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May 28, 2014


SAMHSA Prescription Drug Abuse Weekly Update
Issue 73  |  May 28, 2014
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Featured Article Journal Articles and Reports News Other State and Local News Webinar Grant Announcement Grant Awarded Other Resources Video Audio Save the Date Take-Back Events Upcoming Conferences and Workshops


Ali Mohammad Sabzghabaee, Nastaran Eizadi–Mood, Ahmad Yaraghi, and Samaneh Zandifar. 2014. "Clinical Research Naloxone Therapy in Opioid Overdose Patients: Intranasal or Intravenous? A Randomized Clinical Trial." Archives of Medical Science 10(2):309–14, doi:10.5114/aoms.2014.42584.

This hundred-patient randomized trial in Iran compared the effects of intranasal and intravenous emergency department administration of 0.4 mg of naloxone in patients who had overdosed on opioids. Intranasal administration diluted the naloxone to a 2-ml nasal spray (1 ml into each nostril). Patients receiving intranasal naloxone had significantly higher heart rates and higher levels of consciousness both descriptively and based on Glasgow Coma Scale scales than those in the intravenous group. Blood pressure, respiratory rate, arterial O2 saturation, and length of hospital stay also varied between the two groups, but the differences were not statistically significant in this small sample.

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Toni M. Rudisill, Songzhu Zhao, Marie A. Abate, Jeffrey H. Coben, and Motao Zhu. 2014. "Trends in Drug Use Among Drivers Killed in U.S. Traffic Crashes, 1999–2010." Accident Analysis and Prevention, 178–87, doi: 10.1016/j.aap.2014.04.003.

Data for 1999 to 2010 from the Fatality Analysis Reporting System show almost every category of drug use is increasing among drivers killed in crashes. The percentage of drivers killed who had drugs in their system rose from 19.0 percent to 29.4 percent, roughly a 55 percent increase over 11 years. The analysis was restricted to 24 states that tested at least half of their drivers for drugs. Increases were 0.6 percent to 4.1 percent for hydrocodone/oxycodone, 2.2 percent to 9.9 percent for methadone, 2.4 percent to 6.0 percent for benzodiazepines.

Read more:

A Hidden Workplace Epidemic: Prescription Painkiller's Impact
National Safety Council
Thursday, June 5, 2014
1:00–2:00 p.m. (CDT)

Learn how prescription pain reliever use is affecting workplace safety and driving up Workers' Compensation and other costs. Dr. Don Teater, medical adviser, National Safety Council, will show you how to update your drug-free workplace and health plans to address prescription drug use and misuse.

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Journal Articles and Reports

Francisco Alonso, Cristina Esteban, Luis Montoro, and Francisco Tortosa. 2014. "Psychotropic Drugs and Driving: Prevalence and Types." Annals of General Psychiatry 13:14, doi:10.1186/1744–859X–13–14.

In a Spanish telephone survey with a 93 percent response rate, 15 percent of 1,107 drivers were using psychotropic drugs to treat depressive disorders, anxiety disorders, insomnia, or tranquilizers.

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Marc L. Fleming, Jamie C. Barner, Carolyn M. Brown, Marv D. Shepherd, Scott A. Strassels, and Suzanne Novak. 2014. "Pharmacists' Training, Perceived Roles, and Actions Associated With Dispensing Controlled Substance Prescriptions." Journal of the American Pharmacy Association 54(3):241–50, doi: 10.1331/JAPhA.2014.13168.

A 2012 mail survey of 1,000 randomly selected community pharmacists in Texas yielded 262 responses. Respondents were more supportive of mandated prescription monitoring program (PMP) use by physicians than by pharmacists. Most would consult a PMP if the prescription were to contain mistakes (68.1 percent) or the patient requested an early refill (66.3 percent).

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Traci C. Green, Madeline Ray, Sarah E. Bowman, Michelle McKenzie, and Josiah D. Rich. 2014. "Two Cases of Intranasal Naloxone Self-Administration in Opioid Overdose." Substance Abuse 35(2):129–32, doi:10.1080/08897077.2013.825691.

Researchers present two case histories of patients treated with intranasal naloxone to treat heroin overdoses following release from prison. Both patients self-administered the medication but were assisted by a witness whom they had instructed in how to prepare and administer it.

