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March 3, 2016

PAW Weekly Update

    

                                          
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SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
          Issue 163  |  March 3, 2016          
   
                                                               
                                                                                                                                                       
   
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.                      
               
                                                                                                                 
                                                                                                                                                                     
Index                            
Featured                            
Journal Articles and Reports                            
Professional Development                            
National                            
Marijuana                            
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Featured

B. Freisthler, W.R. Ponicki, A. Gaidus, and P.J. Gruenewald. 2016. “A Micro-Temporal Geospatial Analysis of Medical Marijuana Dispensaries and Crime in Long Beach, California.” Addiction, doi:10.1111/add.13301.                        

The number of medical marijuana dispensaries in Long Beach, Calif., decreased from 37 at the start of 2012 to 5 by the end of 2013. After adjusting for covariates, dispensary density was related positively and significantly to both violent and property crime in spatially adjacent blocks (incident rate ratios of 1.025 and 1.017, respectively). The effect was localized; density was unrelated to crime levels in broader Census block groupings. The researchers concluded that using law enforcement to reduce medical marijuana dispensaries helped reduce crime in nearby residential areas, but not where the dispensaries were located.                        

Read more:                        
http://onlinelibrary.wiley.com/doi/10.1111/add.13301/abstract                                                  

Ameritox Research Confirms Significant Spike in Potential Nonadherence to Opioids                        
PR Newswire                        
February 22, 2016                        

Ameritox, a nationwide provider of pain medication monitoring laboratory services, has reported that 43 percent of samples collected from prescription opioid patients over the 31 months that ended in July 2015 showed potential nonadherence, up from 36 percent in the 2012. Analysis of samples from 447,000 patients showed that potential nonadherence was greatest among those ages 10–19 (62 percent). Nonadherence declined in each decade but remained high even among those ages 60–69 (39 percent) and 70–79 (37 percent).                        

Read more:                        
http://www.prnewswire.com/news-releases/ameritox-research-confirms-significant-spike-in-potential-nonadherence-to-opioid-medications-300223665.html                       
               
               

Journal Articles and Reports

L. Bastiaens, J. Galus, and C. Mazur. 2016. “Abuse of Gabapentin is Associated with Opioid Addiction.” Psychiatric Quarterly, doi:10.1007/s11126-016-9421-7.                

In a survey of 250 former prison inmates who live in an urban correctional community center in Pennsylvania that provides inpatient treatment/recovery services to people who had substance use disorders before incarceration, 66 percent had past inpatient addiction treatment, 48 percent had past psychiatric hospitalizations, and 25 percent had hepatitis C infection. Multiple misuse disorders were the norm (72 percent); 62 percent had misused prescription drugs, 58 percent had misused opiates, and 16 percent had misused gabapentin. Gabapentin misuse was 26 percent among patients with an opioid use disorder but only 4 percent among patients without an opioid use disorder. The mean respondent age was 37. Seventy-two percent of respondents were white, 27 percent were black, and 1 percent were Hispanic.                

Read more:                
http://link.springer.com/article/10.1007/s11126-016-9421-7                                  

A. Caudarella, H. Dong, M.J. Milloy, T. Kerr, E. Wood, and K. Hayashi. 2016. “Non-Fatal Overdose as a Risk Factor for Subsequent Fatal Overdose Among People Who Inject Drugs.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.02.024.                

Between May 1996 and December 2011, 2,317 people who inject drugs were followed for a median of 61 months in Vancouver, Canada. During follow-up, 134 people died from overdose and 1,795 nonfatal overdoses were reported, with incidence rates of 9 deaths and 120 nonfatal overdoses per 1,000 person-years. Each nonfatal overdose a person had roughly doubled the odds of a subsequent fatal overdose.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00099-5/abstract                                  

A. Manhapra, L. Quinones, and R. Rosenheck. 2016. “Characteristics of Veterans Receiving Buprenorphine vs. Methadone for Opioid Use Disorder Nationally in the Veterans Health Administration.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2015.12.035.                

In data on all veterans with opioid use disorder diagnosis who used Veterans Health Administration services in 2012, researchers identified mutually exclusive groups who received (1) buprenorphine only (n = 5,670); (2) methadone only (n = 6,252); or (3) both buprenorphine and methadone in the same year (n = 2,513). In multivariate analysis, odds of receiving buprenorphine compared to methadone declined by 0.67 for each 10-year increment in age and were lower for urban residence (odds ratio [OR] = 0.26) and black veterans (OR = 0.39). Medical and psychiatric comorbidities and receipt of other psychiatric medications did not significantly differentiate the therapy used.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00006-5/abstract                                  

C. Robitaille and J. Collin. 2016. “Prescription Psychostimulant Use Among Young Adults: A Narrative Review of Qualitative Studies.” Substance Use & Misuse, doi:10.3109/10826084.2015.1110170.                

After reviewing 26 studies published in 2006–15, the authors concluded that qualitative research about young adult misuse of prescription stimulants has chiefly targeted college students. Excluding quantitative studies, little is known about misuse by other social groups, notably people with high-stress jobs. Three patterns related to prescription psychostimulant use emerged: they are used to (1) control external stressors, (2) discipline behavior and increase self-control over attention-deficit/hyperactivity disorder symptoms; and (3) increase one’s performance.                

Read more:                
http://www.tandfonline.com/doi/abs/10.3109/10826084.2015.1110170                                  

L. Rodríguez-Cintas, C. Daigre, L. Grau-López, C. Barral, J. Pérez-Pazos, N. Voltes, M.D. Braquehais, M. Casas, and C. Roncero. 2016. “Impulsivity and Addiction Severity in Cocaine and Opioid Dependent Patients.” Addictive Behaviors, doi:10.1016/j.addbeh.2016.02.029.                

