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May 26, 2016

PAW Weekly Update

    

                                          
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SAMHSA
           
SAMHSA Prescription Drug Abuse Weekly Update
         
         
WEEKLY
           
UPDATE
         
                             
          Issue 175  |  May 26, 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                            
South News                            
Midwest News                            
West News                            
Webinars                            
Grant Announcements                            
Take-Back Events & Drop Boxes                            
Upcoming Events, Conferences & Workshops                                                         
                       

Featured

Travelers Study Aims to Decrease Workplace Injuries, Opioid Addiction                        
Alban Murtishi, Hartford Courant                        
May 17, 2016                        

The Travelers Company has found that 30 percent of the 1.5 million workers’ compensation claims filed with the company over the last 5 years were for injuries that could lead to chronic pain. Opioids are often prescribed to treat the injuries. Travelers developed a model that predicts when a workplace injury could lead to chronic pain. The Early Severity Predictor was applied to 20,000 cases in 2015 and identified more than 9,000 injuries that could potentially lead to chronic pain. Those employees received a sports-medicine-like regimen of treatment instead of pain relievers; they recovered more quickly and at a lower cost.                        

Read more:                        
http://www.courant.com/hc-travelers-workplace-injuries-20160516-story.html                         
https://www.travelers.com/iw-documents/resources/workplace-safety/workplace-injuries-report.pdf                       
               
               

Journal Articles and Reports

C.J. Boyd, J. Cranford, and S.E. McCabe. 2016. “Longitudinal Trajectories of Nonmedical Use of Prescription Medication among Middle and High School Students.” Journal of Addictive Diseases, doi:10.1080/10550887.2016.1186413.                

Four annual, Web-based surveys of all students enrolled in grades 7–12 at five middle and high schools in southeastern Michigan had a 71 percent response rate, with 1,042 students completing four surveys. Repeated measures analyses spilt the students into a group with a minimal probability of nonmedical use of prescription medications and a group prone to non-medical use. Probability of any nonmedical use increased during the transition from middle school to high school. Nonmedical use tended to be a relatively sporadic, behavior that did not persist over time, especially among nonwhite students. White students were more likely to report more continuous use as they aged.                

Read more:                
http://www.tandfonline.com/doi/abs/10.1080/10550887.2016.1186413                                  

R. Cairns, J. Brown, and N. Buckley. 2016. “The Impact of Codeine Re-Scheduling on Misuse: A Retrospective Review of Calls to Australia’s Largest Poisons Centre.” Addiction, doi:10.1111/add.13450.                

The New South Wales, Australia, Poisons Information Center handled 400 calls about toxic reactions/overdoses from codeine combination analgesics during 2004–15. Call frequency increased over time, with an average annual percent change of 19.5 percent for paracetamol/codeine and 17.9 percent for ibuprofen/codeine. The trend did not change significantly after 2010 rescheduling. The median age of patients was around 30 with roughly equal numbers of overdoses by sex.                 

Read more:                
http://onlinelibrary.wiley.com/doi/10.1111/add.13450/abstract                                  

S.L. Calcaterra, A.D. Drabkin, S.E. Leslie, R. Doyle, S. Koester, J.W. Frank, J.A. Reich, and I.A. Binswanger. 2016. “The Hospitalist Perspective on Opioid Prescribing: A Qualitative Analysis.” Journal of Hospital Medicine, doi:10.1002/jhm.2602.                

In semi-structured interviews with 25 hospitalists in Denver or Charleston, S.C., (conducted at two university hospitals, a safety-net hospital, a Veterans Affairs hospital, and a private hospital), respondents felt confident in their ability to control acute pain using opioid medications. They perceived limited success and satisfaction when managing acute exacerbations of chronic pain with opioids. They recounted negative sentinel events that altered opioid prescribing practices in both the hospital setting and at the time of hospital discharge. They described prescribing opioids as a pragmatic tool to facilitate hospital discharges or prevent readmissions, but were conflicted because this practice had the potential to impact patients adversely over the long term.                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1002/jhm.2602/abstract                                  

P.M. Coplan, H.D. Chilcoat, S.F. Butler, E.M. Sellers, A. Kadakia, V. Harikrishnan, J.D. Haddox, and R.C. Dart. 2016. “The Effect of an Abuse-Deterrent Opioid Formulation on Opioid Abuse-Related Outcomes in the Post-Marketing Setting.” Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.390.                

The manufacturer reports OxyContin misuse rates declined from 1 year before to 3 years after abuse-resistant reformulation. Per 100 person years of use, OxyContin cases decreased 48 percent in national poison center surveillance data, 32 percent in RADARS SKIP drug treatment data, and 27 percent in Truven MarketScan claims data on overdoses/disorder treatment. Doctor-shopping for OxyContin reported by law enforcement officials decreased from 0.25 percent to 0.12 percent of users, offset by a rise in doctor shopping for hydrocodone (which was not abuse-resistant), according to the RADARS Drug Diversion Study. Overdose fatalities reported to the manufacturer decreased 65 percent. Abuse of other opioids without abuse-deterrent properties decreased 2 years later than OxyContin and with less magnitude, suggesting OxyContin decreases were not due to broader opioid interventions. Decreases were larger for non-oral than oral abuse.                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1002/cpt.390/abstract                                  

X. Jiang, M. Orton, R. Feng, E. Hossain, N.R. Malhotra, E.L. Zager, and R. Liu. 2016. “Chronic Opioid Usage in Surgical Patients in a Large Academic Center.” Annals of Surgery, doi:10.1097/SLA.0000000000001780.                

