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June 19, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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June 19, 2013 (PDF version)
Please note: Two new categories have been added to better organize the listserv. The first, "Other Local News," contains most local stories. The second is "Grants Received," which immediately precedes "Grant Announcements" and may stimulate thinking about potential funding sources.

Walgreen to Pay $80 Million Fine in D.E.A. Inquiry
The New York Times
June 11, 2013

The Walgreen Company has agreed to an $80 million settlement to resolve federal charges that it failed to properly control narcotic pain reliever sales and report suspicious sales. The license of a Florida distribution facility used by Walgreen was revoked for 2 years. Drug Enforcement Administration officials said many of the drugs dispensed at the facility ended up on the black market, including oxycodone. Walgreen admitted practices at the distribution facility and some of its pharmacies did not meet standards and agreed to establish better internal controls.

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Journal Articles

A. Knowlton, B.W. Weir, F. Hazzard, Y. Olsen, J. McWilliams, J. Fields, and W. Gaasch. 2013. "EMS Runs for Suspected Opioid Overdose: Implications for Surveillance and Prevention." Prehospital Emergency Care 17(3):317-29. doi:10.3109/10903127.2013.792888.

Researchers explored evidence to support the validity of emergency medical services (EMS) data on naloxone administration as a possible proxy for estimating incidence of opioid overdose. They reviewed data from Baltimore City Fire Department EMS patient records matched with dispatch records over a 13-month period in 2008-09. The researchers calculated incidence rates and patient demographic and temporal patterns of naloxone administration and examined patient evaluation data associated with naloxone administration. Results were compared with demographic distributions of the EMS patient and city populations and with prior study findings. Of 116,910 EMS incidents during the study period for patients aged 15 and older, EMS providers administered naloxone 1,297 times (1.1 percent of incidents)--an average of 100 administrations per month. Overall incidence was 1.87 administrations per 1,000 residents per year. Findings indicated that naloxone administration peaked in the summer months (31 percent of administrations), on weekends (32 percent), and in late afternoon (4-5 p.m. [8 percent]), with a trend toward peaking in the first week of the month. The incidence of suspected opioid overdose was highest among male patients, white patients, and those in the 45-54-year age group. Findings on temporal patterns were comparable with findings from prior studies. Demographic patterns of suspected opioid overdose were similar to medical examiner reports of demographic patterns of fatal drug- or alcohol-related overdoses in Baltimore in 2008-09 (88 percent of which involved opioids). In incidents with naloxone administration, less than half of call summaries were listed as overdose related and more than two fifths were coded as "medical illness" or "other." Given naloxone's safety, it is plausible that the drug was used in circumstances in which patients were in an altered mental state in order to facilitate providers' assessment of patients presenting with other health problems. Run reports did not distinguish prescription opiates. Opioid overdose studies in Rhode Island and Australia have also used EMS data.

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C. Roncero, F.J. Álvarez, C. Barral, S. Gómez-Baeza, B. Gonzalvo, L. Rodríguez-Cintas, et al. 2013. "Driving and Legal Status of Spanish Opioid-Dependent Patients." Substance Abuse Treatment, Prevention, and Policy 8:19. doi:10.1186/1747-597X-8-19.

Legal problems, driving violations, and accidents occur more often among opioid-dependent patients than among the general population. Researchers hypothesized that patients who were regular drivers would have better legal outcomes than those who did not possess a valid driving license. They analyzed information from the PROTEUS study on legal and driving status and assessed their possible association. The PROTEUS study was an observational, cross-sectional, descriptive, multicenter nationwide representative study conducted in Spanish healthcare centers for opioid-dependent patients. Driving and legal status of a population of opioid-dependent patients ≥18 years and enrolled in opioid agonist therapy treatment centers in Spain were assessed using a short specific questionnaire and the EuropASI questionnaire to highlight distinct individual clinical needs. Researchers found 621 patients were evaluable (84 percent men, 24.5 percent active workers) and 321 patients (52 percent) drove on a regular basis. Nineteen percent had some problem with the criminal justice system. There was a significant difference (p=0.0433) in status, according to the criminal justice system, between patients who drove on a regular basis and those who did not, with a higher percentage of patients with no pending charges among regular drivers. Regular drivers showed fewer legal problems than non-regular drivers, with the exception of issues related to driving (driving violations and drunk driving).

