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September 4, 2013

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    SAMHSA Prescription Drug Abuse Weekly Update

    ISSUE 35  |  SEPTEMBER 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.

Featured Report

Important Steps Toward Stopping a Deadly Epidemic: New York's I-STOP Law
The Huffington Post
August 26, 2013

Tom Frieden, Director for the Centers for Disease Control and Prevention, discusses the launch of New York State's I-STOP, the Internet System for Tracking Over-Prescribing. The law requires doctors to consult a patient's medical history before prescribing most pain relievers. Also, it requires real-time reporting by pharmacists when filling prescriptions for most controlled substances. This will make New York one of two states to require real-time reporting. Another requirement will make controlled substances available only via e-prescription by December 2014. This is designed to address the problem of forged or stolen prescriptions.

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Journal Articles

L. Degenhardt, H.A. Whiteford, A.J. Ferrari, A.J. Baxter, F.J. Charlson, W.D. Hall, G. Freedman, R. Burstein, N. Johns, R.E. Engell, A. Flaxman, C.J.L. Murray, and T. Vos. 2013. "Global Burden of Disease Attributable to Illicit Drug Use and Dependence: Findings from the Global Burden of Disease Study 2010." The Lancet. doi:10.1016/S0140-6736(13)61530-5.

Researchers conducted systematic reviews of the epidemiology of drug dependence, and analyzed results with Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) Bayesian meta-regression technique (DisMod-MR) to estimate population-level prevalence of illicit drug dependence and use including prescription drug misuse. GBD 2010 calculated new disability weights by use of representative community surveys and an Internet-based survey. They combined estimates of dependence with disability weights to calculate prevalent years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs), and estimated YLDs, YLLs, and DALYs attributable to drug use as a risk factor for other health outcomes. Illicit drug dependence directly accounted for 20 million DALYs (95 percent UI 15.3–25.4 million) in 2010, accounting for 0.8 percent (0.6–1.0) of global all-cause DALYs. Worldwide, more people were dependent on opioids and amphetamines than other drugs. Opioid dependence was the largest contributor to the direct burden of DALYs (9.2 million, 95 percent UI 7.1–11.4). The proportion of all-cause DALYs attributed to drug dependence was 20 times higher in some regions than others, with an increased proportion of burden in countries with the highest incomes. Injecting drug use as a risk factor for HIV accounted for 2.1 million DALYs (95 percent UI 1.1–3.6 million) and as a risk factor for hepatitis C accounted for 502,000 DALYs (286,000–891,000). Suicide as a risk of amphetamine dependence accounted for 854,000 DALYs (291,000–1,791,000), as a risk of opioid dependence for 671,000 DALYs (329,000–1,730,000), and as a risk of cocaine dependence for 324,000 DALYs (109,000–682,000). Countries with the highest rate of burden (>650 DALYs per 100,000 population) included the United States, the U.K., Russia, and Australia.

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Related Article
Study: Marijuana Top Illegal Drug Used Worldwide
The Boston Globe
August 28, 2013

Marijuana is the most popular illegal drug used worldwide, but pain relievers kill the most people, according to a global survey of illicit drug abuse. The researchers found that for all the drugs studied, men in their 20s had the highest rates of abuse. The worst-hit countries were Australia, Britain, Russia, and the U.S. The lowest rates of drug abuse were in Asia and Africa. Of the estimated 78,000 deaths in 2010 because of illegal drug use, more than half were because of pain reliever addictions. Countries with harsh laws against drugs had worse death rates for addicts when compared to countries who relied on other policies to wean people off drugs. The study's senior author from the University of Washington said that "a decriminalized drug policy could potentially transform the public health approach to drug use. The enormous savings in the criminal justice system could be used to fund addiction treatment programs."

