Substance Abuse Newsletter June 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.

June 2017

Opioids

Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times. The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50. Although the data is preliminary, the Times’ best estimate is that deaths rose 19 percent over the 52,404 recorded in 2015. All evidence suggests the problem has continued to worsen in 2017. Because drug deaths take a long time to certify, the Centers for DiseaseControl and Prevention will not be able to calculate final numbers until December. The Times compiled estimates for 2016 from hundreds of state health departments and county coroners and medical examiners. Together they represent data from states and counties that accounted for 76 percent of overdose deaths in 2015.

Opioid misuse and addiction is an ongoing and rapidly evolving public health crisis, requiring innovative scientific solutions. In response, and because no existing medication is ideal for every patient, the National Institutes of Health (NIH) is joining with private partners to launch an initiative in several scientific areas: developing better overdose-reversal and prevention interventions to reduce mortality, saving lives for future treatment and recovery; finding new, innovative medications and technologies to treat opioid addiction; and finding safe, effective, non-addictive interventions to manage chronic pain. Each of these areas requires a range of short-, intermediate-, and long-term research strategies. The New England Journal of Medicine Special Report containing detailed information regarding this initiative may be accessed here.

Ohio Attorney General Mike DeWine filed a lawsuit against five leading prescription opioid manufacturers and their related companies in Ross County Court of Common Pleas. The lawsuit alleges that the drug companies engaged in fraudulent marketing regarding the risks and benefits of prescription opioids which fueled Ohio's opioid epidemic. "These drug manufacturers led prescribers to believe that opioids were not addictive, that addiction was an easy thing to overcome, or that addiction could actually be treated by taking even more opioids," said AG DeWine. The five manufacturers which are listed as defendants include: Purdue Pharma, which sold OxyContin, MS Contin, Dilaudid, Butrans, Hyslingla, and Targiniq; Endo Health Solutions, which sold Percocet, Percodan, Opana, and Zydone; Teva Pharmaceutical Industries and its subsidiary Cephalon, which sold Actiq and Fentora; Johnson & Johnson and its subsidiary Janssen Pharmaceuticals, which sold Duragesic and Nucynta, and Allergan, which sold Kadian, Norco, and several generic opioids.

CVS drugstores in Arizona will begin selling Naloxone without a prescription. Arizona Attorney General Mark Brnovich said he has been working with pharmacies to combat opioid addiction in Arizona. He appeared with CVS officials at a press conference to announce the new policy, which is allowed under a law signed last year by Gov. Doug Ducey. AG Brnovich is treating overdoses as a public-health issue by working with pharmacies to get Naloxone readily available for purchase, while still pursuing those who illicitly provide prescription drugs. "We're going after doctors that over-prescribe, and we're going after pill-mills," he said. A "pill-mill" is a term used to describe clinics or doctors who prescribe drugs for non-medical use.

Attorney General Patrick Morrisey unveiled a new faith-based initiative aimed at empowering religious groups across West Virginia in the fight against substance abuse. The purpose of the initiative is to formulate an action plan and develop ideas of how to combat the drug epidemic in each community represented. The initiative, “Combatting Addiction with Grace”, will connect faith leaders with law enforcement, first responders, residential treatment, and local substance abuse groups among others. It will also provide resources to help those suffering from opioid abuse and addiction, while expanding their understanding of the statewide impact. “It is very encouraging to see the West Virginia Attorney General's Office reaching out to the faith based community for sharing of resources and ideas in an effort to help make a difference together,” said Joe Busch, pastor of congregational care at South Parkersburg Baptist Church.