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T. Shimane. 2013. "The Pharmacist as Gatekeeper: Combating Medication Abuse and Dependence." Yakugaku Zasshi 133(6):617-30.

This article reviews fundamental terms involved in understanding nonmedical use of medications, including abuse, dependence, and intoxication. The current conditions of substance abuse and dependence are then introduced through a summary of epidemiological surveys conducted in Japan. Finally, the role of pharmacists as gatekeepers in preventing medication abuse and dependence is discussed.

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News and Reports

Murkowski Fighting Military Suicide by Addressing Prescription Drug Abuse
Alaska Business Monthly
Accessed June 10, 2013

Three U.S. senators co-sponsored the Servicemembers and Veterans Prescription Drug Safety Act that would direct the attorney general to establish a drug take-back program in coordination with the Departments of Defense and Veterans Affairs. The program would address prescription drug abuse and related suicides. Reported suicide deaths among servicemembers have reached one every 18 hours.

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Stopping Pill Abuse
The News Journal
June 12, 2013

This article and video (2:12 minutes) discuss Delaware's prescription monitoring program and some doctors' lack of participation. Doctors are required to check the database when there is "reasonable belief" a patient is abusing or diverting drugs. State records show Delaware doctors collectively check the database about 400 times a day. Since August, the number of patients getting controlled drugs from five different doctors and five pharmacies dropped from 87 to 60. However, only one in five doctors who prescribed controlled drugs from August through March 31 used the database, and just 28 percent of those who have a controlled substance license registered with the program. During that period, doctors who used the database wrote 502,000 prescriptions for controlled drugs--only 43 percent of all prescriptions for controlled drugs. The 230,000 patients receiving controlled drugs represent one in four Delaware residents. Some doctors said more physicians would use the system if office staff had access. They would like to see the database integrated into the Delaware Health Information Network. Nearly all 200 retail pharmacies in the state comply with the program.

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AAFP, NIDA Offer Educational Program on Addiction
American Academy of Family Physicians
June 11, 2013

The American Academy of Family Physicians and National Institute on Drug Abuse have offered family physicians online information about drug abuse and addiction along with tools to help them care for patients and families dealing with such issues. The video portion of the program, known as the Addiction Performance Project, features professional actors reading from Act III of Eugene O'Neill's Long Day's Journey into Night, a 1956 play about prescription-initiated addiction, which is followed by responses from a panel of family physicians. The project aims to help physicians identify and treat or refer drug-addicted patients in primary care settings; explore individual biases and beliefs about people who abuse drugs and how those beliefs affect physicians' approaches to screening and treatment; and use empathy, knowledge, and supporting tools to improve communication skills and confidence using screening tools and resources.

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Oregon Governor Signs Bill for Overdose Prevention Programs
Digital Journal
June 8, 2013

Oregon's governor signed SB 384 A into law, requiring the Oregon Health Authority to establish rules for training programs that will guide people in using lifesaving treatments for opiate overdose. In addition, it allows professionals to distribute naloxone to individuals who have completed the training program. Trainees are granted immunity from any civil and criminal liability when administering the drug.

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Teenagers Getting Prescription Drugs Online
June 10, 2013

This article and video (5:02 minutes) discuss how easy it is for teens to get prescription drugs online. The video shows a 15-year-old male who works with Digital Citizens Alliance, placing phone orders for prescription pain relievers without a prescription. In both cases, operators had no problem with the adolescent's order, even after knowing his age.

