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March 19, 2015

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 114  |  March 19, 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 International Northeast/Mid-Atlantic News South News Midwest News West News Upcoming Webinars Grant Announcements Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured

J.N. Lind, E.E. Petersen, P.A. Lederer, G.S. Phillips–Bell, C.G. Perrine, R. Li, M. Hudak, J.A. Correia, A.A. Creanga, W.M. Sappenfield, J. Curran, C. Blackmore, S.M. Watkins, and S. Anjohrin. 2015. "Infant and Maternal Characteristics in Neonatal Abstinence Syndrome—Selected Hospitals in Florida, 2010–2011." Morbidity and Mortality Weekly Report 64(08):213–16.

During 2010–11, 242 infants with neonatal abstinence syndrome (NAS) were identified at three Florida hospitals. Most (83 percent) were non-Hispanic white, compared with 57 percent of infants without NAS. Low birth weight was more frequent (19 percent versus 8 percent) among babies with NAS, as was preterm delivery (18 percent vs 12 percent). Almost all infants with NAS were admitted to the neonatal intensive care unit (NICU), compared with 6 percent of other infants. Mean NICU length of stay for infants with NAS was 26.1 days. Urine toxicology screens were performed on 86 percent of infants with NAS. Morphine therapy to control NAS signs was used in 88 percent of infants, followed by phenobarbital in 37 percent of cases. No infant diagnosed with NAS died during birth hospitalization. At discharge, 95 percent were receiving only formula. Of mothers, 82 percent said they were using opioid pain relievers, 60 percent were using methadone, and 4 percent were using buprenorphine (less than 1 percent used heroin during pregnancy). Benzodiazepines were the second most commonly reported substances used (41 percent), followed by tobacco (40 percent), marijuana (24 percent), and cocaine (14 percent). Reported reasons for opioid use included illicit nonmedical (55 percent), drug abuse treatment (41 percent), and chronic pain treatment (22 percent). Urine toxicology screens were performed on 87 percent of mothers of infants with NAS. Ten percent received or were referred to drug addiction rehabilitation or counseling during the infant's birth hospitalization.

Read more:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6408a3.htm?s_cid=mm6408a3_w

National Safety Council Poll: Nearly 70 Percent of Prescription Painkiller Users Do Not Know Sharing Medication Is a Felony
National Safety Council
March 12, 2015

According to a nationwide National Safety Council survey, few American adults know how addictive prescription pain relievers are. Ninety percent of those who used opioid pain relievers were not concerned with addiction, even though many had risk factors that increased their likelihood of becoming abusers. Nearly 70 percent of respondents did not know it was a felony in most states to share prescription pain relievers with friends or family. Forty-two percent thought sharing their prescription pain relievers was appropriate or had few or no negative consequences.

Read more:
http://www.nsc.org/learn/about/Pages/NSC-Poll-Prescription-Painkiller-Sharing.aspx

Download the full report:
http://www.nsc.org/NewsDocuments/031115-Public-Opinion-Poll.pdf

G.C. Welham, J.K. Mount, and A.M. Gilson. 2015. "Type and Frequency of Opioid Pain Medications Returned for Disposal." Drugs—Real World Outcomes, doi:10.1007/s40801-015-0019-4.

At a 4-hour drug take-back event in Dane County (Madison), Wis., 761 households handed over 1,500 pounds of medicine, including 160 pounds of controlled substances. In opioid prescriptions returned for disposal, more than 60 percent of the dispensed amount remained unused. Short-acting combination opioids accounted for more than 80 percent of returned prescriptions. Days of supply dispensed was the strongest predictor of days of supply remaining, regardless of other drug characteristics. Thus, disposal programs appear to be effective at removing unused opiates from patients' homes.

Read more:
http://link.springer.com/article/10.1007%2Fs40801-015-0019-4

Journal Articles and Reports

N. Astone, S. Martin, and L.Y. Aron. 2015. Death Rates for US Women Ages 15 to 54: Some Unexpected Trends. Washington, D.C.: Urban Institute.

Death rates among U.S. non-Hispanic white women ages 15 to 54 are increasing—in part because of prescription opioid overdose. This paper probes other reasons for the rise.

Read more:
http://www.urban.org/publications/2000131.html

T.J. Cicero and M.S. Ellis. 2015. "Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States: Lessons Learned from OxyContin." JAMA Psychiatry, doi:10.1001/jamapsychiatry.2014.3043.