Researchers used a Philadelphia academic medical center’s electronic medical record database to extract data on opioid usage in surgical patients. They included 79,123 patients who had been taking opioids for at least 90 days. Prevalence averaged 9.2 percent, ranging from 4.4 percent to 23.8 percent among specialties. Orthopedics (23.8 percent), neurosurgery (18.7 percent), and gastrointestinal surgery (14.4 percent) were the top three specialties. Major factors influencing chronic opioid use include age, ethnicity, specialty, and multiple specialty visits. Three quarters of chronic users took schedule II opioids.                

Read more:                
http://journals.lww.com/annalsofsurgery/Abstract/publishahead/
Chronic_Opioid_Usage_in_Surgical_Patients_in_a.96631.aspx
                                  

S.L. Kaspersen, K. Pape, S.O. Ose, D. Gunnell, and J.H. Bjørngaard. 2016. “Unemployment and Initiation of Psychotropic Medication: A Case-Crossover Study of 2,348,552 Norwegian Employees.” Occupational & Environmental Medicine, doi:10.1136/oemed-2016-103578.                

After linking the Norwegian Prescription Database to employment data for all 2,348,552 Norwegians employed in 2004, researchers examined prescription use patterns associated with job loss during 2005–10. The rate of first prescriptions for psychotropic drugs increased 1–3 months before job loss and peaked 1 month prior. The odds of starting a prescription for antidepressants increased the most in the month before job loss (odds ratio [OR] = 2.7), followed by hypnotics/sedatives (OR = 2.2), anxiolytics (OR = 2.2) and antipsychotics (OR = 2.1). Rises were greatest in men. Risk of starting psychotropic medication remained raised during a spell of unemployment, but returned to close-to-baseline levels following re-employment. Drugs used to treat somatic and pain conditions showed similar trends but with weaker associations. The findings suggest strengthening preventive health initiatives during the stressful period of uncertainty and notification early in the unemployment process.                

Read more:                
http://oem.bmj.com/content/early/2016/05/10/oemed-2016-103578.abstract                                  

J.G. Katzman, C. Fore, S. Bhatt, N. Greenberg, J.G. Salvador, G.C. Comerci, C. Camarata, L. Marr, R. Monette, S. Arora, A. Bradford, D. Taylor, J. Dillow, and S. Karol. “Evaluation of American Indian Health Service Training in Pain Management and Opioid Substance Use Disorder.” American Journal of Public Health, doi:10.2105/AJPH.2016.303193.                

In January 2015, the Indian Health Service (HIS) mandated training in pain and opioid substance use disorder for all IHS prescribing clinicians. More than 1,300 clinicians were trained across seven administrations of a 5-hour course specific to pain and addiction. Pre-post surveys showed knowledge, self-efficacy, and attitudes improved. Clinicians rated the trainings as comprehensive, interactive, and convenient.                 

Read more:                
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303193                                  

D. Kunyk, M. Inness, E. Reisdorfer, H. Morris, and T. Chambers. 2016. “Help Seeking by Health Professionals for Addiction: A Mixed Studies Review.” International Journal of Nursing Studies, doi:10.1016/j.ijnurstu.2016.05.001.                

A systematic review identified eight qualitative and 23 quantitative studies about health professionals seeking help for addiction. The qualitative studies suggested the professional and experiential context of healthcare compromised readiness to seek help for addiction. Typically, a pivotal event initiated the help seeking process. The quantitative studies found that help seeking most often resulted from reports of adverse events to an employer or regulatory body. Informal sources such as colleagues and family, often aware of the addiction earlier, typically urge use of voluntary, confidential treatment programs. Their avoidance of official reporting does not promote prompt attention to treatment needs.                

Read more:                
http://www.journalofnursingstudies.com/article/S0020-7489(16)30039-6/abstract                                  

J. Nicholsona, C. Dawson-Edwardsa, G.E. Higgins, and I.N. Walton. 2016. “The Nonmedical Use of Pain Relievers among African-Americans: A Test of Primary Socialization Theory.” Journal of Substance Use, doi:10.3109/14659891.2015.1122101.                

Predictably, multivariate analysis of 2013 National Survey of Drug Use and Health data on African-American youth indicated that nonmedical use of prescription pain relievers was more likely among youth who associated with substance using peers and youth who had poor parental bonds.                

Read more:                
http://www.tandfonline.com/doi/abs/10.3109/14659891.2015.1122101                                  

R.V. Smith, A.M. Young, U.L. Mullins, and J.R. Havens. 2016. “Individual and Network Correlates of Antisocial Personality Disorder among Rural Nonmedical Prescription Opioid Users.” Journal of Rural Health, doi:10.1111/jrh.12184.                

