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November 6, 2013

 

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
ISSUE 44 | 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 Article Journal Articles and Reports News Other State and Local News Videos Grants Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Article

W. Wakeland, A. Nielsen, T.D. Schmidt, D. McCarty, L.R. Webster, J. Fitzgerald, and J.D. Haddox. 2013. "Modeling the Impact of Simulated Educational Interventions on the Use and Abuse of Pharmaceutical Opioids in the United States: A Report on Initial Efforts." Health Education and Behavior 40(Suppl 1):74S–86S. doi:10.1177/1090198113492767.

Three educational interventions were simulated in a system dynamics model of medical use, trafficking, and nonmedical use of pharmaceutical opioids. The study relied on secondary data obtained in the literature from 1995 to 2008 and on expert panel recommendations regarding additional model parameters and structure. The behavior of the resulting systems-level model was tested for fit against reference behavior data. After the base model was tested, logic to represent three educational interventions was added and the impact of each intervention on simulated overdose deaths was evaluated over a 7-year period: 2008 to 2015. The model did not differentiate use by youth from adult use. Principal findings were that a prescriber education intervention reduced total overdose deaths in the model and total persons receiving opioid analgesic therapy; medical user education reduced overdose deaths among medical users but increased deaths from nonmedical use; and a "popularity" intervention sharply reduced overdose deaths among nonmedical users while having no effect on medical use.

Read more:
http://heb.sagepub.com/content/40/1_suppl/74S

Journal Articles and Reports

M. Avalos, L. Orriols, H. Pouyes, Y. Grandvalet, F. Thiessard, and E. Lagarde. 2013. "Variable Selection on Large Case-Crossover Data: Application to a Registry-Based Study of Prescription Drugs and Road Traffic Crashes." Pharmacoepidemiology and Drug Safety. doi:10.1002/pds.3539.

This study is a reanalysis of Orriols and colleagues' PLoS Med 2010; 7:e1000366, aimed at improving handling of referent time periods to reduce false positives. The study used linked data from three French nationwide databases: the national health care insurance database, police reports, and the database of police injurious crashes, and was restricted to drivers who tested negative for alcohol at the time of the crash. The case-crossover design compared prescription use in an earlier control month with the month of the crash. Among the 58,700 drivers involved in injurious crashes in France between July 2005 and May 2008, 18,306 (31 percent) had unequal exposure in the case and reference windows for at least one prescription drug. Antiepileptics, benzodiazepine hypnotics, anxiolytics, antidepressants, antithrombotic agents, mineral supplements, diabetes drugs, antiparkinsonian treatments, and several cardiovascular drugs were associated with crash involvement or responsibility. Editor's note: This study may confound the effect of prescription drugs and the health conditions they were prescribed to treat. Research is needed that distinguishes the separate and conjoint effects of diseases and drugs prescribed to treat them.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/pds.3539/abstract

C. Chatterton, K. Turner, N. Klinger, M. Etter, M. Duez, and V. Cirimele. 2013. "Interpretation of Pharmaceutical Drug Concentrations in Young Children's Head Hair." Journal of Forensic Sciences. doi:10.1111/1556-4029.12301

Three separate cases of child administration of prescription drugs are described. Following liquid–liquid extraction, high-performance liquid chromatography–tandem mass spectrometry (HPLC-MS/MS) was used to identify and quantify methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenyl-1-pyrrolidine (EDDP), tramadol, amitriptyline, and nortriptyline in children's hair. The children's ages ranged from 14 months to 7 years. In all three cases, the drug in question was detected in more than one section of hair. Methadone was detected in the concentration range of 0.65–0.99 and 0.04–0.4 ng/mg; tramadol was detected in the concentration range of 1.5–2.2 ng/mg; and amitriptyline and nortriptyline were detected in the concentration range of 0.18–1.06 and 0.38–2.0 ng/mg, respectively. In each case, the children's parents admitted to or were found guilty of drug administration.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/1556-4029.12301/abstract

G.G. Davis and the National Association of Medical Examiners and American College of Medical Toxicology Expert Panel on Evaluating and Reporting Opioid Deaths. 2013. "Complete Republication: National Association of Medical Examiners Position Paper: Recommendations for the Investigation, Diagnosis, and Certification of Deaths Related to Opioid Drugs." Journal of Medical Toxicology [Epub ahead of print]. doi:10.1007/s13181-013-0323-x.