After its introduction, reformulated OxyContin was associated with a significant reduction of past-month abuse (45 percent from January to June 2009 to 26 percent from July to December 2012). Past-month use was stable at 25 percent to 30 percent from 2012 to 2014. These estimates come from the ongoing Survey of Key Informants' Patients program of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System. Between January 2009 and June 2014, 10,874 patients who had a DSM–V diagnosis of opioid abuse (prescription opioids or heroin) completed surveys at entry to one of 150 drug treatment programs in 48 states.

In-depth interviews with 244 patients identified 88 participants who used both pre-abuse-deterrent formulation and abuse-deterrent formulation OxyContin. Among this group, 38 (43 percent) transitioned from nonoral routes of administration to oral use, 30 (34 percent) defeated the abuse-deterrent formulation mechanism and continued inhaled or injected use, and 20 (23 percent) only used the drug orally.

Read more:
http://archpsyc.jamanetwork.com/article.aspx?articleid=2174541

B.A. DiPaula and E. Menachery. 2015. "Physician–Pharmacist Collaborative Care Model for Buprenorphine-Maintained Opioid-Dependent Patients." Journal of American Pharmacists Association 55:187–92, doi:10.1331/JAPhA.2015.14177.

This paper reports on a 12-patient pilot buprenorphine maintenance project that used pharmacists to monitor care, thus reducing physician burden. At a suburban health department, a pharmacist conducted intake assessments and follow-up appointments under physician supervision. The physician did not routinely see patients but cosigned their encounter records. The pharmacist prevented diversion by gathering data from outside providers, pharmacies, and laboratories. Twelve patients who completed full intakes had a 91 percent attendance rate, 100 percent 6-month retention rate, and 73 percent 12-month retention rate. Overall, 127 of 135 (98 percent) urine toxicology screens were positive for buprenorphine, with only 13 (12 percent) also positive for opioids. Shifting from physician to less costly pharmacist time saved an estimated $22,000.

Read more:
http://udwr.japha.org/article.aspx?articleid=2196486

A. Kecojevic, C.F. Wong, H.L. Corliss, and S.E. Lankenau. 2015. "Risk Factors for High Levels of Prescription Drug Misuse and Illicit Drug Use Among Substance-Using Young Men Who Have Sex with Men (YMSM)." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.02.031.

During 2012–13, researchers surveyed 191 Philadelphia men ages 18–29 who had sex with other men and reported prescription drug misuse in the past 6 months. Respondents were recruited from a range of community settings and through advertisements. High levels of childhood physical abuse and perceived stress were associated with greater opioid misuse, while high levels of depression were associated with less opioid misuse. Those with higher levels of perceived stress were more likely to report higher tranquilizer misuse, while those with more experiences of social homophobia/racism and higher levels of depression and somatization reported greater stimulant misuse. Older participants were more likely than younger participants to report higher opioid misuse. Racial minorities were less likely than white participants to report higher misuse of tranquilizers, stimulants, and illicit drugs. Bisexual, heterosexual, and other self-identified participants were more likely than gay self-identified participants to report higher misuse of all three classes of prescription drugs.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(15)00115-5/abstract?rss=yes

J.N. Kennedy, V.S. Bebarta, S.M. Varney, L.A. Zarzabal, and V.J. Ganem. 2015. "Prescription Stimulant Misuse in a Military Population." Military Medicine 180(3S):191–94, doi:10.7205/MILMED-D-14-00375.

In an emergency department waiting room of a military tertiary care hospital, 5 percent of 498 survey respondents reported misusing stimulants in the past 5 years. Misusers were more likely to have a mental health diagnosis and to have suffered a deployment-related injury or other injury, compared with those who reported using stimulants properly. Stimulant misuse did not correlate with age, gender, active duty status, education, location of deployment, number of times deployed, traumatic brain injury diagnosis, or enlistment status.

Read more:
http://publications.amsus.org/doi/abs/10.7205/MILMED-D-14-00375

K.A. Krokmyrdal and R. Andenaes. 2015. "Nurses' Competence in Pain Management in Patients with Opioid Addiction: A Cross-Sectional Survey Study." Nurse Education Today, doi:10.1016/j.nedt.2015.02.022.