Among 526 patients with lifetime cocaine dependence (n = 351), opiate dependence (n = 51), or comorbid cocaine and opiate dependence (n = 124) recruited at a hospital outpatient addiction unit in Barcelona, Spain, from January 2006 to April 2013, those with cocaine dependence and comorbid dependence were more impulsive and had higher addiction severity than those with opioid dependence alone. Opioid-dependent patients had the worst medical status while cocaine-and-opioid-dependent patients had more severe drug use and legal problems than the other groups.                 

Read more:                
http://www.sciencedirect.com/science/article/pii/S0306460316300636                                  

K.Z. Smith, P.H. Smith, S.A. Cercone, S.A. McKee, and G.G. Homish. 2016. “Past Year Non-Medical Opioid Use and Abuse and PTSD Diagnosis: Interactions with Sex and Associations with Symptom Clusters.” Addictive Behaviors, doi:10.1016/j.addbeh.2016.02.019.                

In multivariate analysis of data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, a past-year posttraumatic stress disorder (PTSD) diagnosis was associated with higher odds of past-year nonmedical opioid use (odds ratio [OR] of 2.1 for women and 1.5 for men) and with an opioid use disorder diagnosis for women (OR = 2.5) but not for men. Three measures—nonmedical opioid use, an opioid use disorder diagnosis, and average monthly frequency of nonmedical opioid use—had higher odds in women with PTSD avoidance symptoms and in men with PTSD arousal/reactivity symptoms. The avoidance symptom cluster also was associated with higher odds of an opioid use disorder diagnosis for men.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0306460316300533                 
               

Professional Development

T.E. Albertson, J.A. Chenoweth, D.K. Colby, and M.E. Sutter. 2016. “The Changing Drug Culture: Emerging Drugs of Abuse and Legal Highs.” FP Essentials 441:18–24.                

The number of synthetic drugs used recreationally is increasing. One class of drugs is synthetic cannabinoids, which are sprayed onto herbal preparations and marketed under names such as “K2” and “spice.” Because these substances are sold labeled as not for human consumption and because the chemicals in them frequently change, they often are unregulated, and many users consider them legal, although they are not. Their use often goes undetected because testing for them is not included in routine drug screening. Nonetheless, these substances can have significant toxicities, and their concentrations are dangerously unpredictable. Adverse effects of synthetic cannabinoids includes psychosis. Amphetamine-like drugs have stimulant effects and can cause precipitous drops in blood sodium levels and seizures. New hallucinogens can cause serious vasoconstriction with inadequate blood supply to the heart.                

Read more:                
http://www.ncbi.nlm.nih.gov/pubmed/26881769                                  

W. Scholten and J.E. Henningfield. 2016. “Negative Outcomes of Unbalanced Opioid Policy Supported by Clinicians, Politicians, and the Media.” Journal of Pain & Palliative Care Pharmacotherapy, doi:10.3109/15360288.2015.1136368.                

Researchers analyzed what has occurred with nonmedical use of prescription opioids and try to present a balanced view of the problems. They advocate comprehensive drug control policies implemented in a way to reduce harmful use and diversion problems, balancing the public health benefits and risks of opioid medications. They make recommendations for responsible prescribing, which they believe can help to prevent diversion of prescription opioids while ensuring patient access to the most appropriate medicines. They suggest basing measures to reduce risk of nonmedical use of opioid medicines on accurate evaluation of the mechanisms leading to nonmedical use and diversion.                

Read more:                
http://www.tandfonline.com/doi/abs/10.3109/15360288.2015.1136368                 
               

National

Governors Devise Bipartisan Effort to Reduce Opioid Abuse                
Robert Pear, New York Times                
February 21, 2016                

The National Governors Association (NGA) will join with the American Medical Association to develop treatment protocols to reduce the use of opioid pain relievers. The guidelines will likely include numerical limits or other restrictions on prescriptions. Governors believe doctors should routinely check prescription drug databases to identify patients who are misusing prescription drugs. An NGA monograph acknowledges the difficulties the states face. The NGA will share their concerns with the Obama Administration in an upcoming meeting.                

Read more:                
http://www.nytimes.com/2016/02/22/us/politics/governors-devise-bipartisan-effort-to-reduce-opioid-abuse.html?_r=2                                  

Cities, Counties Announce Joint Task Force on Opioid Abuse Epidemic                
PR Newswire                
February 22, 2016                

The National League of Cities and the National Association of Counties have formed a task force to address opioid and heroin misuse. This task force aims to enhance awareness, facilitate peer exchanges, and identify sound policy and partnership solutions. The associations will explore proven practices for community prevention and overdose response, effective treatment options, and public safety enforcement, and supply reduction. They will share opportunities, challenges, and issues local jurisdictions face when addressing opioid misuse and heroin use.                

Read more:                
http://www.prnewswire.com/news-releases/cities-counties-announce-joint-task-force-on-opioid-abuse-epidemic-300223737.html                                  

Senate Confirms Robert Califf as Head of FDA                
Associated Press, New York Times                
February 24, 2016                

The U.S. Senate has confirmed Robert Califf, M.D., a cardiologist and medical researcher at Duke University, as the new FDA commissioner. Dr. Califf will be expected to follow through on his pledge to re-evaluate how the agency regulates prescription pain relievers. The agency is expected to add new warning labels to widely prescribed pain relievers and increasingly consult with outside advisers on the medications.                