The American College of Medical Toxicology and National Association of Medical Examiners convened an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of toxicology findings, and death certification. The panel made seven recommendations to improve precision of death certificate data available for public health surveillance: 1) A complete autopsy is necessary for optimal interpretation of toxicology results, which must also be considered in the context of the circumstances surrounding death, medical history, and scene findings; 2) A complete scene investigation extends to reconciliation of prescription information and pill counts; 3) Blood, urine, and vitreous humor, when available, should be retained in all cases. Blood from the femoral vein is preferable to blood from other sites; 4) A toxicological panel should be comprehensive and include opioid and benzodiazepine analytes as well as other potent depressant, stimulant, and antidepressant medications; 5) Interpretation of postmortem opioid concentrations requires correlation with medical history, scene investigation, and autopsy findings; 6) If death is attributed to any drug or combination of drugs (whether as a cause or contributing factor), the certifier should list the responsible substances by generic name in the autopsy report and on the death certificate; 7) The best classification for manner of death when due to misuse or abuse of opioids without apparent intent of self-harm is "accident/unintentional." Reserve "undetermined" as the manner for rare cases in which evidence exists to support more than one possible determination.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24132519

S. Doyon, W. Klein–Schwartz, S. Lee, and M.C. Beuhler. 2013. "Fatalities Involving Acetaminophen Combination Products Reported to United States Poison Centers." Clinical Toxicology. doi:10.3109/15563650.2013.848282.

Researchers examined the individual contribution of deaths from overdose of acetaminophen (APAP) or other ingredient(s) to fatalities resulting from ingestion of APAP combination products reported to poison centers. A search was conducted in the National Poison Data System between January 1, 2000, and December 31, 2009. Only fatal cases determined by the American Association of Poison Control Centers' Fatality Review Team to be caused by ingestion of one or more APAP combination product(s) were included. The fatality abstract narrative for each case was obtained. Each narrative abstract was rated independently by four reviewers, and putative cause of death was determined to be APAP, "other ingredient," or "unable to determine." Three hundred and thirty-seven deaths met inclusion criteria: 204 were suicides, 96 were from nonmedical use, 3 were from therapeutic error, 1 was from an unsupervised pediatric ingestion, and 33 were due to unknown reasons. The overall putative cause of death was APAP in 60.8 percent and other ingredients in 29.7 percent. In 9.5 percent of fatalities, the cause of death could not be determined. APAP was responsible for fatality in 79.2 percent of deaths resulting from nonmedical use of APAP combination products.

Read more:
http://informahealthcare.com/doi/abs/10.3109/15563650.2013.848282

H.K. Jagodic, M. Agius, and P. Pregelj. 2013. "Psychopharmacotherapy Prescription and Suicidal Behaviour." Psychiatria Danubina 25(Suppl 2):324–8.

Researchers gathered studies to investigate the possible impact of psychopharmacotherapy prescription practice on the suicide rate. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviors includes many ecological, or population-based, correlational studies of temporal or regional trends in suicide rates and use rates of modern antidepressants, including SSRIs. A number of studies have found a relationship between the increase in national antidepressant prescribing and declining suicide rates, with general agreement (but some exceptions). In general, studies showed increased antidepressant prescribing may indicate improved diagnosis and treatment of depression. Studies that investigated the impact of anxiolytics prescription on suicide rate were scarce, although the ratio of anxiolytics to antidepressants has been described as a quality indicator regarding treatment of depression, which is often combined with anxiety and increased suicide risk. Of importance, sedatives and hypnotics are widely prescribed to elderly people with symptoms of depression, anxiety, and sleep disturbance, but the studies demonstrated that both sedatives and hypnotics were associated with increased risk of suicide in the elderly. Finally, studies on antipsychotic prescriptions demonstrated that treatment with clozapine decreased suicide mortality among individuals with schizophrenia and schizoaffective disorders, and lithium reduced suicide mortality among individuals with mood disorders.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23995201

L. Orriols, M. Wilchesky, E. Lagarde, and S. Suissa. 2013. "Prescription of Antidepressants and the Risk of Road Traffic Crash in the Elderly: A Case-Crossover Study." British Journal of Clinical Pharmacology 76(5):810–815. doi:10.1111/bcp.12090.

Researchers matched reports from the Universal Quebec Automobile Insurance Agency database with data on antidepressant prescriptions from the Quebec Health Insurance Agency. The case–crossover analysis compared exposure during a period immediately before the crash with exposure during earlier periods for the same subject. Of 109,406 drivers aged 66 to 84 involved in a traffic crash between 1988 and 2000, 2,919 (2.7 percent) were exposed to an antidepressant on the day of the crash. Case–crossover analysis found an increased risk of crash among drivers with a prescription for antidepressants before their crash when compared with an antidepressant prescription 4 to 8 months before the crash (OR = 1.19, 95 percent CI 1.08, 1.30 to 1.42. 95 percent CI 1.30, 1.55). With more recent control periods, results were not significant.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/bcp.12090/abstract

J.R. Saper and A.N. Da Silva. 2013. "Medication Overuse Headache: History, Features, Prevention and Management Strategies." CNS Drugs 27(11):867–77. doi:10.1007/s40263-013-0081-y.

