Substance Abuse Newsletter December 2015

The following is a compendium of news reports over the past month that may be of interest to our AG offices who are dealing with substance abuse issues. Neither the National Association of Attorneys General nor the National Attorneys General Training & Research Institute expresses a view as to the accuracy of news accounts, nor as to the position expounded by the authors of the hyperlinked articles.

New Developments in Combatting Opioid Abuse

Maryland’s heroin task force released 33 recommendations in early December, including legislation to authorizing needle-exchange programs in any county as well as developing a plan to increase access to medication-assisted treatment. The panel also recommended that the state legislature create a Maryland Racketeer Influenced and Corrupt Organization (RICO) statute that is modeled after federal law to aid in the prosecution of drug traffickers.

Legislators in New Hampshire have established a joint legislative task force which will “vet proposed legislation addressing the state’s opioid epidemic.” The task force expects to present legislation to the governor by January 21, 2016.

The U.S. Drug Enforcement Administration (DEA) has named heroin as the top drug threat in the United States. DEA also released the results of the 2015 National Drug Threat Assessment (NDTA), which found that drug overdose deaths are now the leading cause of injury death in the country and that Mexican transnational criminal organizations are the biggest criminal drug threat.

The U.S. House of Representatives has now passed The Protecting Our Infants Act, S.799. The bill was passed by the U.S. Senate in October. The legislation requires the Department of Health and Human Services (HHS) to conduct reviews of activities relating to prenatal opioid use and develop a strategy to address gaps and overlaps in research and programs.

The U.S. Food and Drug Administration (FDA) approved Narcan nasal spray in mid-November. While the spray has been used by first responders and primary care givers over recent years, it has been part of an unapproved kit that combines an injectable formulation of naloxone with an atomizer. The FDA also declined to approve the application for a second nasal spray version of Naloxone. The drug is manufactured by Invidior, which said that the FDA’s decision “was principally focused on clinical pharmacology” and that the company is determining what its next steps should be. Finally, the FDA will review Probuphine, an implant that provides a steady dose of buprenorphine, an opioid addiction treatment drug, in January 2016.

The U.S. Federal Trade Commission (FTC) filed a lawsuit against Sunrise Nutraceuticals, LLC, which is based in Boca Raton, Florida, alleging that the company “deceptively claims that its dietary supplement Elimidrol. . . alleviates opiate withdrawal symptoms and increases a user’s likelihood of overcoming opiate addiction.”

In November, U.S. Senator Hal Rogers, along with 16 other members of Congress, sent a letter to HHS Secretary Sylvia Burwell asking her to utilize HHS’s “regulatory authorities to encourage health care providers to consider prescribing abuse-deterrent opioids (ADOs), as appropriate, before prescribing opioids without abuse-deterrent properties, and to increase patient access to ADO options.”

Statistics show that prescription opioid addiction is a growing problem among senior citizens. For example, a study conducted at Towson University revealed that, from 2006 to 2012, emergency room departments in the United States experienced a 78 percent increase in the number of older adults presenting with symptoms of prescription drug or illicit drug misuse.

A report released by Trust for America’s Health states that, over the past decade, 35 states have experienced a dramatic increase in youth drug overdose deaths. The report adds that “[t]he increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription pain killers.”

The American Medical Association (AMA) has urged physicians to act to reduce opioid-related harms by: (1) registering and using prescription drug monitoring programs; (2) bolstering education; (3) becoming trained to provide medication assisted treatment; and (4) co-prescribing Naloxone when it is clinically indicated. The AMA has also called for a ban on advertising prescription drugs and medical devices directly to customers, stating that, “[d]irect-to-consumer advertising [drives up drug prices and] also inflates demand for new and more expensive drugs, even when those drugs may not be appropriate.”

This article details the dangers involved when babies suffering from Neonatal Abstinence Syndrome (NAS) are discharged to families “ill-equipped to care for them.” While the 2003 federal Keeping Children and Families Safe Act mandates that health care providers alert child protection authorities when such children are born, it seems that state laws are not in compliance with this mandate.

A study conducted at the University of Colorado Anschutz Medical Campus suggests that patients who do not have a history of recent opioid use are at a higher risk of chronically using prescription painkillers if the drugs are prescribed to these patients when they are discharged from a hospital. Such patients are almost five times more likely to become a chronic opioid user after one year than patients who were not prescribed an opioid upon discharge.

Arkansas Attorney General Leslie Rutledge co-hosted the state’s fourth annual Arkansas Prescription Drug Abuse Summit in early November. The Summit was a free training and educational opportunity for many of the stakeholders involved in the fight against prescription drug abuse, including law enforcement, medical professionals, pharmacists and educators. Indiana Attorney General Greg Zoeller provided the Keynote Address.