A 2010 Norwegian pilot survey polled 64 nurses in medical units and 34 nurses in orthopedic units at two urban public hospitals, with a 54 percent response rate. Sixty-five percent of respondents had basic skills for evaluating pain, but 54 percent could not evaluate degrees of pain, and 88 percent said they lacked sufficient knowledge about pain treatment for patients with opioid addiction. Primary contributors to their knowledge about pain treatment included workplace experience (88 percent) and colleagues (77 percent). Education, literature, and information technology played much more minor roles. Almost 62 percent did not trust the pain experience self-reported by patients who were opioid abusers.

Read more:
http://www.sciencedirect.com/science/article/pii/S0260691715000982

K.A. McDermott, M.L. Griffin, H.S. Connery, E.Y. Hilario, D.A. Fiellin, G.M. Fitzmaurice, and R.D. Weiss. 2015. "Initial Response as a Predictor of 12-Week Buprenorphine–Naloxone Treatment Response in a Prescription Opioid–Dependent Population." The Journal of Clinical Psychiatry 76(2):189–94, doi:10.4088/JCP.14m09096.

Secondary analysis of data from the Prescription Opioid Addiction Treatment Study (POATS) showed 56 percent of patients who were abstinent in the first 2 weeks of buprenorphine–naloxone treatment were abstinent in weeks 9–12. Conversely, only 6 percent of those who continued using during the first 2 weeks were abstinent at the 3-month time point. Together, these results translate to a predictive value of 94 percent for the lack of abstinence at weeks 9 through 12, while the predictive value of early abstinence alone was below 60 percent. See the article by Weiss et al. (below) for POATS results at week 42.

Read more:
http://www.psychiatrist.com/JCP/article/Pages/2015/v76n02/v76n0209.aspx
D.D. Langleben. 2015. "Commentary: Buprenorphine–Naloxone Treatment of Prescription Opioid Abuse: Does Past Performance Predict Future Results?" The Journal of Clinical Psychiatry 76(2):195–97, doi:10.4088/JCP.14com09617.

The authors caution that nearly half of POATS participants were abstinent or reduced their use at the end of the 12-week treatment period covered by McDermott et al., but 94 percent of participants relapsed within 8 weeks after buprenorphine–naloxone was tapered off in week 12. A more immediate conclusion from the article is that 12 weeks of buprenorphine–naloxone treatment was insufficient to achieve a sustained remission in the POATS cohort. Moreover, the POATS sample may not be representative of the prescription opioid abuse demographic. More than 40 percent of POATS patients reported chronic pain, and 30 percent reported lifetime prevalence of heroin or alcohol abuse and depression.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25742206
R.D. Weiss, J. Sharpe Potter, M.L. Griffin, S.E. Provost, G.D. Fitzmaurice, K.A. McDermott, E.N. Srisarajivakul, D.R. Dodd, J.A. Dreifuss, R.K. McHugh, and K.M. Carroll. 2015. "Long-Term Outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.02.030.

This study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS). POATS was a multisite clinical trial lasting up to 9 months, examining different durations of buprenorphine–naloxone (plus standard medical management for prescription opioid dependence), with participants randomized to receive or not receive additional opioid drug counseling. Of 653 participants, 375 enrolled in a follow-up study with telephone interviews at 18, 30, and 42 months after the main trial enrollment. At month 42, 32 percent were not taking opioids and not on agonist therapy; 29 percent were receiving opioid agonist therapy but met no symptom criteria for current opioid dependence; 8 percent were using illicit opioids while on agonist therapy; and the remaining 31 percent were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM–IV criteria for opioid dependence at month 42 (odds ratio = 4.6). Those still using agonist therapy were less likely to be abusing illicit opioids. Eight percent used heroin for the first time during follow-up; 10 percent reported first-time heroin injection.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(15)00114-3/abstract

C. Ringwalt, M. Garrettson, and A. Alexandridis. 2015. "The Effects of North Carolina's Prescription Drug Monitoring Program on the Prescribing Behaviors of the State's Providers." The Journal of Primary Prevention 36(2):131–37, doi:10.1007/s10935-014-0381-0.

Neither the number of providers who queried North Carolina's Prescription Drug Monitoring Program (PDMP) nor the number of days on which they queried the system was associated with a decrease in patients who filled prescriptions for controlled substances or prescriptions for controlled substances filled. A slight positive relationship existed between growth in PDMP use and the number of prescriptions filled for opioid analgesics. Thus, concerns that PDMPs may constrain legitimate controlled substance prescribing are not supported.

