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May 22, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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May 22, 2013 (PDF version)
Featured Report
Prescription Drug Misuse in Pregnancy and Parenting: A Report for Service Providers Working with First Nations Women in Ontario
Best Start Resource Centre

This report presents service providers with strategies to prevent and address prescription drug misuse among pregnant First Nations women and those with young children. Strategies include individual supports and community-wide approaches.

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Journal Articles

M.O. Martel, A.D. Wasan, R.N. Jamison, and R.R. Edwards. 2013. "Catastrophic Thinking and Increased Risk for Prescription Opioid Misuse in Patients with Chronic Pain." Drug and Alcohol Dependence.

This study examined variables that may underlie the association of catastrophic thinking and risk for prescription opioid misuse among chronic pain patients. Patients with chronic musculoskeletal pain (n = 115) were asked to complete the SOAPP-R, a validated self-report questionnaire designed to identify patients at risk for opioid misuse. Patients were also asked to complete self-report measures of pain intensity, catastrophizing, anxiety, and depression. Consistent with previous findings, researchers discovered that catastrophizing was associated with increased risk for prescription opioid misuse. Results also revealed the association between catastrophizing and risk for opioid misuse was partially mediated by patients' anxiety levels. Follow-up analyses, however, indicated that catastrophizing remained a significant "unique" predictor of opioid misuse risk, even when controlling for patients' levels of pain, anxiety, and depressive symptoms.

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F. Modarai, K. Mack, P. Hicks, S. Benoit, S. Park, C. Jones, S. Proescholdbell, A. Ising, and L. Paulozzi. 2013. "Relationship of Opioid Prescription Sales and Overdoses, North Carolina." Drug and Alcohol Dependence.

This ecological study compared trends and patterns in opioid sales, opioid drug overdoses treated in emergency departments (EDs), and unintentional overdose deaths in North Carolina. Annual sales data provided by the Drug Enforcement Administration for select opioids were converted into morphine equivalents and aggregated by zip code. Rates of opioid drug sales were trended from 1997 to 2010. In addition, opioid sales were correlated and compared with opioid-related ED visits--information provided by the Centers for Disease Control and Prevention syndromic surveillance system, and unintentional overdose deaths--information provided by the 2008-10 N.C. Vital Statistics. Finally, spatial cluster analysis was performed and rates were mapped by zip code in 2010. Opioid sales increased substantially from 1997 to 2010. Quarterly rates of opioid drug overdoses treated in EDs from 2008 to 2010 correlated with opioid sales (r = 0.68, p = 0.02). Specific regions of the state, particularly in the southern and western corners, had high rates of prescription opioid sales and overdoses.

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M. Wilson, W.M. Compton, D.A. Dawson, R.B. Goldstein, and B.F. Grant. 2013. "Crosswalk Between DSM-IV Dependence and DSM-5 Substance Use Disorders for Opioids, Cannabis, Cocaine and Alcohol." Drug and Alcohol Dependence.

Researchers used data from a nationally representative sample of U.S. adults to compare concordance of past-year DSM-IV opioid, cannabis, cocaine, and alcohol dependence with past-year DSM-5 disorders at thresholds of 3+, 4+, 5+ and 6+ positive DSM-5 criteria among past-year users of opioids (n = 264), cannabis (n = 1622), cocaine (n = 271) and alcohol (n = 23,013). Substance-specific 2 × 2 tables yielded overall concordance (kappa), sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV). For DSM-IV alcohol, cocaine, and opioid dependence, optimal concordance occurred when 4+ DSM-5 criteria were endorsed, corresponding to the threshold for moderate DSM-5 alcohol, cocaine, and opioid use disorders. Maximal concordance of DSM-IV cannabis dependence and DSM-5 cannabis use disorder occurred when 6+ criteria were endorsed, corresponding to the threshold for severe DSM-5 cannabis use disorder. At these optimal thresholds, sensitivity, specificity, PPV, and NPV generally exceeded 85 percent (>75 percent for cannabis). Overall, excellent correspondence of DSM-IV dependence with DSM-5 substance use disorders was documented in this general population sample. Applicability of treatments tested for DSM-IV dependence is supported by these results for people with a DSM-5 alcohol, cocaine, or opioid use disorder of at least moderate severity or severe cannabis use disorder.

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R.B. Voas, R.L. DuPont, C.L. Shea, and S.K. Talpins. 2013. "Prescription Drugs, Drugged Driving and Per Se Laws." Injury Prevention 19:218-21. doi:10.1136/injuryprev-2012-040498.

National attention to drugged driving led to calls for drug and alcohol testing of all drivers arrested for suspected impaired driving. Wider use of drug testing has facilitated recent development of more sensitive onsite drug tests, which police officers can use at the station house or roadside. Trends suggest there will be a significant increase in the number of people identified, prosecuted, and convicted of drugged driving. This article focuses on prescribed medicines and how their identification among drivers can be successfully managed under traditional impairment and per se drugged driving laws.

