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November 13, 2013


SAMHSA Prescription Drug Abuse Weekly Update
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 Articles Journal Articles and Reports News Other State and Local News Webinar Archive Videos Grant Announcement Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Articles

16 SAMHSA Fact Sheets and Issue Briefs on Preventing Prescription Abuse Now Available
West Virginia University Injury Control Research Center
Accessed November 7, 2013

This series of fact sheets and issue briefs was developed by the Preventing Prescription Abuse in the Workplace Technical Assistance Center, with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA). The versions provided come from a presentation at the National Safety Council Congress in October 2013. Fact sheet titles include the following:

"Managing Chronic Low Back Pain While Minimizing Use of Dangerous Prescription Opioids" (a set of four issue briefs)

"Opioid and Narcotic Painkillers: Know the Benefits, Understand the Dangers"

"The Slippery Slope of Relieving Pain: Be Wary of Opioid Drugs"

"Prescription Drug Abuse Awareness: Information for Employers"

"Realtors: Warn Your Clients About Prescription Drug Theft"

"Funeral Directors: Help Your Clients Avoid Prescription Drug–Related Victimization"

"Pharmacists: Warn Your Customers About Prescription Drug Theft"

"Attention Shoppers: Keep Your Prescription Drugs Out of Sight"

"How to Handle Leftover Medication"

"Safeguard Your Mail-Order Prescription Drugs"

"Prescription Drug Monitoring Programs: A Cost-Saving Tool for Employers"

"5 Reasons Not to Share Prescription Drugs at Work"

"Monitoring Prescription Drug Use in the Workplace: What Can Employers Ask?"

Read more:

Training Program Helps Health Care Providers Address Prescription Drug Abuse
Health Canal
November 6, 2013

A Colorado health care training course designed to curb prescription drug abuse reported preliminary data that statewide chronic pain prescription practices have changed since its launch in November 2012. Through a partnership with COPIC and the Colorado Medical Society, the Center for Worker Health and Environment at the Colorado School of Public Health developed and launched an online educational course to retrain health care providers on updated state and federal chronic pain management guidelines and instructions for prescribing opioids. Online training enrolled more than 1,000 Colorado health care providers. A 3-month follow-up survey indicated providers had changed their chronic pain management practices based on what they learned in the course. Of providers currently managing pain patients, 84 percent of survey respondents said they changed the way they practice. Nearly 80 percent agreed or strongly agreed their knowledge about treatment and management of noncancer chronic pain increased as a result of taking the course, and 74.8 percent agreed or strongly agreed they are more confident in their ability to manage chronic, noncancer pain patients. Among providers who took the course but are not currently managing chronic pain patients, 79.2 percent indicated they now coordinate care with providers who manage chronic pain patients, based on knowledge that they gained in the course.

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Journal Articles and Reports

L. Finnegan. 2013. "Substance Abuse in Canada: Licit and Illicit Drug Use During Pregnancy: Maternal, Neonatal and Early Childhood Consequences." Ottawa, ON: Canadian Centre on Substance Abuse.

This report addresses medical and obstetrical consequences of prescription and illicit drug abuse and dependency in pregnant women, as well as short- and long-term effects of prenatal exposure on child development. It also details treatment approaches essential for avoiding or reducing adverse outcomes in substance-using pregnant women and their infants. Measures include comprehensive prenatal care and medication-assisted treatment. A closing Call to Action draws on themes from earlier chapters.

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Related Article
L. Eggertson. 2013. "Stigma a Major Barrier to Treatment for Pregnant Women with Addictions." Canadian Medical Association Journal. doi:10.1503/cmaj.109-4653.

