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March 19, 2014

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 63  |  March 19, 2014
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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 News Other State and Local News Other Resources Webinars Grant Announcements Grant Award Take-Back Events and Drop Boxes Save the Dates Upcoming Conferences and Workshops

Featured

Team Awareness: Resilience Facilitator Training
Organizational Wellness and Learning Systems
May 5–8, 2014
8:30 a.m. to 5:30 p.m.
Madison Park Church of God
6607 Providence Drive
Anderson, Indiana

Team Awareness and Team Resilience curricula have been used by many types of workplaces. Their modules include Relevance and Well-Being, Policy and Accountability, Raw Coping Power, Tolerance and Destigmatization, Communication, and Encouragement and Compassion (Nudging). A new module covering Prescription Drug Use will be released at this training. Randomized clinical trials of the full curriculum (absent the new module) show improved skills in stress management, reduced stigma, increased help-seeking, improved work climate, and reductions in problem drinking. This training provides a full review of the entire curriculum so that facilitators can replicate the program with fidelity to the original scientific protocol. The 4½-day course uses an 1) Observe, 2) Debrief, 3) Practice Protocol for each module. Participants will prepare and deliver modules to receive peer feedback. Participants receive access to the PowerPoint slide deck, facilitator notes, handouts, ideas for customization, and session rating forms.

Read more:
http://organizationalwellness.com/events/team_awareness_resilience_facilitator_
training_may_2014/


Oxycontin Maker to Offer Abuse-Resistant Zohydro
Associated Press
March 12, 2014

In a press release less than a week after competitor Zogenix began shipping its Zohydro pain reliever to pharmacies, Purdue Pharma announced it has completed testing of an abuse-resistant version of extended-release high-dosage hydrocodone and will be submitting it for Food and Drug Administration approval shortly. The company's tablets are designed to prevent users from crushing them for snorting or injection. Purdue Pharma said a study of its once-a-day hydrocodone pill showed positive results in a 588-patient study of low back pain. Sixty-five percent of patients experienced a 30 percent reduction in their pain, while 48 percent of patients reported a 50 percent reduction in pain. Purdue Pharma's formulation would last longer than Zohydro, which is designed to be taken twice a day, or every 12 hours. Zohydro is readily abusable. FDA approved it over objections from its Advisory Panel and is facing substantial pressure from Congress and addiction professionals to reverse its decision. Shares of Zogenix Inc. plunged more than 20 percent after the announcement.

Read more:
http://bigstory.ap.org/article/oxycontin-maker-offer-abuse-resistant-zohydro

Journal Articles and Reports

Association of State and Territorial Health Officials. Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care. 2014.

This report describes two trends: an increase in the prevalence of prescription opioid abuse and an increase in the incidence of neonatal abstinence syndrome. The report presents an extensive literature review and provides examples of how states are taking steps to address gaps in knowledge regarding neonatal abstinence syndrome through interdepartmental efforts, perinatal learning collaboratives, and quality improvement initiatives.

Read more:
http://www.astho.org/Prevention/NAS-Neonatal-Abstinence-Report

Niloofar Bavarian, Brian R. Flay, Patricia L. Ketcham, Ellen Smit, Cathy Kodama, Melissa Martin, and Robert F. Saltz. 2014. Using Structural Equation Modeling to Understand Prescription Stimulant Misuse: A Test of the Theory of Triadic Influence. Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.02.700

Researchers aimed to test a theory-driven model of health behavior to predict the illicit use of prescription stimulants among college students. They used a probability sample of 554 students from one California university (response rate = 90.5 percent). Students completed a paper-based survey developed with guidance from the Theory of Triadic Influence. A single structural equation model of frequency of illicit use of prescription stimulants in college was then tested using constructs from the theory's three streams of influence (intrapersonal, social situation/context, and sociocultural environment) and four levels of causation (ultimate causes, distal influences, proximal predictors, and immediate precursors). Approximately 18 percent of students reported engaging in illicit prescription stimulant usage during college, with frequency of use ranging from once to 40 or more times per academic term. The model tested had strong fit and the majority of paths specified within and across streams were significant at the p < 0.01 level. It explained 46 percent of the variance in frequency of illicit prescription stimulant usage.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871614007704

Joanne E. Brady, Hannah Wunsch, Charles Dimaggio, Barbara H. Lang, James Giglio, and Guohua Li. 2014. Prescription Drug Monitoring and Dispensing of Prescription Opioids. Public Health Reports 129(2):139–47.

