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June 11, 2014

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 75  |  June 11, 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 Article Journal Articles and Reports Professional Education & Editorial News Other State and Local News Other Resources Webinar Video Audio Request for Proposal Take-Back Events Save the Date Upcoming Conferences and Workshops

Featured

A. Reddy, M. de la Cruz, E.M. Rodriguez, J. Thames, J. Wu, G. Chisholm, D. Liu, S. Frisbee–Hume, S. Yennurajalingam, D. Hui, H. Cantu, A. Marin, V. Gayle, N. Shinn, A. Xu, J. Williams, and E. Bruera. 2014. "Patterns of Storage, Use, and Disposal of Opioids Among Cancer Outpatients." The Oncologist, doi:10.1634/theoncologist.2014-0071.

Researchers surveyed 300 adult cancer outpatients (median age 57) in a supportive care center. Nine percent locked up their opioids, 69 percent kept them hidden but unlocked, and 19 percent stored them in plain sight. Another nine percent reported sharing opioids, and 17 percent reported losing them. Single patients (44 percent vs. 21 percent) and those with a history of alcohol abuse (40 percent vs. 21 percent) or illicit drug use (42 percent vs. 23 percent) were more likely to use opioids in these unsafe ways. Among all 300 patients, 74 percent were unaware of proper opioid disposal methods and 46 percent had unused opioids at home.

Read more:
http://theoncologist.alphamedpress.org/content/
early/2014/05/26/theoncologist.2014-0071.abstract


Free Prescription Drug Employer Kit
National Safety Council
Accessed June 4, 2014

This Employer Kit produced by the National Safety Council educates managers and employees about risks related to prescription drug use at work. It contains materials to help people communicate and develop policies on prescription pain reliever use, including fact segments and handouts for health and safety education programs targeting employment, benefits, safety, and Employee Assistance Programs; 5-minute safety talks; a poster series focused on home safety and disposal; an infographic about prescription pain reliever risks; and content to help develop an effective policy for prescription drug use in the workplace.

Read more:
http://www.nsc.org/safety_home/PrescriptionDrugOverdoses/Pages/Employer-Policies.aspx

Journal Articles and Reports

J. Birt, J. Johnston, and D. Nelson. 2014. "Exploration of Claims-Based Utilization Measures for Detecting Potential Nonmedical Use of Prescription Drugs." Journal of Managed Care Pharmacy 20(6):639–46.

Researchers consulted a large, multi-state employer-based administrative claims database (MarketScan) to evaluate drug use in the first year after an index prescription for six classes of drugs with known abuse potential and three classes without. The study cohort included 6,291,810 patients whose mean age was 52 years; 57.9 percent were female. Examining traditional population-level measures of adherence, the mean medication possession ratio (MPR) and mean proportion of days covered (PDC) for drugs with known abuse potential were lower than those for drugs without known abuse potential. Measures of asymmetrical use within a population were evaluated with the Lorenz curve, representing the total drug supply used by the heaviest 1 percent, 5 percent, and 50 percent of all users. Acetaminophen with codeine, acetaminophen with oxycodone, oxycodone, and acetaminophen with hydrocodone had the highest Lorenz-1 percent values. The MPR, PDC, Lorenz-1 percent, and Lorenz-50 percent were able to discriminate between drugs with known abuse potential and those without (c-statistic 0.979 to 1), but the ratio of MPR to PDC was not able to discriminate between the drugs (c-statistic 0.592).

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24856602

L–Yu Chen, E.C. Strain, P.K. Alexandre, G.C. Alexander, R. Mojtabai, and S.S. Martins. 2014. "Correlates of Nonmedical Use of Stimulants and Methamphetamine Use in a National Sample." Addictive Behaviors 39(5):829–36, doi:10.1016/j.addbeh.2014.01.018.

In data from the 2009–11 National Survey on Drug Use and Health, adult and adolescent stimulant users were categorized in the following groups: nonmedical attention deficit hyperactivity disorder (ADHD) stimulant users only, methamphetamine users only, and ADHD stimulant and methamphetamine users. Multivariate logistic regression analyses indicated that compared with adolescent stimulant users, stimulant/methamphetamine users were more likely to be female, younger, and uninsured, while methamphetamine users were more likely to be younger, in a minority group, and from a higher-income family. Compared with adult stimulant users, methamphetamine and stimulant/methamphetamine users were more likely to be male, older, uninsured, no longer married, or from rural areas. Adolescent methamphetamine users were more likely than stimulant users to report illegal drug use, while adult methamphetamine users were less likely to report prescription drug use than their stimulant-user counterparts. Overall, adult and adolescent stimulant/methamphetamine users were more likely than stimulant users to report substance use, mental health problems, and deviant behaviors.