Stigma is one of the biggest barriers to effective treatment for pregnant women who use legal or illegal substances, according to a new report from the Canadian Centre on Substance Abuse. Dr. Loretta Finnegan, the report's author, said many pregnant women who come to clinics or emergency rooms for help with addictions feel unwelcome and judged. Dr. Finnegan is the former medical advisor to the director of the Office of Research on Women's Health at the U.S. National Institutes of Health, and founder of a Philadelphia clinic for women with drug addictions. Doctors need to be better informed about women's unique treatment needs. Two thirds of pregnant women with substance abuse problems also have concurrent mental health problems, and a large proportion have been sexually and/or physically abused in childhood or as adults, said Colleen Dell, research chair in substance abuse at the University of Saskatchewan.

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J.V. McDonald. 2013. "Appropriate Prescribing of Opiates as Professional Conduct." Rhode Island Medical Journal: 33–35.

Chronic pain is often treated with prescription opiates, which offer some relief yet present dependence, addiction, and overdose risks to patients. Physicians find themselves at odds with patients regarding pain management and may feel bullied or pressured when it comes to prescribing. The Rhode Island Board of Medical Licensure and Discipline recognizes the value of established parameters.

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Internet Drug Outlet Identification Program
Progress Report for State and Federal Regulators: October 2013
National Association of Boards of Pharmacy
Accessed November 7, 2013

Most rogue online drug sellers reviewed by the National Association of Boards of Pharmacy (NABP) in the last 3 months offer medications or drug products not approved by the Food and Drug Administration. This report includes findings for more than 10,500 Internet drug outlets reviewed by NABP. Nearly 97 percent of the sites reviewed operate out of compliance with U.S. pharmacy laws and practice standards of other developed countries. They are listed as "Not Recommended" on NABP's consumer protection Web site.

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Study: Access to Health Care Increases Prescription Opioid Availability and Associated Abuse
Science Codex
November 5, 2013

In a recent study, researchers at Indiana University–Purdue University Indianapolis discovered access to health care increases availability of prescription opioids, which, in turn, is associated with higher rates of opioid abuse and associated consequences. They concluded that the structure of local health care systems at the county level is a major determinant of community-level access to opioids. This study focused on counties within Indiana because of the unique availability of detailed dispensation data from the state's prescription drug monitoring program. The most widely prescribed opioid is hydrocodone (Vicodin), accounting for 68.9 percent of all opioid prescriptions, followed by oxycodone at 11.7 percent, codeine-containing products at 8.5 percent, and fentanyl at 2.6 percent. Prior research showed most abusers report they obtain prescriptions on their own or from friends and relatives who were prescribed opioids. The study's findings were presented at the American Public Health Association annual meeting on November 5, 2013.

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U-M Research Supports Need for More Control over Prescribed Drugs for Youths
University of Michigan
November 6, 2013

Teens who are prescribed pain relievers are at "notable risk" for abusing opioid drugs, said Dr. Carol Boyd, a professor of nursing and women's studies at the University of Michigan Addiction Research Center. Dr. Boyd said adolescents exposed to addictive medication are more likely to engage in nonmedical use and diversion, including buying, selling, and giving away pills. Her team recently sampled more than 2,600 Michigan students who completed a Web-based survey about substance use, behavior disorders, and pain symptoms. About 70 percent reported they never used painkillers; 24.5 percent were classified as medical opioid users (those who used their medications as prescribed); 3.5 percent were described as nonmedical self-treaters (those who used someone else's opioids for pain); and 1.6 percent were called nonmedical sensation seekers. Adolescents in the latter group get high, experiment, or create altered states with someone else's medications, while those with medical clearance use their own prescription drugs. However, all teens in the study who use prescribed opioids had substance use and behavioral disorders at rates that were significantly higher than youth who had never received a prescription for an opioid painkiller. When factoring in gender differences among medical users, girls with opioid prescriptions were at greater risk for behavioral problems, and their problems differed from boys' problems. Dr. Boyd said the motive behind narcotic pain reliever use may be more relevant than the means of obtaining the medication when considering adolescents' prescription drug abuse. She presented this data at the Association for Medical Education and Research in Substance Abuse National Conference.