Clinical assessments of 503 drug users from rural Kentucky participating in an ongoing study showed 31 percent met Diagnostic and Statistical Manual of Mental Disorders (Fourth Ed.) criteria for antisocial personality disorder. In multivariate analysis, antisocial personality disorder was associated with distrust and conflict within an individual’s social networks, past 30-day use of heroin and crack, male gender, younger age, lesser education, heterosexual orientation, and comorbid major depressive disorder.                

Read more:                
http://onlinelibrary.wiley.com/doi/10.1111/jrh.12184/abstract                                 

K.D. Wagner, L.J. Bovet, B. Haynes, A. Joshua, and P.J. Davidson. 2016. “Training Law Enforcement to Respond to Opioid Overdose with Naloxone: Impact on Knowledge, Attitudes, and Interactions with Community Members.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.05.008.                

Of 81 law enforcement officers participating in a 2014 naloxone training program in San Diego, 89 percent had responded to an overdose while serving as officers. Pre and post surveys showed that the training increased opioid overdose knowledge and competencies and reduced concerns about naloxone administration. Attitudes toward people who overdosed were unchanged. In the 4 months, officers administered naloxone 11 times; nine people survived, and three survivors made at least one visit to substance abuse treatment. Qualitative data suggest that officers had generally positive experiences when they employed skills from the training.                

Read more:                
http://www.drugandalcoholdependence.com/article/S0376-8716(16)30113-2/abstract                 

Professional Development

C.A. Marco, A. Venkat, E.F. Baker, J.E. Jesus, and J.M. Geiderman. 2016. Prescription Drug Monitoring Programs: Ethical Issues in the Emergency Department. Annals of Emergency Medicine, doi:10.1016/j.annemergmed.2016.04.018.                

Read more:                
http://www.sciencedirect.com/science/article/pii/S0196064416300865                 

National

Weekly Address: A Conversation about Addiction                
White House                
May 14, 2016                

President Obama and Grammy Award-winning artist Macklemore discussed the opioid addiction epidemic. Macklemore discussed his life in recovery and the loss of a friend who overdosed on prescription drugs at a young age. The president stressed the importance of having public conversations about addiction and the need for more funding for treatment.  (Includes video: 4:24 minutes)                

Read more:                
https://www.whitehouse.gov/the-press-office/2016/05/14/weekly-address-conversation-about-addiction                                  

Hiring Hurdle: Finding Workers Who Can Pass a Drug Test                
Jackie Calmes, New York Times                
May 17, 2016                

Employers across the country are struggling to find workers who can pass a pre-employment drug test. One hurdle stems partly from the growing ubiquity of drug testing and another from an increase in the use of drugs, especially marijuana, heroin, and other opioids. The scope of the problem is unclear because figures on job applicants who test positive for drugs miss the many people who simply skip tests they cannot pass. Quest Diagnostics reports show that after declining for decades from 13.6 percent positive in 1988, the percentage of drug tests by employers that were positive for illicit drugs rose in 2013 and 2014, reaching 4.7 percent.                

Read more:                
http://mobile.nytimes.com/2016/05/18/business/hiring-hurdle-finding-workers-who-can-pass-a-drug-test.html?referer=https://news.google.com                                 

Poll: Many Parents Keep Prescription Opioids at Home                
University of Michigan Health System                
May 16, 2016                

A nationally representative 2016 survey of 1,176 parents with at least one child ages 5–17 found nearly half of parents whose child had leftover pain medication from a surgery or illness say they kept the leftover opioids at home. Parents whose child’s provider discussed what to do with the pills, however, were far more likely to dispose of them properly. Nearly a third of parents polled reported at least one pain medication prescription for their child. Most prescriptions (60 percent) were for narcotics. Half of parents reported their child had leftover medication. Eight percent returned it to the doctor or pharmacy, 47 percent kept it at home, 30 percent disposed of it in the trash or toilet; 6 percent used it for other family members, and 9 percent did not remember what they did with it.                

Read more:                
http://www.eurekalert.org/pub_releases/2016-05/uomh-pmp051616.php                                 

Feds Collect Record Amount of Meds on National Rx Take-Back Day                
U.S. Drug Enforcement Administration                
May 6, 2016                

The U.S. Drug Enforcement Administration collected 893,498 pounds of unwanted medications during its National Prescription Drug Take-Back Day in April, more than in any of than the previous 10 events since the program began in 2010. The five states with the largest collections were Texas (almost 40 tons), California (32 tons), Wisconsin (31 tons), Illinois (24 tons), and Massachusetts (24 tons).                  