Read more:                
http://www.nytimes.com/aponline/2016/02/24/us/politics/ap-us-fda-commissioner.html?_r=0                                  

FDA Urged to Warn About Dangerous Medication Combinations amid Overdose Crisis                
City of Baltimore Health Department                
February 22, 2016                

Health directors, experts, and physicians from across the country have signed a petition urging the FDA to put a black-box warning on opioids and benzodiazepines that states: “Concurrent use of the medications increases the risk of fatal overdose.” Existing warnings about the concurrent use of opioids and benzodiazepines are inconsistent, infrequent, and insufficient. The petition also calls for medication guides for both classes of medication to specifically warn patients about the risks of combined opioid and benzodiazepine use.                 

Read more:                
http://health.baltimorecity.gov/news/press-releases/2016-02-22-public-health-officials-urge-fda-issue-warnings-dangerous-combination                                  

Shortage of Addiction Counselors Further Strained By Opioid Epidemic                
Emily Corwin, NPR                
February 24, 2016                

This article discusses the shortage of addiction counselors due to inadequate pay, stress, and long hours. Some treatment centers have waiting lists because they lack enough staff to provide services, even though beds are available. A shortage of addiction workers has been a problem for decades.                

Read more:                
http://www.npr.org/sections/health-shots/2016/02/24/467143265/shortage-of-addiction-counselors-further-strained-by-opioid-epidemic                                  

U.S. Sen. Grassley Sponsors Bill to Address Pain Reliever Abuse                
Radio Iowa                
February 23, 2016                

U.S. Sen. Chuck Grassley (R-Iowa) is cosponsoring legislation that would reauthorize a program to help parents with drug misuse receive services and reunite with their children. The bill is an update of legislation enacted in 2006 and reauthorized in 2011. The latest version focuses on opioid misuse.                                 

Read more:                
http://www.radioiowa.com/2016/02/23/senator-grassley-sponsors-bill-to-address-pain-killer-abuse                                  

Many Physicians Suffer from Anxiety and Substance Use But Don’t Get Treatment                
Lecia Bushak, Medical Daily                
February 24, 2016                

The YouTube series Healthcare Triage is out with a new video to raise awareness about physician depression in hopes of removing the stigma of mental health treatment. The video states that too many physicians turn to alcohol and substances to self-medicate instead of getting mental health treatment. Doctors have easier access to drugs than others and, it states, are more likely to misuse prescription drugs than the general population. Physicians also experience burnout and have a high suicide rate. (Includes video: 6:19 minutes)                

Read more:                
http://www.medicaldaily.com/doctor-depression-substance-abuse-anxiety-374802                                  

America’s Opioid Epidemic is Everywhere—But It’s Especially Bad In These Five States                
Emma Court, Market Watch                
February 24, 2016                

Trust for America’s Health last year reported that West Virginia, New Mexico, Kentucky, Nevada, and Oklahoma have the highest drug overdose death rates and some have the highest pain reliever prescription rates. Deaths by drug overdose soared 605 percent between 1999 and 2010 in West Virginia, which had the highest rate. The rate quadrupled in Kentucky and tripled in Oklahoma, while it increased 80 percent in Nevada and 59 percent in New Mexico. This article discusses four ways the problem is being fought across the country.                

Read more:                
http://www.marketwatch.com/story/americas-opioid-epidemic-is-everywhere-but-its-especially-bad-in-these-5-states-2016-02-24                 
                 

Marijuana

H.S. Kim, K.E. Hall, E.K. Genco, M. Van Dyke, E. Barker, and A.A. Monte. 2016. “Marijuana Tourism and Emergency Department Visits in Colorado.” New England Journal of Medicine 374:797–8, doi:10.1056/NEJMc1515009.                  

In Colorado, the rate of emergency department visits possibly related to cannabis use among out-of-state residents doubled from 85 per 10,000 visits in 2013 to 168 per 10,000 visits in 2014—the first year of retail marijuana sales. Among Colorado residents, the rate did not change significantly between 2013 and 2014, increasing from 106 to 112 per 10,000 visits. Rates did not change significantly between 2012 and 2013 among either out-of-state residents or Colorado residents.                  

Read more:                  
http://www.nejm.org/doi/full/10.1056/NEJMc1515009                                     

J.M. Trigo, D. Lagzdins, J. Rehm, P. Selby, I. Gamaleddin, B. Fischer, A.J. Barnes M.A. Huestis, B. Le Foll. 2016. “Effects of Fixed or Self-Titrated Dosages of Sativex on Cannabis Withdrawal and Cravings.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.02.020.                  

Compared to placebo, high fixed doses of Sativex significantly reduced cannabis withdrawal but not craving during abstinence. Self-titrated doses were lower and showed limited efficacy compared to high fixed doses. Participants reported a significantly lower high following Sativex or placebo compared to smoke-as-usual conditions. All doses were well-tolerated.                  

Read more:                  
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00095-8/abstract                                      

Connecticut Lawmakers Approve Expansion of State’s Medical Marijuana Program                  
Andrew Ragali Record-Journal                  
February 23, 2016                  

The Connecticut legislature’s Regulation Review Committee has added six ailments to the state’s medical marijuana program: sickle cell disease, post-laminectomy syndrome with chronic radiculopathy, severe psoriasis and psoriatic arthritis, amyotrophic lateral sclerosis, ulcerative colitis, and complex regional pain syndrome. The program now includes 17 aliments for which patients can receive a prescription for medical marijuana.                   