Read more:

Christi Hildebran, Deborah J. Cohen, Jessica M. Irvine, Carol Foley, Nicole O'Kane, Todd Beran, and Richard A. Deyo. 2014. "How Clinicians Use Prescription Drug Monitoring Programs: A Qualitative Inquiry." Pain Medicine, doi: 10.1111/pme.12469

Researchers collected qualitative data from 35 diverse clinicians spread across nine states through two online focus groups and seven telephone interviews. Some participants, mainly from pain clinics, reported checking the prescription monitoring program (PMP) with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for suspected abusers. Participants described varied approaches to sharing PMP information with patients, including openly discussing potential addiction or safety concerns, avoiding discussion altogether, and approaching discussion confrontationally. Participants described patient anger or denial as common responses and noted the role of patient satisfaction surveys as an influence on prescribing.

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Amy J. Jeffers and Eric G. Benotsch. 2014. "Nonmedical Use of Prescription Stimulants for Weight Loss, Disordered Eating, and Body Image." Eating Behaviors, doi: 10.1016/j.eatbeh.2014.04.019.

College students (N=707) completed an online survey assessing nonmedical use of prescription stimulants, in general and for weight loss. Overall, 4.4 percent of participants reported nonmedical use of prescription stimulants to lose weight; 56.7 percent of these users got the medication from friends. Compared with nonusers, nonmedical users predictably had higher body image concerns and higher eating disorder symptomatology.

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Caroline Victorri–Vigneau, Cedric Collin, Catherine Messina–Gourlot, Christel Raffournier, Michel Mallaret, Jérôme Besse, Marie–Anne Courne, Nathalie Richard, Véronique Sébille, and Philippe Arnaud. 2014. "Designing a Tool Allowing for a Standardized Assessment of Resistance to Drug Diversion." Expert Opinion on Drug Delivery, doi:10.1517/17425247.2014.901307.

Researchers designed a tool for standardized assessment of a drug formulation's resistance to diversion. With a Steering Committee, they applied eight tests and parameters to 14 drugs. Buprenorphine Subutex had the lowest score, and flunitrazepam Rohypnol the highest.

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Matthew Zuckerman, Stacy N. Weisberg, and Edward W. Boyer. 2014. "Pitfalls of Intransal Naloxone." Prehospital Emergency Care, doi:10.3109/10903127.2014.896961

Researchers presented a case where naloxone failed to restore ventilation.

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Former National Transportation Safety Board Boss Hersman Takes Reins of Safety Council
USA Today
May 21, 2014

Deborah Hersman is the new president and CEO of the National Safety Council. Her top priority is to reduce the number of Americans who die every year from accidental drug overdoses, including 16,000 who die from prescription pain relievers. Hersman said the safety council will attack the problem with a four-pronged approach: coordinated state action with prescription drug monitoring programs; education of doctors; enhanced enforcement targeting "pill mills" and doctor- and pharmacy-shopping; and overdose treatment including allowing access to naloxone. Hersman previously chaired the National Transportation Safety Board.

Read more:

Centers for Disease Control and Prevention. 2014. "Tamper-Resistant Prescription Form Requirements."

The Public Health Law Program, in partnership with the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control, has created menus summarizing legal strategies that states have used to address prescription drug misuse, abuse, and overdose. A new menu inventories state legal strategies addressing laws on tamper-resistant prescription forms.

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Celebrities Who Died From Prescription Drug Overdose
Infographic Journal
May 20, 2014

This infographic titled, "Celebrities Who Died from Prescription Drug Overdose" was created to bring awareness for rising prescription drug overdose incidents.

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Medicare Won't Let Massage Therapists Prescribe Drugs Any More
May 20, 2014

Effective June 1, 2015, Medicare Part D will pay only for prescriptions written by people enrolled as Medicare providers and identified as valid prescribers. Last year, the U.S. Department of Health and Human Services inspector general reported that 2,780 prescribing professionals lacked authority to prescribe medication and order drugs for Medicare patients. Fixing the problem should save $160 million annually.

