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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.
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Report: New Opioid Prescribing Policies Likely Not Cause of Increased Heroin Use
National Institute on Drug Abuse
January 13, 2016
Federal and state policies aimed at curbing inappropriate prescribing of opioids did not directly lead to the recent nationwide increase in heroin use, assert the deputy director of the National Institute on Drug Abuse and prescription drug misuse researchers from the U.S. Food and Drug Administration and Centers for Disease Control and Prevention. In an article published in the New England Journal of Medicine, they said transition to heroin use began before the implementation of robust prescription drug monitoring programs and abuse-deterrent opioid formulations. Transition from nonmedical use of prescription opioids to heroin use appears to be part of the progression of addiction in a subgroup of nonmedical users of prescription opioids, primarily among persons with frequent nonmedical use and those with prescription opioid abuse or dependence. People who use prescription opioids nonmedically rarely use heroin, and the transition to heroin use appears to occur at a low rate. The researchers suggest that increased accessibility, lower market price, and higher purity of heroin were major drivers of recent heroin use increases and related deaths.
Read more:
http://www.drugabuse.gov/news-events/news-releases/2016/01/new-opioid-prescribing-policies-not-likely-to-have-caused-increase-in-heroin-use
http://www.nejm.org/doi/full/10.1056/NEJMra1508490
S.S. Lee, Y. Choi, and G.S. Pransky. 2016. “Extent and Impact of Opioid Prescribing for Acute Occupational Low Back Pain in the Emergency Department.” Journal of Emergency Medicine, doi:10.1016/j.jemermed.2015.10.015.
Of the 155,670 low-back claims found in Liberty Mutual Insurance’s workers’ compensation claims data between 2009 and 2011, 2,887 were new, acute, lost-time, lower-back pain cases without other injuries and the claimants were treated in the emergency department within 3 days post-onset but not admitted. Twelve percent of the people with new non-chronic cases were dispensed opioids within 2 days of first visit. Controlling for severity, early receipt was associated with long-term opioid use (22.6 percent versus 16.0 percent, adjusted risk ratio = 1.3) and increased total medical costs for those in the highest opioid dosage quartile (an increase of $7,385 per case compared with the no-opioid group) but not associated with disability duration or subsequent low back surgery.
Read more:
http://www.jem-journal.com/article/S0736-4679(15)01150-6/abstract
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Journal Articles and Reports
B-M. Lindgren, M. Eklund, Y. Melin, and U.H. Graneheim. 2016. “From Resistance to Existence—Experiences of Medication-Assisted Treatment as Disclosed by People with Opioid Dependence.” Issues in Mental Health Nursing 36(12):963-970, doi:10.3109/01612840.2015.1074769.
Eleven narrative interviews with patients in a medication-assisted treatment program in Sweden revealed that patients described the program as a process from resistance to existence. Participants seized the chance to claim a life lived with dignity, struggled with hidden challenges, and eventually were freed from their pasts and grateful for their renewed life. The recovery process was a long-term commitment. Participants wanted a more individual and flexible process based on personal needs and values.
Read more:
http://www.tandfonline.com/doi/abs/10.3109/01612840.2015.1074769
L. Maldjian, A. Siegler, and H.V. Kunins. 2016. “Evaluation of Overdose Prevention Trainings in NYC: Knowledge and Self-efficacy among Participants Twelve Months after Training.” Substance Abuse, doi:10.1080/08897077.2015.1135850.
In a 1-year follow-up survey with 273 of 344 (79 percent) overdose prevention trainees in New York City, 99 percent said naloxone reverses heroin overdoses, 77 percent said it reverses opioid analgesics, and 68 percent said it reverses methadone overdoses. Respondents said overdose response actions were giving naloxone (86 percent) and calling 9-1-1 (76 percent). Mean knowledge scores were higher for college graduates than those without a college degree and for indoor-training recipients. Mean knowledge scores did not differ by trainee age, race, or gender.