Researchers evaluated the impact of state prescription drug monitoring programs (PDMPs) on opioid dispensing. They acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). They used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs. Annual MMEs dispensed per capita increased progressively until 2007, then stabilized. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was not associated with MMEs dispensed per capita (p=0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66 percent decrease in Colorado to a 61 percent increase in Connecticut. Implementation of state PDMPs up to 2008 did not significantly impact per-capita opioids dispensed. The analysis did not account for PDMP characteristics or usage levels, which your editor considers a fatal flaw in this paper.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24587548

Lucy Burns, Amanda Roxburgh, Raimondo Bruno, and Joe Van Buskirk. 2014. Monitoring Drug Markets in the Internet Age and the Evolution of Drug Monitoring Systems in Australia. Drug Testing and Analysis, doi:10.1002/dta.1613.

This paper provides an overview of each component of Australia's drug monitoring system, demonstrating how the system has evolved over time. The Drug Trends Unit at the National Drug and Alcohol Research Centre monitors drugs including misused prescription drugs through four separate systems. The Illicit Drug Reporting System measures the price, purity, and availability of drugs that are primarily injected. The Ecstasy and Related Drugs Reporting System monitors psychostimulants that are used recreationally. The National Illicit Drugs Indicator Project analyzes indicator data including drug-related hospitalizations and deaths. Finally, the Drugs and Emerging Technologies Project analyzes the role of the Internet in the procurement and use of novel psychoactive substances.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/dta.1613/abstract

Shane Darke. 2014. Opioid Overdose and the Power of Old Myths: What We Thought We Knew, What We Do Know and Why It Matters. Drug and Alcohol Review 33(2):109–14, doi: 10.1111/dar.12108

In reviewing the literature on opioid overdose, the author shares his views on four prominent myths about who is dying and when they are dying that have bedeviled the field. The myths include 1) the young, inexperienced user overdoses, 2) variation in purity of illicit opioids is the major cause of overdose, 3) the opioid is crucial in overdose, not other drugs, and 4) impurities in illicit opioids are the major cause of overdose.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/dar.12108/abstract;jsessionid=
418E36C705364CA5431A5BD3E499F411.f02t04?systemMessage=Wiley+Online+Library+
will+be+disrupted+Saturday%2C+15+March+from+10%3A00-12%3A00+GMT+%2806%3A00-


M.L. Fleming, J.C. Barner, C.M.Brown, M.D. Shepherd, S. Strassels, and S. Novak. 2014.
Using the Theory of Planned Behavior to Examine Pharmacists' Intention to Utilize a Prescription Drug Monitoring Program Database. Research in Social Administrative Pharmacy 10(2):285–96, doi: 10.1016/j.sapharm.2013.05.009.


This study aims to 1) explore the theory of planned behavior's utility in predicting Texas pharmacists' intention to use an online accessible PDMP; 2) to determine the contribution of each construct, attitude, subjective norm and perceived behavioral control in predicting pharmacists' intention; and 3) test whether the addition of perceived obligation is significantly related to pharmacists' intention. A cross-sectional, 36-item questionnaire was developed from focus groups and literature on pharmacists' views regarding prescription drug abuse. A total of 998 practicing Texas community pharmacists were surveyed about their intention to use the PDMP database. The response rate was 26.2 percent (261/998). The theory of planned behavior's constructs were significant predictors of a high intention to use the PDMP. Pharmacists with positive attitudes were almost twice as likely to have high intention (odds ratio [OR] = 1.8, 95 percent CI = 1.2–2.8). Subjective norm was the strongest predictor of pharmacists' high intention (OR = 2.2, 95 percent CI = 1.4–3.3). Pharmacists with high behavioral control were also twice as likely to have high intention (OR = 1.9, 95 percent CI = 1.2–3.0). Additionally, pharmacists' perceived obligation contributed to the prediction of high intention (OR = 1.8, 95 percent CI = 1.0–3.1) controlling for the theoretical constructs.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23816495

Brent J. Morris, Justin Zumsteg, Kristin Archer, Brian Cash, and Hassan R. Mir. "Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma Population." American Academy of Orthopaedic Surgeons 2014 Annual Meeting, New Orleans, La., March 11, 2014.

