SAMHSA Prescription Drug Abuse Weekly Update
Issue 135  |  August 13, 2015
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
Table of Content Featured Article Journal Articles and Reports Professional Education and Policy Debate National Marijuana International Northeast/Mid-Atlantic News South News Midwest News Webinars Webinar Archive Grant Awards Grant Announcement National Take-Back Initiative Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


Banking for Pot Industry Hits a Roadblock
Nathaniel Popper, The New York Times
July 30, 2015

Banking regulators denied Denver's Fourth Corner Credit Union a "master account," which would have allowed the financial institution to interact with hundreds of Colorado-licensed marijuana businesses. The governor filed a lawsuit in federal court against the Federal Reserve, demanding equal access to the financial system. State government says lack of access to banks is a public safety issue and hampers Colorado's efforts to collect taxes. Nearly all banks have refused to open accounts for marijuana businesses in Colorado. (Includes video: 10:04 minutes)

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Drug Needle Exchanges Gain Ground After Indiana HIV Outbreak
Mary Wisniewski and Steve Bittenbender, Reuters
August 2, 2015

Indiana opened its first state-run needle exchange last spring, responding to an HIV outbreak. A pilot needle exchange program is due to begin in West Virginia in September, and Southern Ohio has opened exchanges in two cities since 2012. Louisville, Ky., opened an exchange in June, and the city of Lexington and rural Pendleton County have since approved exchanges.

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Journal Articles and Reports

B. Aden, A. Dunning, B. Nosyk, E. Wittenberg, J.W. Bray, and B.R. Schackman. 2015. "Impact of Illicit Drug Use on Health-Related Quality of Life in Opioid Dependent Patients Undergoing HIV Treatment." Journal of Acquired Immune Deficiency Syndromes, doi:10.1097/QAI.0000000000000768.

In 2004–09, a U.S. clinical trial of buprenorphine support for 307 HIV–infected patients with opioid dependence tracked their health-related quality of life using the standardized Short Form–12 (SF–12) instrument and its SF6D scoring. In multivariate mixed effects regression models controlling for demographic, clinical, and social characteristics, four factors were associated with lower health utility: continuing illicit opioid use, nonopioid illicit drug use, not being on antiretroviral therapy (ART), and being on ART with poor adherence. The observed decrement in health utility associated with illicit opioid use was greater for those on ART.

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S. Hong, J.G. Cagle, D.J. Van Dussen, I.V. Carrion, and K.L. Culler. 2015. "Willingness to Use Pain Medication to Treat Pain." Pain Medicine, doi:10.1111/pme.12854.

Multivariate analysis of random-digit-dial survey data from 123 U.S. adults (250 interviews were attempted) found willingness to use pain medicine was based primarily on threat appraisal, modified by coping appraisal, attitudes, perceived control, and—to a lesser extent—subjective norms. Lower income and greater awareness of hospice were also associated with more willingness to use pain medicine.

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L. Jessell, P. Mateu–Gelabert, H. Guarino, S.P. Vakharia, C. Syckes, E. Goodbody, K.V. Ruggles, and S. Friedman. 2015. "Sexual Violence in the Context of Drug Use Among Young Adult Opioid Users in New York City." Journal of Interpersonal Violence. Epub ahead of print.

A convenience sample of 46 young adults (ages 18–32) in New York City who reported lifetime nonmedical use of prescription opioids completed in-depth, semi-structured interviews. Another 164 who reported heroin and/or nonmedical prescription opioid use in the past 30 days completed structured assessments. Respondents reported frequent incidents of sexual violence experienced personally and by their opioid-using peers. Common scenarios were victimization of users who lost consciousness after substance use and implicit or explicit exchanges of sex for drugs or money that increased risk of sexual violence.

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B.G. Messina, N.M. Dutta, M.M. Silvestri, A.R. Diulio, K.B. Garza, J.G. Murphy, and C.J. Correia. 2015. "Modeling Motivations for Non-Medical Use of Prescription Drugs." Addictive Behaviors, doi:10.1016/j.addbeh.2015.07.024.

In an online survey of 1,016 Auburn University undergraduates, past-year nonmedical use rates for prescription drugs were 13.6 percent for tranquilizers and sedatives, 18.6 percent for pain relievers, and 25.4 percent for stimulants. Self-treatment and recreational motives helped explain pain reliever and stimulant misuse but not tranquilizer and sedative misuse. Respondents received extra credit they could allot within their courses.

