Substance Abuse Newsletter March 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

The latest numbers from the Centers for Disease Control and Preventionshow that one in four drug overdoses in 2015 wasrelated to heroin. In 1999, just 6% of all overdoses were related to the drug. When looking at overdoses overall, opioid-related deaths represented the majority. In 2015, overdoses involving opioids represented 73% of all overdose deaths, a significant jump from 57% in 2010. Opioids include heroin as well as drugs with a similar chemical structure, such as oxycodone and illicit synthetics like fentanyl. Dr. Holly Hedegaard of the National Center for Health Statistics, who co-authored the study, also noted that this was the first time the number of overdose deaths in the United Statesexceeded 50,000. In 2010, there were 38,329 overdose-related deaths, and, by 2015, that number had climbed to 52,404. By comparison, in 2015, there were 36,252 total firearm-related deaths across the country.

The Ohio Substance Abuse Monitoring Network sent out the alert about the abuse of Gabapentin, which is more commonly known as its brand name: Neurontin. Investigators with OSAM said there's been a surge in how much Neurontin is being made available on the streets. Neurontin is a non-narcotic seizure medication that can also be used to treat nerve pain, but doctors said some users are mixing the drug with heroin to get a better high. Some are even taking the drug to help them get through withdrawal symptoms in between highs. The Ohio Board of Pharmacy said Neurontin was the number one drug dispensed in Ohio in December of 2016.

Dr. Paul Moore, a dentist and pharmacologist at the University of Pittsburgh's School of Dental Medicine, studies the relative usefulness of ibuprofen and other NSAIDs in acute pain management and worked on a recent update of the American Dental Association's prescribing guidelines for opioids. It was the national group's first update on the topic in a decade. In addition, the Pennsylvania Dental Association assisted in the creation of an additional informational tool titled, the “Pennsylvania Guidelines on the Use of Opioids in Dental Practice” which may be accessed here.

Medical/Marijuana/Synthetics

The number of people sentenced for federal marijuana-related crimes dropped for the fifth year in a row, according to data released by the U.S. Sentencing Commission. A total of 3,534 offenders received sentences for federal marijuana crimes in 2016. The overwhelming majority of these cases — 3,398 of them — involved trafficking marijuana. Another 122 individuals received federal sentences for simple possession of marijuana, although some of these offenders may have pleaded down from a more serious offense. The commission's statistics show that more than 97 percent of people charged with a federal crime plead guilty, rather than go to trial. Colorado and Washington became the first states to legalize recreational marijuana in 2012. The data show a sharp drop in the number of federal marijuana sentences the following year, down from 6,992 to 4,942.

Buying medical marijuana in Ohio will require a knowledge of THC content, not just how many ounces of plant material or edibles are on the scale. Proposed rules outlined by the Ohio State Board of Pharmacy would make Ohio the only state to determine how much medical marijuana can be purchased based on the amount of tetrahydrocannabinol — the active chemical ingredient that produces a high — it contains. For example, under the proposed rules for a 90-day supply of medical marijuana, people with qualifying medical conditions could buy 4 ounces to 6 ounces of marijuana plant material, but varying amounts of marijuana-infused oils, patches, and edibles based on THC content. The purchasing rules, along with rules for growers, manufacturers, dispensaries, and doctors and patients, are available online here.

New research from the Centers for Disease Control and Prevention says young people who use synthetic cannabinoid are also more likely to use other drugs or alcohol, to behave violently, and to have high-risk sex, according to a study published in the journal Pediatrics. To understand the overall behavior of these users, Heather Clayton, lead researcher of the new study and a health scientist in the CDC's Division of Adolescent and School Health, turned to the 2015 Youth Risk Behavior Survey, a school-based anonymous questionnaire administered to a nationally representative sample of high school students.

The National Institute on Drug Abuse has published a new DrugFacts issue titled “What is medical marijuana?” The publication discusses FDA approved medications that contain cannabinoid chemicals in pill form and preclinical and clinical trials with marijuana and its extracts to treat symptoms of illness and other conditions. The publication can be accessed here.

Texas Attorney General Ken Paxton today announced a new initiative by the Consumer Protection Division (CPD) of his office to educate parents, grandparents, teachers, coaches, and others on the dangers of illegal synthetic drugs. The attorney general’s office has launched a special area on its agency website providing Texans with the information and resources they need to become fully informed about synthetic drugs. A section with answers to frequently asked questions (FAQs) about synthetic drugs can be printed out as a pdf and shared with others. Because most people are unfamiliar with what the drugs look like, the FAQs includes photos of the colorful packaging used to entice young people to buy synthetic cannabinoids, commonly known as Kush, Spice, and fake pot. The site may be accessed here.