Read more:
http://www.sciencedirect.com/science/article/pii/S0306460314000197

A.K. Clark, C.M. Wilder, and E.L. Winstanley. 2014. "A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs." Journal of Addiction Medicine 8(3):153-63, doi:10.1097/ADM.0000000000000034.

This systematic review of 19 articles describes the use and effectiveness of opioid overdose prevention programs. It summarizes participant demographics, the number of naloxone administrations, the percentage of survival in overdose victims receiving naloxone, post-naloxone administration outcome measures, opioid overdose prevention program characteristics, changes in knowledge about overdose responses, and barriers to naloxone administration during overdose responses. Current evidence from nonrandomized studies suggests bystanders (mostly opioid users) can and will use naloxone to reverse opioid overdoses when properly trained, and that this training can be conducted successfully through opioid overdose prevention programs.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24874759

A. Garg, P. Sinha, P. Kumar, and O. Prakash. 2014. "Use of Naltrexone in Ketamine Dependence." Addictive Behaviors 39(8):1215–16, doi:10.1016/j.addbeh.2014.04.004.

The anesthetic ketamine is misused as a rave drug for its psychedelic effect, and no guidelines exist for effective management of ketamine withdrawal. In this article, researchers report a case of successful ketamine dependence treatment using naltrexone.

Read more:
http://www.sciencedirect.com/science/article/pii/S0306460314001063

P. Gavaza, M. Fleming, and J.C. Barner. 2014. "Examination of Psychosocial Predictors of Virginia Pharmacists' Intention to Utilize a Prescription Drug Monitoring Program Using the Theory of Planned Behavior." Research in Social Administrative Pharmacy 10(2):448–58, doi:10.1016/j.sapharm.2013.06.011.

This study examined which theory of planned behavior (TPB) model constructs (i.e., attitude, subjective norm, perceived behavioral control, past use behavior, and perceived moral obligation) were significant predictors of Virginia community pharmacists' intentions to use a prescription drug monitoring program. A cover letter with a link to a 28-item online survey was e-mailed to 600 members of the Virginia Pharmacists Association, with 97 providing usable responses (a 16.2 percent response rate). The majority of respondents were white (96.4 percent), female (50.5 percent), and working in independent community pharmacies (60.4 percent), with an average age of 49.5 ± 13.4 years. Overall, pharmacists intended to use the state's prescription monitoring program (PMP), had a positive attitude about using it, perceived that others wanted them to use it, and believed they had control over their use behavior. Attitude, subjective norm, perceived behavioral control, and perceived moral obligation significantly predicted pharmacists' self-reported intent to use the PMP, but past use did not.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23953982

E. Halliday, J. Hyrne, C. Rhoden, P. Rhoden, C. Tyler, and E. Richardson. 2014. "Student Perceptions of the Use of Marijuana and Abuse of Prescription Drugs at Clemson University." Clemson University, Focus on Creative Inquiry. Paper 36.

This study probed perceptions of prescription drugs and marijuana among users at Clemson University, and compared them with perceptions at Duke University and the University of North Carolina at Greensboro. One fourth of Clemson University undergraduate students were e-mailed a survey link. There was a 9 percent response rate (low even by e-mail standards). Nevertheless, their responses were similar to those from students at the other universities. Nearly 40 percent perceived marijuana use and prescription drug abuse as major issues at Clemson. Eleven percent had prescriptions for attention deficit hyperactivity disorder medications.

Read more:
http://tigerprints.clemson.edu/foci/36

A.B. Kelly, G.C.K. Chan, A. White, J.B. Saunders, P.J. Baker, and J.P. Connor. 2014. "Is There Any Evidence of Changes in Patterns of Concurrent Drug Use Among Young Australians 18–29 Years Between 2007 and 2010?" Addictive Behaviors 39(8):1249–52, doi:10.1016/j.addbeh.2014.04.009.

Researchers analyzed data from 3,836 respondents ages 18–29 in Australia's 2010 National Drug Strategy Household Survey. Only about 2 percent of the young adults reported nonmedical use of prescription drugs in the past year. Almost all were among the 2.3 percent of respondents, who latent class analysis identified as regular illicit drug and alcohol abusers.

