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October 30, 2013

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SAMHSA
SAMHSA Prescription Drug Abuse Weekly Update
WEEKLY
UPDATE
ISSUE 43 | 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 Journal Articles and Reports News Other State and Local News Videos Grant Announcement Grants Received Take-Back Events and Drop Boxes Upcoming Conferences and Workshops

Featured Articles

Some Teens Find New Ways to Abuse Prescription Drugs
Yahoo Video
October 24, 2013

Doctors warn parents that teens are melting lollipops or hard candy, mixing in prescription drugs, then reforming and rewrapping the drug-laced candies, which allows them to mask prescription drug abuse. (Duration:1:58 minutes)

Read more:
http://finance.yahoo.com/video/teens-ways-abuse-
prescription-drugs-014032898.html

D. Fulton–Kehoe, R.K. Garg, J.A. Turner, A.M. Bauer, M.D. Sullivan, T.M. Wickizer, and G.M. Franklin. 2013. "Opioid Poisonings and Opioid Adverse Effects in Workers in Washington State." American Journal of Industrial Medicine. doi:10.1002/ajim.22266.

Researchers calculated rates of opioid poisonings and adverse effects and examined opioid prescriptions in the Washington State workers' compensation system from 2004 to 2010. Using data from the Health Care Cost and Utilization Project Nationwide Inpatient Sample, they also calculated national rates of opioid poisonings and adverse effects from 1993 to 2010. Nationally, rates of opioid poisonings and adverse effects increased significantly during that period. The authors identified 96 opioid poisonings and 312 opioid-related adverse effects in Washington from 2004 to 2010. Rates in Wash. workers' compensation did not change substantially over that time. Most poisonings and adverse effects occurred in cases without chronic opioid use and with prescribed doses <120 mg/day morphine-equivalent dose. Since many poisonings and adverse effects occurred in patients without high-dose or long-term opioid therapy, opioid dosing and duration guidelines may not be sufficient to reduce morbidity related to prescription opioid use.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/ajim.22266/abstract;jsessionid=71C20CB84AE224
CBE29287480BFFB08F.f01t02

Journal Articles and Reports

P.M. Coplan, K. Hrishikesh, L. Sandstrom, C. Landau, and H.D. Chilcoat. 2013. "Changes in Oxycodone and Heroin Exposures in the National Poison Data System After Introduction of Extended-Release Oxycodone with Abuse-Deterrent Characteristics." Pharmacoepidemiology and Drug Safety. doi:10.1002/pds.3522.

This study evaluated the effects of physicochemical barriers to crushing and dissolving on safety outcomes associated with extended-release oxycodone (ERO) tablets (OxyContin) using a national surveillance system of poison centers. Other single-entity (SE) oxycodone tablets and heroin were used as comparators and to assess substitution effects. The National Poison Data System covering all U.S. poison centers was used to measure changes in exposures in the year before versus the 2 years after introduction of reformulated ERO (July 2009–June 2010 vs. September 2010–September 2012). Outcomes included abuse, therapeutic errors affecting patients, and accidental exposures. After ERO reformulation, abuse exposures decreased 36 percent for ERO, increased 20 percent for other SE oxycodone, and increased 42 percent for heroin. Therapeutic errors affecting patients decreased 20 percent for ERO and increased 19 percent for other SE oxycodone. Accidental exposures decreased 39 percent for ERO, increased 21 percent for heroin, and remained unchanged for other SE oxycodone. During the study period, other interventions to reduce opioid abuse occurred—for example, educational and prescription monitoring programs. However, these interventions are thought to have only small effects. More important, the interventions cannot explain the drop in incidents involving ERO exposures with unchanged incidence rate for other opioids. In conclusion, after ERO reformulation, calls to poison centers involving abuse, therapeutic errors affecting patients, and accidental exposures decreased for ERO, but not for comparator opioids. Abuse-deterrent formulations of opioid analgesics can reduce abuse, but switching to other accessible non–abuse-deterrent opioids might occur.

Read more:
http://onlinelibrary.wiley.com/doi/10.1002/pds.3522/abstract

J. A. Gershman. 2013. "Implementing a Medication Safety and Poison Prevention Program at a Senior Center." The Consultant Pharmacist 28(10):670–71. doi:10.4140/TCP.n.2013.670.

This article discusses a medication-safety education session conducted at a local senior center by a pharmacy professor and students. The author attended a train-the-trainer Webinar to educate pharmacy students. Senior center participants were taught about poison prevention, drug interactions, and appropriate drug disposal through an interactive format. Researchers plan to continue the medication safety program at the center as a longitudinal project to promote patient safety. The author opines that pharmacists should be encouraged to play an active role in community outreach programs.