Read more:                  
http://www.myrecordjournal.com/news/state/8483457-129/lawmakers-approve-expansion-of-states-medical-marijuana-program.html                                      

Infographic: Medical Marijuana in the Workplace                  
Adrienne Hurst, National Federation of Independent Business                  
February 17, 2016                  

This infographic features statistics on medical marijuana in the workplace and stresses the importance of a clear, current workplace drug policy.                  

Read more:                  
http://www.nfib.com/content/business-resources/legal/infographic-medical-marijuana-in-the-workplace-73013                                      

Report: Arizona’s Medical Marijuana Program Receives above Average Grade                  
Cooper Rummel, KTAR                  
February 25, 2016                  

Americans for Safe Access, an organization that advocates for safe and legal access to medical marijuana, has ranked Arizona’s medical marijuana program above average compared to other states. Arizona received a B-minus on the organization’s annual state report card. The state scored high in every major category except product safety.                  

Read more:                  
http://ktar.com/story/929785/report-arizonas-medical-marijuana-program-receives-above-average-grade                                      

Patients Struggle to Get Medical Marijuana in New York                  
David Robinson, Journal News                  
February 25, 2016                  

Only 1,174 of more than 200,000 eligible New Yorkers have been certified for medical marijuana. Some people cannot find a doctor to certify them. Only 421 out of 90,000 New York doctors have registered to participate in the program. Some doctors say flaws in New York’s program expose them to risk of Drug Enforcement Administration penalties. The state’s health department has mishandled regulations on how doctors certify marijuana patients. Questions about conflicts, inaccurate statements, and botched dispensary openings are mounting.                  

Read more:                  
http://www.lohud.com/story/news/investigations/2016/02/24/medical-marijuana-new-york/79655424                                      

Several Medical Marijuana Bills Considered in Hawaii                  
Kirsten Johnson, Hawaii Tribune-Herald                  
February 22, 2016                  

A bill in Hawaii’s senate would allow open-air growing operations, greenhouses, and shade houses to serve as medical marijuana production centers. The bill would also establish a medical marijuana oversight commission within the state’s health department, which would also be required to conduct unannounced visits and relicensing inspections of facilities, including dispensaries.A bill in the state’s house of representatives would repeal penalties pertaining to certain medical marijuana prohibitions and amend penalties to make them more on a par with alcohol prohibitions. The bill would change the penalty for fraudulently obtaining medical marijuana from a class C felony to a petty misdemeanor.                   

Read more:                  
http://westhawaiitoday.com/news/local-news/several-medical-marijuana-bills-considered                                      

Marijuana Battle Heats Up In Montana                  
Dustin Klemann, KPAX                  
February 23, 2016                  

SafeMontana, an advocacy organization opposed to the legalization of marijuana, is seeking signatures for Initiative 176, which would repeal the Montana Medical Marijuana Act and “would eliminate differences between federal and state law with respect to the legal status of the possession and use of marijuana.” The initiative needs 24,175 signatures by June 17 to qualify for the election in November. Opponents believe SafeMontana campaign tactics, such as improperly using the state’s seal on its Facebook page to gather supporters (the campaign has since removed the seal), are unethical. A complaint was filed against SafeMontana with the Montana Office of Political Practices. (Includes video: 7:31 minutes)                  

Read more:                  
http://www.kpax.com/story/31282508/marijuana-battle-heats-up-in-montana                                      

Medical Marijuana Increasingly Legal, But Trustworthy? A Call for Regulations                  
Molly Jackson, Christian Science Monitor                  
February 18, 2016                  

Medical marijuana, now legal in 23 states and the District of Columbia, requires stricter regulation, experts say. Consistency, quality control, and consumer safety differ from one state to another, and patients are experiencing overdoses or side effects, such as nausea and hallucinations, due in part to little knowledge about correct dosages. Ryan Vandrey, Ph.D., a professor at John Hopkins School of Medicine, has found that most edible cannabis products have their tetrahydrocannabinol THC dosage mislabeled. Industry officials are eager for guidelines, and there is more of an effort to get industry stakeholders together. For example, Washington now requires labeling for all cannabis products in-state and requires quality assurance tests. Results must be available for customers. In Colorado, packaging must disclose any pesticides or herbicides used in production.                   

Read more:                  
http://m.csmonitor.com/USA/USA-Update/2016/0218/Medical-marijuana-increasingly-legal-but-trustworthy-A-call-for-regulations                                     

Shoppers Drug Mart in Canada Says Pharmacies ‘Safest Option’ For Dispensing Pot                  
Linda Nguyen, Canadian Press                  
February 25, 2016                  

Shoppers Drug Mart, a Canadian drugstore chain, is looking at the possibility of selling medical marijuana. The Neighbourhood Pharmacy Association of Canada believes pharmacies are best equipped to dispense medical marijuana given their expertise in prescription drug management. They have systems in place to monitor, track usage, and determine drug interactions. Health Canada regulations stipulate that the only legal method to obtain medical marijuana is through a licensed producer and, therefore, pharmacies are not permitted to dispense medical marijuana.                   

Read more:                  
http://www.metronews.ca/news/canada/2016/02/24/shoppers-drug-mart-says-pharmacies-are-safest-option-for-medical-marijuana.html                 
               

International

Nova Scotia’s (Canada) Drug Monitoring Program did not Flag Doctor Charged with Trafficking                
Susan Bradley, CBC News                
February 25, 2016                

Sarah Jones, M.D., of Tantallon, Nova Scotia, was arrested and accused of prescribing 50,000 oxycodone and oxyneo pills to one patient who never received them. She was not flagged by the province’s prescription drug monitoring program (PDMP), and officials could not provide an explanation. The PDMP regularly shares information with licensing authorities for doctors, dentists, pharmacists, and nurses. This includes patients who see multiple doctors in a 30-day period and patients who have been charged with drug trafficking offenses. It gets 350–500 requests annually from law enforcement agencies for information connected with criminal investigations.                

