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October 29, 2014


SAMHSA Prescription Drug Abuse Weekly Update
Issue 95  |  October 29, 2014
The Prevention of Prescription Drug Abuse in the Workplace (PAW) TA Center addresses prescription drug abuse—a growing public health problem with increasing burdens on workers, workplaces, and our economy. To subscribe colleagues, family members, or friends to this listserv sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), please click here or send their e-mail addresses to paw@dsgonline.com.
Table of Content Other Journal Articles and Reports Professional Education News Other State and Local News Other Resources Webinar Grants Awarded Request for Proposal Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


B. Fischer, C. Burnett, and J. Rehm. 2014. "Considerations Towards a Population Health Approach to Reduce Prescription Opioid-Related Harms (With a Primary Focus on Canada)." Drugs: Education, Prevention, and Policy, doi:10.3109/09687637.2014.936827.

Currently, there is no integrated population health framework for prescription opioids (i.e., an evidence-based approach toward the largest possible reductions of prescription opioid–related harms), though similar frameworks are well established for alcohol and illicit psychoactive drugs. Recent prescription opioid–focused policy initiatives launched in Canada present long lists of recommendations. However, the feasibility and impact of these initiatives on related harms are uncertain. In addition, the recommendations are notably silent on population health–based considerations and approaches. This article outlines prevention and treatment pillars for a population health framework that addresses prescription opioid–related harms and offers suggestions for implementation in Canada. It points to the urgent need to systematically review evidence on appropriate and effective use of prescription opioids in clinical care and translates the findings into guidelines and control mechanisms that clearly define and limit prescribing to instances supported by solid evidence and which benefit the patient. At the same time, the recommendations aim to eliminate excessive dosing and unjustified medical use. Dispensing controls are a critical means of environmental control. Current polysubstance overdose patterns show patients need strong warnings about interactions with alcohol and other drugs, as well as access to naloxone kits. Evidence on optimal treatment is also inadequate.

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Curb Prescription Drug Abuse at Work with Six Proactive Steps
Roy Maurer, Society for Human Resource Management
October 22, 2014

The National Safety Council recommends six steps for employers to maintain a safe work environment: 1) reevaluate the company's drug policy; 2) educate employees about the dangers of prescription pain reliever use and misuse; 3) train supervisors so they can act as the company's first line of defense; 4) promote the Employee Assistance Program; 5) include prescription medications in the drug-testing program; and 6) partner with healthcare and workers' compensation insurance providers.

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Journal Articles and Reports

J. Boyer, M. Droppa, J. Finneran, M. Smith, and A. Bernius. 2014. "Appreciative Inquiry: An Innovative New Strategy to Decrease Prescription Drug Abuse on a College Campus." Journal of Addiction Research and Therapy 5:195, doi:10.4172/2155-6105.1000195.

Appreciative Inquiry (AI) is a participatory research method developed in 1987 that helps companies and communities discover their strengths, enhance interconnections, and use social capital to produce a strategic plan addressing significant issues. New Hampshire recently prioritized AI as an evidence-based strategy. This article describes the state's 2013 AI effort to engage a college campus to decrease prescription drug abuse. The process involved 47 college students, faculty, administrators, and community partners. Several grassroots strategies emerged to decrease prescription drug abuse, including a vision for the college to be a national leader in prevention.

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L–Y. Chen, E.C. Strain, R.M. Crumb, C.L. Storr, and R. Mojtabai. 2014. "Sources of Nonmedically Used Prescription Stimulants: Differences in Onset, Recency and Severity of Misuse in a Population-Based Study." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.09.781.

According to 2006–11 National Survey on Drug Use and Health data, the most common sources of nonmedically used prescription stimulants were friends and relatives, followed by physicians and illegal sources. Compared with participants reporting friends and relatives as sources, logistic regression showed participants reporting an illegal source were more likely to be male, unemployed, have less than a high school education, have a history of criminal behavior, and have an earlier age of use onset. Participants reporting a physician source were more likely to have mental health problems and use mental health services. Those reporting physician or illegal sources had higher odds of past-month stimulant use, frequent use (≥10 days per year), drug dependence, and substance abuse/dependency treatment.

