Substance Abuse Newsletter June 2016

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 US Food and Drug Administration has approved the first buprenorphine implant that can treat opioid addiction. The first buprenorphone implant is called probuphine. This can provide a constant and yet low-level dose of buprenorphine for half a year to patients who are already taking low-to-moderate doses of other forms of buprenorphine. Probuphine, a match-sized rod that is inserted under the skin, is set to complete the treatment program for these patients.

The DEA has released a Roll Call video to all law enforcement nationwide about the dangers of improperly handling fentanyl and its deadly consequences. Acting Deputy Administrator Jack Riley and two local police detectives from New Jersey appear on the video to urge any law enforcement personnel who come in contact with fentanyl or fentanyl compounds to take the drugs directly to a lab. It is 40 to 50 times stronger than street-level heroin. A very small amount ingested, or absorbed through your skin, can kill. The video can be accessed at: http://go.usa.gov/chBWW

Connecticut Governor Dannel P. Malloy has signed a bill that would limit prescriptions for opioid painkillers in most cases to seven days. The law takes effect July 1 and is aimed at reducing the availability of unused pills, a problem experts say is one of the main reasons for a dramatic rise in opioid addiction. The bill adopts a Centers for Disease Control and Prevention recommendation that state’s limit the length of painkiller prescriptions to seven days, unless a doctor can document a reason for a larger supply. All prescriptions for minors are limited to seven days. The bill also requires that all first responders have access to an opioid antagonist like naloxone, and grants immunity from civil liability to licensed professionals administering the drug.

Virginia Attorney General Mark Herring announced that DVDs of Heroin: The Hardest Hit, an award-winning documentary on the impact of heroin and prescription drugs on the Commonwealth of Virginia, are now available through the Office of Attorney General. Schools, faith-based organizations, community organizations, civic groups, sports leagues, and others can request a free DVD featuring either the full 43-minute film, or a shorter 30-minute film designed for easy presentation in schools. Anyone interested in receiving a DVD copy, streaming the film online, or planning a screening in their community with the assistance of the Office of Attorney General should visit www.HardestHitVA.com.

New England governors are coming together to discuss ways to confront the opioid addiction crisis. Massachusetts Gov. Charlie Baker will meet June 14, 2016 with Vermont Gov. Peter Shumlin, Connecticut Gov. Dannel Malloy, Rhode Island Gov. Gina Raimondo, Maine Gov. Paul LePage and New Hampshire Gov. Maggie Hassan. The governors are participating in a forum at the Harvard Medical School to discuss what their states have done to curb opioid abuse, overdoses and deaths. Organizers say the conference also is aimed at primary care physicians, pain specialists and others interested in the public health aspects of opioids.

Medical/Marijuana

Gov. John Kasich signed a bill on June 8, 2016 which legalized medical marijuana in Ohio, though patients shouldn't expect to get it from dispensaries there anytime soon. The bill lays out a number of steps that must happen first to set up the state's medical marijuana program, which is expected to be fully operational in about two years. The law would allow patients to use marijuana in vapor form for certain chronic health conditions, but bar them from smoking it or growing it at home. Kasich's signature made Ohio the 25th state to legalize a comprehensive medical marijuana program. When the law takes effect in September, cities and towns could move to ban dispensaries or limit the number of them. Licensed cultivators, processors, dispensaries and testing laboratories could not be within 500-feet of schools, churches, public libraries, playgrounds or parks. Employers could continue to enforce drug-testing policies and maintain drug-free workplaces.

Although marijuana use among youth poses a risk to health, nationally only 1 in 5 adolescents perceived it as such. According to SAMHSA’s 2014 National Survey on Drug Use and Health, this misperception among youth exists at a time when marijuana concentrates continue to become more potent, which is cause for public concern. According to SAMHSA’s Short Report, “State Estimates of Adolescent Marijuana Use and Perceptions of Risk of Harm from Marijuana Use: 2013 and 2014,” in the 12 to 17 age group, approximately 1.8 million youth reported using marijuana in the past month. The Drug Enforcement Agency describes marijuana concentrate as a substance containing highly potent THC (tetrahydrocannabinol, the psychoactive component of marijuana). This concentrate is often referred to as oil or “710” (“OIL” spelled upside down and backwards). THC levels in this oil could range from 40 to 80 percent, which is about four times stronger than what is found in a “high grade” marijuana plant.