Read more:                
http://www.cbc.ca/news/canada/nova-scotia/nova-scotia-drug-monitoring-doctor-1.3464409                                  

Canadian Woman Stole Veterinarian’s Fentanyl for Self-Medication                
Neil Bowen, Sarnia Observer                
February 26, 2016                 

Kristine Lynn McCaig, a former employee of a veterinarian in Canada, has been sentenced for stealing a fentanyl patch intended for use on pets. She had been suffering abdominal pains which resulted in surgery. She is currently under a doctor’s care for pain management. She pled guilty to theft and fentanyl possession and was sentenced to 4 months of house arrest.                

Read more:                
http://www.theobserver.ca/2016/02/26/woman-stole-veterinarians-fentanyl-for-self-medication                 
               

Northeast/Mid-Atlantic News

Massachusetts Fentanyl Trafficking Law Takes Effect on Tuesday                
Chloe Gotsis, Office of the Massachusetts Attorney General                
February 22, 2016                

A Fentanyl trafficking law takes effect March 1 in Massachusetts. A person caught trafficking fentanyl for amounts greater than 10 grams could be sentenced to 20 years in state prison.                 

Read more:                
http://wwlp.com/investigative-story/fentanyl-trafficking-law-takes-effect-on-tuesday                                  

Former VA Nurse in Rhode Island Pleads Guilty To Stealing Prescription Drugs                
Stephanie Johnston and Shawn Towne, WPRI                
February 23, 2016                

Lisa McManaman, a former registered nurse at the Providence (R.I.) Veteran Affairs Medical Center, has pled guilty to stealing prescription drugs from an automated medication dispensing system. By overriding the system 19 times, she stole approximately 240 pills including oxycodone and morphine. She also failed to disclose her 2013 termination as a nurse at another hospital in Rhode Island on her employment application. McManaman pleaded guilty to one count of theft of government property and one count of false statements. (Includes video: 0:33 minutes)                

Read more:                
http://wpri.com/2016/02/23/former-va-nurse-pleads-guilty-to-stealing-prescription-drugs                                  

A Mayor Wants Space Where Addicts Can Inject Heroin Safely                
David Klepper, Associated Press                
February 22, 2016                

Ithaca (N.Y.) Mayor Svante Myrick has said he wants his city to host the nation’s first supervised injection facility, which would enable heroin users to use illegal drugs under the care of a nurse without getting arrested by police. Nurses or physicians could quickly administer an antidote if a user overdoses. Addicts also can get clean syringes and be directed to treatment and recovery programs. Canada, Europe, and Australia already have these facilities. Ithica’s police chief, John Barber, said he is wary of supervised injection sites.                

Read more:                
http://abcnews.go.com/Health/wireStory/apnewsbreak-mayor-supervised-heroin-injection-site-37114577                                  

New York Hospitals Strain to Meet Deadline on E-Prescriptions                
American Pharmacists Association                
February 24, 2016                

Some hospitals and physicians in New York are struggling to meet the state-imposed March 27 deadline for mandatory e-prescribing. Several institutions are asking for additional time to comply; however, the state’s health department has no plans to extend the deadline again. The Internet System for Tracking Over-Prescribing Act was passed in 2012 in an effort to reduce prescription drug misuse, medical errors, and fraud.                

Read more:                
http://www.pharmacist.com/new-york-hospitals-strain-meet-deadline-e-prescriptions                                 

Broome County (N.Y.) Project to Educate Doctors on Opioid Abuse                
WICZ                
February 22, 2016                

Broome County, N.Y., has announced the Opioid Prescription Reduction by Academic Detailing Project to increase doctor awareness about best opioid prescribing practices. It will educate 98 local providers at primary, urgent care, and dental facilities. A contractor will visit each location at least three times during the contract period. The county legislature will determine the contractor in March. The project is funded by the Community Foundation of South Central New York.                 

Read more:                
http://www.wicz.com/news2005/viewarticle.asp?a=42645                                  

Former Shore Pharmacist Had Pharmacy License Suspended Twice                
Cindy Stansbury, Press Of Atlantic City                
February 26, 2016                

Frederick McLeish has been charged with stealing morphine from Shore Medical Center in Somers Point, N.J., and replacing it with saline. Prior to working at Shore, his pharmacy license was suspended twice due to substance misuse issues and for stealing prescription pain relievers. McLeish was suspended from Shore in September 2014 and later fired. He voluntarily surrendered his license to practice pharmacy in December 2014. He admitted to diverted morphine, fentanyl, and hydoxizine tablets for his own use without a valid prescription. Despite three suspensions, McLeish could still have his license reinstated under directions outlined within official documents from the state’s pharmacy board that accompanied his suspension.                

Read more:                
http://www.pressofatlanticcity.com/news/former-shore-pharmacist-had-pharmacy-license-suspended-twice/article_695367a8-dc24-11e5-b270-03b1fc68adf7.html                                  

New Jersey Cop Was Impaired on Drugs, Alcohol in Fatal Crash                
NJ Advance                
February 26, 2016                

Captain Earl B. Alexander IV with the Deal Police Department, N.J., was impaired with illegal narcotics, alcohol, and prescription drugs when he died in a single-car crash earlier this year. A lab report showed that he had the following drugs in his system: stimulant drugs ethylone, butylone, methylone, dibutylone, dimethylone and fluoroamphetamine; a prescription antidepressant sold as Lexapro or Celexa; a prescription sleep medication sold as Ambien; an amphetamine such as Adderall or Dexedrine; diphenhydramine, the chemical found in the over-the-counter antihistamine Benadryl; and a blood-alcohol concentration of 0.19 percent, more than twice the legal limit of 0.08. Alexander was not coming from or going to work when the crash occurred.                 