PDMP

Authorities in New Jersey have sanctioned a record 31 doctors in New Jersey in the past 12 months for overprescribing painkillers and other narcotics. New Jersey has pursued criminal charges against some and imposed sanctions including suspension and taking away their license to practice. Authorities learned of many of the wayward doctors through a prescription monitoring program that allows for the tracking of how medication is being prescribed, which doctor is prescribing it, and to whom it is being written. A grand jury indicted one of the 31 doctors, Byung Kang, 77, who is charged with selling prescriptions for high-dose oxycodone pills to people he knew were addicts and to drug dealers, the attorney general’s office said.

Impaired Driving

San Diego police are utilizing a new instrument as a tool to confirm the presence of marijuana and other drugs in impaired drivers — a mouth-swab device that is already being used by police departments in more than a dozen states and is expected to become more popular with the legalization of marijuana. The two Dräger DrugTest 5000 instruments, which cost about $6,000 each, were donated by the San Diego Police Foundation last week. The instrument tests for the presence of seven drugs — marijuana, cocaine, opiates, methamphetamine, amphetamine, methadone and benzodiazepines. The device does not read the level of intoxication; drivers would have to take a blood test for that information. To use, the driver is handed a mouth swab and instructed to run it around the inside of the mouth for up to four minutes. The swab is then placed into the machine, along with a vial of testing solution. It takes about six to eight minutes for results to print out. Like the handheld preliminary alcohol screening devices frequently used in the field in California, drivers there cannot be forced to submit to a Dräger 5000 test.

The AAA Foundation for Traffic Safety has released a report that summarizes major national-level results for the AAA Foundation’s ninth annual Traffic Safety Culture Index. This index is a nationally-representative survey that assesses a few key indicators of the degree to which traffic safety is valued and is being pursued.

Other

Wisconsin Attorney General Brad Schimel and the Pharmacy Society of Wisconsin (PSW) announced a new training tool designed to deter pharmacy robberies. The Pharmacy Robbery Prevention and Response training, provided to pharmacies by law enforcement, will teach pharmacists, pharmacy technicians, clerks, and other pharmacy personnel how to deter a robbery, what to do when a robbery occurs, and what to do after a robbery occurs. The adoption of this training’s content by pharmacies is not required but rather a series of recommendations to make pharmacy premises resistant to robberies. Examples of effective deterrents include: geographic location, categories, amount, and accessibility of drug stock, security equipment, physical design, and management practices.

A Delaware federal judge ruled that Actavis Laboratories' generic version of Zohydro ER infringed on two patents for the powerful opioid, held by a Pernix Therapeutics Holdings Inc. subsidiary. In a 29-page memorandum, U.S. District Judge Gregory M. Sleet of the District of Delaware said that while the generics did not literally infringe on the patents, they performed essentially the same function as Zohydro, which releases hydrocodone over long periods of time to treat severe pain. Sleet's ruling also barred Actavis, a subsidiary of drug giant Teva Pharmaceutical Industries Ltd., from selling its generics until the Zohydro patents expire in 2019 and 2034, respectively. The patents, which describe an abuse-resistant composition and a delayed release system, are licensed to Pernix by Recro Gainesville, a Georgia-based pharmaceutical company that specializes in products for hospitals and ambulatory care.

U.S. Customs and Border Protection (CBP) officers and agriculture specialists at eight South Texas ports of entry seized a significant amount of narcotics, currency, and false documents, and uncovered numerous immigration and agricultural violations during Fiscal Year 2016. Fiscal Year 2016 began October 1, 2015, and ended Sept. 30, 2016. During FY 2016, CBP officers at eight ports of entry extending from Brownsville to Del Rio that comprise the Laredo Field Office seized 157,947 pounds of narcotics that carried a combined estimated street value of $188 million. Specifically, they seized 144,483 pounds of marijuana; 5,877 pounds of cocaine; 6,728 pounds of methamphetamine, up 35 percent from FY 2015; 859 pounds of heroin, $3.8 million in undeclared currency, 70 firearms, and 25,278 rounds of ammunition.

A senior paramilitary leader and one of Colombia’s most notorious drug traffickers was sentenced to serve 198 months in prison for his role leading an international drug trafficking conspiracy responsible for the importation of ton-quantities of cocaine into the United States. DEA Acting Administrator Chuck Rosenberg and Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division made the announcement. Hernan Giraldo Serna, a Colombian national, pleaded guilty in 2009 to one count of conspiracy to distribute cocaine knowing and intending that it would be imported into the United States. U.S. District Judge Reggie B. Walton imposed the sentence. According to admissions in the plea agreement, Serna ascended to a leadership position in 1996 within the Autodefensas Unidas de Colombia (United Self Defense Forces of Colombia or AUC), a terrorist and paramilitary organization in Colombia. In September 2001, the AUC was designated a Foreign Terrorist Organization by the U.S. Department of State. In May 2003, the AUC was placed on the Significant Foreign Narcotics Traffickers list by order of the President, pursuant to the Foreign Narcotics Kingpin Designation Act. In February 2004, Giraldo Serna individually was designated as a Tier II Kingpin by the Department of Treasury’s Office of Foreign Assets Control, subjecting him to severe economic sanctions under the Kingpin Act.


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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