The proportion of substance abuse treatment admissions of those aged 12 and 
older involving abuse of prescription pain relievers rose from 2.2% in 1998 to 9.8% 
in 2008, according to a new study from the Substance Abuse and Mental Health 
Services Administration (SAMHSA). The dramatic rise occurred among nearly all 
segments of the population regardless of age, gender, educational level and 
employment status. 

The Food and Drug Administration (FDA) has unveiled a new plan designed to curb 
the misuse of prescription opioids. The long-awaited and controversial Risk 
Evaluation and Mitigation Strategy (REMS) for long-acting and extended-release 
opioids includes mandatory prescriber and patient education.

FDA has released the new plan in advance of an advisory committee meeting 
scheduled for July 22 and 23. They are seeking input from stakeholders and the 
public.  The new proposal is advocating more oversight, but the FDA has dropped 
a number of earlier ideas such as prescriber accreditation and patient registration 
programs. Prescriber education is in the plan, but the burden will be on drug 
manufacturers to offer training and demonstrate improvements in prescribing 
through surveys. The plan does not require any formal prescriber enrolment or real-
time verification of training. The plan is also advocating a medication guide to 
inform people of the safe use, storage, and disposal of long-acting and extended-
release opioids. The medication guide would be provided to patients each time a 
prescription is dispensed.

A hearing of the United States Special Committee on Aging convened on June 
30th on the problem of unused medications and how to dispose of them.  
Chairman Kohl announced plans to work with members of the Committee to 
develop a comprehensive package of legislative reforms to reduce waste and 
ensure safe disposal of medications. Federal panelists included Gil Kerlikowske, 
Director, White House Office of National Drug Policy Control and Joseph 
Rannazzisi, Deputy Assistant Administrator, Office of Diversion Control, Drug 
Enforcement Administration, US Department of Justice.  

Other witnesses included Mary Hendrickson, Director of Quality and Regulatory 
Affairs, Genco Pharmaceutical Services, Milwaukee, WI; Bernard Strain, father of 
Timothy Michael Strain, Philadelphia, PA; Stevan Gressitt, Founding Director, 
Maine Institute for Safe Medicine, Faculty Associate University of Maine, Center 
on Aging, Unity, ME; and Bruce Behringer, Associate Vice President and Executive 
Director, Office of Rural and Community Health ad Community Partnerships, East 
Tennessee State University, Johnson City, TN. Testimony is available at the U.S. 
Special Committee on Aging (see link above).  For a recording of the hearing, see 
the United States Senate Special Committee on Aging's website.

The National Council on Patient Information and Education (NCPIE), as a
member of the National Council on Medication Error Reporting and Prevention,
is participating in the National Alert Network (NAN) for Serious Medication
Errors. The NAN has been activated for an urgent message on the potential
for serious or fatal errors with epinephrine.  Download the PDF for
details on this NAN - Alert.

Members of NCPIE are strongly advised to evaluate the risk for this error in
their organizations and settings of care and implement their recommended
safety procedures.

The excesses of the Baby Boomer generation are starting to show up at the door 
of U.S. treatment programs, which saw admissions of patients ages 50 and older 
almost double between 1992 and 2008.  Patients over age 50 comprised 12.2 
percent of all treatment admissions in 2008, up from 6.6 percent in 1992.  

Admissions for heroin use among this age group more than doubled, cocaine 
admissions quadrupled, and significant increases in older Americans seeking 
treatment for prescription drugs and marijuana also were reported. More older 
Americans also are reporting problems with multiple substances, including alcohol, 
illicit drugs, and prescription medications. (Source:  Join Together Newsletter, 
Boston Univ. School of Public Health, 6/21/10)