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N. Dasgupta, K. Creppage, A. Austin, C. Ringwalt, C. Sanford, and S.K. Proescholdbell. 2014. "Observed Transition from Opioid Analgesic Deaths Toward Heroin." Drug & Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.10.005.

From 2007 through 2013, 4,332 overdose deaths in North Carolina involved prescription opioids, 455 involved heroin, and 44 involved both drugs. Time-series analysis of the monthly ratio of prescription opioid-to-heroin overdose deaths revealed a marked shift toward heroin deaths, with the ratio falling from 16:1 to 3:1. The shift in overdose deaths started before the introduction of tamper-resistant opioid analgesics. Age of death from heroin overdose shifted toward younger adults. Most heroin and opioid analgesic deaths occurred in metropolitan areas, with little change between 2007 and 2013.

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D.A. Fiellin, R.S. Schottenfeld, C.J. Cutter, B.A. Moore, D.T. Barry, and P.G. O'Connor. 2014. "Primary Care–Based Buprenorphine Taper vs. Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial." JAMA Internal Medicine, doi:10.1001/jamainternmed.2014.5302.

A 14-week, 113-patient randomized trial found ongoing buprenorphine maintenance therapy was better than buprenorphine taper in primary care–based treatments for prescription opioid dependence. The buprenorphine taper was initiated after 6 weeks of stabilization, lasted for 3 weeks, and included medications for opioid withdrawal—after which patients were offered short-acting naltrexone treatment. The maintenance group received ongoing therapy. All patients received physician and nurse support and drug counseling. Researchers measured illicit opioid use via results of urinalysis and patient report, treatment retention, and reinitiation of buprenorphine therapy (taper group only). During the trial, the mean percentage of urine samples negative for opioids was lower for patients in the taper group (35.2 percent) than for patients in the maintenance group (53.2 percent). Once they were no longer receiving buprenorphine, patients in the taper group reported more days per week of illicit opioid use than those in the maintenance group (1.27 vs 0.47) and had fewer maximum consecutive weeks of opioid abstinence (2.7 vs 5.2). Patients in the taper group were far less likely to complete the trial (6 of 57 vs 37 of 56). Sixteen patients in the taper group reinitiated buprenorphine treatment because of a relapse.

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T.M. Haegerich, L.J. Paulozzi, B.J. Manns, and C.M. Jones. 2014. "What We Know, and Don't Know, About the Impact of State Policy and Systems-Level Interventions on Prescription Drug Overdose." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.10.001.

The authors searched the literature to identify evaluations of state policy or systems-level prescription drug overdose interventions. Eligible studies examined intervention effects on provider behavior, patient behavior, and health outcomes. Overall study quality was low, with a limited number of time-series or experimental designs. Knowledge and prescribing practices were measured more often than health outcomes (e.g., overdoses). Limitations included lack of baseline data and comparison groups, inadequate statistical testing, small sample sizes, self-reported outcomes, and short-term follow-up. Strategies that reduce inappropriate prescribing, use of multiple providers, and a focus on overdose response—such as prescription drug monitoring programs, insurer strategies, pain clinic legislation, clinical guidelines, and naloxone distribution programs—are widely viewed as promising. However, evidence of improved health outcomes, particularly from safe storage and disposal strategies and patient education, is weak.

Read more:

L. Kelly, J. Guilfoyle, J. Dooley, I. Antone, L. Gerber–Finn, R. Dooley, N. Brunton, K. Kakegamuck, J. Muileboom, W. Hopman, H. Cromarty, B. Linkewich, and J. Maki. 2014. "Incidence of Narcotic Abuse During Pregnancy in Northwestern Ontario: Three-Year Prospective Cohort Study." Canadian Family Physician 60(10):e493–98.