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New, Troubling Heroin Addiction Trend Grips Southeast Michigan
Detroit Free Press
June 13, 2013

Authorities say a mix of heroin and fentanyl known as "black shadow" is causing a rise in overdoses in Southeast Michigan. During a 14-day period, eight people overdosed in Washtenaw County alone, and there was one fatality. Calls to the Poison Control Center have nearly doubled this year, with 27 heroin-related calls in May compared with 15 during the same time period in 2012.

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Police Arrest Fourth Samaritan Nurse on Drug Charges
Watertown Daily News
June 8, 2013

A fourth Samaritan Medical Center nurse was charged with illegally dispensing medications, including Percocet, morphine, and Valium. He will face one count each of selling and possessing a prescription controlled substance and first-degree falsifying business records. The New York hospital's auditing system revealed that narcotics had been improperly dispensed.

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ACLU: Pill Mill Database Leaked Patient Info
The Daytona Beach News-Journal
June 11, 2013

The American Civil Liberties Union (ACLU) said thousands of patients' personal information from the Florida Prescription Drug Monitoring Database was given to Volusia County prosecutors and defense attorneys, even though some of the details were not part of a criminal investigation. A spokeswoman for the Department of Health said law enforcement officials have a duty to protect confidentiality of the information during a criminal investigation. The ACLU argues that law enforcement does not have direct access to the database and that prescription information is only given through the database's program managers.

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The Dangers of Adderall
June 13, 2013

This article and video (3:20 minutes) discuss the use and abuse of Adderall on college campuses. New York Senator Chuck Schumer wants colleges to enact tougher standards for diagnosing and monitoring students who take Adderall. He is urging college health services not to prescribe the drug on campus.

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Prescription Drug Abuse Fact-Based Program for Teen Pilot Evaluation
Accessed June 14, 2013

This poster summarizes results of a pilot study of the WAKE UP! educational program for teens about use, misuse, and abuse of prescription drugs. The program was funded by Millenia Pharmaceuticals and piloted in five high schools--three in San Diego, California, and two in Tampa Bay, Florida. An independent evaluation showed 75 percent of teen respondents were significantly more aware of the dangers of misusing and abusing prescription drugs.

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AG Jim Hood Says Google Pulling Videos on How to Get Drugs Without Prescription
The Mississippi Press
June 11, 2013

Mississippi's Attorney General said Google appears to be removing online videos that instruct people how to buy drugs without a prescription. He threatened legal action against the company for not doing enough to stop sales without prescriptions and selling ads next to YouTube videos. According to the Digital Citizens Alliance, searching YouTube for "buy tramadol without a prescription" now results in fewer hits--down from about 900 to about 460 in the past week. Google said it removes videos that are flagged for violating YouTube's guidelines regarding dangerous or illegal content.

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Heroin Trends Across Washington State
Info Brief, University of Washington Alcohol and Drug Abuse Institute
June 2013

Heroin use increased throughout Washington over the past decade, particularly among 18- to 30-year-olds, while prescription opioid use decreased, according to a recent study by the University of Washington. The study revealed that the largest increases in heroin use and abuse were outside metropolitan areas. Between 2000 and 2011, overdose deaths from heroin or related prescription drugs more than doubled in Cowlitz, Snohomish, Grays Harbor, Chelan, Lewis, Mason, Thurston, Benton, and Kitsap counties. The number of accidental deaths statewide involving heroin and prescribed opiates doubled from an annual average of 310 between 2000 and 2002 to an annual average of 607 from 2009 to 2011. In King County, almost three fourths of drug-induced deaths involved heroin or a prescription opiate between 1997 and 2012. The authors suggest the prescription drug monitoring program and 911 Good Samaritan Drug Overdose Law could turn the overdose statistics around.

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Business Bureau Warns About Online Pharmacies
June 12, 2013

The Connecticut Better Business Bureau (CBBB) has warned consumers about purchasing prescription medication from online pharmacies. A Food and Drug Administration study found 85 percent of medication shipped from Canadian online pharmacies came from manufacturers in two dozen different countries. Many of the intercepted products were counterfeit. CBBB provides recommendations for consumers who are considering buying prescription medication from the Internet.

