visits per quarter. In a separate study, the Workers Compensation Research Institute found that from 2012 to 2014 Massachusetts was among the states where opioid prescribing for injured workers was high but declining significantly. A snapshot from the Massachusetts prescription drug monitoring program showed the number of people receiving opioid prescriptions declined from 391,000 in the first quarter of 2015 to 345,000 in the first quarter of 2016. The number of people who obtained prescriptions from more than three providers or more than three pharmacies dropped from 781 to 484.

Read more:
https://www.bostonglobe.com/metro/2016/07/06/massachusetts-doctors-sharply-curtail-opioid-prescriptions/DG74tyBaMTisWxjl42stcP/story.html

Two Atlantic City (N.J.) Firefighters Charged With Buying Fake Heroin
Rebecca Forand, New Jersey Online
July 2, 2016

Atlantic City firefighters Eric Funk and Matthew Doherty were arrested after trying to buy heroin from a New Jersey State Trooper, who was undercover outside the firehouse. Both have been charged with third degree possession of imitation heroin. Funk paid the officer $20 while Doherty gave him a watch in exchange for the drugs. Funk was also charged with possession of drug paraphernalia, possession of a hypodermic syringe, and possession of prescription drugs without a prescription.

Read more:
http://www.nj.com/atlantic/index.ssf/2016/07/2_atlantic_city_firefighters_charged_with_buying_f.html

South News

North Carolina Pharmacists Make Choices with New Naloxone Order
North Carolina Health News
July 5, 2016

North Carolina has become the third state to allow pharmacists to dispense naloxone to people without a prescription. Pharmacists can give one of two forms of naloxone to people based on criteria outlined in the state’s standing order: intranasal spray or intramuscular injection needle. CVS and Walgreens already had standing orders for naloxone, but plan to switch over to the state’s order in upcoming months. Pharmacists participating in the standing order are encouraged, but not required, to register on the North Carolina Division of Public Health’s educational website about naloxone.

Read more:
http://www.northcarolinahealthnews.org/2016/07/05/pharmacists-make-choices-with-new-naloxone-order

Sanctions for Virginia Dentists Who Fail to Report to the Rx Monitoring Program
Virginia Dental Association
July 6, 2016

The Virginia Board of Dentistry has adopted a policy on sanctioning for failure to report to the prescription drug monitoring program (PDMP). The policy is based on the law that requires all dentists who dispense controlled substances in Schedule II, Schedule III, or Schedule IV to register with the PDMP and report the drugs dispensed within 7 days of dispensing.

Read more:
http://www.vadental.org/image-test/2016/07/06/new-board-policy-on-sanctioning-for-failure-to-report-to-the-prescription-monitoring-program

Police Say Confiscated Drugs Found with Arkansas Officer
Kenneth Heard, Arkansas Democrat-Gazette
July 8, 2016

The Batesville, Ark., Police Department has fired Sergeant Phillip Picket, who is accused of stealing methamphetamine, marijuana, alprazolam, and clonazepam from the department’s locked evidence. He faces felony charges of breaking and entering, possession of a controlled substance, possession of drug paraphernalia, and tampering with physical evidence.

Read more:
http://www.arkansasonline.com/news/2016/jul/08/police-say-confiscated-drugs-found-with-1/?f=news-arkansas

Midwest News

Anthem to Monitor Members in Indiana for Drug Abuse
Shari Rudavsky, Indianapolis Star
July 6, 2016

Anthem Blue Cross and Blue Shield will monitor its members to identify those who may be at risk of prescription pain reliever addiction. The company’s Pharmacy Home Program uses patient data to flag policy-holders who overuse medications and puts them on warning to change their behavior. If they do not comply within 60 days, they are asked to choose one pharmacy to fill all of their prescriptions. The company targets people who have many prescriptions filled by multiple providers or who visit the emergency room often for non-emergency care. A person who enters the program may be assigned to one pharmacy, one primary care provider, and one hospital.

Read more:
http://www.indystar.com/story/news/2016/07/04/anthem-debuts-program-curb-overuse-drugs/86612348

Indianapolis Doctors Report More People Abusing Imodium to Get High
Jessica Smith, WISH-TV
July 6, 2016

Doctors at Fairbanks Treatment Center and the Indiana Poison Center have seen an increase in misuse of over-the-counter Imodium. Users take 20 to 25 pills at a time to get high which can cause overdose or cardiac arrest. Two people have died. Doctors have not seen teenagers abusing Imodium. Adult addicts say it is cheaper and easier to get than prescription medications and heroin. Poison centers across the US saw more Imodium cases in the first six months of 2016 than in all of 2015. The Indiana Poison Center saw almost a quarter of its cases in the last 14 years within the last two months.

