SAMHSA Prescription Drug Abuse Weekly Update
Issue 137  |  August 27, 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 West News Other Resources Webinars Grant Award Grant Announcement National Take-Back Initiative Take-Back Events and Drop Boxes Upcoming Conferences and Workshops


L. Rasubala, L. Pernapati, X. Velasquez, J. Burk, and Y. Ren. 2015. "Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists." PLoS One 10(8):e0135957, doi:10.1371/journal.pone.0135957.

A comparison of opioid analgesic prescriptions among patients at a New York urgent dental care center before and after mandatory prescription drug monitoring program use showed 30.6 percent of patients received opioid analgesic prescriptions in the 3 months before mandatory use, 14.1 percent received prescriptions in the first 3 months after use, and 9.6 percent received prescriptions in the 3 months that followed. Total opioid pills prescribed in a 3-month period decreased from 5,096 to 1,120. Acetaminophen prescriptions increased during the same periods.

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L. Rutkow, H–Y. Chang, M. Daubresse, D.W. Webster, E.A. Stuart, and G.C. Alexander. 2015. "Effect of Florida's Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use." JAMA Intern Med, doi:10.1001/jamainternmed.2015.3931.

Applying a time series discontinuity model to July 2010–September 2012 IMS Health LifeLink LRx prescription data revealed that compared with trends in Georgia, passage of Florida's prescription drug monitoring program and pill mill laws were associated with declines in opioid volume (2.5 kg/mo, equivalent to approximately 500,000 5 mg tablets of hydrocodone bitartrate per month) and morphine milligram equivalents (MME) per transaction (0.45 mg/mo, without any change in days of supply). Twelve months after implementation, the laws were associated with a 1.4 percent decrease in opioid prescriptions, a 2.5 percent decrease in opioid volume, and a 5.6 percent decrease in MME per transaction. Reductions were limited to prescribers and patients with the highest baseline opioid prescribing and use.

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Journal Articles and Reports

J. Berecki–Gisolf, B. Hassani–Mahmooei, A. Collie, and R. McClure. 2015. "Prescription Opioid and Benzodiazepine Use After Road Traffic Injury." Pain Medicine, doi:10.1111/pme.12890.

Among 734 people in Victoria, Australia, whose claims for Transport Accident Commission compensation for a noncatastrophic injury in 2010–12 were linked to prescription drug data, 10.5 percent received opioids in the year before injury. In the 18 months after injury, 32.7 percent filled opioid prescriptions (45 percent of hospitalized and 21 percent of nonhospitalized claimants). Benzodiazepines were used by 4.8 percent preinjury and by 7.2 percent postinjury. Preinjury users generally continued opioid use postinjury.

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E. Kaplovitch, T. Gomes, X. Camacho, I.A. Dhalla, M.M. Mamdani, and D.N. Juurlink. 2015. "Sex Differences in Dose Escalation and Overdose Death During Chronic Opioid Therapy: A Population-Based Cohort Study." PLOS One, doi:10.1371/journal.pone.0134550.

Healthcare records of 32,499 individuals ages 15–64 who started chronic opioid therapy for noncancer pain between April 1997 and December 2010 in Ontario, Canada, showed 589 (1.8 percent) escalated to high-dose therapy, and 59 (0.2 percent) died from opioid-related causes while in treatment. In multivariate analysis, men were more likely than women to escalate to high-dose opioid therapy (adjusted hazard ratio [HR] 1.44) and twice as likely to die from opioid-related causes (HR 2.04). A secondary analysis of all 285,520 individuals receiving an opioid—regardless of the duration of therapy—yielded similar hazard ratios.

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T.S. Schepis, B.T. West, C.J. Teter, and S.E. McCabe. 2015. "Prevalence and Correlates of Co-Ingestion of Prescription Tranquilizers and Other Psychoactive Substances by US High School Seniors: Results from a National Survey." Addictive Behaviors, doi:10.1016/j.addbeh.2015.08.002.

In 2002–06 Monitoring the Future data from high school seniors, 5.3 percent reported past-year nonmedical tranquilizer use, with 3.85 percent (72.6 percent of users) taking another substance at the same time. Tranquilizers were most often taken with alcohol (a dangerous mix) or marijuana as recreational drugs.

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K. Sullivan, G. Capp, T.D. Gilreath, R. Benbenishty, I. Roziner, and R.A. Astor. 2015. "Substance Abuse and Other Adverse Outcomes for Military-Connected Youth in California." JAMA Pediatrics, doi:10.1001/jamapediatrics.2015.1413.

