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October 2, 2013

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
IISSUE 39 - OCTOBER 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 Other Resources Videos Twitter Chat Webinar Scholarship Opportunity Grants Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Article

Centers for Disease Control and Prevention. 2013. "Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification—New York City, 2012." Morbidity and Mortality Weekly Report 62(38):777-80.

From August to September 2012, the New York City Department of Health and Mental Hygiene (DOHMH) was notified by the New York City Poison Control Center of three patients who experienced serious adverse events after anesthesia-assisted rapid opiate detoxification (AAROD) at a local outpatient clinic. All three patients required hospitalization and one subsequently died. DOHMH issued an order requiring the clinic cease performing AAROD pending an investigation and searched for additional cases of AAROD-related serious adverse events at the clinic and elsewhere in New York City from September 2011 to September 2012. The search found no serious adverse events at other clinics. Of the 75 patients who underwent AAROD at the implicated clinic during January–September 2012, two died and five others experienced serious adverse events requiring hospitalization. As a result of the findings, the New York State Department of Health, New York Office of Alcoholism and Substance Abuse Services, and DOHMH jointly issued a Health Alert informing New York healthcare providers of AAROD-associated serious adverse events and recommending they avoid AAROD in favor of evidence-based options for opioid dependence treatment.

Read more:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a1.htm?s_cid=mm6238a1_w

Journal Articles and Reports

S. Barlas. 2013. "Prescription Drug Abuse Hits Hospitals Hard: Tighter Federal Steps Aim to Deflate Crisis." Pharmacy and Therapeutics 38(9):531-4.

Hospitals and their pharmacy departments are now at the epicenter of the prescription drug abuse tsunami. The Obama administration is using regulatory agencies in an attempt to crack down on physician-run "pill mills" and the pharmacies that support them.

Read more:
http://www.ptcommunity.com/ptjournal/fulltext/38/9/PTJ3809531.pdf

T.C. Green, N. Zallerb, W.R. Palacios, S.E. Bowman, M. Raya, R. Heimer, and P. Case. 2013. "Law Enforcement Attitudes Toward Overdose Prevention and Response." Drug and Alcohol Dependence. Available online September 2, 2013.

Researchers conducted key informant interviews as part of a 12-week Rapid Assessment and Response process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in Connecticut and Rhode Island locations that were experiencing overdose "outbreaks." Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers' feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police–community relations.

Read more:
http://www.sciencedirect.com/science/article/pii/S0376871613003347

Lancet Publishing Group. 2013. "The Lethal Burden of Drug Overdose." The Lancet 382(9895):833. doi:10.1016/S0140-6736(13)61844-9.

This article discusses the United Kingdom government's unfavorable approaches to drug addiction. The National Office for Statistics reported 2,597 people died from overdoses in 2012; 1,496 cases were related to drug misuse. Opioids are still the biggest killer. Methadone replacement is the most widely used treatment for opioid addiction and reduces harm to patients. However, people enrolled in such programs are at high risk if they relapse. The 2012 data report 414 overdose deaths involving methadone—the third highest mortality in 20 years, and not far short of the 579 deaths involving heroin and morphine. The Coalition Government's 2010 Drug Strategy stated too few people graduate from methadone replacement programs. However, the policy emphasized the importance of complete recovery from drug dependence, including from methadone. Any new treatments should be informed by research findings. The UK government's implementation of its drug strategy was criticized in a report by the Centre for Social Justice published last month. It mentioned 55 percent of local authorities have had funding cut for residential rehabilitation, whereas methadone replacement remains well-supported. It also reported the ineffectiveness of selecting services to treat drug and alcohol addiction on a payment-by-results basis. The government has also seen an emergence of legal highs on psychoactive substances, and it has made those substances priorities for drug control. However, healthcare systems and regulatory agencies are still having difficulty addressing the issue. The United States appears to be making progress in countering accidental drug overdoses with emphasis on evidence-based strategies and availability of treatment under the Affordable Care Act. The UK government has good intentions, but it should ensure new measures are based on the best available evidence and not party politics.

Read more:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61844-9/fulltext?rss=yes

B. Lipton, D. Colon, and J. Robertson. 2013. "Workers Compensation Prescription Drug Study: 2013 Update." NCCI Research Brief.

The National Council on Compensation Insurance (NCCI) has performed several studies on prescription drug use in workers compensation (WC). The initial report, published in 2003, showed utilization (as opposed to price) increases were the driving force behind total per-claim WC prescription cost increases. Several drugs, such as Actiq, Mobic, and OxyContin have shown significant changes in market share since 2003. In the most recent study, from 2011, NCCI demonstrated that increased physician dispensing is associated with increased drug costs per claim. In this research brief, prescription costs per claim continue to grow. Utilization is a major driver of total cost changes. The share of Rx costs for physician-dispensed drugs continues to increase. Narcotics account for 25 percent of drug costs. More than 45 percent of narcotics costs are for drugs with Oxycodone HCL as an active ingredient.

Read more:
https://www.ncci.com/documents/Prescription_Drugs-2013.pdf

News

Dr. Maher Fattouh: County Needs to Curb Epidemic of Opioid Painkillers
The Cap Times
September 25, 2013

Maher Fattouh, medical director of Advanced Pain Management, shares his views about reducing opioid pain reliever abuse. Doctors should not take all the blame. Medical providers must look at the psychological factors within a patient's family, their genetic predisposition, and individual behavior patterns that can predict addiction. It takes a multidisciplinary approach on two levels to prevent addiction. First, everyone has a responsibility and it begins with education. Second, the medical community must continue to raise awareness of pain reliever addiction and decrease reliance on opioids as a treatment for chronic pain. Doctors should limit the dose, time, and quantity of opioids they prescribe. If necessary, they should refer patients to a pain management specialist and consider addiction counseling. Also, physicians should focus on preventive, outpatient, and patient-focused medical models. Alternative options include physical therapy and chiropractic care.