Read more:
http://ascp.metapress.com/content/47668023q6v104u5/?genre=article&id=doipercent3a10.4140percent2fTCP.n.2013.670

E. Girotto, A.E. Mesas, S. Maffei de Andrade, and M.M. Birolim. 2013. "Psychoactive Substance Use by Truck Drivers: A Systematic Review." Occupational Environmental Medicine. doi:10.1136/oemed-2013-101452.

Researchers performed a systematic review in the PubMed, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, and Cochrane databases. The review yielded 36 cross-sectional studies with quantitative results about the use of psychoactive substances among truck drivers. Of these studies, 28 were carried out in countries with large land areas, and 23 obtained their information through self-reporting. The most frequently studied substances were alcohol (n=25), amphetamines (n=17), marijuana (n=16), and cocaine (n=13). Prevalence of use of these substances varied greatly: alcohol (0.1–91.0 percent), amphetamines (0.2–82.5 percent), marijuana (0.2–29.9 percent), cocaine (0.1–8.3 percent). Substance use frequency was lower in studies that investigated the presence of these substances in biological samples than in those based on self-reported use. In 12 studies that evaluated factors associated with intake of psychoactive substances, the following stood out: younger age, higher income, longer trips, alcohol consumption, driving the night shift, traveling interstate routes, long or short sleep periods, fewer hours of rest, little experience, connection with small- and medium-sized companies, income below levels determined by labor agreements, productivity-based earnings, and prior involvement in accidents. The frequency of psychoactive substance use among truck drivers seems to be high, although that varies greatly according to the type of substance and method for collecting the information. Use of these substances was mainly associated with indicators of poor working conditions.

Read more:
http://oem.bmj.com/content/early/2013/09/13/oemed-2013-101452.abstract

M. Maarefvand, H.R. Ghiasvand, and H. Ekhtiari. 2013. "Drug Craving Terminology Among Opiate Dependents; A Mixed Method Study." Iranian Journal of Psychiatry 8(2):97–103.

This study examined craving terminology among different groups of Persian-speaking Iranian opiate dependents. Drug-craving terms were listed by 36 ex-opiate dependents in focus group discussions during the first study phase and based on the Craving Terms Questionnaire. In the second phase, 120 subjects in three groups of opiate dependents and a group of Current Opiate Abusers rated use frequency of each term in the questionnaire under a Twelve-Step Program, Methadone Maintenance, and Other Abstinence-Based Programs. Eighty-nine terms were categorized in stimulation and triggering, attention bias and obsession, decision-making difficulty, information processing impairment, withdrawal induction, drug euphoric experience, mental urge, motor control problem, negative balancing, and stigmatizing. Terms for the three categories of mental urge, attention bias and obsession, and motor control problem were used more than others. Patients in Methadone Maintenance Treatment used different categories of craving terms in comparison with other groups. Abstinent cases reported a higher total score for craving terms in comparison with others in Twelve-Step Programs and Other Abstinence-Based Programs. Each craving-related term is associated with some aspect of the multidimensional concept of craving. A drug-craving thesaurus could provide a better understanding of craving nature from a drug-dependent point of view. There are differences among abstinence- vs. maintenance-based-treated opiate dependents in using craving terms. Addiction therapists will benefit from accessing drug dependents' lexicon to create therapeutic alliances with their clients.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/24130609

R.M. Merrill and A.A. Sloan. 2013. "Drug Combinations Contributing to Death According to Mental Health Status." Mental Health and Substance Use. doi:10.1080/17523281.2013.841748.

This retrospective cohort study examined all drug overdose deaths in Utah from 2005 through 2010 (2,843 total). Data were extracted from Office of the Medical Examiner records. Frequencies, percentages, and rates were used to describe the decedents, and bivariate analyses were performed and assessed using the chi-square test. Decedents with mental and physical health problems were analyzed separately from those with only mental health challenges to account for potential confounding. Half of drug overdose decedents had mental illness—of those, 40 percent also had physical health challenges. Although most deaths overall involved combinations with opiates, only decedents with anxiety were significantly more likely to have opiates implicated in their death (rate ratio [RR]=1.60, 1.04–2.47), while those with schizophrenia were significantly less likely (RR=0.51, 0.29–0.90). Decedents with bipolar disorder, depression, anxiety, or schizophrenia were more likely to have fatally overdosed on drug combinations involving antidepressants and non-prescription medication, and those with mental but not physical illness were less likely to have overdosed on illicit drugs or alcohol. Mentally ill individuals who are currently taking prescription medication should be considered an at-risk group in planning future drug interventions, as many drug combinations involved in their deaths were positively linked to drugs known to alleviate symptoms and infrequently linked to illicit drugs or alcohol.