Researchers collected prospective data on 1,206 consecutive births from July 2010 to June 2013 in Sioux Lookout and its surrounding communities in northwestern Ontario (a catchment area of 28,000 First Nations residents), supplemented by retrospective data for 2009–10. Incidence of narcotic use in pregnancy rose from less than 10 percent to 28.6 percent. Controlled-release oxycodone was the reported drug of abuse in 87.2 percent of narcotic exposures. Intravenous use, which was quite rare in 2009–10, was the route of administration in 30 percent of cases in 2013, and daily use jumped. A prenatal narcotic maintenance and tapering program started in January 2012. Among program attendees, 22.3 percent stopped and 43.7 percent reduced narcotic use before delivery. Incidence of neonatal abstinence syndrome fell from 29.5 percent of narcotic-exposed births in 2010 to 18 percent in 2013.

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J. Manubay, J. Davidson, S. Vosburg, J. Jones, S. Comer, and M. Sullivan. 2014. "Sex Differences Among Opioid-Abusing Patients with Chronic Pain in a Clinical Trial." Journal of Addiction Medicine, doi:10.1097/ADM.0000000000000086.

This study evaluated sex differences in the demographic, diagnostic, and behavioral attributes of 162 patients (120 men and 42 women) with chronic pain who were abusing opioids. Participants had used prescription opioids for 5.4 +/- 6.7 years. The majority of participants (60 percent) had lower back pain and were opioid dependent. Pain exerted a greater effect in women on mood, depression, walking ability, and social relations. Men reported more abuse of alcohol and illicit drugs, unauthorized dose increases, contact with street culture, and arrests.

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R.K. McHugh, G.M. Fitzmaurice, K.M. Carroll, M.L. Griffin, K.P. Hill, A.D. Wasan, and R.D. Weiss. 2014. "Assessing Craving and Its Relationship to Subsequent Prescription Opioid Use Among Treatment-Seeking Prescription Opioid Dependent Patients." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.10.002.

Data from a multisite clinical trial of treatment for prescription opioid dependence were examined to evaluate if a brief, three-item craving scale administered weekly predicted urine-confirmed self-report of prescription opioid use in the subsequent week. Logistic regression controlling for opioid use in the previous week, treatment condition, and lifetime history of heroin use showed greater craving was associated with higher odds of prescription opioid use the following week. For each one-unit increase on a 10-point scale, the odds of using opioids in the subsequent week were 17 percent higher. Urges, cue-induced craving, and perceived likelihood of relapse were all significant predictors.

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The National Association of Medicaid Directors. 2014. "State Medicaid Interventions for Preventing Prescription Drug Abuse and Overdose: A Report for the National Association of Medicaid Directors."

This report describes the prescription drug abuse epidemic and its disproportionate impact on Medicaid programs. The report provides recommendations to assist states in curbing prescription drug abuse and overdoses.

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M.A. Petersen, L.S. Nørgaard, and J.M. Traulsen. 2014. "Going to the Doctor with Enhancement in Mind—An Ethnographic Study of University Students' Use of Prescription Stimulants and Their Moral Ambivalence." Drugs: Education, Prevention, and Policy, doi:10.3109/09687637.2014.970517.

The authors conducted ethnographic fieldwork and in-depth interviews with 20 students enrolled in New York City universities in 2013—all of whom used study drugs or had close friends who did. The analysis identified three themes. "The doctor prescribed them" illustrates how students use doctors to easily access study drugs and legitimize stimulant use because they have a prescription. "A good cause" shows that the purpose counts as a measure for stimulant use being considered morally acceptable. "Being responsible" refers to students regarding themselves as responsible stimulant users—particularly when not following a doctor's directions.

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A.M. Roth, R.A. Armenta, K.D. Wagner, S.C. Roesch, R.N. Bluthenthal, J. Cuevas–Mota, and R.S. Garfein. 2014. "Patterns of Drug Use, Risky Behavior, and Health Status Among Persons Who Inject Drugs Living in San Diego, California: A Latent Class Analysis." Substance Use and Misuse, doi:10.3109/10826084.2014.962661.

This report on a study of 511 drug injectors (51.5 percent white, 73.8 percent male, mean age 43.5 years) contrasts methamphetamine users (51 percent) and heroin users (49 percent). Multivariate analysis showed methamphetamine users were more likely to be HIV-positive and report prior sexually transmitted infections. Heroin users were more likely to be positive for Hepatitis C and report previous opioid overdose.