Read more:
http://host.madison.com/ct/news/opinion/column/dr-maher-fattouh-county-needs-to-curb-
epidemic-of-opioid/article_7a49817d-ccdf-550a-817a-1cdfcb4196dd.html


Death by Prescription
The Huffington Post
September 23, 2013

Deborah King, a New York Times bestselling health and wellness author and spiritual teacher, shares her views about prescription drug abuse and overdose deaths. She reminds readers that famous people make up a very small percentage of accidental prescription medicine deaths—the majority are ordinary people. She asks poignant questions about the need to seek multiple prescription drugs from multiple doctors and discusses the risks individuals take when using prescription drugs, like mixing them with alcohol. King states something needs to be done about pharmacists and doctors who do not use their state's prescription drug monitoring database. People need to refrain from automatically reaching for a pill to deal with depression, anxiety, or insomnia, or relying on opioid drugs to relieve pain. She offers alternative ways to address these issues, including meditation, biofeedback, exercise and fresh air, better nutrition, going to bed at a decent hour, and holistic techniques such as acupuncture and massage. She also suggests learning how to process emotional trauma without resorting to drugs and the need to have more education about the dangers of pharmaceuticals.

Read more:
http://www.huffingtonpost.com/deborah-king/prescription-drug-overdose_b_3882396.html

Adolescent Health Highlight: Use of Illicit Drugs
Child Trends, Adolescent Health Highlight
September 2013

This Adolescent Health Highlight presents statistical information about the extent, types, and patterns of adolescents' use of illicit drugs; discusses their effects on adolescents' health and well‐being; shares findings from research on factors that can help adolescents avoid substance use and abuse; and presents strategies for preventing illicit drug use among adolescents and treating those with drug problems. Illicit drugs include psychotherapeutic medications not taken under a health provider's supervision, marijuana/hashish, cocaine, heroin, hallucinogens, or inhalants.

Read more:
http://www.childtrends.org/wp-content/uploads/2013/09/Illicit-drug-use-Highlight-9.13.pdf

AMA Webinar Addresses Genetics' Role in Patient Response to Opioids
Occupational Health and Safety
September 24, 2013

The American Medical Association hosted a Webinar on September 25 about pain management and pharmacogenetics—the study of genetic variation in drug response. The Webinar series helps physicians combat prescription drug abuse and promotes responsible pain management, explaining the genetic foundation and clinical importance of certain genetic variations, how they can affect a patient's reaction to opioids, and how pharmacogenetic research could inform clinical decision making in pain management. The 1-hour Webinar is archived online for on-demand viewing.

Read more:
http://ohsonline.com/articles/2013/09/24/ama-webinar-addresses-genetics-role-in-patient-
response-to-opioids.aspx?admgarea=news


Genart's 18th Annual Film Festival Announces Collaboration with The Partnership at Drugfree.org for #endmedicineabuse Project
PRNewswire
September 25, 2013

Genart, the experiential events and digital content marketing company supporting emerging talent, and The Partnership at Drugfree.org will debut the film Out of Reach at Genart's 18th Annual Film Festival on October 3, 2013, at AMC Loews Village 7 in New York City. Cyrus Stowe, the teen filmmaker, was selected by Genart and The Partnership at Drugfree.org to turn his entry into a short documentary with the help of A&E Intervention's Tucker Capps. The film captures the issue of teen prescription drug abuse as it exists in Cyrus's world.

Read more:
http://www.prnewswire.com/news-releases/genarts-18th-annual-film-festival-announces-
collaboration-with-the-partnership-at-drugfreeorg-for-endmedicineabuse-project-225197622.html


ASU Alumni Create Product to Mimic Effects of Adderall Without Risk Factor
The State Press
September 23, 2013

Three Arizona State University alumni have launched Mental Mojo, a powdery substance that was created to increase alertness and energy. The founders came up with the idea after witnessing rampant abuse of Adderall among their peers. They noticed other law students were using Adderall to stay up for long periods of time to study. Some had prescriptions, but many were buying it illegally. Mental Mojo is a combination of nootropic cognitive enhancers and amino acid complexes mixed together in a single-serve package. The creators said it is similar to a Rockstar energy drink in caffeine content, but not supposed to induce jitteriness. A neuroscientist from Barrow Neuorological Institute in Phoenix helped ensure product safety. They will be selling Mental Mojo on college campuses with the message to stay away from prescription drugs. Editor's Note: Like all designer drugs, this substance may not be safe or effective.

Read more:
http://www.statepress.com/2013/09/23/asu-alumni-create-product-to-mimic-effects-of-
adderall-without-risk-factor


Program Introduced for Universal Drug Testing of Pregnant Women
WEAR ABC 3
September 26, 2013

This article and video (2:05 minutes) discuss programs involving universal drug testing for pregnant women in selected hospitals throughout the country. The goal is to identify babies who may be at risk for serious health concerns due to withdrawal. The incidence of babies exposed to drugs has risen fivefold in the last 5 years. Almost 4 percent of babies are exposed to some sort of opiate in utero. The most common complications are due to withdrawal from prescription drugs. Pregnant women are asked to submit a urine sample for drug testing. If they test positive for prescription or any other drugs, the babies are not taken away. The information is used for the medical care of the babies and mothers to provide needed services. A mother has the right to refuse this test, but refusal would prompt scrutiny.

Read more:
http://www.weartv.com/news/features/top-stories/stories/program-introduced-universal-
drug-testing-pregnant-women-36447.shtml

Other State and Local News

Spike in Prescription Drug Deaths Prompts Call for More Education
ABC Australia
September 15, 2013

The Victorian Coroners Court reports 176 Victorians died from drug overdoses in the first half of 2013 and prescription drugs accounted for 82 percent of the deaths. A drug expert says the rate of deaths caused by prescription drug overdoses in Victoria is alarming and demonstrates the need for more education for patients and health professionals.

Read more:
http://www.abc.net.au/news/2013-09-25/spike-in-prescription-drug-deaths-prompts-call-
for-more-educati/4979500?section=vic


DEA Raid Nets Large Amount of Oxycodone
Albuquerque Journal
September 26, 2013

The Drug Enforcement Administration arrested several people on federal drug charges in Santa Fe, New Mexico. Officers seized approximately 7,300 milligrams of Oxycodone in the investigation. Oxycodone sells for about $30 per pill on the street. It has a value of about $1 per milligram, so at 7,300 mg, the total take from Operation High Desert Bash was about $7,300 worth of the pain relievers.