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Lawsuit Filed by Kentucky County Against OxyContin Maker Settled
Western Kentucky Public Radio
June 7, 2013

Purdue Pharma has agreed to pay $4 million to settle a lawsuit for OxyContin abuse. In 2007, Pike County Government filed the suit asking for damages the community suffered after the company marketed the drug as a safer alternative to other pain medicines. The government will use the funds to establish a reentry partnership for people convicted of drug violations and for addiction rehabilitation.

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Documentary on Prescription Drug Abuse to Be Screened at Raritan Valley Community College
The Star-Ledger
June 12, 2013

A new documentary developed by the Safe Communities Coalition of Hunterdon/Somerset, From Pills 2 Heroin: The Domino Effect, aims to raise awareness about the dangers of prescription drug abuse. In the film, individuals share personal and family struggles with addiction.

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Urban Outfitters Halts Prescription-Themed Products
June 14, 2013

Urban Outfitters has decided to stop selling prescription-themed products such as glasses, coasters, mugs, and drink holders. The American Association of Poison Control Centers and several state attorneys general wrote letters to the CEO asking for the products to be removed from stores.

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Other Resources
Prescription (Rx) Drug Abuse Prevention: Campaign Slogan Poster, Parent Postcards, and Senior Postcards
Georgia Prescription Drug Abuse Prevention Initiative (GPDAPI)
Accessed June 10, 2013

The poster and postcards, components of the GPDAPI Media Awareness Campaign, are designed to support prescription and over-the-counter drug abuse awareness. They highlight the need for prevention education and the importance of safe storage and proper disposal of prescription medication and over-the-counter drugs. Materials can be downloaded for use in schools, colleges, universities, senior centers, businesses, doctors' offices, hospitals, and restaurants.

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Tips for Safe Medicine Storage
PROTECT, Centers for Disease Control and Prevention
Accessed June 14, 2013

This informational sheet provides tips for medicine storage while traveling (1-page PDF).

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Tips for Grandparents on Safe Medicine Storage
PROTECT, Centers for Disease Control and Prevention
Accessed June 14, 2013

This informational sheet provides medicine storage tips for grandparents (1-page PDF).

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Other Local News
New Castle County Police Unveils Delaware's First Prescription Drug Disposal Box
June 11, 2013

New Castle County Police placed a permanent prescription drug disposal box in the lobby of its public safety building--the first to be offered by any police agency in the state. Residents have access to the site 24 hours a day, 7 days a week to dispose of prescription or over-the-counter medication.
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Turquoise Lodge Hospital Tackles Teen Drug Abuse
June 10, 2013

This article and video (1:47 minutes) discuss the opening of the rehabilitation and detox center at Turquoise Lodge Hospital in southeast Albuquerque, New Mexico. The New Mexico legislature approved $2 million last session to get the 30-day program started. The 20-bed facility accommodates teenagers addicted to prescription drugs, heroin, cocaine, and methamphetamine.

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Parents Reminded to Watch for Signs of Underage Drug, Alcohol Use
The Northwestern
June 11, 2013

This article warns parents about underage drug and alcohol use in Winnebago County, Wisconsin, and surrounding areas. In the past 2 years, the area has seen an increase in overdose deaths related to prescription drugs and heroin. Strategies for preventing children from drinking and using drugs are provided.

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Somerset County Residents Urged to Properly Dispose of Prescription Drugs
The Messenger-Gazette
June 12, 2013

The Safe Communities Coalition of Hunterdon/Somerset urges residents to safely dispose of prescription medication at one of three permanent prescription drop-off locations in Somerset County, New Jersey.

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More and More WV Babies Born Addicted to Drugs
The Herald-Dispatch
June 9, 2013

One of every five babies in Charleston, W.Va., is born with narcotics or marijuana in his or her blood. One of every 13 babies born at Cabell Huntington Hospital is addicted to drugs, and Charleston Area Medical Center has seen about the same rate. This article discusses efforts and challenges related to coping with a rising number of drug-addicted newborns.

