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June 18, 2015

PAW Weekly Update

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 127  |  June 18, 2015
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports Professional Education and Policy Debate National Marijuana International Northeast/Mid-Atlantic News Southern News Midwest News West News Other Resources Grant Awarded Grant Announcements Take-Back Events and Drop Boxes Webinars Upcoming Conferences and Workshops

Featured

Avalere. 2015. "Medicare Drug Plans Favor Generic Opioids That Lack Abuse Deterrent Properties."

In high-profile decisions, OxyContin® (oxycodone HCl controlled release) was approved for abuse-deterrent labeling in 2013, and soon after, Opana® extended release (oxymorphone HCl) was rejected. Those decisions had little effect on Medicare formulary decisions. Using its proprietary DataFrame® database, Avalere found that in 2012, 70 percent of Part D beneficiaries were enrolled in a plan that covered Opana. An equal percentage was enrolled in a plan that covered OxyContin. For Opana, 63 percent were still covered in 2015, compared with only 42 percent for OxyContin. OxyContin's Medicare Part D plan coverage rate dropped from 61 percent of plans in 2012 to 49 percent in 2013 and 35 percent in 2014. Opana's coverage rate fell less steeply, from 71 percent of plans in 2012 to 66 percent in 2013 and 57 percent in 2014. In 2015, Opana coverage continued to fall—to 46 percent of plans—while OxyContin coverage leveled at 33 percent. Additionally, 60 percent of plans that covered OxyContin required prior authorization. In sharp contrast, generic oxycodone hydrochloride (HCl) immediate release, which has no abuse-deterrent properties, was covered by all Part D plans in 2015, and only 0.3 percent of plans required prior authorization. These differences may be driven by cost.

Read more:
http://avalere.com/expertise/managed-care/insights/medicare-drug-plans-favor-generic-opioids-that-lack-abuse-deterrent-propert

http://avalere-health-production.s3.amazonaws.com/uploads/pdfs/
1433848970_Medicare_Drug_Plans_Favor_Generic_Opioids_that_
Lack_Abuse_Deterrent_Properties.pdf


B. Zedler, L. Xie, L. Wang, A. Joyce, C. Vick, J. Brigham, F. Kariburyo, O. Baser, and L. Murrelle. 2015. "Development of a Risk Index for Serious Prescription Opioid-Induced Respiratory Depression or Overdose in Veterans' Health Administration Patients." Pain Medicine, doi:10.1111/pme.12777.

A case-control analysis of Veterans Health Administration data identified 1,877,841 patients with a pharmacy record for an opioid prescription between October 1, 2010, and September 30, 2012. Overdose or serious opioid-induced respiratory depression (OSORD) occurred in 817 patients. Ten controls were selected per case (n = 8,170). With logistic regression, the authors developed a risk index based on 15 items, including mental health disorders and pharmacotherapy, impaired drug metabolism or excretion, pulmonary disorders, specific opioid characteristics, and recent hospital visits. Predicted probability of OSORD ranged from 3 percent in the lowest risk decile to 94 percent in the highest. No validation was attempted with data not used in training the model.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/pme.12777/abstract

Journal Articles and Reports

N. Bavarian, B.R. Flay, P.L. Ketcham, and E. Smit. 2015. "The Illicit Use of Prescription Stimulants on College Campuses: A Theory-Guided Systematic Review." Health Education and Behavior, doi:10.1177/1090198115580576.

This systematic review of 62 studies published from 2000 to 2013 on prescription stimulant misuse rates among college students was organized using the three streams of influence and four levels of causation specified in the theory of triadic influence. Prevalence rates vary. Misuse is more common among those with attention deficit hyperactivity disorder diagnoses/prescriptions or a low grade point average. Prescription stimulant use is also influenced by broader social and societal factors.

Read more:
http://heb.sagepub.com/content/early/2015/05/28/1090198115580576

I.A. Binswanger, S. Koester, S.R. Mueller, E.M. Gardner, K. Goddard, and J.M. Glanz. 2015. "Overdose Education and Naloxone for Patients Prescribed Opioids in Primary Care: A Qualitative Study of Primary Care Staff." Journal of General Internal Medicine, doi:10.1007/s11606-015-3394-3.

In focus groups at 10 primary care, internal medicine, family medicine, and infectious disease/HIV practices in three large Colorado health systems, 56 clinical staff demonstrated substantial knowledge gaps regarding naloxone and its use in outpatient settings. They expressed uncertainty about whom to prescribe naloxone to and identified a range of logistical barriers to the drug's use. Staff also described fears of offending patients and concerns about increased risk behaviors in patients prescribed the drug. When considering naloxone use, some providers reflected critically and with discomfort on their own opioid prescribing. These barriers were balanced by beliefs that prescribing naloxone could prevent death and result in safer opioid use.

Read more:
http://link.springer.com/article/10.1007/s11606-015-3394-3

M. Cerdá, J. Santaella, B.D.L. Marshall, J.H. Kim, and S.S. Martins. 2015. "Nonmedical Prescription Opioid Use in Childhood and Early Adolescence Predicts Transitions to Heroin Use in Young Adulthood: A National Study." The Journal of Pediatrics, doi:10.1016/j.jpeds.2015.04.071.