Read more:
http://www.abqjournal.com/270171/north/dea-raid-nets-large-amount-of-oxy.html

Georgia Drug Authorities Gain Foothold in Fight Against Drugs
Calhoun Times
September 21, 2013

The Georgia Bureau of Investigation (GBI) has a handle on the methamphetamine epidemic. It is now battling a different problem: prescription drug abuse. The hardest part is finding the right evidence to bring charges against dealers. When someone reports suspected pill abuse, the user may be able to produce a prescription. The GBI relies on individuals participating in drug take-back programs and getting tips from citizens. It is an uphill battle, with pain clinics popping up and drugs such as heroin being transported via the interstates. The GBI is committed to changing its methods of law enforcement to combat the problem.

Read more:
http://www.calhountimes.com/view/full_story/23656291/article-Georgia-drug-authorities-gain-foothold-in-fight-against-drugs?instance=home_news_1st_left

Bill Would Widen Use of Heroin-Fighting Drug
Cincinnati.com
September 26, 2013

The Ohio General Assembly could soon pass a bill that would allow family, friends, and first responders to use naloxone to stop a heroin or OxyContin overdose. Healthcare providers, including physician assistants, would be able to prescribe naloxone without fear of criminal liability. Providers would have to tell family members and friends that the law requires them to call 911 before or after administering the drug. The chair of the House Health Committee plans to ask the Speaker to let the full House vote on the bill when it returns from its 3-month break.

Read more:
http://news.cincinnati.com/article/20130925/NEWS010801/309250150/Bill-
would-help-stop-heroin-overdoses-advances?gcheck=1&nclick_check=1


Keeping Prescription Drugs Out of the Hands of Teens
Clearys Notebook
September 24, 2013

Next year, 4th grade students in Gloucester Township, N.J., will receive a lesson on the dangers of prescription pill abuse as part of the Society Improvement Program. The session will provide tips and suggestions that may prevent students from abusing prescription medication.

Read more:
http://www.gloucestercitynews.net/clearysnotebook/2013/09/keeping-prescription-
drugs-out-of-the-hands-of-teens.html


Faces of Drug Abuse: Parents Share Agonizing Stories of Children's Deaths
Daily Independent
September 23, 2013

Mike Donta's son, who battled addiction, tragically hung himself. Karen Shay's daughter died after taking prescription pain relievers at a party. Both Donta and Shay travel across Kentucky talking to students about the dangers of prescription drug abuse. They have spoken to more than 25,000 school children since losing their own and were in attendance when the Kentucky Attorney General announced two $1,500 scholarships in honor of their kids. Donta said he and Shay are honored to see their children's memories carried on through the scholarships. They are investigating how they might legally establish a foundation to continue the funding in future years. (See more information below on the Sarah Shay and Michael Donta Memorial Scholarship for Hope and Healing.)

Read more:
http://dailyindependent.com/x703121423/Faces-of-drug-abuse

Lawmakers Seek Tighter Controls on Drug Database
The Daytona Beach News-Journal
September 24, 2013

The Florida Department of Health is pursuing new rules to protect the privacy of individuals whose prescriptions are captured in the prescription drug monitoring program. House and Senate committee members said more needs to be done to ensure private information does not fall into the wrong hands. The Department of Health conducted an internal investigation after the release of 3,200 records was reported, and held two rule-making workshops. It is a felony by state law to knowingly distribute records from the database to unauthorized individuals. The proposed rule changes would create a log of people requesting database records and require anyone receiving the information to sign an affidavit; reports would be limited to PDF format and all records would be labeled confidential. The program would also conduct audits to circumvent inappropriate database use. Editor's Note: Some of these changes are controversial and may be designed to deliberately gut the system.

Read more:
http://www.news-journalonline.com/article/20130924/WIRE/130929670/1025?p=1&tc=pg

Kiosk Available for Prescription Drug Disposal
The Edwardsville Intelligencer
September 24, 2013

Republic Services donated a medication disposal kiosk to the Edwardsville Police Department. Residents can drop off prescription and over-the-counter medications 24 hours a day, 7 days a week.

Read more:
http://www.theintelligencer.com/local_news/article_f4f6c6e6-252f-11e3-a05b-
001a4bcf887a.html


State Efforts on E-Prescribing, Prescription Monitoring Vary
FierceHealthIt
September 24, 2013

The Oregon Board of Pharmacy, Lincoln County, and Oregon Pharmacy Coalition lobbied for the reintroduction of House Bill 3522 before the House Interim Committee on Healthcare, which would allow e-prescribing of Schedule II drugs. More than 30 states allow e-prescribing of Schedule II drugs. In Pennsylvania, lawmakers and the governor want to create a database that includes addictive medications. The state's prescription drug monitoring database is currently limited to powerful pain relievers. Missouri is the only state that has not passed legislation to create a prescription drug monitoring program. Experts say the programs do not carry tough consequences for inappropriate prescribers.

Read more:
http://www.fiercehealthit.com/story/state-efforts-e-prescribing-prescription-
monitoring-vary/2013-09-24


Drugs Identified in Deceased Persons by Florida Medical Examiners
Florida Department of Law Enforcement
March 2013

Florida medical examiners submitted a toxicology report to the Medical Examiners Commission showing 4,126 drug-related deaths from January through June 2012. For a death to be considered "drug related," there must be at least one drug identified in the decedent; this is recorded as a drug occurrence. The state's medical examiners determined if drugs were the "cause" of death or merely "present" in the body at the time of death. It is not uncommon for a decedent to have multiple drugs listed as a cause of death. Though a medical examiner determines a drug is present or identifiable in the decedent, the drug may not have played a causal role in the death. Drug occurrence data in this report should not be aggregated.