Medication overuse headache (MOH) is a daily, or almost daily, headache that arises from overuse of one or more classes of migraine-abortive or analgesic medication. The main classes of drugs that cause MOH are opioids, butalbital-containing mixed analgesics, triptans, ergotamine tartrate derivatives, simple analgesics (except for plain aspirin), and perhaps nonsteroidal anti-inflammatory drugs. MOH can be debilitating and results from biochemical and functional brain changes induced by certain medications taken too frequently. At this time, migraine and other primary headache disorders in which migraine or migraine-like elements occur, seem exclusively vulnerable to the development of MOH. Other primary headache disorders are not currently believed to be vulnerable. MOH treatment consists of discontinuation of the offending drug(s), acute treatment of withdrawal symptoms and escalating pain, establishing a preventive treatment when necessary, and implementation of educational and behavioral programs to prevent recidivism. For most patients, MOH can be treated in the outpatient setting; however, for the most difficult cases, including those with opioid or butalbital overuse or those with serious medical or behavioral disturbances, effective treatment requires a multidisciplinary, comprehensive headache program: either day hospital with infusion or an inpatient hospital setting.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23925669

S.M. Smith, R.C. Dart, N.P. Katz, F. Paillard, E.H. Adams, S.D. Comer, A. Degroot, et al. 2013. "Classification and Definition of Misuse, Abuse, and Related Events in Clinical Trials: ACTTION Systematic Review and Recommendations." Pain 154(11):2287–96. doi:10.1016/j.pain.2013.05.053.

The Analgesic, Anesthetic, and Addiction Clinical Trials, Translations, Innovations, Opportunities, and Networks (ACTTION) public–private partnership convened an expert panel to develop mutually exclusive and exhaustive consensus classifications and definitions of misuse, abuse, and related events (MAREs) occurring in analgesic medication clinical trials. The proposed ACTTION classifications and definitions are designed as a first step in a system to adjudicate MAREs in analgesic clinical trials and postmarketing adverse event surveillance and monitoring, which can be used in conjunction with other methods for assessing a treatment's abuse potential. Existing classifications and definitions describing prescription drug MAREs differ depending on the purpose of the classification system. They may apply to single events or ongoing patterns of inappropriate use and are not standardized or systematically employed, thereby complicating the ability to adequately assess MARE occurrence. In a systematic review of existing prescription drug MARE terminology and definitions from consensus efforts, review articles, and major institutions and agencies, MARE terms were often defined inconsistently or idiosyncratically, or had definitions that overlapped with other MARE terms.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/23792283

L.K. Whiteside, M.A. Walton, A.S.B. Bohnert, F.C. Blow, E.E. Bonar, and R.M. Cunningham. 2013. "Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department." Pediatrics. doi:10.1542/peds.2013-0721.

Researchers systematically recruited participants aged 14 to 20 presenting in the emergency department (ED) at the University of Michigan Medical Center between September 2010 and September 2011. A computerized self-report screening survey with validated items measuring past-year nonmedical prescription opiate use (NPOU), nonmedical prescription sedative use (NPSU), substance use, and violence was delivered to participants, and a retrospective chart review was performed. Of the 2,135 participants (86.0 percent response rate), 222 (10.4 percent) reported either NPOU or NPSU. Among the 185 (8.7 percent) participants who reported NPOU, 14.6 percent had a current home prescription for an opioid, and among the 115 (5.4 percent) with NPSU, 12.3 percent had a current home prescription for a sedative. After controlling for demographics (age, gender, race, public assistance), correlates of NPOU or NPSU included other substance use and drinking and driving or riding with a drinking driver. Additional correlates of NPOU included receiving an intravenous opioid in the ED, and for NPSU, dating violence, presenting to the ED for a non-injury complaint, and ED visit in the past year. Nearly one in 10 young people who use the ED for care report NPOU or NPSU, and only 12.3 percent and 14.6 percent report having current home prescriptions for sedatives and opioids.

Read more:
http://pediatrics.aappublications.org/content/early/2013/10/23/peds.2013-0721.abstract?
sid=563b9ca1-f34f-4b16-a039-f2933c58c862

Related Press Release
ER Study Finds 1 in 10 Older Teens Misuse Rx Painkillers and Sedatives
University of Michigan Health System
October 29, 2013

The University of Michigan conducted a study that asked teens and young adults about their use of fentanyl, oxycodone, hydrocodone, methadone, buprenorphine, Suboxone, Valium, Serepax, Ativan, Xanax, Librium, Rohypnol, GHB, and others. They discovered 10.4 percent of teens and young adults treated in the emergency room (ER) admitted to misusing a prescription pain reliever or sedative at least once in the last year. The majority admitted to not having a prescription. They took the drug to get high, took more than was prescribed, or took someone else's prescribed drugs. The study also revealed several risk factors associated with nonmedical use of prescription pain relievers and sedatives. Those who misused pain relievers were more likely to receive an intravenous opioid pain reliever during their ER visit. Those who misused prescription drugs were significantly more likely to have also abused alcohol and nonprescription drugs. They were also more likely to have ridden with a drunk driver.