Read more:
http://www.sciencedirect.com/science/article/pii/S0306460314001117

S.C. Lee, W. Klein–Schwartz, S. Doyon, and C. Welsh. 2014. "Comparison of Toxicity Associated with Nonmedical Use of Benzodiazepines with Buprenorphine or Methadone." Drug and Alcohol Dependence 138(1):118–23, doi:10.1016/j.drugalcdep.2014.02.014.

This study compared severity of nonmedical buprenorphine (BUP) and methadone toxicity with concomitant use of benzodiazepines (BZP) in cases involving people 18 and over reported to the National Poison Data System. From November 2002 to December 2010, there were 692 methadone–BZD cases and 72 BUP–BZD cases. Clinical effects in methadone–BZD and BUP–BZD groups were lethargy (71.1 percent, 59.7 percent), respiratory depression (29.0 percent, 15.3 percent), coma (22.4 percent, 5.6 percent), respiratory arrest (4.5 percent, 0), hypotension (11.8 percent, 2.8 percent), and cardiac arrest (1.9 percent, 0), respectively. Patients in the methadone–BZD group were four times more likely to receive naloxone (60.4 percent vs. 15.3 percent) or be intubated (16.3 percent vs. 4.2 percent) than those in the BUP–BZD group. Hospitalization rates were highest for methadone–BZD patients: 67.3 percent were admitted compared with 43.3 percent of BUP–BZD patients. There were no BUP–BZD deaths. The more frequent exposures to methadone–BZD resulted in 16 deaths.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871614000696

C. Okunseri, E. Okunseri, Q. Xiang, J.M. Thorpe, and A. Szabo. 2014. "Prescription of Opioid and Nonopioid Analgesics for Dental Care in Emergency Departments: Findings from the National Hospital Ambulatory Medical Care Survey." Journal of Public Health Dentistry, doi:10.1111/jphd.12055.

Using data on nontraumatic dental patients from the U.S. National Hospital Ambulatory Medical Care Survey for 1997–2000 and 2003–07, researchers estimated there was a 43 percent probability of receiving a prescription for opioid analgesics, a 20 percent probability of receiving a prescription for nonopioid analgesics, and a 12 percent probability for receiving both; with 25 percent receiving neither. Most patients categorized as having severe pain received opioid prescriptions for nontraumatic dental condition–related visits in emergency departments. After adjusting for covariates, dental patients with self-reported severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and nonopioid analgesic combinations.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/jphd.12055/abstract;jsessionid=
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A. Pulver, C. Davison, and W. Pickett. 2014. "Recreational Use of Prescription Medications Among Canadian Young People: Identifying Disparities." Canadian Journal of Public Health 105(2).

The 2009–10 cycle of the nationally representative Canadian Health Behaviour in School-Aged Children study (n=10,429) asked students in grades 9–10 about past-year recreational use of pain relievers, stimulants, and sedative/tranquilizer medications. Approximately 7 percent of students reported past-year recreational use of prescription medicine. Females reported 1.25 times the risk of recreational pain reliever use compared with males. Students of lower socioeconomic status were 2.41 times more likely to report recreational use of any type of medication. Recreational use of pain reliever medications was highest among rural youth living close to urban centers. Rates for all medications were similar between immigrant and non-immigrant students.

Read more:
http://journal.cpha.ca/index.php/cjph/article/view/4208

H. Uosukainen, J.H.O. Turunen, J. Ilomäki, and J.S. Bell. 2014. "Community Pharmacy Services for Drug Misuse: Attitudes and Practices of Finnish Pharmacists." International Journal of Drug Policy, doi:10.1016/j.drugpo.2014.05.009.

Based on a 2012 mail survey, this Finnish study compared attitudes of pharmacists representing pharmacies that dispensed buprenorphine-naloxone (n=77, 77 percent response rate) versus matched comparison pharmacies that did not (n=236, 85 percent response rate). Pharmacists who responded on behalf of pharmacies that dispensed were significantly more likely to perceive that dispensing opioid substitution treatment is part of the pharmacist's professional role (62 percent vs. 27 percent) and less likely to be concerned about safety (39 percent vs. 73 percent), the public image of the pharmacy as a result of dispensing such treatment (17 percent vs. 34 percent), or diversion (56 percent vs. 73 percent).

Read more:
http://www.sciencedirect.com/science/article/pii/S0955395914001388

Professional Education & Editorial

B. Fischer, J. Gooch, B. Goldman, P. Kurdyak, and J. Rehm. 2014. "Non-Medical Prescription Opioid Use, Prescription Opioid-Related Harms and Public Health in Canada: An Update 5 Years Later." Canadian Journal of Public Health 105(2).