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A.M. Garcia. 2013. "State Laws Regulating Prescribing of Controlled Substances: Balancing the Public Health Problems of Chronic Pain and Prescription Painkiller Abuse and Overdose." The Journal of Law, Medicine and Ethics Suppl 1:42-5. doi: 10.1111/jlme.12037.
This article explores inadequate treatment of pain in the U.S. and the subsequent rise of prescription pain reliever abuse, misuse, and overdoses. Since 2007, states have increasingly used their authority to address inappropriate prescribing. State strategies to address this complex problem have included establishing and strengthening prescription drug monitoring programs, regulating pain management facilities, and establishing dosage thresholds above which a consult with a pain specialist is required. It will be important to evaluate the impact these policies are having on legitimate access to pain care.

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T.J. Inocencio, N.V. Carroll, E.J. Read, and D.A. Holdford. 2013. "The Economic Burden of Opioid-Related Poisoning in the United States." Pain Medicine. doi: 10.1111/pme.12183.

This study quantifies the economic burden of opioid poisoning in the U.S. to help evaluate the economic case for efforts to reverse or prevent opioid poisoning and its associated morbidity and mortality. Mean costs and prevalence were estimated using publicly available datasets. The study estimated medical and productivity costs from a societal perspective. Medical costs included treatment for opioid poisoning in the emergency department (ED) and inpatient settings, along with emergency transport and drug costs. Productivity costs included lost wages due to mortality and absenteeism costs from ED visits and hospitalizations. In 2009, total costs were an estimated $20.4 billion (in 2011 U.S. dollars) with indirect costs constituting 89 percent of the total. Medical costs were $2.2 billion including $.85 billion in ED costs and $1.35 billion in inpatient costs. Absenteeism costs were $335 million and lost future earnings due to mortality were $18.2 billion. Listserv Editor's Note: Other published estimates of opioid addiction costs are broader in scope. This estimate, for example, omits the costs of medical visits and related diagnostic tests that doctor shoppers and pill mills incur in generating prescriptions. It also omits addiction treatment costs.

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S. Lee, W. Klein-Schwartz, C. Welsh, and S. Doyon. 2013. "Medical Outcomes Associated with Nonmedical Use of Methadone and Buprenorphine." The Journal of Emergency Medicine 45(2):199-205.

Researchers compared outcomes associated with nonmedical use of methadone versus nonmedical use of buprenorphine in patients presenting to the emergency department (ED) and reported to poison centers. This was a retrospective cohort study using data from the American Association of Poison Control Centers from January 1, 2003 to December 31, 2009 (7 years). Inclusion criteria were nonmedical use of methadone or buprenorphine (or buprenorphine/naloxone) as a single substance by history, age 18 years or older, ingestions only, evaluated in an ED. Outcome measures were clinical effects, treatments, disposition, and final medical outcomes. Of 1,920 cases, 1,594 were in the methadone group and 326 were in the buprenorphine group. Frequently reported clinical effects were lethargy, 59.2 percent versus 29.4 percent, and respiratory depression, 28.7 percent versus 2.5 percent, for methadone and buprenorphine groups, respectively. Hospitalization rates were 67.4 percent in the methadone group and 32.2 percent in the buprenorphine group. Half of all patients in the methadone group were admitted to the intensive care unit (ICU) versus only 15 percent of all the patients in the buprenorphine group. Twenty-six patients in the methadone group died versus no deaths in the buprenorphine group. There were significant differences in the distribution of clinical effects, disposition, and medical outcomes (p<0.001). Patients who use methadone nonmedically have higher hospitalization rates, greater ICU utilization rates, and considerably worse medical outcomes when compared with patients who use buprenorphine nonmedically.

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L. Ogilvie, C. Stanley, L. Lewis, M. Boyd, M. Lozier. 2013. Centers for Disease Control and Prevention.
"Notes from the Field: Acetyl Fentanyl Overdose Fatalities--Rhode Island, March–May 2013."
Morbidity and Mortality Weekly Report, 62(34):703-704.