Multivariate analysis of 2004–11 National Survey on Drug Use and Health data from respondents ages 12–21 showed a history of nonmedical use of prescription opioids was strongly associated with heroin initiation (hazard ratio 13.1). Those beginning nonmedical use of opioids at ages 10–12 had the highest risk of transitioning to heroin. The association did not vary by race/ethnicity or income group.

Read more:
http://www.jpeds.com/article/S0022-3476(15)00459-X/abstract

R. Daniulaityte, R. Carlson, G. Brigham, D. Cameron, and A. Sheth. 2015. "Sub Is a Weird Drug:" A Web-Based Study of Lay Attitudes About Use of Buprenorphine to Self-Treat Opioid Withdrawal Symptoms. The American Journal on Addiction, doi:10.1111/ajad.12213.

Using the PREDOSE Semantic Web platform, researchers identified 1,217 buprenorphine-related posts from 2005–13 on an online forum that permits open discussion about illicit drugs. Posts initially increased, and peaked in 2011. Content analysis of a one-third random sample showed posts were equally divided between positive and negative views on buprenorphine's effectiveness for relieving opioid withdrawal symptoms. Participants thought the drug's effectiveness could be compromised based on the "size of a person's habit," or when users repeatedly switch back and forth between buprenorphine and illicit opioids. Most posts reported use of significantly lower amounts of buprenorphine (≤ 2 mg) than doses used in standard treatment. Concomitant use of other psychoactive substances was also common.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26009867

A.W. Dick, R.L. Pacula, A.J. Gordon, M. Sorbero, R.M. Burns, D. Leslie, and B.D. Stein. 2015. "Growth in Buprenorphine Waivers for Physicians Increased Potential Access to Opioid Agonist Treatment, 2002–11." Health Affairs 34(6):1028–134, doi:10.1377/hlthaff.2014.1205.

The percentage of counties that have a shortage of physicians with waivers for buprenorphine treatment provision fell from 99 percent in 2002 to 47 percent in 2011. The percentage of the U.S. population residing in these counties declined from 49 percent in 2002 to 10 percent in 2011.

Read more:
http://content.healthaffairs.org/content/34/6/1028.abstract

A. Fareed, A.M. Buchanan–Cummings, K. Crampton, A. Grant, and K. Drexler. 2015. "Reversal of Overdose on Fentanyl Being Illicitly Sold as Heroin with Naloxone Nasal Spray: A Case Report." The American Journal on Addiction, doi:10.1111/ajad.12230.

As part of a Veterans Health Administration initiative, the Atlanta Veteran Affairs Medical Center educated 63 veterans and their families, friends, and significant others about opioid overdose and use of naloxone reversal kits. They also prescribed 41 kits. The center has received three reports of opioid overdose reversals using their kits thus far.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26039379

R.N. Hansen, D.M. Boudreau, B.E. Ebel, D.C. Grossman, and S.D. Sullivan. 2015. "Sedative Hypnotic Medication Use and the Risk of Motor Vehicle Crash." American Journal of Public Health, doi:10.2105/AJPH.2015.302723.215-872-3277.

Researchers tracked 409,171 adults in an integrated healthcare system who had enrolled continuously for at least 1 year between 2003 and 2008 and were licensed to drive in Washington. During that time, 5.8 percent of patients received first sedative prescriptions, with 11,197 person-years of exposure. Linking health plan data to driver's license and collision records until death, disenrollment, or study end, a proportional hazards model revealed initiating use of three sedatives was associated with an increased risk of crash relative to nonuse (temazepam hazard ratio [HR] 1.3, trazodone HR 1.9, and zolpidem HR 2.2). These risk estimates are equivalent to blood alcohol concentration levels between 0.06 percent and 0.11 percent.

Read more:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302723

C.W. Norwood and E.R. Wright. 2015. "Integration of Prescription Drug Monitoring Programs (PDMP) in Pharmacy Practice: Improving Clinical Decision-Making and Supporting a Pharmacist's Professional Judgment." Research in Social and Administrative Pharmacy, doi:10.1016/j.sapharm.2015.05.008.

Multivariate analysis of a 2012 Web-based survey of 1,582 Indiana pharmacists (15 percent of those invited) indicated pharmacists were 6.4 times more likely to report dispensing fewer controlled substance prescriptions if they also reported that the state's prescription drug monitoring program (PDMP) provides increased access to patient information. Pharmacists who always used the PDMP reported refusing an average of 25 controlled substance prescriptions annually compared with an average of 7 refusals for pharmacists who never used it. Pharmacists who used the PDMP at every visit were 3.3 times more likely to have refused dispensing a controlled substance prescription than pharmacists who never used the system.

Read more:
http://www.rsap.org/article/S1551-7411(15)00105-9/abstract

J. Strang. 2015. "Death Matters: Understanding Heroin/Opiate Overdose Risk and Testing Potential to Prevent Deaths." Addiction 110(S2):27–35, doi:10.1111/add.12904.

