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March 10, 2016

PAW Weekly Update

    

                                          
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SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
          Issue 164  |  March 10, 2016          
   
                                                               
                                                                                                                                                
                                                                                                                   
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.                      
               
                                                                                                                 
                                                                                                                                                                     
Index                            
Featured                            
Journal Articles and Reports                            
Professional Development                            
National                            
Marijuana                            
International                            
Northeast/Mid-Atlantic News                            
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Featured

B.J. Morasco, D. Peters, E.E. Krebs, A.E. Kovas, K. Hart, and S.K. Dobscha. 2015. “Predictors of Urine Drug Testing for Patients With Chronic Pain: Results from a National Cohort of U.S. Veterans.” Substance Abuse, doi:10.1080/08897077.2015.1110742.                        

Of the 22,646 veterans in fiscal year 2011 who started opioid therapy for chronic non-cancer pain at a Veterans Affairs (VA) medical facility, 19 percent had urine drug tests within 90 days to monitor compliance. Multivariate analysis showed testing was more likely for male patients than female patients (risk ratio [RR] = 1.2), black patients than white patients (RR = 1.2), and single or divorced/separated patients than married patients (RR = 1.1). Testing was also more likely among patients who had a comorbid substance use disorder (RR = 1.4), posttraumatic stress disorder (RR = 1.1), bipolar disorder or schizophrenia (RR = 1.3), urine testing prior to initiating opioid therapy (RR 1.4), and a higher baseline opioid dose (RR = 1.4). Factors associated with lower likelihood of testing included living in a highly rural setting (RR = 0.6), having a VA service-connected disability (RR = 0.9), and having a nurse practitioner or physician assistant as one’s primary care clinician (RR = 0.7).                        

Read more:                        
http://www.ncbi.nlm.nih.gov/pubmed/26516794                       
               
               

 Journal Articles and Reports

C.S. Carpenter, C.B. McClellan, and D.I. Rees. 2016. “Economic Conditions, Illicit Drug Use, and Substance Use Disorders in the United States.” National Bureau of Economic Research Working Paper No. 22051 February 2016.                

Between 2002 and 2013, economic downturns were associated with increases in substance use disorders that involved hallucinogens and prescription pain relievers. The associations are robust to a variety of specification choices and are concentrated among prime-age white men with low educational attainment.                 

Read more:                
http://www.nber.org/papers/w22051                                  

Prevention Status Reports                
Centers for Disease Control and Prevention                
February 29, 2016                

The Centers for Disease Control and Prevention’s (CDC) newest online Prevention Status Reports highlight the status of policies and practices designed to address 10 important public health problems, including prescription drug overdose. Individual reports are available for all 50 states and the District of Columbia. Each report describes the public health problem, identifies potential solutions to the problem drawn from research and expert recommendations, and reports the local status of those solutions using a simple, three-level rating scale. The overdose reports focuses on two state prescription drug monitoring program (PDMP) policies: (1) requiring timely data submission by dispensers and (2) requiring universal use before prescribing. Without reporting on or rating state status, it lists other PDMP practices for states to consider.                 

Read more:                
http://www.cdc.gov/psr                
http://www.cdc.gov/psr/national-summary.html                                  

C.A. Crane, R.C. Schlauch, S. Devine, and C.J. Easton. 2016. “Comorbid Substance Use Diagnoses and Partner Violence mong Offenders Receiving Pharmacotherapy for Opioid Dependence.” Journal of Addictive Diseases, doi:10.1080/10550887.2016.1154400.                

Among 1,926 newly sentenced offenders in New Haven, Conn., 88 were receiving medication-assisted treatment for opioid use disorders. An intake survey found that of the 88 offenders, one-third said they perpetrated intimate partner violence in the past year. In multivariate regression (controlling for age, sex, education, and other substance misuse), odds of perpetrating were 10.1 times as high for methadone/buprenorphine maintenance patients who misused benzodiazepines relative to those who did not misuse drugs or alcohol. The increase in odds was much lower for those who misused cocaine, alcohol, or cannabis.                

Read more:                
http://www.tandfonline.com/doi/abs/10.1080/10550887.2016.1154400                                  

J. Delorme, C. Chenaf, J.L. Kabore, B. Pereira, A. Mulliez, A. Tremey, G. Brousse, M. Zenut, C. Laporte, and N. Authier. 2016. “Incidence of High Dosage Buprenorphine and Methadone Shopping Behavior in a Retrospective Cohort of Opioid-Maintained Patients in France.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.02.035.                