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California Counties Sue Drug Makers Over Painkiller Abuse
May 23, 2014

Attorneys for Orange and Santa Clara Counties filed a lawsuit in California Superior Court claiming drug makers violated state laws against false advertising and unfair competition. The suit says that pharmaceutical companies co-opted doctors and patient advocacy groups to overstate the benefits of pain pills while soft-pedaling the risks of addiction. It claims that manufacturers targeted "misleading medical education programs, treatment guidelines, and other efforts" at primary care doctors who would encounter patients with pain, but "are less likely than specialists to have the time or knowledge to evaluate defendants' deceptive messages or to closely monitor patients for signs of improvement or adverse outcomes (such as addiction)."

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Xanax-Related Emergency Room Visits Double in Six Years
May 22, 2014

Emergency room visits related to Xanax misuse more than doubled from 2005 to 2011. In 81 percent of cases, Xanax was mixed with another drug or alcohol. Misuse was highest and grew most among 25- to 34-year-olds.

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Older Americans Hooked on Prescription Drugs: 'I Was a Zombie'
USA Today
May 21, 2014

This article and video (4 minutes 35 seconds) discuss the toll that prescription drug misuse has on seniors. Most misuse opioids or anti-anxiety medications. From 1999 to 2010, senior overdose deaths nearly tripled and overdose visits to emergency room rose almost 50 percent.

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Seeking Help: Combating Prescription Drug Abuse
Barksdale Air Force Base
May 22, 2014

This article discusses the risks of misusing and abusing prescription drugs among U.S. Air Force personnel. The Alcohol Drug Abuse and Prevention program manager identified Vicodin, Percocet, and Norco as commonly abused medications. The Air Force encourages service members to use its tools and programs designed to assist those suffering with addiction.

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Preventing Prescription Drug Abuse
Safety+Health Magazine
May 23, 2014

The National Safety Council lists behaviors that may indicate a worker has a prescription drug-related problem and how to prevent drug misuse.

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CVS Caremark Publishes 2013 Corporate Social Responsibility Report
Wall Street Journal
May 19, 2014

This press release discusses CVS Caremark's 2013 Corporate Social Responsibility Report. One topic covered is safe disposal of prescription drugs.

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Call for Monitoring of Prescription Drugs as Chronic Pain Sufferers Risk Addiction
May 19, 2014

This article and video (2 minutes 3 seconds) discuss Australian health groups' call for greater oversight of prescription opioids. Victorian Alcohol and Drug Association chief executive Sam Biondo said real-time prescription monitoring can provide a red flag before misuse gets out of hand. Australian Pain Society President Malcolm Hogg said doctors rely on opioids when alternative treatment is unavailable. He said in an environment where disability support pensioners are encouraged back into work by government, patients need more comprehensive care. Biondo recently released a position paper calling for numerous changes to the way chronic pain is managed. He supports a multidisciplinary model of care, with doctors, pharmacists, and allied health professionals working together to meet patient needs.

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Other State and Local News

Hickenlooper Signs Bills Combating Prescription Drug Misuse
Colorado Medical Society
May 21, 2014

Colorado Gov. John Hickenlooper signed House Bill 14–1283, "Modify Prescription Drug Monitoring Program," and House Bill 14–1207, "CDPHE Household Medication Take-Back Program," passed by the Colorado General Assembly. HB14–1283 updates the prescription drug monitoring program by bringing it up to national standards aimed at decreasing "doctor shopping" and reducing prescription drug abuse. It also creates a permanent infrastructure to collect and dispose of unused household medications.

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Most Emergency Room 'Super-Frequent Users' Have a Substance Abuse Addiction
Henry Ford Health System
May 17, 2014

At the Henry Ford Hospital, 255 patients visited the emergency department at least 10 times in a 12-month period between 2004 and 2013. Of these patients, 77 percent were substance abusers, including 47 percent addicted to prescription narcotics such as Vicodin and Dilaudid; 44 percent abused illicit drugs.

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Miami, Fla., Veterans Affairs Hospital Employee Alleges Crimes Ignored
Miami Herald
May 22, 2014

This article discusses allegations that Miami's Veterans Affairs (VA) Hospital administrators covered up patients' dealing prescription opioids, patient abuse, and prescription drugs missing from the hospital pharmacy. A VA detective alleges he was reassigned to a clerical position when he tried to investigate these incidents. A public affairs officer for the hospital said the detective's allegations lack substantiating evidence.

