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May 19, 2016

PAW Weekly Update

    

                                          
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SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
          Issue 174  |  May 19, 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                            
International                            
Northeast/Mid-Atlantic News                            
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Featured

J. Blanchard, S.B. Hunter, K. Chan Osilla, W. Stewart, J. Walters, and R. Liccardo Pacula. 2016. “A Systematic Review of the Prevention and Treatment of Prescription Drug Misuse.” Military Medicine, doi:10.7205/MILMED-D-15-00009.                        

Researchers found that among 20 U.S. Department of Defense (DoD) directives and 11 clinical guidelines and consensus statements on prescription drug misuse, most focus on opioids. The directives focus on defining misuse and consequences following identification, which could inadvertently lead to service members delaying needed treatment out of fear. Researchers also reviewed six clinical guidelines (including two from DoD/Veterans Affairs), five consensus statements, and seven published systematic reviews. Most guidelines focused on prescription opioids with little guidance on management of misuse of other classes of prescription drugs. In 2012, DoD/Veterans Affairs clinical recommendations for prescription opioid misuse were similar to non-DoD clinical guidelines. Most guidelines noted the lack of strong research evidence for care recommendations on prevention of prescription opioid misuse. Guidelines consistently call for a comprehensive assessment of a patient’s medical history, including of substance use and comorbid psychiatric and medical conditions before initiation of therapy. Written management plans and urine drug screens are recommended when misuse risk is high, despite limited proof of effectiveness. Recommendations for pre-prescription screening examinations also have little supporting evidence. DoD/Veterans Affairs guidelines regarding treatment for substance use disorders discuss general approaches to treatment and do not focus on specific management of prescription drug misuse.                        

Read more:                        
http://publications.amsus.org/doi/10.7205/MILMED-D-15-00009                                                  

What Fed’s Electronic Recordkeeping Rule Means for Workplace Testing                        
Kathryn J. Russo, Jackson Lewsi, P.C.                        
May 12, 2016                        

The U.S. Occupational Safety and Health Administration (OSHA) has published its final electronic recordkeeping rule, “Improve Tracking of Workplace Injuries and Illnesses,” which states that “blanket post-injury drug testing policies deter proper reporting” and concludes that “the final rule does prohibit employers from using drug testing (or the threat of drug testing) as a form of adverse action against employees who report injuries or illnesses.” The rule has no impact on post-accident testing mandated by federal regulations or permitted by state workers’ compensation laws. OSHA intends to issue more guidance on the rule. Meanwhile, employers who conduct post-accident drug and alcohol testing should review their policies to ensure they are not conducting overly broad “automatic” post-injury testing that could be viewed as a deterrent to injury reporting by employees. The author recommends that employers consult with counsel to determine whether their post-accident drug and alcohol testing programs comply with all applicable laws.                         

Read more:                        
http://www.natlawreview.com/article/what-osha-s-electronic-recordkeeping-rule-means-workplace-post-accident-drug-and                       
               

Journal Articles and Reports

D.P. Alford, J.S. German, J.H. Samet, D.M. Cheng, C.A. Lloyd-Travaglini, and R. Saitz. 2016. “Primary Care Patients with Drug Use Report Chronic Pain and Self-Medicate with Alcohol and Other Drugs.” Journal of General Internal Medicine 31(5):486–491.                

At a hospital-based primary care clinic in Boston, 589 adult patients screened positive for illicit or prescription drug misuse between June 2009 through January 2012. Of misusers, 87 percent reported chronic pain (13 percent mild, 24 percent moderate, and 50 percent severe). Seventy-four percent reported pain-related dysfunction (15 percent mild, 23 percent moderate, and 36 percent severe). Of 576 who used illicit drugs, 51 percent used them to treat pain. Of 121 who misused prescription drugs, 81 percent used them to treat pain. Of 265 who reported heavy drinking in the past 3 months, 38 percent drank to treat pain.                

Read more:                
http://link.springer.com/article/10.1007%2Fs11606-016-3586-5                                  

A. Bachyrycz, S. Shrestha, B.E. Bleske, D. Tinker, and L.N. Bakhireva. 2016. “Opioid Overdose Prevention Through Pharmacy-Based Naloxone Prescription Program: Innovations in Healthcare Delivery.” Substance Abuse, doi:10.1080/08897077.2016.1184739.                

Pharmacists in New Mexico have prescribed 133 naloxone rescue kits since 2013, according to the Prevention of Opioid Overdose by New Mexico Pharmacists Registry. Of these, 10.5 percent were repeat prescriptions. Mean patient age was 41.5, and 60.2 percent female. Only 11.3 percent of the prescriptions were from pharmacists practicing in rural/mixed urban-rural areas. Reasons for a prescription were patient request (56.4 percent), use of high-dose of prescription opioids (28.6 percent), and history of opioid misuse (15.0 percent). More than a third of patients (38.5 percent) admitted polysubstance use in the previous 72 hours.                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/08897077.2016.1184739                                  

M.C. Kennedy, T. Kerr, K. DeBeck, H. Dong, M.J. Milloy, E. Wood, and K. Hayashi. 2016. “Seeking Prescription Opioids from Physicians for Nonmedical Use Among People Who Inject Drugs in a Canadian Setting.” American Journal of Addictions, doi:10.1111/ajad.12380.                