District of Columbia Attorney General Karl A. Racine announced that the District has joined the Northeast and Mid-Atlantic Heroin Task Force (NEMA-HTF), which is made up of the Attorneys General from Virginia, Maryland, Pennsylvania, New Jersey, New York, Massachusetts, and Maine. The task force works to foster collaboration and information sharing to fight heroin distribution networks and decrease the number of heroin overdose-related fatalities.

Georgia Attorney General Sam Olens announced the winners of the “We’re Not Gonna Take It” video contest, which is aimed at preventing prescription drug abuse among teens. The winners produced 30-second videos “encouraging their peers to live a healthy lifestyle by rejecting prescription drug abuse.” The winning video will be aired on television stations throughout Georgia, through a partnership with the Georgia Broadcasters Association and the Healthcare Distribution Management Association.

Indiana Attorney General Greg Zoeller has announced that a grant award from Eli Lilly and Companies will fund over 100 prescription drug disposal sites at pharmacies in Indiana. The grant was provided to Yellow Jug Old Drugs, which is a program that provides prescription drug disposal services to pharmacies. General Zoeller, together with the National Safety Council, also announced the release of the results of a study into the prevalence of on-the-job prescription drug abuse in Indiana. The study is the result of a partnership between the Indiana Attorney General’s Prescription Drug Abuse Prevention Task Force and the National Safety Council. More information about the study and the results can be found at this link.

Kentucky Attorney General Jack Conway has announced the winners of the 2015 Keep Kentucky KidsSafe public service announcement (PSA) contest. Each winner will receive $250 in Amazon gift cards, provided by the National Association of Drug Diversion Investigators (NADDI). The winning PSAs can be viewed on YouTube.

Massachusetts Attorney General Maura Healey praised the state legislature’s advancement of legislation criminalizing the trafficking of fentanyl. In August, General Healey, together with House Judiciary Chairman John Fernandes, filed this legislation.

General Healey also announced that two Massachusetts physicians have agreed to pay over $400,000 for allegedly charging opioid addiction treatment patients cash for services that were already covered by Medicaid.

Montana Attorney General Tim Fox has launched a new campaign, called Resolve, which specifically targets prescription drug and heroin abuse. The campaign will focus on educating the public as to the proper use and disposal of prescription drugs.

New Jersey Acting Attorney General John J. Hoffman and New York Attorney General Eric Schneiderman have announced the arrest of a drug dealer on charges that he supplied fentanyl-lacedheroin that killed a man in New York State. The defendant has been charged with the first-degree charge of strict liability for drug-induced death as well as distribution of heroin. The arrest is the result of a joint investigation conducted by law enforcement in both states as well as through the partnership of the Northeast and Mid-Atlantic Heroin Task Force (NEMA-HTF).

Ohio Attorney General Mike DeWine, together with Ohio Governor John Kasich, asked 200 school superintendents, principals, counselors, and other education leaders to “help in the battle against opioid addiction” by ensuring that educators are aware of the problem and deliver regular warnings to students about the dangers of drug use.

General DeWine was also recently interviewed by 60 Minutes in connection with a report called “Heroinin the Heartland.” The footage of the interview can be accessed at this link and the transcript can be accessed at this link.

Oregon Attorney General Ellen Rosenblum announced that $567,000 of the $1.1 million settlement reached between the Oregon Department of Justice and Insys, a pharmaceutical company, over the unlawful promotion of Subsys, an opioid, will go to the Oregon Coalition for Responsible Use of Meds and the Oregon Health & Science University. The money will be used to combat opioid drug abuse within Oregon.

The office of Virginia Attorney General Mark Herring has produced a documentary detailing the dangers of opioid abuse. The film is called “Heroin: The Hardest Hit,” and will be available free of charge to schools and other organizations.

Updates in the Field of Marijuana Legalization

Officials in the District of Columbia are considering whether to continue the ban on marijuana use in private businesses. The current ban affects residents of public housing, including disabled veterans, as these individuals do not own their residences. If the emergency legislation which authorized the ban expires on January 15, 2016, it will be legal to use marijuana in private District of Columbia businesses.

Residents in Minnesota who are suffering from intractable pain will now be allowed to purchase medical marijuana.

A new law in New Jersey allows parents or primary caregivers to administer edible medical marijuana to sick or disabled children while the children are at school. The law also protects school districts from any related liability.

Pacific Power and Portland General Electric have reported that legal indoor marijuana growing operations are straining Oregon’s electrical grids. The companies are asking growers to communicate with power providers before beginning growing operations.

In South Dakota, the Flandreau Santee Sioux Indiana tribe burned its marijuana crop after federal authorities “signaled a potential raid.” The tribe has meetings scheduled with the U.S. Department of Justice and South Dakota Attorney General Marty Jackley to discuss the issue further.

Spokane County, Washington, will now vacate municipal court convictions for misdemeanor marijuana possession that occurred prior to July 2014. Felony convictions will remain unaffected.

