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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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WEBINAR
Weed in Your Workplace: What You Need to Know
National Safety Council
Wednesday, April 20, 2016
2:00 p.m. (ET)
An expert panel will discuss what employers need to know about the critical safety impact legal marijuana can have on public and workplace policy. They will cover questions including: Does secondhand marijuana smoke pose a risk for motor vehicle operators? What are appropriate cut-off levels to ensure workplace and public safety? And, what can employers do to address the impacts of marijuana use? Experts will explain how employers can use this information to develop best practice policies for their companies. Speakers will include Ron Flegel, director of the Center for Substance Abuse Prevention’s Division of Workplace Programs within the Substance Abuse and Mental Health Administration, and Barry K. Logan, Ph.D., national director of forensic and toxicological services at NMS Labs.
Register:
http://eventcallregistration.com/reg/index.jsp?cid=59487t11
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Marijuana-Based Drug Found to Reduce Epileptic Seizures
Andrew Pollack, New York Times
March 14, 2016
GW Pharmaceuticals has announced it will seek FDA approval to market Epidiolex, a botanically based medical marijuana drug. Clinical trials found it reduced convulsive seizures better than placebo in patients with Dravet syndrome, a rare and debilitating type of epilepsy for which there are currently no treatments approved in the United States. The latest study involved 120 patients (average age of 10) with an average frequency of 13 convulsive seizures a month at the start of the study. Among the 60 children randomly assigned to take Epidiolex, the frequency of convulsive seizures fell by 39 percent during the 14-week treatment period compared to the 4 weeks prior to treatment. With the placebo, the reduction was 13 percent. A separate study found comparable reductions.
Read more:
http://www.nytimes.com/2016/03/15/business/marijuana-based-drug-found-to-
reduce-epileptic-seizures.html?_r=0
http://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(15)00379-8.pdf
http://themarijuanareport.org/wp-content/uploads/2016/03/AES-Letter-2016.pdf
http://www.gwpharm.com/GW%20Pharmaceuticals%20Announces%20Positive
%20Phase%203%20Pivotal%20Study%20Results%20for%20Epidiolex%20cannabidiol.aspx
D. Dowell, T.M. Haegerich, and R. Chou. “CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016.” Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Early Release, March 15, 2016, 65.
The Centers for Disease Control and Prevention has issued a guideline with 12 recommendations for primary care clinicians who prescribe opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The guideline does not apply to treatment of acute pain, such as following surgery. It addresses (1) when to initiate or continue opioids for chronic pain; (2) opioid selection, dosage, duration, follow-up, and discontinuation; and (3) assessing risk and addressing harms of opioid use. This guideline is intended to improve communication between clinicians and patients about risks and benefits of opioid therapy for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death. It includes a checklist for prescribing opioids for chronic pain and a website with additional tools to guide clinicians in implementing the recommendations.
Read more:
http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm?s_cid=rr6501e1er_e
http://www.cdc.gov/drugoverdose/prescribing/resources.html
http://jama.jamanetwork.com/article.aspx?articleid=2503508
Related Article
L.C. Scott and S. Lewis. 2016. Opioids for Chronic Pain. JAMA, doi:10.1001/jama.2016.3224.
The authors offer advice, based on the new Centers for Disease Control and Prevention guideline, to healthcare practitioners and people with chronic pain.
Read more:
http://jama.jamanetwork.com/article.aspx?articleid=2503507 |
Supreme Court Rejects Challenge to Colorado Marijuana Law from Other States
David G. Savage, Los Angeles Times
March 20, 2016
The U.S. Supreme Court, by a 6–2 vote, has declined to hear a lawsuit brought by Nebraska and Oklahoma, whose state attorneys complained that marijuana was pouring into their states as a result of its legalization in Colorado. The rejected lawsuit challenged marijuana legalization laws adopted in Colorado and elsewhere that permit adults to buy, sell, or use the drug. Justices Clarence Thomas and Samuel Alito dissented. “The plaintiff states have alleged significant harms to their sovereign interests caused by another state,” Thomas wrote. “We should let this complaint proceed further rather than denying leave without so much as a word of explanation.” Last year, the Court asked U.S. Solicitor General Donald Verrilli to weigh in on the issue. In December, he urged the court to turn away the lawsuit.
Read more:
http://www.latimes.com/nation/la-na-court-marijuana-states-20160321-story.html
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Journal Articles and Reports
I. Berling, N.A. Buckley, and G.K. Isbister. 2016. “The Antipsychotic Story: Changes in Prescriptions and Overdose Without Better Safety.” British Journal of Clinical Pharmacology, doi:10.1111/bcp.12927.
A tertiary referral toxicology unit in Australia treated 3,180 antipsychotic overdoses during 1987–2012. The drugs in 1,485 overdoses came from the original generation of antipsychotics, 1,695 were newer antipsychotics, and 250 were lithium-based (a traditional and still-prescribed drug for bipolar disorder which was not a focus in this article). Over 26 years, annual antipsychotic prescriptions increased 2.3-fold and antipsychotic overdoses increased 1.8-fold. Overdoses on the older antipsychotics decreased from 80 per year to 16 while overdoses on newer antipsychotics increased to 160 per year (including 125 on Zyprexa/olanzapine or Seroquel/ quetiapine). Antipsychotic overdoses had a median length of stay of 18.6 hours, with 15.7 percent admitted to the intensive care unit, 10.4 percent ventilated and 0.13 percent dying in hospital; these profiles were similar for older and newer antipsychotics. Although the antipsychotics prescribed changed over the 26-year period, overdose risk was not lower with the newer drugs.
Read more:
http://onlinelibrary.wiley.com/doi/10.1111/bcp.12927/abstract
R. Cairns, B. Daniels, D.A. Wood, and J. Brett. 2016. “ADHD Medication Overdose and Misuse: The NSW Poisons Information Centre Experience, 2004–2014.” Medical Journal of Australia 204 (4):154, doi:10.5694/mja15.00791.
