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November 20, 2013

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
ISSUE 46 | NOVEMBER 2013
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 Other Resources Videos Grant Announcement Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Articles

S.J. Herzig, M.B. Rothberg, M. Cheung, L.H. Ngo, and E.R. Marcantonio. 2013. "Opioid Utilization and Opioid-Related Adverse Events in Nonsurgical Patients in US Hospitals." Journal of Hospital Medicine. doi:10.1002/jhm.2102.

Researchers investigated patterns and predictors of opioid utilization in adult nonsurgical admissions to 286 U.S. hospitals, variation in use, and the association between hospital-level use and rates of severe opioid-related adverse events. Opioid exposure and severe opioid-related adverse events during hospitalization were defined using hospital charges and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Of 1.14 million admissions, opioids were used in 51 percent. The mean ± standard deviation daily dose received in oral morphine equivalents was 68 ± 185 mg; 23 percent of those exposed received a total daily dose of ≥100 mg oral morphine equivalents. Opioid-prescribing rates ranged from 5 percent in the lowest-prescribing hospital to 72 percent in the highest-prescribing hospital (mean, 51 percent ± 10 percent). After adjusting for patient characteristics, adjusted opioid-prescribing rates ranged from 33 percent to 64 percent (mean, 50 percent ± standard deviation 4 percent). Among the exposed, 0.60 percent experienced severe opioid-related adverse events. Hospitals with higher opioid-prescribing rates had a higher adjusted relative risk of a severe opioid-related adverse event per patient exposed (relative risk: 1.23 [1.14-1.33] for the highest-prescribing compared with the lowest-prescribing quartile). The majority of hospitalized nonsurgical patients were exposed to opioids, often at high doses. Hospitals that used opioids most frequently had an increased adjusted risk of a severe opioid-related adverse event per patient exposed.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/jhm.2102/abstract

T.K. Nuckols, L. Anderson, I. Popescu, A.L. Diamant, B. Doyle, P. Di Capua, and R. Chou. 2013. "Opioid Prescribing: A Systematic Review and Critical Appraisal of Guidelines for Chronic Pain." Annals of Internal Medicine. doi:10.7326/0003-4819-160-1-201401070-00732.

Researchers used MEDLINE, the National Guideline Clearinghouse, specialty society Web sites, and international guideline clearinghouses (searched in July 2013) to select guidelines published between January 2007 and July 2013 addressing opioid use for chronic adult pain. They excluded guidelines on specific settings, populations, and conditions. Guidelines and associated systematic reviews were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and AMSTAR: a measurement tool to assess systematic reviews, respectively. Recommendations for mitigating opioid-related risks were compared. Thirteen guidelines met selection criteria. Overall AGREE II scores were 3.00 to 6.20 (on a scale of 1 to 7). AMSTAR ratings were poor to fair for 10 guidelines. Two guidelines from the American Pain Society and American Academy of Pain Medicine (Journal of Pain 10:113–30, 2009) and one guideline from the Canadian National Opioid Use Guideline Group (Canadian Medical Association Journal, 182:923–30, 2010) received high AGREE II and AMSTAR scores. AMSTAR also highly scored a 2012 online review by the Department of Veterans Affairs and Department of Defense. The majority of the guidelines recommend clinicians avoid doses greater than 90 to 200 mg of morphine equivalents per day, have additional knowledge to prescribe methadone, recognize risks of fentanyl patches, titrate cautiously, and reduce doses by at least 25 to 50 percent when switching opioids. Guidelines also agree that opioid risk assessment tools, written treatment agreements, and urine drug testing can mitigate risks. Most recommendations are supported by observational data or expert consensus. Despite limited evidence and variable development methods, recent chronic pain guidelines agree on several opioid-risk mitigation strategies, including upper dosing thresholds, caution with certain medications, attention to drug–drug and drug–disease interactions, and use of risk assessment tools, treatment agreements, and urine drug testing.

Read more:
http://annals.org/article.aspx?articleID=1767856

Journal Articles and Reports


L.J. Maier, M.E. Liechti, F. Herzig, and M.P. Schaub. 2013. "To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse Among Swiss University Students." PLOS ONE. doi:10.1371/journal.pone.0077967.