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Americans Turn Out in Droves for DEA's Seventh National Prescription Drug Take-Back Day
United States Drug Enforcement Administration
November 6, 2013

Americans turned in 647,211 pounds (324 tons) of prescription medication at 5,683 take-back sites during the Drug Enforcement Administration's (DEA's) National Take-Back event on October 26. It was the second-largest collection of medication in 7 Take-Back days. The DEA and its state, local, and tribal law enforcement and community partners have removed more than 3.4 million pounds (1,733 tons) of medication from circulation since the program's inception.

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Internet Drugs Can Kill
The Huffington Post
November 1, 2013

Steve Pociask, president and chief executive officer of the American Consumer Institute Center for Citizen Research, and Joseph P. Fuhr Jr., professor of economics at Widener University, warn consumers about purchasing prescription drugs from online pharmacies. They suggest finding out where the online pharmacy is located and where it obtains its drugs. In addition, consumers should be suspicious of companies that distribute drugs without a prescription. Some of these sites are linked to terrorist groups and organized crime.

Read more:

Doctor Jailed for Illegally Prescribing Drugs at Starbucks Defends His Actions
ABC News
November 7, 2013

This article and video (1:02 minutes) discuss Dr. Alvin Yee's pain management practice at Starbucks locations throughout Orange County, California. Dr. Yee claimed he did not pay Starbucks rent. In exchange for addictive pain relievers, patients would pay as much as $600 for an initial visit and $300 for follow-up visits. Some patients asked for Adderall and Xanax. In November 2010, Dr. Yee met with a Drug Enforcement Administration (DEA) agent posing as a patient. The agent was given prescriptions for 60 OxyContin, 60 Xanax, and 120 Roxicodone. The DEA arrested and charged Yee with 56 counts of prescribing controlled substances without a legitimate medical purpose. Dr. Yee pleaded guilty to seven counts and a judge sentenced him to 11 years in a federal prison. An undercover video of his Starbucks business was shown nationally on 20/20 on November 8, 2013.

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Advice for Small Employers Testing New Hires for Drugs
Bloomberg Businessweek
November 7, 2013

This article answers three questions about drug testing: How can a small company do drug testing for job applicants? How much does it cost? Do you send the employees to a local lab or hire a contractor to handle the entire process?

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Families Challenged to Tackle Prescription Drug Abuse Across US
Digital Journal
November 8, 2013

The 4th Annual American Medicine Chest Challenge (AMCC) was held on November 9, 2013. This national public health initiative raises awareness about the dangers of prescription drug abuse and encourages safe disposal. Asking families to take the Five-Step AMCC meant taking inventory of medicine, securing their medicine chests, taking medicine only as prescribed, safely disposing of medicine, and talking to children about prescription drug dangers. The AMCC and Actavis are donating permanent prescription drug collection boxes to law enforcement partners in Florida and New Jersey.

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Prescription Drug Abuse: A Pharmacist's View
The GoodRx Prescription Savings Blog
November 1, 2013

A state-licensed pharmacist shares her perspective on the role of the pharmacist, what individuals can do to prevent abuse, and available resources.

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With Rise of Painkiller Abuse, a Closer Look at Heroin
National Public Radio
November 2, 2013

This article and audio (12:28 minutes) discuss how the prescription drug epidemic is connected to heroin. As communities combat the problem, addicts turn to heroin because it's cheaper and easier to obtain. All Things Considered host Arun Rath interviews experts about the growing trend.

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Commentary: The Quest for Alternatives to Opioids in Chronic Pain: The Role of the Interventional Pain Physician
The Partnership at Drugfree.org
November 5, 2013

Timothy R. Deer, president and chief executive officer of The Center for Pain Relief, discusses commonly used procedures to eliminate or reduce addictive pain medications. Deer encourages patients and physicians to consider alternative interventions that may reduce risks associated with drug therapy.