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S.K. Vosburg, J.D. Jones, J.M. Manubay, J.B. Ashworth, D.Y. Shapiro, and S.D. Comer. 2013. "A Comparison Among Tapentadol Tamper-Resistant Formulations (TRF) and Oxycontin(®) (Non-TRF) in Prescription Opioid Abusers." Addiction 108(6):1095-106. doi:10.1111/add.12114.

Researchers examined whether tamper-resistant formulations (TRFs) of tapentadol hydrochloride extended-release (ER) 50 mg (TAP50) and tapentadol hydrochloride 250 mg (TAP250) could be converted into forms amenable to intranasal (study 1) or intravenous abuse (study 2). They employed randomized, repeated-measures study designs. A non-TRF of OxyContin® 40 mg (OXY40) served as a positive control. No drug was taken in either study. The studies took place in an outpatient setting in New York City with 25 experienced, healthy ER oxycodone abusers. The primary outcome for study 1 was the percentage of participants who indicated they would snort the tampered tablets; the primary outcome for study 2 was the percentage yield of active drug in solution. Other descriptive variables, such as time spent manipulating the tablets, were also examined to more clearly characterize tampering behaviors. Tampered TRF tablets were less desirable than tampered OXY40 tablets. Few individuals were willing to snort the TRF particles (TAP50: 24 percent, TAP250: 16 percent, OXY40: 100 percent, P < 0.001). Less drug was extracted from TAP50 tablets than from OXY40 tablets (3.52 versus 37.02 percent, P = 0.008). No samples from TAP250 tablets contained analyzable solutions of the drug. It took participants longer to tamper with TAPs (study 1: TAP50 versus OXY40, P < 0.01; TAP250 versus OXY40, P < 0.01; study 2: TAP250 versus OXY40, P < 0.05). Tamper-resistant formulations of tapentadol tablets do not appear to be well-liked by individuals who tamper regularly with ER oxycodone tablets.

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News and Reports
Experts Agree Awareness Is Key in Fight Against Prescription Drug Abuse
May 12, 2013

This article and video (3:02) discuss how awareness, prevention, and collaboration can reduce prescription drug abuse in Montana. Officials use drug drop boxes and the prescription drug monitoring program while doctors participate in the Community Safe Prescriber initiative. Emergency rooms and medical offices place "Community Safe" stickers on doors and windows so patients know prescribers will try to keep them safe by monitoring their medications.

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Prescription Plague Rages: A Fatal Overdose on Staten Island Every 9 Days in 2011
Staten Island Advance
May 14, 2013

According to the Staten Island Department of Health, one Staten Islander died of a prescription pain medicine overdose every 9 days in 2011. Pain reliever overdoses claimed the lives of 40 residents in 2011--a 261 percent increase from the 11 deaths reported in 2005. Citywide, pain reliever overdoses accounted for 220 deaths in 2011--a roughly 65 percent increase in 6 years. Overdoses kill more people in Staten Island than murder and motor vehicle crashes combined. The fatal overdose rate is more than four times the rate in Brooklyn, Queens, and Manhattan, and roughly 3.5 times the rate in the Bronx.

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In Suit Over Death, Boogaard's Family Blames the NHL
The New York Times
May 12, 2013

The family of Derek Boogaard filed a wrongful-death lawsuit against the National Hockey League (NHL), claiming the league was responsible for Boogaard's physical trauma and brain damage as well as his addiction to prescription pain relievers. In 2011, he died after accidentally overdosing on prescription pain relievers and alcohol. The suit maintains Boogaard was prescribed 1,021 pills from about 12 doctors during the 2008-09 season. When the season ended (following nose and shoulder surgeries), doctors prescribed 150 pills of oxycodone over a 16-day period. The suit argues the NHL "breached its duty" to Boogaard by failing to monitor his prescriptions or establish proper procedures for administering and tracking them.

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Tenn. Hospital Treats Drug-Dependent Babies
ABC News
May 12, 2013

In 2008, East Tennessee Children's Hospital treated 33 infants for neonatal abstinence syndrome (NAS); last year, the hospital treated 283 babies suffering from drug dependence. Officials expect the number of NAS cases to rise this year to 320. In most situations, women had abused prescription pain relievers or anti-anxiety medicines while pregnant. Knoxville Hospital treats drug-dependent babies by giving them small doses of opiates and gradually weaning them off, caring for infants an average of 4 weeks. The state estimates nearly 1,200 drug-dependent babies were born in Tennessee from 2010 to 2011.