Between 2004 and 2014, the New South Wales Poisons Information Center advised on 1,735 overdoses on Ritalin/Concerta/methylphenidate, Dexedrine/dexamphetamine, Provigil/modafinil (often prescribed for sleep disorders), or Strattera/atomoxetine (prescribed for attention deficit-hyperactivity disorder). At least 93 percent required hospitalization. Annual methylphenidate exposures rose 2.1-fold, while dexamphetamine exposures declined by 25 percent. Illicit use (defined as co-ingestion with alcohol or a street drug) increased by 429 percent. Trends in exposures paralleled trends in dispensing recorded in Pharmaceutical Benefits Scheme data.
Read more:
https://www.mja.com.au/journal/2016/204/4/adhd-medication-overdose-and-misuse-nsw-poisons-information-centre-experience?utm_source=mja&utm_medium=web&utm_
campaign=related_content
G. Campbell, R. Bruno, N. Lintzeris, M. Cohen, S. Nielsen, W. Hall, B. Larance, R.P. Mattick, F. Blyth, M. Farrell, and L. Degenhardt. 2016. “Defining Problematic Pharmaceutical Opioid Use Among People Prescribed Opioids for Chronic Non-Cancer Pain: Do Different Measures Identify the Same Patients?” Pain, doi:10.1097/j.pain.0000000000000548.
Among a national sample of 1,134 Australians prescribed opioids for chronic non-cancer pain, 24 percent met criteria for addiction, 18 percent for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM–5) substance use disorder, and 19 percent for International Classification of Diseases, 11th Revision, (ICD–11) dependence. There was ‘substantial’ concordance between addiction and both DSM–5 use disorder and ICD–11 dependence, but concordance was much greater with ICD–11 dependence. Participants who met criteria for addiction only were older, less likely to engage in non-adherent behaviors, self-reported fewer problems or concerns with their medication, and had lower rates of psychological distress than those who also met DSM–5 or ICD–11 criteria.
Read more:
http://journals.lww.com/pain/Abstract/publishahead/Defining_
problematic_pharmaceutical_opioid_use.99565.aspx
S. Cherico-Hsii, A. Bankoski, P. Singal, I. Horon, E. Beane, M. Casey, K. Rebbert-Franklin, and J. Sharfstein. 2016. “Sharing Overdose Data Across State Agencies to Inform Public Health Strategies: A Case Study.” Public Health Reports 131(2):258–63.
Maryland in 2014 began routine sharing of data on overdose decedents across agencies that oversee health and mental hygiene, corrections, juvenile services, emergency medical services, and human services. The effort focused on identifying possible intervention points that could have saved decedents’ lives. Key aspects of this approach included gubernatorial leadership, a unified commitment to data sharing across agencies with memoranda of understanding, and designation of a data management team. Early findings included (1) people face extreme overdose death risks in the week following release from corrections facilities, and (2) more than half of all overdose deaths occurred among Medicaid beneficiaries. Maryland launched intervention efforts targeting these populations.
Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26957660
T. Ciesielski, R. Iyengar, A. Bothra D. Tomala, G. Cislo, B.F. Gage. 2016. “A Tool to Assess Risk of De Novo Opioid Abuse or Dependence.” American Journal of Medicine, doi:10.1016/j.amjmed.2016.02.014.
Over four years (October 2009 to September 2013), 2,067 of 695,851 privately insured patients (0.3 percent) had medically identified opioid use disorders, according to integrated pharmacy and medical claims data from a pharmacy benefit manager (Express Scripts). In multivariate regression, opioid prescription factors predicting disorders included being a chronic opioid user (odds ratio [OR] = 4.4), high morphine equivalent daily dose (OR = 2.0), higher than average number of days per month with opioids (.05 increase per day), obtaining opioids from multiple prescribers (OR = 1.7), and using multiple pharmacies (OR = 1.6). Demographic predictors of disorders were younger age (per decade older, OR = -0.7); male gender (OR = 1.4); and residing in the South (OR = 1.6), West (OR = 1.5), or Midwest (OR = 1.2). Medical history predictors were history of mental illness (OR = 3.5), non-opioid substance use disorder or overdose (OR = 2.8), alcohol use disorder (OR = 2.4), or tobacco use (OR = 1.8).
Read more:
http://www.amjmed.com/article/S0002-9343(16)30202-9/abstract
P. Dayal, and Y.P.S. Balhara. 2016. “Profile of Female Patients Seeking In-Patient Treatment for Prescription Opioid Abuse from a Tertiary Care Drug Dependence Treatment Centre from India.” Indian Journal of Medical Research 143(1):95–100.
In north India, 31 female patients with prescription drug misuse disorders were admitted to a drug treatment center during 2008-2012. Twelve (39 percent) misused opioids and another 11 (36 percent) misused opioids and benzodiazepines. All but one of the opioid misusers were introduced to opioids by medical practitioners treating pain. Common co-occurring psychiatric diagnoses were depressive disorder (26 percent), cluster B traits/disorder (19 percent) and somatoform disorder (13 percent). Eight women did not complete treatment. Thirteen women were offered maintenance treatment, with 70 percent retained for at least 6 months.
Read more:
http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2016;volume=143;
issue=1;spage=95;epage=100;aulast=Dayal
K. Dion. 2016. “Improving Outcomes of Opioid Overdose: Preparing Nursing Students to Intervene.” Journal of Addictions Nursing 24(1):7–11, doi:10.1097/JAN.0000000000000106.
Among a convenience sample of 49 baccalaureate nursing students in Massachusetts who attended brief training about prescription opioids, 63 percent had some or no background knowledge of opioid overdose, and 86 percent had not received training on intranasal naloxone. Student knowledge increased significantly following the educational intervention. Twenty-four students requested hands-on training for implementation of the intranasal naloxone and scored 100 percent accuracy in return demonstration.