Oregon’s tax revenue from marijuana sales is much higher than what economists originally expected. Sales are expected to raise $43 million in revenue for Oregon this year, already raising $10.5 million in tax revenue in the first three months. The profitable pot sales were originally estimated to bring $2 million to $3 million for 2016 in Oregon — a figure sales revenue smashed within the first month at $3.48 million from January’s deposits. Taxes for marijuana sales range from 17-25%, depending on where customers are buying it from. See also the Oregon Department of Revenue’s Committee on Marijuana Legalization report.

Edible marijuana products containing up to 15 milligrams of THC are now available for retail sale in registered medical marijuana dispensaries across the state of Oregon to adults 21 or over. Temporary Oregon Administrative Rules went into effect June 2. The rules, under OAR 333-008-1500, are available online at http://www.oregon.gov/oha/mmj/Documents/Rulemaking/333-008-Marijuana-Early-Start-Temporary-Rule-Text.pdf.

The state of Alaska approved the first licenses ever awarded for a commercial marijuana business in the 49th state. The first license came at 1:58 p.m. as the Alaska Marijuana Control Board approved a license for CannTest LLC of Anchorage to legally test commercial marijuana. The license isn’t just historic for Alaska — it’s historic for the United States. Every other state to legalize commercial marijuana sales has had some pre-existing system of medical marijuana dispensaries. Alaska is the first state in the country to create a system of commercial sale from scratch.

Nationwide, federal marijuana trafficking offenses are on the decline. The United States Sentencing Commission (USSC), which compiles data on federal law enforcement efforts, recently released its latest drug trafficking statistics. The statistics show federal marijuana trafficking offenses have fallen sharply since 2012, the year that Colorado and Washington residents voted to legalize marijuana. The decline continues through 2015, the most recent year for which data is available. Meanwhile, trafficking in other drugs, notably meth and heroin, appears to be on the rise.

Please see links below for a report that summarizes proceedings for the Marijuana and Cannabinoids: A Neuroscience Research Summit which the National Institutes of Health convened on March 22–23, 2016. The Summit presented evidence-based information on the neurological and psychiatric effects of marijuana, other cannabinoids, and the endocannabinoid system. Presenters also suggested scientific areas for future research. NIH hopes that this science will inform practice and policy at a time when the landscape regarding the recreational and medicinal use of marijuana is rapidly shifting. Summit website (see Summary link at bottom of Welcome page): http://apps1.seiservices.com/nih/mj/2016/ PDF of Summary: http://apps1.seiservices.com/nih/mj/2016/Documents/BriefMJSummitMeetingSummary.pdf

A task force in Oregon studying energy and water use associated with marijuana production is likely to recommend that the state do more to educate growers about existing agricultural rules and practices, as well as back a certification process that encourages Oregon's new industry to pay closer attention how it uses natural resources. The task force, made up of growers, agency representatives and lawmakers, is set to make recommendations to the Legislature later this summer.

Methamphetamine

The United States Drug Enforcement Administration has posted state maps indicating methamphetamine incidents, including labs, dumpsites or chemical and glassware seizures for the years 2004-20014. https://www.dea.gov/resource-center/meth-lab-maps.shtml

Synthetics

A new synthetic drug that can be purchased online and is connected to at least 50 deaths nationwide has several states scrambling to stop its spread. At least three states - Ohio, Wyoming and Georgia - already have taken action to ban U-47700 after it was connected to overdoses. A spokeswoman for the U.S. Drug Enforcement Administration said that the agency is studying the opioid but hasn't yet moved to control it. Nearly eight times more potent than morphine, U-47700 comes in various forms and can be injected, snorted or taken orally. The U in the name stands for Upjohn, a pharmaceutical manufacturer that developed the drug in the mid-1970s as scientists were looking for a synthetic alternative to morphine.