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M. Meyers and J. Phillips. 2015. "Caring for Pregnant Opioid Abusers in Vermont: A Potential Model for Non-Urban Areas." Preventive Medicine, doi:10.1016/j.ypmed.2015.07.015.

This article describes Vermont's comprehensive, community-based program to treat opioid dependence during pregnancy and the process used to develop it. Appreciation for the severity and importance of the state's opioid dependence problem among healthcare providers and legislators was key.

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L. Orsolini, G. Francesconi, D. Papanti, A. Giorgetti, and F. Schifano. 2015. "Profiling Online Recreational/Prescription Drugs' Customers and Overview of Drug Vending Virtual Marketplaces." Human Psychopharmacology: Clinical and Experimental 30(4):302–18, doi:10.1002/hup.2466.

PubMed, Google Scholar, and Scopus searches in March 2014 identified 20 articles that profiled recreational drug market customers and 51 that profiled online pharmacy customers. Typical online recreational drug customers are highly educated Caucasian males in their 20s who use the Web to minimize impact on their work or professional status. Conversely, people without health insurance look to the Web as a source of more affordable prescription medicine. Drug vending websites typically present themselves with a "no prescription required" headline and use aggressive marketing strategies.

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K.K. Rigg and S.M. Monnat. 2015. "Comparing Characteristics of Prescription Painkiller Misusers and Heroin Users in the United States." Addictive Behaviors, 51:106–12, doi:10.1016/j.addbeh.2015.07.013.

In 2010–13 National Survey on Drug Use and Health data, reported past-year opioid use patterns were 179 heroin only (0.1 percent of respondents), 9,516 prescription pain relievers only (4.4 percent), and 506 heroin and prescription pain relievers (0.25 percent). Socioeconomic disadvantage, older age, disconnection from social institutions, criminal justice involvement, and easy access to heroin were associated with greater odds of being in the heroin-only group. Users of both heroin and prescription pain relievers were more likely to be young white males in poor physical and mental health who also misused other prescription medications beginning in adolescence. Prescription opioid misusers were the most economically stable, most connected to social institutions, least likely to be involved with the criminal justice system, and had the least access to heroin.

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A. Sgarlato and S.J. deRoux. 2015. "Prescription Opioid Related Deaths in New York City: A 2 Year Retrospective Analysis Prior to the Introduction of the New York State I-STOP Law." Forensic Science, Medicine, and Pathology, doi:10.1007/s12024-015-9699-z.

A review of 2011–12 prescription opioid fatalities in New York City identified 1,286 chemical intoxication deaths, including 547 involving prescription opioids. Methadone was most frequently involved, followed by oxycodone. Only 37 percent of decedents had a valid opioid prescription. Of nonopioid medications associated with prescription opiate deaths, benzodiazepines were the most frequent (68 percent), primarily alprazolam (Xanax).

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C.H.J. Yang, M. Doshi, and N.A. Mason. 2015. "Analysis of Medications Returned During a Medication Take-Back Event." Pharmacy 3(3):79–88, doi:10.3390/pharmacy3030079.

This study analyzed prescription data on 2,459 of 3,600 medication containers collected at a 4-hour Lansing, Mich., drug take-back event in September 2013. The most common therapeutic classes collected were pain/spasm, cardiovascular, and mental health, including 304 controlled substance prescriptions. On average, 66 percent of medications dispensed were unused. Immunologic medications had the lowest unused quantity at 54 percent, while the geriatrics/miscellaneous therapeutic class yielded the highest unused quantity at 79 percent.

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Professional Education and Policy Debate

The Joint Commission. 2015. "Medication Management: Countering Drug Diversion." Joint Commission: The Source 13(8):1–10.

Prescription drug abuse is one of the fastest growing healthcare problems in the United States. It has affected so many patients, families, healthcare workers, and hospitals that the Centers for Disease Control and Prevention has formally labelled the problem an epidemic. This article provides strategies for reducing diversion in your organization.

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R. Hiscott. 2015. "Rethink Chronic Pain." Neurology Now 11(4):10–11, doi:10.1097/01.NNN.0000470756.41753.3a.

The author suggests alternative strategies to prescription pain reliever use, such as changing one's mindset, exercising, setting reasonable goals, and trying cognitive–behavioral therapy.

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J. Mai, G. Franklin, and D. Tauben. 2015. "Guideline for Prescribing Opioids to Treat Pain in Injured Workers." Physical Medicine and Rehabilitation Clinics of North America 26(3):453–65, doi:10.1016/j.pmr.2015.04.005.