Five years ago, researchers highlighted Canada's emerging problem of prescription opioid–related harms and emphasized the need for targeted surveillance, research, and interventions. The country's prescription opioid use has increased by 70 percent since then, levels of nonmedical prescription opioid use in general and in key risk populations remain high, and prescription opioid–related treatment admissions and overdose deaths have risen substantially. Systematic monitoring of prescription opioid–related harms is lacking, with no available national morbidity or mortality statistics. Policy measures implemented recently at the federal and provincial levels remain to be systematically evaluated. Evaluation will be hampered by a downturn in nonmedical prescription opioid use prior to intervention.

Read more:
http://journal.cpha.ca/index.php/cjph/article/view/4143

M.A. Hedaya. 2014. "The Need for Tamper-Resistant and Abuse-Deterrent Formulations." Journal of Pharmaceutical Care Health Systems 1:e102, doi:10.4172/jpchs.1000e102.

This editorial discusses the need for tamper-resistant and abuse-deterrent formulations. The author says manufacturers and researchers must stay current on which drugs are being abused, how they are being abused, and the tampering methods used to get high. He believes abuse-deterrent products should never be considered abuse-proof, because sophisticated methods to "beat" these formulations could likely be found quickly on the Internet.

Read more:
http://omicsgroup.org/journals/the-need-for-tamperresistant-and-abusedeterrent-formulations-JPCHS-1-e102.php?aid=26193

S. Levy and L.M. Siqueira. 2014. "Testing for Drugs of Abuse in Children and Adolescents." Pediatrics 133(6):e1798–e1807, doi:10.1542/peds.2014-0865.

This clinical report provides guidance to pediatricians and other clinicians on efficacy and efficient use of drug testing based on a review of the scientific literature, policy guidelines, and published clinical recommendations.

Read more:
http://pediatrics.aappublications.org/content/133/6/e1798

C.M. Wilder, F.W. Brason, A.K. Clark, M. Galanter, A.Y. Walley, and E.L. Winstanley. 2014. "Development and Implementation of an Opioid Overdose Prevention Program Within a Preexisting Substance Use Disorders Treatment Center." Journal of Addiction Medicine 8(3):164–9, doi:10.1097/ADM.0000000000000032.

This case study of the development and implementation of an opioid overdose prevention program is generalized from an actual clinic's experience. Four experts reflect on the medical, administrative, peer support, community, and evaluation aspects of this case. This discussion highlights challenges and important considerations in the creation of programs to address the ever-increasing opioid overdose risk.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24874760

News

National Safety Council Offers 5 Tips for Using Opioid Painkillers Safely
PRNewswire
June 3, 2014

In this press release, the National Safety Council (NSC) urges Americans to take precautions with prescription pain relievers. Five tips from Dr. Don Teater, NSC's medical advisor, will help reduce the risk of developing an addiction to or overdosing on prescription pain relievers. Dr. Teater suggests talking to one's doctor about whether an opioid pain reliever is the right treatment, taking prescription opioids for the shortest time possible, paying attention to the body's reaction to pain relievers, never sharing medications, and never mixing pain relievers with alcohol or certain other medications.

Read more:
http://www.prnewswire.com/news-releases/national-safety-council-offers-5-tips-for-using-opioid-painkillers-safely-261718641.html

KEATING: Helping Vets Beat Prescription Drug Abuse
Bill Keating, Taunton Daily Gazette
June 1, 2014

Bill Keating, a U.S. Representative and member of the Congressional Caucus on Prescription Drug Abuse, shared his views on prescription drug abuse struggles among the Armed Forces and civilians. Keating authored the Stop the Tampering of Prescription Pills Act, which calls for abuse-deterrent formulations for generic and brand opioid-based pain relievers. He is working to amend the act to ensure legislators not only target certain drugs, but all drugs that have abuse and addiction potential.

Read more:
http://www.tauntongazette.com/article/20140530/OPINION/140539422/11207/OPINION

Drugs for Treating Heroin Users: A New Abuse Problem in the Making?
Elizabeth Barber, The Christian Science Monitor
May 30, 2014

Drugs like Suboxone are being sold on the streets, and may even be a gateway to heroin or opioid use. Suboxone is available by prescription for take-home use, but it is weaker than methadone. The drug contains a mixture of buprenorphine and naloxone. Poor oversight of dispensing and use has led to street sales. Some addicts sell their prescriptions to feed heroin habits or buy it to reduce withdrawal symptoms when they can't afford heroin. Medical examiners do not regularly test for the drug.