Read more:
http://www.fdle.state.fl.us/Content/getdoc/9c4df7c2-4b07-4f7a-acfb-6461719c0e44/
2012-interim-drug-reportFINAL.aspx
Related Press Release

Prescription Drug Deaths Falling Across Florida
Florida Department of Law Enforcement
September 24, 2103

The Attorney General and Florida Department of Law Enforcement Assistant Commissioner released Drugs Identified in Deceased Persons by Florida Medical Examiners, a 2012 report that showed deaths caused by oxycodone plunged by 41 percent in 2012, and overall occurrences of prescription drug deaths decreased by 9.9 percent. In 2012, drugs were either present or the cause of death in 8,330 Floridians—down from 9,135 in 2011. Fewer people also died from methadone, hydrocodone, and cocaine. The drugs that caused the most deaths in 2012 were oxycodone, alprazolam, ethyl alcohol, cocaine, methadone, morphine, hydrocodone, and diazepam.

Read more:
http://www.fdle.state.fl.us/Content/News/Prescription-drug-deaths-
falling-across-Florida.aspx


Deaths Involving Prescription Drugs Up Locally
The Gainesville Sun
September 24, 2013

The Eighth District saw the number of accidental deaths caused by prescription drugs increase 95 percent, but decrease 20 percent statewide. Gainesville Police said prescription narcotics are not as plentiful as they once were because the state has tighter regulations. Oxycodone was found in 42 deaths in the Eighth District in 2012 and in 24 deaths in 2011. Hydrocodone deaths increased from 16 in 2011 to 22 in 2012. The Eighth District had two heroin-related deaths in 2012 and no heroin-related deaths in 2011. Morphine deaths rose from 22 in 2011 to 43 in 2012. Deaths with methadone totaled 26 in 2012 and 22 in 2011.

Read more:
http://www.gainesville.com/article/20130924/ARTICLES/130929794/-1/
entertainment?Title=Deaths-involving-prescription-drugs-up-locally&tc=ar
Cartooning on Clarion Alley to Prevent Overdoses
Kitap Sun
September 23, 2013

San Francisco artists Mike Reger and Erin Amelia Ruche created a mural to raise awareness about using naloxone. They partnered with the Drug Overdose Prevention and Education Program that offers training as well as take-home naloxone. The drug has reversed nearly 1,000 overdoses locally since the program began in 2003, according to the Department of Public Health. Ruche has successfully administered naloxone twice to a friend overdosing on opioids. Reger, along with other artists, has created two comics about drug overdoses and naloxone and distributed them throughout the city. This outreach campaign is sponsored by the education program and funded by the city's Department of Public Health.

Read more:
http://www.kitsapsun.com/news/2013/sep/23/cartooning-on-clarion-alley-to-
prevent-overdoses/#axzz2fjtkRabS


Prescription Drug Abuse, Sharing on Rise Among College Students
KMSP-TV
September 24, 2013

This article and video (2:57 minutes) discuss the outrage people felt after FOX 9 News aired a story about a University of Minnesota student who was charged with three felonies after police caught her with prescription drugs and a scale in a dormitory. The 18-year-old was intoxicated and had several prescription pills that were not prescribed to her. People felt the news linked the co-ed's face and name to a problem that is greater than one person. Prescription drug abuse among college students is a common occurrence. Twenty percent of new high school graduates have abused a prescription drug for a nonmedical reason. A survey of college students recently found 70 percent of college students reported sharing medications.

Read more:
http://www.myfoxtwincities.com/story/23521145/prescription-drug-abuse-
sharing-on-rise-among-college-students


Police: Prescription Drug Thief Targeting the Elderly in Tacoma
KOMO News
September 23, 2013

This article and video (2:10 minutes) warned residents that a prescription drug thief is targeting senior living communities in Tacoma, Washington. A young woman with a small child knocked on the door, claiming interest in viewing the neighborhood for her elderly mother. Then she asked to use the bathroom, where she raided the medicine cabinet. The woman stole pain medication meant for the homeowner's dog. The victim's neighbor told police a stranger matching the same description and scheme knocked on her door 1 week before. In that case, the thief stole the dog's Vicodin.

Read more:
http://www.komonews.com/news/local/Police-Prescription-drug-thief-targeting-
the-elderly-in-Tacoma-224945972.html?tab=video&c=y


Oakland County Sheriff Investigating $50,000 Prescription Theft at Clarkston-Area Pharmacy
MLive.com
September 20, 2013

Oakland County Sheriff officials said roughly $50,000 in prescription drugs were taken from a Clarkston-area pharmacy in Michigan, including methadone, morphine, and OxyContin.

Read more:
http://www.mlive.com/news/flint/index.ssf/2013/09/oakland_county_sheriff_investi.html

Illegal Spread of Painkillers Focus of Federal Program for Shinnecock
Newsday
September 24, 2013

The U.S. Attorney sent a prescription drug task force to the Shinnecock Indian Nation reservation to educate tribal members about the dangers of prescription drugs as part of a "holistic" approach to checking the illegal spread of opioid pain relievers. The task force has traveled New York's Eastern District to prevent widespread use of drugs before they become a greater danger—an outreach that complements investigative and enforcement strategies. Tribe members learned the warning signs to look for among young people. The tribe will host a drug take-back event on October 26 to get people to dispose of unwanted prescription medications.

Read more:
http://www.newsday.com/long-island/suffolk/illegal-spread-of-painkillers-focus-of-federal-program-for-shinnecock-1.6134781?firstfree=yes

Norfolk DA's Office Asks for Help in Fighting Prescription Drug Abuse
Norwood Patch
September 26, 2013

The Norfolk District Attorney and Assistant District Attorney have asked the Norwood Senior Center to help them fight prescription drugs in the community. At a Senior Summit, the DA talked about the success of local drug disposal kiosks. He warned that people go to open houses to access medicine cabinets and take what they want. The DA has hired a Safe Prescribing Consultant to work on educating the public about prescription drug abuse dangers and to analyze what is being prescribed where and to whom. He mentioned the importance of grandparents getting involved with the discussion on drug abuse. He referred them to the MetLife Foundation's booklet on "The Power of Grandparents."