Read more:
http://www.tandfonline.com/doi/abs/10.1080/17523281.2013.841748

G.M. Reisfield and L.R. Webster. 2013. "Benzodiazepines in Long-Term Opioid Therapy." Pain Medicine 14(10):1441–46. doi:10.1111/pme.12236.

Researchers highlight actual and potential problems associated with benzodiazepines in long-term opioid therapy for anxiety and mood disorders, insomnia, and other indications and offer recommendations concerning co-prescriptions. They draw conclusions about the safety and efficacy of benzodiazepine therapy and discuss treatment admissions related to substance use disorders.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/pme.12236/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

S.C. Sigmon, K.E. Dunn, K. Saulsgiver, M.E. Patrick, G.J. Badger, S.H. Heil, J.R. Brooklyn, and S.T. Higgins. 2013. "A Randomized, Double-Blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers." JAMA Psychiatry. doi:10.1001/jamapsychiatry.2013.2216.

Researchers conducted a double-blind, 12-week randomized clinical trial at an outpatient research clinic. Following a brief period of buprenorphine stabilization, 70 prescription opioid–dependent adults were randomized to receive 1-, 2-, or 4-week tapers followed by naltrexone therapy. During phase 1 (weeks 1–5 after randomization), participants visited the clinic daily; during phase 2 (weeks 6–12), visits were reduced to three times weekly. Participants received behavioral therapy and urine toxicology testing throughout the trial. Opioid abstinence at the end of phase 1 was greater in the 4-week taper compared with the 2- and 1-week taper conditions (P=.02), with 63 percent (n=14), 29 percent (n=7), and 29 percent (n=7) of participants abstinent in the 4-, 2-, and 1-week conditions, respectively. Abstinence at the end of phase 2 was also greater in the 4-week condition compared with the 2- and 1-week conditions (P=.03), with 50 percent (n=11), 16 percent (n=4), and 20 percent (n=5) of participants abstinent in the 4-, 2-, and 1-week conditions, respectively. There were more treatment responders in the 4-week condition (P=.03), with 50 percent (n=11), 17 percent (n=4), and 21 percent (n=5) of participants in the 4-, 2-, and 1-week groups considered responders at the end of treatment, respectively. Retention and naltrexone ingestion also were superior in the 4-week vs. briefer tapers (both P=.04). Experimental condition was the strongest predictor of treatment response, followed by buprenorphine stabilization dose.

Read more:
http://archpsyc.jamanetwork.com/article.aspx?articleid=1761270

L.R. Webster. 2013. "Pills, Polices, and Predicaments: The Unintended Consequences of a Health Care System's Policy Toward Opioids." Pain Medicine 14(10):1439–40. doi:10.1111/pme.12271.

This article suggests several public health initiatives to address the prescription drug abuse crisis. Office of National Drug Control Policy data revealed young people abuse prescription drugs second only to marijuana, and one third of people who start using illicit drugs begin with prescription drugs. Suggested efforts include aggressive dissemination of information through public and patient educational programs about prescription drug overuse.

Read more:
http://onlinelibrary.wiley.com/doi/10.1111/pme.12271/abstract

E. Wood, J.H. Samet, and N.D. Volkow. 2013. "Viewpoint: Physician Education in Addiction Medicine." JAMA 310(16):1673-74. doi:10.1001/jama.2013.280377.

Researchers argue that the medical community fails to diagnose and treat substance use disorders, in part because of the failure to educate physicians about addiction medicine.

Read more:
http://jama.jamanetwork.com/article.aspx?articleid=1758759

News

Commentary: DEA and You—Ending the Epidemic of Prescription Drug Abuse Together
The Partnership at Drugfree.org
October 25, 2013

Michele Leonhart, an administrator at the Drug Enforcement Administration (DEA), shares her views about the DEA's efforts to reduce prescription drug abuse. The DEA regulates access to dangerous substances and ensures manufacturers, distributors, doctors, and pharmacists are properly licensed and have sufficient controls to minimize the risk of diversion of dangerous controlled prescription drugs. DEA is in the process of finalizing regulations as part of the Secure and Responsible Drug Disposal Act that will allow for a permanent nationwide solution to the disposal of controlled substances. Until then, it will continue to sponsor National Prescription Drug Take-Back events.

