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March 26, 2015

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
Issue 115  |  March 26, 2015
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports Professional Education Medical Marijuana National News Northeast/Mid-Atlantic News South News Midwest News West News Other Resources Upcoming Webinars Grant Announcements Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured

Drug Guide for Parents
Partnership for Drug-Free Kids
Accessed March 20, 2015

The Drug Guide for Parents is now available as a mobile app for Android and iPhones. This guide provides information on drugs most commonly abused by teens and includes photos, slang terms, and short- and long-term effects. It features quick links to connect to a parent support specialist through the Helpline, and other valuable resources to prevent teen drug and alcohol abuse.

Read more:
http://www.drugfree.org/drug-guide/mobile-app

T. Miller, S.P. Novak, D.M. Galvin, R.S. Spicer, L. Cluff, and S. Kasat. 2015. "School and Work Status, Drug-Free Workplace Protections, and Prescription Drug Misuse Among Americans Ages 15–25." Journal of Studies on Alcohol and Drugs 76(2):195–203.

Multivariate analysis of 2004–08 National Surveys on Drug Use and Health data showed students ages 15–25 were less likely than nonstudents to misuse prescription drugs. Segmenting student from nonstudent groups, working consistently was associated with a further reduction in misuse for those ages 18–25. At 18 and over, the misuse pattern varies by type of drug, with nonworking students less likely than working nonstudents to misuse pain relievers, but more likely to misuse prescription stimulants. Controlling for demographics and substance use history, both Employee Assistance Program services and awareness that one's employer had a drug-free workplace policy were associated with significantly lower misuse of prescription drugs (odds ratio = 0.85 for each program). This effect was due to differences in stimulant and sedative misuse, but not prescription opioid misuse. Drug testing programs and employer-provided substance abuse educational materials, however, were not associated with prescription misuse. Associations of workplace antidrug policies and programs with marijuana use and alcohol abuse and dependence contrasted sharply with these patterns. All four aspects were significantly associated with lower marijuana use. None was associated with problem drinking.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/25785794

DEA Issues Nationwide Alert on Fentanyl as Threat to Health and Public Safety
United States Drug Enforcement Administration
March 18, 2015

The Drug Enforcement Administration (DEA) issued a nationwide alert about the dangers of fentanyl and fentanyl analogues/compounds, warning that fentanyl can be absorbed through the skin and airborne powder can be accidentally inhaled. The DEA expressed concern about law enforcement coming in contact with fentanyl on the streets.

Read more:
http://www.dea.gov/divisions/hq/2015/hq031815.shtml

Journal Articles and Reports

L. Ashrafioun, A.S.B. Bohnert, M. Jannausch, and M.A. Ilgen. 2015. "Evaluation of the Current Opioid Misuse Measure Among Substance Use Disorder Treatment Patients." Journal of Substance Abuse Treatment, doi:10.1016/j.jsat.2015.02.007.

To test the 11-item Current Opioid Misuse Measure (COMM), 351 clients of a substance use disorder treatment center were surveyed. Factor analyses on the responses yielded a two-factor solution, but each item in the second factor cross-loaded onto the first factor, so COMM was scored on just one dimension. The weighted COMM scores consider drug use severity; endorsement of positive, negative, and pain relief outcome expectancies related to opioid use; pain intensity; and effect on physical and mental health functioning. Although they did not validate COMM results against drug tests, the authors assert that COMM can be used to examine nonmedical use of prescription opioids over the course of treatment, to aid treatment planning, and in research as an outcome measure.

Read more:
http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(15)00060-4/abstract

S. Bahlani, S. Mehta, A. King, and R. Moldwin. 2015. "I-STOP/PMP: A Tool for Monitoring Prescription Drug Abuse in Patients with Chronic Pain Syndromes." Journal of Clinical Urology, doi:10.1177/2051415815575219.

During the 6-month period after 397 urological pelvic pain patients were treated at a large New York hospital, 14 patients (3.5 percent) were prescribed duplicate medications by more than one practitioner. Prescription drug monitoring program data showed the duplicate prescriptions were for benzodiazepines (4 patients) or opioids (10 patients).

Read more:
http://uro.sagepub.com/content/early/2015/03/08/2051415815575219.abstract

Brandeis University, Prescription Drug Monitoring Program Training and Technical Center of Excellence. 2015. Use of PDMP Data by Opioid Addiction Treatment Programs.

This report describes how several treatment programs that dispense methadone and buprenorphine use prescription drug monitoring program (PDMP) data to help ensure patients receive only medically indicated controlled substances. It also discusses perceptions of treatment program medical directors on PDMP usability and the pros and cons of nondisclosure of treatment-dispensed methadone to PDMPs.