Heroin injection causes a rapid drop in oxygen saturation, recovering slowly over the following half hour. This 20-year retrospective on opiate overdose research reports that half of heroin/opiate misusers have overdosed, even more have witnessed an overdose, and most are willing to intervene—and often have—during an overdose. Both drug-using peers and family members improve knowledge and gain confidence from overdose response training. Ten percent of dispensed naloxone is used in emergency situations. Drug overdose deaths are much more likely following prison release and post-discharge from detoxification and other inpatient or residential settings.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/add.12904/full

M.E. Tsay, G. Procopio, B.D. Anderson, and W. Klein–Schwartz. 2015. "Abuse and Intentional Misuse of Promethazine Reported to US Poison Centers: 2002 to 2012." Journal of Addiction Medicine 9(3):233–37, doi:10.1097/ADM.0000000000000124.

Between 2002 and 2012, U.S. poison control centers fielded 354 single-product promethazine antihistamine misuse exposures, with 259 about co-formulated products that typically contain codeine. The annual exposure rate per 1,000 population doubled between 2002 and 2012. Exposures at ages 10 to 29 accounted for more than half of cases. Co-formulated products were more likely to require care in emergency departments (56 percent versus 38 percent) and critical care units (11 percent versus 8 percent). Outcomes involved moderate effects for 18 percent of promethazine only and 32 percent of compound formulation exposures. Two percent of exposures in each group involved life-threatening effects. Clinical effects included drowsiness (43 percent), tachycardia (7 percent), agitation (14 percent), confusion (14 percent), slurred speech (13 percent), hallucinations (7 percent), dizziness (7 percent), and hypertension (5 percent). Drowsiness and tachycardia were more frequent with co-formulation.

Read more:
http://journals.lww.com/journaladdictionmedicine/Abstract/2015/05000/
Abuse_and_Intentional_Misuse_of_Promethazine.11.aspx


A. Westanmo, P. Marshall, E. Jones, K. Burns, and E.E. Krebs. 2015. "Opioid Dose Reduction in a VA Health Care System—Implementation of a Primary Care Population-Level Initiative." Pain Medicine 16(5):1019–26, doi:10.1111/pme.12699.

In April 2011, the Minneapolis veterans healthcare system implemented a primary care–based opioid safety initiative to reduce high-dose prescribing at an urban teaching hospital and 11 outpatient clinics. The program was evaluated by examining rates of opioid dispensing within 90-day windows before and after implementation and through surveys of primary care providers at the main hospital. Following implementation, the number of patients prescribed > 200 morphine-equivalent mg daily decreased from 342 (0.65 percent of unique pharmacy patients) to 65 (0.12 percent). The number of unique pharmacy patients who received at least one opioid prescription in a 90-day period decreased from 6,942 (14 percent) in April to June 2011 to 5,981 (11 percent) in October to December 2014. Most providers agreed it was reasonable for the medical center to set a 200 morphine-equivalent mg limit (76 percent at baseline and 87 percent at follow-up).

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/pme.12699/abstract

Professional Education and Policy Debate

S. Barlas. 2015. "Pharmacists Step Up Efforts to Combat Opioid Abuse: The CDC and Congress Are Trying to Pitch In." P&T Community 40(6):369–71, 401.

State and national professional and regulatory bodies are focusing on opioid misuse, upgrading requirements for healthcare practitioners to ensure all controlled substances are prescribed and dispensed for legitimate medical purposes.

Read more:
http://www.ptcommunity.com/journal/article/full/2015/6/369/pharmacists-step-efforts-combat-opioid-abuse

National

Drug Experts Worry Liquid Opiate Could Be Addictive, Lead to Abuse
Claudia Rupcich, WRIC
June 12, 2015

VivaZen is a liquid shot marketed as a natural pain reliever, and therefore, is not regulated. The main ingredient is kratom—a plant from Southeast Asia. Kratom gives users a high similar to the one produced by opiates, and users claim the substance helps them deal with opiate withdrawal. If continuously consumed over long periods of time at high intake levels, users can become dependent. A licensed clinical social worker at Dominion Behavioral Health in Virginia worries teens addicted to pain relievers may turn to kratom as a legal and less costly alternative. (Includes video: 1:38 minutes)

Read more:
http://wric.com/2015/06/11/drug-experts-worry-liquid-opiate-could-be-addictive-lead-to-abuse

Millennium Health and the Mark Wahlberg Youth Foundation Launch Film to Raise Awareness of Youth Prescription Drug Abuse
PRNewswire
June 9, 2015

"If Only," a short film on the dangers of youth prescription drug misuse, is now available online along with a discussion toolkit. The film and toolkit are part of the "Drop Them Off" campaign launched earlier this year. "If Only'' aims to increase awareness among teenagers, parents, and the public about the importance of safe use, storage, and disposal of prescription drugs.