Researchers compared postoperative orthopedic trauma patients with multiple narcotic providers versus a single narcotic provider. Primary outcome measures were number of narcotic prescriptions, duration of narcotics and MME dose per day. Secondary outcome measures were predictors of "doctor shopping." A prospective cohort study included 151 adult patients admitted to the inpatient orthopedic trauma service at a single high-volume level-1 trauma center during 2011. Enrolled patients had an operatively treated, isolated orthopedic injury. The state PDMP database was used to identify all narcotic prescriptions filled three months prior to hospital admission and six months following discharge. It included narcotic dosage, quantity, date and prescribing provider. Patients were assigned into two groups: a single narcotic provider group with prescriptions only from the treating surgeon (or surrogate) or a multiple provider group with prescriptions from both the treating surgeon (or surrogate) and additional provider(s). The prevalence of postoperative doctor shopping was 20.8 percent. Doctor shopping led to a statistically significant increase in postoperative narcotic prescriptions (two prescriptions vs. seven prescriptions; p <.001), longer duration of postoperative narcotic use (28 days vs. 112 days; p <.001) and increased MME dose per day (26mg versus 43mg; p = .002). Multivariable linear regression confirmed a statistically significant increase in postoperative narcotic prescriptions [β = 3.2 (95 percent CI, 0.99 to 5.4; p = .004)], longer duration of postoperative narcotic use [β = 36.7 (95 percent CI, 8.5 to 64.9; p = .01)] and increased MME dose per day [β = 10.1 (95 percent CI, 0.32 to 19.8; p = .04)] in doctor shopping patients. Doctor shoppers were more likely to have no more than a high school education (relative risk 3.2, 95 percent CI, 1.38 to 8.1; p = 0.02) and have a history of preoperative narcotic use (relative risk 4.5, 95 percent CI, 2.9 to 7.0; p <.001).

Read more:
http://www.abstractsonline.com/Plan/ViewAbstract.aspx?mID=3358&sKey=e24ba476-2bd0-4c78-b49f-08ced52ca169&cKey=fc8fa27e-8ae3-4e86-bc45-9330e76a915a&mKey=4393d428-d755-4a34-8a63-26b1b7a349a1

Robert G. Newman. 2014. Prescription Opioid Dependence: The Clinical Challenge. JAMA Psychiatry 71(3):338, doi:10.1001/jamapsychiatry.2013.4530.

This letter comments on "A Randomized, Double-Blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers" by Sigmon, Dunn, Salsgiver, and colleagues (see Oct. 30, 2013, listserv). Sigmon et al. concluded that their findings "suggest that a meaningful subset of [prescription opioid]–dependent outpatients may respond positively to a four-week taper plus naltrexone maintenance intervention." The letter argues that this is an overly positive assessment. The trial merely confirmed what has been known for decades: when treatment of opioid dependence ends, relapse is the rule rather than the exception, and this reality applies regardless of the duration of detoxification or associated medical or psychological support that is offered. This should be conveyed to those seeking care along with "agonist maintenance." The challenge is to ensure access to long-term treatment.

Read more:
http://archpsyc.jamanetwork.com/article.aspx?articleID=1833736

Carrie D. Patnode, Elizabeth O'Connor, Maya Rowland, Brittany U. Burda, Leslie A. Perdue, and Evelyn P. Whitlock. 2014. Primary Care Behavioral Interventions to Prevent or Reduce Illicit Drug Use and Nonmedical Pharmaceutical Use in Children and Adolescents: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, doi:10.7326/M13–2064

Researchers systematically reviewed the benefits and harms of primary care–relevant interventions designed to prevent or reduce illicit drug use or the nonmedical use of prescription drugs among youth. They used PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through June 4, 2013; MEDLINE through Aug. 31, 2013; and manual searches of reference lists and gray literature. Two investigators independently reviewed 2253 abstracts and 144 full-text articles. English-language trials of primary care–relevant behavioral interventions that reported drug use, health outcomes, or harms were included. Of six trials identified, most focused on marijuana. Three trials—all of the same computerized home course of nine weekly 45-minute modules for mother–daughter dyads—has never been used in primary care. Those trials reported significant reductions in nonmedical prescription drug use occasions (see, for example, Steven P. Schinke, Lin Fang, and Kristin C.A. Cole. 2009. "Computer-Delivered, Parent-Involvement Intervention to Prevent Substance Use Among Adolescent Girls." Preventive Medicine 49:429–35).

Read more:
http://annals.org/article.aspx?articleid=1840852

Gareth Rees and Ed Day. 2014. Addiction to Prescription Drugs. Prescriber 25(5): 5–6, doi: 10.1002/psb.1169

This editorial discusses four strategies that have been outlined by the Office of National Drug Control Policy that may have relevance to the United Kingdom. They include educating patients and prescribers about the dangers of abusing prescription drugs; better monitoring of prescribing of "at risk" medications; disposing of unwanted medications; and developing partnerships between key stakeholders.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/psb.1169/citedby

Harmony Rhoades, Hailey Winetrobe, and Eric Rice. 2014. Prescription Drug Misuse Among Homeless Youth. Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.02.011.