Read more:
http://www.pdmpexcellence.org/sites/all/pdfs/Use%20of%20
PDMP%20data%20by%20opioid%20treatment%20programs.pdf

http://www.pdmpassist.org/content/reports-pdmp-center-excellence

Brandeis University, Prescription Drug Monitoring Program Training and Technical Center of Excellence. 2015. Electronic Alerts for Prescribers: Massachusetts Prescription Monitoring Program Experience.

This report describes Massachusetts's recently initiated prescription drug monitoring program (PDMP) electronic alert system. Prescribers are notified via email about patients who meet a threshold for multiple provider episodes—an indicator of risk for drug addiction, misuse, and abuse. Instead of patient identification, the emails provide a link to the password-protected PDMP database, where providers can look up a patient's prescription history. Electronic alerts have efficiently notified thousands of prescribers about at-risk patients. Responses to an online survey indicated prescribers find the alerts useful in clinical practice.

Read more:
http://www.pdmpexcellence.org/sites/all/pdfs/MA%20PMP%20electronic%20alert%20NFF.pdf
http://www.pdmpassist.org/content/reports-pdmp-center-excellence

L. Degenhardt, R. Bruno, R. Ali, N. Lintzeris, M. Farrell, and B. Larance. 2015. "The Introduction of a Potentially Abuse Deterrent Oxycodone Formulation: Early Findings from the Australian National Opioid Medications Abuse Deterrence (NOMAD) Study." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.02.038.

This study tracked 606 Australians known to be tampering with pharmaceutical opioids before the April 2014 switch to an abuse-deterrent sustained-release oxycodone formulation. The sample used the Sydney Medically Supervised Injecting Centre or inner-Sydney needle-syringe programs. Injecting Centre visits for OxyContin fell from 62 percent of monthly visits pre-introduction to 5 percent of visits in August 2014. Tests on exchanged needles also showed Reformulated OxyContin® was among the least commonly used and injected drugs. Reformulated OxyContin was cheaper than original OxyContin.

Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(15)00142-8/abstract

S.A. Fleming, S. Vermillion, R. Bailey–Galvis, M. Bodeau, D.K. Fowler, K. Hamer, S.A. Moessbauer, C. Peterson, and M.C. Staunton. 2015. Drug-Impaired Driving: Additional Support Needed for Public Awareness Initiatives. Washington, D.C.: United States Government Accountability Office.

State- and national-level data provide limited information on the extent of drugged and drug-impaired driving in the United States. The lack of a clear link between impairment and drug concentrations in the body makes it difficult to define drug impairment, and the large number of available drugs makes it hard to define and identify impairment. Consequently, the National Highway Traffic Safety Administration's (NHTSA's) 2013–14 National Roadside Survey of Alcohol and Drug Use by Drivers documents when drivers had drugs in their system, but not whether the drugs impaired the drivers. Arrest data on drug involvement and driver drug-testing results are similarly limited. This makes public awareness a challenge. Federal and state agencies are taking actions to address drug-impaired driving, including improvements in research and data, education for police officers, evidence gathering, and legal changes. NHTSA plans to improve public awareness through surveys on drug-impaired driving behaviors and attitudes and training for medical professionals. Other efforts to improve public awareness include general messaging that reminds the public about the impairing effects of drugs. The Government Accountability Office recommends NHTSA take additional actions to support states in advertising the dangers of drug-impaired driving.

Read more:
http://www.gao.gov/products/GAO-15-293

Download the full report:
http://www.gao.gov/assets/670/668622.pdf

Y–I. Hser, E. Evans, C. Grella, W. Ling, and D. Anglin. 2015. "Long-Term Course of Opioid Addiction." Harvard Review of Psychiatry 23(2):76–89, doi:10.1097/HRP.0000000000000052.

Researchers reviewed the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment)—many of whom have been referred by the criminal justice system. Cumulative evidence indicates opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than the rate of the general population. Among those who survive, the prevalence of stable abstinence from opioid use is low (less than 30 percent after 10–30 years of observation), and many continue to use alcohol and other drugs after ceasing opioid use. Histories of sexual or physical abuse and comorbid mental disorders are associated with opioid use persistence, whereas family and social support and employment facilitate recovery. Maintaining opioid abstinence for at least 5 years substantially increases the likelihood of future stable abstinence.

Read more:
http://journals.lww.com/hrpjournal/Abstract/2015/03000/Long_
Term_Course_of_Opioid_Addiction.3.aspx


K.L. Kirsh, H.A. Heit, A. Huskey, J. Strickland, K. Egan, and S.D. Passik. 2015. "Trends in Drug Use from Urine Drug Testing of Addiction Treatment Clients." Journal of Opioid Management 11(1):61–68, doi:10.5055/jom.2015.0253.