Among 1,252 people who inject drugs in Vancouver, Canada, and surveyed between June 2013 and May 2014, 36.6 percent tried to get an opioid prescription for nonmedical use. Among those who tried, 74.9 percent succeeded at least once. In multivariate analysis, odds of seeking a prescription increased with age (odds ratio [OR] = 1.02 per year of age), race (Caucasian OR = 1.38), history of overdose (OR = 1.32), past participation in methadone maintenance therapy (OR = 1.90), and history of dealing drugs (OR = 1.65).                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1111/ajad.12380/abstract                                  

N.K. Park, L. Melander, and S. Sanchez. 2016. “Nonmedical Prescription Drug Use Among Midwestern Rural Adolescents.” Journal of Child & Adolescent Substance Abuse doi:10.1080/1067828X.2015.1049392.                

A little over 10 percent of students in Nebraska have ever misused prescription drugs, with 4.7 percent misusing in the past 30 days, according to Nebraska Risk and Protective Factor Student Survey data from 18,050 students in grades 6, 8, 10, and 12. In multivariate analysis, odds of lifetime misuse were lower for youth with greater parental attachment (odds ratio [OR] = 0.61), greater school attachment (OR = 0.65), and agreed that “In my community, there are many fun or interesting things to do that are safe and legal” (OR = 0.82). Odds were higher for girls (OR = 1.18) and predictably increased with age. Odds of current use were similar, with odds also lower for youth who felt safe in their neighborhood (OR = 0.78). Rural (as opposed to urban) residence reduced the odds of lifetime use in models that did not control for perceptions of safe options and living conditions (OR = 0.93).                

Read more:                
http://www.tandfonline.com/doi/abs/10.1080/1067828X.2015.1049392                                  

G.J. Pfister, R.M. Burkes, B. Guinn, J. Steele, R.R. Kelley, T.L. Wiemken, M. Saad, J. Ramirez, and R. Cavallazzi. 2016. “Opioid Overdose Leading to ICU Admission: Epidemiology and Outcomes.” Journal of Critical Care, doi:10.1016/j.jcrc.2016.04.022.                

Among 178 adult patients admitted to a Louisville, Ky., hospital’s intensive care unit (ICU) for opioid overdose in 2011–14, most overdosed on oxycodone or hydrocodone. Sixty-three percent had used other drugs or alcohol as well as opioids, with 39 percent using benzodiazepines, 13 percent amphetamines, and 12 percent alcohol. Median ICU length-of-stay was 3 days. Eighteen patients (10 percent) died in the hospital and six (3 percent) were discharged to a nursing home. Most patients required invasive mechanical ventilation (85 percent).Patients with co-ingestions were more likely to undergo invasive mechanical ventilation (91 percent vs. 77 percent) and had longer ICU length of stay (3 vs. 2 days).                

Read more:                
http://www.sciencedirect.com/science/article/pii/S088394411630048X                                  

A.C. Pomerleau, J.D. Schrager, and B.W. Morgan. 2016. “Pilot Study of the Importance of Factors Affecting Emergency Department Opioid Analgesic Prescribing Decisions.” Journal of Medical Toxicology, doi:10.1007/s13181-016-0553-9.                

A 2013 survey of 203 emergency department providers at Emory University in Atlanta drew 142 responses (70 percent response rate). The five highest-rated factors affecting a decision to prescribe opioids were patient’s prescription history, patient’s history of substance use disorder, diagnosis that was likely to cause the patient’s pain, the provider’s clinical gestalt, and the provider’s concern about unsafe use of the medication. The five lowest-rated factors were patient’s age, patient’s satisfaction, patient’s reported pain score, the prescribing culture of the clinical site, and the provider’s concern about medication diversion.                

Read more:                
http://link.springer.com/article/10.1007/s13181-016-0553-9                                  

N.E. Suardi, M. Preve, M. Godio, E. Bolla, R.A. Colombo, and R. Traber. 2016. “Misuse of Pregabalin: Case Series and Literature Review.” European Psychiatry 33:S376, doi:10.1016/j.eurpsy.2016.01.1067. Abstract of the 24th European Congress of Psychiatry, March 12–15, 2016, Madrid, Spain.                

Pregabalin (brand name Lyrica) is a non-opioid medication prescribed to treat pain or epilepsy. People who misuse it typically snort the drug. Symptoms include euphoria, psychomotor activation, and sedation. The authors assessed 10 inpatients diagnosed with pregabalin misuse. All 10 tested positive for cocaine, alcohol, or heroin at admission and had elevated anxiety scores.                 