During May 14-21, 2013, CDC and Rhode Island public health officials conducted a field investigation to determine whether 10 deaths represented an increase in the typical number of overdose deaths and what role might have been played by acetyl fentanyl. Data on illicit drug overdose deaths during March 1, 2012-March 31, 2013 were abstracted from the Rhode Island Office of State Medical Examiners database and examined using Poisson regression. Data were also abstracted from autopsy reports, toxicology results, and medical records relating to the 10 deaths that were preliminarily positive for acetyl fentanyl. The state health laboratories performed all toxicology testing for acetyl fentanyl. Investigators found that the number of illicit drug overdose deaths in Rhode Island was significantly higher in March 2013 (21, including 10 attributed to acetyl fentanyl), compared with the monthly average during March 2012-February 2013 (8.9, p<0.001). During the field investigation, two additional acetyl fentanyl overdose deaths were confirmed (dates of death: March 20 and May 16, 2013), bringing the total number of acetyl fentanyl deaths to 12. Among the 12 acetyl fentanyl decedents, ages ranged from 19 to 57 years, and eight were male. All but one of the deaths occurred in northern Rhode Island; six occurred in the same small city. Evidence suggested that acetyl fentanyl was administered intravenously in at least four (33 percent) of the deaths. The route of acetyl fentanyl administration was undetermined for the remaining eight decedents. The GC/MS toxicology results for 10 of the 12 decedents showed, in addition to acetyl fentanyl, various mixtures of other drugs, including cocaine (58 percent), other opioids (33 percent), ethanol (25 percent), and benzodiazepines (17 percent). None of the decedents tested positive for fentanyl by GC/MS. Toxicology results for one decedent showed only acetyl fentanyl. Since completion of the field investigation, two persons using acetyl fentanyl together died on May 26, 2013, increasing the number of acetyl fentanyl deaths to 14.

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H.C. Sachs. 2013. "The Transfer of Drugs and Therapeutics into Human Breast Milk: An Update on Selected Topics." Pediatrics. doi:10.1542/peds.2013-1985.

This report discusses several topics of interest surrounding lactation, such as the use of psychotropic therapies, drugs to treat substance abuse, narcotics, galactagogues, and herbal products, as well as immunization of breastfeeding women.

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B. Setnik, K. Sommerville, V. Goli, L. Han, and L. Webster. 2013. "Assessment of Pharmacodynamic Effects Following Oral Administration of Crushed Morphine Sulfate and Naltrexone Hydrochloride Extended-Release Capsules Compared with Crushed Morphine Sulfate Controlled-Release Tablets and Placebo in Nondependent Recreational Opioid Users." Pain Medicine 14(8):1173-86. doi: 10.1111/pme.12148.

Researchers report on a randomized, double-blind, placebo-controlled, three-way crossover study on nondependent recreational opioid users treated at a single Canadian center. They orally administered crushed extended-release capsules (MSN) (120 mg morphine sulfate and 4.8 mg naltrexone hydrochloride), crushed 120 mg morphine sulfate controlled-release (MS-CR), and a placebo. The study started with preliminary screening to eliminate dependent users and people with medical conditions, followed by a naloxone challenge and drug discrimination survey (to confirm non-dependence and assure subjects could discriminate between MS-CR and placebo--typically involving a 2-3 day stay at the study center). The treatment phase comprised three visits, each with a 2-night confined stay. Each treatment period was separated by a minimum of 4 days not to exceed 14 days between dosing. A follow-up visit occurred 3-14 days following the last study drug administration or at the time of early withdrawal. Researchers obtained subjective ratings (100-point visual analog scales) of positive drug effects (drug liking, high, good effects, take drug again, and overall drug liking), any effects, and negative effects (bad effects, feel sick, nausea, sleepy, and dizzy), along with pupillometry, pharmacokinetic (PK), and safety assessments. All study participants had used morphine sulfate recreationally at least 10 times in the past year. Following a common but somewhat controversial procedure, early on, the study excluded 14 people who were unable to distinguish the effects of morphine sulfate CR from placebo. The study included 33 subjects, but 7 were dropped before the final inpatient stay because the effect size calculation suggested only 25 completers were needed. Crushed MS-CR significantly increased ratings of all positive subjective measures relative to placebo (P<0.0001). Crushed MSN significantly decreased all positive subjective ratings compared with MS-CR (P≤0.005), but significantly increased ratings compared with placebo (P<0.03). Peak pupil diameter was significantly larger for MSN than MS-CR (P<0.0001). PK analysis indicated that maximum morphine plasma concentration was significantly lower and time to maximum concentration was significantly longer for crushed MSN compared with crushed MS-CR. Naltrexone mean maximum concentration peaked at 0.8 hours and morphine mean maximum concentration at 0.9 hours with MSN. This study was performed by Pfizer.