Read more:
http://www.csmonitor.com/USA/Society/2014/0530/Drugs-for-treating-heroin-users-a-new-abuse-problem-in-the-making

Pensioners Selling Prescription Drugs to Dealers
Kathleen Donaghey, The Courier-Mail
June 7, 2014

This article discusses how Australian pensioners are selling their prescription medication. The most desired drugs are MS Contin, OxyContin, and fentanyl patches. Individuals can make $4,000 for a box of fentanyl patches, according to the latest figures from the Australian Crime Commission. In Queensland, General Practitioner Ken Treichel banned six elderly patients in the past year after discovering they were selling their medications. Queensland Health maintains a prescription monitoring database and a hotline for doctors, but the patient data can be months out of date. The Australian Medical Association Queensland has called for a "real time" electronic reporting system to track prescriptions. The federally funded Electronic Recording and Reporting of Controlled Drugs is currently operational, but not in use in Queensland, as it is still being assessed.

Read more:
http://www.couriermail.com.au/news/queensland/pensioners-selling-prescription-drugs-to-dealers/story-fnihsrf2-1226946329377

Rugby League: NRL Now Testing for Prescription Drugs in an Australian First
Adrian Proszenko, Sydney Morning Herald
June 4, 2014

The Australian National Rugby League began testing players for prescription drugs, becoming the first governing sports body in the country to do so. The league informed its 16 clubs in writing that Laverty Pathology will screen players for illicit drugs, including amphetamines, ketamine, cannabis, cocaine, and opiates, and synthetic versions of those drugs, such as synthetic cannabis and synthetic bath salts. The league's integrity and compliance unit will notify players and their clubs about a failed test, the sanction imposed, and their rights to appeal. Players who test positive will participate in a case review with the league's chief medical officer and their own club doctor, and will have to attend a rehabilitation program.

Read more:
http://www.smh.com.au/rugby-league/league-news/rugby-league-nrl-now-testing-for-prescription-drugs-in-an-australian-first-20140604-zrx7x.html

Chicago Accuses Drug Companies of Pushing Opioids
Andrew Harris, Bloomberg
June 3, 2014

The City of Chicago has sued Johnson & Johnson, Purdue Pharma, Endo Health Solutions, Teva Pharmaceutical Industries, and Actavis for allegedly pushing consumer use of opioid pain relievers, creating addicts, and driving up drug costs. Lawyers for the city filed a claim in state court stating, "Since 2007, the city has paid for nearly 400,000 claims for opioid prescription fills, costing nearly $9,500,000, and suffered additional damages for the costs of providing and using opiates long-term to treat chronic non-cancer pain." The lawyers accused drug companies of deceiving the public about risks associated with the use of pain relievers they manufactured, while overstating their benefits.

Read more:
http://www.bloomberg.com/news/2014-06-03/chicago-sues-drug-companies-for-pushing-prescription-opiates-1-.html

Other State and Local News

Governor, Commissioners Announce Strategic Plan to Tackle Prescription Drug Abuse Epidemic
State of Tennessee
July 3, 2014

Tennessee Governor Bill Haslam and Department of Mental Health and Substance Abuse Services Commissioner E. Douglas Varney released "Prescription for Success," Tennessee's plan to prevent and treat prescription drug abuse. The plan aims to reduce the number of Tennesseans who abuse controlled substances; reduce the number of Tennesseans who overdose on controlled substances; reduce the amount of controlled substances dispensed in Tennessee; increase access to drug disposal outlets in Tennessee; increase access and quality of early intervention, treatment, and recovery services; expand collaboration and coordination among state agencies; and expand collaboration and coordination with other states.

Read more:
https://news.tn.gov/node/12499

Virginia Prescription Monitoring Program Statistics Through Year End 2013
Virginia Department of Health Professions
Accessed June 2, 2014

This report charts 2013 program statistics from the Virginia Prescription Monitoring Program. The program processed 1.3 million requests in 2013—a 65 percent increase from the previous year. The program also added 4,187 registered users in 2013. By the end of 2013, the database contained 98 million prescription records.