Read more:
http://wishtv.com/2016/07/06/indianapolis-doctors-report-more-people-abusing-imodium-to-get-high

Michigan Fights Deadly Heroin and Opioid Epidemic
Brad Devereaux, MLive Media Group
July 5, 2016

This article discusses seven things to know about opioid abuse efforts and overdose deaths in Michigan. They include: 1) the numbers are rising; 2) Michigan is working to reduce overdoses; 3) the epidemic is not only in Michigan; 4) experts want to change prescription culture; 5) when addicts cannot get pills, some use heroin; 6) police will safely destroy unwanted drugs; and 7) antidote has saved lives.

Read more:
http://www.mlive.com/news/index.ssf/2016/07/10_things_about_michigans_dead.html

West News

Hawaii’s Marijuana and Opiate Use Near Record High
Maui Now
July 5, 2016

Diagnostic Laboratory Services reported that workplace marijuana usage in Hawai’i increased from 2.2 percent in the second quarter of 2015 to 2.4 percent in the first quarter of 2016 and 2.9 percent in the second quarter – returning to a range last seen in the second quarter of 2013. Opiate use rose from 0.2 percent in the second quarter of 2015 to 0.4 percent. The company conducts 7,000 to 10,000 drug tests per quarter.

Read more:
http://mauinow.com/2016/07/05/hawaiis-marijuana-and-opiate-use-near-record-high

California Bill Would Crack Down On Opioid Doctor Shoppers
Darcy Costello, Lexington Herald Leader
July 1, 2016

California’s senate has passed legislation that would require providers to consult the prescription drug monitoring program database before prescribing narcotic pain relievers. They would have to recheck it every four months for as long as the drug regimen continues. The measure is waiting an Assembly committee hearing.

Read more:
http://www.kentucky.com/living/health-and-medicine/article87143902.html

Seattle Cancer Care Alliance Settles Investigation After 96,000 Pills Diverted
KIRO
July 7, 2016

The Seattle Cancer Care Alliance has agreed to pay $250,000 to settle a U.S. Justice Department investigation into how a nurse was able to divert more than 96,000 oxycodone pills from an onsite pharmacy. It also agreed to make sure pharmacists take reasonable steps to validate prescriptions. From 2011 through 2013, the nurse had physicians sign prescriptions, then altered them to increase the potency and quantity of the pills provided. She picked up the prescriptions at the pharmacy, supposedly as a favor to the patients. The nurse committed suicide after her actions came to light. The problem came to light in 2013 when a former Alliance patient was injured on the job and prescribed pain medication. When the Washington Department of Labor and Industries denied a claim from the patient because the state prescription drug monitoring program indicated she was already receiving pain medication from the Alliance. The patient disputed that, and Labor and Industries workers alerted the Alliance, which investigated, discovered the nurse’s fraud, fired her, and alerted state and federal agencies.

Read more:
http://www.kiro7.com/news/local/seattle-cancer-care-alliance-settles-investigation-after-96000-pills-diverted/391241913

Webinars

Reducing Opioid Abuse by Incorporating Patient Management Strategies from Psychiatry and Behavioral Health
American Dental Association
Aug. 24, 2016 | 3–4 p.m. (ET)

This webinar covers strategies to educate the dental team on addictive disease, how to recognize addictive disease, and provide pain management in dental patients.

Read more:
http://pcss-o.org/event/reducing-opioid-abuse-by-incorporating-patient-management-strategies-from-psychiatry-and-behavioral-health

Pain Management in Dentistry: A Changing and Challenging Landscape
American Dental Association
Sept. 2, 2016 | 3–4 pm (ET)

This webinar will explain the rationale for combining the two peripherally-acting analgesics acetaminophen (Tylenol) and ibuprofen (Advil); the importance of recent changes made in opioid/acetaminophen formulations containing analgesics such as Vicodin ES; and patient recommendations for the safe and responsible use of prescription opioid analgesics.

Read more:
http://pcss-o.org/event/pain-management-in-dentistry-a-changing-and-challenging-landscape

Grant Announcements

Safety and Outcome Measures of Pain Medications Used in Children and Pregnant Women (R03) | (R01) | (R21)
National Institutes of Health
Due: Oct. 16, 2016 | Jan. 7, 2020 | Jan. 7, 2020
Read more (R03):
http://grants.nih.gov/grants/guide/pa-files/PA-16-313.html
Read more (R01):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284425
Read more (R21):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284428

Safety and Outcome Measures of Pain Medications Used in Children and Pregnant Women (R03) | (R01) | (R21)
National Institutes of Health
Due: Oct. 16, 2016 | Jan. 7, 2020 | Jan. 7, 2020
Read more (R03):
http://grants.nih.gov/grants/guide/pa-files/PA-16-313.html
Read more (R01):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284425
Read more (R21):
http://www.grants.gov/web/grants/view-opportunity.html?oppId=284428