Read more:
http://www.tandfonline.com/doi/abs/10.1080/08897077.2015.1135850
S.P. Novak, E.L. Ball, A.R.Winstock, and N. Peiper. 2015. “The Prevalence of Common Infectious Diseases among Nonmedical Prescription Opioid Users: Preliminary Findings from the National Prescription Opioid Misuse, Abuse, and Diversion (NOMAD) Study.” Epidemiology 5:205, doi:10.4172/2161-1165.1000205.
Among 344 past-year nonmedical prescription opioid users (recruited from online advertisements and referrals from ongoing research studies of prescription drug abusers in the United States), 72.5 percent reported at least one lifetime common infectious disease. The most common were hepatitis B (18.8 percent), A (8.9 percent), and C (8.4 percent). Over 5 percent reported an HIV/AIDS diagnosis. Eighty percent contracted their first sexually transmitted disease by age 25. Injection practices were associated with common infectious diseases, and in particular hepatitis A and C. Comorbidities significantly associated with lifetime common infectious diseases were bipolar disorder (odds ratio [OR] = 16.3), opioid use disorder (OR = 8.3), and history of mood disorder (OR = 6.8). Incarceration and drug treatment were associated with a lower risk of disease. Most infectious disease onsets (95.4 percent) were prior to initiation of nonmedical prescription opioid misuse or diversion.
Read more:
http://www.omicsonline.org/open-access/the-prevalence-of-common-infectious-diseases-among-nonmedical-prescriptionopioid-users-preliminary-findings-from-the-national-pres-2161-1165-1000205.php?aid=65513
É. Roy, M.A. Nolin, I. Traoré, P. Leclerc, and H.M. Vasiliadis. 2015. “Nonmedical Use of Prescription Medication among Adolescents Using Drugs in Quebec.” Canadian Journal of Psychiatry 60(12):556–63.
Among Quebecois high school students ages 12–17 who had used drugs in the previous 12 months, 5.4 percent misused prescription drugs, according to Quebec Health Survey of High School Students data from 2010–11. In multivariate analysis, odds of misuse were 4.1 for those with polysubstance use, 2.1 with anxiety disorder, 2.0 with low self-esteem, 2.0 with low self-control, 1.7 with regular alcohol use, 1.5 with attention deficit hyperactivity disorder, and 1.4 with low parental supervision.
Read more:
http://europepmc.org/abstract/med/26720824
R. Shadick, F.B. Dagirmanjian, L. Trub, and H. Dawson. 2016. “Sexual Orientation and First Year College Students’ Nonmedical Use of Prescription Drugs.” Journal of American College Health, doi:10.1080/07448481.2015.1117469.
Ten percent of students at a small private university in New York City admitted using prescription drugs non-medically, according to a survey of 4,428 first-year students (of which 3,451 [78 percent] contained usable demographics). In multivariate analysis, relative to white students, odds of nonmedical use were 0.7 for Hispanic, 0.4 for Asian, and 0.4 for black students. Odds did not differ significantly by sex. Relative to heterosexual students, gay and lesbian students did not have significantly higher odds of nonmedical use, but bisexual (odds ration [OR] = 3.0) and questioning students (OR = 2.4) did. Compared to heterosexual female students, lesbian, bisexual and questioning female students reported higher nonmedical use overall and for pain relievers. For stimulants and anxiolytics, bisexual students reported the highest nonmedical use, followed by gay and lesbian students.
Read more:
http://www.tandfonline.com/doi/abs/10.1080/07448481.2015.1117469
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Professional Development
T. Shimane. 2016. “The Pharmacist as Gatekeeper of Prescription Drug Abuse: Return to “Community Scientists”.” Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan 136(1):79–87, doi:10.1248/yakushi.15-00228-3.
This article reviews prescription drug misuse and use disorder levels in Japan. It examines the role of pharmacists as gatekeepers in preventing misuse and discusses the effect of intervention in the form of gatekeeper training for community pharmacists.
Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26725672
J.A. Yang, N. Ashtari, L. Kyupelyan, and A.M. Runyan. 2016. “Treatment of an Older Adult with Borderline Personality Disorder and Prescription Opioid Abuse.” Clinical Case Studies, doi:10.1177/1534650115623656.