Read more:                
https://www.infona.pl/resource/bwmeta1.element.elsevier-eecfb736-7e97-3aa1-8942-f7ee9d27bd20                                 

S.E. Wakeman, G. Pham-Kanter, and K. Donelan. 2016. “Attitudes, Practices, and Preparedness to Care for Patients with Substance Use Disorder; Results from a Survey of General Internists.” Substance Abuse, doi:10.1080/08897077.2016.1187240.                

A 2014 survey of 290 inpatient and outpatient general internists at Massachusetts General Hospital in Boston drew 149 responses (51.4 percent response rate). Among respondents, 46 percent frequently cared for patients with substance use disorders (SUD), 16 percent frequently referred patients to substance use treatment, and 6 percent frequently prescribed a medication to treat SUD. Twenty percent felt very prepared to screen for SUD, 9 percent to provide a brief intervention, 7 percent to discuss behavioral treatments, and 9 percent to discuss medication treatments. Thirty-one percent felt that SUD is different from other chronic diseases because they believe using substances is a choice. Fourteen percent felt treatment with opioid agonists was replacing one addiction with another. Twelve percent of hospitalists and 6 percent of primary care physicians believed that someone who uses drugs is committing a crime and deserves punishment. Preparedness was associated with evidence-based clinical practice and favorable attitudes. Frequently caring for patients with SUD was associated with preparedness, clinical practice, and favorable attitudes.                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/08897077.2016.1187240                                 

M. Vogel, C. Nordt, K.M. Dürsteler, U.E. Lang, E. Seifritz, M. Krausz, and M. Herdener. 2015. “Evaluation of Medication-Assisted Treatment of Opioid Dependence—The Physicians’ Perspective.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.04.039.                

A case register recorded 17,234 medication-assisted opioid treatment episodes for 7,432 patients in Zurich between 1998 and 2013. The register includes a physician-completed assessment on the course of the treatment episode. Mean assessment of the overall course of treatment was moderate. Predictors of physician ratings were treatment break off as reason for termination, psychological improvement throughout treatment, wish for abstinence from the substitute, social integration index at termination, and social as well as medical improvement. The negative association of treatment break off with medication-assisted opioid treatment assessment was stronger in semi-rural than urban areas.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30107-7/abstract                 

Professional Development

M. Galanter, M. Seppala, and A. Klein. 2016. “Medication-Assisted Treatment for Opioid Dependence in Twelve-Step-Oriented Residential Rehabilitation Settings.” Substance Abuse, doi:10.1080/08897077.2016.1187241.                

Read more:                
http://www.tandfonline.com/doi/full/10.1080/08897077.2016.1187241                                  

U.E. Ghitza. 2016. “Overlapping Mechanisms of Stress-Induced Relapse to Opioid Use Disorder and Chronic Pain: Clinical Implications.” Frontier in Psychiatry, doi:10.3389/fpsyt.2016.00080.                

Read more:                
http://journal.frontiersin.org/article/10.3389/fpsyt.2016.00080/full                                  

M. Norton , A. Young Cho, C. Giebler, T. Smith, and K. Walton. 2016. “Buprenorphine/Naloxone Addiction in a Pharmacist as a Result of Migraine Self-Treatment.” Mental Health Clinician 6(3):127–30, doi:http://dx.doi.org/10.9740/mhc.2016.05.127.                

Read more:                
http://mhc.cpnp.org/doi/abs/10.9740/mhc.2016.05.127                 

National

House Passes Bills to Combat Opioid Abuse in United States                
Kate O’Keefe, Wall Street Journal                
May 12, 2016                

The U.S. House of Representatives has passed several bills to address pain reliever misuse and heroin use. The bills provide for substance use treatment, education, and law enforcement efforts to tackle the opioid epidemic, among other provisions. House leaders plan to vote to assemble most of the opioid bills into a single measure, a package similar to legislation passed by the Senate in March. After the House and Senate resolve differences between the two versions, President Obama is expected to sign the legislation into law.                

Read more:                
http://www.wsj.com/articles/house-passes-bills-to-combat-opioid-abuse-in-u-s-1463090994                                  

House Passes Legislation to Prevent Veteran Opioid Abuse                
Karina E. Flores, WNDU                
May 10, 2016                

The U.S. House of Representatives has passed legislation that would require all Veterans Affairs facilities to participate in states’ prescription drug monitoring programs.                

Read more:                
http://www.wndu.com/content/news/House-passes-Walorskis-legislation-to-prevent-veteran-opioid-abuse-378901821.html                                  

Five Ways to Manage Opioid Abuse in the Workplace                
Mike Ahern, Construction Executive                
May 5, 2016                

The author says employers can help reduce opioid risks in the workplace, especially among workers in the construction industry, in five ways: (1) educate employees about responsible prescription opioid use. (2) understand risk factors of opioid misuse. (3) provide support and safe return to work to injured employees. (4) communicate treatment options, and (5) ask the right questions. The author advises business owners to educate themselves and their employees on drug screening and related policies. He suggests consulting with an insurance provider on workers’ compensation policies to better understand risks and coverage options available. He also urges employers to be prepared to support an employee in efforts to return to work in a healthy and safe manner.                 