Researchers surveyed 451 homeless youths recruited from drop-in centers in Los Angeles, California about substance use, mental health, service utilization, trauma, and sexual risk behavior. Multivariable logistic regression assessed correlates of past month prescription drug misuse. Nearly 50 percent reported lifetime prescription drug misuse and 21.6 percent reported prescription drug misuse in the past month. The most frequently used prescriptions in the past month were: opioids only (24.5 percent), sedatives only (23.4 percent), and stimulants only (10.6 percent); 14.9 percent used some combination of these three types of prescription medications. Homeless youths reported that prescriptions were most commonly obtained for free from friends or relatives (24.5 percent). Foster care involvement was associated with decreased prescription drug misuse, while hard drug use, suicidal ideation, and unprotected sex were associated with increased prescription drug misuse.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871614000660

E.K. Sauber–Schatz, Karin A. Mack, Shane T. Diekman, and Leonard J. Paulozzi. 2014. Associations between Pain Clinic Density and Distributions of Opioid Pain Relievers, Drug-Related Deaths, Hospitalizations, Emergency Department Visits, and Neonatal Abstinence Syndrome in Florida. Drug and Alcohol Dependence 133(1):161–66, doi: 10.1016/j.drugalcdep.2013.05.017.

Researchers correlated overdose death rates, hospital-discharge rates for drug-related hospitalizations including neonatal abstinence syndrome, and emergency department rates for drug-related visits with registered pain clinic density and opioid pills dispensed per person at the county-level in Florida in 2009. An estimated 732 pain clinics operated in Florida in 2009, a rate of 3.9/100,000 people. Among the 67 counties in Florida, 23 (34.3 percent) had no pain clinics, and three had 90 or more. Adjusted negative binomial regression found no significant association between pain clinic rate and drug-related outcomes. However, rates of drug-caused, opioid-caused, and oxycodone-caused death correlated significantly with rates of opioid and oxycodone pills dispensed per person in adjusted analyses. For every increase of one pill in the rate of oxycodone pills per person, the rate of oxycodone-related overdose death increased by 6 percent.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23769424

News

Government Is Right to Crack Down on Prescription Opioid Abuse
Washington Post
March 12, 2014

The Washington Post argues that the government had no choice but to act to curb prescription drug abuse by implementing policies making it more difficult to obtain prescription opioids such as oxycodone. The government did not foresee a spike in heroin abuse. Addicts began turning to heroin well before the government started cracking down on prescription opioids. If the government's efforts continue, levels of both prescription drug addiction and heroin addiction should subside.

Read more:
http://www.washingtonpost.com/opinions/the-government-is-right-to-crack-down-on-prescription-opioid-abuse/2014/03/12/34c4d55e-a886-11e3-8d62-419db477a0e6_story.html

Sen. Casey Urges FDA to Review Naloxone
Daily Times
March 13, 2014

U.S. Sen. Robert Casey urged the Food and Drug Administration to review the status of naloxone during a Health Education Labor and Pensions Senate Committee meeting. Casey has asked for naloxone to be approved as a behind-the-counter drug, which requires the approval of a pharmacist to be purchased. Casey has also pushed for legislation that would include new training for prescribers and establish grants for states to promote safe medical disposal and educate residents on prescription drug abuse.

Read more:
http://www.delcotimes.com/social-affairs/20140313/sen-casey-urges-fda-to-review-naloxone

Holder Urges Use of Drug to Help in Heroin Overdoses
USA Today
March 10, 2014

Atty. Gen. Eric Holder urged first responders to carry naloxone. Holder said in a video message posted on the Justice Department Web site that heroin addiction is an urgent and growing public health crisis.

Read more:
http://www.usatoday.com/story/news/politics/2014/03/10/holder-heroin-overdose-help/6247281/

CVS Probed in Alleged Loss of Painkillers
Los Angeles Times
March 10, 2014

This article and video (1 minute, 59 seconds) discuss possibility of the CVS Caremark Corporation facing as much as $29 million in fines for allegedly losing track of hydrocodone pills at four California stores. It faces 2,973 possible violations of the federal Controlled Substances Act for alleged discrepancies between the company's records and its inventory of prescription drugs. The drugs, more than 37,000 pills, were apparently taken from CVS stores in Modesto, Fairfield, Dixon, and Turlock, and may have been sold on the black market. This is the second time in the last year that CVS has found itself facing stiff fines for questionable oversight of prescription drugs.