This study describes the use of prescription medication and drugs of abuse for neuroenhancement among Swiss university students. In a cross-sectional study, students at the University of Zurich, University of Basel, and Swiss Federal Institute of Technology Zurich were invited to participate in an online survey. A total of 28,118 students were contacted and 6,275 completed the survey. Across the institutions, 13.8 percent of respondents indicated they had used prescription drugs (7.6 percent) or drugs of abuse, including alcohol (7.8 percent), at least once specifically for neuroenhancement. The most frequently used prescription drugs for neuroenhancement were methylphenidate (4.1 percent), sedatives (2.7 percent), and beta-blockers (1.2 percent). Alcohol was used for this purpose by 5.6 percent of participants, followed by cannabis (2.5 percent), amphetamines (0.4 percent), and cocaine (0.2 percent). Arguments for neuroenhancement included increased learning (66.2 percent), relaxation or sleep improvement (51.2 percent), reduced nervousness (39.1 percent), coping with performance pressure (34.9 percent), increased performance (32.2 percent), and experimentation (20 percent). Neuroenhancement was significantly more prevalent among more senior students, students who reported higher levels of stress, and students who had previously used illicit drugs. Although "soft enhancers," including coffee, energy drinks, vitamins, and tonics, were used daily in the month before an exam, prescription drugs or drugs of abuse were used much less frequently. A significant proportion of Swiss university students across most academic disciplines reported neuroenhancement with prescription drugs and drugs of abuse. However, these substances are rarely used on a daily basis and more sporadically used prior to exams.

Read more:
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0077967

S.E. McCabe, B.T. West, and C.J. Boyd. 2013. "Motives for Medical Misuse of Prescription Opioids Among Adolescents." The Journal of Pain 14(10):1208–216.

This study examined motives for medical misuse of prescription opioids among adolescents and assessed differences in motives by demographic characteristics, substance abuse, and diversion behaviors. A survey conducted in 2011–12 polled 2,964 Detroit adolescents (51 percent female) in middle school and high school. Thirteen percent reported past-year medical use of prescription opioids. Among those prescribed opioids in the past year (n = 393), 17.9 percent reported medical misuse (defined as using too much, using the drugs to get high, or using the drugs to increase alcohol or other drug effects). The most prevalent motives for medical misuse were "to relieve pain" (84.2 percent) and "to get high" (35.1 percent). Multivariate analyses indicated motives differed by race and that different motives were associated with different substance abuse and diversion behaviors. The odds of past-year substance abuse among medical misusers motivated by non–pain relief were more than 15 times greater than among nonusers (adjusted odds ratio = 15.2, 95 percent confidence interval = 6.4–36.2, P < .001). No such differences existed between nonusers and appropriate medical users or between nonusers and medical misusers motivated by pain relief only.

Read more:
http://www.jpain.org/article/S1526-5900(13)01029-8/abstract

K.L. McCall III, C. Tu, M. Lacroix, C. Holt, K.L. Wallace, and J. Balk. 2013. "Prescribing Trends and Physician and Pharmacy Utilization Patterns: Epidemiological Analysis of the Maine Prescription Monitoring Program from 2006 to 2010." Journal of Substance Use 18(6):467–75. doi:10.3109/14659891.2012.685794.

This article presents a retrospective analysis of the Maine Prescription Monitoring Program (PMP) for prescribing trends and use patterns from state fiscal years 2006 to 2010. The sample included 11,542,850 Schedule prescriptions for 1,024,649 unduplicated patients in a 5-year database of the PMP. The number of controlled prescriptions steadily increased from 2.05 million in 2006 to 2.51 million in 2010. Opioid analgesics and stimulants were the most commonly prescribed and fastest-growing scheduled drug categories, respectively. Most individuals (82.9 percent) accessed controlled drugs from one to two prescribers and pharmacies. Patients who went to five prescribers or more used a greater number of pharmacies than those who went to fewer than five prescribers (P < 0.001).

Read more:
http://informahealthcare.com/doi/abs/10.3109/14659891.2012.685794

L.M. Rossen, D. Khan, and M. Warner. 2013. "Trends and Geographic Patterns in Drug-Poisoning Death Rates in the U.S., 1999–2009." American Journal of Preventive Medicine 45(6). doi:10.1016/j.amepre.2013.07.012.