This case study describes treatment integrating the recovery model, person-centered therapy, and the stages of change model with an older adult client with borderline personality disorder and co-occurring opioid misuse. During treatment, the client’s overuse of opioids, depression, and suicidal ideation decreased.
Read more:
http://ccs.sagepub.com/content/early/2016/01/07/1534650115623656.abstract
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National
How the White House Plans to Address Rural America’s Struggle with Heroin
Juliet Eilperin, Washington Post
January 15, 2016
President Obama has appointed Agriculture Secretary Tom Vilsack to lead a new interagency effort focused on addressing rural America’s struggle with heroin, opioid misuse, and other major problems. Secretary Vilsack will look across federal agencies to see what unique capabilities they have to invest in addressing these issues.
Read more:
https://www.washingtonpost.com/politics/agriculture-secretary-to-lead-effort-addressing-rural-areas-struggles-with-drugs/2016/01/14/2fb61684-bb05-11e5-b682-4bb4dd403c7d_story.html
CVS Pharmacy Offering Naloxone Prescription Free
Stacey Pinno, WECT
January 11, 2016
CVS Pharmacy will expand its availability of naloxone to 20 other states, including North Carolina, by the end of March. CVS will offer naloxone for $40–$50 per dose but offer it free to customers who cannot afford it.
Read more:
http://www.wect.com/story/30931937/cvspharmacy-offering-naloxone-prescription-free
National Safety Council Applauds National Transportation Safety Board Most-Wanted List
PRNewswire
January 13, 2016
The National Transportation Safety Board’s transportation safety priorities (its most-wanted list) for 2016 include ending substance impairment in transportation. Prescription opioid use is an ever-growing threat. The drugs can alter a person’s judgment, impair coordination, and create confusion. People taking them are often too impaired to drive or report to work.
Read more:
http://news.sys-con.com/node/3632511
Combating Prescription Drug Misuse through Education
Harvard University School of Dental Medicine
January 8, 2016
Harvard University’s School of Dental Medicine will create case-based training modules to educate students and healthcare professionals about pain management and appropriate opioid prescribing. Once completed and tested, the modules will be available to the public on the National Institutes of Health website, along with modules from the other 10 centers of excellence in pain education.
Read more:
http://hsdm.harvard.edu/news/combating-prescription-drug-misuse-through-education
Navy Drug-Screening Lab Maintains Warfighter Readiness
Julie M. Lucas, NAS Jacksonville Public Affairs
January 13, 2016
The Navy Drug Screening Laboratory in Jacksonville, Fla., supports Navy and Marine Corps zero tolerance policies for drug misuse by testing 8,000 urine samples per day (collected worldwide) for the presence of illicit drugs, including marijuana and prescription drugs. The Uniform Code of Military Justice prohibits the use of medical marijuana and legalized recreational marijuana use. The Navy’s positive testing rates are substantially below the civilian rates of drug use in the United States.
Read more:
http://jacksonville.com/military/jax-air-news/2016-01-13/story/navy-drug-screening-lab-maintains-warfighter-readiness
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Marijuana
Rocky Mountain High Intensity Drug Trafficking Area. 2016. “The Legalization of Marijuana in Colorado: The Impact, Latest Results for Colorado Youth and Adult Marijuana Use.”
Colorado legalized recreational marijuana in 2013, and retail marijuana businesses began operation in 2014. The Rocky Mountain High Intensity Drug Trafficking Area reported that Colorado is first in the nation for past mouth marijuana use, up from fourth in 2011–12. In 2013–14, past-month marijuana use among Colorado youth increased 20 percent compared to 2011–12. Past-month marijuana use for 2013–14 among Colorado youth was 74 percent higher than the national average. It was only 39 percent higher in 2011–12. Past-month marijuana use among youth nationwide declined 4 percent during the same time period.
Read more:
http://www.rmhidta.org/html/FINAL%20NSDUH%20Results-%20Jan%202016
%20Release.pdf
Online Course: What Do We Know About Marijuana?