Read more:
http://norwood.patch.com/groups/politics-and-elections/p/norfolk-das-office-
asks-for-help-in-fighting-prescription-drug-abuse


Stopping the Silent Epidemic of Prescription Drug Abuse: As I See It
The Patriot-News
September 23, 2013

Dauphin County Commissioner George P. Hartwick, III, and Dauphin County District Attorney Ed Marsico sounded the alarm about prescription drug abuse after six young people died of drug overdoses in the county over Labor Day weekend and three more committed suicide. They emphasized the importance of educating the community now, while tackling the problem with prevention, treatment, and enforcement strategies. This includes connecting professionals with those who need help; using prescription drop boxes to dispose of unwanted medications; and hosting a prescription drug summit about the problem. Also, the Secretary of the Drug and Alcohol Department for the Commonwealth of Pennsylvania is drafting a policy bulletin on how to seamlessly hand off individuals at hospitals and emergency rooms to treatment when an overdose has occured.

Read more:
http://www.pennlive.com/opinion/index.ssf/2013/09/stopping_the_silent_
epidemic_of_prescription_drug_abuse_as_i_see_it.html


ACLU Calls for Patient Privacy after PA Pill-Tracking Database Vote
Philly.com
September 24, 2013

The American Civil Liberties Union (ACLU) of Pennsylvania said House Bill 1694 could jeopardize the security of medical data. The bill would create a confidential electronic database of controlled substance prescriptions, and law enforcement could request information related to Schedule II drugs when someone is being investigated. Doctors, pharmacists, dentists, and others licensed to dispense medication would also be authorized to query the database for patient or prescription information. The ACLU said law enforcement does not need a court order to get information from the database, which can be stored for up to 6 years. Law enforcement could request the state keep the information on file longer. HB 1694 will go on the calendar for consideration by the House of Representatives.

Read more:
http://www.philly.com/philly/news/pennsylvania/ACLU_calls_for_patient_
privacy_after_PA_pill-tracking_database_vote.html


Pitt Professor Charged with Possession of Narcotics
The Pitt News
September 26, 2013

A Pittsburgh pharmaceutical researcher has been charged with illegally obtaining prescription drugs using federal grants and university funds. Billy Day, a 52-year-old professor in the School of Pharmacy, was arraigned on 18 counts of obtaining prescription drugs by fraud. Day admitted he had been using drugs purchased for his lab and was seeking treatment. In 2011, he took a bottle of midazolam from an associate professor. He took another bottle this year. Day promised to replace them but never did. An audit of his lab purchases revealed he had made 18 different orders for scheduled narcotics valued at more than $3,800. Day paid for them using grants from the National Institutes of Health and university funds. He ordered midazolam, nitrazepam, alprazolam, lorazepam, and clonazepam.

Read more:
http://www.pittnews.com/news/article_5249e95a-2723-11e3-9bca-001a4bcf6878.html

Prescription for Pain: Young Addict Finds Road to Recovery
The Providence Journal
September 21, 2013

This article shows how Abbie Stenberg, a Rhode Island woman, became addicted to prescription drugs at age 14. When she was 12, Stenberg hurt her back in gymnastics, and a doctor prescribed Vicodin. She started lying about her pain to get more drugs. Soon Stenberg was selling Adderall she had been taking since middle school to buy marijuana. She spent the rest of high school in and out of substance abuse treatment programs. Doctors supplied her with anti-anxiety medicine and sleeping pills. One day, a customer offered Stenberg OxyContin. She ended up spending $100 to $200 a day on drugs. When it became too expensive, she turned to heroin. Now, Stenberg is working full time at a restaurant, living in a recovery house, and attending a 12-step program.

Read more:
http://www.providencejournal.com/breaking-news/content/20130921-prescription-for-pain-young-addict-finds-road-to-recovery.ece

Berks Coroner Awaits Tools to Improve Response Time
Reading Eagle Press
September 22, 2013

The Berks County, P.A., coroner said staff members are talking with outside sources about developing software to quickly provide drug-specific overdose statistics. The county's current software does not have the capacity to generate such statistics. The secretary of the Department of Drug and Alcohol Programs said the state plans to create a software platform in which coroners can upload nonpersonal data on deaths immediately after they occur. The importance of being able to gather the information was underscored by a recent report from the U.S. Drug Enforcement Administration's Philadelphia Division.

Read more:
http://readingeagle.com/article.aspx?id=513544

Leaders Discuss Use of Prescription Drugs in Schools
Santa Cruz Sentinel
September 21, 2013

Community Prevention Partners organized a panel of drug experts to talk about prescription drug abuse and show the film Behind the Orange Curtain, which tackles prescription drug abuse in Orange County, California. The Santa Cruz County Sheriff's Office and leaders at Janus, a drug and alcohol recovery center, have seen this trend among youth in Santa Cruz County. Young people are introduced to opiates at parties, and then in their early 20s, they become addicted to methamphetamine or heroin.

Read more:
http://www.santacruzsentinel.com/copsandcourts/ci_24147456/
leaders-discuss-use-prescription-drugs-schools?source=rss


Coalition Aims to Crack Down on Opioid Abuse
Sentinel and Enterprise
September 26, 2013

The Massachusetts Opioid Abuse Prevention Coalition suggests starting in the medicine cabinet to reduce prescription drug abuse. Earlier this year, Fitchburg received an Opioid Abuse Prevention Collaborative Grant to assist the Massachusetts Public Health Network in developing a regional response to opioid misuse and abuse, overdoses, and fatalities. It will implement a primary prevention strategy in Fitchburg and one overdose prevention strategy in another community by January 1. The opioid prevention group is looking at Narcan education; more efforts revolving around prescription drug take back; education on the dangers of keeping prescriptions around; and potentially establishing a secure, permanent drop-off box.