Read more:
http://www.latimes.com/business/la-fi-lazarus-20140311,0,3176765,full.column#axzz2vg5IwTbo
RELATED ARTICLE
United States Should Reclassify Prescription Painkiller to Cut Rampant Theft
Los Angeles Times
March 13, 2014

This article discusses theft of prescription pain relievers by CVS Pharmacy employees. It also discusses ways to curb theft by instituting tighter security measures and by changing the regulatory status of hydrocodone. Hydrocodone is classified as a Schedule III drug, which means it represents only a "moderate to low" risk of being habit forming and has little potential for abuse. Last month, the Drug Enforcement Administration proposed switching hydrocodone from Schedule 3 to Schedule 2, arguing that "hydrocodone is one of the most abused drugs in the nation." With reclassfication, hydrocodone would no longer sit out on pharmacy shelves with other Schedule 3 medications. Instead, it would be kept locked with other Schedule 2 drugs, requiring a pharmacist's involvement for a technician to gain access. The National Association of Chain Drug Stores, the National Alliance of State Pharmacy Associations, and other industry groups banded together last year to oppose tighter restrictions on hydrocodone. The groups said a Schedule 2 classification for hydrocodone would make it harder for people to obtain the drug because doctors would no longer be able to call in a prescription. Patients instead would have to hand-deliver prescriptions to pharmacists.

Read more:
http://www.latimes.com/business/la-fi-lazarus-20140314,0,4159808,full.column#axzz2vxXbEvZj
Lawmakers Appeal to Sebelius Over Food and Drug Administration Approval of New Pain Pill
Hill
March 10, 2014

Sen. Joe Manchin sent a letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius asking her to overturn the Food and Drug Administration's approval of Zohydro, a highly addictive and easily abused prescription drug scheduled to begin sales next month. He was the second lawmaker to appeal to her this month.

Read more:
http://thehill.com/blogs/regwatch/healthcare/200389-lawmakers-appeal-to-hhs-chief-over-fda-approval-of-new-pain-pill

Food and Drug Administration Chief Defends Controversial Zohydro Painkiller as Criticism Intensifies
Fox News
March 14, 2014

The Food and Drug Administration's Commissioner told Senate lawmakers that the recently-launched Zohydro fills an "important and unique niche" for treating chronic pain. Her agency has received criticism since approving the drug, amid concerns from lawmakers, addiction specialists, and others that the drug will exacerbate the national epidemic of prescription drug abuse. Senator Joe Manchin recently introduced a bill that would force the Food and Drug Administration to withdraw the drug and prohibit the approval of any similar medications that do not have tamper-resistant design features.

Read more:
http://www.foxnews.com/health/2014/03/14/fda-chief-defends-controversial-zohydra-painkiller-as-criticism-intensifies/

Millennium Labs Helps Launch Coalition Tackle Prescription Drug Misuse, Abuse in San Diego
PRNewswire
March 11, 2014

This press release announces launch of Safe Homes Coalition by the Greater San Diego (Calif.) Association of REALTORS, local nonprofits, Millennium Laboratories, and other partners. The coalition will work to inform people about the proper use, storage, and disposal of prescription drugs. The coalition was created as a response to prescription drug thefts during real estate open houses. It will air public service announcement on local television and radio stations. It will also distribute 10,000 bags to be used by homeowners to secure prescription medications prior to open houses in San Diego. The bags will be distributed through seven REALTORS® service centers in the county. The coalition plans to conduct presentations and distribute related materials to real estate professionals. Its outreach effort will also include a Facebook page with information about prescription drug abuse and ways to counter it. The group hopes to expand its campaign throughout California and across the United States.

Read more:
http://www.prnewswire.com/news-releases/millennium-labs-helps-launch-coalition-to-tackle-prescription-drug-misuse-abuse-in-san-diego-249647221.html

Overdoses, Cellphone-Linked Car Crashes Among Top Causes of Fatal Injury in United States
HealthDay
March 13, 2014

The U.S. National Safety Council reported that poisonings, mostly from drug overdoses, are the leading cause of accidental death among working-age adults in the United States. In half of those cases, the overdose resulted from prescription-drug abuse. In 18 states and Washington, D.C., poisoning is the leading cause of accidental death. Both legal and illicit drugs accounted for nearly 91 percent of poisoning deaths reported in 2010. About half of those poisoning deaths are caused by overdoses of prescription drugs.

Read more:
http://consumer.healthday.com/senior-citizen-information-31/misc-death-and-dying-news-172/injury-facts-report-685810.html

Saving the World One Pill at a Time
Scienceline
March 11, 2014

This article discusses efforts across the country to safely dispose of prescription medications. Many communities offer isolated drug take-back days throughout the year, but some are underutilized.