Read more:
http://www.uofmhealth.org/news/archive/201310/er-study-finds-1-10-older-teens-misuse-rx-painkillers-and

News

FDA Approves More Powerful, Pure Hydrocodone Drug
The Boston Globe
October 26, 2013

The Food and Drug Administration (FDA) approved Zohydro ER for patients with pain that requires long-term treatment and cannot be treated with other drugs. It is the first pure hydrocodone drug approved in the United States. Some people were surprised by the approval. Last year, an FDA Advisory Panel of pain specialists expressed concern about the drug's abuse potential and consequently voted 11 to 2, with one abstention, against approving it. FDA is requiring postmarketing studies of Zohydro ER to assess known serious risks of misuse, abuse, increased sensitivity to pain (hyperalgesia), addiction, overdose, and death associated with long-term use beyond 12 weeks.

Read more:
http://www.bostonglobe.com/business/2013/10/25/fda-approves-more-powerful-pure-
hydrocodone-drug/AGTqSQGTFkkB55h761gnAN/story.html

NH Lobbying Gets Novelty Prescription Bottles Axed
The Boston Globe
October 30, 2013

Celeste Clark, Director of the Raymond Coalition for Youth, contacted Branders.com in a request to stop selling novelty pill bottles. Clark sent letters and emails and called the Chief Executive Officer, Jerry McLaughlin. He shared her concerns with the 30 customers who had purchased the bottles over the last 2 years and wrote to the company's 500,000 other customers, saying he was pulling the product.

Read more:
http://www.boston.com/news/local/new-hampshire/2013/10/30/group-discussing-prescription-
drug-abuse/OeYX9YC36f4rHBFzY79QqN/story.html

PCMA Supports Bipartisan Legislation Creating 'Safe Pharmacy' Networks to Reduce Prescription Drug Abuse in Medicare
Digital Journal
October 31, 2013

This press release announces the Pharmaceutical Care Management Association's (PCMA's) support for the Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013. The legislation gives drug plans the same authority to prevent fraud and abuse in Part D as they currently have in Medicare Parts A and B. The bill also directs Part D drug plans to create safe pharmacy networks to dispense controlled substances to beneficiaries at high risk for abuse. Recently, PCMA released the Safe Rx Initiative, a set of policy solutions to reduce prescription drug abuse and fraud and make it more difficult to "drugstore shop" at multiple pharmacies (See July 31, 2013, Weekly Update for more details).

Read more:
http://www.digitaljournal.com/pr/1559551

FDA and Partners Launch e-Learning Course on Evaluating Drug Promotion
FDA Voice
October 28, 2013

The Food and Drug Administration (FDA) and Medscape have launched an e-learning course as part of Bad Ad, a program designed to raise awareness among health care providers and students about drug ads and promotional materials. In addition, they developed several case studies based on FDA Warning and Untitled letters issued to drug companies. The case studies can be downloaded from the Bad Ad Web site; cover a range of promotional materials, including a Web site, journal ad, and TV ad; and touch on numerous promotional practices that do not comply with FDA regulations. Through these studies, students will have an opportunity to evaluate and discuss real-life examples of misleading drug promotion. Anyone can take the course.

Read more:
http://blogs.fda.gov/fdavoice/index.php/2013/10/fda-and-partners-launch-e-learning-course-on-
evaluating-drug-promotion

http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/DrugMarketing
AdvertisingandCommunications/ucm209384.htm

http://www.sigmatech.com/BadAd

DoD Widens Addiction Treatment Options
Marine Corps Times
October 31, 2013

Effective November 21, a new treatment option will be available for service members and Tricare beneficiaries addicted to pain relievers. The Department of Defense lifted a restriction that prohibited Tricare from covering certain drug therapies used in substance abuse treatment. The change involves medications considered potentially addictive for prolonged detoxification or long-term maintenance therapy such as buprenorphine and methadone. Previous rules allowed Tricare to cover the medications only for short-term, intense detoxification or pain management. The incident rate of opioid abuse diagnoses among active duty troops soared from 15 per 100,000 person-years in 2000 to 80 per 100,000 person-years in 2011, according to the Armed Forces Health Surveillance Center.