In a random sample of people covered by the French national health insurance system, 2,043 patients (1 in 350) received medication-assisted treatment for opioid use disorders, with 1,450 using high-dose buprenorphine and 593 using methadone, between April 2004 and December 2012. Shopping behavior was defined as opioid dispensations with at least 1 day of overlap, based on prescriptions from at least two prescribers and filled in at least three pharmacies. The 1-year Incidence of shopping behavior was 8.4 percent in the buprenorphine group, 0.0 percent in the methadone group, and 0.2 percent in a comparison group without a history of opioid use disorders. The 5-year incidence of shopping (with exposure starting at commencement of medication-assisted treatment) was 1.6 percent for methadone and 20.6 percent for buprenorphine. Half of shopping behavior started during the first year of treatment. In multivariate analysis, factors associated with past-year shopping behavior among those on buprenorphine were male sex (hazard ratio [HR] = 1.7), low-income status (HR = 3.0), mental health disorders (HR = 1.4), concurrent hypnotics use (HR = 1.9), concurrent use of weak opioids (HR = 1.5) and of morphine (HR = 1.7). High-dosage buprenorphine shoppers had a higher, yet nonsignificant risk of death (HR = 1.56) than non-high-dosage buprenorphine shoppers.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00110-1/abstract                                  

A. McAuley, A. Munro, S.M. Bird, S.J. Hutchinson, D.J. Goldberg, and A. Taylor. 2016. “Engagement in a National Naloxone Programme Among People Who Inject Drugs.” Drug and Alcohol Dependence, doi:org/10.1016/j.drugalcdep.2016.02.031.                

Survey responses in Scotland’s Needle Exchange Surveillance Initiative (NESI) showed that the proportion of participants who had been prescribed naloxone within the last year increased from 8 percent (175 in 2,146) in 2011–12 to 32 percent (745 in 2,331) in 2013–14. In contrast, the proportion of those with prescriptions who carried naloxone with them on the day they were interviewed decreased from 16 percent to 5 percent.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00106-X/abstract                                  

B.R. Nordstrom, E.C. Saunders, B.  McLeman, A. Meier, H. Xie, C. Lambert-Harris, B. Tanzman, J. Brooklyn, G. King, N. Kloster, C.F. Lord, W. Roberts, and M. McGovern. 2016. “Using a Learning Collaborative Strategy with Office-Based Practices to Increase Access and Improve Quality of Care for Patients with Opioid Use Disorders.” Journal of Addiction Medicine, doi:10.1097/ADM.0000000000000200.                

Researchers initiated a learning collaborative about opioid use disorder management with 28 physician practices in Vermont. Physician engagement in the collaborative was favorable (86 percent). Six of seven quality measures improved from baseline to 8 months. Practice variation decreased over time on all measures. The number of patients who received medication-assisted therapy did not increase significantly.                

Read more:                
http://journals.lww.com/journaladdictionmedicine/Abstract/publish
ahead/Using_a_Learning_Collaborative_Strategy_With.99643.aspx
                                  

R.M. Pavarin, D. Berardi, and D. Gambini. 2016. “Emergency Department Presentation and Mortality Rate Due to Overdose: A Retrospective Cohort Study on Non-Fatal Overdoses.” Substance Abuse, doi:10.1080/08897077.2016.1152342.                

Between 2004 and 2012, 10 emergency departments in Bologna, Italy, treated 294 episodes of nonfatal overdose that involved 218 patients. In the 1,048 person-years of exposure after treatment, mortality rates for all causes were 35.5 per 1,000 per years for men and 20.6 for women. Mortality rates for overdose were 16.6 for men and 13.7 for women. In multivariate regression, male patients, patients over age 30, patients who refused emergency department treatment, and patients who previously had contacted mental health services had a higher risk of overdose death.                

Read more:                
http://www.ncbi.nlm.nih.gov/pubmed/26914353                                  

D.S. Tehran, A. Nahvi, M. Hajirasouli, H. Naseri, K. Lotfi, and M. Niknejad. 2016. “Effects of Stimulant and Opiate Drugs on Driver Behavior During Lane Change in a Driving Simulator.” Travel Behaviour and Society 4:69–78, doi:10.1016/j.tbs.2016.01.004.                

Six stimulant users, six opiate-users, and six non-drug users were tested in a driving simulator in Iran. Opiate users and non-drug users changed lanes similarly. Stimulant users changed lanes more abruptly and less safely.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S2214367X16000053                  
               

Professional Development

 J.T. Jones. 2016. “Advances in Drug Testing for Substance Abuse Alternative Programs.” Journal of Nursing Regulations 6(4):62–7, doi:10.1016/S2155-8256(16)31009-2.                

The primary focus of substance use alternative programs for nurses is to provide early identification, entry into treatment, and safe reentry into the workplace. A key component of these alternative programs is monitoring abstinence through drug testing. Program administrators must make careful decisions regarding drug screening standards and the appropriate drug testing profile. Recent improvements in technology offer tests using alternative matrixes, such as oral fluids, hair, fingernails, and dried blood spots.                 

Read more:                
http://www.journalofnursingregulation.com/article/S2155-8256(16)31009-2/abstract                                  

J.V. Pergolizzi, G. Zampogna, R. Taylor, E. Gonima, J. Posada, and R.B. Raffa. 2016. “A Guide for Pain Management in Low and Middle Income Communities. Managing the Risk of Opioid Abuse in Patients with Cancer Pain.” Frontiers in Pharmacology, doi.org/10.3389/fphar.2016.00042.                

