The National Attorneys General Training & Research Institute

The National Attorneys General Training & Research Institute The National Attorneys General Training & Research Institute

Substance Abuse Newsletter June 2018

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

Wisconsin Attorney General Brad Schimel announced the Wisconsin Department of Justice (DOJ) is now offering a Dose of Reality to Native American Tribal Communities on the dangers of misusing opioid and narcotic pain medications. In addition to customized brochures, flyers, and posters, online advertisements will run throughout the summer, targeted at young tribal members and their influencers – parents, caregivers and elders. “Here’s a dose of reality: nonmedical use of opioids in Native American youth occurs two-to-three times more than with other ethnic groups,” said Attorney General Schimel.

Hospira, Inc., a Pfizer company, is voluntarily recalling lots 72680LL and 76510LL of Naloxone Hydrochloride Injection, USP, 0.4 mg/mL, 1 mL in 2.5 mL, Carpuject Single-use cartridge syringe system (NDC 0409-1782-69), to the hospital/institution level due to the potential presence of embedded and loose particulate matter on the syringe plunger. In the event that impacted product is administered to a patient, the patient has a low likelihood of experiencing adverse events ranging from local irritation, allergic reactions, phlebitis, end-organ granuloma, tissue ischemia, pulmonary emboli, pulmonary dysfunction, pulmonary infarction, and toxicity. The risk is reduced by the possibility of detection, as the labeling contains a clear statement directing visual inspection of the product for particulate matter and discoloration prior to administration. To date, Hospira, Inc., has not received reports of any adverse events associated with this issue for these lots.

The White House has launched an ad campaign that focuses on preventing and reducing the misuse of opioids among youth and young adults. The campaign features advertisements that depict real-life events of four young people who went to extraordinary measures to obtain opioids to satisfy their addictions. The materials were developed through a partnership among the White House Office of National Drug Control Policy, the Ad Council and the Truth Initiative. The materials may be accessed here.

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced the update of the SAMHSA Opioid Overdose Prevention Toolkit. The Toolkit offers information and facts from literature and links to resources to prevent opioid-related overdoses and deaths. Because interdisciplinary collaboration is critical to success, SAMHSA offers the Toolkit as an educational resource for community members, first responders, prescribers, patients, and families. The toolkit may be accessed here.

Medical/Marijuana/Synthetics

United States Senators Elizabeth Warren and Cory Gardner introduced legislation to amend the Controlled Substances Act to provide a new rule regarding the application of the Act to marijuana. The legislation is known as Strengthening the Tenth Amendment Through Entrusting States (STATES) Act. If passed, the bill would amend the Controlled Substances Act to include a framework that says it no longer applies to those following state, territory, or tribal laws “relating to the manufacture, production, possession, distribution, dispensation, administration, or delivery of [marijuana]." The bill may be accessed here.

School nurses in Colorado now can administer nonsmokable medical marijuana to students whose parents have given permission. Colorado law already permitted parents to give their children medical marijuana at school, typically for treating seizures. House Bill 1286, signed by Gov. John Hickenlooper, allows parents to bring the medicine to a school nurse’s office for a child who has a medical marijuana card. The law requires that the medicine be kept in a locked storage container and that the school principal and a parent have a written agreement. It also says the parent must bring a doctor’s note that instructs the school nurse about dosage and timing. Under the law, students receiving medical marijuana at school cannot carry the medicine to the nurse’s office or bring it on a school bus.

Mayors from seven U.S. cities in states with legal marijuana said they have formed a coalition to push for federal marijuana policy reform. Mayors from Denver, Seattle, Portland, San Francisco, Los Angeles, Las Vegas, and West Sacramento sponsored a resolution at the U.S. Conference of Mayors in Boston that asked the U.S. government to remove cannabis from a list of illegal drugs, among other things. It was approved unanimously by the broader gathering, said Larry Jones, a spokesman for the conference. Mayors from Oakland, California, and Thornton, Colorado, weren't sponsors but pledged to advocate for federal reforms.

Colorado Gov. John Hickenlooper vetoed a bill that would have allowed licensed marijuana “tasting rooms” in Colorado — legislation that was the first of its kind in the nation — citing health and safety concerns. House Bill 1258 would have let adults at current recreational marijuana retailers consume small amounts of pot through edibles or by vaping. House Bill 1258 was opposed by the American Lung Association and the American Cancer Society Cancer Action Network.