This study analyzes a sample of 4,299 drug tests that a national laboratory testing company ran for addiction treatment and recovery programs. In total, 48.5 percent of test specimens were in full agreement with practice reports. The remaining samples fell into one of seven categories of unexpected results—the most frequent being detection of an additional unreported prescription medication (n = 1,097).

Read more:
http://pnpcsw.pnpco.com/cadmus/testvol.asp?journal=jom&year=2015
http://www.prnewswire.com/news-releases/millennium-research-institute-urine-drug-testing-study-published-in-journal-of-opioid-management-300053322.html

Y. Kubota, K. Hasegawa, H. Taguchi, T. Kitamura, C. Nishiyama, T. Iwami, T. Nishiuchi, and A. Hiraide. 2015. "Characteristics and Trends of Emergency Patients with Drug Overdose in Osaka." Acute Medicine and Surgery, doi:10.1002/ams2.107.

Data collected by emergency medical service crews in Osaka City, Japan, indicated that annual drug overdose cases increased from 1,136 in 1998 to 1,822 in 2010. Most patients were between 16 and 40 years old. Females made up 70 percent of overdose cases. The time from emergency call to hospital arrival for overdose patients increased markedly—in part because it took longer to get hospitals' agreement to care for suspected overdose patients.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/ams2.107/abstract

Y. Liang and B.J. Turner. 2015. "National Cohort Study of Opioid Analgesic Dose and Risk of Future Hospitalization." Journal of Hospital Medicine, doi:10.1002/jhm.2350.

Without controlling for health status, this study analyzed data on 87,688 U.S. health maintenance organization enrollees with noncancer pain aged 45 to 64 who filled two or more opioid analgesic prescriptions from January 2009 to July 2012. Over 3 years, an annual average of 12 percent of subjects were hospitalized for a mean 6.5 days. Predictably, adjusted odds of future hospitalization for high total opioid dose (> 1,830 mg) were 35 percent to 44 percent greater than the odds for (presumably healthier) enrollees with no opioid analgesic prescriptions or those prescribed smaller doses. Among the high-dose group, odds of hospitalization were 41 percent to 51 percent greater during 6-month periods when subjects were prescribed high doses for more than 3 months. Similar effects were observed for hospital days.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/jhm.2350/abstract

S.R. Mueller, A.Y. Walley, S.L. Calcaterra, J.M. Glanz, and I.A. Binswanger. 2015. "A Review of Opioid Overdose Prevention and Naloxone Prescribing: Implications for Translating Community Programming into Clinical Practice." Substance Abuse, doi:10.1080/08897077.2015.1010032.

A literature search identified 41 articles on evaluations of overdose education and naloxone distribution (OEND) programs, effects of OEND programs on experiences and attitudes of participants, willingness of medical providers to prescribe naloxone, comparisons of different routes of naloxone administration, and naloxone's cost-effectiveness. Studies show those at risk for overdose and bystanders are willing and able to be trained to prevent overdoses and administer naloxone. Counseling patients about overdose risk and prescribing naloxone is an emerging clinical practice that may reduce overdose deaths when prescribing opioids.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/08897077.2015.1010032#.VQxv2WnwvoY

J.W. Price. 2015. "A Comparison of Random and Post-Accident Urine Opiate and Opioid Tests." Journal of Addictive Diseases, doi:10.1080/10550887.2014.975614.

This study (Editor's note: that suffers from two well-documented and serious selection bias problems) explored the correlation between opiate/opioid use and work-related accidents by comparing the proportion of opiate/opioid laboratory positive urine drug test specimens for post-accident versus random samples. Predictably given the selection biases, the post-accident group was more likely to be using opioids.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/10550887.2014.975614#.VQxvtmnwvoY

W. Winegarden. 2015. "Issue Brief: Estimating the Net Economic Benefit of Abuse-Deterrent Opioids." EconoSTATS, George Mason University.

This issue brief, which has not been peer reviewed, estimates the net annual economic benefit of switching patients to more expensive abuse-deterrent opioid formulations is $1,757 to $4,033 per patient. The numbers rely on published estimates of the gains—in particular, estimates by Rossiter et al. (Journal of Medical Economics, 2014) that healthcare costs among patients who shifted to deterrent formulations fell 22.7 percent for commercially insured patients and 18.0 percent for Medicaid/uninsured patients. (Editor's note: This analysis almost certainly underestimates the savings. It assumes all opiates will switch to deterrent formulations. In reality, many opioid prescriptions are for low-dosage opiates that are not available with abuse deterrents and not typically prescribed in ways that require them. So it substantially overestimates costs.)