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B. Setnik, V. Goli, N. Levy-Cooperman, C. Mills, M. Shram, and I. Smith . 2013. "Assessing the Subjective and Physiological Effects of Intranasally Administered Crushed Extended-Release Morphine Formulations with and without a Sequestered Naltrexone Core in Recreational Opioid Users." Pain Resource Management 18(4):e55-62.

This article is similar to the one described immediately above except that the crushed drugs were ingested nasally rather than orally. Together, the two studies (and related studies on injected crushed drugs) assess whether a sequestered naltrexone core reduces the potential for abuse of crushed morphine sulfate controlled-release (MS-CR). The study design is virtually identical to the design for the oral ingestion study. The study included 33 subjects, but 7 were dropped before the final inpatient stay because the effect size calculation suggested only 25 completers were needed. The study screened out 25 people who were unable to distinguish the effects of MS-CR from placebo. Both MSN and MS-CR showed significantly higher pupil diameter values compared with placebo. MSN showed significantly lower scores than MS-CR for drug liking and high scores on both mean peak effect and in area under the effect curve over 2 hours following dosing compared with MS-CR. MSN showed significantly lower scores for all other positive subjective effects (good drug effects, overall drug liking, and take drug again scores) compared with MS-CR (P<0.001). Peak minimum pupil diameter was significantly larger for MSN than MS (P=0.002). Mean peak morphine plasma concentration and median time to maximum morphine concentration following administration of MSN and MS-CR were similar (27.3 ng⁄mL and 0.57 hours versus 27.7 ng⁄mL and 0.6 hours). Median time to naltrexone mean maximum concentration with MSN was 0.55 hours after inhalation. This study was performed by Pfizer.

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C.F. Wong, K. Silva, A. Kecojevic, S.M. Schrager, J. Jackson Bloom, E. Iverson, and S.E. Lankenau. 2013. "Coping and Emotion Regulation Profiles as Predictors of Nonmedical Prescription Drug and Illicit Drug Use Among High-Risk Young Adults." Drug and Alcohol Dependence 132(1):165-171.

Researchers interviewed young adults aged 16-25 years who had misused prescription drugs within the past 90 days in Los Angeles and New York. The current study used latent profile analysis to empirically derive coping and emotion regulation classes/profiles, then predicted patterns of substance use by class (N=560). Four latent classes/groups were identified: (1) suppressors, (2) others-reliant copers, (3) self-reliant copers, and (4) active copers. Distinct patterns of prescription and illicit drug misuse were found among different coping/emotion regulation profiles, including differences in age of initiation of opiates, tranquilizers, and illicit drugs, recent injection drug use, substance use-related problems, and past 90-day use of tranquilizers, heroin, and cocaine. Specifically, suppressors and others-reliant copers evidenced more problematic patterns of substance use compared to active copers.

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News and Reports

FDA Approves Reformulated Oxycontin to Discourage Abuse, Cut Overdoses
The Nation's Health
July 2013

Federal officials approved a new formulation of the controlled-release drug to discourage misuse and abuse of OxyContin.

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Related Article
Reformulated OxyContin®: An Interview with Dr. Paul Coplan, Executive Director, Risk Management and Epidemiology, Purdue Pharma
August 29, 2013

This article features a Q&A with Paul Coplan, the Executive Director of Risk Management and Epidemiology at Purdue Pharma, about the reformulated OxyContin. He discusses the differences between the reformulated and original OxyContin as well as its safety and efficacy; the post-marketing studies; and monitoring patients for signs of abuse.