Read more:
http://www.marinecorpstimes.com/article/20131031/BENEFITS06/310310025/DoD-widens-addiction-
treatment-options

Patients Tweet About Prescription Opioid Abuse
Medscape
October 29, 2013

Opioid tweets are commonly about medication abuse, according to a study of 2,100 tweets sent in a week. Jeanmarie Perrone from the University of Pennsylvania said the study demonstrates Twitter can foster a better understanding of prescription opioid use and abuse. Using the Twitter Archiving Google Spreadsheet to search for keywords, Dr. Perrone and her team included 50 tweets for each keyword over 7 days and excluded retweets and tweets not in English. Messages were qualitatively analyzed as being about therapeutic use or abuse. Tweets promoting use, whether psychoactive or analgesic, were classified as positive; messages reporting adverse results were classified as negative. Tweets often referred to receiving prescription opioids for dental procedures, from a doctor or emergency department visit, or from friends to treat pain. People also frequently tweeted taking prescription opioids to help them sleep, and reported getting high while taking opioids for pain. They also used Twitter to report adverse effects. Vikhyat Bebarta, from the San Antonio Military Medical Center in Texas, said Twitter could represent a real-time measurement. Dr. Perrone presented this study on October 15, 2013, at the American College of Emergency Physicians 2013 Scientific Assembly: Abstract 344.

Read more:
http://www.medscape.com/viewarticle/813416

HYFN and The Partnership at Drugfree.org Announce the Release of New Prescription Drug Abuse Prevention App
PRWeb
October 29, 2013

HYFN and The Partnership at Drugfree.org produced an interactive quiz designed to raise awareness among parents, caregivers, health care providers, and educators about the widespread prevalence and danger of teenage prescription drug abuse. The app features a series of interactive questions that engage users on touchscreen devices, desktops, and laptops before encouraging them to share their results via social media.

Read more:
http://www.prweb.com/releases/2013/10/prweb11267911.htm

Earl Campbell Opens Up About His Addiction to Painkillers and His Campaign to Help Others
Yahoo! Sports
October 29, 2013

Earl Campbell, former professional football player, shares his story about struggling with pain reliever addiction. While Campbell was recovering from his fifth back operation after being diagnosed with spinal stenosis, his doctor prescribed Vicodin and OxyContin. He began taking the drugs with Budweiser. The problem spiraled out of control and Campbell's sons told him they were admitting him to a rehabilitation facility. He agreed and has been sober for almost 4 years. Campbell never believed addiction could kill or take hold of him. Now, he is asking people to tell the Food and Drug Administration to reconsider approving an implant device that ensures medication is taken as prescribed.

Read more:
http://www.thepostgame.com/blog/men-action/201310/earl-campbell-fighting-painkiller-addiction-football-
vicodin-oxycontin-spinal

University Students Turning to Prescription Medicines to Stay Awake
Herald Sun
October 28, 2013

A University of New South Wales study discovered one in 10 students was using prescription amphetamines. One in four was using NoDoz tablets and nearly 3 percent were using narcolepsy or Alzheimer's medication. More than 1,700 students from four southeastern Australian universities responded to the online "convenience" survey. The results suggested Australian students may be using prescription medications at a greater rate than students in the United States or Germany. Some (15.3 percent) used amphetamines for studying only. Half of those using cognitive-enhancing drugs like Modafinil and racetams used them only for studying, as did half of those using caffeine drinks or drugs.

Read more:
http://www.heraldsun.com.au/news/national/university-students-turning-to-prescription-
medicines-to-stay-awake/story-fni0xqrb-1226748485257

Other State and Local News

When It's 'Okay' to Use Drugs While Pregnant
KIRO Radio
October 30, 2013

This audio (3:42 minutes) and transcript discuss what Rachel Belle, a feature contributor and personality on The Ron and Don Show, learned after receiving a list of doctors who have conducted research on newborns experiencing prescription drug withdrawal. The National Advocates for Pregnant Women felt her previous story stigmatized women who use methadone or prescription drugs during pregnancy, and informed her that women are (perhaps inappropriately) advised to use methadone to treat addiction during pregnancy.

Read more:
http://mynorthwest.com/874/2384183/When-Its-Okay-to-Use-Drugs-While-Pregnant

Students Pop Pills to Increase Success
Minnesota Daily
October 31, 2013

Experts caution against using Adderall to study, but University of Minnesota students say it's easy to do. They get the drug from friends or their doctors. About 5.7 percent of students on the Twin Cities campus reported taking a drug they were not prescribed at least once in the past year, according to data from Boynton Health Service's 2013 College Student Health Survey. Gary Christenson, Boynton's Chief Medical Officer, thinks using drugs that could enhance concentration on tests or in the classroom should be considered cheating. Some students disagree. They say Adderall may help increase focus, but will not help them learn information they are expected to know for a test.