Read more:
http://scienceline.org/2014/03/saving-the-world-one-pill-at-a-time/

Other State and Local News

State Steps Up Efforts to Head Off Abuse of Prescription Painkillers
NJ Spotlight
March 14, 2014

New Jersey officials are stepping up their efforts to reduce prescription drug abuse. The state Division of Consumer Affairs Director recently highlighted some steps the state has taken to reduce opioid abuse. They include making it easier for doctors and advanced practice nurses who prescribe controlled substances to register with the PDMP. For example, prescribers will no longer be required to have a document notarized to register with the PDMP. They can now register online when they renew their registration to prescribe these drugs. The state has hired additional investigators with medical experience and initiated 30 legal actions against those with a pattern of indiscriminant prescribing, leading to revocation of 14 prescribers' licenses. The state also added security features to prescription pads that make them more difficult to forge.

Read more:
http://www.njspotlight.com/stories/14/03/14/state-steps-up-efforts-to-head-off-prescription-abuse/

Supreme Court Says 'Prescription Drug Defense' Applies to Department of Transportation License Hearings
Radio Iowa
March 14, 2014

The Iowa Supreme Court says drivers can use a "prescription drug defense" in driver's license revocation hearings. The case involved Teresa Bearinger, who drove off the road and hit a mailbox two blocks from her home. She told police she was having trouble with her prescription medication for a neurological problem. A drug test revealed only prescription drugs in her system. Iowa law allows drivers to take medications as prescribed by doctors and drive as long as they do not take alcohol with them. The Iowa Department of Transportation said that the "prescription drug defense" applies only to a criminal charge and does not apply to administrative hearings on license revocations. The Department of Transportation revoked Bearinger's license for 180 days, and she appealed. The Iowa Supreme Court ruling says the justices do not believe the legislature intended to withhold the prescription drug defense for an administrative license revocation, and ordered the revocation reversed.

Read more:
http://www.radioiowa.com/2014/03/14/supreme-court-says-prescription-drug-defense-applies-to-dot-license-hearings/

Daytona Beach (Fla.) Attorney Files New Suit over Prescription Pill Database
Daytona Beach News–Journal
March 13, 2014

Criminal Defense Attorney Michael Lambert has refiled a lawsuit against Seventh Circuit State Attorney R.J. Larizza seeking to declare portions of Florida's PDMP database unconstitutional. Fourth Judicial Circuit Judge Waddell A. Wallace dismissed the initial complaint last month. John Tanner, Lambert's attorney, said the second amendment complaint does not ask for an injunction but does seek to declare unconstitutional portions of the state law for the PDMP. Judge Wallace wrote in his first order that law enforcement's obtaining prescription drug records of the 3,300 persons "did not violate the constitutional protection against unreasonable searches and seizures." Wallace also said that a person's expectation of privacy regarding their prescription records should be reduced since the Legislature requires that copies of the records be maintained.

Read more:
http://www.news-journalonline.com/article/20140313/NEWS/140319696/1040?p=1&tc=pg

Pennsylvania Medical Professionals Address Prescription Drug Abuse 'Crisis'
Daily Times News
March 10, 2014

Pennsylvania's medical community announced the formation of a multispecialty physician panel to address prescription drug abuse. The panel will provide recommendations to the medical community, including the potential to adopt Pennsylvania-specific prescription guidelines. It will also work closely with a task force previously formed by state officials to advise on this issue.

Read more:
http://www.delcotimes.com/general-news/20140310/pa-medical-professionals-address-prescription-drug-abuse-crisis

Chester County (Pa.) Releases Heroin Overdose Stats
Philly.com
March 12, 2014

Officials in Chester County reported 24 heroin overdose deaths last year; 18 of these (75 percent) involved both heroin and prescription drugs. The ages ranged from 21 to 79 years old and 14 were men. The county has taken a proactive and multifaceted approach to address this problem. It has created a prescription drug drop box program and is working with legislators to craft Good Samaritan laws encouraging users to call 911 if friends overdose. The Chester County District Attorney's Office issued a $5,000 grant to help kick-start a local chapter of the advocacy group Narcotics Overdose Prevention and Education.