Read more:                
http://www.dea.gov/divisions/hq/2016/hq050616.shtml                                  

Cigna Outlines Steps to Help Curb National Drug Epidemic                
Business Wire                
May 19, 2016                

Health insurer Cigna has outlined its plans to help curb the country’s opioid epidemic. It aims to cut customer use of opioids by 25 percent over 3 years. Cigna will encourage rapid adoption of new Centers for Disease Control and Prevention guidelines on opioid use and support efforts to require prescribers to check state prescription drug monitoring program databases when prescribing more than a 21-day supply of an opioid pain reliever. It will limit the quantity of pain relievers prescribed when appropriate, identify high-risk customers in its database, and explore additional controls for high-risk customers.                

Read more:                
http://www.businesswire.com/news/home/20160519005703/en/Cigna-Outlines-Steps-Curb-National-Drug-Epidemic                                  

Propublica Unintentionally Helps Drug Abusers Find Physicians Who Freely Prescribe Opioids                
Ayla Ellison, Becker’s Hospital Review                
May 13, 2016                

ProPublica’s Prescriber Checkup database details the prescribing habits of thousands of physicians. Some readers are taking advantage of the database to find physicians likely to prescribe widely abused drugs. ProPublica’s Google Analytics data revealed that as many as 25 percent of Prescriber Checkup’s page views this year involve searches for amphetamines, narcotic pain relievers, and anti-anxiety medications. Many readers landed at the Prescriber Checkup after searching the web for “doctors who prescribe narcotics easily” or “doctors that will prescribe anything.” ProPublica noted that some readers are likely looking for physicians who will help them with chronic anxiety or pain. ProPublica will add a warning to all its narcotic drug pages that reminds readers of the serious health risks associated with taking opioids.                

Read more:                
http://www.beckershospitalreview.com/hospital-physician-relationships/propublica-unintentionally-helps-drug-abusers-find-physicians-who-freely-prescribe-opioids.html                                 

Pharmacists Aim to Increase Consumer Awareness of Counterfeit Medications                
AwaRxe                
May 19, 2016                

The National Association of Boards of Pharmacy (NABP) realeased the Pharmacy Top-Level Domain Program to raise consumer awareness about the dangers of medications purchased from unapproved and unknown online sources. As the Internet Drug Outlet Identification Program Progress Report for State and Federal Regulators (April 2016) describes, NABP reviewed 11,000 websites selling prescription medications online to U.S. consumers; 96 percent were operating illegally. NABP has evaluated internet pharmacies that have a “.pharmacy” domain name and found them in compliance with pharmacy laws and with standards for pharmacy practice and patient safety.                

Read more:                
http://www.awarerx.pharmacy/news/2016/5/nabp-aims-to-increase-consumer-awareness-of-counterfeit-medications-offers-safe-and-legal-online-pharmacies-through-pharmacy-tld-program                                  

Over 40 States Now Prescription Monitoring Program InterConnect Members                
National Association of Boards of Pharmacy                
May 19, 2016                

Alabama, Massachusetts, Pennsylvania, and the District of Columbia have joined 38 other states by executing a memorandum of understanding with the National Association of Boards of Pharmacy (NABP) to participate in the NABP Prescription Monitoring Program (PMP) InterConnect. The PMP InterConnect is a secure communications exchange platform that facilitates the transmission of PMP data across state lines to authorized requestors.                

Read more:                
http://www.nabp.net/news/over-forty-states-are-now-members-of-pmp-interconnect                                 

When the Addict is a Doctor                
Steven Ross Johnson, Modern Healthcare                
May 14, 2016                

Peter Grinspoon, M.D. ,wrote about his experience with drug addiction in the new book Free Refills: A Doctor Confronts His Addiction. The author discusses addiction among doctors and the help they can receive from the state to recover. Some doctors fear losing their job or license so they delay seeking help. Others find their license suspended due to drug tests administered when they seek help. Education about substance abuse during medical training may help healthcare providers deal with addiction.                

Read more:                
http://www.modernhealthcare.com/article/20160514/MAGAZINE/305149988                                  

Sen. John McCain Calls for Hearing on Pro Sports and Prescription Drug Abuse                
Rick Klein, ABC News                
May 17, 2016                

U.S. Sen. John McCain (R-Ariz.) has called for a Senate Commerce Committee hearing on the links between professional sports and prescription drug addiction.                 

Read more:                
http://abcnews.go.com/Politics/john-mccain-calls-hearing-pro-sports-prescription-drug/story?id=39176273                 

Marijuana

N.L. Cohen, A.J. Heinz, M. Ilgen, and M.O. Bonn-Miller. 2016. “Pain, Cannabis Species, and Cannabis Use Disorders.” Journal of Studies on Alcohol and Drugs 77(3), 515–520, doi:10.15288/jsad.2016.77.515.                  

A survey of 163 medical cannabis users (77 percent male), recruited from a medical marijuana dispensary in California found that buyers who said they used cannabis to manage chronic pain experienced fewer cannabis use problems than those who used it for other reasons. Among those who used marijuana for pain, the average pain level in the past week was not associated with cannabis use problems. People who used cannabis for chronic pain were more likely to use indica over sativa strains, believing they caused fewer cannabis use problems.                  