Read more:
http://www.dhp.virginia.gov/dhp_programs/pmp/docs/ProgramStats/2013PMPStatsFinal.pdf
http://www.dhp.virginia.gov/dhp_programs/pmp

Attorney General Mills Announces 2013 Drug Death Statistics—Heroin Continues to Claim More Lives
Office of the Maine Attorney General
June 2, 2014

Maine Attorney General Janet Mills and the Office of the Chief Medical Examiner reported that 176 drug-induced deaths, most of them unintentional, occurred in Maine in 2013—an increase of 13 deaths from 2012. Of these, 105 deaths were attributable to prescription opioids; 34 were attributable to heroin. In 2012, 28 people died in Maine as a result of a heroin overdose, compared with just seven in 2011. Of 830 drug cases the Maine Drug Task Force closed in 2013, 44 percent involved prescription drugs (down from 51 percent in 2012); 20 percent involved heroin (up from 8 percent); and 18 percent involved cocaine.

Read more:
http://www.maine.gov/ag/news/article.shtml?id=621052

Report Shows More Frederick County Students Abusing Prescription Drugs
WFMD
June 4, 2014

The 2013 Maryland Youth Risk Behavior Surveillance Survey of middle and high school students showed 4 percent of 6th graders in Frederick County, 7 percent of 8th graders, 11 percent of 9th graders, and 24 percent of 12th graders admitted to taking a prescription drug not prescribed for them.

Read more:
http://www.wfmd.com/articles/wfmd-local-news-119935/report-shows-more-frederick-county-students-12425258

UC Part of New Research Effort into Chronic Pain
Hannah Poturalski, Oxford Press
June 3, 2014

The University of Cincinnati, University of Michigan, and Eli Lilly have formed the Midwest Pain Consortium for a 2-year research pilot to study chronic pain management and other "non-competitive" challenges facing the pharmaceutical industry. The consortium will begin by using neuroimaging techniques to study pain development in the brain. The 2-year pilot will also study potential new medications and other nonpharmaceutical approaches to pain management. The partnership will attempt to better understand why some people have adverse reactions to certain pain medications and others do not. Eli Lilly will provide $400,000 in funding.

Read more:
http://www.oxfordpress.com/news/news/uc-part-of-new-research-effort-into-chronic-pain/ngC8C

Pill-Mill Crackdown in Ohio Having Success
Kathy Lynn Gray, the Columbus Dispatch
June 3, 2014

Law enforcement claimed another success after a West Portsmouth man was sentenced for operating three Ohio pill mills. A federal judge in Cincinnati ordered the owner to serve a 14-year prison sentence and forfeit $6.3 million in proceeds from the clinics. Six doctors who worked at the clinics were also convicted. Ohio Attorney General Mike DeWine has focused on the pill mill problem since 2011 and estimates that through July 2013, he has helped convict 15 people. DeWine's office reported that 53 doctors and 13 pharmacists lost their Ohio licenses for improperly prescribing or dispensing prescription drugs from 2011 through February 2014. Twelve people were indicted in April by a Knox County grand jury for taking part in a pill-trafficking ring. The group was accused of transporting more than 100,000 pills from Florida to Ohio. In another case, 52 people were indicted in late 2012 and early 2013 in Franklin County on charges of transporting $2.8 million worth of OxyContin from Florida to Ohio.

Read more:
http://www.dispatch.com/content/stories/local/2014/06/03/pill-mill-crackdown-having-success.html

Expanded Prescription Drug Monitoring Program Balances Privacy and Public Safety: Kathleen G. Kane
Kathleen G. Kane, PennLive.com
June 6, 2014

Kathleen G. Kane, Pennsylvania's Attorney General, shares her opinion about expanding the prescription monitoring program (PMP) while imposing privacy limitations as a way to effectively reduce prescription drug abuse. Pennsylvania's PMP only collects data on Schedule II narcotics. Legislation introduced by Senator Pat Vance would expand the database to include all dispensed Schedule III, IV, and V narcotics. Several provisions fully supported by law enforcement were added to the bill to guarantee privacy rights are not violated—for example, law enforcement must get a court order to access the database.

Read more:
http://www.pennlive.com/opinion/2014/06/expanded_prescription_drug_mon.html

UW Research Examines Dating, Prescription Drug Mix
WXOW
June 5, 2014

University of Wisconsin–Madison researchers are prospectively studying the effect of prescription drug use and misuse on young couples' happiness.