Read more:
http://journals.lww.com/jan/Abstract/2016/01000/Improving_Outcomes
_of_Opioid_Overdose__Preparing.2.aspx
B. Hill-Taylor, I.S. Sketris, D.M. Gardner, and K. Thompson. 2016. “Concordance with a STOPP (Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions) Criterion in Nova Scotia, Canada: Benzodiazepine and Zoplicone Prescription Claims by Older Adults with Fall-Related Hospitalizations.” Journal of Population Therapeutic and Clinical Pharmacology 23(1):e1–12.
Prescription claims data from the Nova Scotia, Canada, Seniors’ Phamacare Program were linked with fall-related injury data from a hospital discharge census. Over 5 years, of 8,271 older adults discharged following a fall-related hospitalization, 1,789 (22 percent) had filled a prescription for benzodiazepine and zopiclone in the 100 days prior to admission. In the 100 days following discharge, 74 percent of those users filled at least one more prescription for the drugs. After falls, patients were more likely to continue filling prescriptions for these drugs if they were young and female.
Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26949844
S.R Lenton, P.M. Dietze, and M. Jauncey. 2016. “Australia Reschedules Naloxone for Opioid Overdose.” Medical Journal of Australia 204(4):146–7, doi:10.5694/mja15.01181.
The Australia Department of Health, Therapeutic Goods Administration changed naloxone scheduling to make it available over the counter (OTC) effective February 1, 2016. Australia is the second country after Italy to have OTC naloxone available nationwide. Naloxone is currently listed (exclusive of dispensing fee) at AUD$16.90 per minijet OTC, distributed by pharmaceutical company UCB Australia. However, under the Pharmaceutical Benefits Scheme, five minijets cost AUD$37.70, or AUD$6.10 by prescription. Therefore, naloxone will be listed both as a Schedule-3 OTC drug and a Schedule-4 prescription drug.
Read more:
https://www.mja.com.au/journal/2016/204/4/australia-reschedules-naloxone-opioid-overdose
W.G. Mantyh, R.R. Auger, T.I. Morgenthaler, M.H. Silber, and W.R. Moore. 2016. “Examining the Frequency of Stimulant Misuse Among Patients with Primary Disorders of Hypersomnolence: A Retrospective Cohort Study.” Journal of Clinical Sleep Medicine [Epub ahead of print].
Of 105 adult Mayo Clinic patients diagnosed with narcolepsy or idiopathic hypersomnia between 2003–8, 11 percent had a history of illicit substance misuse and 1 percent of stimulant misuse. Fifty-four percent had psychiatric diagnoses, with 88 percent of those depression. In a median of 26 months of monitored stimulant therapy treatment, none of the 105 patients had evidence of misuse.
Read more:
http://www.ncbi.nlm.nih.gov/pubmed/26943713
R.V. Smith, J.R. Havens, and S.L. Walsh. 2016. “Gabapentin Misuse, Abuse and Diversion: A Systematic Review.” Addiction, doi:10.1111/add.13324.
A systematic review identified 23 case studies and 11 epidemiological reports about gabapentin (used to treat epilepsy, neuropathic pain, hot flashes, and restless leg syndrome) misuse from the United States, European Union, India, and South Africa. Prevalence of misuse was 40–65 percent among individuals with prescriptions and 15–22 percent within populations of people who misuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self-medication or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug misuse disorder were most often involved in its misuse.
Read more:
http://onlinelibrary.wiley.com/doi/10.1111/add.13324/abstract
K. Smolina, E. Gladstone, and S.G. Morgan. 2016. “Determinants of Trends in Prescription Opioid Use in British Columbia, Canada, 2005–2013.” Pharmacoepidemiology and Drug Safety, doi:10.1002/pds.3989.
Between 2005 and 2013, administrative data on prescription drug dispensations in British Columbia, Canada, showed opioid consumption increased by 31 percent, driven by longer duration of opioid therapy and by an increase in the use of stronger opioids. Consumption increased for oxycodone, hydromorphone, fentanyl, and tramadol; and declined for morphine, codeine, and other opioids. Usage did not differ by sex and age group. Per capita opioid consumption was three times as higher in the lowest income quintile than the highest income quintile.
Read more:
http://onlinelibrary.wiley.com/doi/10.1002/pds.3989/abstract
S.L. Walsh, P.A. Nuzzo, S. Babalonis, V. Casselton, and M.R. Lofwall. 2016. “Intranasal Buprenorphine Alone and in Combination with Naloxone: Abuse Liability and Reinforcing Efficacy in Physically Dependent Opioid Abusers.” Drug and Alcohol Dependence, doi:10.1016/j.drugalcdep.2016.03.005.
Eleven male and female volunteers physically dependent on short-acting opioids resided as inpatients during a double blind, within subject, placebo-controlled study of buprenorphine-based drugs. Patients were allowed to dose nasally as needed. They self-administered buprenorphine more often than placebo or a buprenorphine/naloxone combination drug. Both buprenorphine drugs produced opioid-craving-reduction effects (e.g., increased ratings of “liking” the sensation they produced) compared to placebo. The effects of buprenorphine and buprenorphine/naloxone were not reliably dose-dependent. Intranasal buprenorphine/naloxone elicited modest and transient opioid withdrawal-like effects in the first hour post-drug administration, while simultaneously reducing or blocking the early onset of effects seen with buprenorphine alone.
Read more:
http://www.drugandalcoholdependence.com/article/S0376-8716(16)00145-9/abstract
W.C. Watkins. 2016. “A Social Learning Approach to Prescription Drug Misuse Among College Students.” Deviant Behavior, doi:10.1080/01639625.2015.1060799.
A survey of 841 undergraduates at a large southern university in an unstated year found that 24.6 percent had misused prescription drugs in the past year, with 12 percent misusing pain relievers and 12 percent misusing stimulants. Misuse was higher among students who had a friend misusing, spent more time with friends, had peers with positive attitudes toward misuse, or perceived misuse as posing minimal risk. The survey had an 81 percent response rate.
