Prescription Pain Reliever Abuse in Schools

SAMHSA Report - United Stated Department of Health and Human Services

12.4 percent of young adults age 18 to 25 used prescription pain relievers nonmedically in the past year.

How did these young adults get these medications?
According to a recent report from SAMHSA's Office of Applied Studies, among young adults age 18 to 25 who used prescription pain relievers nonmedically in the past year, over half (53.0 percent) obtained their most recent pain reliever used nonmedically from a friend or relative for free.

Among young adults age 18 to 25 who used prescription pain relievers nonmedically in the past year and met the criteria for prescription pain reliever dependence or abuse, 37.5 percent obtained their most recent prescription pain relievers for nonmedical purposes for free from a friend or relative, 19.9 percent bought them from a friend or relative, and 13.6 percent obtained them from one doctor.

www.navigent3.com
Oral Fluid-based Drug Free Workplace Solutions

Union Against Drug Testing ?

Source: September 6, 2008, Charleston Gazzette

MSHA: Test coal miners for drugs and alcohol


The White House administration will propose a rule early next week to require drug testing of miners who work in "safety sensitive" jobs in the nation's coal and non-coal mines.

U.S. Mine Safety and Health Administration ( MSHA ) officials are pushing for speedy approval of the rule, offering the mining community and the public a tight 30-day comment period - less than half the time provided for two other rules proposed by MSHA this year.

"An alcohol- and drug-free mine program as proposed in this rule will contribute to the prevention of such incidents and provide all miners, regardless of what state they work in and the size of the mine they work for, equal safety protection from working alongside miners under the influence of alcohol and/or drugs on the job,"

MSHA said in a proposal scheduled to be published in Monday's Federal Register.

The proposed rule would replace existing standards for drugs and alcohol at metal and non-metal mines with an industry-wide rule that also covers coal operations.

It would designate certain substances - alcohol and a list of controlled substances - that could not be possessed on mine property or used while performing safety-sensitive job duties, unless they were being used according to a valid prescription.

Mine operators would be required to establish an alcohol- and drug-free program, including a written policy, employee education, supervisory training and drug testing for miners in safety-sensitive jobs and their supervisors. Safety-sensitive job duties are defined as "any type of work activity where a momentary lapse of critical concentration could result in an accident, injury or death."

Company policies also must include treatment referrals for miners who violate the policy. The proposed rule also would require those who violate the prohibitions to be removed from the performance of job-sensitive duties until they complete recommended treatment and their alcohol- and drug-free status is confirmed by testing.

"Mining under the best of circumstances can be dangerous," said MSHA chief Richard Stickler, "and the use of alcohol and illegal substances creates additional, unnecessary hazards in the workplace."

MSHA's Federal Register notice did not include any mention of a public hearing on the proposal.

Department of Labor spokesman David James said the agency anticipates receiving a request for a hearing and that MSHA "is preparing to do" such a hearing.

"There will likely be a notice for public hearing published sometime during the public comment period," James said.

Coal industry officials have long sought an MSHA rule to require drug testing of miners, but the United Mine Workers union has questioned the need for such testing and worried about the specifics of how companies would carry out such testing.

Kentucky adopted its own drug-testing program for miners in 2006, and Virginia passed similar rules in 2007. West Virginia has declined to adopt drug-testing requirements for coal miners.

In October 2005, MSHA announced that it was working on such a rule, but after a string of mine disasters in 2006 and 2007, the drug-testing proposal appeared to have been put on the back burner as the agency scrambled to enact numerous safety reforms mandated by Congress.

Then, in early June, MSHA officials submitted their proposed rule to the White House Office of Management and Budget for its review. The OMB approved the proposal late last week, records show.

In its proposed rule notice, MSHA said

"a preliminary review of fatal and non-fatal mine accident records revealed a number of instances in which alcohol and drugs or drug paraphernalia were found or reported, or where the post-accident toxicology screen revealed the presence of alcohol or drugs."

MSHA cited a study that showed

more than 13 percent of full-time miners were heavy alcohol users and 7 percent admitted that they had used illicit drugs within the past month.

"Using alcohol and/or drugs can affect a miner's coordination and judgment significantly at a time when he or she needs to be alert, aware and capable of performing tasks where there is a substantial risk of injury to oneself or others," the MSHA notice said.

"Even prescription medications may affect a miner's perception and reaction time. Mining is a complicated and hazardous occupation, and a clear focus on the work at hand is a crucial component of mine safety."