Read more:
http://www.wxow.com/story/25707480/2014/06/05/uw-research-examines-dating-prescription-drug-mix

Emergency Departments' Role with Pain Medications
Warren Withers, Tahoe Daily Tribune
June 4, 2014

Warren Withers, medical director of Emergency Medical Services at Barton Health in Nevada, discusses Barton Hospital Emergency Department's commitment to alleviating pain and its obligation to do no harm. The department will work closely with community physicians to coordinate care for patients with chronic pain, direct people with chronic pain to primary care and/or chronic pain specialists, identify high-risk behavior and use that information in its prescribing practices, and make the safety and well-being of patients and the community its highest goal.

Read more:
http://www.tahoedailytribune.com/southshore/11632040-113/pain-opiate-medications-chronic

Other Resources

Four Medication Safety Tips for Older Adults
United States Food and Drug Administration
June 5, 2014

This resource provides information on taking medicine as prescribed, keeping a medication list, being aware of potential interactions, and reviewing medications with a healthcare provider.

Read more:
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm399834.htm
http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM399867.pdf

FDA Opens New Drug Database to the Public
Mohana Ravindranath, The Washington Post
June 3, 2014

The Food and Drug Administration (FDA) is releasing searchable sets of prescription drug data. It unveiled the pilot for openFDA, a data source intended for tech developers, researchers, consumers, and others. The Internet cloud–based data provides information on millions of reports of adverse drug events, such as serious side effects, use errors, and product quality problems reported to the FDA between 2004 and 2013.

Read more:
http://www.washingtonpost.com/business/on-it/fda-opens-new-drug-database-to-the-public/2014/06/03/e4dac188-eb2f-11e3-b98c-72cef4a00499_story.html
http://open.fda.gov

Undergraduates. Overmedicated. The 2014 Version.
Digital Citizen Alliance
Accessed June 4, 2014

The Digital Citizens Alliance looks at rampant prescription drug use on college campuses during final exams. This one-page infographic features statistical data.

Read more:
https://media.gractions.com/314A5A5A9ABBBBC5E3BD824CF47C46EF4B9D3A76/597be7a8-4f22-4ffa-9ef3-8e3496fc9fc7.pdf

National Recovery Month 2014 Toolkit
SAMHSA
Accessed June 5, 2014

SAMHSA created this toolkit to increase awareness of the power of recovery. The kit provides individuals and organizations with needed resources to help people with mental health and/or substance use disorders. It also assists in planning Recovery Month events and offers resources to distribute in communities and at local events. The 25th annual Recovery Month theme, "Join the Voices for Recovery: Speak Up, Reach Out," aims to foster public understanding and acceptance of the benefits of prevention, treatment, and recovery from behavioral health conditions. The observance also promotes ways first responders, faith leaders, youth and young adults, and policymakers can recognize these issues and reach out to help others.

Read more:
http://recoverymonth.gov/Recovery-Month-Kit.aspx

Webinar

A Webinar Featuring Evidence-Based and Promising Workplace Programs to Prevent Prescription Drug Abuse
Substance Abuse and Mental Health Services Administration
Preventing Prescription Abuse in the Workplace Project

June 16, 2014
2–3:30 p.m. Eastern Time

This Webinar will provide an overview of four model workplace prescription abuse prevention programs and describe key replicable programmatic factors to successfully address prescription abuse in the workplace. The Webinar will also offer attendees an opportunity to ask questions and share their experiences implementing effective prevention programs.

For more information and to register:
Contact Lauren Thompson at lthompson@econometricainc.com or (240) 333-4816.

Video

Drug Diversion in Healthcare Settings
Jose Perz, Medscape
June 2, 2014

Dr. Joe Perz, a healthcare epidemiologist at the Centers for Disease Control and Prevention (CDC), addresses drug diversion in the CDC Expert Video Commentary series on Medscape. The commentary focuses on diversion involving healthcare personnel who steal controlled substances for personal use. Under these circumstances, patient harm can take many forms, including substandard care delivered by an impaired provider, denial of appropriate therapy or pain control, and infection risks stemming from tampering with injectable drugs. Healthcare professionals who divert drugs risk losing their licenses, credentials, and employment—and even their lives. Other possible consequences include litigation and imprisonment. (Duration: 5:20; includes transcript)

Watch:
http://www.medscape.com/viewarticle/825801

Audio

Physician Sounds Alarm on Illegal Drugs Sold on Amazon
WBAA
June 5, 2014

Here & Now's Robin Young talks with physician and journalist Dr. Ford Vox about Amazon sales of dangerous steroids, muscle relaxants, and antibiotics without a prescription. (Duration: 8:16)

Listen:
http://wbaa.org/post/physician-sounds-alarm-illegal-drugs-sold-amazon

Request for Proposal

Colorado Consortium for Prescription Drug Abuse Prevention Public Awareness Workgroup: Prescription Drug Safe Use, Storage, and Disposal Statewide Social Marketing Campaign
Colorado Governor's Office
Deadline: July 1, 2014

The vendor will execute a comprehensive, culturally responsive social marketing campaign statewide. This campaign will be designed, using evidence-based practices, to influence changes in attitude and behavior to improve public health and focus on safe prescription drug use, storage, and disposal. Through collaboration with the Colorado Department of Public Health and Environment and Governor's Office, the initiative will appropriately leverage and successfully coordinate with existing efforts.