Read more:                
http://enewsletters.constructionexec.com/managingyourbusiness/2016/05/five-ways-to-manage-opioid-abuse-in-the-workplace                                  

Research: Patients’ Illicit Substance Use Differs By Types of Insurance Coverage                
PR Newswire                
May 12, 2016                

A review of over 450,000 patient samples collected nationwide for opioid dose monitoring over 3 years found that 16 percent of tests paid by Medicaid showed use of an illicit substance, according to drug testing company Ameritox. The detection rate was roughly half that level in tests covered by commercial insurance, workers’ compensation or Medicare. More than 22 percent of patients ages 10–19 with a prescription opioid medication tested positive for an illicit substance, most often marijuana or cocaine. Illicit drug use declined in each decade of life thereafter. Illicit substances were detected in 13 percent of male patients and 8 percent of female patients.                

Read more:                
http://www.prnewswire.com/news-releases/ameritox-presents-research-that-reveals-patients-illicit-substance-abuse-differs-among-types-of-insurance-coverage-300267507.html                                  

Opinion: Doctors Must Lead Us Out of Our Opioid Abuse Epidemic                
Sanjay Gupta, M.D., CNN                
May 12, 2016                

Overdoses are the most common cause of preventable death in America. Sanjay Gupta. M.D., chief medical correspondent for CNN, blames mostly doctors. Dr. Gupta says doctors must lead the way to address the opioid misuse epidemic in this country. They need to engage patients and discuss treatment with them, whether it is with short term opioids or alternatives. They need to help set realistic expectations for patients and follow up to see how treatment is going. (Includes several short videos)                

Read more:                
http://www.cnn.com/2016/05/11/health/sanjay-gupta-prescription-addiction-doctors-must-lead                                  

Overdose Deaths High Among Middle Aged, Too                
Kristin Gourlay, Rhode Island Public Radio                
May 6, 2016                

Drug overdose death risk is high among people ages 44–64. People in this age group sometimes rotate or switch medications that can cause accidental overdose. Their bodies are not used to the medications or the high dosages. Combining medications also puts people at risk, especially using opioids and benzodiazepines together. Middle-aged people can sometimes become isolated due to divorce or children leaving home. When they experience an overdose, no one is there to revive them. People in this age group tend to take longer acting opioids which raise their risk of developing an opioid use disorder. (Includes audio: 4:14 minutes)                

Read more:                
http://ripr.org/post/overdose-deaths-high-among-middle-aged-too                 
                 

Marijuana

Fatal Road Crashes Involving Marijuana Double After State Legalizes Drug                  
AAA                  
May 10, 2016                  

Fatal crashes involving drivers who tested positive for marijuana increased from 8 percent to 17 percent in Washington after the state legalized recreational use in December 2012. Testing establishes use within a multi-day span, not that the drug was psychoactive at the time of the crash. This AAA Foundation for Traffic Safety concludes that most current legal tests for driving while impaired by marijuana have no scientific basis. The foundation recommends replacing the laws in Colorado, Montana, Nevada, Ohio, Pennsylvania, and Washington with a two-component system that requires (1) a positive test for recent marijuana use and (2) behavioral and physiological evidence of driver impairment. The second component would rely on specially trained police officers to determine if a driver is impaired, backed up by a test for the presence of tetrahydrocannabinol (THC) rather than a specific THC threshold. Mark A. R. Kleiman, a New York University professor who specializes in issues involving drugs and criminal policy, recommends that states consider making driving under the influence of marijuana a traffic violation rather than switching to a new kind of law.                  

Read more:                  
http://newsroom.aaa.com/2016/05/fatal-road-crashes-involving-marijuana-double-state-legalizes-drug                   
http://www.usnews.com/news/politics/articles/2016-05-10/study-no-scientific-basis-for-laws-on-marijuana-and-driving                                     

Access to Medical Cannabis Still Slow Going in the Quad Cities                  
Chris Minor, WQAD                  
May 9, 2016                  

Patients in the Quad Cities (four counties in northwest Illinois and southeast Iowa) are having a tough time finding doctors to write medical marijuana prescriptions. The owner of Nature’s Treatment, a licensed medical marijuana dispensary, said doctors at two major hospital groups in the area were reluctant to prescribe. Only board-certified physicians in pain management can write marijuana prescriptions for patients at Unity Point. Genesis Health Group allows any physician to prescribe. (Includes video: 1:36 minutes)                  

Read more:                  
http://wqad.com/2016/05/09/access-to-medical-cannabis-still-slow-going-in-the-quad-cities                                      

Legal Pot in Alaska and What It Could Mean for Keeping Your Job                  
Samantha Angaiak, KTUU                  
May 6, 2016                  

Joe Dunham, statewide supervising investigator for Alaska’s Wage and Hour Administration, said employers are allowed to require drug testing for alcohol and drugs. If the test is random, it should be in a written policy to prevent potential discrimination. Costs for drug testing have to be paid by the employer. Any travel cost and time spent going to and from the testing facility is considered work time. The commissioner of Alaska’s labor and workforce development department said an employer who has a legitimate drug and alcohol policy retains the rights under that policy to take action against employees who test positive for marijuana, regardless of its legalization.                   