Community Anti-Drug Coalitions of America
Accessed January 15, 2016
This course explores the latest research about the harms of marijuana, how it impacts users and society, and the issue of marijuana as medicine. It includes activities in which participants can practice responding to community member’s questions and concerns. Finally, it looks at how coalitions can include local conditions around marijuana use and consequences in their logic models and implement environmental, population-changing strategies. (Course Duration: 45 minutes)
Read more:
http://learning.cadca.org/products/1022/what-do-we-know-about-marijuana
Survey: Some Minnesota Doctors Remain Leery of Medical Marijuana
Jennifer Brooks, Star Tribune
January 12, 2016
Of 262 physicians responding to a Minnesota Task Force on Medical Cannabis survey (unknown response rate), most said they did not know enough about medical marijuana to discuss the risks and benefits with a patient, opposed the idea of expanding Minnesota’s program to pain patients, and thought the program just meant more hassle and paperwork for them. The task force will soon submit its report on the medical cannabis program to Minnesota’s legislature.
Read more:
http://www.startribune.com/survey-some-minnesota-doctors-remain-leery-of-medical-marijuana/365074481
Utah Veterans Work to Legalize Medical Marijuana amid Wave of Suicides, Overdoses
Cathy Standard Examiner
January 13, 2016
Utah Veterans for Medical Cannabis is working to legalize medical marijuana. Some veterans hope to use marijuana to treat their posttraumatic stress disorder (PTSD) symptoms. Drew Reese, who served 7 years in the Army and 4 years in the Air Force, claims that research shows that marijuana is slowing the suicide epidemic. He has lost more than 18 friends to drug overdoses. Two bills are now being drafted for Utah’s 2016 legislative session. The veterans group is disappointed with both bills. One only allows veterans to access medical marijuana with certain combat-related injuries and excludes PTSD due to sexual assault or trauma from stateside military base shootings. The other only permits the use of cannabidiol oil.
Read more:
http://www.standard.net/Government/2016/01/13/Veterans-work-to-legalize-medical-marijuana-amidst-wave-of-suicides-overdoses.html
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International
Health Canada Plans Changes to Allow Easier Access to Overdose Drug
CTV News
January 15, 2016
Health Canada will fast-track changes that allow nonprescription use of naloxone for opioid overdose. It is examining whether naloxone can be used safely outside the supervision of a healthcare practitioner before it changes the drug’s prescription status.
Read more:
http://www.ctvnews.ca/health/health-canada-plans-changes-to-allow-easier-access-to-overdose-drug-1.2738804
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Northeast/Mid-Atlantic News
Massachusetts House Passes Opioid Addiction Bill
Shira Schoenberg, MassLive
January 13, 2016
The Massachusetts House has passed a bill that would limit first prescriptions to adults for opioids for acute pain to a 7-day supply. All opioid prescriptions for minors would be limited to 7 days. The bill requires that if the patient consents, within 24 hours and before discharge, a mental health professional must provide a substance use evaluation to anyone who enters the emergency department experiencing an opioid overdose. The bill now heads to negotiators to resolve inconsistencies with a version passed in the state's senate.
Read more:
http://www.masslive.com/politics/index.ssf/2016/01/massachusetts_house_passes_opi.html
Vermont Adopts Appriss Platform to Mitigate Drug Diversion
GlobeNewswire
January 11, 2016
Vermont has adopted health IT developer Appriss’s Prescription Drug Monitoring Solution platform, which accommodates mandatory pharmacy reporting and offers secure accessibility to data across state lines.
Read more:
http://globenewswire.com/news-release/2016/01/11/801003/10159058/en/Vermont-Adopts-Appriss-Platform-to-Mitigate-Drug-Diversion.html?f=22&fvtc=7
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South News
Bill Encouraging Health Plans to Cover Abuse-Deterrent Opioids Advances in Fla. Legislature
Katie Irby, Bradenton Herald
January 13, 2016
Florida’s House Health Innovation Subcommittee has approved a bill that would prevent insurance companies from requiring authorization for abuse-deterrent opioids, unless the insurance company also requires prior authorization for opioids that do not deter abuse. The bill would also bar insurance companies from requiring patients to use a non-abuse-deterrent opioid before covering abuse-deterrent opioids, so physicians can prescribe abuse-deterrent opioids as an initial treatment. An Express Scripts spokesperson said the bill would drive up insurance premiums and was the equivalent of a drug mandate.
