Substance Abuse Newsletter February 2017

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.

Opioids

China’s National Narcotics Control Commission this week announced that scheduling controls against four fentanyl-class substances -- carfentanil, furanyl fentanyl, valeryl fentanyl, and acryl fentanyl -- will begin on March 1, 2017. This announcement is the culmination of ongoing collaboration between the Drug Enforcement Administration (DEA) and the Government of China, and reaffirms the shared commitment to countering illicit fentanyl. "Fentanyl-related compounds represent a significant and deadly component of the current opioid crisis. These actions will undoubtedly save American lives and I would like to thank my Chinese counterparts for their actions on this important issue," said Acting Administrator Chuck Rosenberg. “This announcement demonstrates the continued commitment on the part of both our countries to address this threat wherever possible.”

Patients addicted to opioids often seek care in the emergency department (ED). They are more likely to receive addiction treatment and reduce opioid use long-term if they are started on medication to reduce cravings in the ED, according to a new Yale study. The benefits of such treatment persist for two months after the initial visit to the ED, the researchers said. The study was published in the Journal of General Internal Medicine.

Medical/Marijuana

The Colorado Department of Public Health and Environment released a comprehensive guide for worker safety for the marijuana industry Tuesday. The guide took about two years to complete and is likely the first of its kind compiled by a state agency, said Roberta Smith, Occupational Health Program Manager at CDHE. Part of the purpose of the guide, Smith said, is to remind the industry that though the federal government has not sanctioned the legalization medical and recreational marijuana, businesses in the industry are still required to follow rules from the U.S. Occupational Safety and Health Administration. The 79-page guide also has information on Colorado’s labor laws, workers’ compensation laws, hazardous waste laws, the Colorado Pesticide Applicator’s Act, local fire codes and other regulations specific to the retail and medical marijuana industry. The guide may be accessed here.

The Colorado Department of Public Health and Environment has also released its annual report on marijuana related health concerns. The report is titled “Monitoring Health Concerns Related to Marijuana in Colorado: 2016”. Included in the report are trends the author consider important to continue monitoring. Some of those trends include the following: about 6% of pregnant women choose to use marijuana during pregnancy and at least 14,000 children in Colorado are at risk of accidentally ingesting marijuana products that are not safely stored. The full report may be accessed here.

A bipartisan group of U.S. representatives formed the first-ever "Congressional Cannabis Caucus" to work on legislation related to marijuana legalization and regulation. Democrats Earl Blumenauer of Oregon and Jared Polis of Colorado teamed up with Republicans Dana Rohrabacher of California and Don Young of Alaska to form the caucus. All four representatives are from states where recreational marijuana use is legal. The group didn't lay out specific legislative objectives, but the lawmakers said that there is a need for explicit rules that square federal law, which strictly prohibits marijuana use, with the growing number of state laws that allow for medical and recreational use.

The State of Oregon wants doctors to conduct a full patient evaluation when recommending medical marijuana. The Oregon Health Authority is asking doctors to obtain a comprehensive medical history for patients, perform a complete physical, discuss the risks of cannabis and maintain detailed records. The new guidelines strongly oppose smoking as a way to use marijuana. The OHA also wants doctors to recommend the lowest possible dose to achieve treatment goals.

The western Colorado town of Parachute is getting a drive-through marijuana shop in March 2017, believed to be the first in the state. The Parachute Board of Trustees approved a business license for Tumbleweed Express. “As far as I can tell, we are not aware of this business model ever coming up before,” said Robert Goulding, spokesman for the state Marijuana Enforcement Division. Tumbleweed Express also had to get approval from the Marijuana Enforcement Division, which said the store cannot allow anyone younger than 21 on the premises, even in the back seat of a car.

PDMP

On Thursday, March 16, 2017 at 1:00 p.m. EST, a webinar titled” How to Predict Overdose Death with PDMP Data and Advanced Analytics” is being offered free of charge. The webinar will presents results using data from the Ohio Automated Rx Reporting System (OARRS) combined with known overdose deaths from the state of Ohio to build predictive models to serve as an early detection system for overdose risk. Due to the complexity of the data, including the variety of drugs, pathways of usage, behavioral elements, and trends in usage, there are unlimited ways to combine the data. The learning objectives include: how PDMP data and advanced analytics can impact detection of prescription narcotic and opioid overdose deaths; the identification of comprehensive data results, from a variety of complex data patterns, for early detection of overdose risk; and a review the early identification process of prevention and management of substance use disorders.

Other

Aetna, one of the nation's largest insurance companies, says that starting in March it will remove what's been a key barrier for patients seeking medication to treat their opioid addiction. The change will apply to all its private insurance plans, an Aetna spokeswoman confirmed. Aetna is the third major health insurer to announce such a switch in recent months. Specifically, the company will stop requiring doctors to seek approval from the insurance company before they prescribe particular medications ― such as Suboxone ― that are used to ease withdrawal symptoms. The common insurance practice, called "prior authorization," has frustrated doctors because it sometimes results in delays of hours to days before a patient can get the needed treatment.

The Oregon Liquor Control Commission issued a ban on marijuana-infused alcohol drinks. OLCC Director Steve Marks says the OLCC is following the lead of the DEA and prohibiting marijuana-infused alcohol. There are currently other marijuana drinks sold in Oregon — like coffees, tonics and colas — but not alcohol. There is an exception — which is alcohol infused with industrial hemp. It’s regulated by the Bureau of Alcohol, Tobacco Tax and Trade and it can’t contain any of the active ingredients in cannabis, including THC and CBD, both of which are Schedule 1 drugs.

Utah is proposing legislation that would make it the first state in the US to reduce drivers' legal blood alcohol limit from .08 to .05. The bill sent to the House floor was sponsored by Rep. Norman Thurston, R-Provo. If HB155 becomes law, it would take effect Dec. 30, 2018. Bella Dinh-Zarr, vice chairwoman of the National Traffic Safety Board (NTSB), cited the success in dozens of European and Asian countries that lowered the legal alcohol limit for drivers and reduced the number of drunken driving fatalities. The NTSB has recommended lowering alcohol driving limits to .05 or lower since 2013, Dinh-Zarr said. If the standard were adopted nationwide, fatal alcohol crashes would drop by 11 percent, she said, saving nearly 1,800 people each year.

The Ohio State Highway Patrol says the agency’s new anti-drug emphasis is paying off with record seizures of heroin, opiates, and other illegal substances. Troopers confiscated 156 pounds of heroin in 2016, a 290 percent increase from 2015, along with record amounts of illegal painkillers and methamphetamines. The agency is building on a plan developed in 2011 to bring troopers into the state’s efforts to reduce Ohio’s addictions epidemic, said Patrol Lt. Robert Sellers. The patrol has doubled the number of drug-sniffing dogs to 34 statewide and now trains every trooper in techniques for locating illegal drugs. Troopers are told “to look beyond the license plate” during traffic stops for signs of criminal activity. Sellers said the patrol’s efforts — which have become a national model for other agencies — will continue and that even more drug-sniffing dogs will be added, with plans for a permanent police dog training facility.


Joanne Thomka is the Editor of Substance Abuse News and may be reached at 202-326-6269. 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 this publication. For content submissions or to contact the editor directly, please e-mail jthomka@naag.org.

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