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March 12, 2015

SAMHSA Prescription Drug Abuse Weekly Update
Issue 113  |  March 12, 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 Medical Marijuana National News Northeast/Mid-Atlantic News South News Midwest News West News Upcoming Webinars Grant Received Grant Announcements Take-Back Events and Drop Boxes Upcoming Conferences and Workshops The Weekly Update has added a section with limited coverage of medical marijuana issues.


L. Rutkow, L. Turner, E. Lucas, C. Hwang, and G.C. Alexander. 2015. "Most Primary Care Physicians Are Aware of Prescription Drug Monitoring Programs, but Many Find the Data Difficult to Access." Health Affairs 34(3):484–92, doi:10.1377/hlthaff.2014.1085.

A 2014 nationally representative mail survey of 1,000 primary care physicians yielded 420 responses. Six percent said their state did not have a prescription drug monitoring program (PDMP). Of the remainder, 77 percent knew about their state's program, and 87 percent of that subgroup (56 percent of respondents with an available PDMP) reported using the program at least once. Multivariate regression showed a) internists had 64 percent lower odds of program use than family and general practice physicians and b) for every additional 10 patients seen per month, physicians had a 6 percent increase in odds of program use. Seventy-four percent of physicians who used the PDMP thought the data had contributed to less frequent opioid prescribing, but most described the effect as small. Barriers preventing program use included time-consuming information retrieval (58 percent of those who knew their state had a PDMP), lack of an intuitive format for PDMP responses to physician queries (28 percent), and no easy access to program data (4 percent). Of PDMP users, 31 percent said their state's program was somewhat or very difficult to use.

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Include Medicine Cabinets on Your Spring Cleaning List
PR Newswire
March 2, 2015

Pennsylvania physicians declared the first week of spring as Medicine Cabinet Clean-Up Week. Medical groups are asking households to drop off unneeded medications at prescription drug take-back sites. A complete list of locations can be found on the Department of Drug and Alcohol Programs website.

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Journal Articles and Reports

H. Hedegaard, L–H. Chen, and M. Warner. 2015. "Drug-Poisoning Deaths Involving Heroin: United States, 2000–2013." National Center for Health Statistics Data Brief 190.

The 2000–13 U.S. age-adjusted rate for drug-poisoning deaths involving heroin jumped from 0.7 per 100,000 to 2.7 per 100,000. The rate increased in all regions of the country, mostly after 2010, with the greatest rise in the Midwest. In 2000, non-Hispanic blacks ages 45–64 had the highest rate of drug-poisoning deaths involving heroin (2.0 per 100,000). In 2013, non-Hispanic whites ages 18–44 had the highest rate (7.0 per 100,000). That same year, the number of drug-poisoning deaths involving heroin was nearly four times higher for men (6,525) than for women (1,732).

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H. Khosrojerdi, G.A. Talesh, G.H. Danaei, S.S. Saremi, A. Adab, and R. Afshari. 2015. "Tramadol Half Life Is Dose Dependent in Overdose." DARU Journal of Pharmaceutical Sciences 23:22, doi:10.1186/s40199-015-0104-y.

Among 25 tramadol overdose patients admitted to an Iranian hospital, serum tramadol concentration at admission averaged 787 mg/dl. Tramadol half-life averaged 9.2 hours (range 5.0–13.4), with half-life rising as concentration rose.

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H. Pihkala and M. Sandlund. 2015. "Parenthood and Opioid Dependence." Substance Abuse and Rehabilitation 6:33–40, doi:10.2147/SAR.S75796.

In 2012–13, Swedish researchers interviewed seven fathers and five mothers receiving medication-assisted opioid maintenance treatment. All interviewees were in contact with at least one of their children under age 18. Patients were concerned about possible future discrimination against their children (i.e., stigma by association). They viewed their own mothers and fathers as the most important guides and supports for good parenting.

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Professional Education

A.M. Dela Cruz and M.H. Trivedi. 2015. "Opioid Addiction Screening Tools for Patients with Chronic Noncancer Pain." Texas Medicine 111(2):61–5.

This article reviewed important terms for understanding prescription opioid addiction and described several tools for screening patients with chronic noncancer pain.

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Medical Marijuana

Tribes from Around US Gather to Discuss Legal Marijuana
Gene Johnson, The State
February 27, 2015

In December, the U.S. Department of Justice (DOJ) announced it would allow Indian tribes to legalize and regulate marijuana on their reservations. About 200 tribal leaders attended a meeting of the National Congress of American Indians to discuss marijuana legalization with DOJ officials. Tribes must follow the same law enforcement priorities as states that legalize the drug. About 17 states have some criminal jurisdiction over tribal lands. If the state where tribes are present prohibits marijuana, tribal members could face state criminal prosecution for legalizing or regulating the drug. Several tribes said they are proceeding with caution and are reluctant to outpace changes in state laws. The council of the Hoopa Valley Tribe has requested recommendations from health, law enforcement, and other tribal officials in considering the consequences of marijuana legalization, including whether it might jeopardize federal aid for health care, fire services, or housing. Some tribes would first consider regulating cannabis for medical use. They said making pot more accessible might cut down on methamphetamine or prescription drug abuse among tribal members. Representatives of 75 tribes recently attended a separate seminar at the Tulalip Resort Casino to discuss regulatory and social issues related to marijuana legalization.