Read more:
http://www.bradenton.com/news/local/heroin-epidemic/article54532485.html
Welfare Drug Testing: W.Va. Bill Could Help Curb Misuse
Bluefield Daily Telegraph
January 14, 2016
Proposed legislation would permit drug testing of welfare recipients in West Virginia if the state’s health department has “reasonable suspicion” of substance use by the welfare recipient. A test failure or refusal to take a test would render the applicant ineligible for benefits. Proponents believe the bill will be helpful in battling the prescription drug misuse epidemic.
Read more:
http://www.bdtonline.com/opinion/welfare-drug-testing-w-va-bill-could-help-curb-abuse/article_83a52490-ba44-11e5-af8c-97ae749c074c.html
Psychiatrist Arrested After 36 Patients Die
Adam Harding, WALB
January 14, 2016
Federal agents have raided psychiatrist Narendra Nagareddy’s office in Jonesorbo, Ga., arresting him after 36 of his patients died, including at least 12 from overdoses on prescription medication. He is accused of violating Georgia’s Controlled Substance Act. (Includes video: 1:57 minutes)
Read more:
http://www.walb.com/story/30971975/psychiatrist-arrested-after-36-of-his-patients-died
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Midwest News
Wisconsin’s Assembly Adopts Bills Aimed at Curbing Opiate, Heroin Abuse
Patrick Marley, Journal Sentinel
January 12, 2016
Wisconsin’s assembly has approved three bills, which now head to the state’s senate for consideration. One requires doctors to check the prescription drug monitoring program database before prescribing narcotics and other addictive drugs. Another requires law enforcement officials to provide information to the database when they find evidence of prescription drugs being misused or stolen. The third requires pain clinics and methadone clinics to register with the state.
Read more:
http://www.jsonline.com/news/statepolitics/assembly-to-consider-package-aimed-at-curbing-opiate-heroin-abuse-assembly-to-consider-package-aime--364935771.html
Committee Advances Prescription Drug Monitoring Bill
Nebraska Veterinary Medical Association
January 9, 2016
The Nebraska Health and Human Services Committee has advanced a bill that would require providers, including veterinarians, to report information to the prescription drug monitoring program within 24 hours of dispensing all drugs. The Nebraska Veterinary Medical Association expects an amendment to limit veterinarians’ duty to report to controlled drugs schedule II–IV and give veterinarians one additional year to begin reporting. The bill now goes to a floor vote.
Read more:
http://www.nvma.org/resources/blog/committee-advances-prescription-drug-monitoring-bill.html
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West News
Report: San Diego Veterans Healthcare System Failed to Monitor, Treat Veteran
Patricia Kime, Military Times
January 12, 2016
A Veterans Affairs (VA) inspector general report accuses the VA San Diego Healthcare System of failing to care for Marine Sgt. Jeremy Sears, who had a traumatic brain injury and experienced posttraumatic headaches before committing suicide in October 2014. Allegedly, the VA doctors did not follow department guidelines for prescribing opioid medications and ignored Sears’s request to discontinue use.