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Expert: Jackson Suffered From 'Severe Addiction' To Prescription Drugs
August 27, 2013

An addiction specialist testified that Michael Jackson suffered from a "severe addiction" to pain medication and was secretive about his use of prescription drugs. The singer shopped for doctors to obtain prescription pain relievers and his doctors did not maintain proper boundaries. Jackson died in 2009 from an overdose of propofol. Jackson family attorneys agree the singer was addicted to pain medication.

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Prescription Drug Abuse: A Workplace Crisis
Colorado Biz
July 16, 2013

Cole Wist, an attorney with more than 20 years of experience representing employers in labor and employment matters, shares his views on prescription drug abuse in the workplace. He suggests that employers update their safety and human resource policies, train supervisors and employees, monitor enforcement trends, and take proactive steps now. Statistics demonstrate that prescription drug abuse presents a recognized occupational hazard that is likely to cause death or serious physical harm.

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Stimulant Abuse a Growing Problem on College Campuses
Digital Journal
August 24, 2013

This press release discusses the health effects and legal consequences for college students who use and abuse ADD/ADHD medications. At some point, users may need to take larger doses to achieve the same effect, which may lead to an overdose or death. Increasing the dosage may elevate blood pressure or cause vomiting and seizures. Possessing stimulant drugs without a valid prescription is a criminal offense. It is also a crime for someone to give their medication to another person. The penalties for these crimes can include community service, probation, and prison time. A drug conviction can disqualify students from receiving financial aid. It can also keep students from obtaining some professional licenses or entering certain careers.

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A Doctor Prescribed My Son 140 Pain Pills in One Week. Now My Son Is Dead.
The Huffington Post
August 29, 2013

Peggy Martin's 24-year-old son Riley died from an overdose of cocaine, Percocet, and Lortab. She never suspected he was using drugs. A month before graduating college, he received a DWI which decreased his chances of becoming a police officer. When he was unable to find a job in his preferred field, he suffered from anxiety and depression, so a doctor prescribed him Zoloft and Klonopin. After a routine tonsil operation, a doctor prescribed him 50 Percocets. He kept calling the doctor asking for more. One doctor prescribed him over 140 pain pills within a week. Riley overdosed in his apartment on prescription drugs and cocaine. Now, his mother advocates for greater access to naloxone. She also emphasizes the need for affordable treatment options for addicted persons.

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Prescription Drug T-Shirts: Are Shirts Reading 'Xanax,' 'Adderall' on Back Artful Commentary or Dangerous Encouragement?
Medical Daily
August 29, 2013

Brian Lichtenberg designed T-shirts that feature the words "Xanax," "Adderall," and "Vicodin" for Kitson LA, a Los Angeles boutique. The designer said the shirts are meant to open a dialogue about drug abuse and called them a "parody of pop culture." Actress Kristen Johnston voiced her concerns about the shirts on Twitter and Good Morning America; she battled a Vicodin addiction for years. Adderall, Vicodin, and Xanax all have trademarked copyrights on their names and drug manufacturers have released statements about taking legal action. Lichtenberg released a statement on the boutique's Facebook page stating that the T-shirts are not meant to encourage prescription drug abuse.

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Related Article
Kitson LA: Remove Shirts That Promote Prescription Drug Abuse
The Partnership at Drugfree.org
August 28, 2013

The Partnership at Drugfree.org sent a letter to Christopher Lee, Chief Executive Officer of Kitson LA, asking him to stop selling the prescription T-shirts.

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6 Tips for Talking to Kids about Drugs--From Former Addict and Anti-Drug Advocate
NBC Latino
August 28, 2013

Edwin Irizarry, a Puerto Rican, has been sober for the past 7 years. He offers six tips for talking to youth about drugs.