Read more:                  
http://www.ktuu.com/content/news/378488915.html                                      

Medical Marijuana Draws Parents to United States for Children’s Treatments                  
Sam Levin, The Guardian                  
May 9, 2016                  

“Marijuana refugees” are moving to Colorado, California, and Oregon to legally use cannabis to treat their children’s health conditions. For example, Yvonne Cahalane traveled from Dunmanway, Ireland, to Colorado to access medical marijuana for her son, whose rare form of epilepsy abated for months with medical marijuana. Cahalane has launched a petition backed by more than 8,000 people thus far in hopes that her son’s story will pressure Ireland to change its laws and allow her to return home with his medicine. Their current visas will expire at the end of the 2016.                  

Read more:                  
http://www.theguardian.com/society/2016/may/09/medical-marijuana-families-move-to-colorado-epilepsy                
               

International

Naloxone Kits to Be Available in Alberta, Canada, Without Prescription                
Lydia Neufeld, CBC News                
May 11, 2016                

Naloxone kits will soon be available at pharmacies without a prescription in a second Canadian province, Alberta. Six hundred pharmacies have registered to provide the kits. More than 2,000 naloxone kits have already been provided by prescription to Albertans at risk of overdosing. The government reported that more than 120 naloxone kits have reversed overdoses involving fentanyl. In the first quarter of 2016, 69 Albertans died from fentanyl overdoses; 274 died in 2015.                

Read more:                
http://www.cbc.ca/news/canada/edmonton/life-saving-naloxone-kits-soon-available-without-prescription-1.3577575                     
               
               

Northeast/Mid-Atlantic News

Stricter Regulations Proposed for Opioid Prescriptions                
State of Delaware                
May 11, 2016                

Delaware’s secretary of state has proposed stricter regulations for prescribing opioid analgesics. The regulations include three major provisions: 1) for an acute injury or procedure, a practitioner can prescribe a maximum initial seven-day supply of an opioid medication before additional steps are required; 2) prescribing beyond a seven-day supply or for additional prescriptions after the first seven-day supply, the practitioner will be required to check the patient’s prescription history in the state prescription drug monitoring program (PDMP) and to obtain informed consent from the patient for potential risks of addiction, misuse, and accidental overdose; and 3) practitioners will be required to check the PDMP and administer a urine drug screening at least twice a year to patients who receive chronic treatment with opioid medications. The practitioner must also consider and discuss alternative treatment options with a patient, and conduct a risk assessment to identify patients who are or may be at risk for dependence or misuse of a prescribed opioid. A signed treatment agreement will also be required for these patients.                

Read more:                
http://news.delaware.gov/2016/05/11/stricter-regulations-proposed-for-opioid-prescriptions                                  

Buffalo, N.Y., Emergency Departments Prepare for Deluge of Opiate Patients                
Henry Davis, Buffalo News                
May 8, 2016                

Emergency departments (ED) in the Buffalo, N.Y., area are preparing for a surge of opioid patients. The pain management practice of Eugene Gosy, M.D., was shut down following his indictment on federal charges of unlawfully distributing narcotics. Patients are starting to show up in EDs seeking care and medications. Local physicians working on guidelines for prescribing opioids accelerated their release in the wake of the federal case against Dr. Gosy. The guidelines state that a primary care physician outside the ED who can follow a patient’s treatment should provide all opioids. They permit treating acute pain in the ED but state that prescriptions should be for the shortest duration appropriate. Public health officials advised Gosy’s patients to seek care from their primary care physicians, a pain management specialist, or one of the area’s federally qualified health centers.                

Read more:                
http://www.buffalonews.com/city-region/medical/local-ers-prepare-for-deluge-of-opiate-patients-20160507                                  

Three Philadelphia Doctors Illegally Sold $5 Million Worth of Prescriptions                
Emily Baby, Inquirer Daily News                
May 12, 2016                

A federal grand jury has indicted three doctors on charges of selling $5 million worth of prescription drugs out of a South Philadelphia clinic. They sold Suboxone (buprenorphine) and Klonopin (designed to treat seizures and panic attacks) from 2011–14. They did not perform medical examinations before prescribing the drugs. They were charged with distribution of controlled substances, conspiracy to distribute controlled substances, healthcare fraud, and money laundering.                