Researchers used population-based observational study data on 304,087 drug-poisoning deaths in the United States from the 1999–2009 National Vital Statistics Multiple Cause of Death Files (analyzed in 2012). Because of the zero-inflated and right-skewed distribution of drug-poisoning death rates, a two-stage modeling procedure was used, in which the first stage modeled the probability of observing a death for a given county and year, and the second stage modeled the log-transformed drug-poisoning death rate, given a death had occurred. Empirical Bayes estimates of county-level drug-poisoning death rates were mapped to explore temporal and geographic variation. Only 3 percent of counties had drug-poisoning age-adjusted death rates (AADRs) greater than 10 per 100,000 per year in 1999–2000, compared with 54 percent in 2008–09. Drug-poisoning AADRs grew by 394 percent in rural areas compared with 279 percent for large central metropolitan counties, but the highest drug-poisoning AADRs were observed in central metropolitan areas from 1999 to 2009.

Read more:
http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3905-stamped-111213.pdf

P. Veliz, Q.M. Epstein–Ngo, E. Meier, P.L. Ross–Durow, S.E. McCabe, and C.J. Boyd. 2013. "Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of Opioid Medication Among Adolescent Sports Participants." Journal of Adolescent Health. doi:10.1016/j.jadohealth.2013.09.002.

Researchers used data from the Secondary Student Life Survey. A total of 1,540 adolescents in Southeast Michigan participated in three waves of data collection between the 2009–10 and 2011–12 school years, with 82 percent of the baseline sample completing all three waves. Using generalized estimating equation models to analyze longitudinal data, researchers found male adolescents who participated in organized sports during each wave of the Secondary Student Life Survey had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (adjusted odds ratio [AOR], 1.86; 95 percent confidence interval [CI], 1.23–2.82), higher odds of past-year medical misuse of opioid medication as a result of taking too much (AOR, 10.5; 95 percent CI, 2.42–45.5), and higher odds of past-year medical misuse of opioid medication to get high (AOR, 4.01; 95 percent CI, 1.13–14.2) compared with males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and nonmedical use of opioid medication.

Read more:
http://www.jahonline.org/article/S1054-139X(13)00484-9/abstract

News


For Veterans with PTSD, a New Demon: Their Meds
The Wall Street Journal
November 10, 2013

This article discusses former Marine Timothy Fazio's struggle with addiction to prescription pain relievers and posttraumatic stress disorder (PTSD). Between 2008 and 2011, the VA prescribed him more than 3,600 pills containing oxycodone. He overdosed six times.

Many of the more than 2 million Americans who served in Iraq or Afghanistan suffer from pain and PTSD. To treat them, the VA often uses powerful opioid pain relievers. A study by a VA researcher found veterans with PTSD were nearly twice as likely to be prescribed opioids as those without mental health problems. They were also more likely to get multiple opioid pain relievers and to receive the highest doses. Veterans with PTSD were more than twice as likely to suffer negative outcomes (like injuries and overdoses) if they were prescribed opioid pain relievers. VA figures show 30 percent of Iraq and Afghanistan veterans under VA care have PTSD, and more than half suffer chronic pain. Last year, more than 50,000 veterans were treated by the VA for serious problems associated with opioid use—nearly double the number a decade earlier. By contrast, the total number of VA patients grew 30 percent during that time. The number of opioid prescriptions written by the VA rose 287 percent between 1999 and 2012, according to data obtained by The Wall Street Journal through an open-records request. The rate of accidental drug overdoses among VA-enrolled veterans is nearly twice that of the U.S. population as a whole, according to a different study led by a VA doctor, which controlled results for age and gender. Opioid medications were the leading cause.

Read more:
http://online.wsj.com/news/articles/SB10001424052702304672404579181840055583388?mod=WSJ_hps_LEFTTopStories

Caution: These Are the Most Addictive Pain Meds
Harvard Health Letter, Harvard Medical School
November 2013

This newsletter reports that 97 percent of opioid users do not have a problem. But it warns patients that long-term use may increase the risk of dependence. Karsten Kueppenbender, an addiction psychiatrist at McLean Hospital, advises patients to take opioids by the clock as prescribed. For long-term use, she suggests ensuring doctors connect the patient to a medical team with a strict protocol for taking opioids.

