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Last Updated
April 13, 2015
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April 9, 2015
One-Quarter of Narcotic Painkillers Misused; 10 percent of patients become addicted
Almost a quarter of powerful narcotic painkillers that are prescribed for chronic pain are misused,
and the rate of addiction among patients hovers near 10 percent, a new review shows.  The findings
raise questions about the benefits of widespread use of these painkillers to treat chronic pain,
the researchers said.  "On average, misuse was documented in approximately one out of four or five
patients, and addiction [was found] in approximately one out of 10 or 11 patients" prescribed the
drugs as part of their treatment for chronic pain, wrote Kevin Vowles, from the University of New
Mexico, and colleagues. In the review, researchers analyzed 38 published studies, 35 of which were
conducted in the United States. The average rates of misuse were 21 percent to 29 percent, while
the average rates of addiction were 8 percent to 12 percent, according to the review in the April
issue of the journal Pain. 

April 9, 2015
Metric System Best for Dosing Liquid Medicine, Say Pediatricians
The American Academy of Pediatrics (AAP) recommends that parents and health care providers use only
metric units when giving children liquid medicine. In new guidelines issued last week, AAP urged
forgoing teaspoons and tablespoons – and particularly kitchen spoons – to avoid incorrect dosing
that often leads to unintentional medication overdoses. In fact, more than 70,000 children visit
emergency rooms each year because of unintentional overdose, AAP reports. 

The guidelines also include the following recommendations for pediatric dosing:
•             Using the abbreviation “mL” for milliliter
•             Stating “daily” on labels rather than “qd,” which could be misinterpreted as “qid” or
               four times daily
•             Reviewing milliliter-based dosing with families
•             Providing clearly labeled dosing devices, such as syringes
•             Eliminating non-metric units from medicine labels

More information is available in the AAP’s policy statement.

April 2, 2015
FDA final guidance on the evaluation and labeling of abuse-deterrent opioids
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.

The science of abuse-deterrent technology is still relatively new and evolving. The final guidance
is intended to assist drug makers who wish to develop opioid drug products with potentially
abuse-deterrent properties. The FDA is working with many drug makers to support advancements in
this area and help drug makers navigate the regulatory path to market as quickly as possible. In
working with industry, the FDA will take a flexible, adaptive approach to the evaluation and
labeling of potentially abuse-deterrent products.

While this final guidance does not address generic opioid products, the agency understands the
importance of available generic options to ensure appropriate access to effective opioid drugs for
patients who need them. The FDA is committed to supporting the development and use of generic drugs
that have abuse-deterrent properties and is working on draft guidance in this area.

To help support the safe use of all opioid products, the FDA is working in many other ways to help
prescribers and patients make the best possible choices about how to use these powerful drugs. The
agency’s goal is to find the balance between appropriate access to opioids for patients with pain
and the need to reduce opioid misuse and abuse.

April 1, 2015
Pharmacists can help patients understand, manage their heart medications
NCPIE serves as co-editor for a monthly column in Pharmacy Today (American
Pharmacists Association) The column is entitled “One-to-One” and is intended to help develop
pharmacists’ medication communication and counseling skills to promote safe and appropriate
medicine use.

March 30, 2015
CDC/Medscape Falls Prevention Video (Free Medscape login required)
Are You Asking Older Adult Patients the Right Questions? -- One in three older adults falls each
year, yet less than half tell their health care provider. A new CDC/Medscape video commentary with
CDC's Dr. Grant Baldwin aims to help start this important conversation.  A fall among an older
adult can lead to injuries that reduce mobility, limit social interactions, decrease physical
fitness, lower quality of life, and increase the risk of early death. Through STEADI, CDC is
working to educate patients and health care providers about how to help keep older adults safe from
falls, so they can stay healthy, active, and independent longer. 

The video, part of CDC's STEADI initiative (Stop Elderly Accidents, Death & Injuries), highlights
three questions that health care providers can integrate into routine office visits with patients
65 and older:

               1. Have you fallen in the past year?
               2. Do you feel unsteady when standing or walking?
               3. Do you worry about falling?

Using the tools in CDC's STEADI initiative, the video then guides health care providers on
screening, assessments, and proven interventions, such as:

              • Reviewing medications to ensure appropriate geriatric doses and reducing fall
               risk-increasing drugs.
              • Recommending Vitamin D supplements.

Related from NCPIE: Medication Use Safety
Training for Seniors (MUST for Seniors).