Read more:
https://www.bidscolorado.com/co/portal.nsf/xpSolicitationView.xsp?action=openDocument&documentId=8CF92B6124937CD487257CE80077695E

Take-Back Events and Drop Boxes

'The Yellow Jug Old Drugs' Program Expands Beyond Michigan
9&10 News (Michigan)
June 2, 2014
http://www.9and10news.com/story/25667165/the-yellow-jug-old-drugs-program-expands-beyond-michigan

Sheriff's Office Launches Drug Drop Box Program
Arapahoe County (Colorado)
June 2, 2014
http://www.arapahoegov.com/CivicAlerts.aspx?AID=179

NCSO Collecting Out-of-Date Prescription Drugs
Jessicah Peters, Newton Citizen (Georgia)
June 5, 2014
http://www.newtoncitizen.com/news/2014/jun/05/ncso-collecting-out-of-date-prescription-drugs/

Toledo Police to Collect Unused Prescription Drugs on June 14
The Toledo Chronicle, the Tama News-Herald (Ohio)
June 5, 2014
https://www.tamatoledonews.com/page/content.detail/id/547565/Toledo-Police-to-collect-unused-prescription-drugs-on-June-14.html?nav=5010

Prescription Drug Drop-Off Boxes Now in Blair Co.
Mark Stempka, WJAC (Pennsylanvia)
June 5, 2014
http://www.wjactv.com/news/features/top-stories/stories/prescription-drug-dropoff-boxes-now-blair-co-2897.shtml

Save the Date

Sixth Annual American Medicine Chest Challenge: National Day of Awareness and Safe Disposal of Rx and OTC Medicine
American Medicine Chest Challenge
November 8, 2014
http://www.americanmedicinechest.com

Upcoming Conferences and Workshops

Orange County Prescription Drug Abuse Summit
Orange County Drug-Free Coalition
June 18, 2014
Orlando, Florida
https://www.eventbrite.com/e/orange-county-prescription-drug-abuse-summit-tickets-11543048569

2014 CSTE Annual Conference
Council of State and Territorial Epidemiologists
June 22–26, 2014
Nashville, Tennessee
http://www.csteconference.org

Pharmacy Diversion Awareness Conference
U.S. Department of Justice, Drug Enforcement Administration
June 28–29, 2014—Renaissance Phoenix (Ariz.) Downtown
July 12–13, 2014—Sheraton Philadelphia (Pa.) Downtown Hotel
August 2–3, 2014—Denver (Colo.) Marriott Tech Center
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness

Clinical Challenges in Opioid Prescribing: Balancing Safety and Efficacy
Colorado Prescription Drug Abuse Prevention Program of Peer Assistance Services, Inc.; SAMHSA
July 11, 2014
Denver, Colorado
http://peerassistanceservices.org/events/clinical-challenges-in-opioid-prescribing

CADCA's Mid-Year Training Institute 2014
July 20–24, 2014
Orlando, Florida
http://www.cadca.org/events/detail/mid-year-training-institute-2014

Prevention of Youth Substance Abuse in Rural Communities Conference: Bringing Hope to Communities in Despair
Coalition for Healthy Youth
August 6–8, 2014
Lancaster, South Carolina
http://www.lcpartnersforyouth.org/Coalition

Preventing Prescription Drug Abuse—Non-Members
New Jersey Pharmacists Association
August 7, 2014
Secaucus, New Jersey
http://njpharmacists.org

27th Annual NPN Prevention Research Conference
National Prevention Network
September 15–18, 2014
Hartford, Connecticut
http://swpc.ou.edu/npn

2014 Harold Rogers PDMP National Meeting
Brandeis University, Prescription Drug Monitoring Program Training and Technical Assistance Center
September 22–24, 2014
Washington, D.C.
http://www.pdmpassist.org/content/events
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.