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Samples of the Bottle Blocker Made Available to Prevention Community for Evaluation as a New Tool to Save Lives
August 30, 2013

Teen Stopper Protection is offering a free sample of the Bottle Blocker to organizations or individuals to evaluate. It is a tamper-proof locking device that fits any liquor or pill bottle to prevent underage drinking and prescription drug abuse. The two-piece device fits on any bottle with a neck. The custom latex cap covers the bottle cap, and then it is secured with a cable tie. The ties come in a custom color with an imprinted logo to make them difficult to replace. The Bottle Blocker is used the same way on medication bottles. This press release includes a video (3:01 minutes).

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Other State and Local News

Session Looks at Prescription Drug Abuse
The Bismarck Tribune
August 28, 2013

Nearly 30 representatives of medical and law enforcement groups gathered in Bismarck, N.D., to discuss prescription drug abuse and ways to enact solutions. The group also discussed prescription drug take-back programs.

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2 Investigators, BGA: Drugs Disappearing from Stroger Hospital
CBS Chicago
August 26, 2013

This article and video (3:14 minutes) discuss the Drug Enforcement Administration's (DEA's) audit of Cook County Stroger Hospital that found lax security and inadequate record-keeping for its prescription drugs. The hospital was not in compliance with federal regulations. Problems included failure to conduct regular inventories and to satisfy reporting requirements related to controlled substances. Sources and doctors told the DEA that pills have been disappearing from dosages prescribed for patients for years with no oversight or accountability in place. In a letter to the county board, the Inspector General said his onsite inspections of the hospital's receiving dock found "security practices and procedures were lax to non-existent." Some drugs were missing or stolen from refrigerators, secured storage cabinets and nursing stations, or while being transferred from the pharmacies to the nursing stations. County hospital police reports document more than 80 incidents when drugs were reported lost, missing, or stolen since 2006. The DEA is working with the hospital to tighten procedures.

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Drug-Death Epidemic Must Be Stopped
Chico News and Review
August 29, 2013

Someone dies every 4.3 days from drug use in Butte County, Calif., a rate 3.5 times higher than the state average, according to the California Department of Public Health. In the past 10 years, 641 citizens died from drug overdoses, primarily from prescription drug use. In 2012, the youngest overdose victim was 16; the oldest was 84. Of this group, 28 were females and 44 males, with a combined average age of 48 years old. Most died with more than one drug in his or her system. This problem requires a countywide effort with strong leadership.

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Ohio to Help Babies Born with Addictions by Helping Moms
The Columbus Dispatch
August 30, 2013

Ohio announced a new initiative called the Maternal Opiate Medical Support Project. It aims to improve the health of mothers and newborns and reduce the cost of extended hospital stays for babies born with neonatal abstinence syndrome. It should reduce healthcare costs for taxpayers because most of these births are paid by Medicaid. In 2011, treatment for newborns affected by neonatal abstinence syndrome cost more than $70 million and nearly 19,000 days in hospitals, according to the Ohio Hospital Association. The 3-year pilot project hopes to serve about 200 mothers and babies. It will provide drug-addiction counseling and treatment, along with nonclinical services including housing, transportation, and baby-sitting during medical or treatment appointments. State officials estimate the project will reduce infant stays in neonatal intensive-care units by 30 percent.

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Adderall Abuse among Student Athletes Drawing Concern from Local Physicians
The Gateway News
August 28, 2013

Young people are actively searching for Adderall, according to Shannon McNally-Velasquez, a former college athlete who practices internal medicine in Youngstown, Ohio. She said that Adderall abuse among athletes has trickled down from the pro level. She sees a lot of kids coming into her office who want an ADHD diagnosis so that they can obtain Adderall. The pressure of competition has increased dramatically from her playing days, tempting athletes to use anything they can to gain an edge. Tom Bartsokas, a team physician for local high schools, said most young athletes are the same as the pros who were suspended for the use of performance-enhancing drugs in one way: they want to use illicit drugs to push their bodies to a higher level.