Read more:
http://www.tandfonline.com/doi/full/10.1080/01639625.2015.1060799
F. Zeidan, A.L. Adler-Neal, R.E. Wells, E. Stagnaro, L.M. May, J.C. Eisenach, J.G. McHaffie, and R.C. Coghill. 2016. “Mindfulness-Meditation-Based Pain Relief is not Mediated by Endogenous Opioids.” Journal of Neuroscience 36(11): 3391–7, doi:10.1523/JNEUROSCI.4328-15.2016.
Researchers recorded pain reports in response to painful heat stimuli in 78 healthy adults during meditation or a non-meditation control, with randomly selected people in each group intravenously administered either naloxone or placebo saline. Meditation during saline or naloxone infusion significantly reduced pain intensity and unpleasantness ratings when compared to the control plus saline group. Pain intensity and pain unpleasantness did not differ significantly between the meditation plus naloxone and the meditation plus saline groups. Thus, naloxone infusion did not affect meditation-induced pain relief; mindfulness meditation does not rely on opioid-like mechanisms to reduce pain.
Read more:
http://www.jneurosci.org/content/36/11/3391.short
http://www.nih.gov/news-events/scientists-discover-non-opioid-pain-pathway-brain
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Professional Development
P. Dietze and K. Cantwell. 2016. “Intranasal Naloxone Soon to Become Part of Evolving Clinical Practice Around Opioid Overdose Prevention.” Addiction 111(4):584–6, doi:10.1111/add.13260.
The authors share their opinions about a paper, “Clinical provision of nasal naloxone without prior experimental testing and without regulatory approval: imaginative shortcut or dangerous bypass of essential safety procedures?” by J. Strang, R. McDonald, B. Tas, and Day E (in Weekly Update, February 11, 2016). They agree with Strang and colleagues that determining the suitability of intranasal naloxone for opioid overdose requires more independent research, but say many of their concerns were alleviated by recent developments. The authors reiterate that the impending availability of suitable intranasal forms should not be a barrier to program implementation with other naloxone preparations.
Read more:
http://onlinelibrary.wiley.com/doi/10.1111/add.13260/full
D.M. Lisi. 2016. “National Pain Strategy: Implications for Pharmacy Practice.” U.S. Pharmacist 41(3):31–5.
The National Pain Strategy is a comprehensive population health-level plan that addresses the issue of inadequate pain management in the United States and the national opioid misuse epidemic. Currently, the draft version is undergoing revisions. The National Pain Strategy focuses on six important areas of need in pain management: population research, prevention and care, disparities, service delivery and reimbursement, professional education and training, and public awareness and communication. Each of these key areas has direct implications for the pharmacy profession, and pharmacists will have the opportunity to play an active role in the optimal management of patients’ pain.
Read more:
http://www.uspharmacist.com/content/c/59953/?t=health+policy%2Fpublic+
policy,pain_management
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National
Poll: One in Three Americans Blame Doctors for National Opioid Epidemic
Dylan Scott, STAT
March 17, 2016
A recent nationally representative survey asked 1,011 adults who they thought was most to blame for the U.S. epidemic of opioid addiction. Thirty-seven percent primarily blamed users of strong pain pills, 34 percent doctors for inappropriately prescribing the medications, 10 percent pharmaceutical companies, and 7 percent the FDA. Seven in 10 supported two key elements of the new Centers for Disease Control and Prevention prescribing opioid guidelines: advising doctors to give patients no more than a 3-day supply of opioid pain relievers to treat most cases of acute pain, and trying other treatment options first before prescribing opioids for chronic pain. More than half of respondents (55 percent) were concerned that the guidelines would make it too hard for people who need prescription pain medications to get them. There was no significant difference between Democrats and Republicans.
Read more:
https://www.statnews.com/2016/03/17/stat-harvard-opioid-poll/
https://cdn1.sph.harvard.edu/wp-content/uploads/sites/94/2016/03/STAT-Harvard-Poll-Mar-2016-Prescription-Painkillers.pdf
Watch How the Drug Overdose Epidemic Spread in America
Chris Wilson, Time
March 16, 2016
The Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute have released updated interactive County Health Rankings & Roadmaps that show the spread in per-capita drug overdoses from 2002 to 2014. The rate of deaths due to drug overdoses has increased 79 percent since 2002. Drug overdose deaths are highest in northern Appalachia and in parts of the West/Southwest United States, and lowest in the Northeast. Compared with other types of counties, rural counties have higher rates of drug overdose deaths.
Read more:
http://time.com/4260798/drug-epidemic-america/
http://www.countyhealthrankings.org
Related Article
Senate Advances Bill to Aid Drug-Dependent Newborns
John Shiffman and Duff Wilson, Reuters
March 16, 2016
The U.S. Senate Health, Education, Labor, and Pensions Committee has approved a bill that calls for better “plans of safe care” to help drug-dependent mothers raise newborns as the babies suffer through opioid withdrawal. The bill would also require states to report the number of infants identified as born drug-dependent each year, and the number for whom plans of safe care are developed. The bill also requires the Department of Health and Human Services to better monitor state policies intended to protect drug-dependent newborns. The bill heads to the full Senate for debate.
Read more:
http://www.reuters.com/article/us-usa-baby-heroin-idUSKCN0WI2KM
Drug Use in the Military and the Need for Harm Reduction
Tessie Castillo, Huffington Post
March 14, 2016
A former Marine and certified addictions counselor talks about his prescription drug misuse after getting injured during a tour of duty in Iraq. Rumley became addicted to prescription pain relievers supplied by the Veterans Administration (VA). When the VA stopped refilling his prescriptions, he turned to heroin. He sought help at an opioid detox program and received buprenorphine. Now a certified addictions counselor, Rumley would like to see the military put more resources into viable discharge and reintegration plans for soldiers returning from a tour of duty. He would also like to see the military adopt an evidence-based harm reduction approach to dealing with addiction issues. Brad West, a veteran who had a similar experience would like to see the military set-up a system where soldiers can seek treatment instead of living in fear that admitting to an addiction will only lead to discharge.