Read more:                
http://www.nj.com/monmouth/index.ssf/2016/02/nj_cop_was_
impaired_on_drugs_alcohol_in_fatal_cras.html
                 
               

South News

South Carolina Medicaid Seeks to Curb Prescription Drug Abuse                
Lauren Sausser, The Post and Courier                
February 23, 2016                

The South Carolina Medicaid program will require doctors to consult the state’s prescription drug monitoring program before prescribing Medicaid patients any controlled substances, starting April 1. Providers will risk losing payments for noncompliance. More than 1 million South Carolinians are enrolled in the Medicaid program; most are children.                

Read more:                
http://www.postandcourier.com/article/20160223/PC16/160229725                                  

Prescription Opioid Overdoses in 2015 Increased by 131 Percent in One Alabama County                
Rachel Osier Lindley, WBHM                
February 25, 2016                

In Jefferson County, Ala., total opiate deaths were unchanged from 2014 to 2015, but their pattern shifted. In 2015, 74 people died from prescription opioid overdoses, up from 32 in 2014. More than half of the deaths involved fentanyl. Heroin overdose deaths dropped from 138 in 2014 to 97 in 2015. (Includes audio: 1:03 minutes)                

Read more:                
https://news.wbhm.org/feature/2016/43794                                  

Doctors’ Prescriptions Fuel North Carolina Drug Overdose Epidemic                
Charlotte Observer                
February 20, 2016                

Experts believe doctors prescribe too many addictive pain relievers and they are driving up the number of overdose deaths. North Carolina’s rate of fatal drug overdoses increased 75 percent since 2002. A 2014 report from the North Carolina Program Evaluation Division, the research arm of the state’s legislature, revealed that North Carolina officials failed to respond quickly to this problem. They did not provide doctors with specific guidelines on prescribing pain relievers or produce a coordinated strategy to address the problem. The state has produced a new position statement on the issue, giving doctors general guidelines on how to prescribe pain relievers. Some doctors also refuse to use the state’s prescription drug monitoring program database. Officials claim more doctors are now registering to use the system. Experts predict the epidemic will worsen without swift action from doctors and lawmakers.                 

Read more:                
http://www.charlotteobserver.com/news/local/article61525372.html                                 

Federal Judge Refuses to Throw Out Prescription Drug Case                
Associated Press                
February 26, 2016                                 

U.S. District Judge Sul Ozerden has refused to throw out an indictment in the prescription drug case against Sherrie Box Bennett of Vancleave, Mississippi. A defense attorney claimed that a prosecutor’s statements and a Sun Herald news report prejudiced his client’s case. The 11-count indictment alleges Bennett, who is a nurse, and her husband dispensed and distributed prescription drugs outside the scope of professional practice from 2010 through May 2013. Sherrie Bennett is also accused of writing illegal prescriptions for herself, her husband, and other relatives.                

Read more:                
http://www.wbbjtv.com/2016/02/26/federal-judge-refuses-to-throw-out-prescription-drug-case                 

Bill Would Allow Tennessee Pharmacists to Dispense Overdose Drug                
Nick Shepherd, Times News                
February 21, 2016                 

A committee in Tennessee’s senate has approved a bill that would allow pharmacists to dispense naloxone to either a person at risk of experiencing an opiate-related overdose, a family member, or friend. Pharmacists would be required to complete an opioid antagonist training program within the previous 2 years to dispense the medication. The bill would also establish immunity from disciplinary or adverse administrative actions and civil liability if the medication is dispensed properly.                 

Read more:                
http://www.timesnews.net/Local/2016/02/21/Bill-in-Tennessee-legislature-allows-for-easier-access-to-overdose-drug                 
               

Midwest News

Report: Heroin Death Rate in St. Louis County (Mo.) ‘Alarming’                
St. Louis Post-Dispatch                
February 24, 2015                

The St. Louis County (Mo.) health department has reported that heroin deaths increased from 88 in 2013 to 110 in 2014. The county medical examiner reported 99 heroin deaths through the third week of December 2015. That number could rise as autopsies are completed. Some heroin deaths may be masked by the addition of fentanyl in the heroin. Fentanyl can kill so quickly that the heroin it is mixed with might not show up on a toxicology report in an autopsy. Deaths from other drugs are steady or declining in the metropolitan area. The health department’s report includes an eight-point action plan to address the opioid epidemic, notably increased availability of overdose treatment.                

Read more:                
http://www.stltoday.com/lifestyles/health-med-fit/report-heroin-death-rate-in-st-louis-county-alarming/article_b5d8fbcf-5bef-56cf-8928-75c3dd9da935.html                                  

Bill Would Let Michigan Schools Stock Anti-Overdose Drug                
Rebecca Kruth, Michigan Radio                
February 20, 2016                

Michigan lawmakers are considering bills that would give schools the option to stock and administer naloxone. The legislation would require districts to work with the state’s education and health departments to set up rules for the drug’s use and train school employees on how and when to administer it. School employees would have immunity from criminal and civil liability.                