Read more:
http://econostats.org/estimating-the-net-economic-benefit-of-abuse-deterrent-opioids

Professional Education

E.E. Krans, G. Cochran, and D.L. Gerald. 2015. "Caring for Opioid-Dependent Pregnant Women: Prenatal and Postpartum Care Considerations." Clinical Obstetrics and Gynecology, doi:10.1097/GRF.0000000000000098.

Pregnancy is an opportune time to identify opioid dependence, facilitate conversion to opioid maintenance treatment, and coordinate care with specialists in addiction medicine, behavioral health, and social services. Comprehensive prenatal care for opioid-dependent women involves evaluation and management of co-occurring psychiatric disorders, polysubstance use, infectious diseases, and social stressors, as well as counseling for breastfeeding (once opioid free), contraception, and neonatal abstinence syndrome. Although complex psychiatric, social, and environmental factors faced by this population pose significant challenges to obstetric care providers, development of strong patient–provider relationships can facilitate the ability to deliver efficient and effective health care during pregnancy.

Read more:
http://journals.lww.com/clinicalobgyn/Abstract/publishahead/Caring_for_
Opioid_dependent_Pregnant_Women__.99842.aspx

MEDICAL MARIJUANA

Texas Lawmakers Introduce Medical Marijuana Legislation
KVUE
March 13, 2015

Texas lawmakers introduced House Bill 3785, along with a senate companion bill, which would create a program allowing people with qualifying medical conditions to receive licenses for limited amounts of medical marijuana (if their doctors recommend it). The bill would also direct the Texas Department of State Health Services to establish a tightly regulated system of licensed marijuana cultivators, processors, and dispensaries.

Read more:
http://www.kvue.com/story/news/state/2015/03/13/texas-lawmakers-introduce-medical-marijuana-legislation/70279576

Nevada Bill Would Let Pets Use Pot; Proposal Calls for Medical Marijuana Cards for Animals
Michelle Rindels, Associated Press
March 17, 2015

The Nevada legislature is considering a bill that would allow animal owners to provide marijuana for their pets, with veterinarian certification that the animal's illness could be alleviated by the drug. The pot-for-pets provision is part of a larger bill that would overhaul the state's medical marijuana law, removing penalties for drivers who have marijuana in their blood and requiring training for pot shop owners.

Read more:
http://www.usnews.com/news/offbeat/articles/2015/03/17/nevada-bill-would-allow-sick-pets-to-use-medical-marijuana

Parents Tell Legislature: Allow Children to Use Medical Marijuana
Daniela Altimari, Hartford Courant
March 13, 2015

The Connecticut Judiciary Committee is considering legislation that would allow children to participate in the state's medical marijuana program. Parents testified before the committee, urging members to approve Senate Bill 1064. The bill would also allow the state's Department of Consumer Protection to approve marijuana research programs and provide immunity from prosecution for those conducting the research, extend immunity (both criminal and civil) to nurses who administer medical marijuana, make it easier for patients in hospice or other inpatient care to obtain medical marijuana by allowing the product to be delivered directly, and simplify the laboratory testing dispensaries are required to run to ensure their product is pure.

Read more:
http://www.courant.com/health/hc-medical-marijuana-children-20150313-story.html

Three Maine Tribes Consider MJ Cultivation, Sales
Marijuana Business Daily
March 19, 2015

The Maliseet, Passamaquoddy, and Micmacs tribes are considering the economic benefits of growing and selling marijuana on their native lands. The Pinoleville Pomo Nation, a California tribe, plans to break ground on a 90,000-square-foot greenhouse that will employ as many as 100 people. Some say this will boost ancillary businesses, including software providers and testing labs.

Read more:
http://mmjbusinessdaily.com/three-maine-tribes-consider-mj-cultivation-sales

National

Congress Pressures FDA to Finalize Opioid Guidance
Kristina Fiore, MedPage Today
March 18, 2015

The "Cromnibus" appropriations bill that passed last December requires the Food and Drug Administration to publish its guidance on abuse-deterrent opioids by June 30, 2015, to avert an automatic $20 million cut in salaries and expenses authorized for the commissioner's office.

Read more:
http://www.medpagetoday.com/Psychiatry/Addictions/50541

McConnell Seeks Bipartisan Move on Infant Drug Addiction
James R. Carroll, The Courier Journal
March 19, 2015

Senate Majority Leader Mitch McConnell is spearheading bipartisan legislation that directs the Department of Health and Human Services to recommend steps for infant drug dependency prevention and treatment. The measure calls for identification of research and program gaps related to infant opioid dependency. Through this legislation, the Centers for Disease Control and Prevention would be encouraged to collaborate with states to conduct surveillance and collect data on infant opioid dependency. The Senate and House bills are supported by the American Academy of Pediatrics, American Congress of Obstetricians and Gynecologists, and the March of Dimes.