Read more:
http://www.huffingtonpost.com/tessie-castillo/drug-use-in-the-military_b_9459020.html
Roots of Opioid Epidemic Can Be Traced Back to Two Key Changes in Pain Management
Theodore Cicero and Matthew S. Ellis, Washington University in St Louis, The Conversation
March 14, 2016
The authors suggest two changes in pain management are the roots of the opioid epidemic: early recognition and proactive treatment of pain, and the introduction of OxyContin.
Read more:
http://medicalxpress.com/news/2016-03-roots-opioid-epidemic-key-pain.html
Drug Overdoses Kill More People Than Car Crashes in Oregon, Washington
Joe Douglass, KATU
March 12, 2016
Several months ago, Trust for America’s Health and the Robert Wood Johnson Foundation reported that drug overdoses now kill more people than car crashes in Oregon, Washington, and 34 other states. Four in five new heroin users start out misusing prescription pain relievers. (Includes video: 4:12 minutes)
Read more:
http://katu.com/news/local/drug-overdoses-kill-more-people-than-car-crashes-in-oregon-washington
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J.M. Hall, M.M. Shattell, and E.A. McConnell. 2016. “The Marijuana Phenomenon: Contradictions and Silence.” Journal of Addictions Nursing 24(1):1–6, doi:10.1097/JAN.0000000000000105.
The authors of this editorial argue that nursing professors are silent when it comes to ethics, practices, and policies around legalized medical and recreational marijuana use. They discuss the many contradictions about marijuana, noting that the contradictions must be explored and evidence-based policy recommendations developed to overcome the silence about how providers view marijuana. The authors hope this will close the gaps in nursing knowledge regarding marijuana as it affects users and how the drug is used medically.
Read more:
http://journals.lww.com/jan/Abstract/2016/01000/The_Marijuana_Phenomenon
__Contradictions_and.1.aspx
Can You Fire An Employee Using Pot? Finally, Some Clarity on the Issue
Tina Reed, Washington Business Journal
March 14, 2016
According to Scott Oswald, managing principal at the Employment Law Group, PC, employers in Maryland and the District of Columbia are allowed to enforce a zero-tolerance drug policy for medical marijuana. In states where recreational marijuana use has been legalized, employees can be fired for failing a drug test. State marijuana laws do not give employees the right to use the drug even with a marijuana recommendation. In nine states where medical marijuana is allowed, employers must accommodate those certified as requiring medical marijuana. Accommodations do not have to include usage of marijuana inside the workplace and usually only apply if that employee provides proof of a medical marijuana recommendation before they get drug-tested. If employees get fired for marijuana use, they cannot collect unemployment if the employer has a zero-tolerance drug policy that had been previously signed off on and acknowledged by the employee.
Read more:
http://www.bizjournals.com/washington/news/2016/03/14/can-you-fire-an-employee-using-pot-finally-some.html
State Medical Marijuana Program May Overhaul Policies on Drugs in the Workplace
Eli Anderson, Watertown Daily Times
March 17, 2016
Roy Galewski, a partner at Harris Beach law firm and a specialist in labor and employment law, discussed medical marijuana at the North Country Human Resources Association meeting. Medical marijuana patients are protected from discrimination under the Compassionate Care Act. A majority of employers have strict policies against an employee coming to work impaired by drugs. The law also prevents certified medical marijuana users from using the drug while in a public place, which Galewski believes include workplaces. He also believes testing for marijuana will become “almost useless” for employees who are certified drug users because marijuana stays in the body for weeks or days, which could prevent testing from differentiating permitted from unpermitted use. Except for employers with federal contracts or funding. Galewski advises businesses to research the Compassionate Care Act, keep an eye out for updates, and consider sharpening their company drug policies.
Read more:
http://www.watertowndailytimes.com/news03/state-medical-marijuana-program-may-overhaul-policies-on-drugs-in-the-workplace-20160317
Ten Marijuana Dispensaries Raided in Otsego County (Mich.)
Mara Thompson, WPBN/WGTU
March 11, 2016
Straits Area Narcotics Enforcement has raided 10 marijuana dispensaries in Otsego County, Michigan—nine in the city of Gaylord and one in Vanderbilt. Two people were arrested for dispensing marijuana to individuals who had medical marijuana cards but were not registered patients. Officers seized more than 150 jars of marijuana along with tetrahydrocannabinol edibles, drinks, waxes, extract, and oils. It is illegal to possess the edibles, waxes, and oils. Officers also took 143 marijuana plants, prescription opiates, other prescription drugs, more than $17,000 in cash, and two vehicles.
Read more:
http://upnorthlive.com/news/local/ten-marijuana-dispensaries-raided-in-otsego-county
Massachusetts Sheriffs Opposed to Marijuana Legalization
Monica Ricci, WWLP
March 15, 2016
Massachusetts sheriffs oppose marijuana legalization because it destigmatizes drug use and makes it easier for young people to get marijuana. The proposal they oppose would allow recreational use of marijuana and possession of up to an ounce for those age 21 and older. It would also let individuals possess up to 10 ounces of marijuana in their homes. The question could appear on the November ballot.
Read more:
http://wwlp.com/2016/03/15/massachusetts-sheriffs-opposed-to-marijuana-legalization
New Panel to Determine If More New Jersey Patients Can Get Medical Marijuana
Susan K. Livio, NJ Advance Media for NJ.com
March 13, 2016
New Jersey’s health department has appointed a panel of physicians and other health professionals to decide whether state’s medical marijuana program should admit more patients. The panel will consider expanding the list of six diseases that allow patients to get medical marijuana. The panel’s organizational meeting will discuss the process for evaluating petitions.
Read more:
http://www.nj.com/politics/index.ssf/2016/03/state_appoints_medical_marijuana
_panel_to_consider.html
Medical Cannabis Research Agreement Signed in Maryland
PR Newswire
March 15, 2016
Green Leaf Medical has signed a research agreement to supply free medical cannabis in a variety of cannabinoid profiles to Maneesh Sharma, M.D., and the Interventional Pain Institute in Maryland. Dr. Sharma will conduct patient trials designed to test the efficacy of using medical cannabis to treat specific chronic pain conditions.