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Commentary: We Must Do Better in Helping Veterans with Alcohol and Drug Problems
The Partnership at Drugfree.org
November 8, 2013

David Rosenbloom, founder of Join Together and professor at Boston University School of Public Health, shares ways the U.S. can help veterans overcome drug and alcohol addictions. This includes removing barriers to treatment and recovery for Reserve and Guard members and expanding access to VA services. The Internet and mobile and social networking have made it possible to reach returning soldiers who do not live near a VA facility. Rosenbloom recently completed a successful randomized clinical trial of a Web-based, self-administered intervention to help people returning from combat reduce unhealthy drinking and posttraumatic stress disorder (PTSD) symptoms. Recruited through Facebook ads, participants reduced daily and heavy drinking and experienced a decline in PTSD symptoms compared with the control group. Now Rosenbloom has received support from the Bristol–Myers Squibb Foundation and VA to make the program freely available to all returnees.

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Prescription Painkiller Abuse: How Does It Affect Kids?
November 6, 2013

Gary A. Emmett, a pediatrics professor at Thomas Jefferson University, shares his views about prescription drug abuse by providing statistical data on neonatal abstinence syndrome, prescription overdoses, and the availability of prescription pain relievers to children. He suggests talking to kids about the dangers of abusing painkillers and finding out where they spend their time.

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New Silk Road Drug Bazaar Opens a Month After FBI Bust
November 7, 2013

A new Internet marketplace for illegal drugs debuted online with the same name and look as the Silk Road Web site, which was shut down by U.S. law enforcement authorities last month. (See October 9, 2013, Weekly Update). The new Silk Road listed hundreds of advertisements for illegal drugs available from independent sellers using Bitcoin digital currency. The owner bragged that the site improves on technology meant to keep identities secret and includes measures to prevent users from losing their Bitcoins if the site shuts down.

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Related Report
National Take Back Day
United States Drug Enforcement Administration
October 26, 2013

This report shows state results for National Take-Back Day, held October 26, 2013.

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Jeffersontown Startup Company Wants to Reduce Drug Abuse
November 5, 2013

This article and video (2:01 minutes) discuss PillGuard—a handheld, programmable pill dispenser. A pharmacist programs the correct dosage and dispensing information into the unit and the patient enters a PIN at a designated time to get his or her medication. PillGuard has been on the market since Labor Day.

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Other State and Local News

Former Drug Addict Describes Network of AZ Moms Popping Pills
November 6, 2013

This article and video (4:34 minutes) discuss mothers using prescription medications like Percocet and Xanax to get through the day. One woman, "Lori," started using Xanax and antidepressants to deal with financial stress. Soon she supplemented her doctor's prescription by joining a network of medicated moms. They could easily get prescription drugs because they went to the same doctors. Lori also ordered pain pills online and doctor-shopped in the United States and Mexico. She once spent $2,000 to $3,000 a week on her addiction but has been clean for 2 years.

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Hilliard Teens Combat Prescription Drug Abuse in Puerto Rico
Hillard Darby High School
November 1, 2013

Hilliard high school students traveled to Puerto Rico to train teens on prescription drug abuse and misuse. They were selected along with two other Central Ohio students to accompany staff from Youth to Youth International, a drug prevention/youth leadership program. The training team worked with more than 30 high school teens, teaching them to conduct an educational presentation, "The pHARMING Effects." Students in Puerto Rico plan to present what they learned to others.

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Third Prescription Drug Dealing Bust Near UCSB in One Week
November 3, 2013

Santa Barbara County Sheriff's Narcotics Investigators arrested three drug dealers accused of selling prescription drugs near the University of California, Santa Barbara campus. Detectives seized more than 2,000 Xanax pills for sale from two alleged dealers and then served a search warrant at a residence for another individual. They seized guns, marijuana, and large amounts of prescription medication.