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Prescription Drug Drop Set for June 29 in Newton
Newton Daily News
June 11, 2013

The Jasper County, Iowa, Sheriff's Office; Newton Fire Department; and Youth Prevention Awareness Coalition will host a drive-through prescription drug drop on June 29 at the Newton Fire Department.

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Heroin and Prescription Overdoses Rise Throughout N.J.; Skyrocket in Ocean County
The Star-Ledger
June 11, 2013

Ocean County, N.J., has already seen 52 fatal overdoses in 2013--one fewer than the total number in 2012. Sixty percent (31) were 20 to 26 years old, according to county records. Many overdose deaths occur when heroin, pain relievers, alcohol, and other drugs are combined. Other counties in the state are also likely to surpass the number of 2012 overdoses. In 2011, there were 368 heroin-related deaths in 21 N.J. counties--up from 287 in 2010.

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Romanoff Joins Innovative Statewide Program to Combat Abuse of Prescription Pain Medications
The Sacramento Bee
June 12, 2013

This press release announces the appointment of Dr. Mark Romanoff, a board-certified anesthesiologist and pain management specialist, as regional trainer and mentor for Project Lazarus. He will coach professionals, consult on pain management cases, and assist with public education and community outreach. Project Lazarus has expanded into a statewide North Carolina initiative to help combat misuse and abuse of prescription medication.

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Grants Received
Organizations Receive $300K Grant to Stem Opiate Addiction in County
North Adams Transcript
June 12, 2013

The Massachusetts Department of Health awarded a 3-year, $300,000 grant to Berkshire Public Health Alliance and Berkshire Regional Planning Commission to help address opiate addiction in Berkshire County.

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ETSU Awarded $2.2 Million to Research Prescription Drug Abuse
Johnson City Press
June 13, 2013

East Tennessee State University (ETSU) received a $2.2 million research grant from the National Institute on Drug Abuse to address prescription drug abuse and misuse. Using these funds, it will launch a 5-year interprofessional research program. Investigators from the colleges of Public Health, Pharmacy and Medicine in the ETSU Academic Health Sciences Center will study how improving communication among healthcare providers, pharmacists, and patients can reduce illicit use of prescription medicine. In addition, they will quantify outcomes of drug take-back events and drug donation boxes.

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Ohio University Lancaster Participates in Prescription Drug Abuse Education Grant
Ohio University Lancaster
June 6, 2013

The Ohio University Lancaster campus received grant funding from the Cardinal Health Foundation to increase awareness and implement Generation Rx education and prevention tactics. The grant funded the purchase of six television monitors to display prescription drug abuse messages across campus.

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Grant Announcement

Healthy Living Grant Program
Deadline: July 16, 2013

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Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference
June 22 and 23, 2013: Chicago, Illinois
July 13 and 14, 2013: Portland, Oregon
August 3 and 4, 2013: Baton Rouge, Louisiana
August 16 and 17, 2013: San Diego, California
August 18 and 19, 2013: San Jose, California
September 21 and 22, 2013: Boston, Massachusetts

Conference on Diversion of Controlled Substances, Pharmacist's Corresponding Responsibility, and California's CURES Program
June 27, 2013
Rancho Los Amigos Rehabilitation Center
7601 E. Imperial Highway
Downey, CA 90242

This summit, sponsored by the Drug Enforcement Administration and California State Board of Pharmacy, intends to better inform board licensees about the pitfalls of prescription drug abuse, diversion, and failure to exercise corresponding responsibility, as well as the use of CURES and controlled substance dispensing.

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The Generation Rx University Conference for Prescription Drug Abuse Prevention and Recovery
August 7-8, 2013
Columbus, Ohio

National Conference on Addiction Disorders 2013
September 21-25, 2013
Anaheim, California

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2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2, 2013
Chicago, Illinois
Please e-mail Rekaya Gibson at rgibson@pire.org with questions or comments about the SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv.  
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.

The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" 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 viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" 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 journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.

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