During a previous comment period, UMW officials questioned whether MSHA had shown the need for a nationwide drug-testing program.

MSHA responded, "Although a subsequent internal [Department of Labor] review of accident reports failed to reveal a significant number of cases where alcohol or drugs were determined to be causative factors, it did reveal a lack of consistency in whether and how alcohol and drug tests are performed and in the investigative process used to determine whether alcohol or drugs may have been factors.

"In fact, currently accident investigations do not routinely include an inquiry into the use of alcohol or drugs and this is a failure that the proposed rule intends to address," MSHA said.

MSHA estimated that the drug-testing rule would cost the mining industry $16 million during its first year and $13 million every year after that.

Prescription Pain Relievers - Deaths from Misuse Dramatically

Source: CNN 2008

Home deaths from drug errors soar
Deaths from medication errors at home are up dramatically in last 20 years

Increase steepest in death rates from mixing meds, alcohol, street drugs at home

Researchers cite dramatic rise in home use of prescription painkillers

CHICAGO, Illinois (AP) -- Deaths from medication mistakes at home, such as actor Heath Ledger's accidental overdose, rose dramatically during the past two decades, an analysis of U.S. death certificates finds.


Prescription drug abuse plays a role in the rise in fatalities, but it's unclear how much, researchers said.

The authors blame soaring home use of prescription painkillers and other potent drugs, which 25 years ago were given mainly inside hospitals.

"The amount of medical supervision is going down and the amount of responsibility put on the patient's shoulders is going up," said lead author David P. Phillips of the University of California, San Diego.

The findings, based on nearly 50 million U.S. death certificates, are published in Monday's Archives of Internal Medicine. Of those, more than 224,000 involved fatal medication errors, including overdoses and mixing prescription drugs with alcohol or street drugs.

Deaths from medication mistakes at home increased from 1,132 deaths in 1983 to 12,426in 2004. Adjusted for population growth, that amounts to an increase of more than 700percent during that time.

In contrast, there was only a 5 percent increase in fatal medication errors away from home, including hospitals, and not involving alcohol or street drugs.

Abuse of prescription drugs plays a role, but it's unclear how much. Valid prescriptions taken in error, especially narcotics such as methadone and oxycodone, account for a growing number of deaths, said experts who reviewed the study.

The increases coincided with changing attitudes about painkillers among doctors who now regard pain management as a key to healing. Multiple prescription drugs taken at once -- like the sleeping pills, painkillers and anxiety drugs that killed "Dark Knight" star Ledger -- also play a part, experts said.

"When we see overdoses, we're seeing many more mixed drug overdoses," said Dr. Jeffrey Jentzen, president of the National Association of Medical Examiners and director of autopsies at the University of Michigan in Ann Arbor. Jentzen said autopsies are much more likely to include toxicology tests today than 25 years ago, which would contribute to finding more fatal medication errors as cause of death.

But Phillips said there were no significant increases in other poisonings, such as suicidal overdoses or homicides, so more testing doesn't explain the huge increase. The analysis excluded suicides, homicides and deaths related to side effects.

The increase was steepest in death rates from mixing medicine with alcohol or street drugs at home; that death rate climbed from 0.04 per 100,000 people in 1983 to 1.29 per 100,000 people in 2004.

Many patients ignore the risk of mixing alcohol with prescriptions, said Cynthia Kuhn of Duke University Medical Center, who was not involved in the study.

"They think, 'Oh, one drink won't hurt.' Then they have three or four," Kuhn said.

The increase in deaths was highest among baby boomers, people in their 40s and 50s.

"We're sort of drug happy," said boomer Dr. J. Lyle Bootman, the University of Arizona's pharmacy dean, who was not involved in the research. "We have this general attitude that drugs can fix everything."


People share prescriptions at an alarming rate, Bootman said. One recent study found 23 percent of people say they have loaned their prescription medicine to someone else and 27 percent say they have borrowed someone else's prescription drugs.

Kenneth Kolosh, a statistics expert at the National Safety Council, praised the study but said improved attention to coding location on death certificates may account, in part, for the huge increases the researchers found.

Phillips countered that home deaths from any cause increased relatively little during the time period, so better coding doesn't explain the change.

Michael R. Cohen, president of the Institute for Safe Medication Practices, said more states should require pharmacists to teach patients about dangerous drugs and insurers should pay pharmacists to do so.