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ADHD Drug Abuse Rises on College Campuses
November 5, 2013

This article and video (3:13 minutes) discuss college students taking attention deficit hyperactivity disorder (ADHD) drugs to help them study. North Carolina State, Penn State, and Georgia Tech said they could no longer handle the volume of requests for the drugs. Some schools have started forbidding clinics to prescribe them. Other universities, including Oregon State University, require students to sign contracts promising not to misuse or share pills. The school does not allow early refills to replace lost or stolen medication. University of Oregon also uses a student agreement.

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Prescription Drug Abuse on the Rise in San Diego
November 4, 2013

This article and audio (1:43 minutes) discuss a study conducted by the San Diego County Prescription Drug Abuse Task Force that revealed an increase in the number of San Diegans who abuse prescription drugs and heroin. The report card tracks nine indicators of the problem from 2008 to 2012. During that time, prescription drug overdose deaths increased sharply, as did prescription drug–related visits to emergency departments. Most commonly abused were narcotic pain relievers like OxyContin and Valium. Nearly 20 percent of 11th graders in San Diego County report experimenting with prescription drugs.

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OBN Visits Lawton to Help Fight Prescription Drug Abuse
November 5, 2013

The Oklahoma Bureau of Narcotics (OBN) met with drug prevention organizations in Lawton to discuss ways to reduce prescription drug abuse. Last year, 78 percent of drug overdoses came from pharmaceutical drugs, said an OBN official. He suggested modeling Oklahoma's efforts on the program in New York City and noted education is the key to stopping the proliferation. On December 19, the governor will reveal Oklahoma's new plan to fight prescription drug abuse.

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Dentist Pleads Guilty in Prescription Drug Case
November 4, 2013

An Idaho dentist pleaded guilty to obtaining controlled substances by writing prescriptions for people who were not patients or in need of the drugs. Federal prosecutors convicted the 37-year-old on one count of acquiring and obtaining a controlled substance by fraud or deception. He admitted to writing about 93 fraudulent prescriptions to get more than 2,500 dosage units of drugs containing hydrocodone and alprazolam.

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Committee to Start Prescription Drug Abuse Study
Montana Office of Public Instruction
November 5, 2013

A Montana legislative committee will begin a prescription drug abuse study by hearing from medical and law enforcement professionals about the use, abuse, and diversion of drugs. The presentations will occur at the November 15 meeting of the Children, Families, Health, and Human Services Interim Committee in Helena. The committee will also hear about development and use of Montana's prescription drug registry.

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New Oklahoma Law Ends Automatic Refills on Prescription Painkillers
November 1, 2013

This article and video (2:38 minutes) discuss a new Oklahoma law that prohibits automatic refills for hydrocodone, effective November 1, 2013. People will have to go to or call their doctors every month to get more. Doctors can still call in prescriptions, but they cannot email them, and prescriptions cannot be transferred between pharmacies.

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Ex-Washington County Deputy Guilty in Drug Theft from Drop Box
Saint Paul Pioneer Press
November 5, 2013

A former Washington County, Minnesota, sheriff's deputy was convicted on charges of illegal possession of prescription drugs and misconduct by a public employee. Surveillance footage showed the man opening a drug drop box and removing the drum of medications. On a separate occasion, officers watching a live feed saw him access the bin again. He had more than 200 pills in his office and vehicle.

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Middle Schoolers Grind Up Drugs, Pass Mix Around
The Storm Lake Times
November 7, 2013

Three middle school girls ground and mixed together prazosin, pseudoephedrine, Risperdal, and escitalopram, then repackaged the medicine into capsules before providing the drugs to another student. Police were called to Storm Lake Middle School in Iowa after school officials recovered a baggie that contained the mixture. The girls were arrested and charged with providing a prescription drug to a minor.