Read more:
http://www.drugfree.org/join-together/government/commentary-dea-and-you-ending-the-
epidemic-of-prescription-drug-abuse-together?utm_source=Join%20Together%20
Daily&utm_campaign=d8d7144325-JT_Daily_News_FDA_Recommends&utm_medium=
email&utm_term=0_97f4d27738-d8d7144325-221990529

NIDA's Drug Abuse Information for Teens Goes Mobile
National Institutes of Health
October 21, 2013

As part of National Substance Abuse Prevention Month, the National Institute on Drug Abuse (NIDA) announced that teens and adults can more easily find answers to questions about drug abuse and addiction and by using smartphones and tablets. NIDA's improved Parents and Educators page makes it more straightforward for caregivers and teachers to find free, scientifically based prevention and education resources. Teachers can obtain resources for elementary, middle, and high school students. Spanish language information on drug abuse and addiction are also available.

Read more:
http://www.nih.gov/news/health/oct2013/nida-21.htm

FDA Urging a Tighter Rein on Painkillers
The New York Times
October 24, 2013

The Food and Drug Administration recently recommended tighter controls on narcotic pain reliever prescribing. The change, expected to take place next year, involves reclassification of hydrocodone-containing pain relievers from Schedule III to Schedule II drugs. It would reduce the number of refills patients could get before going back to their doctors. Patients would also be required to take a prescription to a pharmacy. The new regulations would halve the supply of the drug a patient could obtain without a new prescription. The FDA recommendation may affect the availability of the drugs, how pharmacies operate, and the types of medical professionals who can prescribe the medications. The recommendation requires approval from the Department of Health and Human Services and adoption by the Drug Enforcement Administration.

Read more:
http://www.nytimes.com/2013/10/25/business/fda-seeks-tighter-control-on-prescriptions-
for-class-of-painkillers.html?_r=0

Risk and Protective Factors Associated with Nonmedical Use of Prescription Drugs: A Review of Literature
Substance Abuse and Mental Health Services Administration Center for the Application of Prevention Technologies
September 2013

This study used a social–ecological framework to identify risk and protective factors related to nonmedical use of prescription drugs. The review covered articles published between 2006 and 2012, a range of dates dictated by available resources and the view that recent (post-2005) articles would be more relevant for planning prevention activities. The review centered on U.S. samples of adolescents and older adults. While all classes of prescription drugs were examined, specific focus was placed on opioid/pain reliever prescription drugs—the most common class of prescription drugs used for nonmedical purposes. Most articles concentrated on youth and identified risk but not protective factors.

Read more:
http://captus.samhsa.gov/sites/default/files/capt_resource/nmupd_rp_literature_review_
final_for_web_10-22-13.pdf

Is Suboxone a Wonder Drug that Helps Heroin Addicts Get Clean—Or Just Another Way to Stay High?
The Village Voice News
October 23, 2013

This article discusses Suboxone use from a drug addict's point of view and medical practitioners' perspectives. Chris uses Suboxone to sustain himself until his next bag of heroin arrives. He first bought the drug from a friend who had a prescription and eventually found a physician willing to prescribe him 24 milligrams a day. Chris sells the rest on Craigslist. Addicts buy Suboxone from dealers when they can no longer afford their drug of choice or to get sober temporarily. Dana Jane Saltzman, an internist in New York, is authorized to prescribe Suboxone. Most of her Suboxone patients are white-collar workers with a pain pill addiction.

Read more:
http://www.villagevoice.com/2013-10-23/news/suboxone-reckitt-benckiser-cure-for-heroin-addiction-or-black-market-bonanza

Document Security Systems Announces Partnership with National Association of Drug Diversion Investigators
The Wall Street Journal
October 21, 2013

Document Security Systems (DSS) announced a partnership with the National Association of Drug Diversion Investigators (NADDI) to help NADDI's members and consumers combat drug diversion and counterfeit. They will have access to DSS's AuthentiSite technology as part of an initiative to standardize prescription drug authentication. AuthentiSite can be employed to verify Web sites for prescription drug purchases and validate pharmaceutical product information lists of authorized suppliers. It provides Web site authentication from a smartphone application by scanning a seal to verify the site represents a true, licensed reseller.