Read more:                
http://www.philly.com/philly/news/20160512_Feds__3_doctors_
illegally_sold__5M_worth_of_prescriptions.html
                                  

Rhode Island Senate Committee Approves Bills to Combat Opioid Crisis                
Colin Spence, WPRI                
May 13, 2016                

A Rhode Island senate committee has approved legislation that ensures those who are treated at hospitals, clinics, and urgent care facilities with a substance use disorder receive follow-up care to address their addiction; requires all health insurance providers cover prescriptions for naloxone; requiring health practitioners and health plans to support clinical practices fostering use of abuse-deterrent opioid analgesic drug product formulations approved by the FDA; establishes prescribing limits for addictive pain medication when prescribed for acute pain; and allows electronic system data transmission of Schedule V prescriptions.                 

Read more:                
http://wpri.com/2016/05/13/ri-senate-committee-approves-several-bills-combating-the-opioid-crisis                                  

Rhode Island Department of Health: Overdose Deaths Up 135 Percent                
WLNE                
May 10, 2016                

Rhode Island’s health department has reported that drug overdose deaths increased 135 percent since 2012, even though prescription drug overdose deaths declined 34 percent. Deaths increased from 232 in 2014 to 257 in 2015. Overdose deaths related to fentanyl have increased 15-fold since 2012.                

Read more:                
http://www.abc6.com/story/31940044/ri-department-of-health-overdose-deaths-up-135                                  

New York Task Force to Combat Heroin and Prescription Opioid Crisis                
State of New York                
May 10, 2016                

New York’s governor has launched a statewide heroin task force charged with ending the heroin and opioid crisis in the state. The task force will build upon the state’s previous efforts. It will develop a comprehensive statewide system that identifies ways to expand awareness of heroin and opioid addiction; enhance statewide prevention efforts; increase access to treatment; and improve support for those in recovery. Members of the task force will hold public listening sessions across the state to inform their recommendations.                  

Read more:                
https://www.governor.ny.gov/news/governor-cuomo-announces-statewide-task-force-combat-heroin-and-prescription-opioid-crisis                                 

Agriculture Secretary Discusses Strategies to Address Opioid Epidemic                
U.S. Department of Agriculture                
May 9, 2016                

U.S. Department of Agriculture (USDA) Secretary Tom Vilsack recently visited with stakeholders and leaders in New Hampshire to discuss the state’s efforts to address the opioid epidemic. This article summarizes the scope of the crisis in the state, the Obama Administration’s response, and the USDA’s efforts.                

Read more:                
http://www.usda.gov/wps/portal/usda/usdahome?contentid=2016/05/0108.xml&contentidonly=true                 

South News

Former Sam’s Club Employee in Texas Sues Company Over Drug Test Results                
John Suayan, Southeast Texas Record                
May 8, 2016                

Luke Martinez, a former Sam’s Club employee in Texas, is suing Sam’s Club and his coworker, Misty Rhame, for giving him pain medication that resulted in a positive drug test. Martinez claimed that Rhame, the store’s loss control manager, told him that it would not appear in a drug screen. Martinez was terminated from his job and is now seeking unspecified monetary damages.                 

Read more:                
http://setexasrecord.com/stories/510723438-former-sam-s-club-employee-alleges-medication-provided-by-fellow-worker-resulted-in-positive-drug-test                                  

Fentanyl, Heroin Fueling Deadly Crisis in South Florida                
Tonya Alanez, Sun Sentinel                
May 13, 2016                

More people last year died from Fentanyl in Fort Lauderdale, West Palm Beach, Miami, and Orlando than any other Florida cities. In the first quarter of 2016, the Broward County medical examiner’s office recorded 20 heroin deaths, 28 fentanyl deaths, and 20 deaths caused by a combination of the two opiates. If Broward deaths from heroin and fentanyl continue at the current pace, the county will see an uptick from 159 deaths in 2015 to an estimated 272 in 2016. And 2015 was up one-third from 2014. Statewide in the first half of 2015, heroin deaths increased by 115 percent and fentanyl deaths increased 105 percent. Five fentanyl fatalities occurred on a single day in February 2016. (Includes videos: 1:02 minutes)                

Read more:                
http://www.sun-sentinel.com/local/broward/fl-fentanyl-heroin-use-crisis-20160512-story.html                                  

Austin (Texas) Police See an Increase in Overdoses Possibly Related to Fentanyl                
Calily Bien and Amanda Brandeis                
May 9, 2016                

The Austin Police Department is warning the community about rising drug overdoses that appear to be linked to fentanyl. (Includes video: 2:45 minutes)                

Read more:                
http://kxan.com/2016/05/09/austin-police-see-an-increase-in-overdoses-possibly-related-to-fentanyl                                  

Virginia CVS Pharmacies to Offer Nalaxone Without Prescription                
Shayne Dwyer, WDBJ7                
May 11, 2016                

Naloxone will now be available without a prescription at all CVS locations in Virginia. Twenty-two other states allow sales of this medication without a prescription.                