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Prescription Drug Abuse Hits Newborn Babies Hard
The Times
November 2, 2013

In Northeast Georgia's neonatal intensive care unit (NICU), about two babies are treated for neonatal abstinence syndrome (NAS) per month—a 50 percent increase in only 5 years, according to Nurse Manager Janessa Canals–Alonso. A baby suffering from NAS is given medication such as methadone and slowly weaned off the drug. The onset of withdrawal symptoms can begin as early as 24 hours after birth or delayed until 5 to 7 days of age, depending on the type of drug or substance used. It is expensive to treat infants with NAS, with costs running over $1,000 per day in the NICU. Unit stays average 15 days for an infant in withdrawal.

Read more:

Webinar Archive

Overview of the Opioid Addiction Epidemic
Children's Safety Network
Webinar date: October 16, 2013

This Webinar was presented by Dr. Andrew Kolodny, chief medical officer of Phoenix House and president of Physicians for Responsible Opioid Prescribing. Dr. Kolodny discussed factors that led to sharp increases in opioid overdose deaths and addiction. He also named strategies for bringing the epidemic under control. The audio presentation and PowerPoint slides are now available.

Read more:


Deadly Dose: How Prescription Drugs Could Kill You
Katie Talk Show
Accessed November 4, 2013

Katie Couric discusses prescription drug abuse with Dr. Sanjay Gupta. (Duration: 6:50 minutes)


Prescription Drug Abuse
Mississippi Public Broadcasting
November 1, 2013

Dr. Rick Deshazo, Southern Remedy talk show host, investigates the problem of prescription drug abuse and addiction in Mississippi. (Duration: 24:01 minutes)


Grant Announcement

Medical Toxicology Foundation Research Award: Prescription Drug Abuse Prevention
American College of Medical Toxicology
Deadline: February 14, 2014, 11:59 p.m. ET

The Medical Toxicology Foundation is accepting proposals for innovative research projects designed to mitigate harm associated with prescription drug abuse. The Foundation will support outstanding research and other initiatives with the potential to reduce prescription drug misuse and abuse, particularly among young people. A major goal is to support the development and/or analysis of innovative prevention, treatment, and/or harm-reduction strategies.

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Take-Back Events and Drop Boxes

Drop Box for Prescription Drugs Available at Smithsburg Police Department
Herald Mail Media
November 6, 2013

Kansans Turn in Nearly 5 Tons of Medication
November 1, 2013

Kent Police Collect More Than 210 Pounds of Prescription Medication
Kent Report
November 1, 2013

Rotary Groups Pool for Prescription Dropboxes
The Morning Sun
November 2, 2013

Operation Medicine Drop Collects 9.5 Million Pills Across NC
North Carolina Department of Justice
November 1, 2013

DEA Helps V.I. Residents Dispose of 234 Pounds of Prescription Drugs Safely
Virginia Island Daily News
November 1, 2013

30 Days to a Safer Neighborhood: Doddridge County Drug Pick-Up System
November 3, 2013

Upcoming Conferences and Workshops

Town Hall Meeting on Prescription Drug Abuse
November 20, 2013
Fort Collins, Colorado

Monroe County Drug Summit
December 3, 2013
8 a.m. to 4 p.m.
Monroe County Community College
1555 S. Raisinville Rd.
Monroe, Michigan

This summit will focus on what residents can do to reduce prescription drug misuse and heroin use in their community. Legal and medical professionals will share information on the topics.

Read more:

Lecture: Prescription Drug Use-The Dos and the Don'ts
January 29, 2014
Huntley, Illinois

24th National Leadership Forum: The Power of Movement
February 3–6, 2014
National Harbor, Maryland

SAMHSA's 10th Prevention Day
The Power of Prevention: Strengthening Behavioral Health and Public Health for the Next Decade
February 3, 2014
National Harbor, Maryland

Pain Management Through a Wide Lens: Balancing Safety and Effectiveness
March 8, 2014
St. Louis, Missouri

11th Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland

National Rx Drug Abuse Summit
April 22–24, 2014
Atlanta, Georgia

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.