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National News

Udall Introduces Bill to Combat Prescription Drug Abuse and Misuse in New Mexico
The Grant County Beat
March 4, 2015

Senator Tom Udall (D-N.M.) has introduced legislation to combat prescription drug abuse and misuse. The Increasing the Safety of Prescription Drug Use Act would expand access to treatment options for addicted patients, strengthen training for medical professionals, and increase abuse prevention opportunities. The bill would also help medical professionals avoid overprescribing medication by giving patients access to real-time prescription databases across state lines.

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Doctors and Nurses Should Be Tested for Drugs and Alcohol: Medical Ethicist
Celia Vimont, Partnership for Drug-Free Kids
March 4, 2015

Medical ethicist Dr. Arthur Caplan believes doctors and nurses should undergo random drug testing. He thinks consequences for drug and alcohol use should consider the circumstances, with decisions made by a hospital's chief medical officer or board of trustees.

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Northeast/Mid-Atlantic News

Addiction Experts Decry LePage Plan to Cut Methadone Funds
Jackie Farwell, Bangor Daily News
March 3, 2015

Maine addiction experts spoke out against Governor Paul LePage's plan to eliminate state funding for methadone treatment. His plan would transition those seeking treatment from methadone clinics to Suboxone, eliminating methadone treatment from the state's Medicaid program. Groups took aim at the LePage administration's assertion that Suboxone is safer and more controllable than methadone. The administration countered that Suboxone is at least as cost effective as methadone over the long term.

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South Jersey Funeral Homes Help Educate on Prescription Drug Disposal
Brittany M. Wehner, South Jersey Times
March 1, 2015

The Salem–Cumberland Regional Action Toward Community Health and GRASP Coalition are working with South Jersey funeral homes to educate the community on proper disposal of prescription medications. Thus far, 12 funeral homes have pledged to provide information on drop-box locations and proper disposal.

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Report: Drug Overdose Deaths Declined in 2014 in Washington Co.
Scott Beveridge, Observer-Reporter
March 3, 2015

Reported drug overdose deaths in Washington County, Pa., decreased from 58 in 2013 to 36 in 2014.

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Police: I-Stop Program Leading to Heroin Use
Jeff Preval, WGRZ
March 4, 2015

The Jamestown, N.Y., Police Department said more prescription pill abusers are switching to heroin because of the state's prescription drug monitoring program. But the department does not have numbers to support this statement.

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South News

Use of Alabama Prescription Drug Monitoring Program Skyrocketed in 2014
Amy Yurkanin, Alabama Media Group
March 3, 2015

Use of the Alabama prescription drug monitoring program database rose 50 percent from 2012 to 2014. The increase followed legislation requiring doctors to register with the program by January 2014. Doctors consulted the database 761,943 times in 2014 compared with 525,576 in 2012.

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General Assembly Passes Attorney General's Public Safety Bills
Augusta Free Press
February 28, 2015

Virginia Attorney General Mark R. Herring highlighted the passage of several bills proposed by his office to address the state's heroin and prescription drug problem. HB1500 will provide immunity for minor offenses if a person reports an overdose, remains on the scene, and identifies him or herself as the reporter. HB1458 will authorize naloxone use by any law enforcement agency, and SB817 will allow probation officers to access Virginia's prescription drug monitoring program.

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Procedures Set Up to Help Drug-Addicted Newborns
David Beard, The Dominion Post
February 27, 2015

The House Health Committee approved two bills to address West Virginia's drug addiction problem. HB 2961 would require insurance companies to offer the same coverage for new abuse-resistant opioid pain relievers as they offer for conventional products. HB 2999 would set up licensing procedures for "neonatal abstinence centers" that wean drug-addicted newborns and infants. The bills are headed to the Judiciary Committee.

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New Program Aims to Tackle Prescription Drug Misuse in Three NC Counties
Carly Stephenson, Time Warner Cable News
March 4, 2015

The Partnership for Success will be working in North Carolina's Rowan, Cabarrus, and Davidson Counties to address prescription drug misuse among 12- to 25-year-olds who do not use drugs. The Partnership will also use the Lead and Seed school-based prevention program. Other plans include efforts around medication disposal and education and outreach to physicians. (Includes video: 1:41 minutes)

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Houston Region Leads State in Opioid-Related Deaths
John D. Harden, The Houston Chronicles
March 4, 2015

In Houston, Texas, opioid-related deaths decreased from 2008 to 2012, while the statewide total slightly increased. Deaths related to heroin, opium, and methadone represented nearly 40 percent of all opioid-related deaths in the state from 2008 to 2012.