Read more:
http://link.springer.com/article/10.1007%2Fs10935-014-0381-0

C. Winston and M. Holodniy. 2015. "Surveillance for Opioid Overdose in the Veterans Health Administration, 2004–2014." Online Journal of Public Health Informatics 7(1).

In Veterans Health Administration national hospital discharge data for January 2004 through June 2014, 6,317 of 5,459,815 admissions had a principal diagnosis of opioid poisoning. Only 1 percent of those surviving to admission died in the hospital. Opioid poisoning rates were highest among younger veterans and lowest among veterans 65 and older. Trends over time showed increases for all except 45–54-year-olds. Overdose rates were highest in the Western United States, where trends were stable over time compared with increases in other regions. Admission rates plateaued in 2010 at roughly 1.3 per thousand.

Read more:
http://ojphi.org/article/view/5725

Professional Education

J. Sanchez–Ramos. 2015. "Neurologic Complications of Psychomotor Stimulant Abuse." International Review of Neurobiology, doi:10.1016/bs.irn.2015.02.003.

This chapter reviewed the adverse neurologic consequences of chronic psychomotor stimulant use and abuse, with a focus on two prototypical stimulants: methamphetamine and cocaine.

Read more:
http://www.sciencedirect.com/science/article/pii/S0074774215000069

D. Teater. Evidence for the Efficacy of Pain Medications. 2015. National Safety Council.

This report by a National Safety Council Medical advisor examines evidence on the pain-relieving abilities of acetaminophen, opioid, and nonsteroidal anti-inflammatory drugs (NSAIDs). The report includes a brief history of pain medications in the United States; compares the effectiveness of acetaminophen, opioid, and NSAID medications for pain relief; and discusses types of acute and chronic pain and the effectiveness of pain medication in their treatment.

Download the full report:
http://safety.nsc.org/painmedevidence

2015. Call to Action and Issue Brief: Justice System Use of Prescription Drug Monitoring Programs—Addressing the Nation's Prescription Drug and Opioid Abuse Epidemic. Washington, D.C.: United States Department of Justice, Office of Justice Programs.

This brief focuses on prescription drug monitoring programs (PDMPs) as a valuable tool in the justice system's fight against abuse, misuse, and diversion of prescription drugs. It outlines the nature and purpose of PDMPs and highlights the value of PDMP data for law enforcement, probation and parole officers, and court personnel. The brief underscores the importance of public health and public safety community partnerships and outlines practices for effectively using PDMP data for criminal justice purposes. It points to resources, promising practices, and examples of implementation, hoping to foster replication.

Read more:
https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=270758
https://www.bja.gov/Publications/Global-JusticeSystemUsePDMPs.pdf

MEDICAL MARIJUANA

The Tricky Logistics of Medical Marijuana
Matthew Hamilton, Times Union
March 9, 2015

New York's medical marijuana program includes five licensed operators that each have four dispensaries. Advocates want concerns about accessibility and affordability addressed before the regulations are approved. Also, the price of medical marijuana to be set by the state's department of health is not known by potential patients or the businesses preparing to submit proposals. New York is the only state in the nation to set uniform costs. Advocates are asking for a sliding scale and prices that will make the drug affordable for low-income patients. New York will have a cash program, although the draft regulations do not outline whether cash, check, or credit sales will be used.

Read more:
http://www.timesunion.com/news/article/The-tricky-logistics-of-medical-marijuana-6122787.php

When States Dare to Decide on Medical Marijuana
Conor Friedersdorf, The Atlantic
March 10, 2015

Senators Rand Paul, Cory Booker, and Kirsten Gillibrand are introducing a bipartisan bill that would "allow patients, doctors, and businesses in states that have already passed medical marijuana laws to participate in those programs without fear of federal prosecution." They believe states can act as laboratories of democracy: People in different regions can live under a system of their preference while acting as a model for other Americans as they weigh the best approach. Other lawmakers want the federal government to override the will of the people in various states. They argue many people who get medical marijuana cards do not really need the drug.