Read more:                  
http://www.jsad.com/doi/10.15288/jsad.2016.77.515                                      

S. Grant, E.R. Pedersen, and C. Neighbors. 2016. “Associations of Posttraumatic Stress Disorder Symptoms with Marijuana and Synthetic Cannabis Use Among Young Adult U.S. Veterans: A Pilot Investigation.” Journal of Studies on Alcohol and Drugs 77(3), 509–14, doi:10.15288/jsad.2016.77.509.                  

In a 2015 pilot online survey of a convenience sample of 790 U.S. veterans under age 35 recruited through Facebook, 61.8 percent reported lifetime marijuana use and 20.4 percent reported past-month use. Comparable figures for synthetic cannabis use were 17.0 percent and 3.4 percent. Those screening positive for posttraumatic stress disorder (PTSD) were more likely to report using marijuana and synthetic cannabis in their lifetime and in the past month. Positive PTSD screens, as well as greater expectancies that marijuana leads to relaxation and tension reduction, were associated with past-month marijuana use in logistic regression analyses.                  

Read more:                  
http://www.jsad.com/doi/10.15288/jsad.2016.77.509                                      

S. Isaac, B. Saini, and B.B. Chaar. 2016. “The Role of Medicinal Cannabis in Clinical Therapy: Pharmacists’ Perspectives.” PLOS One, doi:10.1371/journal.pone.0155113.                  

In semi-structured interviews with 34 registered pharmacists in Australia, the majority felt national legalization of a standardized form of cannabis would be suitable. They suggested various factors and strategies to manage its supply. The majority favored supply from a community pharmacy setting due to the importance of accessibility for patients.                  

Read more:                  
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155113                                      

Louisian Governor Signs Medical Marijuana Bill                  
WGNO                  
May 19, 2016                  

Louisiana’s governor has signed legislation to expand the state’s medical marijuana program. The bill adds seizure disorder and other debilitating conditions to the list of qualifying illnesses for medical marijuana. It also allows private companies to make marijuana oil if Louisiana State University and Southern University decide not to produce the drug.                   

Read more:                  
http://wgno.com/2016/05/19/its-official-gov-edwards-signs-louisianas-medical-marijuana-bill                                      

Ohio House Passes Medical Marijuana Bill                  
Josh Givens, Logan Daily News                  
May 12, 2016                  

Ohio’s house of representatives has passed a bill to legalize medical marijuana use for people with any of 20 qualifying medical conditions. The bill would not allow patient to grow marijuana at home or smoke it. The prescribing doctor would have to recommend the type of marijuana and the method of consumption. The bill heads to the Senate for consideration.                   

Read more:                  
http://www.logandaily.com/news/ohio-house-passes-medical-marijuana-bill/article_cd596ca5-3b69-5ab1-9cde-ae7137c033dc.html                                      

Phoenix Business Leaders Say Legalizing Marijuana Bad for Business                  
Lindsey Reiser, KPHO/KTVK                  
May 12, 2016                  

The Greater Phoenix Chamber of Commerce has come out against legalizing marijuana for recreational use. It feels the workforce will become unreliable or companies will not want to locate there, which could outweigh any financial benefits. The Campaign to Regulate Marijuana Like Alcohol believes employers can still create drug-free environments if they want; and the marijuana industry will create jobs. This issue will be on the November ballot. (Includes video: 1:38 minutes)                  

Read more:                  
http://www.azfamily.com/story/31953247/valley-chamber-of-commerce-says-legalizing-marijuana-bad-for-business                                      

Positive Marijuana Tests Skyrocket in Fatal Utah Crashes                  
Heidi Hatch, KUTV                  
May 17, 2016                  

Positive marijuana tests increased nearly 300 percent in 3 years in fatal Utah crashes, coinciding with the time period marijuana has been legal in Colorado. In the last decade, 128 people who have died in fatal crashes in Utah have tested positive for marijuana. Utah Highway Patrol troopers are being trained to watch for marijuana-impaired driving.                  

Read more:                  
http://kutv.com/news/local/marijuana-positive-tests-sky-rocket-in-fatal-utah-crashes                                      

Seniors are Filling Their Prescriptions—At a Pot Shop                  
CBS News                  
May 19, 2016                  

People ages 55 and older are the fastest-growing demographic of marijuana users, increasing from 2.8 million to 4.3 million users from 2013 to 2014. (Includes video: 4:02 minutes)                  

Read more:                  
http://www.cbsnews.com/news/seniors-marijuana-use-fastest-growing-pot-users-prescriptions                                     

NFL Player Eugene Monroe Donates $80,000 to Medical Cannabis Research                  
MP Wilkinson, Mary Jane                  
May 14, 2016                  

Eugene Monroe, a National Football League (NFL) player, has donated $80,000 to the University of Pennsylvania and John Hopkins University to examine the impact of cannabinoid therapy on NFL players. Monroe hopes his donation and support can sway the NFL toward changing their anti-cannabis policy and acknowledge that the plant is an adequate option to treat pain.                   