Read more:
http://online.wsj.com/article/PR-CO-20131022-907602.html

CVS/Pharmacy Launches National Medication Disposal for Safer Communities Program
The Wall Street Journal
October 23, 2013

This press release announces the launch of the CVS/pharmacy Medication Disposal for Safer Communities Program. The new program is designed to provide police departments with a way to team up with CVS locations in their areas or help raise community awareness of local drug disposal programs managed by law enforcement. CVS has established a toll-free phone number and Web site for the program. Law enforcement agencies can use these channels to arrange future events at their local CVS pharmacies. Agencies that operate ongoing collection site programs can also arrange to have the address and hours of operations posted at local CVS pharmacies.

Read more:
http://online.wsj.com/article/PR-CO-20131024-912502.html?mod=googlenews_wsj

Drug Firms Ordered to Turn Over Shipment Records to W.Va. 'Pill Mills'
The Charleston Gazette
October 24, 2013

Four out-of-state drug companies must disclose their records of prescription pill shipments to West Virginia pharmacies over the past 5 years, a Boone County judge ruled. The companies will have 30 days to comply. They must disclose every pharmacy in West Virginia to which they've delivered drugs. Jim Cagle, a Charleston lawyer working for the Attorney General's Office, said the companies should be sanctioned if they refuse to cooperate. He feels the information would show the companies helped fuel Southern West Virginia's problem with prescription pain relievers.

Read more:
http://www.wvgazette.com/News/201310240107

Nine Charged with Running Massive Mail-Order Painkiller Ring
NBC News
October 23, 2013

Nine New York–area pharmacy owners, pharmacists, and others have been arrested and charged with operating a mail-order drug scheme for oxycodone and other pain relievers worth millions. The pharmacies allegedly filled prescriptions for $6 and $9 per pill, according to the indictment. Defendants used intermediaries to purchase at pharmacies in New York and New Jersey and then hired three licensed pharmacists to fill pain reliever prescriptions for patients who had no legitimate medical need for the drugs. Other defendants acted as straw buyers or recruited pain clinics in Florida to access patients willing to pay marked-up prices for oxycodone and other pain relievers.

Read more:
http://investigations.nbcnews.com/_news/2013/10/23/21100887-nine-charged-with-running-massive-mail-order-painkiller-ring

Other State and Local News

Fentanyl Abuse an 'Epidemic' in South Ottawa High School
CBC News
October 25, 2013

This article and video (2:09 minutes) discuss the increase in prescription drug abuse among high school students in Ottawa, Ontario. An estimated 253 deaths in Ontario were linked to fentanyl from 2009 to 2011—three times more than heroin deaths. Some parents are aware of fentanyl's dangers, but others are not. One mom thought OxyContin was still popular among teens.

Read more:
http://www.cbc.ca/news/canada/ottawa/fentanyl-abuse-an-epidemic-in-south-ottawa-high-school-1.2251596

Heroin Use, Deaths on the Rise in Middle Class America
CBS Denver
October 21, 2013

This article and video (4 minutes) discuss heroin addiction and death among the middle class in Colorado, which ranks second in the nation for prescription pill abuse. Experts say as prescription pills become more difficult to access, addicts turn to heroin. Cynthia Scudo started using heroin after a hip injury in her 40s. She was prescribed OxyContin for the pain, but then graduated to heroin. Cynthia used the drug for 9 years and has been clean for 2 years. Osvaldo Cabral, an addiction counselor at the CeDAR Center for Addiction, noticed an increase in heroin use a few years ago when the maker of OxyContin reformulated its pills.

Read more:
http://denver.cbslocal.com/2013/10/21/heroin-usedeaths-on-the-rise-in-middle-class-america

Coalition Launches Program to Prevent Doctor Shopping
Community Anti-Drug Coalitions of America
October 24, 2013

In the latest addition to the Community Anti-Drug Coalitions of America's Coalition Ideas Exchange, the Weymouth Youth Coalition Substance Abuse Prevention Team launched the Preventing Doctor Shopping and Pharmacy Hopping campaign to help local pharmacists and physicians reduce access to and misuse of prescription drugs. The coalition led a collaborative effort to increase local pharmacists' use of the state's Prescription Monitoring Program (PMP). The campaign included educating and enrolling pharmacists in the PMP, as well as supporting statewide legislation to ensure proper prescription monitoring practices among Massachusetts physicians.