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Organizations Team Up to Combat Prescription Drug Abuse in Utah
KSTU-Fox 13
August 24, 2013

This article and video (2:20 minutes) discuss a partnership between the Utah Department of Human Services and Smith's Food and Drug Stores pharmacies to make people aware of the dangers of prescription drugs. The Utah Pharmaceutical Drug Crime Project plans to increase "Use Only as Directed" messages at Smith's pharmacies. In addition, the pharmacies are using special bags for their prescriptions that have directions for use, storage, and disposal printed on them.

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Kentucky Increases Number of Permanent Prescription Drug Disposal Locations
The Lane Report
August 28, 2013

Kentucky Governor Steve Beshear announced that the state now has 149 permanent prescription drug disposal locations in 97 counties, making it easier for Kentuckians to properly dispose of medications. The permanent disposal boxes are monitored and are located in law enforcement buildings. The disposal boxes are funded by the Kentucky Agency for Substance Abuse Policy, Operation Unite, the Kentucky League of Cities, and state and local law enforcement agencies.

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Kenton Hosts Hearing on "Epidemic" of Prescription Drug Overdose
The Lima News
August 27, 2013

Ohio State Representative Robert Sprague chaired a meeting in Kenton that addressed prescription opiate abuse, the second of four meetings of the House Prescription Drug Addiction and Healthcare Reform Study Committee. Officials gathered information and testimony on this growing problem in the state. Hearings will be held in Cuyahoga and Lucas counties in September.

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MANCHESTER Big Red Barrel Available at Village Hall for Unused Drugs
The Manchester Enterprise
August 23, 2013

The Washtenaw County Sheriff's Department, the Manchester Wellness Coalition, and the Village of Manchester in Michigan announced they installed a Big Red Barrel in the lower level hallway of the Village Hall. Residents can dispose of their unused, unwanted, or expired prescription medications and over-the-counter drugs in the barrel. Students at the South and West Washtenaw Consortium manufactured the barrel.

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Reynolds: Time to Make Overdose Antidote Readily Available
August 29, 2013

Jeffrey L. Reynolds, Executive Director of the Long Island Council on Alcoholism and Drug Dependence in New York, would like to see naloxone become readily available to nonmedical people. It is only available by prescription in the U.S. The community has access through a limited number of state-approved overdose prevention programs that train participants to recognize the signs of overdose and equip them with Narcan kits. The Suffolk County Police Department put the kits into sector cars. Since July 2012, police officers have resuscitated more than 60 Long Islanders. He argues that the nasal spray or injector should be stocked in every first-aid kit and every school nurse's office. It should be given to chronic-pain patients who might mix up dosages. Parents of addicted teens should be able to carry it like an epinephrine auto injector for allergies.

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Proposed Changes to Florida Prescription Drug Database Under Fire
The Palm Beach Post
August 27, 2013

Florida Department of Health officials want to tighten security on the state's prescription drug monitoring program after the names and detailed prescription-drug histories of more than 3,000 people were released to defense attorneys in May. The draft rule changes are "minor, inconsequential and fail to address the practical issues" that led to the release of private data of thousands of people who weren't under investigation, an ACLU of Florida lobbyist said during a recent meeting. The proposed rule would limit distribution of records obtained from database searches to a single authorized user at any given agency. Quincy Police Chief Walter McNeil, representing the Florida Police Chiefs Association, said that is too restrictive and it would impede investigators. He argues that allowing more law enforcement personnel to have access to the records will not make patient privacy more vulnerable. The ACLU is demanding that database searches require a warrant. Its lawyer said the proposed rule changes do nothing to narrow the scope of the searches; and it does not include any remedy for patients whose prescription drug data was released to third parties. Current laws and rules do not require individuals to be notified if their histories have been wrongfully released. The department will publish the proposed rule and take public comments before formally adopting it.

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Adams County Health Department Unveils New Drug Collection Unit
Quincy Herald-Whig
August 24, 2013

Law enforcement and Adams County Health Department officials in Illinois launched a new prescription drug drop box produced by MedReturn. It will be available weekdays during the health department's business hours. Residents can dispose of prescriptions, over-the-counter drugs, and pet medicines.