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Midwest News

Program in the Works to Combat Drug Abuse
Karen Sells, Herald and Tribune
March 4, 2015

Tennessee has developed Prescription for Success, a program addressing prescription drug abuse and misuse. Mayor Dan Eldridge would like to see a local program implemented in Washington County. A draft of a local initiative had two objectives: 1) to increase the number of corporations, agencies, and businesses that have Drug-Free Workplace programs and 2) to design and implement a comprehensive substance abuse prevention plan for Washington County and/or Johnson City schools.

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Ky Program Helps Drug Addicts Keep Their Babies
Laura Unger, The Courier Journal
March 1, 2015

Kentucky is gaining national recognition for its Sobriety Treatment and Recovery Teams (START) program, which launched in Louisville and Covington in 2007. The program partners social service professionals with recovering addicts working as family mentors. START operates in four counties, and program eligibility varies by county. Some programs accept all drug-affected families with young children; others only enroll families if babies test positive for drugs at birth. States are now developing programs using START as a model.

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Ohio House Approves Drug-Overdose Bill
Marc Kovac, Vindy.com
March 5, 2015

The Ohio House approved HB4, allowing family members and close friends of people addicted to drugs to obtain naloxone without a written prescription. Pharmacists and others would be authorized to furnish the drugs, provided they follow a physician-established protocol. The bill now heads to the Senate.

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Illinois Lawmakers to Propose Measure to Battle Heroin Abuse
Kerry Lester, Associated Press
March 2, 2015

Two Illinois lawmakers plan to propose legislation requiring all state and local government agencies that employ law enforcement officers and firefighters to possess Narcan®. The legislation would also require the state Board of Education to develop a heroin and opiate drug prevention program for schools and require coroners to report drug overdose deaths to the Department of Public Health. It would designate pharmacies as prescription drug take-back sites and require doctors to determine "possible addiction tendencies" before prescribing pain relievers.

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Nine Opioid Overdoses Reported in St. Louis County Since Friday
Julie Kruse, WDIO
March 2, 2015

In St. Louis County, Minn., nine heroin and prescription drug overdoses—one fatal—occurred last weekend. Seven opioid overdoses were reported in Duluth. (Includes video: 1:50 minutes)

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Officials: Drug Trend Points to More Heroin in Siouxland
Kirby Kaufman, Sioux City Journal
March 1, 2015

Iowa officials said heroin is making its way to Sioux City from Chicago and Mexico, and the influx will drive additional drug-related crimes.

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Drug Overdoses Are Big Problem in Winnebago County
Kristen Cwynar, WTVO
February 27, 2015

In Illinois's Winnebago County, the coroner said she has seen three times the number of drug overdoses than car accidents. (Includes video: 2:21 minutes)

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West News

Bill Would Put Governor in Control of Drug-Related Agencies
Muskogee Phoenix
March 3, 2015

By a 5–4 vote, the Oklahoma Senate General Government Committee approved a bill that calls for the heads of 10 different state agencies and boards to be fired starting January 1, 2016, and allows the governor to name their replacements. The committee selected the 10 agencies because their executive directors have access to Oklahoma's prescription drug monitoring program database. They sought an extra layer of oversight to ensure agency directors are properly vetted. The bill is primarily intended to start discussions on this issue, and will not likely go to the full Senate for a vote this year.

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2014 Alaska Drug Report Shows Increases in Heroin and Meth Use
February 27, 2015

According to the Statewide Drug Enforcement Unit's 2014 annual drug report, 4.93 pounds of heroin were seized by Alaska law enforcement in 2012, compared with 55.12 pounds in 2013 and 22.42 pounds in 2014. A significant number of deaths were caused by heroin and other opiates. Prescription medication continues to be abused—particularly oxycodone and hydrocodone.

Read more:

Lawmakers Want Pills That Can't Be Crushed and Snorted, Melted and Injected
CBS Denver
March 3, 2015

During a committee meeting, Representative Jonathan Singer demonstrated how a prescription pill can be easily crushed. Singer proposed a bill that would bar Colorado pharmacists from substituting crushable pain relievers with other drugs and require insurers to cover both at the same cost. The bill was amended to direct the Governor's Task Force on Substance Abuse to study the issue and report back in 2016. (Includes video: 1:50 minutes)

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Lawmakers Examine Bill to Create Prescription Drug Use Database
Patranya Bhoolsuwan and Kash Cashell, KLAS-TV
March 2, 2015