Read more:
http://www.prnewswire.com/news-releases/millennium-health-and-the-mark-wahlberg-youth-foundation-launch-film-to-raise-awareness-of-youth-prescription-drug-abuse-300095715.html

Collegium Announces Issuance of U.S. Patent Covering DETERx®—an Abuse-Deterrent, Extended-Release Technology Platform
CNN
June 8, 2015

Collegium Pharmaceutical, Inc. has patented its DETERx® technology platform, which is used in the company's Xtampza ER (oxycodone extended-release capsules, not yet FDA approved). The patent covers multiple opioid molecules and nonopioid drugs prone to misuse that are developed using DETERx®.

Read more:
http://money.cnn.com/news/newsfeeds/articles/globenewswire/10137647.htm

MARIJUANA

R. Law, J. Schier, C. Martin, A. Chang, and A. Wolkin. 2015. "Notes from the Field: Increase in Reported Adverse Health Effects Related to Synthetic Cannabinoid Use—United States, January–May 2015." Morbidity and Mortality Weekly Report 64(22):618–19.

From January through May 2015, poison centers reported 3,572 calls related to synthetic cannabinoid use—up from 1,085 calls during the same period in 2014. Most calls involved male users (81 percent) with a median age of 26. Commonly reported adverse health effects were agitation (35 percent), tachycardia (29 percent), drowsiness or lethargy (26 percent), vomiting (16 percent), and confusion (4 percent). Among 2,961 calls for which a medical outcome was reported, 11 percent had a major adverse effect (life-threatening signs or symptoms or those that resulted in substantial residual disability), and 48 percent had a moderate effect (lesser signs or symptoms that required some form of treatment). Among 626 calls about use in combination with other substances, the most commonly reported substances were alcohol (23 percent), plant-derived marijuana (16 percent), and benzodiazepines (11 percent). Males were significantly more likely than females to have a severe outcome.

Read more:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6422a5.htm?s_cid=mm6422a5_w

B. Onders, M.J. Casavant, H.A. Spiller, T. Chounthirath, and G.A. Smith. 2015. "Marijuana Exposure Among Children Younger than Six Years in the United States." Clinical Pediatrics, doi:10.1177/0009922815589912.

Child-safe packaging requirements are needed for commercially sold marijuana products. From 2000 through 2013, the National Poison Data System logged 1,969 marijuana exposures among children under 6, with a mean age of 1.8 years at exposure. Three fourths of children were exposed through ingestion, and 19 percent required admission to a healthcare facility. The rate of marijuana exposure was significantly (2.8 times) higher in states that allowed marijuana use prior to 2000 than in states where use was prohibited. In transitional states, the child exposure rate was 2.25 times higher after medical marijuana use was permitted. The exposure rate increase in states that have forbidden marijuana use was 1.15.

Read more:
http://cpj.sagepub.com/content/early/2015/06/03/0009922815589912

Seven States Where Medical Marijuana Is Legal but Barely Accessible
Kristen Gwynne, Rolling Stone
June 9, 2015

Massachusetts, Minnesota, Illinois, Delaware, New Jersey, New Hampshire, and Texas are struggling to translate their medical marijuana laws into functional programs. Logistical failures and political resistance are among the obstacles in implementing state medical marijuana laws.

Read more:
http://www.rollingstone.com/politics/news/7-states-where-medical-marijuana-is-legal-but-barely-accessible-20150609

State Announces Providers for NH Medical Marijuana Dispensaries
Meghan Foley, The Keene Sentinel
June 10, 2015

New Hampshire health officials selected three nonprofit organizations to run the state's medical marijuana dispensaries. New Hampshire's Department of Health and Human Services will start issuing identification cards to patients about 6 weeks prior to the centers' openings, which could take about 9 months.

Read more:
http://www.sentinelsource.com/news/local/state-announces-providers-for-nh-medical-marijuana-dispensaries/article_f5e6356e-4525-54a6-a083-791d67981cec.html

International

More Than 400 a Month Arrested for Drug Driving Since New Laws Introduced: 50 Percent of Motorists Stopped Are Testing Positive
Ray Massey, Daily Mail
June 11, 2015

More than 400 drugged drivers have been arrested each month since March, when the new UK drug-driving offense enforced by roadside 'drugalysers' was introduced.

Read more:
http://www.dailymail.co.uk/news/article-3120803/More-400-month-arrested-drug-driving-new-laws-introduced-50-motorists-stopped-testing-positive.html

Harper Government Takes Action to Improve Drug Control
Government of Canada
June 11, 2015

The Minister of Health and parliamentary secretary to Canada's Minister of Public Safety and Emergency Preparedness have proposed enhancements to the Controlled Drugs and Substances Act. These improvements would equip the Ministry and law officers with tools to quickly control dangerous new drugs, combat illegal drug production and distribution, and enable Health Canada inspectors to increase compliance with the legitimate controlled substance industry.