The Squaxin Island Indian tribe is opening a recreational marijuana retailer shop in Washington State. It is believed to be the first store of its kind to open on an Indian reservation. The tribe has entered into an agreement with the state under which the tribe will collect a tribal tax equivalent to the state tax charged in non-reservation retailers.

On March 22-23, 2016, in Bethesda, Maryland, the National Institutes of Health will host “Marijuana and Cannabinoids: A Neuroscience Research Summit.” The goal of the Summit “is to ensure evidence-based information is available to inform practice and policy.” More information about the Summit can be accessed by clicking on this link.

The United States Postal Service has warned Oregon and Alaskan newspapers that, under federal law, it is illegal to mail newspapers that contain marijuana advertisements.

This article provides a good overview of the current state of marijuana legalization and taxation in various U.S. jurisdictions.

The American Medical Association (AMA) is advocating for the inclusion of warnings on medical and recreational marijuana products that will inform consumers that marijuana use during pregnancy and breast feeding may be harmful. The AMA is also in favor of mandatory signage at retail shops which would provide the same message.

A study conducted by Kings College London suggests that frequent use of high-potency marijuana may damage nerve fibers responsible for the communication between the two hemispheres of the brain. The findings have been published in Psychological Medicine.

This article details the dangers of dabbing, which occurs when “users inhale vapor from dabs of waxy or solid marijuana concentrate, creating an intense high.” These dangers include serious burns and explosions.

Mexico’s Supreme Court has voted to allow a group of activists to legally grow and smoke marijuana.

Synthetic Drug News

The office of District of Columbia Attorney General Karl A. Racine has introduced legislation, called the Synthetics Abatement and Full Enforcement Drug Control Act of 2015 which, if passed, will schedule substances based on the class of chemical compounds contained in the drugs rather than the individual compound in a particular substance. The legislation also codifies certain District Department of Health synthetic cannabinoid and cathinone regulations.

Florida Attorney General Pam Bondi is warning constituents about the dangers of flakka, a syntheticdrug that can cause delusions, hallucinations, and increases in body temperature. Flakka is also known as “gravel.”

In early November, over the period of one week, the Illinois Poison Center experienced a 600 percent increase in calls relating to synthetic cannabinoids. The majority of the drugs were sold in Chicago under the name “Jamaican Party Spice.” According to the American Association of Poison Control Centers, calls relating to poison control centers synthetic marijuana nationally have almost doubled in the past year.

New Jersey authorities shut down a synthetic marijuana operation that could have put $27 million worth of the drug onto New Jersey streets. The laboratory that was raided was the largest that authorities have seen in the state. Over 2,000 packets of ready-for-sale synthetic marijuana were seized, as well as 500,000 empty packets, tools, lab equipment, and 234 bottles of “bath salts.”

Other News of Interest

On Tuesday, December 15, 2015, at 1:00 PM Eastern Time, ONDCP will hold a webinar entitled: “Reducing the Use of New Psychoactive Substances: State, Local, and Community Experiences.” The webcast will showcase the steps communities have taken to reduce the use of New Psychoactive Substances within their communities, large and small. To register, please click on this link.

Researchers at the UCLA School of Dentistry, the UCLA Fielding School of Public Health, and the UCLA Integrated Substance Abuse Program have published findings that show disproportionately high rates of dental disease among methamphetamine users.

A study published in Drug and Alcohol Dependence found that people who drank vodka mixed with diet soda had higher breath alcohol levels than those who drank vodka mixed with regular soda. A previous study conducted at the University of Adelaide in Australia found that alcohol enters the bloodstream more quickly when it is mixed with diet soda, compared to when it is mixed with regular soda.

Mothers Against Drunk Driving (MADD) has announced that while it hasn’t officially changed its name, it has incorporated drugged driving into its message and should now be known as Mothers Against Drunk and Drugged Driving.

One of NAAG’s Research Fellows recently viewed a webinar hosted by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) entitled, “Increasing Health Insurance Marketplace Open Enrollment,” which focused on ensuring that substance abuse services are available to everyone and integrated into mainstream healthcare. To learn more about the webinar or obtain a copy of the PowerPoint slides, please email me at fliquori@naag.org.

In October 2015, the National Highway Traffic Safety Administration (NHTSA) hosted a briefing on impaired driver assessment tools. I attended and found it to be very informative. NHTSA has now posted materials relating to the briefing on its website.

Arizona Attorney General Mark Brnovich announced that seven search warrants have been executed and five indictments filed in connection with a $2.8 million money laundering, drug trafficking, and fraud of state benefits investigation.


Francesca Liquori is the Editor of Substance Abuse News and may be reached at 202-326-6041. Substance Abuse News is a publication of the National Association of Attorneys General. Any use and/or copies of this newsletter in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in ths publication.

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