This guideline provides recommendations for prudent opioid prescribing and addresses issues critical to the care and rehabilitation of injured workers. The use of chronic opioid therapy requires regular monitoring and documentation, such as screening for risk of comorbid conditions with validated tools, checking prescription monitoring program databases, assessing function, and administering random urine drug tests, as well as discontinuing opioids if treatment has not resulted in clinically meaningful improvement in function.

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The First 3D-Printed Prescription Drug Has Arrived—Here's Why It Matters
Kevin Loria, Business Insider
August 4, 2015

The Food and Drug Administration approved its first 3D–printed drug. The tablet, called Spritam (Aprecia Pharmaceuticals), is designed to give a high dose of anti-epileptic medication that dissolves in a sip of water, which helps patients who have trouble swallowing. This method supports printing an individually customized drug. Unfortunately, it also makes production of illicit drugs simpler.

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HHS Kicks in Millions More to Fight Opioid Abuse Epidemic
American Academy of Family Physicians
August 5, 2015

The Substance Abuse and Mental Health Services Administration (SAMHSA) is awarding 11 grants of about $1 million each as part of its Targeted Capacity Expansion: Medication Assisted Treatment-Prescription Drug and Opioid Addiction (MAT–PDOA) program. SAMHSA plans to award similar amounts in 2016 and 2017. The grants will 1) increase the number of individuals who receive MAT services, 2) increase the number of individuals receiving integrated care (i.e., medical, behavioral, or social and recovery support services), and 3) decrease illicit drug use at the 6-month follow-up.

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Brown Unveils New Effort to Address Prescription Drug Abuse by Preventing 'Doctor Shopping' to Obtain Multiple Prescriptions
Sherrod Brown, Senator of Ohio
August 3, 2015

U.S. Sen. Sherrod Brown is sponsoring the Stopping Medication Abuse and Protecting Seniors Act, which would create a patient review and restriction, or "lock-in," program limiting Medicare beneficiaries with a history of drug misuse to one prescriber and one pharmacy. The act also encourages insurers, Part D plan sponsors, and healthcare professionals to improve treatment access and incentives for the estimated 170,000 Medicare beneficiaries battling opioid addiction.

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The Indianapolis Colts Want Your Prescription Drugs
The Washington Post
August 6, 2015

An Indianapolis Colts prescription drug disposal campaign offers fans a 2014 highlights DVD in exchange for their old medication. The promotion, part of the team's partnership with Indiana's Prescription Drug Abuse Prevention Task Force, has been criticized on Twitter because owner Jim Irsay was arrested in March 2014, suspended six games, and fined $500,000 after pleading guilty to a misdemeanor count of driving under the influence of oxycodone and hydrocodone. Since then, Irsay completed drug rehab and joined the battle to reduce prescription opioid addiction.

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Groups Team Up to Give Free Cannabis to Veterans
August 2, 2015

Grow4Vets and High There! have been handing out cannabis to military veterans for a year in Colorado. Now their "Save a Million Vets Tour" will travel across the country, helping vets get medication. The tour is headed to Los Angeles, Nevada, Arizona, and New Mexico. (Includes video: 1:32 minutes)

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'Zero Tolerance' Policy on Drugs in Workplace Upheld by Human Rights Tribunal Where Employee Did Not Have 'Marijuana Card'
Adrian Miedema, JD Supra
July 31, 2015

The British Columbia Human Rights Tribunal upheld a case in which an employee who smoked marijuana on the job without legal and medical authorization was not discriminated against when dismissed under his employer's "zero tolerance" policy. A logging contractor diagnosed with cancer smoked marijuana to manage pain. He and a coworker shared six to eight joints a day. They smoked at work only when the foreman was not present. The employee did not have a prescription, medical document, or marijuana card and did not inform his employer he was using an impairing or potentially impairing substance.

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Medical Cannabis Trial to Find Right Dose for End-of-Life Cancer Population
Jennifer Martin, Brisbane Times
August 1, 2015

University of Newcastle Professor Jennifer Martin discusses Australia's first medical cannabis trial for terminally ill adults. The initial stage will enroll 30 patients of different ages and weights who have a life expectancy of 3 to 6 months. The objective is to find which cannabis dose is right for a potentially frail, underweight, end-of-life cancer patient. A placebo will be included to determine if the thought of receiving cannabis triggers a response or if it is in fact the tetrahydrocannabinol. The drug will be delivered via vapor. After inhaling, participants will be shown a food chart to determine how much they feel like eating and asked about their anxiety and quality of life. A statewide stage two trial of 300 patients is planned.