Read more:
http://news.gc.ca/web/article-en.do?nid=986499

Call Centers: New Battle Front for Fake Drugs
Kathy Chu and Trefor Moss, The Wall Street Journal
June 7, 2015

Philippine police raided a call center for alleged counterfeit drug sales, discovering a product manual for Viagra and other medicines, a script, and a handwritten ledger detailing feedback from U.S. callers. The police confiscated 150 computers, but did not arrest anyone for selling fake pharmaceuticals. Generally, counterfeiters open call centers in one country and locate production and websites advertising the drugs in others. Pfizer learned the call center was recruiting agents to sell pharmaceuticals and identified more than 100 websites advertising brand-name drugs that linked directly to it. The company obtained Viagra-labeled samples sold by the center and later determined they were counterfeit.

Read more:
http://www.wsj.com/articles/call-centers-new-battle-front-for-fake-drugs-1433712783

Northeast/Mid-Atlantic News

New Jersey Strikes Deal to Get Discount on Heroin Antidote that Doubled in Price
CMD Media
June 5, 2015

The New Jersey Office of the Attorney General negotiated a 20 percent discount for naloxone from manufacturer Amphastar Pharmaceuticals Inc. Amphastar also agreed to cap prices. The company will provide a $6 rebate for each $29 naloxone syringe purchased by a New Jersey law enforcement agency or other public entity. They must submit a written account to the attorney general's office that certifies the number of company syringe purchases made in a given calendar quarter. The office will then consolidate all certifications into a single "summary submission" to Amphastar. Upon review and approval, Amphastar will pay a lump rebate sum to the office, which will in turn distribute individual rebate payments to public first responder agencies.

Read more:
http://njtoday.net/2015/06/05/new-jersey-strikes-deal-to-get-discount-on-heroin-antidote-that-doubled-in-price

Maryland Law to Expand Access to Abuse Deterrent Painkillers
Trang Do, ABC 2 News
June 11, 2015

A new Maryland law requires insurers to cover formulations of pain relievers resistant to crushing or liquefaction. (Includes video: 5:55 minutes)

Read more:
http://www.abc2news.com/news/in-focus/maryland-law-to-expand-access-to-abuse-deterrent-painkillers

More Drug Agents Dispatched to Baltimore to Assist with RX Thefts
KCEN TV
June 6, 2015

The Drug Enforcement Administration will send about 10 additional agents to Baltimore to investigate prescription drug thefts at 27 pharmacies and clinics during the recent riots. An estimated 175,000 doses of narcotics have been reported missing. Fewer than half of affected providers have filed loss reports.

Read more:
http://www.kcentv.com/story/29257473/more-drug-agents-dispatched-to-baltimore-to-assist-with-rx-thefts

MMS Launches Online Opioid Safety Resources Portal for Prescribers, Patients
Massachusetts Medical Society
June 5, 2015

The Massachusetts Medical Society launched Smart Scripts MA, a comprehensive online resource on opioid misuse for patients, physicians, and other prescribers. Its goals are to promote safe prescribing, storage, and disposal of opioid medications and reduce opioid overdoses.

Read more:
http://www.massmed.org/News-and-Publications/Vital-Signs-This-Week/MMS-Launches-Online-Opioid-Safety-Resources-Portal-for-Prescribers,-Patients/#.VXcnIWnJAgA

Gloucester PD's Experiment Gets Results in War Against Opioid Addiction
Janet Wu, WCVB
June 8, 2015

Over the past 8 days, eight people turned themselves in for addiction problems, according to the Gloucester Police Department in Massachusetts. The department's new policy is to not prosecute people seeking help, but to match them with detox programs. (Includes video: 1:59 minutes)

Read more:
http://www.wcvb.com/health/gloucester-pds-experiment-gets-results-in-war-against-opioid-addiction/33471442

Overdose Increase Brings Call for More Teachers, Police
Eagle-Tribune
June 7, 2015

City officials would like to see Haverhill, Mass., hire more drug abuse educators and counselors for schools and more police officers to manage the increase in heroin and prescription drug overdoses. The part-time addiction and recovery specialist position created for the school district last year was elevated to a full-time job this year. Paramedics from Trinity Emergency Medical Services responded to 475 overdoses in Haverhill in 2014. Two hundred and seventy-five resulted from opiate misuse. Overdose responses in 2014 were up 14 from the prior year.

Read more:
http://www.eagletribune.com/news/haverhill/overdose-increase-brings-call-for-more-teachers-police/article_0ffab362-e642-56ec-9162-090d08d4d827.html

Elderly Doctor, Wife Charged in $77M 'Pill Mill'
Rebecca Rosenberg, Kathleen Culliton, and Bruce Golding, The New York Post
June 9, 2015

Dr. Rogelio Lucas, 77, and his office-manager wife, Lydia, 79, pleaded not guilty to conspiracy and drug charges. The couple allegedly worked with several major drug rings to write more than 23,600 prescriptions for more than 3 million tablets of oxycodone, with a street value exceeding $77 million. They deposited about $500,000 in various bank accounts between June 2013 and July 2014, and investigators seized more than $600,000 in cash from their home in Scarsdale. The couple's case was heard in Manhattan Criminal Court.

Read more:
http://nypost.com/2015/06/09/doctor-wife-accused-of-running-77m-prescription-pill-mill

Tips to Prevent Prescription Drug Abuse at Home
West Mifflin Police Department
June 8, 2015

Pennsylvania's West Mifflin Police Department shares dos and don'ts to reduce the risk of drug fraud and misuse at home.