Read more:
http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2013/November/
caution-these-are-the-most-addictive-pain-meds?utm_source=health&utm_medium=
pressrelease&utm_campaign=health111

There Was a Message in This Bottle: Why Listening to Customers Matters
The Huffington Post
November 13, 2013

Jerry McLaughlin, chairman and chief executive officer of Branders.com, was asked by the Raymond Coalition for Youth to remove a promotional item containing mints in a prescription bottle. McLaughlin discusses why he removed the product. (See November 6, 2013, Weekly Update for previous article.)

Read more:
http://www.huffingtonpost.com/jerry-mclaughlin/message-in-a-bottle_b_4261108.html

Udall Introduces Bill to Combat Prescription Drug Abuse
KRWG TV/FM
November 8, 2013

Senator Tom Udall has introduced the Increasing the Safety of Prescription Drug Use Act, a bill to fight misuse and improve treatment options for addicted patients. The legislation would expand medical education training and use of timely data to ensure patients safely and legally receive prescriptions. It would also strengthen monitoring techniques for existing high-risk prescriptions and implement new measures to prevent prescription drugs from falling into the wrong hands. The bill would foster partnerships between the Department of Health and Human Services and state and local governments to increase ongoing opportunities for proper medication disposal.

Read more:
http://krwg.org/post/udall-introduces-bill-combat-prescription-drug-abuse

Americans See U.S. Losing Ground Against Mental Illness, Prescription Drug Abuse
Pew Research Center
November 13, 2013

When it comes to mental illness, only 19 percent say the nation is making progress, while 16 percent say progress is being made on prescription drug abuse. Significantly more Americans say the country is losing ground on these two problems (35 percent on mental illness, 37 percent on prescription drug abuse), according to the latest national survey by the Pew Research Center.

Read more:
http://www.pewresearch.org/fact-tank/2013/11/13/americans-see-u-s-losing-ground-against-mental-illness-prescription-drug-abuse

The Reality of Prescription Drug Addiction in Women
SHEKnows
November 13, 2013

This article discusses the shift in prescription drug abuse among women, side effects of addiction, keys to prevention, and detox and rehabilitation.

Read more:
http://www.sheknows.com/health-and-wellness/articles/1019409/the-reality-of-prescription-drug-addiction-in-women

Health IT Helping to Fight the Prescription Drug Abuse Epidemic
United States Department of Health and Human Services
November 14, 2013

The Office of the National Coordinator for Health Information Technology launched a new Standards & Interoperability (S&I) Framework Initiative: Prescription Drug Monitoring Programs (PDMP) and Health IT Integration. The initiative seeks to tackle a number of existing challenges, including the lack of common technical standards and vocabularies that would enable PDMPs to share computable information with health IT systems. It also aims to bring together PDMP and heath IT communities to establish a standardized approach for retrieving data stored in PDMPs and deliver it to electronic health records and health information exchanges. Those interested are encouraged to sign up.

Read more:
http://www.healthit.gov/buzz-blog/health-innovation/health-helping-fight-prescription-
drug-abuse-epidemic/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%
3A+healthitbuzzblog+(Health+IT+Buzz+Blog)

FDA Cracks Down, Finally, on Painkillers: Our View
USA Today
November 12, 2013

USA Today shares its editorial view supporting the Food and Drug Administration's decision to restrict pain medications such as Vicodin, Lortab, and generic hydrocodone. Overdose deaths from narcotic pain relievers in the U.S. have quadrupled since 1999, killing 45 people and sending 1,370 to emergency rooms daily. By contrast, cocaine kills 12 people every day; heroin kills eight.

Read more:
http://www.usatoday.com/story/opinion/2013/11/10/painkillers-prescription-drug-hydrocodone-fda-editorials-debates/3490545

New Drug Rules Could Harm Patients: Opposing View
USA Today
November 10, 2013

Ardis Dee Hoven, president of the American Medical Association, and Chris Hansen, President of the American Cancer Society Cancer Action Network, share their views about the Food and Drug Administration's decision to reclassify hydrocodone. The Institute of Medicine reports that 100 million Americans suffer from chronic pain. They claim there is no evidence that reclassifying hydrocodone will curb misuse and abuse. Policymakers need a comprehensive, rational plan.