Opioid therapy can be safe and effective for use in cancer patients with pain, but there are rightful concerns about inappropriate opioid use even in the cancer population. Cancer patients with pain must be evaluated for risk factors for potential opioid misuse and assessed for aberrant drug-taking behaviors. A variety of validated screening tools are available. For example, the Opioid Risk Tool evaluates 10 psychosocial risk factors for opioid misuse. Cancer patients tend to have frequent changes in pain. Fortunately, clinicians can use universal precautions, such as chemical monitoring, to help reduce the risk of opioid overdose while assuring that cancer patients get the pain therapy they need. Another useful misuse safeguard is to prescribe abuse-deterrent opioid formulations.                 

Read more:                
http://journal.frontiersin.org/article/10.3389/fphar.2016.00042/full                                 

F.K. Thomas, C. Melinda, L. Jinhee, A. Mitra, and L. Robert. 2015. “Reducing Mortality of People Who Use Opioids Through Medication Assisted Treatment for Opioid Dependence.” Journal of HIV & Retro Virus 1(1):1–5.                

Medication-assisted treatment impacts public health through the reduction of opioid use, opioid overdose mortality, and transmission of infectious diseases. It can be provided in both clinical and community settings.                 

Read more:                
http://hiv.imedpub.com/reducing-mortality-of-people-who-useopioids-through-medication-assistedtreatment-for-opioid-dependence.php?aid=8154                
               

National

                A Novel Lawsuit Takes On Workplace Addiction Epidemic                
Dina Gusovsky, CNBC                
March 3, 2016                

Wayne Automatic Fire Sprinklers has filed a lawsuit in a federal court in Florida against Insys Therapeutics, a maker of opioid pain relievers. The plaintiff accuses Insys of engaging in a “massive fraud scheme and criminal enterprise to obtain money from Wayne for illegally prescribed pain relievers through Wayne’s employee health insurance plan,” further accusing Insys of working with a Florida-based physician, a clinic, and two other companies to illegally prescribe and dispense Subsys sublingual fentanyl spray “with the sole motivation of financial gain including kickbacks.” Subsys is approved only for cancer pain but was being prescribed off-label. Some doctors and sales representatives already have pleaded guilty or been convicted of participating in the broader scheme. Experts say the Wayne case is a unique use of a Florida law designed to protect consumers from fraud and could set a precedent for how employers address the drug epidemic. (Includes three videos: 3:15 | 2:32 | 8:37 minutes)                

Read more:                
http://www.cnbc.com/2016/03/03/a-shocking-lawsuit-tackling-workplace-addiction-epidemic.html                                  

New Twist in Addiction Crisis: Deadly Pain Reliever Impostors                
Andrew Welsh-Huggins, Associated Press                
February 29, 2016                

Authorities around the country are sounding the alarm about potent pain relievers disguised as other medications. Tennessee officials have seen two dozen cases in recent months of pills that contained fentanyl but marked as less potent oxycodone and Percocet. In San Francisco, the health department has blamed several overdoses last summer on lookalike Xanax that contained fentanyl. In Cleveland, federal agents arrested a man in February after seizing more than 900 fentanyl pills marked as oxycodone. Canada has also issued warnings about multiple recent cases of lookalike oxycodone pills that contained fentanyl.                

Read more:                
http://abcnews.go.com/Health/wireStory/twist-addiction-crisis-deadly-painkiller-impostors-37273728                                  

D. Meinert. 2016. “Combatting the Prescription Drug Crisis.” Society for Human Resource Management, HR Magazine 61(2), March 2016.                

This article discusses the growing prescription drug crisis, including the stigma and costs. It warns about questions employers cannot ask potential or current employees about substance use. The article also discusses how employers can take a proactive role in addressing the prescription pain reliever crisis. For example, companies can educate employees about the risks of pain relievers. Treatment can work. Employee assistance programs can work closely with treatment center counselors to help employees transition back to work.                

Read more:                
http://www.shrm.org/publications/hrmagazine/editorialcontent/2016/0316/pages/0316-prescription-drug-abuse.aspx                                  

Fisher & Phillips Offers Employers a Prescription for Treating Opioid Abuse in the Workplace                
Fisher & Phillips, PR.com                
February 27, 2016                

John Heller, an attorney for a national management-side labor and employment law firm, believes employers should provide employees with information on opioid misuse and programs to help them overcome addiction. He believes employers should also implement drug testing policies that address opioid use and misuse. Heller discusses four ways employers can address opioid addiction in the workplace: expanding testing, reviewing results, developing appropriate policies, and preparing employees by informing them of the changes.                

Read more:                
http://www.pr.com/press-release/660003                 

Senate Rejects $600 Million for Heroin, Opioid Epidemic                
Brian Tumulty, Journal News                
March 2, 2016                

The U.S. Senate has rejected a $600 million emergency spending proposal to fund the nation’s heroin and opioid misuse response. The failed proposal came as an amendment to the recently introduced Comprehensive Addiction and Recovery Act of 2016. The Obama administration had requested a $1.1 billion increase over 2 years, starting in fiscal 2017, which begins October 1, 2016.                