Analysis of 2013 California Healthy Kids Survey data from 54,679 military-connected and 634,034 nonmilitary-connected middle and high school students at public civilian schools revealed youth in military families were more likely to report alcohol use (45 percent vs. 39 percent) and prescription drug misuse (36 percent vs. 27 percent).

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Professional Education and Policy Debate

D. Jaber, I. Al Awwa, and M. Wazaify. 2015. "Multiple Prescription Drug Abuse and Salt Craving in a Psychotic Patient: A Case Report from a Teaching Hospital in Jordan." International Journal of High Risk Behaviors and Addiction 4(3):e22449, doi:10.5812/ijhrba.22449v2.

A 28-year-old woman presented with hypocalcemia, hypokalemia, and hypomagnesemia. She had a history of laxative and diuretic misuse, with salt craving. Psychiatric evaluation revealed a disturbed social background, with masked depression that necessitated treatment. Misuse of multiple prescription drugs and salt/salty food addiction usually reflects an addictive personality, which can lead to use disorder.

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Z. Paschkis and M.L. Potter. 2015. "CE: Acute Pain Management for Inpatients with Opioid Use Disorder." American Journal of Nursing, doi:10.1097/01.NAJ.0000471243.30951.92.

This article reviews current literature on acute pain management for inpatients with opioid use disorder (OUD) and dispels common myths about opioids and OUD.

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White House Launches New Effort to Combat Heroin Epidemic
Peter Sullivan, The Hill
August 17, 2015

The White House announced a new Heroin Response Strategy emphasizing the epidemic's public health aspects and pairing medical experts with law enforcement officials. The strategy includes $2.5 million to create five pairs of regional coordinators (Appalachia, New England, Philadelphia/Camden, New York/New Jersey, and Washington/Baltimore) across 15 northeastern states. Public health coordinators will oversee reporting of overdose information, issue alerts on dangerous batches, and set the distribution of naloxone. Public safety coordinators will provide support and intelligence to law enforcement looking to disrupt the heroin supply.

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The Heroin Epidemic, in 9 Graphs
Lindsey Cook, U.S. News & World Report
August 19, 2015

This article features nine graphs illustrating the heroin epidemic. The graphs include rates of drug-poisoning deaths involving heroin by selected age and race and ethnicity groups in 2000 and 2013, rates of drug-poisoning deaths involving heroin by selected age groups in 2000–13, and the annual average percentage of past-year heroin users with selected substance abuse or dependence in 2002–13.

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The Great American Heroin Emergency
The Washington Post
August 20, 2015

This editorial urges the government to better address the heroin epidemic. It lauds planned federal spending increases to support prescription drug monitoring programs (PDMPs), stating PDMPs are an especially effective prevention tool. However, the article expresses concern that the federal government tends not to speak with a single voice on this issue. For example, the Food and Drug Administration (FDA) approved OxyContin for use at ages 11–17 just days before the White House launched its antiheroin plan. According to the editorial, the FDA says this approval was designed to reign in ill-advised off-label use by imposing tight guidelines for dosing and efficacy.

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Sen. Manchin Condemns Approval of OxyContin for 11 Year Olds
Channing Frampton, WHSV
August 17, 2015

U.S. Senator Joe Manchin is demanding the Food and Drug Administration (FDA) reconsider its decision to allow OxyContin prescriptions for children as young as 11. Manchin will call for a senate investigation of the FDA decision.

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Sens. Markey, Hatch Call for Greater Access to Heroin and Prescription Drug Treatment
Ed Markey, U.S. Senator for Massachusetts
August 18, 2015

Senators Edward J. Markey and Orrin Hatch are among a bipartisan group that asked the Department of Health and Human Services to raise the number of patients a physician can treat with buprenorphine.

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This Is What a Decade of Drug Overdose in Oklahoma Looks Like
Jaclyn Cosgrove, The Oklahoman
August 20, 2015

This Centers for Disease Control and Prevention chart shows the types of drugs that have caused deaths in 25 states over the past 10 years. The drugs include semisynthetic opioids, heroin, benzodiazepines, cocaine, methadone, stimulants, synthetic opioids, and other unspecified narcotics.

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State Medical Board Backs Marijuana for Pain Syndrome
Hartford Courant
August 19, 2015

Connecticut's medical marijuana program added "complex regional pain syndrome" to the list of conditions appropriate for medical marijuana use. The program will draft regulations for the condition, and a hearing and public comment period will commence before the proposed regulation is sent to the attorney general's office for review. The legislature's regulation review committee has the final vote on adding conditions.