Read more:
http://www.usatoday.com/story/opinion/2013/11/10/fda-american-medical-association-american-cancer-society-editorials-debates/3490521

Justices Consider Drug Dealer's Responsibility for Man's Fatal Overdose
The Washington Post
November 12, 2013

This article discusses the 2013 federal case Burrage v. United States. Joshua Banka bought, stole, and used OxyContin, marijuana, and prescription drugs. In addition, he purchased heroin from a dealer named Marcus Andrew Burrage. Banka died and Burrage was charged with and convicted of distributing heroin and distribution of heroin resulting in death. The Supreme Court considered the case, and a number of justices believe the government must prove more before a drug dealer gets the enhanced penalties the law prescribes "if death or serious bodily injury results from the use" of the illicit drugs.

Read more:
http://www.washingtonpost.com/politics/justices-consider-drug-dealers-responsibility-for-mans-fatal-overdose/2013/11/12/02a1cc38-4bd6-11e3-9890-a1e0997fb0c0_story.html

LOCKMED Develops New Product to Curb Prescription Drug Abuse
Digital Journal
November 10, 2013

This press release announced the launch of Vanguard Home Medication Lockbox, which aims to provide a general storage container for medications. The box has a fold-down handle for easy storage, tamper-proof hinges, pre-drilled holes to secure it, an inside divider compartment to organize medications, and a vented side wall to be used in refrigeration.

Read more:
http://www.digitaljournal.com/pr/1577236

Other State and Local News

Cartel Hits Midwest with Heroin Killing Chicago Youth
Bloomberg
November 13, 2013

This article discusses how drug addicts are transitioning from prescription pain relievers to heroin with assistance from the Sinaloa Mexican cartel. As prescription medications become more expensive and harder to get, individuals are using heroin, which is cheaper and more widely available. Government officials and drug treatment experts report that users are younger, more affluent, and more likely to live in suburbs or small towns. They also snort or inject a more potent heroin. The Sinaloa cartel acts as a wholesaler, selling kilograms to dealers who dilute the heroin with other white powders to expand their supply and profits. When it gets to Chicago's West Side, one tenth of a gram is sold in tinfoil packets or baggies for $10.

Read more:
http://www.bloomberg.com/news/2013-11-13/cartel-hits-midwest-with-heroin-killing-chicago-youth.html

Police: When Prescription Pill Abuse Becomes Too Expensive, Users Switch to Cheaper Heroin
The Washington Post
November 13, 2013

This article and video (5:37 minutes) discuss undercover investigations by Prince William County Virginia police officers as they execute "Operation Blue Dragon," targeting suspected prescription pill and heroin dealers. The video provides a behind-the-scenes look at officers arresting dozens of suspects. They target low-level drug dealers and users in the suburbs.

Read more:
http://www.washingtonpost.com/local/in-prince-william-police-find-prescription-drugs-lead-many-to-heroin-addiction/2013/11/13/63694320-4c71-11e3-9890-a1e0997fb0c0_story.html

Special Report: Stories of Opioid Addiction and Recovery
CBC
November 14, 2013

Admission rates for Hamilton opioid withdrawal programs are now the second highest in Ontario, Canada, behind only northern Ontario, according to statistics obtained by CBC Hamilton from the Drug and Alcohol Treatment Information System. In 2002, one in 10 people who entered a withdrawal management program at St. Joseph's Healthcare was an opioid patient. By 2012, it was one in four. Three people tell the stories of their addiction and give advice for those in similar situations.

Read more:
http://www.cbc.ca/news/canada/hamilton/news/stories-of-opioid-addiction-and-recovery-1.2425653

Related Articles
Special Report: Prescription Painkiller Abuse Exploding in Hamilton
CBC
November 14, 2013

This article and video (3:57 minutes) discuss prescription drug abuse in Hamilton and the rising risk of deaths and overdoses. Ontario has a prescription monitoring program, but physicians do not have to access the information unless a pharmacy tells them a patient has prescriptions from multiple doctors, making hospital-hopping a problem.

Read more:
http://www.cbc.ca/news/canada/hamilton/news/prescription-painkiller-abuse-exploding-in-hamilton-1.2419875

Special Report: Prescription Painkillers Fuelling Crime in Hamilton
CBC
November 13, 2013

This article discusses the increase in opioid use and abuse in Hamilton and associated crimes, such as pharmacy robberies. Patients are diverting their prescription drugs and selling them for profit. They are also using the Internet to get drugs.