Read more:
http://www.westmifflinpolice.com/tips-to-prevent-prescription-drug-abuse-at-home

Southern News

U.S. Attorney to Bring Prescription Drug Education to Morgantown
MetroNews
June 11, 2015

William Ihlenfeld, U.S. attorney for the Northern District, will soon disclose a plan for North Central West Virginia to scale back drug addiction and prescription misuse and ramp up physician education. Ihlenfeld is bringing a prescriber education conference to Morgantown that will teach physicians how to recognize prescription drug misuse.

Read more:
http://wvmetronews.com/2015/06/11/u-s-attorney-to-bring-prescription-drug-education-to-morgantown

AL Task Force Rolls Out Campaign to Curb Prescription Drug Abuse
Jennifer Horton, WSFA
June 9, 2015

The Alabama Drug Abuse Task Force launched a media campaign called "Zero Addiction" to address prescription drug misuse. It also rolled out a website to connect people with help in their county and city. (Includes videos: 2:40 minutes, 30 seconds, 30 seconds)

Read more:
http://www.wsfa.com/story/29268964/al-task-force-rolls-out-campaign-to-curb-prescription-drug-abuse

Midwest News

Spike in Heroin Overdoses Takes Toll on Ohio Town's Psyche
Mitch Stacy, ABC News
June 11, 2015

Since mid-April, Marion, Ohio, has seen 56 overdoses—five of which were fatal. If not for naloxone, more victims would have died in this town of only 37,000. Victims ranged in age from the late teens to early 60s. Police are now seeing the source of the so-called "blue drop" heroin laced with fentanyl that caused the spike.

Read more:
http://abcnews.go.com/Health/wireStory/spike-heroin-overdoses-toll-ohio-towns-psyche-31682926

Four Heroin ODs in 1 Hour in St. Louis County ER
Casey Nolen, KSDK
June 10, 2015

St. Anthony's Medical Center in St. Louis County, Mo., saw four heroin overdoses in less than 1 hour. Three patients came from the House Springs area; the fourth was from Mehlville. Paramedics saved all four with naloxone. (Includes video: 2:20 minutes)

Read more:
http://www.ksdk.com/story/news/local/2015/06/10/four-overdose-heroin-in-one-hour-in-same-emergency-room/28779283

Police Department Removes Prescription Drug Disposal Box from Lobby
Columbia Daily Tribune
June 6, 2015

The Columbia Police Department of Missouri removed a prescription drug disposal box from its lobby to comply with guidelines from the Environmental Protection Agency and Department of Natural Resources.

Read more:
http://www.columbiatribune.com/news/local/police-department-removes-prescription-drug-disposal-box-from-lobby/article_18c4f317-7c42-553f-ae46-78b02a1c9a04.html

West News

Colorado Researcher's Black-Market Drug Site a Window on Opioid Abuse
Electa Draper, The Denver Post
June 8, 2015

StreetRx is a website that allows drug buyers and sellers to anonymously report pill prices in U.S. cities. Launched in 2010, the site helps officials understand market forces, track the market, and gain insight into drug abuse without tracing individuals. Law enforcement also uses the site's drug pricing to inform its undercover buying and selling. The website, which provides links to treatment programs and drug-disposal sites, sees about 2,500 unique visitors and logs 200 to 250 price entries daily.

Read more:
http://www.denverpost.com/news/ci_28272360/colorado-researchers-black-market-drug-site-window-opioid

Rx Meds Are Found on Street After DEA Orders Drop Box Be Relocated
Kayne Crison, Arizona City Independent
June 10, 2015

In late April, the Drug Enforcement Administration informed officials at Regional Fire and other rural fire districts that prescription medication drop boxes are only allowed at law enforcement agencies. The local drop box was removed from the Arizona City Fire Station and relocated at the Pinal County Sheriff's Office substation just a few hundred feet away. Now people are leaving bags of expired medications on the pavement right outside the substation because no one is there to receive the discarded drugs. The substation is not open 24 hours and has no regular office staff.

Read more:
http://www.trivalleycentral.com/arizona_city_independent/people/rx-meds-are-found-on-street-after-dea-orders-drop/article_d972e86a-0ed4-11e5-a9fb-1783f2ca9816.html

Over-the-Counter Opiate Rescue Kits Available in Santa Barbara County
Nia Wong, KEYT, KCOY, KKFX
June 9, 2015

The Pain Management Pharmacy in Santa Barbara County, Calif., has sold 90 naloxone kits since April 10, 2015, when sales without a prescription began.

Read more:
http://www.keyt.com/news/Over-the-Counter-Opiate-Rescue-Kits-Available-in-Santa-Barbara-County/33472374

Nasal Spray Could Save Lives in Indian Country
Walter Lamar, Indian Country
June 9, 2015

Walter Lamar (Blackfeet/Wichita), a former FBI special agent and deputy director of Bureau of Indian Affairs law enforcement, discusses how naloxone in Indian country could save lives. Washington's Lummi tribe was among the first in the nation to use naloxone kits, along with prevention and education training. Within 6 weeks of training, officers had reversed three overdoses. Recently, the Suquamish Tribe announced a partnership to equip all officers and selected members of the general public with naloxone kits. Tribes worked with local pharmacies to keep supplies of the kits available, distribute kits, and provide training. Unfortunately, naloxone use is not widespread in tribal communities, and some insurers are wary of underwriting its use or cost.