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Vets with PTSD Sue Colorado for Right to Use Medical Marijuana
Emma Gannon, Court House News
August 21, 2015

Four war veterans and a sexual assault victim sued Colorado for refusing to allow medical marijuana prescriptions for post-traumatic stress disorder (PTSD). These individuals "self-medicated" after their trauma and were prescribed drugs for PTSD. Medical marijuana has relieved their symptoms more effectively and with fewer side effects than prescription drugs. The plaintiffs seek judicial review of the Board of Health ruling and an order that PTSD is a debilitating condition for which physicians may prescribe marijuana. The Colorado Board of Health has 3 weeks to file an answer.

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Could Medical Marijuana Reduce Dependence on Opiates in Utah?
Andrea Smardon, KUER
August 19, 2015

Dr. Lynn Webster, a clinician and past president of the American Academy of Pain Medicine, testified before Utah lawmakers that marijuana products could help reduce the number of Utahans addicted to opiates. Dr. Webster acknowledged more research is needed on the risks and benefits of medical marijuana products. (Includes audio: 1:53 minutes)

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Medical Marijuana Law Could Be a Bust
Athens Daily Review
August 16, 2015

A new Texas law allows doctors to prescribe cannabis oil for patients with epilepsy. Because prescribing the main psychoactive ingredient of cannabis violates federal law, some advocates doubt state physicians will write prescriptions for the oil. Federal courts have generally only permitted physicians to recommend cannabis.

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Report: Washington Seeing Spike in THC–Impaired Drivers in Fatal Collisions
Lynsi Burton, Seattlepi.Com
August 20, 2015

In Washington, the number of THC–positive drivers involved in fatal collisions jumped to 12 percent in 2014 from 6 percent in 2012, with another 40 percent of drivers not tested. (Editor's note: The trend shown may result in part from the increasing number of THC–positive drivers on the road in general post-legalization.) Half of THC–positive drivers also exceeded the state blood alcohol limit of 0.08. Forty-four percent of cannabis-positive drivers also tested positive for THC in 2010, but that percentage went up to 63 in 2013 and 84 in 2014. About half of THC–positive drivers in fatal crashes in 2014 exceeded the 5 ng/ml limit that state law imposed for drivers. One driver was at 70 ng/ml.

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In the Shadow of Hazy Marijuana Laws, Hawaiian Patients Rely on a Network of Hush-Hush Growers
Anne M. Shearer, Katie Campbell, Rilwan Balogun, and Matias Ocner, News21, The Washington Post
August 18, 2015

Reporters interviewed Hawaiian patients about the source of their medical marijuana for the past 15 years. Under state law, most of Hawaii's estimated 13,000 patients first had to commit a crime to obtain and grow medical marijuana. Though Hawaii legalized medical marijuana in 2000, it did not make provisions for legal dispensaries. It required patients to grow their own supply, without indicating where to get seeds or plants. A new law, which allows 16 medical marijuana dispensaries, intends to eradicate illegal medical marijuana sales across the islands. The health department is establishing rules for dispensaries, but it is likely to be at least a year before any open. (Includes videos: 4:17 | 2:22 minutes)

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Feds Limit Research on Marijuana for Medical Use
Jayson Chesler and Alexa Ard, News21
August 18, 2015

Of the $1.4 billion in marijuana research funded by the National Institutes of Health (NIH) from 2008 to 2014, $1.1 billion went to misuse and addiction studies. The remainder funded studies of marijuana's effects on the brain and potential medical benefits. Getting NIH grants to study the drug's potential medical uses requires both Food and Drug Administration and Drug Enforcement Administration approval.

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Austin–Travis County, Texas EMS Reports Responding to 655 Synthetic Cannabinoid-Related Calls Since May 29th
Center for Substance Abuse Research, University of Maryland
August 13, 2015

Between May 29 and August 13, 2015, Texas Emergency Medical Services in Austin–Travis County responded to 655 calls related to synthetic cannabinoids from 708 patients.

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Police Drug Inspector Warns of Increased Fentanyl Abuse
Chris Herhalt,
August 17, 2015

Toronto Police are warning the public about fentanyl that is 40 times more potent than heroin. Fentanyl is usually combined with a street drug, which can lead to potentially lethal overdoses among users. This year alone, British Columbia reported 55 fentanyl deaths in the province. (Includes video: 11:09 minutes)

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Winnipeg Naloxone-Distribution Program Could Prevent Fentanyl Deaths
CBC News
August 20, 2015

Street Connections is a Winnipeg team that hands out medical care supplies to drug users. The team hopes to launch a free naloxone distribution program and offer training on the drug's use. (Includes video: 1:33 minutes)

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Warning as Thousands of 'Stolen' Diazepam Flood Wales
James McCarthy, Media Wales
August 15, 2015

Gwent Police (Wales) warned against buying illegal prescription pills after a user showed an investigator a box of diazepam and claimed he bought it in Newport following a theft. The seller told the buyer thousands of pills were available. Police in the area said no one has reported a diazepam theft.