Read more:                  
https://www.merryjane.com/news/nfl-player-eugene-monroe-donates-80-000-to-medical-cannabis-research                                      

New Infographic Shows Legalization is Not Inevitable                  
National Families in Action                  
May 2016                  

This Infographic pictures marijuana legalization efforts in the states via ballot initiatives and legislation. The four states and the District of Columbia that have legalized marijuana for recreational use have done so through ballot initiatives. All five legalized marijuana for medical use first. No state legislature has legalized marijuana for recreational use via legislation. Considerably more legalization efforts have failed than succeeded.                  

Read more:                  
http://themarijuanareport.org/wp-content/uploads/2014/05/Legalization-Overview-Infographic.jpg                                      

Medical Use of Cannabis and Cannabinoids in the Treatment of Cancer                  
Ricardo Oliveira, Lift                  
May 16, 2016                  

The National Cancer Institute has released an online medical summary on the use of cannabis and cannabinoids in the treatment of people with cancer. Two versions are available: one for health professionals and another for patients, families, and caregivers.                   

Read more:                  
https://news.liftcannabis.ca/2016/05/16/information-medical-use-cannabis-cannabinoids-treatment-cancer                

International

Overdose Deaths Spark Calls for Stricter Medication Guidelines in Australia                
Bridget Judd, ABC                
May 17, 2016                

The Western Victorian Primary Health Network in Australia is calling for stricter guidelines around prescription pain medications. The Great South Coast region had more prescription overdose deaths than anywhere else in regional Victoria based on population. The health network hosted a training session on prescribing for health professionals in Warrnambool.                

Read more:                
http://mobile.abc.net.au/news/2016-05-18/warrnambool-community-puts-focus-on-prescription-drug-abuse/7424190?pfm=sm&section=vic                                  

Party Drug ‘Purple Drank’ A Dangerous Mix, Canadian Police Say                
CBC News                
May 14, 2016                

Halton Regional Police in Canada are warning parents and teens about the dangers of “purple drank,” a mix of cold medication and soda or some other drink. The concoction is potentially dangerous and addictive. Police have seen an increase in cases over the past six months, with users having heart failure and dying. Purple drank is named for its typical color and it is also known as “syrup,” “sizzurp” and “lean.”                 

Read more:                
http://www.cbc.ca/news/canada/toronto/purple-drank-halton-1.3582964                 

Northeast/Mid-Atlantic News

Rhode Island Senate Approves Bills Aimed at Opioid Crisis                
Christian Winthrop, Newport Buzz                
May 19, 2016                

Rhode Island’s senate has approved a package of legislation to address the opioid overdose crisis. One bill required all health insurance providers that cover prescriptions to cover opioid antagonists when purchased by a family member or friend to protect the life of an overdose victim. Another bill required health practitioners and health plan coverage to support clinical practices fostering use of abuse-deterrent opioid analgesic drug product formulations approved by the FDA. A third bill establishes prescribing limits for addictive pain medication when prescribed for acute pain; requires full use of the state’s prescription drug monitoring program to help prevent abuse; and creates limits for dosage of initial prescriptions for acute pain management. The bills now head to the state’s house of representatives for consideration.                

Read more:                
http://www.thenewportbuzz.com/ri-senate-approves-bills-aimed-at-opioid-crisis/8361                                  

Maryland Takes One Step Forward and One Step Back Against Opioids                
Editorial Board, Washington Post                
May 18, 2016                

Although Maryland’s general assembly has passed a bill requiring all prescribers participate in the state’s prescription drug monitoring program (PDMP) as a condition of their state licenses, it ended an existing rule requiring doctors to receive continuing medical education on pain management and opioid prescribing. It also barred the state’s board of physicians from conditioning licensing on the completion of any specific continuing education course ever again. The governor’s office argued that the PDMP bill authorized the administration to come up with a better alternative.                

Read more:                
https://www.washingtonpost.com/opinions/maryland-takes-one-step-forward-and-step-back-against-opioids/2016/05/18/1b39a936-1939-11e6-aa55-670cabef46e0_story.html                                  

Pennsylvania State Senators Propose Opioid Legislation                
Kirstin Kennedy, The Times                
May 18, 2016                 

Pennsylvania state senators have proposed legislation that focuses on securing money to increase education and prevention, emergency treatment programs, and support of treatment centers. The legislation would also address loan forgiveness programs for students seeking a career in addiction treatment.                

Read more:                
http://www.timesonline.com/news/health/senate-democrats-propose-opioid-legislation-in-pennsylvania/article_5a3ce3ea-1d31-11e6-bee0-931c6de23095.html                                  

Curbing Opioid Abuse Among Pennsylvania Elderly                
Mark Hiller, WBRE/WYOU                
May 17, 2016                

The Pennsylvania Medical Society has launched an initiative called “Opioids for Pain: Be Smart. Be Safe. Be Sure.” The initiative encourages patients and doctors to discuss the safe use of opioids to avoid overdoses and addiction. The Medical Society recommends individuals, particularly seniors, ask their doctors seven basic questions before taking pain medication. Richard Huntington, M.D., with Geisinger Family Medicine suggests talking to seniors about how their medications are being used, if they are using them properly, and if they need to be on them anymore. (Includes video: 2:09 minutes)                

Read more:                
http://www.pahomepage.com/news/curbing-opioid-abuse-among-pa-elderly                                  

Pennsylvania College to Educate Nurse Practitioners on Opioid Abuse                
Pennsylvania State University                
May 18, 2016                

On April 29, Pennsylvania State University’s College of Nursing pledged to educate practitioners on opioid misuse. The college says it has been addressing pain management for years by including best practices for nonpharmacological management of chronic pain.                 