Medical/Marijuana/Synthetics

The Colorado Department of Public Health and Environment has developed a guide to help assist employers in the marijuana industry build occupational safety and health programs. While the foundation of this guide includes existing Colorado state and federal regulations, it is not a comprehensive guide to all of the regulations pertaining to occupational safety and health. It should be noted that this guide does not present any new occupational safety and health regulations for the marijuana industry. Marijuana cultivators, extractors, labs, and retailers are required to adhere to all regulations established by the Colorado Department of Revenue’s Marijuana Enforcement Division. The marijuana industry in Colorado falls under federal OSHA jurisdiction and businesses must comply with OSHA regulations and recordkeeping requirements. In addition to OSHA regulations, marijuana businesses are required to comply with other state regulations including Colorado labor laws, Colorado workers’ compensation laws, Colorado hazardous waste laws, Colorado Pesticide Applicator’s Act, local fire codes, and other regulations that are specific to employment and labor as well as the production of retail and medical marijuana.

Coloradans with post-traumatic stress disorder (PTSD) will now be able to treat their conditions with doctor-approved medical marijuana. Gov. John Hickenlooper signed Senate Bill 17, which will allow physicians, after consultation and a medical background review, to prescribe patients suffering from doctor-diagnosed PTSD with medical marijuana treatments.

Colorado approved using marijuana taxes to fund police efforts to crack down on illegal growing operations. A measure signed into law by Gov. John Hickenlooper sets aside nearly $6 million a year in Colorado marijuana tax revenue to reimburse police for investigating black-market marijuana activity authorities say has increased since the state legalized recreational marijuana in 2012. Colorado's fund is the first in any state designated to specifically combat the black market. The black-market grants are aimed at rural communities, where there may be no pot dispensaries and no local tax benefit from legalization.

Counterfeit Drugs

The Georgia Department of Public Health (DPH) has become aware of a dangerous, potentially lethal substance contained in street drugs surfacing in central and South Georgia. Dozens of patients have been hospitalized and there are reports of deaths that may be associated with the drugs, but confirmation is pending. Patients reportedly purchased yellow pills alleged to be Percocet, an opioid pain medication. The substance is extremely potent and has required massive doses of naloxone (Narcan) to counteract its effects. First responders say patients are unconscious or unresponsive and have difficulty breathing or have stopped breathing. Many patients need to be placed on ventilators. The Georgia Bureau of Investigation’s Crime Lab has identified counterfeit pills related to the reported overdoses in the Central Georgia area. Analysis has confirmed that the pills contain a mixture of two synthetic opioids, cyclopropyl fentanyl and U-47700. Cyclopropyl fentanyl is a fentanyl analogue that is chemically similar to fentanyl. It is unknown how the human body will react to this drug since it is not intended for human or veterinary use. Cyclopropyl fentanyl had not previously been seen in Georgia. U-47700 is a synthetic opioid 7.5 times stronger than morphine.

Methamphetamine

Police investigating a reported burglary have seized almost $1 million worth of methamphetamine-laced lollipops. Six hundred pounds of the homemade candy-drug mixture melted into various shapes -- including Batman and "Star Wars" figures -- were discovered in a Houston home. Police said the drugs had a street value of almost $1 million. A concerned neighbor called police Monday to report that a house was being burglarized. According to the Harris County Sheriff’s Office, when officers arrived on the scene they discovered a male and female removing the lollipops from the home. "They had so many narcotics in their vehicle they couldn't close the back hatch of their car," Lt. Ruben Diaz said.

A San Antonio man has been convicted of murder and other charges in the death of his 2-year-old grandson, who authorities say swallowed a lethal dose of methamphetamine. Investigators say Joel Soto allowed his grandson Jeremy to take the drug in November 2013 and then set his truck on fire with the child’s body inside to hide the crime. A jury, on June 9, 2017, found Soto guilty of murder, injury to a child, drug possession and arson charges. Medical examiner Dr. Kimberly Molina told jurors that an autopsy found methamphetamine in the child’s body and that the boy was dead when his body was set on fire. Soto faces a sentence of up to life in prison. He will be sentenced on July 10.

Other

SAMHSA is pleased to announce the release of the Behavioral Health Barometer, United States, Volume 4. Topics addressed in the report include substance use, serious mental illness, serious thoughts of suicide, and behavioral health treatment. The barometer uses data from the National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services and presents findings by age, gender, racial and ethnic categories, poverty status, and health insurance status. The report may be accessed here.


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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