Read more:
http://www.militarytimes.com/story/military/benefits/veterans/2016/01/12/report-va-san-diego-failed-monitor-treat-veteran/78697512
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Grant Announcements
Research on Prescription Opioid Use, Opioid Prescribing, and Associated Heroin Risk (RFA-CE-16-003)
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention
Due: February 18, 2016
http://www.grants.gov/view-opportunity.html?oppId=280151
Increasing Access to Medication-Assisted Treatment in Rural Primary Care Practices (R18)
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality
Due: March 4, 2016
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-16-001.html
Drug-Free Communities Support Program (SP-16-001)
SAMHSA
Due: March 18, 2016
http://www.samhsa.gov/sites/default/files/grants/pdf/sp-15-001_0.pdf
National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for that
U.S. Department of Health and Human Services, National Institute on Drug Abuse
Submission Period begins November 3, 2015, 9:00 a.m. (ET)
Submission Period ends April 29, 2016, 11:59 p.m. (ET)
http://nida.ideascale.com/a/pages/addiction-research-theres-an-app-for-that
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Take-Back Events & Drop Boxes
Norwalk (Conn.) Police Collect 181.5 Pounds of Drugs in Drug Drop Box in 2015
Leslie Lake, The Hour
January 13, 2016
http://www.thehour.com/npd-collects-pounds-of-drugs-in-drug-drop-box-in/article_8da4d78a-ba33-11e5-a8d6-d7c297e4fe8d.html
Otter Tail County (Minn.) Tops 700 Pounds in Collection of Drugs
Jeff Meier, Fergus Falls Daily Journal
January 14, 2016
http://www.fergusfallsjournal.com/2016/01/county-tops-700-pounds-in-collection-of-drugs
Prescription, Over-the-Counter Drug Take-Back Program Unveiled in Carroll County (Ill.)
Prairie Advocate
January 13, 2016
http://www.prairieadvocate.com/2016/01/09/prescription-otc-drug-take-back-program-rolled-out-in-carroll-county/aikp7fm
Unwanted Prescription Drug Collection in Lincoln County (N.C) Up in 2015
Lincoln Herald
January 13, 2016
http://lincolnherald.net/main.asp?SectionID=3&SubSectionID=28&ArticleID=15185
Prescription Drug Drop-Off Box Set Up in Pennsylvania’s Slate Belt Region
Pamela Sroka-Holzmann, LehighValleyLive.com
January 12, 2016
http://www.lehighvalleylive.com/slate-belt/index.ssf/2016/01/slate_belt_police_install_drop.html
Erie County (Penn.) Drop-Off Collection for Prescription Drugs
Erin Tighe, WJET-TV
January 11, 2016
http://www.yourerie.com/news/local-news/drop-off-collection-for-prescription-drugs
Prescription Drug Disposal at University Park (Texas) City Hall
City of University Park (Texas)
January 8, 2016
https://www.uptexas.org/News-Events/2016/Prescription-drug-disposal-at-City-Hall
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Upcoming Conferences and Workshops
Ohio Workers’ Compensation Medical & Health Symposium
Bureau of Workers’ Compensation
March 10–11, 2016
Greater Columbus Convention Center
400 N. High St.
Columbus, Ohio
This 2-day symposium features national and state experts who will discuss topics including opioid and non-opioid drug guidelines for managing prescribing; challenges of managing addiction; and how to guide injured workers in managing their own health. The symposium, a free educational opportunity for healthcare providers, will be held in conjunction with the annual Bureau of Workers’ Compensation Safety Congress & Expo.
Read more:
https://www.bwc.ohio.gov/provider/brochureware/PainSymposium/default.asp
Pharmacy Diversion Awareness Conference
U.S. Drug Enforcement Administration
February 27–28, 2016
Charleston, West Virginia
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness
26th National Leadership Forum and SAMHSA’s 12th Prevention Day
Community Anti-drug Coalitions of America & SAMHSA
February 1–4, 2016
http://www.cadca.org/forum2016
Register:
http://www.cadca.org/events/26th-national-leadership-forum-including-samhsas-12th-prevention-day/registration
Ensuring Access to Pain Care: Engaging Pain Medicine and Primary Care Teams
American Academy of Pain Medicine
February 18–21, 2016
Palm Springs, California
http://www.painmed.org/annualmeeting
2016 National Rx Drug & Heroin Summit
March 28–31, 2016
Atlanta
http://nationalrxdrugabusesummit.org
3rd Annual Smart Approaches to Marijuana Education Summit
March 31, 2016
Atlanta
http://nationalrxdrugabusesummit.org/sam-summit-2
Register:
https://www.123contactform.com/form-1486587/2016-National-Rx-Drug-Abuse-Summit
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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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