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Evidence Hearing Set for Utah Fire Chief Accused of Prescription Fraud
The Salt Lake Tribune
August 23, 2013

A Unified Fire Authority assistant chief was charged with 14 counts of third-degree felony for falsely obtaining prescriptions. He had a large number of prescriptions for controlled substances from various pharmacies and three doctors. Two doctors did not know he had been prescribed drugs from other physicians. The Utah man admitted taking pain medication three times a day.

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OUR VIEW: Addressing the Scourge of Overdoses
Taunton Daily Gazette
August 26, 2013

This editorial discusses overdoses in Eastern Massachusetts, which leads the nation in the number of drug-related emergency room visits involving heroin and other opiates. Two hospitals in Fall River report slightly more women than men were treated at their emergency rooms for overdoses. Taunton's Morton Hospital did not have a breakdown by gender, but reported 120 overdoses in the ER in 2012 and 91 so far this year. Leading drugs responsible for overdoses include Xanax and oxycodone. The author suggests ways people can prevent overdoses.

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Other Resources

CADCA's Rx Abuse Prevention Toolkit: From Awareness to Action
Community Anti-Drug Coalitions of America
Assessed August 30, 2013

This toolkit provides the facts, approaches, strategies, and messages that coalitions can use to move communities beyond that first stage of awareness into action. It incorporates a logic model and provides strategies that coalitions can use to achieve community change. In addition, the toolkit includes templates, such as sample news releases and op-eds; and step-by-step guidance on how to hold a prescription drug take-back program and educational events.

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Office of Indiana Attorney General
Accessed August 27, 2013

This Web site, launched by the Indiana Attorney General and the Indiana Drug Abuse Prevention Task Force, is used to raise awareness about prescription drug abuse throughout the state.

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Opioid Overdose Prevention Toolkit
August 2013

This toolkit equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. It includes Overdose Facts for Community Members, Five Essentials for First Responders, Overdose Information for Providers, Safety Advice for Patients, and Resources for Overdose Survivors and Family Members.

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FACT SHEET: Preventing, Treating, and Surviving Overdose
The White House, Office of National Drug Control Policy
August 28, 2013

This resource describes efforts by the government to reduce drug use and its consequence while implementing effective policy reform.

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Prescription Drug Abuse More Deadly Than Car Accidents
The Arizona Republic
Accessed August 27, 2013

In this video (2:00), the Centers for Disease Control and Prevention says prescription drug abuse is more deadly than car accidents and shows no sign of getting better.

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Unused Prescription Drugs: To Flush or Not to Flush?
Los Angeles Times
August 23, 2013

This video (1:09) and transcript describe how individuals should dispose of prescription medications.

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Insights from a National Epidemic: The Medicine Abuse Project--Free Resources for States and Communities
September 5, 2013

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Request for Proposal

Colorado Slates Youth Marijuana, Prescription Drug Abuse PR
Proposal Deadline: September 23, 2013

Colorado is seeking help with a public relations campaign aimed to curb misuse and abuse of marijuana and prescription pills among its youth, ages 12 to 20. The governor's office will oversee the campaign. A year-long contract is planned to begin in October.

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Save the date

DEA's National Take-Back Initiative
October 26, 2013

Upcoming Conferences and Workshops

Educational Forum on Prescription Drug Abuse for Healthcare Providers
September 14, 2013
North Chesterfield, Virginia

Pharmacy Diversion Awareness Conference
September 21-22, 2013
Boston, Massachusetts

National Conference on Addiction Disorders 2013
September 21-25, 2013
Anaheim, California

Harold Rogers Prescription Drug Monitoring Program National Meeting
September 25-27, 2013
Washington, D.C.

2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2, 2013
Chicago, Illinois

4th Annual Executive Forum on Creating a Culture of Health and Wellness
October 7-8, 2013
Chicago, Illinois

2013 American Association for Treatment of Opioid Dependence Conference
November 9-13, 2013
Philadelphia, Pennsylvania

11th Annual World Health Care Congress
April 7-9, 2014
National Harbor, Maryland
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.
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