Read more:
http://www.sentinelandenterprise.com/news/ci_24180025/coalition-aims-crack-down-opioid-abuse

NSSA Joins Forces with DFS to Promote Drug-Free Lifestyle
Surfline
September 25, 2013

Three months ago, 20-year-old Chris Love overdosed on prescription drugs. Local community members launched DFS, the Drug Free Sports movement, to encourage young surfers and athletes to live a drug-free lifestyle. The National Scholastic Surfing Association (NSSA) partnered with DFS to help spread the drug-free message through the positive aspects of surfing, competing, and education. NSSA events will soon have public service announcements and signage to help spread the anti-drug message. The DFS movement is a sticker campaign intended to showcase the positive lifestyle choices of the individual whose board carries the sticker. Thus far, hundreds of stickers have been distributed to surfers throughout Southern California's beach communities, Australia, Japan, Brazil, Dubai, and South Africa. In the past 24 months, the surf community has lost more than two dozen members, all under age 23, to illicit drug use.

Read more:
http://www.surfline.com/surf-news/press-release/nssa-joins-forces-with-dfs-to-promote-drug-free-lifestyle_102081

Few Florida Counties Fund Statewide Prescription Database
The Tampa Tribune
September 23, 2013

Hillsborough-based doctors, pharmacists, and others have queried the prescription drug monitoring database more than half a million times since its creation. The database receives no regular state funding and relies on grants and contributions, according to documents obtained by The Tampa Tribune from the state Department of Health. Only eight of Florida's 67 counties made contributions in 2011-12 to operate the drug database. Hillsborough Sheriff's Colonel said her office was not aware it had been solicited for a donation. State law prohibits the database from getting state money or donations from pharmaceutical companies.

Read more:
http://tbo.com/news/politics/few-florida-counties-fund-statewide-prescription-database-20130923

DEA Official Addresses Prescription Drug Abuse 'Epidemic'
Tricities.com
September 27, 2013

A U.S. Drug Enforcement Administration agent spoke at Bristol Regional Medical Center in Virginia. The agent said it will take everyone in the community to help reduce prescription drug abuse. Two factors have caused the problem to escalate: drug addicts doing what they can to satisfy their cravings, and drug prescribers disregarding ethics. People living in rural areas are among the highest at risk along with Medicaid patients, who are prescribed pain relievers at twice the rate of non-Medicaid patients. Education helps curb demand for the drug. Better treatment for abusers is also needed.

Read more:
http://www.tricities.com/news/local/article_801d5b8e-2712-11e3-abac-001a4bcf6878.html

Mt. Lebanon Group Will Offer Posters, Website, Drop-Off Box to Stop Prescription Drug Abuse
Trib Total Media
September 22, 2013

The Prescription Drug Awareness Task Force plans to start a poster campaign and Web site to raise awareness about prescription drug abuse. It will also offer a drop box at the Mount Lebanon Public Safety Building where individuals can leave unwanted prescription drugs 24 hours a day.

Read more:
http://triblive.com/news/adminpage/4727577-74/drug-prescription-drugs#axzz2fjt065nq

Son's Heroin Death Prompts Dad to Seek HIPAA Rule Change
USA Today
September 22, 2013

Heroin use and arrests in Camden, New Jersey, have steadily increased over the past 5 years, precipitated by opioid prescription drug abuse. In December, Gregg Wolfe lost his son Justin to a heroin overdose. Justin was also addicted to prescription pain relievers and he told his doctor about his drug use. He instructed the physician to inform only his mother, but not his father, since his parents were divorced. Wolfe learned of his son's Percocet addiction 2 months later. When he contacted an outpatient rehabilitation center about his son's condition, privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) barred him from receiving any information. In New Jersey, minors can receive treatment without a parent's consent for drug and alcohol abuse, sexual assault, and pregnancy. Meanwhile, Justin started selling his Suboxone and Adderall and buying street drugs. In April, Wolfe testified before the U.S. House Subcommittee on Oversight and Investigations and asked that an exception be added to HIPAA to allow parents of children with life-threatening mental disorders or addictions to access their medical records (see video, 8:54 minutes). His request includes adult children living under the auspices of their parents' care or covered by their insurance. He continues to work with his representative to craft legislation.

Read more:
http://www.usatoday.com/story/news/nation/2013/09/22/heroin-patient-privacy-rules/2850135/

Ohio Judge Tries Drug to Rehabilitate Addicted Inmates
USA Today
September 26, 2013

Ohio Judge Robert Peeler has been ordering shots of Vivitrol for addicted defendants while in jail. Vivitrol contains the non-narcotic drug naltrexone that blocks the brain's ability to get high on opiates. If inmates complete their series of injections and stay clean, their felony charges could be dismissed. Some sheriffs say the drug's 25 percent success rate is not worth the cost to taxpayers.

Read more:
http://www.usatoday.com/story/news/nation/2013/09/26/inmates-heroin-addiction-drug-treatment/2875127

Should Drug Testing for Pregnant Women Be Mandatory?
USA Today
September 25, 2013

Indiana's attorney general (AG) sparked a debate about whether drug testing for pregnant women should be mandatory. Two national groups are circulating an online petition asking him to apologize for calling for mandatory testing and to stop inciting disrespect for pregnant women's civil liberties. The petition has more than 3,500 signatures. The AG, co-chairman of the state's Prescription Drug Abuse and Prevention Task Force, claimed he never called for mandatory testing. He made the comments on P-I Live (see video [58:38 minute] included with this article). Some are concerned mandatory testing would drive women away from prenatal care.

Read more:
http://www.usatoday.com/story/news/politics/2013/09/25/pregnancy-prescription-drug-screening/2871611

'Skittles' Parties Draw Concerns of Prescription Drug Abuse
WSMX
September 23, 2013

This article and video (2:46 minutes) discuss the increase in "Skittles" parties in Tennessee.

Young people mix an array of prescription pills and eat them like candy. The Wilson County Sheriff's Office advises parents to count their medications and lock them up.

Read more:
http://www.wsmv.com/story/23508683/skittles-parties-draw-concerns-of-prescription-drug-abuse

Other Resources

Adderall Abuse—The Study Drug Infographic
Love Infographics
Accessed September 26, 2013

This infographic provides a visual overview of Adderall abuse.

Read more:
http://www.loveinfographics.com/categories/health-and-diet-infographics/adderall-abuse-the-study-drug-infographic

Videos

Family Helping Bring Awareness to Prescription Drug Abuse
Newsfix
Accessed September 24, 2013

This video (1:36 minutes) and transcript discuss how a teen began abusing prescription drugs and what the family is doing to raise awareness.