Read more:
http://www.courier-journal.com/story/politics-blog/2015/03/19/kentucky-sen-mitch-mcconnell-seeks-bipartisan-action-on-infant-drug-addiction-bill/25021807

Aging Baby Boomers Bring Drug Habits into Middle Age
Zusha Elinson, The Wall Street Journal
March 16, 2015

Older adults are abusing drugs, getting arrested for drug offenses, and dying from drug overdoses at increasingly higher rates. The Wall Street Journal interviewed dozens of older drug users and recovering addicts who had taken drugs their entire lives and never slowed down. Others had used drugs when they were younger, then returned to the habit later in life. Drug rehabilitation programs are now offering therapy sessions designed for older adults. These programs are eliminating bunk beds, hiring more experienced addiction counselors, and providing medical care on site. Aches and pains are being treated with acupuncture and nonaddictive pain relievers.

Read more:
http://www.wsj.com/articles/aging-baby-boomers-bring-drug-habits-into-middle-age-1426469057

Northeast/Mid-Atlantic News

Senate Passes Holzapfel Bill to Increase Monitoring of Frequently Abused Prescription Drugs
New Jersey Senator Jim Holzapfel
March 16, 2015

The New Jersey Senate approved legislation that would require a doctor prescribing Schedule II Controlled Dangerous Substances to access the prescription drug monitoring program (PDMP) and check the PDMP at least quarterly thereafter if a patient continues to receive prescriptions for the substances. The bill also requires pharmacists to access the PDMP before dispensing a Schedule II Controlled Dangerous Substance to check for signs of misuse, abuse, or diversion. Pharmacies would be required to submit weekly updates on prescription data to the PDMP.

Read more:
http://www.senatenj.com/index.php/holzapfel/senate-passes-holzapfel-bill-to-increase-monitoring-of-frequently-abused-prescription-drugs/21397

90 Percent of NJ Residents Want More Information from Their Doctors About Potential Addictive Qualities of the Medications They Are Being Prescribed
PRNewswire
March 17, 2015

A survey from PublicMind and the Partnership for a Drug-Free New Jersey shows 91 percent of New Jersey residents agree physicians should be legally required to discuss the risk of developing a physical or psychological dependency before prescribing pain medication to patients. Almost two thirds believe this discussion will help reduce the number of people who become addicted to pain treatments. Thirty percent say it will have no impact.

Read more:
http://www.prnewswire.com/news-releases/90-of-nj-residents-want-more-information-from-their-doctors-about-potential-addictive-qualities-of-the-medications-they-are-being-prescribed-300051624.html

Governor Delays Prescription Law Aimed at Preventing Drug Abuse
Erin Billups, Time Warner Cable News
March 17, 2015

Governor Andrew Cuomo delayed signing a bill that would require New York to use only electronic prescriptions. Doctors, hospitals, and nursing homes had 2 years to prepare, but their software vendors needed more time to build better programs and get clearance from the Drug Enforcement Administration (DEA). Providers' electronic systems also need to be cleared by the DEA to write prescriptions for controlled substances. The new law goes into effect March 27, 2016.

Read more:
http://www.ny1.com/nyc/all-boroughs/health-and-medicine/2015/03/17/governor-delays-prescription-law-aimed-at-preventing-drug-abuse.html

Breaking Good
Cara Tabachnick, The Washington Post Magazine
March 15, 2015

A court-ordered monthly shot of Vivitrol (long-acting naltrexone) is helping long-term prescription opioid addict Troy Garver stay out of jail and care for his children. Garver got hooked following an occupational injury in 2003. If he begins using drugs or alcohol or fails to attend at least two Alcoholics Anonymous meetings a week, he faces 10 years in prison. About 40 of the nation's 2,000 jails run Vivitrol programs. Cost is a major barrier to expansion, with prices running from $500 to $1,000 per shot. Medicaid covers the shots. Of 83 people in the Washington County (Md.) Health Department program, only two have used illegal drugs or alcohol while receiving Vivitrol.

Read more:
http://www.washingtonpost.com/lifestyle/magazine/his-last-shot-will-a-monthly-jab-of-a-new-drug-keep-this-addict-out-of-jail/2015/03/05/7f054354-7a4c-11e4-84d4-7c896b90abdc_story.html

51 More R.I. Overdose Deaths: This Isn't Stopping, Health Director Says
Lyn Arditi, Providence Journal
March 16, 2015

Thus far in 2015, Rhode Island health officials have reported 51 deaths from accidental drug overdoses. About 67 percent of the deaths from January 1 to March 6 involved illicit fentanyl, compared with 48 percent of deaths during the same period in 2014. Thirteen more died than previously reported in 2014, increasing the year's total to 238.