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C.L. Woolsey, R.D. Williams Jr, B.H. Jacobson, J.M. Housman, J.D. McDonald, J.H. Swartz, M.W. Evans Jr, T.E. Sather, A.E. Barry, and R.T. Davidson. 2014. "Increased Energy Drink Use as a Predictor of Illicit Prescription Stimulant Use." Substance Abuse, doi:10.1080/08897077.2014.969470.

This study expands the authors' earlier report from 267 to 605 undergraduate and graduate students who responded to an Internet survey at a large midwestern university. Of the respondents, 25.3 percent reported using prescription stimulant drugs in the past 30 days. Among nonmedical users, energy drink consumption continued to predict use. Odds of use increased by 14 percent with each additional day of energy drink consumption.

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E.R. Zaaijer, J. Bruijel, P. Blanken, V. Hendriks, M.W.J. Koeter, M.J. Kreek, J.Booij, A.E. Goudriaan, J.M. van Ree, and W. van den Brink. 2014. "Personality as a Risk Factor for Illicit Opioid Use and a Protective Factor for Illicit Opioid Dependence." Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2014.09.783.

Researchers used the popular Cloninger's Temperament and Character Inventory to examine the role of personality as a risk factor for opioid use and protective factor for the development of opioid dependence. They compared personality factors between three groups: 1) 161 never-dependent illicit opioid users; 2) 402 dependent opioid users in methadone maintenance treatment or heroin-assisted treatment; and 3) 135 healthy controls who never used heroin. Never-dependent opioid users reported more Novelty Seeking and Harm Avoidance and less Self-Directedness and Cooperativeness than healthy controls, and more Reward Dependence and Self-Directedness and less Harm Avoidance than dependent opioid users. Never-dependent opioid users reported more Self-Transcendence than dependent opioid users and healthy controls.

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Professional Education

S. Bowman, A. Engelman, J. Koziol, L. Mahoney, C. Maxwell, and M. McKenzie. 2014. "The Rhode Island Community Responds to Opioid Overdose Deaths." Rhode Island Medical Journal 97(10):34–7.

This article describes Rhode Island's efforts to facilitate community- and treatment-oriented approaches to address opioid-involved overdoses and substance use disorders. Strategies addressing this crisis have largely focused on increasing access to naloxone and high-quality and timely treatment and recovery services.

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K.M. Fain and G.C. Alexander. 2014. "Disposing of Medicines Safely." American Journal of Public Health, doi:10.2105/AJPH.2014.302296.

In response to the systematic review by King et al. analyzing opioid-related mortality in North America, the authors suggest using pharmacy take-back programs.

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T.C. Green, J. Bratberg, E.F. Dauria, and J.D. Rich. 2014. "Responding to Opioid Overdose in Rhode Island: Where the Medical Community Has Gone and Where We Need to Go." Rhode Island Medical Journal 97(10):29–33.

This article explores the response of Rhode Island's medical community to the local opioid overdose epidemic and proposes strategies to create a more collaborative and comprehensive response. Needed improvements include preventing, identifying, and treating opioid addiction; providing overdose education; and ensuring access to naloxone.

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S.A. Grenald, T.M. Largent–Milnes, and T.W. Vanderah. 2014. "Animal Models for Opioid Addiction Drug Discovery." Expert Opinion on Drug Discovery, doi:10.1517/17460441.2014.966076.

This paper discusses activation of reward circuitry and compensatory receptor mechanisms associated with opioid addiction. It reviews neuroadaptive changes that animal models suggest arise during opiate dependence, withdrawal, and relapse.

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E. Samuels. 2014. "Emergency Department Naloxone Distribution: A Rhode Island Department of Health, Recovery Community, and Emergency Department Partnership to Reduce Opioid Overdose Deaths." Rhode Island Medical Journal 97(10):38–9.

In response to increasing rates of opioid overdose deaths, the Rhode Island Department of Health, local emergency physicians, and Anchor Community Recovery Center designed an emergency department (ED) naloxone distribution and peer-recovery coach program. Patients at risk for overdose are offered a take-home naloxone kit, patient education video, and—when available—an Anchor peer recovery coach to provide support and referral to treatment. The program was launched at three EDs in August 2014.