Bottle Tracking Program
National Association of Drug Diversion Investigators
Due: None Specified
http://www.naddi.org/aws/NADDI/pt/sp/programs_grants
http://naddibottletracking.org/law-enforcement

Take-Back Events & Drop Boxes

Dauphin County (Pa.) Residents Drop Off 893 Lbs. of Prescription Drugs
Hope Stephan, PennLive
July 1, 2016
http://www.pennlive.com/news/2016/07/disposal_program_brings_in_893.html

Dothan (Ala.) Police Collect Over 200 Lbs. of Unused Drugs
Dothan Eagle
July 7, 2016
http://www.dothaneagle.com/news/local/over-pounds-of-unused-drugs-collected-at-dothan-police-department/article_ca46369e-448e-11e6-8a8c-0f414064f9e8.html

Almost 100 Lbs. of Unwanted Prescription Meds Collected By Ulster (N.Y.) Sheriff
MidHudsonNews.com (New York)
July 7, 2016
http://www.midhudsonnews.com/News/2016/July/07/UC_prescrip_dropoff-07Jul16.html

Benzer Pharmacy Rolls Out RxTakeBack Kiosks at Two Florida Locations
David Salazar, Drug Store News
July 5, 2016
http://www.drugstorenews.com/article/benzer-pharmacy-rolls-out-rxtakeback-kiosks--locations

Ask the Times: Iowa County Has Options for Disposal of Prescription
Roy Booker, Quad City Times
June 7, 2016
http://qctimes.com/news/local/ask-the-times/ask-the-times-county-has-options-for-disposal-of-prescription/article_19073498-f043-52e9-8e99-a2f7e380e2d1.html

Old, Unwanted Medications Can Be Dropped in Box at Shaler (Pa.) Police Station
Rachel Farkas, Trib Total Media
July 1, 2016
http://triblive.com/news/neighborhoods/northhills/10702272-74/drug-box-police

Luzerne County (Pa.) Courthouse Site of Medicine Drop Boxes
Patrick Abdalla, Standard Speaker
July 4, 2016
http://standardspeaker.com/news/luzerne-county-courthouse-site-of-medicine-drop-boxes-1.2063104

Agnesian HealthCare Expands Community Drug Drop Locations in Wisconsin
KFIZ
July 5, 2016
http://www.kfiz.com/local-news/agnesian-healthcare-expands-community-drup-drop-locations

Upcoming Events, Conferences, & Workshops

Fifteenth Annual Mid-Year Training Institute
Community Anti-Drug Coalitions of America
July 17–21, 2016
Las Vegas, Nev.
http://www.cadca.org/events/15th-annual-mid-year-training-institute

Register:
http://www.cadca.org/events/15th-annual-mid-year-training-institute/registration

The Harold Rogers Prescription Drug Monitoring Program National Meeting
Bureau of Justice Assistance, and Prescription Drug Monitoring Program Training and Technical Assistance Center at Brandeis University
Aug. 17–19, 2016
Washington, D.C.

Register:
http://www.pdmpassist.org/content/ttac-meeting-registration-form

National Conference on Addiction Disorders: Taking Recovery to New Heights
Vendome Healthcare Media
Aug.18–21, 2016
Sheraton Denver Downtown Hotel
Denver, Colo.
https://vendome.swoogo.com/ncad-2016/home

Register:
https://vendome.swoogo.com/ncad-2016/begin

2016 Annual Conference
International Health Facility Diversion Association
Sept. 13–14, 2016
Cincinnati, Ohio
https://vendome.swoogo.com/ncad-2016/beginx

Register:
https://www.regonline.com/Register/Checkin.aspx?EventID=1803476

Twenty-Ninth Annual National Prevention Network Conference
National Prevention Network
Sept. 13–15, 2016
Buffalo, N.Y.
http://www.npnconference.org

Register:
http://www.npnconference.org/registration

2016 Conference: Saving Lives: Access to Improved Health & Recovery
American Association for the Treatment of Opioid Dependence
Oct. 29 – Nov. 2, 2016
Baltimore, Md.
http://www.aatod.org/national-conference/2016-aatod-conference-baltimore

Register:
http://www.aatod.org/national-conference/2016-aatod-conference-baltimore/register-now

Bridging the Gaps: Reducing Prescription Drug and Opioid Abuse and Misuse Summit
National Association of Attorneys General and the Association of State and Territorial Health Officials
Nov. 14–16, 2016
Arlington, Va.
http://www.naag.org/nagtri/nagtri-courses/national/bridging-the-gaps-reducing-prescription-drug-and-opioid-abuse-and-misuse-summit.php

National Rx Drug Abuse & Heroin Summit
Operation Unite
April 17–20, 2017
Atlanta, Ga.
https://vendome.swoogo.com/2017-rx-summit/8082

Call for Presentations
Submission Deadline Date: Friday, Aug. 5, 2016
https://vendome.swoogo.com/2017-rx-summit/2017-CFP
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.