Read more:
http://www.providencejournal.com/article/20150316/NEWS/150319461

The York Dispatch Rolls Out New Heroin Series as Epidemic Hits Home
Mollie Durkin, The York Dispatch
March 15, 2015

The York Dispatch examined the effects of heroin-related deaths in York County, Pa. In this series, they explored legislative measures and reviewed the link between heroin and prescription opioids. Law enforcement and prosecutors will discuss their focus on heroin suppliers. The series will also highlight heroin's impact on health and society. (Includes video: 1:11:47)

Read more:
http://www.yorkdispatch.com/ci_27718400/york-dispatch-rolls-out-new-heroin-series-epidemic

New Law Would Strengthen Prescription Rules for Opioids
Ken Dixon, CTPost.com
March 18, 2015

Last year, the Connecticut General Assembly approved naloxone use by emergency medical personnel. Advocates are supporting efforts to increase access by allowing pharmacists to dispense the drug. They want laws to require continuing medical education on pain management, expedient doctors' checks on patients who receive more than 3-day supplies of narcotics, and reconstitute the state's lapsed Alcohol and Drug Policy Council.

Read more:
http://www.ctpost.com/local/article/New-law-would-harden-prescription-rules-for-6143396.php

Silver Hill Hospital Launches Opioid Outpatient Program
Evan Fallor, Westfair Communications
March 19, 2015

Silver Hill Hospital launched an opioid outpatient program in New Canaan, Conn. The program's intensive outpatient phase has a 12-patient capacity. Silver Hill plans to open an adolescent intensive outpatient program for teens in April.

Read more:
http://westfaironline.com/70000/silver-hill-hospital-launches-opioid-outpatient-program

Fatal Overdoses Continue Upward Climb
Dave Solomon, New Hampshire Union Leader
March 18, 2015

The Manchester Police Department issued a public warning after responding to 105 suspected drug overdoses—14 fatal—since January 1. The city had nine fatal overdoses in December. All but one involved heroin, in some cases mixed with fentanyl.

Read more:
http://www.unionleader.com/article/20150318/NEWS07/150319158

Delaware Police Dept. Fights Heroin ODs with Narcan
Mark Eichmann, WHYY
March 20, 2015

Ocean View is the first town in Delaware to certify and equip its officers with Narcan®. The town went 10 years without a single heroin arrest. Now there is one to two arrests per week, and the addiction rate is growing.

Read more:
http://www.newsworks.org/index.php/local/item/79730-delaware-police-dept-fights-heroin-ods-with-narcan

South News

Pill Mills Rule Set to Expire
Bobeth Yates, WWSB
March 19, 2015

Florida's "pill mill" rule is set to expire. The Senate is poised to vote on reauthorization.

Read more:
http://www.mysuncoast.com/news/local/pill-mills-rule-set-to-expire/article_
39ab05ee-ce86-11e4-bd4e-a3ee0297217c.html


VA Task Force Attempting to Combat Heroin Overdoses
WVIR
March 19, 2015

Several bills awaiting Governor Terry McAuliffe's signature would help combat the rise in Virginia's heroin use and prescription drug abuse. The governor's task force met recently to discuss other strategies. Experts believe more preventive methods and public awareness would help turn the trend. (Includes video: 2:08 minutes)

Read more:
http://www.nbc29.com/story/28566712/va-task-force-attempting-to-combat-heroin-overdoses

Midwest News

Medical Group to Campaign to Stop Prescription Abuse in Ohio
Piqua Daily Call
March 18, 2015

The Ohio State Medical Association is partnering with major hospital systems in the Smart Rx program that will offer training for doctors who prescribe pain medications. Doctors will also be encouraged to help find solutions to prescription abuse and addiction.

Read more:
http://hosted2.ap.org/OHPIQ/f71b042167fd4af9972a1dbb4359e99a/Article_2015-03-18-OH--Medical%20Association-Pill%20Abuse/id-0ef293790b5744c5af8b47966484a81d

Prescription Drug Task Force Combats Pill Problem
Kendall Morris, WBIR
March 16, 2015

A prescription drug task force is trying to address the prescription drug abuse epidemic in East Tennessee. The task force works to find solutions and offer suggestions to the General Assembly on reasonable ways to deal with the problem. It supports a bill in the state House and Senate that would revise requirements for medical directors and others working at pain management clinics. (Includes video: 2:39 minutes)

Read more:
http://www.wbir.com/story/news/2015/03/16/prescription-drug-task-force-combats-pill-problem/24883265

State Lawmakers Discuss Abuse-Deterrent Drugs
Kendall Morris, WBIR
March 20, 2015

Tennessee lawmakers are debating a bill that would require insurers to put abuse-deterrent opioids in the same price tier as non-abuse-deterrent opioids. State Senator Steven Dickerson said the bill won't likely move forward this legislative session. Lawmakers are looking at another bill that would launch a study over the next year.