Read more:
http://www.prnewswire.com/news-releases/medical-cannabis-research-agreement-signed-in-maryland-300236386.html
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International
Canadians Push Back Against Opioid Pressure from U.S. Lawmakers
David Eldridge, Politics
March 14, 2016
The Canadian government has responded to American lawmakers calling for Prime Minister Justin Trudeau’s administration to crack down on the flow of Canadian pain relievers into the United States. The Canadian health ministry cautioned against overstating Canada’s role in the opioid crisis in the United States. Sean Upton, Health Canada’s senior media relations officer, wrote in an email that there is “no evidence of disproportionate diversion or abuse” of Canada’s generic controlled-release oxycodone products; and the department is working to address prescription drug misuse.
Read more:
http://www.insidesources.com/canadians-push-back-against-opioid-pressure-from-u-s-lawmakers
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Northeast/Mid-Atlantic News
Massachusetts Governor Signs Landmark Opioid Bill into Law
Shira Schoenberg Mass Live
March 14, 2016
Massachusetts Governor Charlie Baker has signed a comprehensive bill that addresses opioid addiction. The law limits first-time prescriptions for opioid drugs to a seven-day supply, with exceptions for treating cancer or chronic pain. It requires that a mental health professional provide a substance abuse evaluation within 24 hours to anyone who enters the emergency department suffering from an opioid overdose, and it allows patients to partially fill an opioid prescription. Among a host of other provisions, the law requires doctors to check the state prescription drug monitoring program (PDMP) each time they prescribe an addictive opioid; sets continuing education requirements for prescribers; ensures civil liability protection for anyone administering the anti-overdose drug naloxone; requires manufacturers of controlled substances to participate in a drug stewardship program to dispose of unwanted drugs; and strengthens school-based prevention programs. Most provisions of the bill take effect immediately. The emergency department assessments will begin this summer, and the requirement for doctors to check the PDMP will be effective in October.
Read more:
http://www.masslive.com/politics/index.ssf/2016/03/amid_tears_gov_charlie_baker_s.html
Massachusetts Mandates Drug Take-Back Program
Recycling Today
March 15, 2016
Massachusetts now mandates manufacturers to finance and manage a safe disposal program for leftover medications, the first state to do so. Seven counties on the west coast previously passed laws that shift the cost burden for collecting and property managing prescription drugs to the drug marker. The state’s health department will develop rules and regulations to implement the new law.
Read more:
http://www.recyclingtoday.com/article/massachusetts-mandates-drug-stewardship-program
Pharmacists: Insurance Won’t Cover Narcan in Connecticut
Jaclyn Diaz, The Bulletin
March 12, 2016
Only 41 pharmacies in Connecticut are staffed with personnel certified to dispense Narcan. In eastern Connecticut, only four pharmacies have pharmacists certified to dispense Narcan. Pharmacists apparently have not taken the training to get certified because insurance companies will not cover the cost of the drug. Individuals would have to pay $125 or more for the Narcan kit if they want it.
Read more:
http://www.norwichbulletin.com/article/20160312/NEWS/160319879/?Start=1
New York Senate Budgets $167 Million to Address Opioid Abuse
Leila Roos, Jewish Political News Update
March 14, 2016
New York’s senate has voted to allocate $167 million for opioid abuse prevention, treatment, recovery, and education. This includes $10 million in transitional housing for recovering individuals, $2 million for school prevention efforts, and $3.85 million for 11 more recovery community centers.
Read more:
http://jpupdates.com/2016/03/14/nys-senate-budgets-167-million-to-address-opioid-abuse
New York Governor Announces Mandatory Electronic Prescribing to Take Effect March 27
Long Island News & PR
March 17 2016
Beginning March 27, all prescriptions written in New York must be transmitted electronically from the prescriber directly to the pharmacy. Exceptions include disasters, and technological and electrical failures; in which case, prescribers must still use official New York prescription forms and document the reason for use of the paper script each time. Some prescribers have waivers to the e-prescribe mandate. More than 60,000 prescribers are already e-prescribing.
Read more:
http://www.longisland.com/news/03-17-16/cuomo-mandatory-electronic-prescribing.html
App Allows New Jersey Doctors to Track Prescription Drug Abuse
John Bennett, InternetMedicine.com
March 16, 2016
The New Jersey prescription drug monitoring program mobile application, believed to be the first of its kind in the United States, allows state-licensed pharmacists and practitioners to access the online database. It lets users review a patient’s controlled substance prescription history, view previous submitted requests, and get notifications to help curb prescription misuse. The app is available to physicians on iPhone, Windows, and Android devices.
Read more:
http://internetmedicine.com/2016/03/16/app-allows-new-jersey-doctors-to-track-prescription-drug-abuse
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South News
State Secrecy Laws Hide Violations in Georgia’s Prescription Drug Abuse Epidemic
Willoughby Mariano, Atlanta Journal-Constitution
March 16, 2016
The Georgia Board of Pharmacy has the power to revoke the licenses or registrations of pharmacies, pharmacists, and pharmacy technicians guilty of wrongdoing. In some cases, the public is not privy to this information. For example, when pharmacy technicians at Emory University Midtown Hospital financed a 5-year scheme to steal nearly 2 million doses of prescription drugs to sell, the board did not release the identities of the technicians. “No action taken” was written in the board minutes. A public sanction was issued, but no other details were available.