Read more:


Drug Maker Warns That OxyContin Suit Could Be 'Crippling'
David Armstrong, Bloomberg
October 20, 2014

Kentucky filed a civil suit against Purdue Pharma LP, maker of OxyContin, alleging the company trained its sales force to falsely portray the drug as difficult to abuse—even though its own study found a drug abuser could extract most of the active ingredient from a tablet by crushing it. The suit also alleges Purdue Pharma concealed information about OxyContin's dangers. The 12 claims against the company include Medicaid fraud, false advertising, creating a public nuisance, and unjust enrichment. A trial might provide the first detailed public airing of how Purdue Pharma marketed OxyContin to doctors and patients, along with disclosures about whether company officials understood how easily their pills could be abused. The company has already lost initial procedural decisions and claims it cannot get a fair trial in Pike County. Purdue Pharma's chief financial officer said a judgment of $1 billion or more would have a crippling effect on operations and jeopardize long-term viability.

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Official: Hundreds of Miners Tested Positive for Drug Use in Past Two Years
Ashton Marra, West Virginia Public Broadcasting
October 20, 2014

The Director of the West Virginia Office of Miner's Health, Safety and Training reported to the Joint Committee on Labor and Worker Safety Issues that 555 individuals (to date) have had their mining certifications temporarily suspended because of failed drug tests. Seventy-nine of these individuals have been reinstated through the appeals process, and 69 individuals are seeking treatment. Two hundred and sixty-nine will wait the 3-year period required before their certifications can be returned. In the drug-screening process, prescription drugs are most commonly found, followed by marijuana. (Includes audio: 59 seconds)

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Government of Canada Tackles Drug Abuse Among Teens Through New Marketing Campaign
Health News Network
October 21, 2014

The Honorable Lisa Raitt, Minister of Transport, launched Canada's new marketing campaign, equipping parents with the information and tools they need to talk with their teenagers about prescription drug abuse and marijuana. The campaign will run until December 2014, including 7 weeks on television and 10 weeks on Web and social media platforms. Campaign ads illustrate the harmful effects of prescription drug abuse and marijuana use on teenagers' developing brains and bodies.

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Drug-Impaired Driving: A Fatal Issue for Canadian Teens
October 22, 2014

In Canada, the number of teen fatalities from auto collisions who tested positive for drugs rose significantly between 2000 and 2010, to a level comparable with those who tested positive for alcohol. In 2000, more fatally injured 16- to 19-year-old drivers tested positive for alcohol than for drugs (40.3 percent versus 23.6 percent). In 2010, alcohol-related fatalities decreased to 36.6 percent. Drug-related fatalities increased to 39.2 percent, including 28.6 percent for marijuana.

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DEA Launches New Initiative to Combat Illegal Prescription Drug Activity
United States Drug Enforcement Administration
October 22, 2014

The Drug Enforcement Administration (DEA) announced its first-ever federally administered tip line in Arizona. The anonymous Texting Tip Line, TIP411, allows anyone with a cell phone to quickly and easily report suspicious prescription drug activity in real time to a DEA agent. Web tips can also be submitted anonymously. In conjunction with the launch, the DEA is sending educational packets to more than 1,200 Arizona pharmacies. The packet includes a Prescription Drug Intelligence Alert, a "Pharmacist's Guide to Prescription Fraud," a TIP411 flyer, and a refrigerator magnet.

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FDA Approves Labeling with Abuse-Deterrent Features for Third Extended-Release Opioid Analgesic
United States Food and Drug Administration
October 17, 2014

The Food and Drug Administration approved new labeling for Embeda (morphine sulfate and naltrexone hydrochloride) extended-release capsules marketed by Pfizer. The new labeling states Embeda has properties expected to reduce oral abuse when crushed. Taken properly, the drug works by releasing only the morphine in the capsule. When crushed, Embeda's naltrexone blocks some of the morphine's euphoric effects and can precipitate withdrawal in opioid-dependent people. When swallowed intact, the drug can still be abused or misused.

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NABP Issues Policy Statement Supporting the Pharmacist's Role in Increasing Access to Opioid Overdose Reversal Drug
National Association of Boards of Pharmacy
October 20, 2014

The National Association of Boards of Pharmacy (NABP) issued a policy statement promoting an active role for pharmacists in expanding naloxone access and commending municipalities for successfully reversing overdoses.