Read more:
http://www.philly.com/philly/news/Chester_County_releases_heroin_overdose_stats.html

Alcohol, Tobacco and Drug Use Among Teens in Tri-State Declines: Survey
Tech Times
March 13, 2014

The Coalition for a Drug-Free Greater Cincinnati released results from a survey of almost 57,000 students from 107 different schools, that found peer disapproval of alcohol, tobacco, and marijuana use have caused the habits to decline between 25 percent and 50 percent since the year 2000. The coalition found that in the Tri-State area, 95.7 percent of the teens surveyed do not use prescription drugs nonmedically, 90.2 percent do not use cigarettes, 88.6 percent do not use marijuana, and 82.2 percent do not use alcohol. Since 2012, prescription drug use has declined by 34 percent. Furthermore, only 4.3 percent of teens surveyed said they had used illicit prescription drugs during the last 30 days.

Read more:
http://www.techtimes.com/articles/4322/20140313/alcohol-tobacco-and-drug-use-among-teens-in-tri-state-decline-survey.htm

Other Resources

Brandeis University, Prescription Drug Monitoring Program Training and Technical Assistance Center. Technical Assistance Guide No. 01–14: Additional Data Fields for PDMPs to Consider Collecting from Dispensers, March 12, 2014.

The Prescription Drug Monitoring Program Training and Technical Assistance Center at Brandeis University with support from the Bureau of Justice Assistance developed this guide to assist PDMP administrators to begin the process of examining additional data fields they and their user groups may want to consider collecting and include in PDMP reports and to assist administrators in beginning a dialogue with their users on additional data they would find useful in carrying out their responsibilities.

Read more:
http://www.pdmpassist.org/pdf/TAG_Additional_Data_Fields_FINAL.pdf

Seven Startling Facts About Prescription Painkillers
National Safety Council
March 13, 2014

The press release lists seven facts about prescription pain reliever use.

Read more:
http://www.nsc.org/Pages/Seven-startling-facts-about-prescription-painkillers-.aspx

Carly Putnam. "Prescription Drug Abuse in Oklahoma." Oklahoma Policy Institute, March 2014.

This fact sheet provides an overview of prescription drug abuse in Oklahoma, dispels a few myths, and suggests policy reforms going forward.

Read more:
http://okpolicy.org/prescription-drug-abuse-fact-sheet

Medication Safety Toolkit Available for National Poison Prevention Week
Wall Street Journal
March 13, 2014

This press release discusses a Medication Safety toolkit from The Cardinal Health Foundation and The Ohio State University College of Pharmacy. It is designed as a resource to assist parents, teachers, organizational leaders, and health professionals in discussing the issue of medication safety with elementary-age children. The toolkit includes materials such as supplemental worksheets, games, and visual aids, appropriate for elementary-aged children. This toolkit allows for customization based on the audience and venue to help foster conversation and educate the young participants on how to use medicines safely. The various materials can easily be implemented for National Poison Prevention Week which is scheduled for March 1622, 2014. No evidence of toolkit effectiveness was provided.

Read more:
http://online.wsj.com/article/PR-CO-20140313-911261.html

Webinars

The Role of Prescription Drug Monitoring Programs in Protecting Children and Youth—An Update
Children's Safety Network
Tuesday, March 25, 2014
2:00 p.m. to 3:00 p.m. (EST)

Dr. John Eadie at the Prescription Drug Monitoring Program Center of Excellence, and his colleague, Tom Clark, will update participants on PDMP developments over the past two years, provide information about how individuals may contact their states' PDMP, and give examples of the types of information that may help protect children and youth.

Read more:
http://campaign.r20.constantcontact.com/render?ca=e4e81b0d-7b2e-42e1-8c67-933f669b33a6&c=cd194980-ac04-11e3-a78d-d4ae529a8786&ch=cdc36c30-ac04-11e3-a816-d4ae529a8786

Prescription Drugs
Maryland Department of Health and Mental Hygiene, the Center for Injury and Sexual Assault Prevention
Thursday, March 27, 2014
3:00 p.m. to 4:00 p.m. (EST)
www.maryland.gov

Girls and Substance Use: Trends, Challenges, and Opportunities
SAMHSA
Tuesday, April 22, 2014
3:00 p.m. to 4:30 p.m.
http://captus.samhsa.gov/news-and-events/girls-and-substance-use-trends-challenges-and-opportunities

Grant Announcements

2014 Drug-Free Communities Support Program Grants
White House Office of National Drug Control Policy and Substance Abuse and Mental Health Services Administration
Deadline: March 24, 2014
http://www.whitehouse.gov/ondcp/Drug-Free-Communities-Support-Program
http://www.whitehouse.gov/sites/default/files/ondcp/grants-content/dfc_rfa_to_csap_1-23-14.pdf

Fiscal Year 2014 Harold Rogers Prescription Drug Monitoring Program
Bureau of Justice Assistance, U.S. Department of Justice
Deadline: May 6, 2014

The primary purpose of the Harold Rogers Prescription Drug Monitoring Program is to enhance the capacity of regulatory and law enforcement agencies and public health officials to collect and analyze controlled substance prescription data and other scheduled chemical products through a centralized database administered by an authorized state agency.