The Drug Enforcement Administration’s 2017 Final Domestic Cannabis Eradication/Suppression Program statistical report may be accessed here. The Domestic Cannabis Eradication/Suppression Program is the only nationwide law enforcement program that exclusively targets Drug Trafficking Organizations (DTO) involved in cannabis cultivation.

Attitudes about the morality of alcohol and marijuana items were measured for the first time in Gallup's annual Values and Beliefs survey, conducted May 1-10, 2018. The survey asked Americans to indicate whether they believe whether 22 different behaviors and practices are morally acceptable or morally wrong. Alcohol and marijuana rank near the top of the list of practices Americans consider morally acceptable. Only birth control, at 91%, gets a higher percentage sanctioning it than drinking alcohol does. Smoking marijuana trails birth control, drinking alcohol and divorce (76%), but is on par with widely accepted acts including gambling, sex between an unmarried man and woman, gay or lesbian relations, stem cell research, and having a baby outside of marriage.

PDMP

Florida’s House Bill (HB) 21, enacted to help combat opioid abuse, contains several noteworthy changes to Florida law that impact the dispensing of opioids. Effective July 1, 2018, dispensing providers must consult Florida’s Prescription Drug Monitoring Program (PDMP) prior to dispensing controlled substances to patients and must report any controlled substances dispensed in the PDMP by the following business day. Further details regarding the new dispensing requirements may be accessed here.

Wisconsin Governor Scott Walker announced progress in Wisconsin in the battle against opioid abuse as opioid prescriptions dispensed over the last year are down 10 percent, according to a new report released from the Controlled Substances Board on the Wisconsin Prescription Drug Monitoring Program (PDMP). The report analyzes PDMP data from Quarter 1 of 2018 (January 1, 2018 – March 31, 2018) as part of the controlled substance dispensing trends over the past year. In Q1 of 2018 there were 910,616 opioid prescriptions dispensed, a 10 percent decrease over the past 12 months. That equates to 100,286 fewer prescriptions. In addition to the decrease in opioid prescriptions over the past 12 months, the report also highlights: a 6 percent decrease in the total number of monitored prescriptions dispensed or 140,601 fewer prescriptions; a 6 percent decrease in benzodiazepine prescriptions dispensed or 29,468 fewer prescriptions; a 23 percent decrease in the total number of data-driven concerning patient history alerts generated, and a 27 percent decrease in doctor shopping alerts.


Other

Vermont is the first state in the country to pass legislation that could allow the importation of less-expensive prescription drugs from Canada. It was approved by the legislature with bipartisan support and was signed by Governor Phil Scott. Vermonters wouldn't get access to the reduced-cost drugs right away. The law directs the state Agency of Human Services to design a workable program. The drugs would also have to meet the US Food and Drug Administration's safety and effectiveness standards, and they would have to be the ones that "generate substantial savings for Vermont consumers." Once the drugs are imported, the law would not allow the state to sell them to other states. The plan is due by January 1, 2019, and if the Legislature approves it, lawmakers would have to create a financial plan to pay for the drugs. No.133 (S.175) may be accessed here.

A new report from the Governors Highway Safety Association (GHSA) finds that, in 2016, 44% of fatally-injured drivers with known results tested positive for drugs, up from 28% just 10 years prior. More than half of these drivers had marijuana, opioids, or a combination of the two in their system. Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States presents new research to examine the impact of marijuana and opioids on driving ability and provides recommendations on how best to address these emerging challenges. Funded by the Foundation for Advancing Alcohol Responsibility (Responsibility.org), the report found that among drug-positive fatally-injured drivers in 2016, 38% tested positive for some form of marijuana, 16% tested positive for opioids, and 4% tested positive for both marijuana and opioids. While alcohol-impaired driving remains a significant threat to traffic safety, presence of alcohol in fatally-injured drivers is slightly lower than it was a decade ago, decreasing from 41% in 2006 to 38% in 2016. Some of the strategies that have been used to address alcohol-impaired driving can also be employed to deter drug-impaired driving, yet drug impairment presents several unique challenges.


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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