Read more:
http://www.theatlantic.com/politics/archive/2015/03/Senators-Rand-Paul-Cory-Booker-Kirsten-Gillibrand-Bill-End-federal-ban-Medical-Marijuana/387346

Nebraska Senators Introduce Three Bills on Marijuana to Legislature
Justin Perkins, Daily Nebraskan
March 13, 2015

Senator Sue Crawford introduced LB 390 to establish a medical cannabidiol pilot study with the University of Nebraska Medical Center. Senator Tommy Garrett introduced LB 643 to legalize marijuana use for patients suffering from any debilitating medical condition. The bill would require development of a computerized verification system and create an 11-member board to advise the Nebraska Department of Health and Human Services. Senator Matt Williams introduced LB 326, which would clarify penalties for possession of marijuana as well as THC–related substances and synthetic THC products.

Read more:
http://www.dailynebraskan.com/news/nebraska-senators-introduce-bills-on-marijuana-to-legislature/article_4fccfe60-c925-11e4-9386-5b05a83cb3f8.html

National

Bill Protects People Trained in Giving Opioid Overdose Prevention Drug
Allie Robinson Gibson, Bristol Herald Courier
March 11, 2015

U.S. senators introduced the Opioid Overdose Reduction Act, which would protect people trained in administering naloxone from potential lawsuits or liability for attempting to save a life. Representative Richard Neal is expected to introduce similar legislation in the House.

Read more:
http://www.tricities.com/news/bill-protects-people-trained-in-giving-opioid-overdose-prevention-drug/article_e438ae54-c809-11e4-9e67-17abf3a79844.html

VA Accelerates Deployment of Nationwide Opioid Therapy Tool
United States Department of Veteran Affairs
March 9, 2015

The Opioid Therapy Risk Report is now available to all staff in the Veterans Health Administration (VHA). This report includes information about dosages of narcotics and other sedative medications, significant medical problems that could contribute to adverse reactions, and monitoring data to aid in review and management of complex patients. The report allows VA providers to review all pertinent clinical data related to pain treatment in one place, offering a comprehensive veteran-centered and more efficient level of management not previously available to primary care providers. VHA is deploying training aids to providers and facilities to familiarize them with using this tool in daily practice.

Read more:
http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2681

Mallinckrodt Supports Safe Home Disposal of Unused Medications
PR Newswire
March 9, 2015

Mallinckrodt Pharmaceuticals will donate more than 120,000 Medsaway® medication inactivation pouches to healthcare providers to dispose of unused medicines at home.

Read more:
http://www.prnewswire.com/news-releases/mallinckrodt-supports-safe-home-disposal-of-unused-medications-300047678.html

ICANN, Governments Should Do More to Investigate Rogue Online Drug Sellers, USTR Contends
National Association of Boards of Pharmacy
March 11, 2015

The Office of the U.S. Trade Representative reported that the Internet Corporation for Assigned Names and Numbers should do more to help investigate and address the problem of counterfeit prescription drugs sold on the Internet. The new report indicated that counterfeit drugs sold on the Web have included anti-cancer and anti-HIV/AIDS medications that were found to be ineffective, and some even contained toxic ingredients. The report also cites the National Association of Boards of Pharmacy's finding that nearly 97 percent of association-reviewed online pharmacies operate out of compliance with U.S. pharmacy laws and practice standards.

Read more:
http://www.nabp.net/news/icann-governments-should-do-more-to-investigate-rogue-online-drug-sellers-ustr-contends

Download the full report:
https://ustr.gov/sites/default/files/2014%20Notorious%20Markets%20List%20-%20Published_0.pdf

International

Blood Tribe Declares Local State of Emergency—Measure Tied to Concerns Over Prescription Drug Abuse
Lethbridge Herald
March 6, 2015

The Blood Tribe Chief and Council in Standoff, Canada, declared a local state of emergency in response to growing community concern about prescription drug abuse and recent deaths linked to the street drug Oxy 80. The University of Lethbridge Faculty of Health Sciences is helping the council conduct an asset-mapping exercise that will determine which services are available and what is needed to offer assistance to people dealing with addictions. First Nations and Inuit Health Branch has provided 47 naloxone kits to the tribe. Blood Tribe Police Services has ongoing investigations related to increased sales and use of opiates, with two officers assigned. The tribe will seek federal health funding for additional resources.

Read more:
http://lethbridgeherald.com/news/local-news/2015/03/06/blood-tribe-declares-local-state-of-emergency-measure-tied-to-concerns-over-prescription-drug-abuse

MP Charlie Angus Calls for Public Conversation on Fentanyl Abuse
CBC News
March 6, 2015

Charlie Angus, a member of Parliament for Timmins–James Bay in Ontario, Canada, hosted a working group on fentanyl abuse with health experts and police in the Porcupine region. The group is planning strategies to raise awareness and keep the drug off the street.