Read more:
http://www.cadca.org/resources/detail/coalition-launches-program-prevent-doctor-shopping

Teens Working to Prevent Drug and Alcohol Abuse in Robeson County
The Fayette Observer
October 25, 2013

Students at St. Pauls, South Robeson, Purnell Swett, Fairmont, Red Springs, Southeastern Academy, Flora MacDonald Academy, and Lumberton High School and the Robeson County Career Center have been working with Palmer Prevention, a private nonprofit agency, to reduce drug abuse among their peers. They started more after-school activities and clubs to keep youth occupied and are being encouraged to tell other students not to do drugs. Robeson County has one of the highest rates of prescription drug abuse in North Carolina.

Read more:
http://www.fayobserver.com/articles/2013/10/24/1291692?sac=fo.local

Idaho Begins New Anti-Drug Campaign
Fox News Radio
October 23, 2013

Idaho's Office of Drug Policy announced the "Be Aware. Don't Share" campaign that educates adults and teens about prescription drug abuse dangers. The campaign will feature public service announcements on television, radio, and in print. A Web site was also created.

Read more:
http://newsradio1310.com/idaho-begins-new-anti-drug-campaign

Marinette Lawmaker Confronts Daughter's Heroin Addiction, Seeks New Legislation
Journal Sentinel
October 20, 2013

Rep. John Nygren (R-Wisconsin) is sponsoring a series of bills aimed at addressing and minimizing damage from heroin overdoses. One would offer limited immunity for people who call 911 or bring overdose patients to an emergency room. The other would expand the use of Naloxone. Nygren's daughter, who had a heroin habit, overdosed in 2009.

Read more:
http://www.jsonline.com/news/statepolitics/marinette-lawmaker-confronts-daughters-heroin-addiction-seeks-new-legislation-b99122394z1-228506241.html

Lacking Drug Monitoring Program Makes Missouri Easy Target for Criminals
KMOV-TV
October 22, 2013

This article and video (2:43 minutes) discuss the arrest of three people from Kentucky who used fake prescriptions to run a drug operation in Missouri. The Troy Police Chief recovered a notebook in their car filled with addresses of pharmacies in Missouri, Illinois, and Indiana. Suspects hit pharmacies in several states. Missouri does not have a prescription drug monitoring program like the rest of the country, so it is considered an easy target for those looking to fill illegal prescriptions.

Read more:
http://www.kmov.com/news/just-posted/Lacking-drug-monitoring-program-makes-Missouri-easy-target-for-criminals-228854061.html

Task Force Targets Pregnant Drug Abusers
Kokomo Tribune
October 23, 2013

The Attorney General's Prescription Drug Abuse Task Force is considering a new Indiana law that would provide some protection for drug-abusing pregnant women who voluntarily seek and stay in treatment for their addiction. The task force plans to advocate for more legislative remedies in the next session, which include requiring all health providers to report cases of neonatal abstinence syndrome to the state health department and regulating Tramadol as a Schedule IV drug. This would increase criminal penalties for abusing Tramadol or diverting it for someone else's use. The task force is still considering a law that would give pregnant women incentives to confess their drug addiction to their doctor and get into treatment programs. The task force is concerned about the shortage of drug treatment services in the state and lack of healthcare providers who will treat pregnant drug abusers.

Read more:
http://kokomotribune.com/local/x1442591048/Task-force-targets-pregnant-drug-abusers

MT Board of Crime Control Aims to Expand Prescription Drug Registry
KXLH
October 23, 2013

This article and video (1:38 minutes) discuss what the Montana Board of Crime Control hopes to do with a $380,000 federal grant. It plans to expand the prescription drug monitoring program and share data with other states' prescription drug registries. Currently, the drug registry program has nearly 20 percent participation from doctors and others with more than 3.6 million prescriptions in the database.

Read more:
http://www.kxlh.com/news/mt-board-of-crime-control-aims-to-expand-prescription-drug-registry

Montana Meth Project Launches Prescription Drug Abuse Campaign
The Missoulian
October 24, 2013

The Montana Meth Project recently launched the Medicine Abuse Project to address prescription drug abuse among Montana teenagers. Organizers hope to raise awareness, start conversations, and provoke action to stem prescription drug abuse.

Read more:
http://missoulian.com/news/local/montana-meth-project-launches-prescription-abuse-campaign/article_f1ab159e-3b75-11e3-b4d0-001a4bcf887a.html

Pa. Approves Prescription Drug Monitoring
NBC 10 Philadelphia
October 21, 2013

The Pennsylvania House of Representatives approved a bill to create a confidential statewide database for monitoring use and abuse of prescription drugs. The bill would require drug dispensers to provide detailed information about prescriptions of controlled substances ranging from oxycodone and amphetamines to cough medicine with codeine. Information would include names of the prescribing physician, patient, pharmacist, or other dispenser; drug dosage; and payment source. The database aims to help identify addicts who need treatment and aid law enforcement agencies trying to stop illegal diversion of the drugs.