Read more:                
http://michiganradio.org/post/bill-would-let-michigan-schools-stock-anti-overdose-drug#stream/0                                  

Babies Born Drug Addicted: An Epidemic on the Rise in Michigan                
Cassy Arsenault, Fox                
February 25, 2016                

This article discusses babies born addicted to prescription narcotics. Edgar Beaumont, M.D., a neonatologist at Helen DeVos Children’s Hospital in Grand Rapids, Mich., sees about 100 babies a year whose mothers are addicted to pain relievers. Doctors are prescribing medications, but they are not educating patients on how pain relievers could affect them or their unborn children. Cara Tatarelli’s 3-year-old daughter was born addicted to pain relievers and heroin. The 23-year-old told her doctor about her drug problem during her pregnancy, and they devised a mitigation strategy. She is now sober and going to school to become a nurse. (Includes video: 6:00 minutes)                

Read more:                
http://fox17online.com/2016/02/25/babies-born-drug-addicted                 
               

West News

Oregon House OKs Bill Targeting Prescription Drug Abuse                
A.J. Kato, KTVZ                
February 26, 2016                

Oregon’s house of representatives has passed a bill that would allow pharmacists to distribute naloxone without a prescription. The bill would also fund improvements to increase ease of prescription drug monitoring program use by physicians. The bill now heads to the state’s senate for debate. (Includes video: 2:26 minutes)                

Read more:                
http://www.ktvz.com/news/oregon-house-oks-bill-targeting-prescription-drug-abuse/38205294                                  

Drug Company Leaders Should Face Prosecution, Oregon Official Says                
William Theobald, USA Today                
February 23, 2016                

Oregon Assistant Attorney General David Hart has told the state’s senate finance committee that drug company executives should be prosecuted for improper actions that contribute to the growth of opioid addiction. He also believes companies should be required to forfeit the profit they earn from their actions. Hart has led several investigations into improper marketing and promotion practices by pharmaceutical companies. In one case, the state investigated Insys, the maker of Subsys. Investigators alleged the company provided improper financial incentives to doctors to increase prescriptions, promoted the drug to doctors not qualified to prescribe it, and deceptively promoted its use for mild pain. The company agreed to a voluntary settlement that included a $1.1 million payment, which amounted to two times its sales of the drug in Oregon.                 

Read more:                
http://www.statesmanjournal.com/story/news/2016/02/23/drug-company-leaders-should-face-prosecution-oregon-official-says/80810020/?from=global&sessionKey=&autologin=                                  

Data Show Heroin and Prescription Drug Overdoses Continue to Escalate Across Arizona                
Ty Scholes, Cronkite News                
February 25, 2016                

In 2014, 1,052 people required emergency department treatment for prescription drug overdoses in Arizona, up from 1,018 in 2013. Heroin overdoses increased from 521 to 605 in 2014. The 494 deaths from pharmaceutical opioids and benzodiazepines in 2014 was a 16 percent increase from the previous year, while heroin deaths increased 44 percent.                

Read more:                
https://cronkitenews.azpbs.org/2016/02/25/state-data-shows-heroin-and-prescription-drug-overdoses-continue-to-escalate-across-arizona                                  

Alliance, Medical Center in Arizona to Launch Initiative to Address Rx Abuse                
White Mountain Independent                
February 23, 2016                

The Apache County (Ariz.) Drug Free Alliance is partnering with White Mountain Regional Medical Center in Springerville to implement the Rx Drug Misuse and Abuse Initiative, which will use data-driven multidisciplinary approaches to reduce prescription drug misuse.                

Read more:                
http://www.wmicentral.com/news/local_news/alliance-medical-center-to-launch-initiative-to-address-rx-abuse/article_ab871a10-d9b4-11e5-87a5-378dbd33d5b7.html                                  

Navajo County (Ariz.) Sheriff’s Office Warns of Extremely Dangerous Trend                
White Mountain Independent                
February 23, 2016                

The Navajo County Sheriff’s Office has investigated two fatal overdoses within the past 2 weeks in which investigators suspect use of Fentanyl mixed into heroin. The Arizona High Intensity Drug Trafficking Area posted nationwide alerts of heroin seizures that contained Fentanyl.                

Read more:                
http://www.wmicentral.com/news/county_news/ncso-warns-of-extremely-dangerous-trend/article_0b4c79ce-d9b3-11e5-8134-bb4f7df5a411.html                 
               

Other Resources

State Governments Strive to Curb Epidemic of Fatal Opioid Abuse                
Judy Woodruff, PBS NewsHour                
February 23, 2016                

In this interview, Massachusetts Governor Charlie Baker talked about the fight against opioid misuse in his state. (Video, audio, and transcript available) (Duration 8:08 minutes)                

Read more:                
http://www.pbs.org/newshour/bb/state-governments-strive-to-curb-epidemic-of-fatal-opioid-abuse                                  

Three Things Parents of High Schoolers Need to Know About ‘Study Drugs’                
Alexandra Pannoni, U.S. News & World Report                
February 22, 2016                

Experts are warning that so-called “study drugs”—often prescription amphetamines, such as Adderall—are not safer because they are prescription medications. Students may rely on study drugs instead of building crucial life skills. And, there are behavioral signs teens are misusing these drugs.                