Read more:
http://www.mndaily.com/news/campus/2013/10/31/students-pop-pills-increase-success

In 'The Bedroom Project,' Parents Learn to Spot Signs of Teens' Drug Use
Mooresville Tribune
October 30, 2013

Recently, the Mooresville Graded School District and Mooresville Police Department sponsored The Bedroom Project, an adults-only presentation aimed at raising awareness for spotting signs of drug use. The program was initiated by the Prescription Education Abuse Counseling Empowerment Foundation. Shannon Rouse Ruiz created the organization after her 16-year-old daughter, Kaitlyn, died from an unintentional prescription drug overdose. The Bedroom Project featured a mock bedroom designed to instruct parents where to search for drugs in their homes, how to conduct a proper safety sweep, and how to identify signs of use. The presentation included a video about the dangers of prescription drugs, a handout with Kaitlyn's story, a checklist to use when conducting a safety sweep, and tips and resources to help avoid drug and alcohol dangers.

Read more:
http://www.mooresvilletribune.com/news/article_2e32e054-40db-11e3-ae37-001a4bcf6878.html

Collective Actions Issue Brief #5: Prescription Pain Medication Misuse
New Hampshire Department of Health and Human Services' Bureau of Drug and Alcohol Services
Accessed October 28, 2013

This Issue Brief shows prescription pain reliever abuse among New Hampshire's 18- to 25-year-olds remains above the national average and higher than in other northeastern states. Approximately one in eight young adults (12.3 percent) reported abusing pain relievers in the past year according to the 2011 National Survey on Drug Use and Health. New Hampshire also saw its highest number of drug-related deaths ever in 2011, with 200 deaths—approximately 80 percent of which involved prescription drugs. Although these statistics are higher than in other states, New Hampshire's Department of Health and Human Services' Bureau of Drug and Alcohol Services sees signs of a possible shift in behavior, with the number of drug-related deaths lower in 2012 and the rate of young adult pain reliever abuse down from a peak of 14.9 percent in 2010. But opioid addiction has been on the rise. In 2010, oxycodone became the second-most prevalent drug of abuse (after alcohol) among people entering state-funded substance abuse treatment. It is also resulting in a rising number of New Hampshire babies born with symptoms of withdrawal from opioids used by the mother while pregnant.

Read more:
http://www.dhhs.state.nh.us/dcbcs/bdas/documents/issue-brief-rxdrug.pdf

Prescription Drug Dealers Allegedly Robbed Over $1 Million from NYC Pharmacies
New York Daily News
October 30, 2013

New York City authorities charged 13 members of a prescription drug crew with stealing more than $1 million worth of prescription medications over a 3-year period. They cased pharmacies for days prior to heists so they would know what equipment to use, and stole drugs such as oxycodone, Viagra, Cialis, and AIDS medication. A U.S. Attorney said the thieves are responsible for more than 125 burglaries and attempted burglaries since 2010.

Read more:
http://www.nydailynews.com/news/crime/dealers-robbed-1-million-125-city-pharmacies-
article-1.1501793

Siouxland Teens Increasingly Abusing Prescription/OTC Medicines
Sioux City Journal
October 31, 2013

It's common to see a 13-year-old in a drug treatment center in Siouxland, Iowa, said a Jackson Recovery Center prevention specialist. RoxAnn Smith said young patients abuse Adderall, Vyvanse, and Ritalin, getting it in the hallways at school from other students or from local dealers or Internet pharmacies. The Iowa Substance Abuse Information Center reported the number of Iowans age 12 or older treated for prescription pain reliever abuse has increased more than 250 percent, while overdoses increased 1,200 percent. Only 14 percent of parents talked to their children about prescription drug abuse, according to a 2012 Partnership Attitude Tracking Survey.

Read more:
http://siouxcityjournal.com/lifestyles/health-med-fit/siouxland-teens-increasingly-
abusing-prescription-otc-medicines/article_9813a66c-8aa2-5462-8648-dda8cca1da3e.html

Prescription Drug Abuse 'Enormous'
TheSpectrum.com
October 27, 2013

The prescription drug abuse problem is growing in Southern Utah, according to Iron/Garfield/Beaver Narcotics Task Force members. Member David Evans found that while adults are often responsible for selling prescription pills, youth are abusing them. Nonmedical use of prescription pain relievers was highest among Utahans ages 18 to 25 in 2010 and 2011, according to the National Survey on Drug Use and Health. The age group second-most prone to nonmedical use was the 12- to 17-year-old bracket. Evans has also seen numerous opiate-based overdoses resulting in death over the past few years. The Utah Division of Substance Abuse and Mental Health reported approximately 50 deaths statewide from accidental or undetermined intent overdoses from non-illicit drugs in 1999 and nearly 350 in 2007.

Read more:
http://www.thespectrum.com/article/20131027/NEWS01/310270021/Prescription-drug-abuse-enormous-?gcheck=1&nclick_check=1

2012–2013 SAFE Annual Report
Substance Abuse Free Environment, Incorporated
Accessed October 30, 2013

The SAFE annual report shows the level of substance abuse among Chesterfield, Virginia, youth. Data was collected from Chesterfield County School students using a self-reporting survey. The report shows the percentage of 8th graders who used marijuana during a 30-day period rose 100 percent. The percentage of students who misused stimulants during a 30-day period rose more than 128 percent. Alcohol abuse, cigarette use, drunk driving, and inhalant misuse were down.