Read more:                
http://www.wdbj7.com/content/news/CVS-stores-in-Virginia-to-start-offering-anti-overdose-medication-without-prescription-379064271.html                 

Midwest News

Oxycontin Maker Loses Legal Battle in Kentucky to Keep Lawsuit Records Secret                
Victoria Kim and Harriet Ryan                
May 11, 2016                

Purdue Pharma has lost a legal battle to keep records and testimony about OxyContin secret. A Pike County, Ky., judge granted a motion by a news outlet to unseal records from a lawsuit by the state accusing Purdue of fraud, conspiracy, and negligence in development and marketing of the drug. The order does not take effect for 32 days, allowing Purdue time to appeal. The company had argued that the public had no right to see the material because it contained sensitive information about its internal business operations.                 

Read more:                
http://www.latimes.com/local/california/la-me-kentucky-purdue-records-20160512-story.html                                  

Missouri Drug Monitoring Program Stalls in Senate Once Again                
Jason Hancock, Kansas City Star                
May 12, 2016                

Missouri State Sen. Rob Schaaf said he would support legislation to create a prescription drug monitoring program in the holdout state if voters could decide by referendum in November. Proponents agreed to put the issue on the ballot, but not with language Schaaf has suggested. They offered their own language for the ballot, which Schaaf called “deceptive and shameful.”                 

Read more:                
http://www.kansascity.com/news/local/news-columns-blogs/the-buzz/article77334262.html                                  

Pain Reliever, Heroin Overdose Cases Surging in Iowa                
Cynthia Fodor, KCCI                
May 11, 2016                

Iowa’s public health department reported that opioid misuse involving prescription drugs and heroin is one of the fastest growing forms of substance abuse in the state. The number of opioid-related emergency department visits quadrupled in the past 8 years, from 519 to 1,555. The number of overdose deaths jumped from 12 in 2005 to 52 in 2014. The Powell Chemical Dependency Center at Lutheran Medical Center, which treats those addicted to heroin or pain relievers, reported that all of its beds are full. (Includes video: 1:21 minutes)                

Read more:                
http://www.kcci.com/news/pain-reliever-heroin-overdose-cases-surging-in-iowa/39493722                                  

Narcan Use on the Rise                
Rachelle Blair, Lodi Enterprise                
May 11, 2016                

Lodi area and Poynette-Dekorra emergency medical services (EMS) in Wisconsin have administered Narcan on five calls so far this year. Lodi EMS began carrying Narcan in 2012. Since then, it has been administered 15 times. Poynette-Dekorra EMS has been carrying the antidote since late 2013. Since then, it has been administered seven times.                

Read more:                
http://www.hngnews.com/lodi_enterprise/news/local/article_8ddf17ee-17b0-11e6-830e-eb8cc1f53c0d.html                 

West News

Despite Declines, Opioids Still Top List of California Workers’ Compensation Drugs                
California Workers Compensation Institute                
May 5, 2016                

Use of opioids in California workers’ compensation and associated payments have declined in recent years, but potentially addictive pain relievers remain the top therapeutic drug group used in the system, according to the California Workers’ Compensation Institute. Analysis of 10.8 million prescriptions dispensed to California injured workers (2005–14) shows opioids increased from 27 percent of all workers’ compensation prescriptions in 2005 to 32 percent in 2009, but then retreated to 27 percent in 2014. Opioid reimbursements as a proportion of total workers’ compensation drug spending increased from 19 percent in 2005 to a peak of 32 percent in 2009 before falling back to 24 percent in 2014. The decline in opioid use accelerated in 2012, which coincides with increased scrutiny by utilization review and independent medical review programs and restrictions imposed by pharmacy benefit managers, medical provider networks, and payers. In 2014, opioids still accounted for more than a quarter of prescriptions dispensed to injured workers.                 

Read more:                
http://www.cwci.org/press_release.html?id=515                                  

Prescription Drug Use on the Rise in North Dakota                
Sara Berlinger, KFYR                
May 7, 2016                

The number of overdose deaths in North Dakota doubled in a 1-year span. Last month, naloxone became available at pharmacies. (Includes video: 1:55 minutes)                

Read more:                
http://www.kfyrtv.com/home/headlines/Prescription-Drug-Use-on-the-Rise-in-ND-378513015.html                                  

Police: Fatal Overdoses Show Drug Abuse Increasing at University of California Santa Cruz                
Brynne Whittaker, KSBW                
May 10, 2016                

University of California Santa Cruz police are seeing an increase in drug use on campus. In the last 18 months, the school had four students die from drug overdoses, two major ecstasy drug-selling busts, and a double fatal accident where a student was allegedly driving impaired. The most prevalent drugs on campus are Adderall, Xanax, ecstasy, marijuana, and alcohol. The school asked students to watch out for friends and warn them about the dangers of prescription drugs. Police are urging students to call police if their friends need help. (Includes video: 2:21 minutes)                

Read more:                
http://www.ksbw.com/news/police-fatal-overdoses-show-drug-abuse-increasing-at-ucsc/39464340                