Read more:                
http://www.lohud.com/story/news/politics/politics-on-the-hudson/2016/03/02/senate-rejects-600-million-heroin-opioid-epidemic/81224076                                  

                                                                           
                  Related Article                  
White House Takes Stand Against Drug Abuse Bill                  
Sarah Ferris, The Hill                  
March 1, 2016                  

The Obama administration has warned that the proposed Comprehensive Addiction and Recovery Act of 2016 does not go far enough without more funding. Some senators have demanded $600 million in extra funding for the bill. The act focuses on treating drug addictions by improving prescription drug monitoring programs and making naloxone more widely available.                   

Read more:                  
http://thehill.com/policy/healthcare/271305-white-house-takes-stand-against-gops-drug-abuse-bill                                    
               
                                 House Bill Advances Requiring Veterans Affairs to Participate in Rx Monitoring Programs                
The Journal Gazette                
February 26, 2016                

The U.S. House Veterans Affairs (VA) Committee has approved a bill with an amendment that would require VA facilities to participate in state prescription drug monitoring programs.                

Read more:                
http://www.journalgazette.net/news/local/Bill-advances-to-have-VA-work-with-Rx-monitoring-11692376                                  

Servicemembers and Veterans Prescription Drug Safety Act of 2016 Introduced                
Congress.gov                
February 26, 2016                                 

U.S. Rep. Matt Cartwright (D-Penn.) has introduced the Servicemembers and Veterans Prescription Drug Safety Act of 2016. The legislation would provide a prescription drug take-back program for members of the military and veterans and for other purposes.                

Read more:                
https://www.congress.gov/bill/114th-congress/house-bill/4635/text                                                   

Bill Would Fund State Development of Standing Orders for Dispensing Opioid Overdose Antidote                
National Association of Boards of Pharmacy                
March 2, 2016                

U.S. Rep. Robert J. Dold (R-Ill.) has introduced legislation that would provide funding to states to develop standing orders for pharmacies to dispense opioid overdose reversal medication and train healthcare providers to educate the public about administering opioid overdose reversal medication.                

Read more:                
http://www.nabp.net/news/proposed-federal-bill-would-fund-state-development-of-standing-orders-for-dispensing-opioid-overdose-reversal-drug-and-education-programs                                  

Chain Drug Stores Urge Senate to Pass Prescription Drug Abuse, Access Bill                
Pharmacy Times                
February 29, 2016                

The National Association of Chain Drug Stores (NACDS) recently sent a letter to senators, urging them to pass the Ensuring Patient Access and Effective Drug Enforcement Act of 2016. The bill would spur collaboration among health and enforcement authorities for drug abuse solutions that maintain patients’ legitimate access to medications. NACDS said the bill would help federal agencies to identify obstacles to legitimate patient access to controlled substances, issues with diversion of controlled substances, and how collaboration between agencies and stakeholders can benefit patients and prevent diversion and misuse of prescription drugs. The bill also would require consultation with patient and provider groups, pharmacies, and other stakeholders.                 

Read more:                
http://www.pharmacist.com/nacds-urges-senate-pass-prescription-drug-abuse-access-bill                                  

Drug Enforcement Agency Meets with Pharmaceutical Industry Leaders                
KRWG                
February 29, 2016                

U.S. Drug Enforcement Administration (DEA) officials recently met with pharmaceutical industry leaders to discuss ways to minimize drug diversion while maintaining legitimate commerce and patient access. DEA Acting Administrator Chuck Rosenberg said the meeting would help “us all to find the right balance between providing patients with important prescription medications and reducing the addictions, overdoses, and crimes that too often result from these substances falling into the wrong hands.”                

Read more:                
http://krwg.org/post/dea-meets-pharmaceutical-industry-leaders                                  

Could You Be at Risk for Pain Reliever Addiction?                
Lisa Esposito, U.S. News and World Report                
February 26, 2016                

Experts describe early signs of pain reliever addiction and discuss how to take these drugs safely.                

Read more:                
http://health.usnews.com/health-news/patient-advice/articles/2016-02-26/could-you-be-at-risk-for-painkiller-addiction                 
                 

 Marijuana

In a Bind: Montanans Who Use Medical Marijuana Face Uncertain Future                  
Judy Slate, KTVQ                  
March 2, 2016                  

Montana’s supreme court has upheld certain restrictions that the legislature imposed in 2011 to the state’s medical marijuana program, including limiting a provider to three marijuana patients. The changes will likely put most of the 471 medical marijuana providers out of business and leave the 13,000 registered patients with fewer choices. Montana voters in November could consider several related ballot initiatives, including one that would address patients’ access to medical marijuana and others pertaining to the legality of all marijuana. (Includes video: 2:50 seconds)                  

Read more:                  
http://www.ktvq.com/story/31372437/3rd-marijuana-initiative-aimed-at-restoring-patient-access-could-be-on-nov-ballot                                      

New Developments in Medical Marijuana and the Workplace                  
Kevin Haskins, PretiFlaherty                  
March 1, 2016                  

State medical marijuana laws are not created equal. This article gives examples of cases from Colorado and Washington. Courts in both states have construed laws in favor of employers, but that does not mean employers in other states with medical marijuana laws can assume their courts would reach similar interpretations. Medical marijuana laws in states like Colorado and Washington decriminalize medical marijuana without providing any specific employment protections. States such as Maine include specific protections that prohibit employers from taking adverse action against an employee based on their status as a medical marijuana user. Court rulings from states that have decriminalized possession should not be viewed as indicative of how a court would rule in another jurisdiction.                   

