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March 20, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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March 20, 2013 (PDF version)
Featured Articles

A.V. Williams, J. Strang, and J. Marsden. 2013. "Development of Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales for Take-Home Naloxone Training Evaluation." Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.02.007.
Researchers developed an Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS) to evaluate take-home naloxone training. Forty-five items were selected for the OOKS and organized into four sub-scales (risks, signs, actions, and naloxone use). The OOAS was initially formed of 32 items grouped in three sub-scales (competence, concerns, and readiness). Both scales were administered to 42 friends and family members of heroin users and 56 healthcare professionals in England to assess internal reliability and construct validity. The Brief Overdose Recognition and Response Assessment (BORRA) and General Self-Efficacy Scale (GSE) were also administered to family members to test concurrent validity. Family members completed the OOKS and OOAS on a second occasion to assess test-retest reliability. The OOKS and OOAS were deemed internally reliable. Retest was completed by 33 participants after 14 days with sub-scale item sets from each measure falling within the fair-to-excellent range. Professionals reported significantly higher scores on both scales than family members. The OOKS total score was positively correlated with BORRA's Overdose Recognition and Naloxone Indication sub-scales, but the total OOAS score was not associated with the GSE. The authors concluded that the 45-item OOKS and 28-item OOAS are suitable as outcome measures of take-home naloxone training for friends and family members of opioid users.

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AF Expands Drug Testing to Include Abused Prescription Drugs
United States Air Force
March 6, 2013

On May 1, 2013, U.S. military services will start testing for commonly abused prescription drugs. The Secretary of Defense encouraged people who are abusing prescription medications to seek treatment before official testing begins. Procedures that will directly affect drug testing collection sites and military members selected for testing have not changed.

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Journal Articles

K.P. Conway, G.C. Vullo, B. Nichter, J. Wang, W.M. Compton, R.J. Iannotti, and B. Simons-Morton. 2013. "Prevalence and Patterns of Polysubstance Use in a Nationally Representative Sample of 10th Graders in the United States." Journal of Adolescent Health. doi:10.1016/j.jadohealth.2012.12.006.
Researchers examined the prevalence and demographic correlates of self-reported substance use, and identified subgroups of polysubstance users among a nationally representative cohort of U.S. 10th grade students who completed the NEXT Generation Health Study baseline survey in spring 2010 (N = 2,524). Latent Class Analysis (LCA) was used to identify different "classes" (or groups) defined by their substance use patterns. The findings indicated high rates of substance and polysubstance use. Past-year use of marijuana was most common among illicit drugs (26 percent), followed by medication misuse (9 percent) and use of other illicit drugs (8 percent). Results from the LCA of substance use patterns classified youths into 4 groups: 1) 59 percent nonusers, 2) 23 percent predominant alcohol users, 3) 11 percent predominant marijuana users, and 4) 8 percent predominantly polysubstance users. Somatic and depressive symptoms varied significantly by group, with only predominantly polysubstance users reporting elevated levels of somatic and depressive symptoms.

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W.D. Graf, S.K. Nagel, L.G. Epstein, G. Miller, R. Nass, and D. Larriviere. 2013. "Pediatric Neuroenhancement: Ethical, Legal, Social, and Neurodevelopmental Implications." Neurology. doi:10.1212/WNL.0b013e318289703b.
This Ethics, Law, and Humanities Committee position paper focuses on implications of pediatric neuroenhancement (use of prescription medication to augment cognitive or affective function in healthy persons) and outlines discussion points in responding to neuroenhancement requests from parents or adolescents. Based on available data and the balance of ethics issues reviewed, neuroenhancement in legally and developmentally nonautonomous children and adolescents without a diagnosis of a neurologic disorder is not justifiable. In nearly autonomous adolescents, the fiduciary obligation of the physician may be weaker, but social, developmental, and professional integrity issues make prescription of neuroenhancements inadvisable.

