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Federal Guidelines for Opioid Treatment Programs

May 29, 2015 Comments off

Federal Guidelines for Opioid Treatment Programs
Source: Substance Abuse and Mental Health Services Administration

Provides updated guidelines for the operation of opioid treatment programs (OTPs). Covers patient assessment, treatment planning, medication-assisted treatment (methadone and buprenorphine), overdose and relapse prevention, and recovery care.

What Americans believe about opioid prescription painkiller use

April 28, 2015 Comments off

What Americans believe about opioid prescription painkiller use (PDF)
Source: National Safety Council

Key Takeaways:
1. Americans don’t know their painkillers contain opioids, or that it is a felony to share them.
2. Opioid users are unconcerned about addiction, but most have reason to worry.
3. Opioid users overestimate the benefits of opioids and underestimate the risks of addiction or death.

Drug-poisoning Deaths Involving Heroin: United States, 2000–2013

April 23, 2015 Comments off

Drug-poisoning Deaths Involving Heroin: United States, 2000–2013
Source: National Center for Health Statistics

Key findings
Data from the National Vital Statistics System (Mortality)

  • From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin nearly quadrupled from 0.7 deaths per 100,000 in 2000 to 2.7 deaths per 100,000 in 2013. Most of the increase occurred after 2010.
  • The number of drug-poisoning deaths involving heroin was nearly four times higher for men (6,525 deaths) than women (1,732 deaths) in 2013.
  • In 2000, non-Hispanic black persons aged 45–64 had the highest rate for drug-poisoning deaths involving heroin (2.0 per 100,000). In 2013, non-Hispanic white persons aged 18–44 had the highest rate (7.0 per 100,000).
  • From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin increased for all regions of the country, with the greatest increase seen in the Midwest.

FDA issues final guidance on the evaluation and labeling of abuse-deterrent opioids

April 3, 2015 Comments off

FDA issues final guidance on the evaluation and labeling of abuse-deterrent opioids
Source: U.S. Food and Drug Administration

The U.S. Food and Drug Administration today issued a final guidance to assist industry in developing opioid drug products with potentially abuse-deterrent properties.

Opioid drugs provide significant benefit for patients when used properly; however opioids also carry a risk of misuse, abuse and death. To combat opioid misuse and abuse, the FDA is encouraging manufacturers to develop abuse-deterrent drugs that work correctly when taken as prescribed, but, for example, may be formulated in such a way that deters misuse and abuse, including making it difficult to snort or inject the drug for a more intense high. While drugs with abuse-deterrent properties are not “abuse-proof,” the FDA sees this guidance as an important step toward balancing appropriate access to opioids for patients with pain with the importance of reducing opioid misuse and abuse.

The document “Guidance for Industry: Abuse-Deterrent Opioids – Evaluation and Labeling” explains the FDA’s current thinking about the studies that should be conducted to demonstrate that a given formulation has abuse-deterrent properties. It also makes recommendations about how those studies should be performed and evaluated, and discusses what labeling claims may be approved based on the results of those studies.

Audit of VA’s Drug-Free Workplace Program

March 31, 2015 Comments off

Audit of VA’s Drug-Free Workplace Program
Source: U.S. Department of Veterans Affairs, Office of Inspector General

We conducted this audit to assess how effectively VA’s Drug-Free Workplace Program identifies and addresses illegal drug use among VA employees. VA needs to improve management of its Drug-Free Workplace Program. VA selected about 3 of every 10 applicants for pre employment drug testing before hiring these individuals into Testing Designated Positions (TDPs) in fiscal year (FY) 2013. We estimate that of the nearly 22,600 individuals VA reported hiring into TDPs in FY 2013, about 15,800 were hired without a pre-employment drug test. VA facilities tested about 68 percent of the 3,420 employees selected for random drug testing in FY 2013. We identified at least 19,100 employees in TDPs who were not subject to the possibility of monthly random drug testing.

In addition, VA erroneously designated as many as 13,200 employees in non-TDPs for drug testing in FY 2014. Further, only 17 (33 percent) of the 51 employees who tested positive for drugs as a result of reasonable suspicion of on-the-job drug use or after a workplace accident or injury were referred to VA’s Employee Assistance Program.

These issues occurred because VA does not support that all tentative selectees for TDPs need to be drug tested before being hired. VA also does not effectively monitor local facility compliance with random employee drug testing requirements. Furthermore, VA lacks adequate oversight to ensure the accuracy of drug testing data and that consistent personnel actions are taken when employees test positive for drugs. As a result, VA has little assurance that this program is performing as intended to identify and eliminate illegal drug use in its workforce.

Since VA’s workforce is expected to grow significantly with the passage of the Veterans Access, Choice, and Accountability Act of 2014, VA needs to take actions to address weaknesses in its Drug-Free Workplace Program immediately. We recommended the Deputy Assistant Secretary for Human Resources Management implement processes to ensure full compliance with VA’s pre-employment applicant drug testing and random employee drug testing requirements, and improve program integrity by ensuring the accurate coding of employees in TDPs.

The Acting Deputy Assistant Secretary for Human Resources Management concurred with our recommendations and provided an acceptable action plan. We will follow up on the implementation of the corrective actions.

Monitoring Health Concerns Related to Marijuana in Colorado: 2014

March 30, 2015 Comments off

Monitoring Health Concerns Related to Marijuana in Colorado: 2014 (PDF)
Source: Colorado Department of Public Health and Environment

As one of the first two states in the nation to legalize retail marijuana, the Colorado Legislature mandated that the Colorado Department of Public Health and Environment (CDPHE) study the potential public health impacts of marijuana. Though medical marijuana has been legal in Colorado since 2000, it was largely viewed as an individual doctor/patient decision outside the scope of public health policy. However, the legalization of retail (non- medical) marijuana and the potential for greater availability of marijuana in the community, prompted a closer look at potential health impacts on the population at large.

Legalized retail marijuana presents a paradigm shift, grouping marijuana with other legal substances like alcohol, tobacco and prescription drugs, as opposed to illicit drugs like cocaine and heroin. As with alcohol, tobacco, or prescription drugs, misuse of marijuana can have serious health consequences. Standard public health approaches to alcohol, tobacco and prescription drugs is to monitor use patterns and behaviors, health care utilization and potential health impacts, and emerging scientific literature to guide the development of policies or consumer education strategies to prevent serious health consequences. This report presents initial efforts toward monitoring the changes in marijuana use patterns, potential health effects of marijuana use, and the most recent scientific findings associated with marijuana use to help facilitate evidence-based policy decisions and science-based public education campaigns.

CRS — International Drug Control Policy: Background and U.S. Responses (March 16, 2015)

March 25, 2015 Comments off

International Drug Control Policy: Background and U.S. Responses (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The global illegal drug trade represents a multi-dimensional challenge that has implications for U.S. national interests as well as the international community. Common illegal drugs trafficked internationally include cocaine, heroin, and methamphetamine. According to the U.S. intelligence community, international drug trafficking can undermine political and regional stability and bolster the role and capabilities of transnational criminal organizations in the drug trade. Key regions of concern include Latin America and Afghanistan, which are focal points in U.S. efforts to combat the production and transit of cocaine and heroin, respectively. Drug use and addiction have the potential to negatively affect the social fabric of communities, hinder economic development, and place an additional burden on national public health infrastructures.

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