Other Resources

[Video] Top 10 Facts About Prescription Drug Abuse in America                
WatchMojo.com                
May 10, 2016                

WatchMojo News, a weekly series from WatchMojo.com, discuses a list of facts about prescription drug misuse in America. (Duration: 9:26 minutes)                

Watch:                
http://www.msn.com/en-us/sports/watch/top-10-facts-about-prescription-drug-abuse-in-america/vp-BBsP7LE                

Webinars

Human Rights, Accommodation and Medical Marijuana in the Workplace                
Canadian HR Compliance & Management                
Wednesday, June 8, 2016                 
12–1 p.m. (ET)                
https://attendee.gotowebinar.com/register/5342181027592229636                 

Grant Announcements

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths                
SAMHSA                
Due: May 31, 2016                

SAMHSA offers grants to reduce the number of prescription drug/opioid overdose-related deaths and adverse events among individuals ages 18 and older by training first responders and other key community sectors on the prevention of prescription drug/opioid overdose-related deaths and implementing secondary prevention strategies such as the purchase and distribution of naloxone to first responders.                

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

Targeted Capacity Expansion: Medication Assisted Treatment—Prescription Drug and Opioid Addiction grants                
SAMHSA                
Due: May 31, 2016                

This funding opportunity hopes to expand and enhance access to medication-assisted treatment services for persons with opioid use disorder who seek or receive such treatment.                 

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

Strategic Prevention Framework for Prescription Drugs                
SAMHSA                
Due: May 31, 2016                

This grant program provides an opportunity for states, territories, pacific jurisdictions, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant to target the priority issue of prescription drug misuse.                 

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

Prescription Drug Overdose: Data-Driven Prevention Initiative                
National Center for Injury Prevention and Control                
Due: May 27, 2016                 
http://www.grants.gov/web/grants/view-opportunity.html?oppId=282529                                  

Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality                
National Center for Injury Prevention and Control                
Due: June 27, 2016                 
http://www.grants.gov/view-opportunity.html?oppId=283253                                  

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/                

Take-Back Events & Drop Boxes

Connecticut Collects Over 8,000 Lbs. of Prescription Drugs During Take-Back Day                
Anna Bisaro, New Haven Register                
May 6, 2016                
http://www.nhregister.com/general-news/20160506/connecticut-residents-give-back-more-than-8000-pounds-of-prescription-drugs-during-take-back-day                                  

Northern California and Central Valley Collect 13 Tons of Prescription Drugs                
The Recorder                
May 9, 2016                
http://www.recorderonline.com/news/tons-of-prescription-drugs-turned-in/article_0b4db2b4-1593-11e6-bbf2-138a2d5a2b1f.html                                  

Over 4,000 Lbs. Collected in Louisiana on Prescription Drug Take-Back Day                
WQUE                
May 9, 2016                
http://q93.iheart.com/articles/local-news-135361/over-4000-pounds-collected-in-louisiana-14692573                                  

Schuylkill County (Penn.) Officials Collect 679 Lbs. of Drugs at Take-Back Event                
Amy Marchiano, Pottsville Republican                
May 8, 2016                
http://republicanherald.com/news/officials-collect-679-pounds-of-drugs-at-take-back-event-1.2039996                                  

Philadelphia District Attorney’s Office Expanding Prescription Drug Drop-Off Program                
Paul Kurtz, CBS Philly                
May 11, 2016                 
http://philadelphia.cbslocal.com/2016/05/11/philadelphia-expanding-prescription-drug-drop-off                                  

Medication Disposal Kiosk Placed in Cathedral City (Calif.) Walgreens                
Patrick Edgell, KESQ                
May 9, 2016                
http://www.kesq.com/news/medication-disposal-kiosk-placed-in-cathedral-city-walgreens/39455782                 
               

Upcoming Conferences and Workshops

National Prevention Week—Strong as One. Stronger Together.                  
SAMSHA                
May 15–21, 2016                
Nationwide                
http://www.samhsa.gov/prevention-week                                 

Twenty-Fourth Annual Meeting                
Society for Prevention Research                
May 31–June 3, 2016                
San Francisco, Calif.                
http://www.preventionresearch.org/2016-annual-meeting                                 

American Pharmacists Association Institute on Alcoholism and Drug Dependencies                
American Pharmacists Association                
June 3–6, 2016                 
Salt Lake City, Utah                
http://www.pharmacist.com/apha-institute-alcoholism-and-drug-dependencies                                  

International Conference on Opioids                
Journal of Opioid Management                
June 5–7, 2016                
Boston, Mass.                
http://www.opioidconference.org                                  

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                                 

Twenty-Ninth Annual National Prevention Network Conference                
National Prevention Network                
September 13–15, 2016                
Buffalo, N.Y,                
http://www.npnconference.org                

Register:                
http://www.npnconference.org/registration                  
         
                                 
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.