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News and Reports
Doctor Wants Traditional Healing on First Nations Reserves
CBC News
March 14, 2013

A Manitoba doctor would like to see more traditional aboriginal healing centers to help treat pain instead of dispensing prescription drugs. She sees too many people on the northern Manitoba reserves addicted to prescription drugs. The doctor expressed her concern at a Retrieving the Spirit Conference focused on finding ways to deal with rampant prescription drug addiction on reserves.
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Doctor Wins Award for Program to Reduce Prescription Drug Abuse
Radio Iowa
March 12, 2013
Iowa's Drug Policy Coordinator recognized Dr. Gary Hemann with a special state award for developing a program to review emergency department pain medication prescriptions. Dr. Hemann plans to standardize prescribing of pain medications in emergency settings throughout the state.

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Misuse of Prescription Meds While Pregnant on the Rise
The Star Press
March 8, 2013

This article discusses misuse and abuse of prescription drugs among pregnant women in East Central Indiana. On April 6, Prevent Child Abuse of Delaware County will host a conference to seek a better understanding of the problem and potential solutions. Furthermore, it will discuss the impact of prescription misuse on the fetus during pregnancy, and requirements for recovery.

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Parents of Prescription Overdose Victims Plead With Legislators
Los Angeles Times
March 11, 2013

After hearing testimony from parents whose children died of drug overdoses, lawmakers called for the Medical Board of California to use a statewide prescription monitoring database (CURES) to help identify doctors who recklessly prescribe narcotics. Currently, the board launches investigations only in response to complaints. Some legislators feel it should use CURES to actively look for patterns of excessive prescribing. The Times reported that 71 physicians prescribed drugs to three or more patients who later fatally overdosed--several doctors had a dozen or more patients who died. In most cases, the board was unaware of the deaths.
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San Diego Emergency Departments to Crack Down on Painkiller Abuse
March 5, 2013

This article, audio (4:48 minutes), and video (5:31 minutes) discuss the addiction of a man who obtained most of his OxyContin, Xanax, and Adderall from hospital emergency rooms. Similar cases have caused local hospitals to reevaluate their roles in dispensing medications. They have set new guidelines for emergency department doctors that include directing patients with chronic pain to their primary care doctors. All hospitals in San Diego and Imperial County agreed to the guidelines, which will take effect this spring.

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Prescription Drug Abuse a Prevalent Issue in Baton Rouge
The Daily Reveille
March 11, 2013

Prescription drugs are to blame for the majority of the 27 overdose deaths in East Baton Rouge Parish, according to data from the coroner's office. This article includes national trends in prescription drug abuse, the source of the drugs, and suggested solutions to the problem.

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The All-Nighter Pill
The Guardian
March 11, 2013

Use of Adderall as an academic enhancement is growing among college students. This article highlights the need for stronger preventive measures from universities.

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Painkiller Abuse Hits New States
The Wall Street Journal
March 10, 2013

Prescription pain reliever abuse is a fairly new issue in the Western United States. These states are still diagnosing the problem and developing policies and regulations to combat abuse. Oregon, Colorado, Washington, and Idaho have the nation's highest rates of prescription drug abuse, according to a 2010-11 annual survey from the Substance Abuse and Mental Health Services Administration. The survey shows 6.5 percent of Oregon residents age 12 and older abuse opioid pain relievers, compared with 4.5 percent of residents in Kentucky--once one of the leading states for abuse. Overdose deaths from pain relievers rose 172 percent, from 218 in 2004 to 378 in 2011. Despite the increase of Colorado's prescription drug hospital admissions to 7 percent of all admissions in 2012 (nearly three times the 2004 rate), the state is still focusing on tackling methamphetamine issues. In Washington, pain reliever overdose deaths peaked at 512 in 2008, but dropped 23 percent to 407 in 2011.