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Other State and Local News

Overdose Deaths Rise in Pa., N.J.
October 21, 2014

The National Center for Health Statistics reported New Jersey and Pennsylvania had among the biggest increases in overdose deaths nationwide between 2010 and 2012. During this period, New Jersey's drug fatality rate rose 40 percent—the second-biggest surge after Alaska's. Because of that increase, New Jersey's ranking in drug-death rates soared from 41st in 2010 to 18th. Pennsylvania's drug fatality rate increased 23 percent between 2010 and 2012—mostly in the first year. The state ranked eighth nationally in drug deaths in 2012, with 2,365 fatalities.

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Wyoming Ranks 15th in Nation Per-Capita for Prescription Drug Abuse
Tony Cedrone, KCWY
October 21, 2014

Wyoming has the 15th highest drug overdose mortality rate per capita in the country. Drug overdoses have tripled in the past 15 years, with the majority from prescribed medications. Some people become addicted to prescription drugs, while others take them from family and friends. Experts said it is important for parents to be aware of medicines their children are taking, and to properly dispose of unused drugs. (Includes video: 2:06 minutes)

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AG Conway Takes Keep Kentucky Kids Safe Message to Bourbon County
State of Kentucky
October 20, 2014

As part of the Keep Kentucky Kids Safe program, Attorney General Jack Conway visited Bourbon County Middle School to share his message about the dangers of prescription drug abuse and heroin. In many parts of Kentucky, heroin is replacing prescription pain relievers as the drug of choice. Since launching the Keep Kentucky Kids Safe program in 2010, Atty. Gen. Conway and his partners have reached more than 40,000 students, teachers, and parents.

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Ex-Soldier Returns to Fight Substance Abuse in Military
Dustin Racioppi, USA Today
October 18, 2014

Frank L. Greenagel Jr. was discharged from the Army 10 years ago. Soon, the 38-year-old will report for duty with the Pennsylvania National Guard, where he will serve as a behavioral health officer counseling soldiers who have substance abuse problems and post-traumatic stress disorder. Greenagel was strongly influenced to rejoin the military when he treated a former Marine who became addicted to prescription drugs and heroin after being wounded.

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Legislation Aims to Make it Easier to Dispose of Old, Unused Prescriptions
Andrew Kitchenman, NJ Spotlight
October 20, 2014

New Jersey legislators are considering a bill that would allow Project Medicine Drop to expand its drop boxes to police stations statewide. The bill would also require the state to provide drop boxes at the offices of other interested agencies as funding becomes available. Any police department that does not have a drop box would be required to post a public notice indicating where the nearest drop-off container is located. In addition, the state would continue to maintain a current list of all drop-off locations on its website.

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DPHHS: Help Prevent Prescription Drug Abuse Among Teens, Young Adults
State of Montana
October 20, 2014

As part of National Medicine Abuse Awareness Month, Montana Department of Public Health and Human Services officials are urging parents to stay vigilant about preventing prescription drug abuse among teens and young adults. Parents can start by locking up medications and properly disposing them. They should talk with and listen to their teens about prescription drug use.

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Health Alert: Xanax Abuse
Catherine Bosley, WOIO
October 20, 2014

Dr. Howard Mell with the American College of Emergency Physicians stated that Xanax is linked to approximately 120,000 emergency room (ER) visits each year. Dr. Mell sees about 1 in 10 Xanax-related overdose cases while working at his Cleveland-area ER. He says people easily misuse the drug—sometimes just one alcoholic drink taken with Xanax can be deadly. According to Dr. Mell, victims are more often from higher socioeconomic status.

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S.F. Supervisor Proposes Drugmakers Fund Take-Back Program
Stephanie M. Lee, San Francisco Chronicle
October 20, 2014

Supervisor David Chiu plans to introduce legislation before the San Francisco Board of Supervisors that would require drug makers to fund the disposal of unused and unwanted medications. Alameda County became the first in the nation requiring pharmaceutical companies to pay for a drug take-back program, which puts San Francisco on safe legal ground to make pharmaceutical companies participate. If passed, Chiu's law would set up take-back sites at all retail and healthcare facilities that sell drugs. It would require makers of drugs sold in San Francisco to cover the program's administrative and operational costs.