Read more:
http://www.cbc.ca/news/canada/hamilton/news/prescription-painkillers-fuelling-crime-in-hamilton-1.2424111

Related Audio
Curbing Hamilton's Opioid Problem
CBC
November 14, 2013

This audio (35:22 minutes) discusses a special task force that works to overhaul the way prescription opioids are handled and tracked through Hamilton. Norm Buckley, a professor and chair in the Department of Anaesthesia at McMaster University's Michael G. DeGroote School of Medicine, spoke about the problem and how it might be fixed.

Listen:
http://www.cbc.ca/news/canada/hamilton/news/curbing-hamilton-s-opioid-problem-1.2425211

Real Estate Agent Helps Catch Prescription Drug Thief Posing as Potential Home Buyer
KAKE
November 10, 2013

The Wichita Area Association of Realtors issued a warning about a man going to open houses and searching for prescription drugs. One week later, Real Estate Agent Lorie Touchatt found herself alone in the house with him. She sent a text to her husband and the homeowner, asking them to call 911. When the man finally left, police pulled him over just a block away. They found a bottle of prescription narcotics he stole from the home. The man was arrested in 2010 for the same crime.

Read more:
http://www.kake.com/home/headlines/Real-estate-agent-helps-catch-thief-posing-as-potential-home-buyer-231384571.html?ref=571

Drugged Driving on Rise in ABQ
KRQE
November 14, 2013

This article and video (4:53 minutes) discuss the increase in drugged driving and related laws in Albuquerque, New Mexico. Police Detective Christine Frank said the number of drug evaluations for people driving under the influence of synthetic cannabinoids or "spice" has tripled in the past year. Frank also said more drivers are abusing prescription drugs; however, they are not receiving driving while intoxicated (DWI) convictions because the charge is difficult to prosecute—even for those who admit wrongdoing. There is no set level or scientific evidence of impairment for drugs. Prosecutors must rely on testimony from the arresting officer and analysts from the state's scientific lab to prove impairment. David Mills, director of New Mexico's Scientific Laboratory Division, said of those he tests, 90 percent have drugs in their systems, and more are driving with multiple drugs, both legal and illegal. State Representative Bill Rehm has tried for years to pass "per se" laws for drugs, which would result in an automatic DWI for drivers who have any trace amount of illegal drugs in their system.

Read more:
http://www.krqe.com/news/on-assignment/drugged-driving-on-rise-in-abq

Sheriff's Office Offers Internet Safety, Drug Awareness Classes for Parents
Leesburg Today
November 13, 2013

The Loudon County Virginia Sheriff's Office is hosting a series of presentations on Internet safety and synthetic and prescription drug abuse dangers. Presentations will be held from November 18 to February 6 at various locations. The seminars are limited to parents and adults.

Read more:
http://www.leesburgtoday.com/news/sheriff-s-office-offers-internet-safety-drug-
awareness-classes-for/article_035645ca-4cab-11e3-a430-001a4bcf887a.html

Feds: Kentwood Pharmacy a 'Pharmacy Cesspool,' Workers Face Sentencing
MLive.com
November 12, 2013

Three years ago, the Drug Enforcement Administration suspended licenses and seized all controlled substances at Kentwood Pharmacy's seven locations before shutting them down. Three former pharmacists will be sentenced for participating in the sale of repackaged drugs. Kentwood Pharmacy picked up unused or discontinued drugs from hundreds of adult foster care and nursing homes, then restocked the drugs. They rarely credited insurance companies or patients for the returns, which allowed them to double or triple bill for the same drugs provided to multiple patients. They would place the drugs in containers with other drugs, without corresponding lot numbers or expiration dates. According to the government, it is illegal for a pharmacy to accept returned controlled substances, even if they are to be destroyed. In some cases, drugs were sold on the street to abusers. Workers complained about the illegal practices, so the principals moved the restocking operation to a strip mall, and later the basement of a chief pharmacist's home.

Read more:
http://www.mlive.com/news/grand-rapids/index.ssf/2013/11/feds_kentwood_pharmacy_a_pharm.html

Solving Opioid Addiction Crisis: No Silver Bullet
NBC10
November 10, 2013

This article and video (2:28 minutes) discuss Philadelphia's heroin and prescription drug use, which are approaching record highs. NBC10's Lu Ann Cahn spoke to experts and a recovering drug addict about the growing epidemic. Physicians should follow national pain guidelines set forth by the American Academy of Pain Management. Experts urge adults to lock up their pain relievers and properly dispose of medications. Gary Tennis, secretary of the Pennsylvania Department of Drug and Alcohol Programs, said the state plans to install 250 permanent drop-off bins at local police stations to offer patients a year-round option for keeping pills from addicts. One way to curb opioid misuse is to offer those suffering from addiction access to better treatment; another is tighter regulation.