Read more:
http://issuu.com/safecontributions/docs/annual_report

I-Team 10 Investigation: State Flushing Unused Medications
WHEC
October 30, 2013

This article and video (2:57 minutes) discuss why New York State tells residents not to flush unused prescription medications down the toilet. In contrast, flushing is the written protocol for Finger Lakes Developmental Disabilities Services Office, a state-run facility. A former employee was told during training to flush the drugs down a running water drain. She did not understand why the company could not use designated drop-off sites and sent an email to the governor explaining her concerns. The employee received a response from the Director of Health Services at the New York State Office for People with Developmental Disabilities, who said controlled substances are flushed while non-controlled drugs are destroyed through a variety of methods.

Read more:
http://www.whec.com/news/stories/S3204919.shtml

Sister Shares Story of Brother's Suicide After Prescription Drug Addiction
WOWK
October 29, 2013

This article and video (2:42 minutes) discuss the death of 41-year-old David Lawhon, who committed suicide nearly 4 months ago after struggling with prescription drugs. David's family had no idea he was addicted to pain pills until they read his suicide letter. The former construction worker said the pills took away his physical and mental pain. He also revealed he heard voices in the days leading up to his death. David's sister suspects he was ordering pain pills online from Canadian pharmacies.

Read more:
http://www.wowktv.com/story/23816469/sister-shares-story-of-brothers-suicide-after-prescription-drug-addiction

Videos

The Pain Killers—Silent Film About Prescription Drug Abuse
ArtcVideo
October 30, 2013

This public service announcement was created by teens at Preferred Family Healthcare as a reminder to safely store and dispose of prescription drugs. (Duration: 2:52 minutes)

Watch:
http://www.youtube.com/watch?v=NgsaZjrYv5I&feature=youtube_gdata

FOX News—Prescription Drug Abuse
Wolfsberg, Joseph
October 29, 2013

Addiction expert Jeff Wolfsberg talks with FOX News about curbing the national epidemic of prescription drug abuse and addiction. (Duration: 5:07 minutes)

Watch:
http://www.youtube.com/watch?v=LXI3he2T_PA

At Issue #2204 'Prescription Drug Abuse'
WTVP
October 26, 2013

Wayne Wilson talks with a representative from Hult Center for Health Education, the Tazewell County Sheriff, and Preckshot Professional Pharmacy about prescription drug abuse. (Duration: 26:49 minutes)

Watch:
http://www.youtube.com/watch?v=R0we24YjBVg

Grants received

Crime Stoppers of Tangipahoa Gets AMA Foundation $
San Francisco Chronicles
November 1, 2013

The American Medical Association Foundation awarded $10,000 to Crime Stoppers of Tangipahoa, Louisiana, to help create a task force to deliver educational programming focused on reducing prescription drug abuse among teenagers. Task force members will include the North Oaks Health System, Tangipahoa Parish Sheriff's Office, and Hammond City Court. The group is planning to develop a social and digital media campaign and conduct community presentations about the dangers and consequences of abuse. In addition, it will create print materials that will be used along with role playing and simulations.

Read more:
http://www.sfgate.com/news/crime/article/Crime-Stoppers-of-Tangipahoa-gets-AMA-Foundation-4945607.php

Take-Back Events and Drop Boxes

Ohioans Toss Out More Than 8,600 Pounds of Prescription Drugs as Part of Disposal Program
The Blade
October 26, 2013
http://www.toledoblade.com/State/2013/10/26/Ohioans-toss-out-more-than-8-600-pounds-of-prescription-drugs-as-part-of-disposal-program.html

AZ Residents Toss 5 Tons of Old Prescription Meds
CBS 5
October 30, 2013
http://www.kpho.com/story/23835578/az-residents-toss-5-tons-of-old-prescription-meds

Abington Residents Turn in $15k in Prescription Pills
The Enterprise
October 29, 2013
http://www.enterprisenews.com/topstories/x1372979654/Abington-residents-turn-in-15k-in-prescription-pills

Ton of Unwanted Drugs Collected in Eastern Kentucky
The Gleaner
October 29, 2013
http://www.courierpress.com/news/2013/oct/29/ton-unwanted-drugs-collected-eastern-kentucky

Drug Drop-Off Sets Another Record at 1,900 Pounds
La Crosse Tribune
October 28, 2013
http://lacrossetribune.com/news/local/drug-drop-off-sets-another-record-at-pounds/article_367e8dbc-3fff-11e3-b56c-001a4bcf887a.html