Read more:
http://www.nbcphiladelphia.com/news/politics/Pa-Approves-Prescription-Drug-Monitoring-228697451.html

Most Drug Arrests Don't Mirror Prescription Abuse
The Times
October 19, 2013

The Multi-Agency Narcotics Squad unit has seen an increase in prescription drug abuse. The unit comprises a drug task force of officers from the Hall County Sheriff's Office and Gainesville Police Department in Georgia. In 2012, the unit made 83 possession and possession-with-intent arrests—33 were for marijuana, 32 for methamphetamine, 12 for cocaine, 2 for Ecstasy, and 4 for prescription narcotics. The unit made 12 trafficking arrests for larger amounts of drugs: nine for methamphetamine, three for Ecstasy, and one for marijuana. According to county death certificates, 25 people died from accidental drug overdoses in the county—2.29 percent of the overall deaths. Overdoses have surpassed car accidents for accidental deaths in Hall County. In Hall alone, dispensing of oxycodone has increased by 666 percent from 2009 to 2011, according to Tennent Slack, who gives lectures on the dangers of prescription drugs.

Read more:
http://www.gainesvilletimes.com/section/6/article/90388

Pain Pills Can Be Prescriptions for Addiction, Death
USA Today
October 20, 2013

In 2012, 400 people in Macomb County, Michigan, died from prescription narcotic overdoses, according to Joseph Naughton, Director of Medical Education at Henry Ford Macomb Hospitals. Linda Davis, a judge in Clinton Township, has seen the number of opiate-related cases increase in recent years; today they make up 30 to 50 percent of her caseload. Parents need to start talking to their kids in elementary school about the dangers of taking pills. Doctors should prescribe the smallest amount a patient might need, without refills. They also need to tell patients that pain relievers can be addictive and look for signs of addiction. Beth Goldman, Medical Director of Behavioral Health for Blue Cross Blue Shield of Michigan, suggests asking the doctor three specific questions before being prescribed pain pills.

Read more:
http://www.usatoday.com/story/news/nation/2013/10/20/painkiller-overdoses-addiction/3107879

Survey: Most Parents See Risk in Underage Use of Alcohol, Tobacco, Other Drugs
West Central Tribune
October 21, 2013

The Kandiyohi County Drug-Free Communities Coalitions conducted a survey that showed nearly nine out of 10 parents believe it is risky for underage youth to consume alcohol, use tobacco, use marijuana, or misuse prescription drugs. Fewer than 750 Kandiyohi County adults responded to the survey.

Read more:
http://www.wctrib.com/content/survey-most-parents-see-risk-underage-use-alcohol-tobacco-
other-drugs

Drug Monitoring Plan Tweaked for Patient Privacy
WITF
October 21, 2013

This article discusses pending legislation that would allow prescribers and doctors to access information through the Pennsylvania prescription monitoring database on people getting prescriptions. The proposal would also include medicines that treat migraines, seizures, and anxiety. Recently, state lawmakers passed an amendment requiring law enforcement to obtain a search warrant before using the database. Representative Matt Baker said it makes narcotics officers' jobs more difficult. The Pennsylvania Medical Society does not have a problem with the search warrant requirement.

Read more:
http://www.witf.org/state-house-sound-bites/2013/10/drug-monitoring-plan-tweaked-for-patient-privacy.php

Videos

How to Prevent Children from Abusing Prescription Drugs
Life Guru
October 20, 2013

Dr. Mel Pohl explains how parents can help prevent their children from abusing medications. (Duration: 1:41 minutes)

Watch:
http://www.youtube.com/watch?v=7_zYK13I1dI&feature=youtube_gdata

Prescription Drug Abuse Prevention Resource Videos
Dream Free America Foundation
October 18, 2013

This video (3:28) discusses the Ohio State University Generation Rx Lab and its partnership with Cardinal Health.

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

Supporting Prescription Drug Monitoring Program in PA
Representative Gene DiGirolamo
October 22, 2013

Pennsylvania State Representative Gene DiGirolamo speaks in support of legislation to develop a more comprehensive prescription drug monitoring program in Pennsylvania. (Duration: 2:15 minutes)

Watch:
http://www.youtube.com/watch?v=07irQDaI8Lo&feature=c4-overview&list=UUx_jF6JdjN
d7lTNf1jSxLUQ

In US, an Epidemic of Prescription Drug Abuse
VOA Learning English·
October 19, 2013

This video (4:01 minutes) discusses prescription drug abuse in the United States by highlighting the latest statistics.