Read more:
http://www.nbcphiladelphia.com/news/health/Solving-Opioid-Heroin-Addiction-Crisis-No-Silver-Bullet-231637941.html

State Wants Access to VA's Prescription Drug Records
NBC News
November 8, 2013

Ohio Board of Pharmacy officials dislike the fact that the Veterans Health Administration does not fully participate in the state's prescription drug monitoring program. The VA started accessing the Ohio database in February, but has not shared its own prescription data with the system. VA facilities were directed to develop local policies based on individual state requirements for participation, and the Administration nationally is working on development of an information technology system that allows all facilities to submit prescription data in a uniform method.

Read more:
http://www.nbcnews.com/id/53502040/ns/local_news-columbus_oh

'Skittles Parties' on Long Island Raise Concerns
Newsday
November 13, 2013

New York Assemblyman Joseph Saladino and several other elected officials and community leaders denounced the "Skittles party" trend during a State Senate Committee meeting on heroin and prescription drug use. Teenagers dump opioid pain pills and other medications from their parents' medicine cabinets into a large bowl and take them at random. Local youth substance abuse staff say young people also report widespread alcohol use at these parties. Authorities urged parents to secure their medications so children cannot access them, and to properly dispose of pills.

Read more:
http://www.newsday.com/long-island/skittles-parties-on-long-island-raise-concerns-1.6431204

Overdose Drug Available for Families of Addicts
The Oklahoman
November 10, 2013

Oklahoma House Bill 1782 allows a medical provider to prescribe naloxone to a family member of someone who may overdose. The bill also allows first responders to administer naloxone without a prescription to people showing signs of opiate overdose.

Read more:
http://newsok.com/overdose-drug-available-for-families-of-addicts/article/3903091

Prescription Drug Misuse Could Lead to Accidental Poisoning
Times-News
November 11, 2013

Sarah Cooper, a master of public health candidate at University of North Carolina at Chapel Hill, conducted research on prescription drug use in Alamance County. She presented her findings at the Alamance Regional Medical Center, reporting that from 2002 to 2011, 161 deaths in the county were due to poisonings. Of those, 123 were unintentional, with methadone being the leading cause. Vicodin, OxyContin, Percocet, morphine, and codeine were the third most common causes of unintentional fatal poisonings. The county's rate of unintentional poisoning deaths, at 8.6 percent per 100,000 residents, was lower than the overall state rate of 9.8 percent, but higher than the average rate of surrounding counties (8.1 percent). In 2011, 17 of those deaths were in Alamance County. Unintentional poisoning deaths peaked in the county in 2009, at 22.

Read more:
http://www.thetimesnews.com/news/top-news/prescription-drug-misuse-could-lead-to-accidental-poisoning-1.233413

Seminole to Use Federal Money to Help Prescription Drug Abusers
WFTV
November 12, 2013

Seminole County, Florida, leaders will use $15,000 to treat 50 people who abuse prescription pills, instead of spending the money on neighborhood improvements like playgrounds. The agency administering the program will match the funds to offer other services at no charge.

Read more:
http://www.wftv.com/news/news/local/seminole-use-federal-money-help-prescription-drug-/nbqZH

Other Resources

New Law, Funding Aim to Reinvigorate State's Rx Drug Monitoring Program
California Healthline
November 13, 2013

Experts discuss the rising threat of prescription drug misuse and what a new state law and funding for a monitoring program can do about it. This audio transcript includes comments from Senator Mark DeSaulnier; Tom Lenox, Supervising Special Agent for the Food and Drug Administration; Jonathan Lucas, Deputy Medical Examiner for San Diego County; and Richard Thorp, President of the California Medical Association.

Read more:
http://www.californiahealthline.org/~/media/Files/2013/PDF/CHLAudioReport
Transcript111313.ashx

videos

Special Report: Prescription Drug Abuse Part III
ABC News 13
November 14, 2013

This video (4:03 minutes) discusses prescription drug abuse in Waynesville, North Carolina.