Read more:
http://investigations.blog.ajc.com/2016/03/15/violators-in-georgias-prescription-drug-abuse-epidemic-hide-behind-state-secrecy-laws
Three Nurses in Florida Suspended for Alleged Pill Abuse
Michael Finch II, Daytona Beach News-Journal
March 13, 2016
Florida’s health department has reprimanded three nurses for prescription-drug-related offenses that could lead to the loss of their licenses. Francis Ercolino failed to comply with a drug screen. He has an extensive history with an impaired practitioners program starting in the 1990s, due to a history of depression and alcohol and opiate dependence. Ercolino’s license was permanently revoked in June 1999 after he inaccurately recorded the waste and withdrawal of Demerol, but later was reinstated. Tai Mason stole at least 37 pills from her former employer Coastal Nursing and Rehabilitation Center. Throughout December 2015, Mason “dispensed oxycodone, hydrocodone, and tramadol for at least 10 patients but failed to administer these medications to the patients. Mason was charged with six counts of grand theft of a controlled substance. Maureen Falvey, a former nurse at Halifax Health Medical Center, admitted to stealing morphine, oxycodone, Dilaudid, Ativan, Lortab, and Valium. Falvey told the agency that the theft occurred over the span of five months at the hospital. She also said that she did the same with previous employers.
Read more:
http://www.news-journalonline.com/article/20160313/NEWS/160319792/101040?Title=3-Volusia-Flagler-nurses-suspended-for-alleged-pill-abuse
New South Carolina Mandate Will Require Most Doctors to Use Prescription Database
Palmetto Business Daily Reports
March 15, 2016
South Carolina will require most physicians to search the state’s prescription drug monitoring program database before billing Medicaid or the state health plan. Law enforcement made 400 arrests last fiscal year by using the database.
Read more:
http://palmettobusinessdaily.com/stories/510699125-new-south-carolina-mandate-will-require-most-doctors-to-use-prescription-database
Louisville (Ky.) Police See Spike in Overdose Calls
Matthew Glowicki, Courier-Journal
March 15, 2016
The Louisville, Ky., Police Department has reported that overdoses due to mixtures of heroin and prescription drugs, such as the anticonvulsant gabapentin and fentanyl, peaked this month. Officers administered naloxone 26 times in February. Twelve days into March, they have administered the overdose antidote 43 times. In 2015, through March 9, there were 13 deaths associated with heroin. In 2016, in the same period, there were 34 overdose deaths, pending toxicology results.
Read more:
http://www.courier-journal.com/story/news/local/2016/03/14/naloxone-helps-lmpd-sees-spike-overdoses/81769082
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Midwest News
Wisconsin Governor Signs Several Drug-Related Bills into Law
Ted Miller, WBAY
March 17, 2016
Wisconsin Governor Scott Walker has signed nine bills into law that are a part of the Heroin-Opiate Prevention and Education (HOPE) Agenda, which includes 17 pieces of legislation. Three of the bills signed increase funding for treatment programs, make it illegal to use masking agents in drug tests, and require healthcare providers to check the prescription drug monitoring program database before dispensing drugs. (Includes video: 1:01 minutes)
Read more:
http://wbay.com/2016/03/17/gov-walker-signs-more-hope-bills-in-marinette
Arab-American Community in Michigan Comes to Grips with Drugs
George Hunter, Detroit News
March 14, 2016
Dearborn, Mich., has a large Muslim population. Muslims with drug addictions refuse to seek help because of fear for being ostracized. Ghada Abdallah, a pharmacist, and her friend Zainab Jaafer-Chami, are on a mission to education the community about the dangers of prescription drugs, and to get more drug-addicted Muslims to come forward and seek help. Both have relatives who died from an overdose. Abdallah also refuses to fill some prescriptions, particularly for Vicodin, if she knows the doctor is not legitimate. Abdallah has faced some backlash for her efforts to shed light on the drug problem in the Muslim community. Imam Hassan Al-Qazwini of the Azzahra Islamic Center addresses the addiction issue by integrating drug education into his sermons. The police reported that nearly a quarter of the drug arrests in Dearborn involve prescription drugs. The majority of those arrested are Arab-American.
Read more:
http://www.detroitnews.com/story/news/local/wayne-county/2016/03/14/arab-american-drug-abuse/81749192
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West News
Technician in Montana Accused of Stealing Drugs from State Crime Lab
Ashley Nerbovig, Independent Record
March 14, 2016
Steve Brester, a Montana crime lab technician, is accused of stealing prescription medications from lab evidence between September 2014 and June 2015. He was fired from the lab in June. At least 50 drug cases were affected, and prosecutors were forced to drop drug charges in multiple cases.
Read more:
http://helenair.com/news/crime-and-courts/technician-accused-of-stealing-drugs-from-state-crime-lab/article_eccf0c1b-573e-5096-ac2e-d0aed2e1cbc2.html
Bend (Ore.) Park Authorities Leave Drug Policy Unchanged After Lifeguard’s Overdose Death
Kathleen McLaughlin, The Bulletin
March 17, 2016
Even though a lifeguard at Juniper Swim and Fitness Center in Bend, Ore., died of a suspected drug overdose while on duty, the Bend Park and Recreation District has not change its drug policy. The policy requires pre-employment drug screening for all hires. The district also reserves the right to test employees upon reasonable suspicion of drug or alcohol use. It also conducts post-accident drug and alcohol testing. The district policy allows for seasonal workers to spend up to a year without submitting to a new drug test. Around 367 employees in the district’s workforce are part time or seasonal. Employees who need help with drug or alcohol misuse can access an employee assistance program. Out of 58 workplace fatalities reported in Oregon last year, this was the only one involving a drug overdose.
Read more:
http://www.bendbulletin.com/health/4104053-151/bend-park-recreation-district-leaves-drug-policy#
Drug Take-Back, Disposal Program in Snohomish County (Wash.) Proposed for Drug Companies
Sharon Salyer, Daily Herald
March 14, 2016
Snohomish County (Wash.) health officials are poised to require pharmaceutical companies to pay for the disposal of consumers’ unused medications beginning next year. Final action on the proposal is not expected until at least June. Pharmaceutical companies would have 6 months to submit disposal plans for review by the health district. The ordinance would go into effect 3 months after a disposal plan is approved.