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Northeast/Mid-Atlantic News

Healey Proposes New Tool in Fighting Opioid Abuse Epidemic
The Tampa Tribune
August 17, 2015

Massachusetts Attorney General Maura Healey proposed legislation that would make trafficking more than 10 grams of fentanyl a punishable crime, with a maximum penalty of 20 years in state prison.

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Braintree Fire to Receive Donation of 200 Narcan Devices
Daniel Libon, Braintree Patch
August 19, 2015

The Braintree (Mass.) state delegation secured a donation of 200 naloxone auto-injector devices for first responders. The Braintree Fire Department reported more than 50 overdose reversals between February 2014 and June 2015.

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Coroner: 3 Dead, Others Treated After Suspected Overdoses
August 17, 2015

Pennsylvania officials say three people died from suspected heroin overdoses over the weekend. Police are investigating 17 additional weekend overdoses—almost half of them in Washington, Pa.—after reviving three people with naloxone.

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Narcan Still Not Available to Caregivers
Judi Currie, Foster's Daily Democrat
August 18, 2015

New Hampshire stakeholders identified two immediate needs for addressing the heroin crisis: 1) Getting information to doctors so they can properly prescribe Narcan and 2) Giving instructions to caregivers who will administer the drug to addicts. Cost is also a factor for some. The state is stockpiling the drug, looking at ways to distribute it, and working on training materials. It suggests using the website for now.

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Oxycontin Makers Agree to Help in Overprescribing Crackdown
Dareh Gregorian, New York Daily News
August 20, 2015

Purdue Pharma, maker of OxyContin, has agreed to help crack down on overprescribing. The company will ensure sales reps flag doctor's offices and clinics that are potentially involved in "abuse and diversion" of the drug, and stop connecting with providers who are on the "no-call" list. Purdue also agreed to disclose OxyContin's addiction risk on its unbranded websites.

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Calvert County Health Department Launches Campaign Against Opioid Abuse
Andrew Cephas, Maryland Independent
August 21, 2015

Maryland's Calvert County Health Department launched a public awareness campaign about the dangers of opioid misuse. The department is promoting its campaign, which will run until October 1, through radio, television, billboards, movie theater advertising, flyers, posters, and social media.

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Retailer Takes Down Controversial Shirt Promoting Prescription Pills
Mira Wassef, Staten Island Advance
August 19, 2015

Multicolored shirts advertising pills like Vicodin, Percocet, and Xanax have been removed from the Against All Odds retail store in Staten Island Mall, New York. The shirt angered parents and politicians because it glorifies the drugs that are killing so many residents.

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South News

Heroin Overdose Deaths Still Rising in Virginia as Officials Try to Boost Awareness
Gary A. Harki, The Virginian-Pilot
August 15, 2015

The number of Virginians who died from overdosing on heroin or other opioids increased in 2014 for the second straight year, and the state is on pace to rise again. One hundred and twenty-six heroin-related overdose fatalities were confirmed in the first 6 months of 2015. There were 239 in all of 2014.

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Midwest News

Indiana to Receive $1.3 Million in Global Pharmaceutical Settlement
Kayla Crandall, WPTA-TV
August 18, 2015

The attorney general's office in Indiana announced that the state, 47 others, and D.C. have reached a $71 million settlement agreement with Amgen, a pharmaceutical company, for deceptive drug promotion. The funds will be used for prescription drug take-back programs, naloxone programs for first responders, and addiction treatment services.

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Michigan Rep. Introduces Prescription Drug 'Good Samaritan' Legislation
August 20, 2015

State Representative Al Pscholka introduced legislation that would provide immunity for people under 21 who report prescription drug–related medical emergencies.

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Attorney General Conway to Promote Cybersafety, Consumer Protection, and Prescription Drug Awareness at KY State Fair
Kentucky Office of the Attorney General
August 18, 2015

The attorney general and his staff will run a booth at the Kentucky State Fair to raise awareness about cybersafety, consumer protection, and prescription drug misuse.

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OBN Brings Medical Lockboxes to Seniors
The Oklahoman
August 21, 2015

The Oklahoma Bureau of Narcotics and Dangerous Drugs is distributing 500 medical lockboxes to seniors throughout the state. Lockboxes can be coded to open through a fingerprint reading, but they can also be opened with a key.