Read more:
http://www.wbir.com/story/news/2015/03/20/state-lawmakers-discuss-abuse-deterrent-drugs/25064167

Antidote for Heroin Overdose Could Be More Available Under Proposed Bill
Andi TenBarge, TheStatehouseFile.com
March 17, 2015

The Indiana Senate unanimously passed Senate Bill 406, which allows individuals to administer naloxone if they suspect a family member or friend is suffering from heroin addiction. The bill moves to the House Public Health Committee. (Includes video: 2:28 minutes)

Read more:
http://www.jconline.com/story/news/local/indiana/2015/03/17/antidote-heroin-overdose-available-proposed-bill/24893157

Police Investigate Armed Robbery at Indianapolis Nursing Home
Zach Myers, Fox 59
March 17, 2015

Police are searching for an armed man who stole prescription drugs from an assisted living center in Indianapolis. The man pointed a rifle at a female employee and ordered her to open two medication carts, then grabbed various prescription drugs. (Includes video: 1:59 minutes)

Read more:
http://fox59.com/2015/03/17/police-investigate-armed-robbery-at-nursing-home

Why We Oppose the Missouri Prescription Monitoring Program Bill
Robert Twillman, American Academy of Pain Management
March 13, 2015

Missouri is the only state without a prescription drug monitoring program (PDMP). The American Academy of Pain Management opposes Senate Bill 111, which would create a Missouri PDMP. The Academy has 23 concerns about the bill. It's uncertain the proposed PDMP is feasible and claims it would have negative consequences for Missouri's citizens, threatening their privacy. The Academy supports House Bill 130, which would establish a "traditional" PDMP, like those in other states." (Editor's note: The Academy appears to have close ties to the pharmaceutical industry. See www.aapainmanage.org/about/corporate-council.)

Read more:
http://www.aapainmanage.org/academy-in-the-news/why-we-oppose-the-missouri-prescription-monitoring-program-bill

West News

Legislature Makes Overdose-Stopping Drug Available to Friends, Family of Opiate Abusers
Erin Fenner, Idaho Statesman
March 13, 2015

The Idaho House and Senate passed House Bill 108, which would allow pharmacists to give naloxone to friends and family members of drug addicts. The bill also requires the Idaho Office of Drug Policy to create a training module for those who administer naloxone.

Read more:
http://www.idahostatesman.com/2015/03/13/3695359_idaho-legislature-approves-a-bill.html?rh=1

Emergency Departments Unite to Combat Epidemic of Opioid Over-Prescribing and Avoidable Death
Business Wire
March 20, 2015

A Prescription Drug Abuse Medical Task Force announced that emergency departments across Los Angeles County are implementing standardized clinical guidelines for safe opioid prescribing. The guidelines include using opioid medications as a last resort for severe noncancer pain and only at the lowest possible doses, avoiding intravenous or injectable opioids for patients already taking chronic (long term) opioid medications, and using the State of California CURES (prescription drug monitoring program) database.

Read more:
http://www.businesswire.com/news/home/20150320005763/en/Emergency-Departments-Unite-Combat-Epidemic-Opioid-Over-Prescribing#.VQx8QGnwsgA

Prescription Drug Abuse Awareness
KDVR
March 18, 2015

Reporters interviewed Arthur Schut, chief executive officer of Arapahoe House, about the dangers of prescription drug abuse in Colorado. Arapahoe House offers drug and alcohol rehabilitative services. (Includes video: 4:06 minutes)

Read more:
http://kdvr.com/2015/03/18/prescription-drug-abuse-awareness

Other Resources

State Laws on Prescription Drug Misuse and Abuse
Centers for Disease Control and Prevention
March 5, 2015

In partnership with the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control, the Robert Wood Johnson Public Health Law Program created menus summarizing legal strategies states have used to address prescription drug misuse, abuse, and overdose.

Read more:
http://www.cdc.gov/phlp/publications/topic/prescription.html

OpioidCalc
The New York City Department of Health and Mental Hygiene
Accessed March 20, 2015

OpioidCalc is an iPhone and Android app that helps providers assess patients' risk for overdose by calculating total morphine milligram equivalents (MME). Multiple types of opioid analgesics can be included in the total daily MME calculation. Daily MME ≥ 100, which increases risk for overdose, triggers an alert.