Read more:
http://www.heraldnet.com/article/20160314/NEWS01/160319611
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Other Resources
[Online Course] Medicine Safety: Drug Disposal and Storage
Community Anti-Drug Coalitions of America
Accessed March 18, 2016
This online course discusses the dangers of prescription and over-the-counter drug misuse. It discusses how to safely store prescription pain relievers at home and in a clinical setting; warns patients of the risks associated with prescription pain relievers; and suggests ways to safely dispose of medications.
Read more:
http://learning.cadca.org/products/1026/medicine-safety-drug-disposal-and-storage
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Webinars
Understanding the Relationship between Prescription Opioid Misuse and Heroin Abuse
National Drug Early Warning System, University of Maryland
Monday, March 28, 2016
2:00 p.m. (ET)
https://zoom.us/webinar/register/6f81ba5a009695b97c24e00bf0acd2b8
Weed in Your Workplace: What You Need to Know
National Safety Council
Wednesday, April 20, 2016
2:00 p.m. (ET)
http://eventcallregistration.com/reg/index.jsp?cid=59487t11
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Grant Award
Connecticut Given $1.3 Million to Enhance Prescription Drug Monitoring Program
New Britain Herald
March 15, 2016
Connecticut’s health department has received $1.3 million in federal funding to enhance the state’s prescription drug monitoring program and to implement community intervention programs to prevent drug overdose and misuse.
Read more:
http://www.centralctcommunications.com/newbritainherald/article_741bf212-eb16-11e5-a5a1-cfd75cb7be52.html
West Virginia Receives $1.3 Million to Prevent Prescription Overdoses
WSAZ
March 16, 2016
West Virginia’s health department has been awarded $1 million in federal funding to prevent prescription drug overdoses.
Read more:
http://www.wsaz.com/content/news/WVa-receives-13-million-to-prevent-prescription-overdoses--372255122.html
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Prescription Drug Overdose Prevention for States
Centers for Disease Control and Prevention
Due: April 1, 2016
http://www.grants.gov/web/grants/search-grants.html
SP-16-003: Strategic Prevention Framework - Partnerships for Success
SAMHSA
Due: April 12, 2016
http://www.grants.gov/web/grants/search-grants.html
NIJ-2016-9090: Research and Evaluation on Drugs and Crime
Department of Justice, National Institute of Justice
Due April 20, 2016
http://www.grants.gov/web/grants/search-grants.html
FY 2016 Harold Rogers Prescription Drug Monitoring Program
Bureau of Justice Assistance
Due: April 26, 2016
http://www.grants.gov/web/grants/search-grants.html
https://www.bja.gov/funding/PDMP16.pdf
National Institute on Drug Abuse Challenge: Addiction Research: There’s an App for that
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
Bottle Tracking Program
National Association of Drug Diversion Investigators
Due: None Specified
http://www.naddi.org/aws/NADDI/pt/sp/programs_grants
http://naddibottletracking.org/law-enforcement
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National Take-Back Initiative
National Prescription Drug Take-Back Day
Drug Enforcement Administration
Saturday, April 30, 2016
10:00 a.m. – 2:00 p.m.
http://www.deadiversion.usdoj.gov/drug_disposal/takeback
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Take-Back Events & Drop Boxes
Virginia Beach (Va.) Police Collect Nearly 1,500 lbs of Unwanted Prescriptions Since June
Robyn Sidersky, Virginian Pilot
March 13, 2016
http://pilotonline.com/news/local/virginia-beach-police-collect-nearly-pounds-of-unwanted-prescriptions-since/article_fb60e13f-36db-555d-a18a-7054975f4a95.html
Pottawattamie County (Iowa) Sheriff’s Office Drug Drop Box Nets 50 lbs of Unwanted Drugs
Ric Hanson, KJAN
March 17, 2016
http://www.kjan.com/index.php/2016/03/prescription-drug-drop-box-at-the-pott-co-so-nets-50-lbs-of-unwanted-drugs
Update: Medication Drop Box Success for Huntsville (Ala.) Police Department
Bill Young, WAAY
March 14, 2016
http://www.waaytv.com/appnews/update-medication-drop-box-a-success-for-huntsville-pd/article_7ed8f63a-e249-11e5-8f3c-d710515f35dd.html
University of Arkansas Police Department Dropbox to Curb Prescription Drug Abuse
Kaitlyn Akel, Arkansas Traveler
March 16, 2016
http://www.uatrav.com/news/article_fb01bfc2-eaf9-11e5-822e-1b1c272ee5cf.html
Safe Disposal of Old Medications Comes to Towns North of Boston
Wicked Local Middletown
March 13, 2016
http://middleton.wickedlocal.com/article/20160313/NEWS/160319491
Churches Help Jackson Township (Ohio) Police in Drug Take-Back Day
WOhio.com
March 13, 2016
http://www.whio.com/news/news/churches-help-police-in-drug-take-back-day/nqj5z
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Upcoming Conferences and Workshops
Pharmacy Diversion Awareness Conference
U.S. Drug and Enforcement Administration
April 17–18, 2016
Towson, Maryland
http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness
2016 National Rx Drug & Heroin Summit
March 28–31, 2016
Atlanta, Georgia
http://nationalrxdrugabusesummit.org
Third Annual Smart Approaches to Marijuana Education Summit
March 31, 2016
Atlanta, Georgia
http://nationalrxdrugabusesummit.org/sam-summit-2
Register:
https://www.123contactform.com/form-1486587/2016-National-Rx-Drug-Abuse-Summit
Medical Marijuana Seminar
Private Motor Truck Council of Canada
May 3, 2016
Alberta, Canada
Read more:
http://www.todaystrucking.com/alberta-hosting-spring-talk-on-medical-marijuana-in-trucking
http://www.pmtc.ca/News.asp?a=view&id=113
2016 Annual Conference
International Health Facility Diversion Association
September 13–14, 2016
Duke Energy Convention Center
Cincinnati, Ohio
https://ihfda.org/2016-annual-conference
Register:
https://www.regonline.com/Register/Checkin.aspx?EventID=1803476
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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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