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Schumer: New York State to Create Heroin-Tracking Database
May 21, 2014

U.S. Sen. Charles Schumer announced government plans to create the first heroin tracking database; it will target New York state. The Office of National Drug Control Policy will meet with the state to devise a database that allows law enforcement to identify patterns, crack down on heroin rings across county lines, target resources to high-crime areas, determine which types of drugs are the most sought after, and determine necessary security changes in drug distribution networks. Schumer said the rise in prescription drug abuse is one of the main factors in the growth of heroin use.

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New Jersey Prescription Monitoring Program Now Sharing Data With Connecticut, Giving Healthcare Practitioners in Both States Even Greater Power to Fight Prescription Drug Abuse
State of New Jersey
May 22, 2014

The New Jersey and Connecticut prescription drug monitoring programs have started sharing data. The New Jersey Division of Consumer Affairs is working on also sharing with the State of Delaware.

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Doctors Group Seeks Tighter Focus on Substance Abuse
Boston Herald
May 17, 2014

The Massachusetts Medical Society adopted a resolution on youth substance abuse during its annual meeting. It encourages primary care physicians to perform annual physical examinations on adolescents and young adults and to seek an accurate history of any illegal use of drugs, including prescription drugs.

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Detox From Opiates in Eight Hours With Las Vegas Rapid Detox's Groundbreaking Rapid Opiate Detox Program
May 21, 2014

This press release and video (3 minutes 6 seconds) announce the Las Vegas, Nev., Rapid Detox Clinic's eight-hour rapid opiate detox program. The safety and efficacy of the program are not disclosed.

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Substance Abuse a Top Reason Children Are Removed From Homes
Wichita Eagle
May 17, 2014

The Kansas Department for Children and Families reported that substance abuse is the main reason for one in five removals. That ratio has remained steady over the past four fiscal years. Pamela McLucas, a substance-abuse counselor at Wichita Children's Home, reported rising prescription drug abuse, with parents' mixing prescription drugs with alcohol especially problematic.

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New Jersey Targets Opiate Addiction With Ads
May 22, 2014

New Jersey launched an ad campaign and Web site targeting opiate addiction. The ads seek to show that no one is immune from addiction to heroin and prescription drugs. They will bear the message: "Your medicine cabinet could be a gateway to heroin."

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Bill Aimed at Reining in Prescription Drug Abuse Headed to Rhode Island Governor's Desk
Providence Journal
May 22, 2014

Rhode Island's governor will soon receive a bill that requires medical professionals to register with the state's prescription drug monitoring program. The legislation also expands database access to designees of a practitioner or pharmacist on their behalf.

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Study Highlights Prescription Drug Dangers
Columbia (Mo.) Daily Tribune
May 20, 2014

Deaths related to prescription overdoses accounted for 19 percent of cases from several counties that the Boone County, Mo., Medical Examiner's Office investigated from 2010 to 2012. In about 80 percent of the 350 overdose deaths, a prescription medication or a combination of drugs was the main cause of death, with medications contributing in the remainder. Most overdoses were accidental, with some suicides. About 40 were attributed to methadone and 20 to heroin.

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A Webinar Featuring Evidence-Based and Promising Workplace Programs to Prevent Prescription Drug Abuse
Monday, June 16
2:00–3:30 p.m. (EDT)

The Preventing Prescription Abuse in the Workplace project is hosting this Webinar on evidence-based and promising workplace programs. It will provide an overview of four model workplace prescription abuse prevention programs and describe key programmatic factors to replicate to successfully address prescription abuse in the workplace. The Webinar also will provide participants with an opportunity to ask questions and share their experiences with implementing effective prevention programs. Presenters are Heather Healy, LCSW–C, Flight Attendant Drug and Alcohol Program; Fred Wells Brason II, Operation OpioidSAFE; Diane Deitz, Ph.D., of the ISA Group; and Joel Bennett, Ph.D., of Organizational Wellness & Learning Systems.

For more information and to register for the Webinar, contact Lauren Thompson at lthompson@econometricainc.com or 240.333.4816.

Grant Announcement

Prescription Drug Overdose: Boost for State Prevention
Centers for Disease Control and Prevention
Deadline: June 4, 2014

Grant Awarded

University of Kentucky Getting $1.5 Million to Fight Teen Drug Abuse
May 19, 2014

The state Attorney General announced that the University of Kentucky will receive $1.5 million to develop a plan to prevent and treat teen substance abuse. The money comes from $32 million in settlements in cases against two pharmaceutical companies. The university program, called UK Kentucky Kids Recovery, will offer evidence-based treatment and reach out to teachers, families, and medical professionals. Evaluation plans include testing patients' urine over time and looking at their school performance and how they socialize with peers who do not use drugs.