Read more:
http://www.cbc.ca/news/canada/sudbury/mp-charlie-angus-calls-for-public-conversation-on-fentanyl-abuse-1.2985402

WA Inquest Examines Prescription Drug Use
NineMSN
March 9, 2015

The prescription drug deaths of three men prompted the Western Australia coroner to investigate whether dispensers and prescribers would benefit from a real-time prescribing system; whether pharmacists should be able to notify a state or Commonwealth agency that someone ought not receive a controlled drug or prescription-only medicine; and whether a public awareness campaign is needed to increase understanding about the risks and unacceptable behaviors associated with pharmaceutical misuse.

Read more:
http://www.9news.com.au/national/2015/03/09/19/28/wa-inquest-examines-prescription-drug-use

Northeast/Mid-Atlantic News

State Release of Drug Data May Help Curb Excessive Prescribing
Susan Spencer, Worcester Telegram and Gazette
March 9, 2015

The Massachusetts prescription drug monitoring program (PDMP) may be reducing doctor shopping for pills and helping to eliminate healthcare providers who prescribe excessively. At the end of 2014, 66 percent of physicians were enrolled to use the online database. The rate of multiple provider episodes decreased by 15 percent between 2009 and 2013. Before the database went online in 2009, multiple provider episodes increased by 256 percent between fiscal years 1996 and 2008. From January 2013 to November 2014, the PDMP Medical Review Group reviewed 38 cases and released 13 to state boards of registration in medicine, nursing, and physician assistants for further investigation. None were referred to law enforcement.

Read more:
http://www.telegram.com/article/20150309/NEWS/303099610/1116

New Brighton Pharmacy One of the First to Offer Standing Order for Naloxone to Help Curb Overdose Deaths
Jenny Wagner, Timesonline.com
March 11, 2015

The Hometown Apothecary in New Brighton, Pa., and Dr. Neil Capretto, medical director of Gateway Rehabilitation Center, signed a standing order allowing pharmacists to obtain naloxone prescriptions for patients, without requiring them to first see a doctor. The apothecary's pharmacists conduct an assessment before requesting prescription authorization from Dr. Capretto. Pharmacists discuss three naloxone options with patients to determine which they would be most comfortable using. The pharmacists also provide patients with education and printed materials for administering the medication and responding to an overdose.

Read more:
http://www.timesonline.com/healthandwellness/new-brighton-pharmacy-one-of-the-first-to-offer-standing/article_513d420c-c720-11e4-a87d-af3f0330935d.html/?REFER-MI=Home-lead

Life-Saving Drug That Fights Heroin Overdoses Available, but Not Leaving Shelves
Melissa Anardo, Fox 43
March 6, 2015

Naloxone is now available to consumers at Pennsylvania pharmacies, but people in York County are not buying it. The Medicine Shoppe has not received any requests to fill the prescription. Some folks may not know it is available, while stigma plays a role for others. (Includes video: 1:43 minutes)

Read more:
http://fox43.com/2015/03/06/progress-slow-with-life-saving-drug-that-fights-heroin-overdoses

South News

Federal Court Sides with Insurer in 'Pill Mill' Lawsuit
Jessica M. Karmasek, The West Virginia Record
March 12, 2015

Former W.Va. Atty. Gen. Darrell McGraw filed two lawsuits in Boone County Circuit Court in January 2012 against 14 out-of-state drug distributors for "their roles in creating and profiting" from a "prescription drug epidemic." McGraw argued the distributors are a "major scourge" in West Virginia, costing the state $430 million to $695 million annually, and burdening its hospitals, courts, and law enforcement. Gemini Insurance Company argued it has no duty to defend and indemnify its client. It filed a motion for summary judgment in the U.S. District Court for the Southern District of Florida. The federal court granted Gemini's motion, ruling coverage was not implicated because the attorney general's lawsuit was for economic damages, not "bodily injury."

Read more:
http://wvrecord.com/news/273052-federal-court-sides-with-insurer-in-pill-mill-lawsuit

Midwest News

State House OKs Drug Monitoring Program
Southeast Missourian
March 6, 2015

The Missouri House of Representatives approved House Bill 130, which would implement a prescription drug monitoring program. The bill has moved to the Senate.