Read more:                  
http://www.jdsupra.com/legalnews/new-developments-in-medical-marijuana-83829                                                         

Illinois Medical Marijuana Law: What Employers Should Know                  
Matthew Luzadder, Kelley Drye & Warren LLP                  
March 2, 2016                  

This article is a brief overview of the Illinois Medical Marijuana Program and discusses four things employers should understand about the program. The article’s recommendations include: reviewing the company’s approach to drug testing and developing a consistent and transparent plan for responding to drug test results; and for employers in safety-sensitive industries, tightening the language in zero-tolerance policies.                   

Read more:                  
http://www.jdsupra.com/legalnews/illinois-medical-marijuana-law-what-97183                                      

Petition Seeking to Legalize Medical Marijuana in Idaho Withdrawn                  
Idaho State Journal                  
March 3, 2016                  

New Approach Idaho, Inc., has withdrawn its petition to decriminalize three ounces of marijuana and legalize medical marijuana in Idaho. The petition inaccurately stated that the American Academy of Pediatrics (AAP) “endorsed medical access to marijuana.” The AAP opposes legalization of marijuana because of the potential harms to children and adolescents.                   

Read more:                  
http://www.idahostatejournal.com/news/petition-seeking-to-legalize-medical-marijuana-in-idaho-withdrawn/article_af8e37ff-8de7-5cf8-8f95-26fab0962891.html                                      

Iowa Poll: Medical Marijuana Draws 78 Percent Support                  
Tony Leys, The Des Moines Register                  
March 2, 2016                  

Seventy-eight percent of Iowans are comfortable with the use of medical marijuana, up from 58 percent in 2013, according to a recent poll of 804 Iowan adults conducted for the Des Moines Register and Mediacom. However, only 34 percent (an increase of 5 percentage points from 2013) of adults favor allowing people to smoke or eat marijuana for recreational purpose. Support for medical marijuana is strongest among adults ages 35 and younger, 87 percent of whom favor legalizing medical marijuana; 68 percent of those ages 65 or older support it.                  

Read more:                  
http://www.desmoinesregister.com/story/news/health/2016/03/01/iowa-poll-medical-marijuana-draws-78-percent-support/81126478                                      

Georgia House Passes Watered Down Medical Marijuana Expansion Bill                  
Emily Gray Brosious, Sun Times                  
February 29, 2016                  

Georgia’s house of representatives has passed a bill that expands the state’s medical cannabis oil program to include additional illnesses and conditions not currently listed among qualifying conditions for cannabis oil.                  

Read more:                  
http://extract.suntimes.com/news/10/153/16656/georgia-house-passes-watered-medical-marijuana-bill                 
               

International

English Police Report 800 Percent Rise in Drug Driving Arrests                
Luke Heighton, Telegraph                
February 28, 2016                

Police in Cheshire, England, have reported an 800 percent increase in the number of drugged driving arrests made following the introduction of drugalyzers, with half those stopped testing positive for either a banned substance or levels of prescription drugs likely to impair their ability to drive. Cheshire officers used roadside swab tests to apprehend 530 suspected drugged drivers between March 2015 and January 2016. The total for all of 2014 was 70.                 

Read more:                
http://www.telegraph.co.uk/news/uknews/crime/12175995/Police-report-800pc-rise-in-drug-driving-arrests.html                 
               

Northeast/Mid-Atlantic News

Maine Bill Designed to Increase Use of Prescription Monitoring Program                
Maine National Public Radio                
February 29, 2016                

Maine legislators have allowed an after-deadline bill that would increase use of the prescription drug monitoring program (PDMP). The bill would require licensing boards to develop rules requiring doctors, pharmacists and other prescribers to use the computerized database. The governor’s office also is readying legislation that would require PDMP use.                

Read more:                
http://news.mpbn.net/post/bill-designed-increase-use-prescription-monitoring-program#stream/0                                  

Tracking the Tracker: Long Road for Pennsylvania’s Prescription Drug Monitoring Program                
Science Daily                
March 1, 2016                

This article discusses the history of the prescription drug misuse crisis in Pennsylvania. It also examines the political path the state took to build a prescription drug monitoring program system for physicians.                 

Read more:                
https://www.sciencedaily.com/releases/2016/03/160301075306.htm                                  

Pennsylvania County Coroner: Non-Heroin Drugs Used in 70 of 126 Fatalities in 2015                
Rich Cholodofsky, TribLive                
March 3, 2016                

Drug overdose deaths in Westmoreland County, Penn., have jumped in 2015, with 70 of 126 involving drugs other than heroin. Most overdose deaths involved more than one drug, such as opioids and antidepressants. The coroner’s office has recorded 21 fatal overdoses in January and February of this year, a monthly toll comparable to 2015.                 