Read more:
http://www.grants.gov/web/grants/view-opportunity.html?oppId=252394

Grant Award

Alabama Governor Awards Funding to Combat Prescription Drug Abuse
State of Alabama
March 11, 2014

Alabama Gov. Robert Bentley awarded a $125,000 grant to the state's Office of Prosecution Services to combat the illegal use of prescription drugs. The grant funding will support programs to reduce the amount of controlled prescription medications dispensed. The Office of Prosecution Services will work in cooperation with the Alabama Drug Abuse Task Force, the state departments of Public Health and Education, and local district attorneys to implement and enforce prescription drug policy.

Read more:
http://www.alabama.gov/sliverheader/Welcome.do?url=http://media.alabama.gov/pr/list.aspx

Take-Back Events and Drop Boxes

Here's How to Get Rx Drugs off the Streets
Cincinnati.com
March 9, 2014
http://www.cincinnati.com/story/news/2014/03/08/get-rx-drugs-streets/6220939/

National Prescription Drug Take-Back Day!
City and Community of Arvada (Colo.)
March 11, 2014
http://arvada.org/sustainability/national-prescription-drug-take-back-day

Nationwide Prescription Drug Take-Back Day and VIN Etching/Watch Your Car Program; Coat Collection on April 26
City of Takoma Park (Md.) Police Department
March 10, 2014
http://connectedcommunities.us/showthread.php?s=f70bf3c2ac32f07befa32a2b1344b2a8&p=62430#post62430

Fort Collins (Colo.) Police Announce Daily Prescription Drug Drop-Off Program
Coloradan.com
March 12, 2014
http://www.coloradoan.com/article/20140311/NEWS01/303110072/Fort-Collins-police-announce-daily-prescription-drug-drop-off-program?gcheck=1

Prescription Drug Drop-Box Installed at the Safety Center
San Diego County News
March 13, 2014
http://www.sandiegocountynews.com/2014/03/13/prescription-drug-drop-box-installed-at-the-safety-center/

Drug Take-Back Events Scheduled Across North Carolina March 15–22
Sun Journal
March 14, 2014
http://www.newbernsj.com/sj-express/drug-take-back-events-scheduled-across-north-carolina-march-15-22-1.291121

Save the Dates

National Take-Back Initiative
Drug Enforcement Administration
10:00 a.m. to 2:00 p.m.
April 26, 2014
http://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html

Twenty-Seventh Annual NPN Prevention Research Conference
National Prevention Network
September 15–18, 2014
http://swpc.ou.edu/npn/

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

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference
U.S. Department of Justice, Drug Enforcement Administration
April 5–6, 2014—Hilton St. Louis (Mo.) at the Ballpark
June 28–29, 2014—Renaissance Phoenix (Ariz.) Downtown
July 12–13, 2014—Sheraton Philadelphia (Pa.) Downtown Hotel
August 2–3, 2014—Denver (Colo.) Marriott Tech Center
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/

Eleventh Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland
http://www.globalmedicalmeetings.com/events/hr14000

National Rx Drug Abuse Summit
April 22–24, 2014
Atlanta, Georgia
http://nationalrxdrugabusesummit.org

RX for Prevention: Preventing and Responding to Prescription Drug Abuse on Campus
Temple University, Villanova University, U.S. Attorney's Office, and the Clery Center
June 11, 2014
Temple University
1755 N. 13th Street
Philadelphia, Pennsylvania

This summit will examine the emerging trend of nonmedical prescription drug use on campus through the following lenses: prevention: understanding the motives, perceptions, and expectancies that drive nonmedical prescription drug use; intervention: applying evidence-based practice from the field of alcohol and other drug intervention to nonmedical prescription drug use; and enforcement: partnering with local, regional, state, and national organizations to address nonmedical prescription drug use on campus and in surrounding communities.

Read more:
http://clerycenter.org/event/2014-06-11-000000/rx-prevention-preventing-responding-prescription-drug-abuse-campus

2014 Harold Rogers Prescription Drug Monitoring Program National Meeting
Brandeis University, Prescription Drug Monitoring Program Training and Technical Assistance Center
September 23–25, 2014
Marriot Metro Center
Washington, D.C.
http://www.pdmpassist.org/content/events
The Weekly Update is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoint or opinion and are not assessed for validity, reliability or quality. The Weekly Update should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full text of journal articles listed in the Weekly Update.