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Harper Government Supports Youth Drug Prevention Projects Across the Country
Digital Journal
May 23, 2014

This press release announces that Canadian Prime Minister Stephen Harper's government is authorizing $16.1 million in federal funding to help prevent and reduce illicit and prescription drug abuse among youths ages 10 to 24. The funding will support 34 projects across Canada.

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Other Resources

National Safety Month: Tips for Using Painkillers Safely
May 20, 2014

Don Teater, the National Safety Council medical adviser, recommends tips to reduce the danger of using prescription pain relievers and to increase consumer safety.

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New Educational Video for Pharmacists Addresses Prescription Drug Abuse
Wall Street Journal
May 21, 2014

A new educational video teaches pharmacists the warning signs of prescription drug abuse and diversion to watch for when dispensing controlled substance prescriptions. The video weaves personal narratives with interactions between pharmacists and customers. "Red Flags" is sponsored by the National Association of Boards of Pharmacy and six pharmaceutical companies.

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Ex-NFL Players File Lawsuit Citing Drug Culture
Washington Post
May 20, 2014

This video (1 minute 56 seconds) discusses a lawsuit that was filed on behalf of more than 500 former National Football League players who claim they face permanent injuries as a result of the overuse of prescription pain relievers. Also, some players were left with serious drug addictions.



Pain Management for Veterans; Voices for Veterans Recap
May 21, 2014

Mathew Caffrey of the Pain Clinic and Barry Venable from Saint Cloud, Minn., Veterans Affairs joined WJON's host to discuss pain medication and pain management options for veterans. Dr. Caffrey said that each person's pain management options may be different.


Take-Back Events and Drop Boxes

Kaiser Permanente Collects More Than 8,200 Pounds of Unwanted Medications on 'Drug Take-Back Day'
Digital Journal
May 22, 2014

Nearly 1,000 Pounds of Prescription Drugs Collected in Statewide Take-Back Events
AL.com (Alabama)
May 21, 2014

Prescription Drug Drop-Off Box Now in Berkeley, N.J.; More on the Way
Berkeley Patch
May 17, 2014

Marietta, Ga., Police Department Offering Prescription Drug Drop Box Service
City of Marietta
May 22, 2014

In the City: Don't Wait to Dispose of Unwanted Drugs
May 18, 2014

Drug Drop-Box Is Now Open at Andover, Mass., Police Department
May 17, 2014

Save the Date

Sixth Annual American Medicine Chest Challenge National Day of Awareness and Safe Disposal of Prescription and Over-the-Counter Medicine
American Medicine Chest Challenge
November 8, 2014

Upcoming Conferences and Workshops

Prescription for Prevention: Preventing and Responding to Prescription Drug Abuse on Campus
Temple University, Villanova University, U.S. Attorneys' Office, and the Clery Center
June 11, 2014
Philadelphia, Pennsylvania

Orange County, Fla., Prescription Drug Abuse Summit
Orange County Drug Free Coalition
June 18, 2014
Orlando, Florida

Pharmacy Diversion Awareness Conference
U.S. Department of Justice, Drug Enforcement Administration
June 28–29, 2014—Renaissance Phoenix (Ariz.) Downtown
July 12–13, 2014—Sheraton Philadelphia (Pa.) Downtown Hotel
August 2–3, 2014—Denver (Colo.) Marriott Tech Center

CADCA's Midyear Training Institute 2014
July 20–24, 2014
Orlando, Florida

Prevention of Youth Substance Abuse in Rural Communities Conference: Bringing Hope to Communities in Despair
Coalition for Healthy Youth
August 6–8, 2014
Lancaster, South Carolina

Twenty-Seventh Annual NPN Prevention Research Conference
National Prevention Network
September 15–18, 2014
Hartford, Connecticut

2014 Harold Rogers Prescription Drug Monitoring Program National Meeting
Brandeis University, Prescription Drug Monitoring Program Training and Technical Assistance Center
September 22–24, 2014
Washington, D.C.
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.