Read more:                
http://triblive.com/news/westmoreland/10078831-74/overdoses-heroin-drug                                  

New York Fines Maker of Widely Abused Pain Reliever for Downplaying Drug’s Risks                
James T. Mulder, Syracuse Media Group                
March 3, 2016                

New York’s attorney general has reached an agreement with Endo Health Solutions and Endo Pharmaceuticals to stop making false and misleading claims about extended release (ER) Opana. The company agreed to a $200,000 fine as part of the settlement. Endo improperly marketed Opana ER as being crush-resistant even though its own studies showed the drug could be crushed and ground. The investigation also showed the company instructed sales representatives to diminish risks associated with the drug.                

Read more:                
http://www.syracuse.com/health/index.ssf/2016/03/ny_fines_maker_of_
widely_abused_painkiller_200000_for_downplaying_drugs_risks.html
                                  

Pennsylvania Police Officers Recognized for Preventing Opioid Overdoses with Naloxone                
Sam Janesch, LancasterOnline.com                
March 2, 2016                

About 150 police officers across Pennsylvania have been recognized for saving more than 600 lives with nalaxone.                                  

Read more:                
http://lancasteronline.com/news/pennsylvania/police-officers-recognized-for-preventing-opioid-overdoses-with-naloxone/article_7197363c-e0a8-11e5-a61e-5356e9f78eae.html                                  

New York Governor: Nalaxone Now Available at Independent Pharmacies                
The Wellsville Daily Reporter                
March 2, 2016                

Independent pharmacies across New York can now provide naloxone to their customers without a prescription. The Harm Reduction Coalition will issue standing medical orders to the more than 750 independent pharmacies outside the five boroughs of New York City, and chain pharmacies without a designated prescriber. Many smaller counties in the state have no chain pharmacies and rely exclusively on independent pharmacies.                

Read more:                
http://www.wellsvilledaily.com/article/20160302/NEWS/160309937                                  

Massachusetts Dental Group Urges Dentists and Doctors to Work Together to Fight Opioid Crisis                
David Keith, D.M.D., Boston Globe                
March 3, 2016                

David Keith, D.M.D., co-chair of the Massachusetts Governor’s Dental Education Working Group on Prescription Drug Misuse, is urging more integration between dentistry and the medical field to address the prescription opioid epidemic.                

Read more:                
https://www.bostonglobe.com/opinion/letters/2016/03/04/group-urges-more-integration-between-dentists-doctors-fight-opioid-crisis/XzYY3XIXPLLqS4Gg6cE1GL/story.html                                  

Boston’s Heroin Users Will Soon Get a Safer Place to Be High                
Martha Bebinger, NPR                
March 1, 2016                

Boston Health Care for the Homeless in March plans to open a room where heroin users can be high under medical supervision. Patients will not be allowed to take drugs into the room. Staff will check the user’s breathing, other vitals, and general health. A hospital is across the street for emergency assistance. Boston police have no concerns about the program’s “safe room” as planned. They would not support allowing injections. In the past month, emergency medical technicians revived six people after overdoses in the neighborhood where the planned room is located. (Includes audio: 4:34 minutes)                

Read more:                
http://www.npr.org/sections/health-shots/2016/03/01/468572534/bostons-heroin-users-will-soon-get-a-safer-place-to-be-high                 
               

South News

 Virginia General Assembly Fails to Hold Heroin Dealers, Traffickers Accountable                
Augusta Free Press                
March 2, 2016                

The Virginia General Assembly, whose 2016 session ends this week, will not vote this year on a law that would hold heroin dealers and traffickers accountable when their drugs result in a fatal overdose. The law enforcement community has been pushing for this law for 2 years. Virginia’s attorney general currently partners with the U.S. Department of Justice to prosecute these fatal overdoses at the federal level.                 

Read more:                
http://augustafreepress.com/general-assembly-fails-hold-heroin-dealers-traffickers-accountable                                  

West Virginia Sheriff’s Association Opposes New Opioid Legislation                
Daniel Tyson, Register-Herald                
March 3, 2016                

The West Virginia Sheriff’s Association does not support legislation the state is considering that would allow advance practice registered nurses to prescribe 72-hours-worth of a Schedule II drug, such as oxycodone, and 30-days-worth of Schedule III and attention deficit/hyperactivity disorder drugs with no refills. The association believes the law would increase the availability of drugs to addicts. The association is also unsure that the prescription drug monitoring program could handle the increased number of prescribers without buying an upgrade. Finally, it has concerns for the safety of nurse practitioners. It warned that doctors are often threatened with bodily harm and lawsuits when addicts are denied drugs.                 

Read more:                
http://www.register-herald.com/news/sheriff-s-association-against-new-opioid-legislation/article_6672a1bf-d947-5d5c-835f-9a0ced21cf01.html                 
               

Midwest News

St. Louis County Passes Prescription Drug Monitoring Program                
Katherine Hessel, Fox2Now                
March 1, 2016                

The St. Louis County Council has passed a bill that will create a prescription drug monitoring program (PDMP). It will allow other jurisdictions to share the county’s database system and communicate with the system. It will take about 6 months to get the PDMP up and running. Missouri is the only state without a PDMP.                