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Vigo County First Sheriff's Dept. in Indiana to Carry, Administer Opiate Overdose Antidote
October 22, 2014

The Vigo County Sheriff's Department will soon become the first sheriff's office in Indiana to carry Narcan.

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New Initiative to Help Heroin Addicts
Jeff Jenkins, West Virginia MetroNews Network
October 21, 2014

U.S. Attorney Booth Goodwin said people arrested for heroin use in Kanawha Valley are offered immediate treatment. The best candidates for the program are local residents who have a good support system.

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N.J. Lawmakers Hear from Experts on Rising Heroin, Painkiller Addiction
John Reitmeyer, The Record
October 23, 2014

The New Jersey Assembly's Health and Senior Services Committee approved a bill that would require better reporting and analysis of the state's drug overdose data. The committee also approved a measure extending immunity for people reporting overdoses to law enforcement officials who dispense opioid antidotes.

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NJ Convenes Pain Management Council, to Develop Best Practices for Managing Pain While Maintaining Controls Against Rx Drug Diversion and Abuse
October 21, 2014

The New Jersey State Division of Consumer Affairs convened the inaugural meeting of its Pain Management Council—an advisory group that reviews professional standards and regulations for healthcare professionals who prescribe or dispense prescription drugs. Over the next several months, the advisory group will help the Division of Consumer Affairs develop a set of best-practice recommendations for New Jersey's healthcare professionals.

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Two Sisters Accused of Stealing Prescription Drugs from Midland Homes
Lauren Tropea, KMID
October 21, 2014

Real estate agent Melissa Williams and her sister, Melanie Zellner, were accused of stealing prescription opioids from homes they showed in Midland, Texas. The two were caught after a resident reported hydrocodone theft. When police put them under surveillance, they found a bottle of hydrocodone in Zellner's purse. She had replaced the medication with Excedrin. The sisters confessed to entering residences and stealing pills for the past 2 months. (Includes video: 2:22 minutes)

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Michigan Aims to Curb Prescription Drug Misuse
Detroit Free Press
October 20, 2104

The Michigan Department of Community Health announced the launch of a new website, "Do Your Part: Be the Solution," to increase public awareness of risks and potential harm associated with prescription and over-the-counter drug misuse.

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New Program to Prevent Underage Drinking and Prescription Drug Abuse
October 21, 2014

The Comanche Nation launched IAMNDN (Native Drug-Free Nations), a program that focuses on curbing underage drinking and prescription drug abuse among Native American youth. More than 5,000 Native American students ages 12 to 20 are being targeted across southwest Oklahoma. The group launched a public service campaign with posters and pamphlets.

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Other Resources

Prescription Drug Overdose Deaths in the U.S.
National Institute on Drug Abuse
Updated October 2014

This infographic shows the number of overdose deaths involving prescription drugs, opioid analgesics, benzodiazepines, cocaine, and heroin from 2001 to 2011. The highest rise was seen in deaths involving benzodiazepines (with a sixfold increase from 2001 to 2011), followed by deaths involving prescriptions opioid pain relievers (with a threefold increase), and deaths involving heroin (with a 2.5-fold increase).

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The State of Drug Use in America, in 9 Maps
Kevin Short, The Huffington Post
October 22, 2014

This infographic shows how American substance use has shifted drastically in recent decades. Maps display the drugs most commonly cited at treatment admissions in each state, counties with the worst opioid and heroin problems, and changes in drug overdose mortality rates in states with good samaritan laws and laws expanding naloxone access.

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FSMB Foundation Releases Updated Book Aimed at Curbing Opioid Abuse
October 23, 2014

The Federation of State Medical Boards (FSMB) Foundation published an updated and expanded edition of Responsible Opioid Prescribing: A Clinician's Guide. The book is intended to help address the rise of opioid abuse and related deaths by better educating physicians and other clinicians about risks and proper use. It expands information on model guidelines adopted by FSMB in 2013, Food and Drug Administration labeling, and opioid overdose prevention. The book includes portions of the Substance Abuse and Mental Health Services Administration's Opioid Overdose Prevention Toolkit.