Read more:
http://indiancountrytodaymedianetwork.com/2015/06/09/nasal-spray-could-save-lives-indian-country

Heroin, Opioids Replace Meth as Drug of Choice in Grant County
Randal Seyler, Silver City Sun-News
June 10, 2015

Experts said prescription pain relievers and heroin are a major problem among youth and adults in Silver City and Grant County, N.M. In 2013, heroin and pain pills also accounted for most of the state's 458 drug overdose deaths.

Read more:
http://www.scsun-news.com/silver_city-news/ci_28290411

Overdose Antidote Drug Nearly Perfect Tool
Sheila Hager, Union-Bulletin
June 8, 2015

Experts said naloxone, which has about a 90-minute window of effectiveness, is the most useful tool for drug overdose. Washington doctors can now write prescriptions for agencies to distribute the drug to individuals likely to witness a heroin or other overdose. In Walla Walla County, the Blue Mountain Heart to Heart nonprofit agency provides naloxone inhalers to its needle-exchange clients.

Read more:
http://union-bulletin.com/news/2015/jun/08/overdose-antidote-drug-nearly-perfect-tool

Other Resources

Disposal of Unused Medicines: What You Should Know
U.S. Food and Drug Administration
June 3, 2015

The Food and Drug Administration added resources to its website, including an overview of three primary methods of medication disposal: transferring unused drugs to authorized collectors, in household trash, and flushing (specified drugs only).

Read more:
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely
/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm


Prescription Drug Epidemic: 20 Red Flags Physicians Should Watch For
American Osteopathic Association
June 11, 2015

The American Osteopathic Association, National Association of Boards of Pharmacy, Drug Enforcement Administration, and other groups have prepared a list of red flags to watch for when treating, prescribing, and monitoring patients' progress.

Read more:
http://thedo.osteopathic.org/2015/06/prescription-drug-epidemic-20-red-flags-physicians-should-watch-for

Alliance for Balanced Pain Management Introduces New Tool to Help Assess and Reduce Prescription Medicine Misuse and Abuse Risks in the Home
PRNewswire
June 10, 2015

The Alliance for Balanced Pain Management has launched an educational tool, "Are You the Only One Taking Your Medicine?" for consumers and healthcare providers. The tool is meant to assess whether a home is at risk for medication misuse or diversion. It also includes tips for monitoring, safeguarding, and properly disposing of prescription medicines.

Read more:
http://www.prnewswire.com/news-releases/alliance-for-balanced-pain-management-introduces-new-tool-to-help-assess-and-reduce-prescription-medicine-misuse-and-abuse-risks-in-the-home-300096936.html

Grants Awarded

TEAM Newburgh Gets $627,000 to Fight Heroin, Prescription Drug Abuse
Leonard Sparks, Times Herald-Record
June 9, 2015

Catholic Charities Community Services of Orange County, N.Y., received a 5-year, $627,000 grant to address heroin use, prescription drug misuse, and overdoses among 12- to 25-year-olds. The funding is part of an $8.1 million grant awarded to New York by the Center for Substance Abuse Prevention.

Read more:
http://www.recordonline.com/article/20150609/NEWS/150609449

Lowell Gets $55G to Help Fight Opiate Addiction
The Lowell Sun
June 6, 2015

The City of Lowell, Mass., received a $55,000 grant to address opiate addiction. This award is one of 27 community grants from the Edward J. Byrne Memorial Justice Assistance Grant Program.

Read more:
http://www.lowellsun.com/news/ci_28264381/lowell-gets-55g-help-fight-opiate-addiction

Grant Announcements

COPS–Anti-Heroin Task Force Application 2015
Department of Justice, Community-Oriented Policing Services
Deadline: June 19, 2015
http://www.grants.gov/web/grants/search-grants.html

Take-Back Events and Drop Boxes

Law Enforcement, Volunteers Collect 10 Tons of Prescription Drugs in Arkansas
The City Wire (Arkansas)
June 10, 2015
http://www.thecitywire.com/node/37813#.VXnHXGnJDoY

75 Pounds of Drugs Collected on Drop-Off Day
Sudbury Northern Life (Sudbury, Ontario, Canada)
June 6, 2015
http://www.northernlife.ca/news/policeandCourt/2015/06/06-drug-drop-off-day-sudbury.aspx

Dispose of Unwanted Prescription Drugs at the Montclair Police Department Anytime!
Montclair Police Department (California)
June 10, 2015
https://local.nixle.com/alert/5430499

New Way to Drop Off Old Drugs at CVS in Plainfield
Elizabeth Hess, WTNH (Connecticut)
June 12, 2015
http://wtnh.com/2015/06/12/new-way-to-drop-off-old-drugs-at-cvs-in-plainfield