Read more:                
http://www.usnews.com/education/blogs/high-school-notes/2016/02/22/3-things-parents-need-to-know-about-study-drugs                 
               

Webinars

Prescription Monitoring Programs: Capabilities and Benefits                
American Dental Association                
Wednesday, March 16, 2016                
2:00 p.m. – 3:00 p.m. (CT)                
http://www.ada.org/en/publications/ada-news/2016-archive/february/webinar-monitoring-prescription-drug-use                                  

Register:                
http://websurveys.ada.org/s/opioidwebinar                                  

Weed in Your Workplace: What You Need to Know                
National Safety Council                
Wednesday, April 20, 2016                
2:00 p.m. (ET)                 
http://eventcallregistration.com/reg/index.jsp?cid=59487t11                 
               

Grant Announcements

Prescription Drug Overdose Prevention for States                
Centers for Disease Control and Prevention                
Due: April 1, 2016                

The Centers for Disease Control and Prevention seek proposals for prescription drug overdose prevention for states.                

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

Increasing Access to Medication-Assisted Treatment in Rural Primary Care Practices (R18)                
Agency for Healthcare Research and Quality                
Due: March 4, 2016                
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-16-001.html                                  

Drug-Free Communities Support Program (SP-16-001)                
SAMHSA                
Due: March 18, 2016                
http://www.samhsa.gov/sites/default/files/grants/pdf/sp-15-001_0.pdf                                  

SP-16-003: Strategic Prevention Framework - Partnerships for Success (SPF-PFS)                
SAMHSA                
Due: April 12, 2016                
http://www.grants.gov/web/grants/search-grants.html                                  

NIJ-2016-9090: Research and Evaluation on Drugs and Crime                
National Institute of Justice                
Due April 20, 2016                
http://www.grants.gov/web/grants/search-grants.html                                  

National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for that                
National Institute on Drug Abuse                
Submission Period begins November 3, 2015, 9:00 a.m. (ET)                
Submission Period ends April 29, 2016, 11:59 p.m. (ET)                
http://nida.ideascale.com/a/pages/addiction-research-theres-an-app-for-that                 

Bottle Tracking Program                
National Association of Drug Diversion Investigators                
Due: None Specified                
http://www.naddi.org/aws/NADDI/pt/sp/programs_grants                 
http://naddibottletracking.org/law-enforcement                 
               

National Take-Back Initiative

National Prescription Drug Take-Back Day                
Drug Enforcement Administration                
Saturday, April 30, 2016                
10:00 a.m. – 2:00 p.m.                
http://www.deadiversion.usdoj.gov/drug_disposal/takeback                 
               

Take-Back Events & Drop Boxes

Colorado University-Boulder Hosting Prescription Drug Take-Back Event March 9                
Sarah Kuta, Daily Camera                
February 24, 2016                
http://www.dailycamera.com/cu-news/ci_29554700/cu-boulder-hosting-prescription-drug-take-back-event                                  

Have Prescription Medications to Discard? Stop by the Chandler (Ariz.) Police Department             
Greg Howarth, Chandler Police Department                
February 23, 2016                
https://chandlerpd.com/if-you-have-prescription-medication-that-you-need-to-dispose-stop-by-the-pd                                  

Four Orange County (Calif.) Walgreens Will be Take-Back Sites for Medications                
Jenna Chandler, Orange County Register                
February 24, 2016                
http://www.ocregister.com/articles/drugs-705252-prescription-people.html                                  

Drug Drop Box Now In Pottawattamie County (Iowa)                
Mike Petersen, KMAland                
February 23, 2016                
http://www.kmaland.com/news/drug-drop-box-now-in-pottawattamie-county/article_996961ec-da56-11e5-9405-d34fc6d5cad3.html                                  

Prescription Drug Drop Box in Place at the Galloway (N.J.) Police Department                
Anthony Bellano, Galloway Patch                
February 24, 2016                
http://patch.com/new-jersey/galloway/prescription-drug-dropbox-place-galloway-police-department-0                 
               

Upcoming Conferences and Workshops

Pharmacy Diversion Awareness Conference                
U.S. Drug Enforcement Administration                
March 19–20, 2016                
Wilmington, Delaware                
April 17–18, 2016                
Towson, Maryland                
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness                                 

Ohio Workers’ Compensation Medical & Health Symposium                
Bureau of Workers’ Compensation                
March 10–11, 2016                
Columbus, Ohio                
https://www.bwc.ohio.gov/provider/brochureware/PainSymposium/default.asp                                  

Marijuana and Cannabinoids: A Neuroscience Research Summit                
National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Center for Complementary and Integrative Health, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke                
March 22–23, 2016                
Bethesda, Maryland                
http://apps1.seiservices.com/nih/mj/2016                                  

Register:                
http://apps1.seiservices.com/nih/mj/2016/Registration.aspx                                  

2016 National Rx Drug & Heroin Summit                
March 28–31, 2016                
Atlanta, Georgia                
http://nationalrxdrugabusesummit.org                                  

Third Annual Smart Approaches to Marijuana Education Summit                
March 31, 2016                
Atlanta, Georgia                
http://nationalrxdrugabusesummit.org/sam-summit-2                                  

Register:                
https://www.123contactform.com/form-1486587/2016-National-Rx-Drug-Abuse-Summit                                  

Medical Marijuana Seminar                
Private Motor Truck Council of Canada                
May 3, 2016                
Alberta, Canada                                 

Read more:                
http://www.todaystrucking.com/alberta-hosting-spring-talk-on-medical-marijuana-in-trucking                 
http://www.pmtc.ca/News.asp?a=view&id=113                                  

2016 Annual Conference                
International Health Facility Diversion Association                
September 13–14, 2016                
Duke Energy Convention Center                
Cincinnati, Ohio                 
https://ihfda.org/2016-annual-conference                                  

Register:                
https://www.regonline.com/Register/Checkin.aspx?EventID=1803476                 
         
                                 
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