Read more:                
http://fox2now.com/2016/03/01/st-louis-county-passes-prescription-drug-monitoring-program                                  

Missouri House Approves Prescription Monitoring Program                
Adam Aton, Associated Press                
March 1, 2016                

Missouri’s house of representatives has approved legislation that would create a prescription drug monitoring program. The bill would require pharmacies to report to the state health department about scheduled medications dispensed for human consumption. The bill heads back to the senate.                

Read more:                
http://www.columbiamissourian.com/news/missouri-house-approves-prescription-monitoring-program/article_daac87d8-0503-51fd-a5df-473645a87cb4.html                                  

Michigan Doctor Sentenced to Prison for Distributing Prescription Drugs                
Department of Justice, U.S. Attorney’s Office, Eastern District of Michigan                
March 1, 2016                

Abbey Akinwumi, M.D., who operated a medical clinic in Detroit, has been sentenced to 7 years in prison for participating in a conspiracy to distribute prescription pills illegally. Dr. Akinwumi admitted that he issued more than 500,000 doses of oxycodone hydrochloride, approximately 300,000 doses of oxymorphone, and more than 2 million doses of hydrocodone outside the course of legitimate medical practice and without any medical justification. The prescriptions were issued after either a cursory examination or without any examination at all. Akinwumi then billed Medicare, Medicaid, and private insurance companies for medically unnecessary procedures. Once the prescriptions were filled, the pills were sold on the street.                 

Read more:                
https://www.justice.gov/usao-edmi/pr/doctor-sentenced-84-months-prison-distributing-prescription-drugs                                  

Michigan Prison Officer Accused of Selling Prescription Pills                
Mike Martindale, Detroit News                
February 29, 2016                

An off-duty Michigan corrections officer is facing up to 20 years in prison after allegedly selling prescription drugs on the street while in uniform and carrying a firearm. He allegedly delivered 85 Roxicodone, 75 Adderall, and 90 Xanax to an undercover officer and received $1,450. Police found 290 additional drugs in his car–including hydrocodone, OxyContin, tranquilizers, and antidepressants–and prescriptions for more drugs. Law enforcement believes he has been selling prescription drugs for 2 years. He denied smuggling prescription pills into the minimum security facility where he worked.                 

Read more:                
http://www.detroitnews.com/story/news/local/oakland-county/2016/02/29/prison-officer-prescription-pills/81105430                                  

Why Fentanyl Deaths are Spiking in Southeastern Wisconsin                
Ben Wagner, WISN                
March 2, 2016                

Fentanyl has claimed more lives in southeastern Wisconsin in 2016 than in all of 2014. The Milwaukee County Medical Examiner’s Office investigated 28 fentanyl deaths in 2015 and 16 in all of 2014. Fentanyl is to blame for 14 deaths in Milwaukee so far this year. (Includes video: 2:21 minutes)                

Read more:                
http://www.wisn.com/health/why-fentanyl-deaths-are-spiking-in-southeastern-wisconsin/38281776                                 

Report: Iowans Bought 300 Million Prescription Pills in 2015                
Rose Heaphy, KCCI                
February 28, 2016                

An annual report shows that Iowans bought 300 million prescription pills last year. Twenty percent were for the pain reliever Vicodin. Since the state’s prescription drug monitoring program database started, doctor-shopping has decreased.                 

Read more:                
http://www.kcci.com/news/report-shows-iowans-bought-300-million-prescription-pills/38246902                                  

U.S. Drug Enforcement Agency Investigates Three Central Indiana Pain Clinics                
Charlie D Mar, Fox 59                
February 26, 2016                

The Pain Management Centers of Indiana have been searched by federal and local agencies for evidence about alleged overprescribing of pain medications possibly linked to overdose deaths. Records and files were removed from clinics in Peru, Bloomington, and Indianapolis. The main physician’s home was also searched. Criminal charges have not been filed. (Includes video: 1:56 minutes)                

Read more:                
http://fox59.com/2016/02/26/dea-investigates-three-central-indiana-pain-clinics                 
               

                West News

                Legislation Targets Opioid Abuse in New Mexico                
Deborah Baker, Albuquerque Journal                
February 27th, 2016                 

New Mexico’s governor has signed into law legislation that makes naloxone more widely available and requires doctors and other providers to check the state’s prescription drug monitoring program before prescribing an opioid to some patients for the first time. In 2014, more than 900 opioid overdoses were reversed with naloxone—nearly a 29 percent increase from the previous year.                 

Read more:                
http://www.abqjournal.com/731574/news/legislation-targets-opioid-overdose-deaths-in-nm.html                                  

Opioid Drug Deaths on the Increase in Arizona                
Svetlana Popovic, Arizona Sonora News Service                
March 3, 2016                

In Arizona, people in rural areas are more likely to overdose on prescription pain medications than those in cities. The counties of Mohave, Yavapai, Gila, Navajo, and Pima lead the state in the number of deaths from prescription opioid overdoses.                

Read more:                
http://arizonasonoranewsservice.com/opioid-drug-deaths-on-the-increase-in-state                 
               

Other Resources

American Pharmacists Association’s New Web Site Devoted to Opioid Use and Abuse                
Thomas E. Menighan, American Pharmacists Association                
March 1, 2016                

The American Pharmacists Association has launched a resource center for pharmacists who are interested in learning more about opioid use and misuse. The resource center will help educate pharmacists by identifying learning opportunities, highlighting clinical and patient resources, and identifying tools that are useful when working with patients who are prescribed opioids. The center’s resources include training and webinars, interactive tools, federal and state resources related to opioids, information about trends in prescription drug misuse, and networking opportunities.                