Permanent Anonymous Medicine Drop Boxes
State of Delaware
June 8, 2015
http://news.delaware.gov/2015/06/08/permanent-anonymous-medicine-drop-boxes

Prescription Drug Dropoff
Village of Bartlett (Illinois)
Accessed June 8, 2015
http://www.village.bartlett.il.us/Home/Components/Calendar/Event/461/228?backlist=%2F

Drug Take Back Boxes Installed Across Somerset Co.
WBOC (Maryland)
June 10, 2015
http://www.wboc.com/story/29285524/drug-take-back-boxes-installed-across-somerset-co

Senior Center Accepting Old Drugs
Carrie RaCosta, The Burton View (Michigan)
June 11, 2015
http://burtonview.mihomepaper.com/news/2015-06-11/News/Senior_center_accepting_old_drugs.html

MSP Iron Mountain Post to Collect Prescription Drugs
Aaron Boehm, WLUC TV6, FOX UP (Michigan)
June 8, 2015
http://www.uppermichiganssource.com/news/story.aspx?id=1214838#.VXhbdWnJBdg

Town of Southhampton Launches Medicine Disposal Program at Local Senior Centers
Priscila Korb, Westhampton-Hampton Bays Patch (New York)
June 11, 2015
http://patch.com/new-york/westhampton-hamptonbays/town-southampton-launches-medicine-disposal-program-local-senior-centers

Drug-Collection Unit Slated for Installation at MSC Site
Theodore J. Station, Upper Arlington News (Ohio)
June 10, 2015
http://www.thisweeknews.com/content/stories/upperarlington/news/2015/06/09/city-notes-drug-collection-unit-slated-for-installation-at-msc-site.html

Police Holding Prescription Drug Take-Back Day
Chad Klimack, Newark Advocate (Ohio)
June 10, 2015
http://www.newarkadvocate.com/story/news/local/pataskala/2015/06/10/police-holding-prescription-drug-take-back-day/28730287

First Ever Permanent Prescription Take Back Box in Prosser
KEPRTV (Washington)
June 8, 2015
http://www.keprtv.com/news/local/First-ever-permanent-prescription-take-back-box-in-Prosser-306550001.html

Bridgeport Police and FRN Team Up to Fight Prescription Drug Problem
WDTV (West Virginia)
June 8, 2015
http://www.wdtv.com/wdtv.cfm?func=view&section=5-News&item=Bridgeport-Police--FRN-Team-Up-To-Fight-Prescription-Drug-Problem-23645

Permanent Medication Drop Box Located in Marathon City
Wausau Daily Herald (Wisconsin)
June 5, 2015
http://www.wausaudailyherald.com/story/news/2015/06/05/permanent-medication-drop-box-located-marathon-city/28541543

Webinars

The Hidden Threats to Your Safety: What the Public Actually Should Worry About
National Safety Council
June 23, 2015, 11 a.m. (CST)

Participants will learn the main causes of unintentional injury deaths and what threatens states as well as Americans' odds of dying from various causes. Also discussed during the Webinar will be the exponential rise in older adult falls, why poisonings are up 7 percent in a single year, current traffic fatality trends, and why deaths will likely increase.

Register:
https://nsc.csod.com/LMS/LoDetails/DetailsLo.aspx?loid=0307b630-5148-47e4-b1dd-93b9422bb236#t=1

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference
Drug Enforcement Administration, Office of Diversion Control
June 27–28, 2015
Oklahoma City, Oklahoma
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness

Injury-Free NC: Medication and Drug Overdose Prevention Summit 2015
University of North Carolina Injury Prevention Research Center
July 14, 2015, 8:30 a.m. to 4:30 p.m.
University of North Carolina at Chapel Hill
100 Friday Center Dr.
Chapel Hill, North Carolina

This event will provide participants with information, tools, and connections to help address the overdose epidemic in North Carolina.

Read more:
http://iprc.unc.edu/save-the-date-for-the-injury-free-nc-medication-and-drug-overdose-prevention-summit-2015

Register:
https://events.r20.constantcontact.com/register/eventReg?oeidk=a07eatkluli5acdd70c&oseq=&c=&ch=

Mid-Year Training Institute
Community Anti-Drug Coalitions of America
August 2–6, 2015
Indianapolis, Indiana
http://www.cadca.org/myti

Register:
http://www.cadca.org/events/14th-annual-mid-year-training-institute-0/registration

Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio
http://www.pharmacy.ohio-state.edu/outreach/generation-rx-university-conference

28th Annual National Prevention Network Conference: Bridging Research to Practice
National Prevention Network
November 17–19, 2015
Seattle, Washington
http://www.npnconference.org

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

2016 National Rx Drug Summit
Operation UNITE
March 28–31, 2016
The Westin Peachtree Plaza
Atlanta, Georgia
http://nationalrxdrugabusesummit.org
The Weekly Update is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoint or opinion and are not assessed for validity, reliability or quality. The Weekly Update should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full text of journal articles listed in the Weekly Update.