Read more:
http://www.nyc.gov/html/doh/html/hcp/drug-rx.shtml

Watch for Doctor-Shopper Red Flags, Group Warns
Robert Lowes, Medscape
March 18, 2015

A coalition that includes the American Medical Association, American Pharmacists Association, National Association of Boards of Pharmacy, CVS Health, and Walgreens released a document listing warning signs of prescription drug abuse and diversion. The consensus document profiles doctor shoppers and their strange and dangerous behavior.

Read more:
http://www.medscape.com/viewarticle/841727

Upcoming Webinars

ONDCP Webinar on Synthetic Drugs
Office of National Drug Control Policy (ONDCP)
April 8, 2015, 1–2 p.m. EST

The Office of National Drug Control Policy will host a Webinar about the dangers of synthetic drugs. This Webinar will provide details on federal and local efforts to address the problem. The discussion, featuring representatives from the National Institute on Drug Abuse and Drug Enforcement Administration, will focus on the manufacture, distribution, and health risks associated with these drugs.

Read more:
http://www.cadca.org/resources/detail/register-ondcp-webinar-synthetic-drugs

Register:
https://www.whitehouse.gov/webform/webinar-synthetic-drugs

Grant Announcements

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

Prescription Drug Overdose Prevention for States
Centers for Disease Control and Prevention
Deadline: May 8, 2015
http://www.grants.gov/web/grants/search-grants.html

Take-Back Events and Drop Boxes

Operation Medicine Drop Collects 200+ Lbs. of Medication
WFMY (North Carolina)
March 16, 2015
http://www.wfmynews2.com/story/news/2015/03/16/operation-medicine-drop-mcleansville-north-carolina/24874087

Agencies Collect Old Medications in Combined Effort
Darrick Ignasiak, Lexington Dispatch (North Carolina)
March 18, 2015
http://www.the-dispatch.com/article/20150318/News/303189979

Drug Disposal Box Placed at Greenvale Pharmacy
Bill San Antonio, TheIslandNow.com (New York)
March 16, 2015
http://www.theislandnow.com/news/drug-disposal-box-placed-at-greenvale-pharmacy/article_5a15caa6-cbf9-11e4-8d06-db77f12a65bd.html

Hasbrouck Heights Gets Project Medicine Drop Box for Prescription Drugs
Kristie Cattafi, NorthJersey.com
March 18, 2015
http://www.northjersey.com/community-news/borough-gets-project-medicine-drop-box-for-prescription-drugs-1.1291257

Substance Abuse Council: Dispose of Unwanted Rx Meds at Dropoff Locations
Chesterton Tribune (Indiana)
March 19, 2015
http://chestertontribune.com/PoliceFireEmergency/substance_abuse_council_dispose.htm

Drug Drop Box New to Sheriff's Department Lobby
A. Lavalley, The Chicago Tribune (Illinois)
March 19, 2015
http://www.chicagotribune.com/suburbs/post-tribune/news/ct-ptb-porter-county-drugs-st-0323-20150319-story.html

Program Leads to Permanent Prescription Drug Drop-Off Sites in Marion County
United Way of the Mid-Willamette Valley (Oregon)
March 13, 2015
http://www.unitedwaymwv.org/program-leads-permanent-prescription-drug-drop-sites-marion-county

Prescription Drug Collection Box
City of Belle Meade (Tennessee)
Accessed March 16, 2015
http://www.citybellemeade.org/police_dept/prescription-drug-collection-box

Prescription Drug Disposal
City of Rogers (Minnesota)
Accessed March 17, 2015
http://rogersmn.gov/police-services/prescription-drug-disposal

Upcoming Conferences and Workshops

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

2015 Community Safety Summit
National Safety Council
March 30–31, 2015
Austin Convention Center
500 Cesar Chavez St E
Austin, Texas

Attendees will learn how to implement proven lifesaving programs and strategies used by communities throughout the country. Sessions will address leading causes of injuries and deaths, including teen driving, prescription drug overdose, older adult falls, and distracted driving. The summit culminates with a rally for stronger legislation on the steps of the state capitol.

Read more:
http://www.nsc.org/learn/about/Pages/NSC-to-host-first-Community-Safety-Summit-in-Austin.aspx

Register:
http://bit.ly/1LjXbEa

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 and Blake Works
May 7–8, 2015
Boston, Massachusetts
http://captus.samhsa.gov/news-and-events/engaging-youth-rx-drug-abuse-prevention
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.