DEA Acting Administrator Chuck Rosenberg told the Senate Judiciary Committee on June 7, 2016 that reports of “synthetic cannabinoids” – a type of new psychoactive substance (NPS) or synthetic drug - identified by federal, state, and local labs increased from 23 reports in 2009 to 37,500 reports in 2014 according to the DEA National Forensic Laboratory Information System (NFLIS). There are a variety of synthetic designer drugs, which are categorized based on the types of controlled substances they are intended to mimic: cannabinoids, cathinones, and hallucinogens known as phenethylamines. The two most commonly used categories of synthetic designer drugs in the United States are synthetic cannabinoids and synthetic cathinones. Substances identified as synthetic cathinones increased from 29 reports in 2009 to 14,070 reports in 2014 according to the same report.

Danger: Fake Weed + U = Zombie is an equation that the D.C. Department of Health hoped would scare kids away from synthetic drugs. And this week the Department of Behavioral Health is rolling out an extension of the campaign for adults, though it features no undead victims of the drug. Materials can be downloaded at www.K2ZombieDC.com/adults. Information may also be located on Facebook and Twitter using the handle @K2ZombieDC. The new campaign was developed in response to increases in D.C. Fire and EMS calls about cases involving synthetic drugs, among other issues. K2 Zombie DC, the health department's awareness campaign, kicked off in 2013.

Prescription Drug Monitoring

Prescription drug monitoring programs reduced the rate of opiates prescribed in ambulatory settings by more than 30 percent over roughly a decade, according to new research published in the June edition of Health Affairs. The researchers, from Weill Cornell Medical College, Columbia University, the Centers for Disease Control and Prevention, and elsewhere, scanned National Ambulatory Medical Care Survey data across 24 states from 2001 to 2010; that represented more than 26,000 ambulatory care office visits. They examined trends involving Schedule II opiates--those more likely to be abused--prescribed at the point of care. Such results were deemed promising by the researchers, who suggested that PDMPs may have led to increased cautiousness among prescribing providers. The authors also speculated that perhaps the notion of "being watched" may have altered prescriber behavior.

Other

The enhanced Substance Abuse and Mental Health Data Archive (SAMHDA) from SAMHSA is back online with new features and a new URL: http://datafiles.samhsa.gov/. Users are encouraged to explore all of the files available for public use, which include new and updated series data. If you have questions or require technical assistance, contact the SAMHDA Help Desk through the online technical assistance form or by calling 1-888-741-7242.

The National Institute on Alcohol Abuse and Alcoholism announced the winners of its Wearable Alcohol Biosensor Challenge, a competition to design a discreet device capable of measuring blood alcohol levels in near real-time. The winning prototype and recipient of the $200,000 first prize was submitted by BACtrack, a company known nationally for designing and selling portable breath alcohol testers for consumer and professional use. Their entry, the BACtrack Skyn, is worn on the wrist and offers continuous and non-invasive monitoring of a user’s BAC. Alcohol is detected using a fuel cell technology similar to that in devices used by law enforcement for roadside alcohol testing. The device connects via Bluetooth to a smartphone to store data.

More older adults are becoming addicted to powerful pain pills like OxyContin and Percocet to drown out the aches and pains of aging. Women may end up becoming dependent on pain relievers more quickly than men, according to the Centers for Disease Control and Prevention, and their overdoses have been rising rapidly. As prosperous baby boomers age, their prescription drug use is increasing as well. In addition, though wealth provides many boomers with financial freedom, retirement often gives them anxiety, too. There are two factors for aging adults: drug tolerance that builds with time, and the body’s slowing metabolism, which gives drugs a bigger effect.

West Virginia Attorney General Morrisey, in cooperation with the Attorney General’s Public Health Trust and its members, is now accepting applications to fund the placement of four drug incinerators across West Virginia. It represents another step in the Dispose Responsibly of Prescriptions (DRoP) initiative, which has distributed drug disposal drop boxes throughout West Virginia. Law enforcement agencies having received and/or applied for a DRoP box will be given priority in obtaining an incinerator. Attorney General Morrisey believes these incinerators will be a major help to police agencies that struggle finding a place to dispose of the very drugs turned in by their citizens.


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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