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Students Increasingly Turning to Black Market for Adderall as a 'Study Drug'
The Province
May 13, 2013

Brandon no longer takes his Adderall and Ritalin prescriptions for attention deficit hyperactivity disorder. Instead, he sells them to students at the University of British Columbia, Simon Fraser University, and British Columbia Institute of Technology. Getting 180 pills every 90 days, Brandon says the black market for Adderall is massive and growing. Experts believe the supply is mostly generic pills shipped from China and India.

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Students Use Adderall to Make Grades
May 13, 2013

This article and video (2:27 minutes) discuss Adderall abuse on Missouri college campuses. Students admit to taking the drug illegally because it helps them study.

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County May Force Drug Companies to Pay to Get Rid of Your Pills
May 15, 2013

Washington's King County Board of Health may require drug producers to provide and promote secure medicine return systems at no cost to consumers. Drug producers will pay for collection supplies at drop-off sites, prepaid mailers, and collection events. Manufacturers would cover the cost to transport collected medicines and dispose of them by incineration. They would also pay for program promotion and evaluation, administrative costs, and fees for Seattle and King County Public Health to cover annual review and oversight. Drug manufacturers that do not comply could face fines of up to $2,000 per day.

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Conway Urges National Retailer to Stop Selling Products Promoting Prescription Drug Use
May 11, 2013

Kentucky and Ohio's Attorneys General, along with other Attorneys General, sent a letter to Urban Outfitters urging the retailer to stop selling pint glasses, shot glasses, and flasks designed to look like prescription pill bottles. Such products make light of the prescription drug epidemic.

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College Students Use Adderall to Study for Finals
KJCT News 8
May 14, 2013

This article and video (2:14) discuss a new study conducted by the Digital Citizen Alliance and Zogby Analytics. It shows 1 in 3 students use prescription drugs to study for finals. One third of students who use Adderall do so without a prescription.

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Inspector General: Prescription Abuse 'An Epidemic'
Easley Patch
May 12, 2013

South Carolina's Inspector General has called prescription drug abuse an epidemic. Each year, 22,000 people die from prescription drug overdoses. South Carolina has a prescription drug monitoring program to address this problem, but physicians use it on a voluntary basis. South Carolina's neighbor states have made monitoring mandatory.

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RI Kids Abusing Pain Killers at Younger Age
May 15, 2013

In the latest Rhode Island Youth Risk Behavior Survey, 6 percent of middle school students reported taking a prescription drug without a doctor's prescription, as did 14 percent of high school students. Eighteen percent of 12th graders had used pain relievers at least once.

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FDA Allows Sales of Generic Opana Painkiller to Continue
Los Angeles Times
May 10, 2013

The Food and Drug Administration (FDA) will continue to allow generic Opana sales because the reformulated version is not safer than the original. FDA said the reformulated version could still be prepared for injection and snorting.

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Alabama Celebrates Prevention Week
May 15, 2013

This article and video (2:32) discuss Alabama's efforts to raise awareness about prescription pain relievers, other substances, and mental health during National Prevention Week 2013.

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Drug Abuse Hikes Workers' Comp. Risks
May 13, 2013

Corporations may see increased medical costs when doctors overprescribe narcotics to employees injured on the job. Workers' compensation healthcare providers do not follow recommended protocols such as conducting periodic drug screening and psychological evaluation for chronic opioid management. Long-term opioid use may lead to additional costs, productivity loss, and higher risk of opioid misuse and abuse, as well as accidental death.
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Nearly 200 Kilograms of Prescription Drugs Collected in City's First Drop-Off Day
Toronto Star
May 13, 2013

The Toronto Police Department, Toronto Public Health, and City of Toronto collected nearly 200 kilograms of prescription drugs during its first Prescription Drop-Off Day. People can drop off prescription medications at 3,000 pharmacies throughout Ontario.
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A Focus on Perfection Turns Some Moms to Addiction
FOX News
May 16, 2013

Some women use prescription drugs and alcohol to handle pressures of being a perfect mother. In a recent survey of 100 female patients treated for addiction, 44 percent abused prescription drugs and 88 percent abused alcohol in their homes. The National Institute on Drug Abuse reported that approximately 800,000 females, or 2,191 women a day, began abusing prescription drugs last year.
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Prescription Drug Deaths Continue to Fall in Tampa Bay Area
Tampa Bay Time
May 13, 2013

Drug overdoses declined in Florida's Pinellas, Pasco, Hillsborough, and Hernando Counties for the second year in a row, according to medical examiners. There were 305 accidental drug deaths in Pinellas and Pasco Counties last year, down 31 percent from 443 in 2010. Hillsborough County saw 187 drug deaths in 2012, down about 25 percent from 3 years ago. Hernando County dropped from 48 accidental drug overdoses in 2010 to 28 last year.

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More Students Turning to Drugs Like Adderall to Get Through Finals
May 15, 2013

This article and video (2:13) discuss Adderall use and abuse among college students.