Read more:
http://newsfixnow.com/2013/09/23/family-helping-bring-awareness-to-prescription-drug-abuse

Get the Facts and Stop Prescription Drug Abuse Gen RX: PSA Project
Jennifer Worden
September 25, 2013

This video (6:35 minutes) provides facts on prescription drug abuse. It is part of the Generation RX: The Science Behind RX Drug Abuse public service announcement project.

Read more:
http://www.youtube.com/watch?v=UpUa5jyN3-Y

Health Risks of Prescription Drug Abuse
WWSB ABC7
September 20, 2013

This video (3:07 minutes) discusses how and why people become addicted to prescription drugs. It also mentions how individuals gain access to prescription drugs, how to identify the symptoms of abuse, and the health risks.

Read more:
http://www.mysuncoast.com/videos/local_news/health-risks-of-prescription-
drug-abuse/html_00e81c7f-0f12-5ab4-9d99-1a2c4564bab6.html


U.S. Attorney Booth Goodwin presents 'E.O.D.: Equal Opportunity'
The United States Attorney's Office Southern District of West Virginia
July 15, 2013

"E.O.D.: Equal Opportunity Destroyer," developed through a partnership between the U.S. Attorneys' Office for the Southern District of West Virginia and Huntington Police Department, is an educational tool for young people to illustrate the harmful effects of abusing prescription drugs. (17:19 minutes)

Read more:
http://www.youtube.com/watch?v=Dr3jN6atZ44

Twitter Chat

Participate in CADCA Twitter Chat about Medicine Abuse on Oct 7
October 7, 2013
2:00 p.m. (EST)

Community Anti-Drug Coalitions of America (CADCA) will discuss prescription drug abuse and over-the-counter medicine abuse. CADCA will explore solutions to the problem and share tools and resources for parents, educators, and community leaders. Follow @CADCA prior to the chat and use hashtag #PreventMedAbuse to participate in the conversation.

Read more:
http://www.cadca.org/resources/detail/participate-cadca-twitter-chat-about-medicine-abuse-oct-7

Webinar

Overview of the Opioid Analgesic Epidemic: Sponsored by the Children's Safety Network
Wednesday, October 16, 2013
3 p.m.-4 p.m. EST

"Overview of the Opioid Analgesic Epidemic" will be presented by Dr. Andrew Kolodny, Chief Medical Officer of Phoenix House and President of Physicians for Responsible Opioid Prescribing. Dr. Kolodny will discuss factors that led to sharp increases in opioid overdose deaths and opioid addiction. He will also discuss strategies for bringing the epidemic under control.

Read more:
http://campaign.r20.constantcontact.com/render?llr=apwefcdab&v=001NwCPkktRl
azat6brckARIXMNRbQsLbe0uLSLwi9_VNdwpTVPX_BgHaYQcGoTQva0Ob_3_
dtGZ-DeTyksKt4wkXSmNnqyU3b4ca6BYHYnz10%3D

Scholarship Opportunity

The Sarah Shay and Michael Donta Memorial Scholarship for Hope and Healing
Commonwealth of Kentucky, Attorney General's Office
Accessed September 23, 2013

Sarah Shay and Michael Donta Memorial Scholarships were created to help Kentucky students who have excelled in their personal and academic lives, despite seeing firsthand the devastating consequences of prescription drug abuse. These students have embraced a positive lifestyle and a brighter future for themselves and their families. The scholarships are in memory of 19-year-old Sarah Shay, who died of prescription drug overdose in 2006, and 24-year-old Michael Donta, who lost his battle with prescription pain reliever abuse in 2010.

Read more:
http://ag.ky.gov/rxabuse/pages/scholarship.aspx

Grants Received

County Gets Grant to Pay for Prescription Drug Addiction Programs
Ashland Daily Tidings
September 25, 2013

Jackson County, Oregon, was awarded $393,575 in federal funds from the Bureau of Justice to address prescription drug addiction. The county will design standards and develop protocols for Naloxone use. It will also use the funds to pay for educational campaigns and materials related to the dangers of prescribing narcotics.

Read more:
http://www.dailytidings.com/apps/pbcs.dll/article?AID=/20130925/NEWS/309250311/-1/NEWSMAP

RI Gets $11M Grant to Fight Alcohol, Pot and Prescription Drug Abuse by Youth
Daily Journal
September 25, 2013

The Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals received an $11 million grant from the federal government (SAMHSA) to target abuse of alcohol, marijuana, and prescription drugs by teens and young adults.

Read more:
http://www.dailyjournal.net/view/story/6eb885bd1e024e0191e124d67003bbdd/RI--Youth-Substance-Abuse

Call for Public Comment: National Action Plan for Adverse Drug Event Prevention
Provide Feedback on the National Action Plan for Adverse Drug Event Prevention
Open public comment period: September 4 to October 3, 2013

Adverse drug events are the largest contributor to hospital-related complications and account for more than 3.5 million physician office visits each year. As a result of increased attention to reduce and prevent dangers associated with adverse drug events, the U.S. Department of Health and Human Services (HHS), in partnership with the Department of Defense, Department of Veterans Affairs, and Federal Bureau of Prisons, has developed the National Action Plan for Adverse Drug Event Prevention. HHS is seeking feedback on the draft version of the plan from a wide array of stakeholders, including organizations and professional groups.

Participate:
http://1.usa.gov/15fSxvQ

Take-Back Events and Drop Boxes

DEA's National Take-Back Initiative
October 26, 2013
http://www.deadiversion.usdoj.gov/drug_disposal/takeback

Installations Prep for Drug Take-Back Day
The Bayonet
September 25, 2013

The United States Army Installation Management Command will participate in the Drug Enforcement Administration's National Take-Back Initiative on October 26, 2013. It will provide locations for all active duty, family members, civilian employees, and retirees to drop off prescription medications.