Read more:
http://www.semissourian.com/story/2172824.html

Proposal Could Put Overdose-Reversal Drug in Schools
Erin Hegarty, Daily Herald
March 10, 2015

Illinois lawmakers approved legislation that would allow school nurses to administer Narcan®.

Read more:
https://www.dailyherald.com/article/20150310/news/150319846

Powerful Pills from Local Wisconsin VA Showing Up on the Street, Police Say
Mike Tobin, Fox News
March 10, 2015

Mark Nicholson, police chief in Tomah, Wis., said overprescribed pills from Tomah Veterans Affairs are ending up on the streets. Sometimes, people tell police where they got the pills. Officers often see drugs in VA pill bottles. (Includes video: 1:35 minutes)

Read more:
http://www.foxnews.com/politics/2015/03/10/powerful-pills-from-local-wisconsin-va-showing-up-on-street-police-say

Scott County Health Officials Say 42 People Have Tested Positive for HIV
Danielle Lama, WDRB
March 9, 2015

Health officials linked the majority of 42 new cases of HIV in Scott County, Ind., to people sharing needles while abusing Opana. The county typically sees fewer than five new cases of HIV per year. (Includes videos: 2:17 minutes; 45 seconds)

Read more:
http://www.wdrb.com/story/28323923/scott-county-health-officials-say-42-people-have-tested-positive-for-hiv

Community Battles Alarming Jump in Heroin Overdoses
Liz Gelardi, Fox59
March 9, 2015

The Tippecanoe, Ind., County Coroner reported seeing seven overdoses—five of them fatal—in 1 week. Police officers said people are mixing heroin with drugs like Xanax. Drug Enforcement Administration seizures of heroin are up 600 percent in the state. (Includes video: 2:32 minutes)

Read more:
http://fox59.com/2015/03/09/community-battles-alarming-jump-in-heroin-overdoses

OHA Partners with OSMA for New Smart Rx Initiative to Reduce Drug Abuse in Ohio
Ohio Hospital Association
March 11, 2015

The Ohio Hospital Association and Ohio State Medical Association launched Smart Rx—Smart Medicine and Responsible Treatment. Smart Rx is a statewide training tool designed to help healthcare professionals combat prescription drug abuse and stay current on legislation, regulations, and requirements.

Read more:
http://ohiohospitals.org/News-Resources/Newsletters/Health-e-News/OHA-Partners-with-OSMA-for-New-Smart-Rx-Initiative.aspx

West News

Wyoming Students Report Drop in Drinking and Smoking, but Marijuana Use Stays Flat
Daily Journal
March 11, 2015

In the 2014 Prevention Needs Assessment student survey, Wyoming middle schoolers reported a 1 percent prescription drug misuse rate, while high schoolers reported a 3 percent rate.

Read more:
http://www.dailyjournal.net/view/story/7d20b855797c439580ed13
63893a6cb1/WY--Youth-Health


Drug Deaths Decline in Larimer County
Jason Pohl, The Coloradoan
March 10, 2015

In 2014, accidental drug-related deaths in Larimer County, Colo., dropped to their lowest number in years. Prescription pain relievers were a factor in 15 of the county's 32 accidental overdose deaths last year.

Read more:
http://www.coloradoan.com/story/news/2015/03/09/drug-deaths-decline-larimer-county/24675905

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 2: April 1, 2015, 2 p.m. (ET)
Register: https://attendee.gotowebinar.com/register/2290976876822526721

Grant Announcements

Prescription Drug Overdose Prevention for States
Centers for Disease Control and Prevention
Deadline: May 8, 2015

This funding provides state health departments the guidance and resources they need to address the problematic opioid prescribing behind prescription drug overdoses. States that receive funding should address prescribing on multiple fronts. They must expand and enhance their state prescription drug monitoring program and implement health insurer or health system interventions. States may also conduct policy evaluations or implement other prescribing innovations. These activities will impact patient and provider behaviors driving the epidemic, and ultimately improve associated health outcomes.

Read more:
http://www.grants.gov/web/grants/search-grants.html

RFP—Prescription Monitoring Program
State of South Carolina
Bid date and time: April 9, 2015, 2:30 p.m.