Read more:                
http://news.psu.edu/story/411055/2016/05/18/academics/college-nursing-pledges-educate-nurse-practitioners-opioid-abuse                 

South News

West Virginia Attorney General Releases Plan to Combat Prescription Abuse                
Wendy Holdren, Register-Herald Reporter                
May 18, 2016                

West Virginia’s attorney general has released a draft 15-point best practices initiative to reduce opioids as a first-line therapy option and to encourage use of non-opioid alternatives. It calls for use of West Virginia’s prescription drug monitoring program; reduction of risk of opioid misuse; assurance that the prescription medication, dose, and quantity are safe and appropriate; and incorporation of naloxone into opioid treatment discussions. Other highlights include conducting random urine drug screens for patients on opioid treatments; using screening tools to determine misuse risk before prescribing opioids for pain, reviewing medical records and conducting physical examination of patients; and educating patients about proper use, storage and disposal of drugs. The attorney general also unveiled plans to purchase drug incinerators to assist in disposal of unwanted and expired medication.                

Read more:                
http://www.register-herald.com/news/morrisey-releases-plan-to-combat-prescription-abuse/article_de3d9a82-e88d-5a97-b1cd-ce20d9bfb3dd.html                                  

North Carolina Medical Board Investigating 60 Healthcare Workers in Drug Overdoses                
Winston-Salem Journal                
May 14, 2016                

The North Carolina Medical Board is investigating 60 doctors and physician assistants who had two or more patients fatally overdose on prescription pain relievers within a 12-month span. The medical board is also investigating 12 other doctors and physician assistants who prescribed high doses or large volumes of opioids. In some cases, no direct link exists between the deaths and the doctor’s prescribing. However, regulators will look into whether patients received substandard care. From 2013 through 2015, the medical board investigated more than 7,000 cases; in 340 cases, prescribing was the primary issue, with 109 resulting in public sanctions.                

Read more:                
http://www.journalnow.com/news/state_region/n-c-medical-board-investigating-doctors-physician-assistants-in-drug/article_fcd46f51-bdd8-5615-b8a6-8a5af231f20f.html                                  

Doctors Prescribed Man 145 Opioid Pills. Nine Days after Surgery, He Died                
Charlotte Observer                
May 14, 2016                

In February 2012, Riley Martin had a routine tonsillectomy. The doctor prescribed him 145 pills for pain. Nine days later, the 24-year-old overdosed from a toxic mix of cocaine and prescription medications. The North Carolina Medical Board found doctors acted appropriately and did not deserve punishment in the 2012 death. Today, the board wants to take a more aggressive stance by increasing the number of investigations into improper prescribing and into providers who frequently prescribe commonly abused drugs.                

Read more:                
http://www.charlotteobserver.com/news/local/article77695782.html                                  

Walgreens to Provide Nalaxone Without a Prescription in Texas                
KUOW                
May 20, 2016                

Texans will be able to purchase naloxone without a prescription at Walgreens this summer. Recently, Alicia Kowalchuk, M.D., with Baylor Medicine wrote a standing order for the medication for every Walgreens in the state. (Includes audio: 1:39 minutes)                

Read more:                
http://kuow.org/post/walgreens-provide-drug-overdose-reversal-drug-without-prescription-texas                 
               

Midwest News

Wisconsin Attorney General Wants Employers to Help Fight Prescription Drug Abuse                
Sheldon Dutes, WISN                
May 17, 2016                

Wisconsin’s attorney general is asking businesses to help lower the number of people misusing prescription pain relievers. He announced plans to incorporate businesses and companies in the “Dose of Reality” state-wide initiative that launched last September. Schimel wants employees struggling with pain reliever addiction to feel like they can get help at work. He recommends employers test for prescription drugs and educate employees about the dangers of misusing pain relievers. Schimel recommends that companies talk with their legal or human resources departments before doing anything new. (Includes video: 1:04 minutes)                

Read more:                
http://www.wisn.com/news/ag-schimel-wants-employers-to-help-fight-against-prescription-drug-abuse/39600476                                  

Failed Drug Tests a Problem for Businesses in Wisconsin Town                
Alex Beld, Daily News                
May 19, 2016                

West Bend School District in Wisconsin has reported that 85 percent of local businesses have had issues filling entry level positions because of applicants failing to pass controlled substance testing. Most failures result from marijuana or prescription pain reliever misuse. The school district compiled the data from a survey it distributed to the West Bend Area Chamber of Commerce. Survey respondents had almost 5,500 employees.                 