Read more:
http://www.thebayonet.com/2013/09/25/480537/installations-prep-for-drug-take.html

VPD Announces Participation in Drug Enforcement Administration's National 'Take-Back' Prescription Drug Program
City of Ventura
September 24, 2013

The Ventura Police Department (VPD) will participate in the Drug Enforcement Administration's National Take-Back Initiative from 10 a.m. to 2 p.m. on October 26. Residents can drop off prescription medication at two locations within the City of Ventura, California.

Read more:
http://www.cityofventura.net/press-release/vpd-announces-participation-drug-enforcement-administration%E2%80%99s-national-%E2%80%9Ctake-back%E2%80%9D-pre

Prescription Drug Take-Back Day Set
Connecticut Post
September 23, 2013

Northwest Corner Prevention Network and State Police at Troop B will collect prescription drugs during the Drug Enforcement Administration's National Take-Back Initiative on October 26. Residents can dispose of medications from 10 a.m. to 2 p.m. at Housatonic Valley Regional High School in Connecticut.

Read more:
http://www.ctpost.com/default/article/Prescription-drug-take-back-day-set-4836581.php

National Prescription Drug Take Back Day Set for Oct. 26
Crawford County
September 23, 2013

Ohio's Crawford County Sheriff's Office and the Galion Community Hospital will collect prescription medications from 10 a.m. to 2 p.m. during the Drug Enforcement Administration's Take-Back Initiative on October 26. Residents should remove all prescription labels before arriving.

Read more:
http://crawfordcountynow.com/local/national-prescription-drug-take-back-day-set-for-oct-26

Kennesaw Police to Host Drug Take-Back Day
Kennesaw Patch
September 24, 2013

Georgia's Kennesaw Police Department will participate in the Drug Enforcement Administration's National Take-Back Initiative on October 26. Residents can drop off medication from 10 a.m. to 2 p.m. at the city jail.

Read more:
http://kennesaw.patch.com/groups/police-and-fire/p/kennesaw-police-to-host-drug-takeback-day

Drop the Drugs
MyMotherLode.com
September 25, 2013

The Calaveras County Sheriff's Office in California is hosting a "Drop the Drugs" event on October 26. Residents can drop off prescription medications from 10 a.m. to 2 p.m. during the Drug Enforcement Administration's National Take-Back Initiative.

Read more:
http://www.mymotherlode.com/news/local/2266192/Drop-The-Drugs.html

Police to Participate in Prescription Drug Take Back Day
The Sentinel
September 20, 2013

The Shippensburg Police Department and Shippensburg Emergency Medical Services in Pennsylvania will participate in the Drug Enforcement Administration's National Take-Back Initiative from 10 a.m. to 2 p.m. on October 26. Individuals can drop off over-the-counter drugs and prescription medications. Sharpies and syringes will not be accepted.

Read more:
http://cumberlink.com/news/local/crime-and-courts/police-to-participate-in-prescription-drug-take-back-day/article_ca89b65c-2237-11e3-84d7-0019bb2963f4.html

Medication Clean Outs in Rural Areas
Newschannel10.com
September 25, 2013

This article and video (1:58 minutes) discuss the "Medication Clean Out" sponsored by Accolade Home Health Care that will be held on October 2 as part of the Pampa Health Fair. This event will give people in rural areas the opportunity to dispose of prescription drugs.

Read more:
http://www.newschannel10.com/story/23531449/medication-clean-outs-in-rural-areas

Drop Boxes for Prescription Drugs Coming to Dauphin County
The Patriot-News
September 25, 2013

Dauphin County, P.A., will receive drop boxes at seven locations where people can dispose of prescription drugs. The boxes will be installed at police stations in Derry Township, Millesburg, Steelton, Susquehanna Township, Swatara Township, the Capitol Police, and the Dauphin County Sheriff's office.

Read more:
http://www.pennlive.com/midstate/index.ssf/2013/09/dauphin_county_
commissioners_m_46.html


PD Installs Drop Box for Old Prescriptions
The Baldwin Times
September 27, 2013

The Bay Minette Police Department set up a prescription drug drop box in its lobby. The old mailbox was refurbished by the Bay Minette Public Works Department in Alabama. Additionally, Baldwin County Community Alliance (BCCA) will provide financial assistance to other departments who want to participate. The BCCA also will continue to support and participate in National Prescription Drug Take-Back Days.

Read more:
http://www.gulfcoastnewstoday.com/the_baldwin_times/article_711db842-26d9-11e3-aa80-0019bb2963f4.html

Upcoming Conferences and Workshops

4th Annual Executive Forum on Creating a Culture of Health and Wellness
October 7-8, 2013
Chicago, Illinois
http://www.worldcongress.com/events/HH13077

California Department of Health Care Services
Audits & Investigations: Prescription Drug Diversion Symposium
October 10, 2013
1500 Capitol Avenue, Auditorium
Sacramento, California
8:30 a.m. to 5 p.m.

This symposium is intended to enhance the knowledge and skills of those charged with oversight of prescription drug use and related commerce. Presentations will relate to prescription drug diversion and intend to increase efficiency of existing resources; share information on patterns and trends; share best practices for identification, enforcement, and prevention; and provide opportunities to interact with peers and subject matter experts.

Read more:
http://www.dhcs.ca.gov/individuals/Pages/AI_PDDS.aspx

Heroin in Kentucky Headlines
October 24, 2013
9 a.m. to 12 p.m.
First United Methodist Church
401 W. Main St.
Richmond, Kentucky

This conference, organized by the Madison County Agency for Substance Abuse Policy, will highlight the increase of heroin overdose deaths in Kentucky. Guest speakers include the deputy state medical examiner, Madison County coroner, and U.S. Attorney for the Eastern District of Kentucky.

Read more:
http://richmondregister.com/localnews/x134964301/County-group-hosting-conference-on-rise-of-heroin-use

CFPC's Annual Substance Abuse Conference: Our Drug Epidemic
November 1, 2013
Perona Farms
350 Andover Sparta Rd
Andover, New Jersey

This conference, sponsored by the Center for Prevention and Counseling (CFPC), will feature experts in substance abuse and law enforcement who will help explain the increase in overdose deaths due to heroin and prescription drugs. The conference will also offer solutions for addressing this problem.

Read more:
http://www.centerforprevention.org/conference.html

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

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