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New Oxycodone Rules Would Give Drug Maker a Monopoly in Canada, Experts Warn
The Globe and Mail
August 4, 2015

Canada is the world's second-highest per capita consumer of prescription opioids. Health Canada unveiled draft rules in June that would require slow-release oxycodone to be tamper resistant. The rule would force generic versions of the popular drug off the market, giving the company at the center of Canada's prescription pain pill crisis a monopoly. Medical experts question why Health Canada would not apply the proposed rules to all opioids. They also fear the regulations could make doctors believe tamper-resistant oxycodone is safe, leading to more liberal prescribing of the powerful, addictive drug.

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Northeast/Mid-Atlantic News

Prescription Drug Coverage Law Awaits Cuomo's Signature
Michelle Faust, WXXI News
August 6, 2015

New York Governor Andrew Cuomo is deliberating on a bill that gives doctors the ultimate say over which medications their patients take. The legislation prevents Medicaid managed care plans from blocking prescriptions of known misusers or demanding additional proof of treatment necessity.

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Prescription Drug Monitoring Program to Link to Other States
Meredith Cohn, Baltimore Sun
August 6, 2015

Prescription drug monitoring program users in Maryland just gained access to Virginia prescription data and soon will have access to data from more states.

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Despite Efforts, Mass. Opioid Deaths on Pace to Match 2014
Michael Levenson, The Boston Globe
August 5, 2015

The opioid crisis claimed more lives in Massachusetts last year than initially estimated and shows no sign of abating this year, despite additional treatment programs and safeguards to prevent pain pill abuse. The final count of 1,256 opioid overdose deaths in 2014 far exceeds the initial estimate of 1,008. In the first 3 of months of 2015, there were another 312 overdose deaths. The death toll exceeds tolls from car crashes and gunfire combined and has not fallen despite the range of measures put in place to attack the problem. Those efforts include getting naloxone into the hands of more first responders, increasing drug treatment, making it harder for doctors to overprescribe, and an $800,000 ad campaign launched in June to raise awareness of prescription pain pill hazards.

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AG Denn Addresses Delaware's Heroin and Opioid Problem
Greg Guidone, WMDT47 ABC
August 7, 2015

Delaware Attorney General Denn revealed his plan to tackle heroin addiction in the state. He wants to create a board charged with reviewing all heroin and prescription pain medicine deaths to assess what could have been done better. Currently, that only happens following the death of a child. Denn also wants to revamp regulations for opioid prescribing so there is more follow-up with patients.

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South News

DEA Agent: High Cost of Black Market Prescription Pills Leads to Increase in Heroin-Related Deaths
Maya Lau, The Advocate
August 6, 2015

Heroin-related deaths are on the rise in Baton Rouge, La., and prescription medications are the so-called "gateway drugs" at fault, according to Terry Davis, who heads the Drug Enforcement Agency's New Orleans division. At a Rotary Club lunch, he said the high cost of prescription tablets on the black market drives inexperienced dealers to mold heroin with random ingredients into what looks like traditional pills. Unwitting buyers are dying.

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The Public Health Issue of Our Time: Prescription Drug Abuse
Robert Schaaf, The News & Observer
August 3, 2015

Robert E. Schaaf, M.D., president of the North Carolina Medical Society, asks his colleagues to combat opioid abuse by registering to use the prescription drug monitoring program.

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Midwest News

Fatal Overdoses Reach Record Levels in Michigan
Kristi Tanner, Detroit Free Press
August 1, 2015

The Michigan Department of Community Health reported that in 2013, 1,533 people died from drug overdoses in the state—an increase of 18 percent from the previous year. The spike reverses a decline from a 2009 peak of 1,416 deaths.

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Minnetonka's Verde Says It Has Big Solution for Prescription Drug Abuse in its Deterra Product
Star Tribune
August 2, 2015

Verde Technologies of Minnetonka, Minn., says its Deterra drug-deactivation packets give consumers an easy, environmentally benign way to destroy excess prescription drugs at little to no cost and render them safe for disposal or flushing. The biodegradable pouches use molecular absorption technology to neutralize active chemicals in prescription drugs when water is added.