Read more:                
http://www.pharmacist.com/CEOBlog/apha-s-new-website-devoted-opioid-use-and-abuse                
               

Webinars

Prescription Monitoring Programs: Capabilities and Benefits                
American Dental Association                
Wednesday, March 16, 2016                
2:00 p.m. – 3:00 p.m. (CT)                
http://www.ada.org/en/publications/ada-news/2016-archive/february/webinar-monitoring-prescription-drug-use                                  

Register:                
http://websurveys.ada.org/s/opioidwebinar                                  

Weed in Your Workplace: What You Need to Know                
National Safety Council                
Wednesday, April 20, 2016                
2:00 p.m. (ET)                 
http://eventcallregistration.com/reg/index.jsp?cid=59487t11                 
               

Grant Announcements

Drug-Free Communities Support Program (SP-16-001)                
SAMHSA                
Due: March 18, 2016                
http://www.samhsa.gov/sites/default/files/grants/pdf/sp-15-001_0.pdf                                  

Prescription Drug Overdose Prevention for States                
Centers for Disease Control and Prevention                
Due: April 1, 2016                
http://www.grants.gov/web/grants/search-grants.html                                  

SP-16-003: Strategic Prevention Framework—Partnerships for Success (SPF-PFS)                
SAMHSA                
Due: April 12, 2016                
http://www.grants.gov/web/grants/search-grants.html                                  

NIJ-2016-9090: Research and Evaluation on Drugs and Crime                
National Institute of Justice                
Due April 20, 2016                
http://www.grants.gov/web/grants/search-grants.html                 

National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for that                
National Institute on Drug Abuse                
Submission Period begins November 3, 2015, 9:00 a.m. (ET)                
Submission Period ends April 29, 2016, 11:59 p.m. (ET)                
http://nida.ideascale.com/a/pages/addiction-research-theres-an-app-for-that                                  

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

National Take-Back Initiative

National Prescription Drug Take-Back Day                
U.S. Drug Enforcement Administration                
Saturday, April 30, 2016                
10:00 a.m. – 2:00 p.m.                
http://www.deadiversion.usdoj.gov/drug_disposal/takeback                 
               

Take-Back Events & Drop Boxes

Michigan State Police Taking Unused Prescription Drugs                
Huron Daily Tribune                
February 29, 2016                
http://www.michigansthumb.com/news/article_f96d30f6-dcbc-11e5-9a9f-4b9ef9e34905.html                                  

Nolensville (Tenn.) Gets Anti-Abuse Prescription Drug Drop Off                
Zach Harmuth, Williamson Source                
March 4, 2016                
http://williamsonsource.com/nolensville-gets-anti-abuse-prescription-drug-drop-off                                  

Hidalgo County (Texas) Constable Precinct 4 to Be Collection Site for Prescriptions                
KRGB                
March 2, 2016                
http://www.krgv.com/story/31367285/precinct-4-constables-office-will-serve-as-a-collection-site-for-prescription-meds                                  

Cedar Hills (Texas) Residents Can Dispose of Old Medications at Police Station                
Loyd Brumfield, Dallas Morning News                
February 29, 2016                
http://www.dallasnews.com/news/community-news/best-southwest/headlines/20160229-cedar-hill-residents-can-dispose-of-old-medications-at-police-station.ece                
               

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference                
U.S. Drug Enforcement Administration                
March 19–20, 2016                
Wilmington, Delaware                
April 17–18, 2016                
Towson, Maryland                
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness                                 

Marijuana and Cannabinoids: A Neuroscience Research Summit                
National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Center for Complementary and Integrative Health, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke                
March 22-23, 2016                
Bethesda, Maryland                
http://apps1.seiservices.com/nih/mj/2016                                  

Register:                
http://apps1.seiservices.com/nih/mj/2016/Registration.aspx                                  

2016 National Rx Drug & Heroin Summit                
March 28–31, 2016                
Atlanta, Georgia                
http://nationalrxdrugabusesummit.org                                  

Third Annual Smart Approaches to Marijuana Education Summit                
March 31, 2016                
Atlanta, Georgia                
http://nationalrxdrugabusesummit.org/sam-summit-2                 

Register:                
https://www.123contactform.com/form-1486587/2016-National-Rx-Drug-Abuse-Summit                                  

Medical Marijuana Seminar                
Private Motor Truck Council of Canada                
May 3, 2016                
Alberta, Canada                

Read more:                
http://www.todaystrucking.com/alberta-hosting-spring-talk-on-medical-marijuana-in-trucking                 
http://www.pmtc.ca/News.asp?a=view&id=113                                  

2016 Annual Conference                
International Health Facility Diversion Association                
September 13–14, 2016                
Duke Energy Convention Center                
Cincinnati, Ohio                 
https://ihfda.org/2016-annual-conference                                  

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