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Poisoning From Prescription Drug Abuse is 100% Preventable
Nebraska TV
March 11, 2013

The Nebraska Regional Poison Center offers tips on preventing medication poisoning.
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State Monitors for Prescription Addiction
The News-Gazette
March 10, 2013

The clinical director for the Illinois Prescription Monitoring Program discusses the program's progress. When the state discovers someone is visiting multiple prescribers and providers within a 30-day period, it alerts prescribers, who in turn can determine if that person is getting medication legitimately or just "doctor shopping." In 2000, Illinois tracked more than 800,000 controlled substance prescriptions. Currently, it tracks about 19 million prescriptions. However, this figure only represents information from about 30 percent of people who could use the system. Since January 1, 2008, the number of citizens who documented multiple prescribers and dispensers in the same 30-day period has fallen by 66.7 percent. The monitoring program is also available to law enforcement.

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Prescription Drug Abuse Fast Growing Problem in Oklahoma
Oklahoma State Department of Health
March 13, 2013

Of nearly 3,200 unintentional poisoning deaths in Oklahoma from 2007 through 2011, 81 percent involved at least one prescription drug. In 2010, Oklahoma had the fourth-highest unintentional poisoning death rate in the nation (17.9 deaths per 100,000 population). More overdose deaths involved hydrocodone than methamphetamines, heroin, and cocaine combined. The press release offers suggestions for preventing prescription drug overdoses and protecting children.

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Workers' Comp Figures Prominently in National Rx Drug Abuse Summit
March 11, 2013

This article briefly discusses the Third-Party Payer track at the National Rx Drug Summit in April. The track will focus on early identification of potential opioid misuse in an injured worker's treatment.
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Ala. AG Pushes to Make Generic Drugs More Difficult to Abuse
March 11, 2013

Attorneys General in Alabama and North Carolina co-sponsored a letter sent to the U.S. Food and Drug Administration (FDA) to make generic pain medicines more resistant to abuse. The letter was co-signed by 46 other Attorneys General. It urged the FDA to adopt standards requiring manufacturers and marketers of generic prescription pain relievers to develop tamper- and abuse-resistant versions of their products. The signers believe the addition of physical and chemical features to prescription opioids could reduce their misuse.

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Other Resources
NABP PMP InterConnect Fact Sheet
National Association of Boards of Pharmacy
Accessed March 15, 2013

The National Association of Boards of Pharmacy (NABP) Prescription Monitoring Program (PMP) InterConnect facilitates the transfer of PMP data across state lines to authorized users. It allows participating state PMPs throughout the United States to be linked, providing a more effective means of combating drug diversion and drug abuse nationwide. NABP InterConnect is fully operational in Arizona, Connecticut, Indiana, Kansas, Kentucky, Michigan, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, and Virginia.

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Grant Announcement
Harold Rogers Prescription Drug Monitoring Program FY 2013 Competitive Grant Announcement
Deadline: May 2, 2013

The Harold Rogers Prescription Drug Monitoring Program (HRPDMP) allows for states' discretion as they plan, implement, or enhance a PDMP. The program aims to expand 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 central, state agency-administered database.

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Upcoming Conferences and Workshops

National Rx Drug Abuse Summit
April 2-4, 2013
Omni Orlando Resort
1500 Masters Blvd
ChampionsGate, Florida
Maryland Workers' Comp Prescription Drug Abuse Summit
April 12, 2013
8:30 a.m.-1 p.m.
BWI Marriott
1743 Nursery Rd
Linthicum, Maryland
2013 Symposium for Medical Professionals: Kentucky Medical Communities UNITEd
April 13-June 8, 2013
Various Cities, Kentucky
Drug Enforcement Administration's Sixth National Prescription Drug Take-Back Day
April 27, 2013
10 a.m.-2 p.m.
Various Locations Nationwide
National Prevention Week 2013
May 12-18, 2013
Various Locations Nationwide
The Generation Rx University Conference for Prescription Drug Abuse Prevention & Recovery
August 7-8, 2013
The Ohio State University Blackwell Inn & Conference Center
2110 Tuttle Park Place
Columbus, Ohio
Please e-mail Rekaya Gibson at rgibson@pire.org with questions or comments about the SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv.  
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.

The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full-text journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.