The Senate Health and Human Services Committee discussed Senate Bill 114, which would require pharmacists to develop a comprehensive database tracking prescription medications dispensed to patients. The bill would also give physicians better access to a patient's prescription drug history. (Includes video 2:05 minutes)

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Heroin Overdoses Spike in Spokane
Grace Ditzler, KXLY
February 28, 2015

Heroin overdoses in Spokane, Wash., have increased since the beginning of 2015. The Health District believes the increase is a result of more heroin making its way to the area. They suspect this is a temporary surge, as overall overdose numbers have decreased in the past 6 years, following the crackdown on prescription drug use. (Includes video: 2:18 minutes)

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Independence at Home Debuts New Program to Address Substance Abuse Issues Among Older Adults
Business Wire
March 3, 2015

Independence at Home, a community service of California's SCAN Health Plan, launched a new program designed to address alcohol, drug, and prescription medication abuse among older adults. The Substance Assistance for Elders (S.A.F.E.) program will provide screening, assessment, counseling, brief therapy, and action planning for individuals who may be misusing alcohol, drugs, or prescription medicines.

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Upcoming Webinars

Lessons Learned from Implementing Project Lazarus in North Carolina—A Clinical and Community Based Intervention to Prevent Prescription Drug Overdose
Society for Advancement of Violence and Injury Research
Part 1: March 18, 2015, 2 p.m. (ET)
Part 2: April 1, 2015, 2 p.m. (ET)

Part 1 Registration:

Part 2 Registration:

Grant Received

Researchers Receive Funding to Help Evaluate Florida's Prescription Drug Monitoring Program
University of Florida
March 2, 2015

University of Florida researchers have partnered with the state's prescription drug monitoring program (PDMP) to analyze its effectiveness. The researchers will continue gathering data from multiple sources to monitor prescribing trends. They will also use a portion of a $400,000 Bureau of Justice Assistance grant to analyze feedback from healthcare providers who use the PDMP, and assist in creating maps that show where controlled substances are prescribed at notably high rates.

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Grant Announcements

Strategic Prevention Framework Partnerships for Success: State and Tribal Initiative
Substance Abuse and Mental Health Services Administration
Deadline: March 16, 2015

Drug-Free Communities Support Program
Substance Abuse and Mental Health Services Administration
Deadline: March 18, 2015

Drug-Free Communities Mentoring Program
Substance Abuse and Mental Health Services Administration
Deadline: April 14, 2015

Translational Avant-Garde Award for Development of Medication to Treat Substance Use Disorders
National Institutes of Health
Deadline: April 15, 2015

Take-Back Events and Drop Boxes

Turn in Your Unwanted Prescription Drugs on Saturday, April 25, 2015
Hilltown Township (Pennsylvania)
March 2, 2015

Valparaiso Prescription Drop Off Program Nets 1,800 Pounds in 2014
Sarah Gollnor, The Times (Indiana)
February 27, 2015

Prescription Drug Drop Boxes a Success
Heather Middleton, Jackson Progress-Argus (Georgia)
March 2, 2015

ECMC Installs New Kiosks to Collect Unused Prescription Drugs
WKBW (New York)
March 4, 2015

Operation Medicine Drop Is Back On
Karen Holbrook, Elkin Tribune (North Carolina)
March 4, 2015

Drugs Dropped Off Daily at Police Station
Shaun Zinck, Beloit Daily News (Wisconsin)
March 2, 2015

Lakewood Residents Can Dispose of Unwanted Prescription Drugs at Police Station
Patrick Cooley, Northeast Ohio Media Group
February 27, 2015

Jacksonville Police Host Prescription Drug Take Back Day
Holly Nicole Morrison, THV11 (Arkansas)
March 4, 2015

Sheriff's Department to Accept Unneeded Medication
Logan Banner, Owen Wells (West Virginia)
March 5, 2015

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conferences
Drug Enforcement Administration, Office of Diversion Control
March 28–29, 2015: Birmingham, Ala.
May 30–31, 2015: Norfolk, Va.
June 27–28, 2015: Oklahoma City, Okla.

2015 AATOD Conference—Address a Public Health Crisis: Opioid Dependence
American Association for Treatment of Opioid Dependence, Inc. (AATOD)
March 28–April 1, 2015
Atlanta, Georgia

Marijuana Advocacy and Policy Summit
Drug Free Action Alliance
March 31, April 1–2, 2015
Columbus, Ohio

National Rx Drug Abuse Summit
April 6–9, 2015
Atlanta, Georgia

48th Annual Communicating Nursing Research Conference—Equity and Access: Nursing Research, Practice, and Education
Western Institute of Nursing
April 22–25, 2015
Albuquerque, New Mexico

Fourth Annual Generation Rx University Conference for Collegiate Prevention and Recovery
The Ohio State University College of Pharmacy
August 4–6, 2015
Columbus, Ohio

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
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.