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The Rx for Managing Lawful Prescription Drug Use in the Workplace
Honigman Miller Schwartz and Cohn LLP
November 6, 2014
12 to 1 p.m. (EST)

In this Webinar, Honigman partners Cameron Evans and Tara Mahoney will explain the recent ruling of Bates v. Dura Automotive Systems, and how the ruling affects an employer's management of lawful prescription drug use in the workplace. They will also discuss options companies should consider when approaching drug-testing policies and practices in light of the recent ruling.

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Grants Awarded

DHSS Receives $10 Million Federal Grant for Substance Abuse Prevention Services in Del.
October 20, 2014

The Delaware Department of Health and Social Services (DHSS) received a $10 million grant from the Substance Abuse and Mental Health Services Administration for its Partnership for Success program. The program will focus on preventing underage drinking among 12- to 20-year-olds and prescription drug abuse among 12- to 25-year-olds. DHSS will use a competitive bid process to engage community-based nonprofit and for-profit organizations whose missions and target populations meet the grant's requirements.

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Angels Camp Police Receive Grant to Catch Impaired Drivers
The Record
October 23, 2014

The Angels Camp Police Department received a $119,000 grant from the California Office of Traffic Safety to get alcohol- and drug-impaired drivers off the roads.

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Request for Proposal

Chronic Pain Management Research Grant
Milbank Foundation
Postmarked by November 1, 2014

Interventions for Youth Who Misuse/Abuse Prescription Stimulant Medications in High School and/or College-Attending Youth (U01)
National Institutes of Health
Deadline: November 13, 2014, by 5 p.m.

Take-Back Events and Drop Boxes

Leftover Prescriptions? Drop Them Off at Loyola During Take-Back Day
Loyola University Health System (Illinois)
October 20, 2014

Arkansas Prescription 'Take Back' Program One of Nation's Most Successful
State of Arkansas
October 23, 2014

Medication Drop-Off Event Collects Nearly 2,000 Pounds of Medication in Muskegon County
Dillion Davis, MLive Media Group (Michigan)
October 21, 2014

369 Pounds of Medications Collected in Calaveras County During 'Drop the Drugs' Day
Kim Hamilton, The Pine Tree (California)
October 20, 2014

Teen Organizes Prescription Drug Take Back
Cornelius Hocker, KULR (Montana)
October 19, 2014

La Marque PD Gets a Drug Drop-Off Box
Robert Stanton, Houston Chronicle (Texas)
October 21, 2014

Medication Drop Box Available at New Milford Police Department
Susan Tuz, The News-Times (Connecticut)
October 21, 2014

Drug Drop Off Box Coming to Turlock Police Department
Sabra Stafford, Turlock Journal (California)
October 17, 2014

Upcoming Conferences and Workshops

Empowered Health Consciousness and Prescription Drugs: Facilitator Certification Training with Special Focus on Workplace and Parents
Organizational Wellness
November 4, 2014

The Role of the Prescriber in Prescription Drug Abuse 2014
The Academy of Medicine of Cleveland and Northern Ohio (AMCNO)
November 8, 2014
7:30 a.m. to 12:30 p.m.
AMCNO Executive Offices
Park Center Plaza I
6100 Oak Tree Blvd., Lower Level Meeting Room
Independence, Ohio

This session is intended for physicians and healthcare providers in family medicine, internal medicine, emergency medicine, addictionology, pain medicine, psychiatry, dentistry, obstetrics, and nursing.

Read more:

Sixth Annual American Medicine Chest Challenge: National Day of Awareness and Safe Disposal of Rx and OTC Medicine
American Medicine Chest Challenge
November 8, 2014

142nd Annual Meeting and Exposition
American Public Health Association
November 15–19, 2014
New Orleans, Louisiana

National Rx Drug Abuse Summit
April 6–9, 2015
Atlanta, Georgia
The Weekly Update is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoint or opinion and are not assessed for validity, reliability or quality. The Weekly Update should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full text of journal articles listed in the Weekly Update.