Watch:
https://www.myworldnews.com/Channel/162-wlos/Story/265443-special-report-prescription-
drug-abuse-part-iii

How to Prevent Prescription Drug Overdose Deaths?: A Movie by HCLU
International Drug Policy Consortium
November 12, 2013

The Hungarian Civil Liberties Union interviewed several harm reduction professionals in the United States about drug overdose deaths and ways to prevent them. (Duration: 8:03 minutes)

Watch:
http://idpc.net/alerts/2013/11/how-to-prevent-prescription-drug-overdose-deaths-a-
movie-by-hclu

Grant Announcement

Medical Toxicology Foundation Research Award: Prescription Drug Abuse Prevention
American College of Medical Toxicology
Deadline: February 14, 2014

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.

Read more:
http://www.acmt.net/MTF_Prescription_Research_Award.html

Take-Back Events and Drop Boxes

Harford County Installs Drug Drop Box
ABC 2
November 8, 2013
http://www.abc2news.com/dpp/news/region/harford_county/harford-county-installs-
drug-drop-box

Chandler Police Set Up Drop Boxes for Medicine Disposal
AZCentral.com
November 12, 2013
http://www.azcentral.com/community/chandler/articles/20131101chandler-police-
medicine-disposal-sites.html?nclick_check=1

New Prescription Drug Drop Boxes Now at Locations in Riverton, Lander and Dubois
County 10
November 11, 2013
http://county10.com/2013/11/11/new-prescription-drug-drop-boxes-now-locations-
riverton-lander-dubois

Health Department Battles Misuse of Prescription Drugs (VIDEO)
Erie Times-News
November 15, 2013
http://www.goerie.com/health-department-battles-misuse-of-prescription-drugs

Andover Twp. Offers Disposal Spot for Prescription Drugs
New Jersey Herald
November 15, 2013
http://www.njherald.com/story/23976189/2013/11/15/andover-twp-offers-disposal-spot-for-prescription-drugs

Ellenville Prescription Drug-Drop Box in Place
Times Herald-Record
November 9, 2013
http://www.recordonline.com/apps/pbcs.dll/article?AID=/20131109/NEWS/311090319

Upcoming Conferences and Workshops

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 these topics.

Read more:
http://www.monroenews.com/news/2013/nov/05/monroe-county-drug-summit-set-december-3

Staten Islanders Looking for Rx Abuse Epidemic Answers Can Attend Dec. 10 Forum
Staten Island Advance
November 11, 2013

The Tackling Youth Substance Abuse Coalition and Long Island-based Families in Support of Treatment will host a forum on December 10, 2013. Speakers will discuss topics including the severity of the prescription drug abuse problem, how to recognize signs and symptoms of drug abuse, treatment options, and how to handle treatment barriers. More than 50 organizations and agencies are expected to participate, offering free resources.

Read more:
http://www.silive.com/news/index.ssf/2013/11/staten_islanders_looking_for_r.html

Lecture: Prescription Drug Use–The Dos and the Don'ts
January 29, 2014
Huntley, Illinois
http://centegra.org/event/lecture-prescription-drug-use-dos-donts

24th National Leadership Forum: The Power of Movement
February 3–6, 2014
National Harbor, Maryland
http://forum.cadca.org

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
http://forum.cadca.org/?q=node/59

Collaborative Perspectives on Addiction: 'Changing Addictive Behavior: Bench to Bedside and Back Again'
February 28–March 1
W Hotel, Atlanta–Midtown
188 14th Street, NE
Atlanta, Georgia

The American Psychological Association will bring together division leaders from the Society of Addiction Psychology and Psychopharmacology and Substance Abuse to facilitate a lively debate, exchange, and professional development opportunities. The conference is designed to engage early career psychologists and trainees while providing all attendees with the caliber of rigor and substance expected from the divisions.

Read more:
http://www.apadivisions.org/addiction-perspectives.aspx

Pain Management Through a Wide Lens: Balancing Safety and Effectiveness
March 8, 2014
St. Louis, Missouri
http://aspmnstlouisregional.org/2014-conference-information-and-registration.html

11th Annual World Health Care Congress
April 7–9, 2014
National Harbor, Maryland
http://www.globalmedicalmeetings.com/events/hr14000

National Rx Drug Abuse Summit
April 22–24, 2014
Atlanta, Georgia
http://nationalrxdrugabusesummit.org

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.