Strategies to Address Opioid and Prescription Drug Misuse Series
Addiction Technology Transfer Center
August 19, 2015: Opioid Overdose Intervention and Drug Disposal Strategies, 1:30–2:30 p.m. (EDT)

ED Naloxone Distribution: Key Considerations and Implementation Strategies
American College of Emergency Physicians, Trauma and Injury Prevention Section
August 19, 2015, 1–2:30 p.m. (EDT)


Innovative Practices in Medication Assisted Treatment and Primary Care Coordination
Office of National Drug Control Policy
August 27, 2015, 3–4 p.m. (EST)

Webinar Archive

Responding to the Prescription Misuse Epidemic: Promising Prevention Programs and Useful Resources
July 9, 2015

The Substance Abuse and Mental Health Services Administration (SAMHSA)–funded Preventing Prescription Abuse in the Workplace project hosted the last Webinar in a series on prescription drug misuse for SAMHSA's prevention week. Useful resources were provided for responding to the prescription misuse epidemic, and a wide range of topics were covered, including the scope and consequences of prescription drug misuse, alternatives to opioids for treating acute and chronic pain, and raising community awareness. (Duration: 1:41:07)


Grant Awards

SLU Scientist Awarded Special NIH Grant to Solve Pain-Killer Problem
Saint Louis University
July 15, 2015

Daniela Salvemini, a pharmacology and physiology professor at Saint Louis University, was awarded a National Institutes of Health Cutting-Edge Basic Research Award. The 2-year, $378,750 award will continue Salvemini's search for ways to mitigate opioid side effects—focusing on issues like addiction, nausea, and sedation—while preserving their pain-relieving ability.

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Substance Abuse Funding Available to Groups
August 1, 2015

The Connecticut Department of Mental Health and Addiction Services received a 5-year, $8.2 million federal grant. It will in turn award competitive grants to 11 urban communities to help them address youth alcohol use and prescription drug misuse.

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Grant Announcements

2015 Healthy Living Grant Program
American Medical Association
Deadline: September 11, 2015, 5 p.m. (Central)

Partnership for Clean Competition
Pre-applications due November 1
Full applications due December 1

National Take-Back Initiative

National Prescription Drug Take-Back Day
Drug Enforcement Administration
September 26, 2015, 10 a.m. to 2 p.m.
Various locations nationwide

Take-Back Events and Drop Boxes

Drug Take Back Day a Success
The Garden Island (Hawaii)
July 31, 2015

New Prescription Drug Drop-Off Program Starting in Natick
Brian Benson, The Metro West Daily News (Massachusetts)
August 2, 2015

'Selfie with the Sheriff' Project Promotes Safe Drug Disposal
New Jersey Advance Media (New Jersey)
July 31, 2015

Drug Take Back Day Featured at Schuylkill County Fair
Amy Marchlano, Republican Herald (Pennsylvania)
August 1, 2015

Medication Drop-Off Location at Christiansburg Police Department
Justin Ward, WDBJ (Virginia)
August 3, 2015

Incinerated—How Illegal Drugs Are Disposed of
Matthew Lane, Times News (Tennessee)
August 2, 2015

Drug Disposal Program Continues
HTR Media (Wisconsin)
August 1, 2015

Cleveland County Sheriff's Office Conducting Prescription Drug Roundup
KOCO Oklahoma City
August 15, 2015

Prescription Drug Drop-Off to Take Place at Burton Senior Center
Molly Young, MLive (Michigan)
August 5, 2015

Upcoming Conferences and Workshops

Pain. Pill. Problem.
State of Minnesota, Office of the Governor
August 25, 2015, 8:30 a.m. to 5 p.m.
TCF Bank Stadium
DQ Club Room
420 Southeast 23rd Avenue
Minneapolis, Minnesota 55455

This workshop will discuss Minnesota's struggles with prescription pain relievers and determine how best to address the problem. Participants will hear from experts and those directly and indirectly affected by prescription drug misuse.


Prescription Drug and Heroin Conference
Berrien Community Foundation
August 28, 2015
St. Joseph, Michigan 49085

SCOPE of Pain Training
Oakland County Prescription Drug Abuse Partnership
October 3, 2015
Waterford, Michigan


143rd Annual Meeting and Exposition—Health in All Policies
American Public Health Association
October 31–November 4, 2015
Chicago, Illinois


2015 Fall Research Conference: The Golden Age of Evidence-Based Policy
Association for Public Policy Analysis and Management
November 12–14, 2015
Miami, Florida


28th Annual National Prevention Network Conference: Bridging Research to Practice
National Prevention Network
November 17–19, 2015
Seattle, Washington


University of Michigan Injury Center Prescription Drug Overdose Summit
University of Michigan Injury Center
December 1, 2015
Ann Arbor, Michigan

2016 National Rx Drug Summit
March 28–31, 2016
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.