Watch:
http://www.youtube.com/watch?v=RqlbQDZuLH0&feature=youtube_gdata

Prescription Drug Abuse in NY
WHAM
October 23, 2013

Jeff Levi of Trust for America's Health and Carol Thornton of the Safe States Alliance discuss prescription drug abuse in general and in the State of New York. (Duration: 3:41 minutes)

Watch:
http://www.13wham.com/news/features/this-morning/stories/1023-prescription-drug-abuse-
ny-892.shtml

Grant Announcement

Under 21 Substance Abuse Prevention Activity Mini-Grants
Many Voices for Smart Choices—Montgomery County Alliance to Prevent Youth Substance Abuse
Announced: October 7, 2013
Application Deadline: October 31, 2013

Funded by Montgomery County Government, the purpose of these mini-grants is to support youth alcohol use and substance abuse prevention activities throughout the county. Funds must be used to provide direct prevention activities serving youth who are at risk for substance use and/or abuse. The grants are intended to be combined with other local funds for community-based substance abuse prevention activities. This application provides the opportunity for community groups to apply for funds to partially support their planned activities.

Read more:
http://www.collaborationcouncil.org/under21grant.pdf

Grants Received

Wellspring Receives Grant to Help Adolescent Boys with Substance Abuse
Rapid City Journal
October 20, 2013

Wellspring received a $150,000 grant from the John T. Vucurevich Foundation to open the only inpatient substance abuse facility for boys in Western South Dakota. The funds will provide the startup capital for a five-bed residential chemical dependency treatment program for boys 10 to 18 years old.

Read more:
http://rapidcityjournal.com/news/wellspring-receives-grant-to-help-adolescent-boys-with-substance-abuse/article_761eb038-5dfb-5a0b-8a6a-a391f876c9e9.html

Take-Back Events and Drop Boxes

Prescription Drug Collection Nov. 9 at Woodford Co. Health Department
Peoria Journal Star
October 21, 2013

Eureka College students will host a prescription drug collection from 9 a.m. to 12 p.m. on November 9, 2013, at the Woodford County Health Department in Illinois.

Read more:
http://www.pjstar.com/news/x825423523/Prescription-drug-collection-Nov-9-at-Woodford-Co-Health-Department

Covanta Energy Destroys 1 Millionth Pound of Unwanted Prescription Drugs
NorthCentralPA.com
October 22, 2013

Covanta Energy has destroyed one million pounds of prescription medication since its inception in 2010. The company honored partners and advocates of the Prescription for Safety program with its A Million Thanks Award. The award recognizes exceptional leadership in mobilizing support and bringing attention to this issue. Covanta has partnered with municipalities throughout the country to make it safe, easy, and affordable to properly dispose of unused pharmaceuticals.

Read more:
http://www.northcentralpa.com/feeditem/2013-10-22_covanta-energy-destroys-1-millionth-pound-unwanted-prescription-drug

Upcoming Conferences and Workshops

CFPC's Annual Substance Abuse Conference: Our Drug Epidemic
November 1, 2013
Andover, New Jersey
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

Town Hall Meeting on Prescription Drug Abuse, Nov. 20
November 20, 2013
6:45 p.m. to 9 p.m.
Colorado State University
Behavioral Sciences Building, Room 103
410 West Pitkin Street
Fort Collins, Colorado 80521

The Community Anti-Drug Coalitions of America, Colorado State Office of the Governor, and Prescription Drug Abuse Prevention Program will present a statewide discussion on prescription drug abuse among youth. A large-group meeting will take place in Denver with multiple live video feeds throughout the state.

Read more:
http://www.teamfortcollins.org/parents/town-hall-meeting-on-prescription-drug-abuse-nov-20

Pain Management Through a Wide Lens: Balancing Safety and Effectiveness
March 8, 2014
7:15 a.m. to 4:30 p.m.
Goldfarb School of Nursing
Barnes–Jewish College
4483 Duncan Avenue
St. Louis, Missouri 63110

This symposium will analyze current epidemiologic trends in abuse and misuse of prescription analgesics; discuss current clinical risk mitigation strategies in avoidance of opioid misuse, abuse, and diversion; summarize patient and provider barriers to achieving appropriate pain relief; and examine contemporary integrative and pharmacological therapies in pain.

Read more:
http://aspmnstlouisregional.org/2014-conference-information-and-registration.html

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

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

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