Read more:                
http://www.gmtoday.com/news/local_stories/2016/05192016-failed-drug-tests-a-problem-for-local-businesses.asp                                  

Naloxone Billboards Going Up in Ohio                
Terry DeMio, Cincinnati.com                
May 13, 2016                

Ohio’s departments of Health and Mental Health and Addiction Services have launched an awareness campaign to get people to carry naloxone. The campaign includes billboards, radio spots, and social media posts about recognizing and stopping overdoses. The campaign’s website includes locations to get naloxone. The campaign is focused on 15 counties: Hamilton, Butler, Clark, Clermont, Cuyahoga, Franklin, Lorain, Lucas, Marion, Montgomery, Ross, Scioto, Stark, Summit, and Warren.                

Read more:                
http://www.cincinnati.com/story/news/2016/05/12/ohio-push-awareness-life-saving-od-antidote/84283692                                  

Kansas Health Officials Warn Mixing Prescription Drugs Can Be Deadly                
Jake Bowles, KFDI                
May 14, 2016                

The Kansas Department of Health and Environment (KDHE) said 75 percent of all drug poisoning deaths in 2014 were unintentional. Prescription pain relievers contributed to nearly half of all unintentional drug poisoning deaths in Kansas in 2014. KDHE recommends patients 1) talk to their doctors if they have prescriptions for both a pain reliever and a sedative; (2) never mix different drugs together or take more than prescribed without talking to the doctor first; (3) keep medications locked up in a safe place where others cannot easily access them; (4) properly dispose of any unused medications; and (5) never share medication with others.                

Read more:                
http://www.kfdi.com/news/kdhe-mixing-prescription-drugs-can-be-deadly                                  

Overdoses Becoming a Daily Event at Lafayette (Ind.) Emergency Departments                
Ron Wilkins, Lafayette Journal & Courier                
May 14, 2016                                 

St. Elizabeth East and Indiana University Health Arnett Hospital emergency departments treated 130 patients for drug overdoses in the first 113 days of 2016. Officials are most concerned with heroin and Spice, a form of synthetic marijuana.                

Read more:                
http://www.jconline.com/story/news/local/2016/05/14/overdoses-becoming-daily-event-lafayette-ers/84297232                 

West News

Arizona to Require Prescribers to Monitor Prescription Drug Database                
Stephanie Goldberg, Business Insurance                
May 13, 2016                

Arizona’s governor has signed legislation that requires healthcare providers to check the state’s prescription drug monitoring program before prescribing Schedule II, III or IV controlled substances. The law takes effect in October 2017.                

Read more:                
http://www.businessinsurance.com/article/20160513/NEWS08/160519869                                  

Nevada Governor Announces Prescription Drug Abuse Summit                
KOLO                
May 19, 2016                

Nevada’s governor and first lady will host the State Summit on Prescription Drug Abuse in June 2016. The summit will focus on duties and responsibilities of healthcare licensing boards; current coordination and opportunities for expanded collaboration with local, state and federal law enforcement; existing rehabilitation practices and substance abuse treatments; and cooperation and oversight for private sector issues, including sale and availability of pharmaceuticals.                

Read more:                
http://www.kolotv.com/content/news/Governor-Sandoval-announces-prescription-drug-abuse-summit-380173351.html                 

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

Strategic Prevention Framework for Prescription Drugs                
SAMHSA                
Due: May 31, 2016                
http://www.grants.gov/web/grants/search-grants.html                                  

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

Matanuska-Susitna Borough (Alaska) Rx Take-Back Program Colects Record Amount                
KTVA                
May 18, 2016                
http://www.ktva.com/prescription-take-back-program-sees-record-amount-of-drugs-823                                  

Iron Mountain (Mich.) Collects 42 Lbs. of Unwanted Prescription Drugs                
Daily News (Michigan)                
May 16, 2016                
http://www.ironmountaindailynews.com/page/content.detail/id/574086/42-pounds-of-unwanted-prescription-drugs-collected.html?nav=5002                                  

Fredonia (N.Y.) Police Install Year-Round Drug Drop-Off Box                
Evan Anstey, WIVB                
May 13, 2016                
http://wivb.com/2016/05/13/fredonia-police-install-year-round-drug-drop-off-box                                  

Clermont County (Ohio) Adds More Prescription Drug Drop-Off Bins                
Sheila A. Vilvens, Cincinnati.com                
May 19, 2016                
http://www.cincinnati.com/story/news/local/community-news/2016/05/19/clermontcounty/84582674                                  

Berwyn (Ill.) Police Introduce New Drug Drop-Off Box                
Suburban Life Media                
May 16, 2016                
http://www.mysuburbanlife.com/2016/05/09/berwyn-police-introduce-new-drug-drop-off-box/a8fyo79                                  

Brookfield (Wisc.) Committee Directs Police to Begin Prescription Drug Drop Box Program                
Geoff Bruce, Brookfield Elm Grove Now                
May 19, 2016                
http://www.brookfieldnow.com/news/brookfield-committee-directs-police-department-to-begin-prescription-drug-drop-box-program-b99728565-380064641.html                 

Upcoming Events, Conferences, & Workshops

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, New York                
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.