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AG Kilmartin Calls for Painkiller 'Black Box' Warning
May 13, 2013

Forty-five state Attorneys General sent the Food and Drug Administration a letter urging them to put a black box warning on prescription pain relievers to alert women about the dangers of taking the drugs while pregnant.

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Prescription Drug Abuse--It's Not What the Doctor Ordered: Georgia Prevention Initiative Awareness Campaign
The Wall Street Journal
May 14, 2013

The Georgia Prescription Drug Abuse Prevention Initiative of the Council on Alcohol and Drugs launched an Awareness Campaign called "Prescription Drug Abuse--It's Not What the Doctor Ordered." The campaign focuses on educating adults and youth about prescription drug abuse prevention, including the importance of safe storage and disposal of prescriptions.

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Dangers Found in Lack of Safety Oversight for Medicare Drug Benefit
The Washington Post
May 11, 2013

Under Medicare Part D, 27.5 million beneficiaries filled 1.1 billion prescriptions (including refills) from 1.7 million prescribers, with a retail price of $77.7 billion. The government does not monitor the safety or prescribing pattern of Medicare drug benefits except in nursing homes. Medicare could analyze patient information to determine whether patients are being prescribed appropriate drugs for their conditions. However, the Centers for Medicare and Medicaid Services claims this responsibility falls on private health plans that administer the program. Experts say Medicare should also use its data to identify troubling prescribing patterns and take steps to investigate or restrict unsafe practitioners. ProPublica's examination of Part D data from 2007 through 2010 showed Medicare failed to act against providers who were suspended or disciplined by other regulatory authorities. Some doctors continue to prescribe medications under the Medicare program even though they have been criminally charged or convicted for prescribing problems. Others prescribe huge volumes of drugs or regularly write scripts for drugs with questionable safety and efficacy. ProPublica created Prescriber Checkup, an online tool that allows people to search for providers and see the drugs they prescribe.

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Prescription Drug Abuse on the Rise in Fairfax County, Officials Say
Annandale Patch
May 14, 2013

In 2011, there were 51 drug/poison deaths in Fairfax County, Virginia, according to statistics from the Unified Prevention Coalition (UPC) of Fairfax County. The UPC and Fairfax County Police Department are planning Operation Medicine Cabinet Cleanout, May 27 to June 1, to educate and raise awareness about prescription drug abuse.

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Prescription Drug Addiction: An Equal-Opportunity Disease
May 11, 2013

This article and video (2:49) discuss prescription drug addiction with a Montana man whose trouble began after an injury in 1990. He continues to struggle and takes methadone to prevent withdrawal symptoms. In April, Recovery Center Missoula, a 16-bed treatment center, opened its doors to assist addicts.

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Other Resources

Sobe el Acetaminofén
Acetaminophen Awareness Coalition
Accessed May 17, 2013

The Know Your Dose campaign now offers Spanish language resources and educational materials on safe acetaminophen use. The campaign's Web site features a medicine label reader guide, answers to frequently asked questions, and an animated video on the safe use of medicines containing acetaminophen. A hotline, Su Familia, is also available to answer questions and provide referrals to local health resources.

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Prescription Drug Abuse
Cardinal Health Foundation
Accessed May 15, 2013

A new infographic created by the Cardinal Health Foundation and Ohio State University College of Pharmacy illustrates the magnitude and prevalence of the prescription drug abuse problem. View the two-page PDF or visit Cardinal Health's Web site to embed the infographic code on your site.

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Face the State: Prescription Drug Abuse Rampant in Reno
May 11, 2013

This video (12:02) discusses prescription drug abuse in Reno, Nevada, and throughout the country.

Prescription Drugs and Teens
May 16, 2013

This video (3:19) addresses prescription drug abuse among Rhode Island teens.

Grant Announcements
Strategic Prevention Framework Partnerships for Success II SEOW Supplements
FY 2013 Grant Request for Applications
Deadline: May 31, 2013

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Cooperative Agreements for Electronic Health Record and Prescription Drug Monitoring Program Data Integration
Deadline: June 12, 2013

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Upcoming Conferences and Workshops
2013 Symposium for Medical Professionals: Kentucky Medical Communities UNITEd
June 8: Manchester, Kentucky

Pharmacy Diversion Awareness Conference
June 22 and 23: Chicago, Illinois
July 13 and 14: Portland, Oregon
August 3 and 4: Baton Rouge, Louisiana
August 16 and 17: San Diego, California
August 18 and 19: San Jose, California
September 21 and 22: Boston, Massachusetts

The Generation Rx University Conference for Prescription Drug Abuse Prevention and Recovery
August 7-8, 2013
Columbus, Ohio

2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2, 2013
Chicago, Illinois
Please e-mail Rekaya Gibson at rgibson@pire.org with questions or comments about the SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv.  
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.
The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full-text journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.
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