The South Carolina Department of Health and Environmental Control is soliciting proposals for an Electronic Data Collection of Controlled Substances Prescription Information System. The desired outcome is to provide a central repository for all Schedule II–IV controlled substance prescriptions dispensed in the state. Those authorized may request information from this repository to assist in identifying and deterring drug diversion.

Read more:
http://www.southcarolinabids.com/bid-opportunities/2015/03/12/6182916-RFP--Prescription-Monitoring-Program.html

Drug-Free Communities Mentoring Program
Substance Abuse and Mental Health Services Administration
Deadline: April 14, 2015
http://www.samhsa.gov/grants/grant-announcements/sp-15-002

Translational Avant-Garde Award for Development of Medication to Treat Substance Use Disorders
National Institutes of Health
Deadline: April 15, 2015
http://grants.nih.gov/grants/guide/rfa-files/RFA-DA-15-017.html

Take-Back Events and Drop Boxes

Prescription-Drug Collection Day Set
Arkansas Democrat Gazette
March 6, 2015
http://m.arkansasonline.com/news/2015/mar/06/prescription-drug-collection-day-set/?latest

Eustace Commends Hasbrouck Heights for Joining 'Project Medicine Drop' to Help Combat Opiate Abuse
The Bergen Dispatch (New Jersey)
March 10, 2015
http://www.bergendispatch.com/articles/35807747/Eustace-Commends-Hasbrouck-Heights-for-Joining-Project-Medicine-Drop-to-Help-Combat-Opiate-Abuse.aspx

Evesham Police Set Up Drug Drop Off Box for Residents
South Jersey Local News (New Jersey)
March 6, 2015
http://www.southjerseylocalnews.com/articles/2015/03/06/news/
doc54f9f8e0d00aa839316681.txt


Program Leads to Permanent Prescription Drug Drop-Off Sites
Alisha Roemeling, Statesman Journal (Oregon)
March 13, 2015
http://www.statesmanjournal.com/story/news/2015/03/12/program-leads-permanent-prescription-drug-drop-sites/70227512

OTC Med Drop Off Established
International Falls Journal (Minnesota)
March 10, 2015
http://www.ifallsjournal.com/news/public_safety/otc-med-drop-off-established/
article_b246401c-51c2-5ed1-abee-383d85eb6392.html


S.F. Supes Weigh Expanding Safe Drug Disposal
Emily Green, San Francisco Chronicle (California)
March 9, 2015
http://www.sfgate.com/bayarea/article/S-F-supes-weigh-expanding-safe-drug-disposal-6124224.php

Cadott, Stanley Police Team with Shopko for National Drug Take-Back Initiative
Emily Van Ort, WQOW (Wisconsin)
March 6, 2015
http://www.wqow.com/story/28280992/2015/03/06/cadott-stanley-police-team-with-shopko-for-national-drug-take-back-initiative

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.
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness

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
http://www.aatod.org/national-conference/2015-aatod-conference-atlanta

Marijuana Advocacy and Policy Summit
Drug Free Action Alliance
March 31, April 1–2, 2015
Columbus, Ohio
https://www.drugfreeactionalliance.org/maps
https://www.drugfreeactionalliance.org/calendar/event/144

National Rx Drug Abuse Summit
April 6–9, 2015
Atlanta, Georgia
http://nationalrxdrugabusesummit.org

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
http://www.winursing.org/?query=2015+WIN+Conference
https://win.confex.com/win/2015/webprogram/ataglance.html

Training: Engaging Youth in Rx Drug Abuse Prevention
Health Resources in Action (HRiA) and Blake Works
May 7–8, 2015
Health Resources in Action
95 Berkeley Street
Boston, Massachusetts

Participants will learn to communicate more effectively with youth about prescription drug abuse. Proven strategies for engaging young people in substance abuse prevention activities, coalitions, and policy change will be presented. Attendees will also learn best practices for using the DVD Drugs: True Stories, which is included in SAMHSA's National Registry of Evidence-Based Programs and Practices.

Read more:
http://captus.samhsa.gov/news-and-events/engaging-youth-rx-drug-abuse-prevention

Register:
http://events.r20.constantcontact.com/register/event?oeidk=a07eai0x62oca5f692b&llr=jcwvq5cab

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

University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
November 9, 2015
Ann Arbor, Michigan
http://injurycenter.umich.edu/events/university-michigan-injury-center-prescription-drug-overdose-summit/mon-2015-11-09-0830
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.