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West News

Witnesses: Cadet Got Drugs from Online Black Market and Sold Them in Dorms
Tom Roeder, Colorado Springs Gazette
August 18, 2015

Witnesses testified during a school hearing that black market drugs were bought on the Internet with Bitcoins and shipped to the Air Force Academy. Junior Cadet Nathaniel Penalosa is charged with 10 drug crimes, including manufacturing, using, and distributing "Molly." Three cadets were granted immunity from criminal charges to testify against Penalosa, but they still face administrative punishments from the academy. Penalosa could face up to 15 years if convicted by a court-martial on drug distribution. Students said Penalosa sold them Modafinil, an anti-narcolepsy prescription drug, and LSD. A random dorm room inspection last fall turned up drug residue, an electronic scale, and small bags, triggering a sweeping investigation.

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Other Resources

Pharmacy Joins YouTube, Dispenses Advice on Buying Medicine Online Safely
August 6, 2015

The .Pharmacy Top-Level Domain (TLD) Program is now on YouTube. This channel features public service announcements and interviews with Carmen Catizone, executive director of the National Association of Boards of Pharmacy, and Libby Baney, executive director of the Alliance for Safe Online Pharmacies. The videos highlight how the .Pharmacy TLD Program provides a safe, convenient way to find legitimate online sources of medication and related advice.


Purdue Pharma L.P. Launches
PR Newswire
August 17, 2015

Purdue Pharma L.P. launched Team Against Opioid Abuse, a new website designed to educate healthcare professionals and laypeople about opioid analgesics with abuse-deterrent properties.

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Opioid Use Disorders in Hispanics/Latinos
Providers' Clinical Support System for Opioid Therapies
August 27, 2015, 12–1 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)

Recovery Schools
SAMHSA, Minority Fellowship Program Coordinating Center
September 2, 2015, 2–3:30 p.m. (EDT)

Empowered Health Consciousness and Prescription Drugs: Facilitator Certification Training
Organizational Wellness
September 3, 2015, 12–2:30 p.m. (CDT)

This $149 training will provide health professionals, coaches, and trainers with tools to prevent prescription drug misuse among working adults and as part of any wellness, occupational health, human resource, employee assistance, or stress management strategy.

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Grant Award

Grants to Help Local Counties Combat Drug Abuse
Dayton Daily News
August 18, 2015

Ohio's High Intensity Drug Trafficking Areas (HIDTA) will get a $70,000 grant to reduce heroin and prescription drug misuse, a $125,000 award to strengthen HIDTA infrastructure and operations, and a $70,000 award for Operation Street Smart—a national program that offers drug prevention education to community groups focused on youth health and safety. The grants target 13 counties.

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Zachary Police Get Grant for Drug Enforcement
Stacy Gill, The Advocate
August 19, 2015

The National Association of Drug Diversion Investigators awarded the Zachary Police Department of Los Angeles a $5,000 grant to help address prescription drug misuse and diversion.

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Grant Announcement

Data Resource for Post-Marketing Prescription Drug Abuse Surveillance Data from Individuals Entering or Being Assessed for Substance Abuse Treatment
U.S. Department of Health and Human Services
Response date: September 3, 2015

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

Door-to-Door Prescription Drug Take-Back Day in Arlington
Linda Bock, Arlington Patch (Massachusetts)
August 18, 2015

Baker College of Flint Now Site of DEA–Designated Prescription Drug Collection Box
Baker College (Michigan)
August 17, 2015

Big Red Box Spotted at Shelter Island Heights Pharmacy
Ambrose Clancy, Shelter Island (New York)
August 17, 2015

Community Drug Drop at Dosher Hospital
Casey Roman, WECT (North Carolina)
August 15, 2015

Garden Spot Village to Serve as Collection Site for 10th National Drug Take-Back Day
Berksmont News (Pennsylvania)
August 20, 2015

Task Force Collects Prescriptions from Drop Boxes
Times News (Pennsylvania)
August 14, 2015

Shenandoah County Launches Prescription Drug Drop-Off Program
Avery Powell, WHSV (Virginia)
August 18, 2015

Drug Take Back Day Set for Kanawha County
Taylor Eaton, WSAZ (West Virginia)
August 18, 2015

Upcoming Conferences and Workshops

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

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


Sixth Annual Prescription Drug Abuse Symposium
State of Indiana, Attorney General's Office
October 28–29, 2015
Indianapolis, Indiana


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.