State Police Collect More Than 600 Pounds of Medication on National Prescription Drug Take-Back Day
Michigan State Police
October 31, 2013
http://www.michigan.gov/msp/0,4643,7-123--315693--,00.html

Drug Take Back Day Collects 5,000+ Pounds Statewide
Newark Post
October 30, 2013
http://www.newarkpostonline.com/news/article_5ad725ad-776c-5d34-9889-23277d61ec6c.html

7,000+ Pounds of Prescription Drugs Collected in Nebraska Drive
Omaha.com
October 31, 2013
http://www.omaha.com/article/20131031/LIVEWELL01/131039683/1016

Prescription Drug Collection Nov. 9 at Woodford Co. Health Department
Peoria Journal Star
October 21, 2013
http://www.pjstar.com/news/x825423523/Prescription-drug-collection-Nov-9-at-Woodford-Co-Health-Department

Feds Collect a Record 2½ Tons During Prescription Drug Take-Back Day in Southern W.Va.
The Republic
October 30, 2013
http://www.therepublic.com/view/story/7d75db1db2a84959a7367e35275b2a47/WV--Drug-Take-Back

Over 18 Tons of Prescription Drugs Collected in Take-Back Initiative
San Ramon Patch
October 30, 2013
http://sanramon.patch.com/groups/politics-and-elections/p/over-18-tons-of-prescription-drugs-collected-this-weekend-in-takeback-initiative

Operation Medicine Cabinet Nets 927 Pounds of Prescription Drugs
Tampa Bay Newspapers
October 27, 2013
http://www.tbnweekly.com/pinellas_county/content_articles/102713_pco-01.txt

Utah County Gathers and Disposes of 1 Million Prescription Drugs
Utah Public Radio
October 28, 2013
http://upr.org/post/utah-county-gathers-and-disposes-1-million-prescription-drugs

Operation UNITE Collects More Than a Ton of Medicine During Take-Back
WYMT TV
October 29, 2013
http://www.wkyt.com/wymt/home/headlines/Operation-UNITE-collects-more-than-a-ton-of-medicine-during-take-back-229644511.html

Upcoming Conferences and Workshops

Blackstone Area Prevention Coalition's Hosting Town Hall Meeting on Prescription Drug Abuse and Overdose Prevention
November 12, 2013
6 p.m. to 8 p.m.
City of Woonsocket
Harris Hall
169 Main Street
Woonsocket, Rhode Island

The Woonsocket, Cumberland, Lincoln, and North Smithfield Prevention Coalitions will host a Town Hall Meeting to provide information and panel discussion on prescription drug abuse and overdose prevention. James McDonald, Chief Administrative Officer from the Department of Health, will be the keynote speaker.

Read more:
http://woonsocket.patch.com/groups/announcements/p/blackstone-area-prevention-coalitions-hosting-town-hall-meeting-on-prescription-drug-abuse-and-overdose-prevention

2013 American Association for Treatment of Opioid Dependence Conference
November 9–13, 2013
Philadelphia, Pennsylvania
http://www.aatod.org/national-conference/2013-aatod-conference-philadelphia

Town Hall Meeting on Prescription Drug Abuse
November 20, 2013
Fort Collins, Colorado
http://www.teamfortcollins.org/parents/town-hall-meeting-on-prescription-drug-abuse-nov-20

Lecture: Prescription Drug Use—The Dos and the Don'ts
January 29, 2014
6:30 p.m. to 7:30 p.m.
Centegra Health Bridge Fitness Center–Huntley
10450 Algonquin Road
Huntley, Illinois

Pang Chong, a pharmacist at Centegra Health System, will discuss the dos and don'ts of prescription drug use and how to properly dispose of prescription drugs.

Read more:
http://centegra.org/event/lecture-prescription-drug-use-dos-donts

24th National Leadership Forum: The Power of Movement
February 3–6, 2014
Gaylord National Hotel and Convention Center
201 Waterfront Street
National Harbor, Maryland

The Community Anti-Drug Coalitions of America's National Leadership Forum is a 4-day event packed with opportunities to learn about the latest strategies to fight substance abuse and hear from nationally known prevention experts, federal administrators, and concerned policymakers. The forum brings together more than 2,700 national and international participants.

Read more:
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
Gaylord National Hotel and Convention Center
201 Waterfront Street
National Harbor, Maryland

The Substance Abuse and Mental Health Services Administration (SAMHSA) will convene its 10th annual Prevention Day in conjunction with the Community Anti-Drug Coalitions of America's National Leadership Forum. The event will feature the latest information about SAMHSA's third annual National Prevention Week, a health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. Participants will learn about effective programs and the latest prevention-related developments in substance abuse and mental health. They will also have an opportunity to network with other SAMHSA grantees and partners and take part in workshops to enhance their strategic planning and share experiences and information.

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

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.