Reuters reports the company also agreed to work to improve security procedures at its distribution center in Lakeland, Florida, to ensure that opioids are not diverted into the wrong hands. The company is not shutting down the facility, and operations there will continue, according to Cardinal Health.

“This agreement allows us to put this matter behind us, and just as important, will clear the way for a more productive dialogue about how we and others in the health care and regulatory community can work together to prevent the abuse and misuse of prescription drugs,” George Barrett, Chairman and CEO of Cardinal Health, said in a statement. The company noted the DEA confirmed it is planning no further administrative actions at other Cardinal Health facilities.

Earlier this year, the DEA charged Cardinal and four pharmacies with violating their licenses to sell controlled drugs. The DEA said Cardinal had an unusually high number of shipments of controlled painkillers to four pharmacies. The agency suspended Cardinal’s controlled substance license at its distribution center in Lakeland. The center serves 2,500 pharmacies in Florida, Georgia and South Carolina. After the DEA suspended the company’s license, a federal judge granted a temporary restraining order against the DEA’s suspension order.

A federal judge then ruled that drug distribution companies must “self-police” to track unusually big drug shipments that might be used improperly. The ruling allowed the DEA to halt shipments of oxycodone and other controlled medications from the Cardinal Health distribution facility.

It is the third time Colorado’s legislators have rejected a measure to set a legal limit for THC, the AP reports. The House passed the bill, which would limit drivers to 5 nanograms of THC per milliliter of blood. The state Senate vote was tied, failing to pass by one vote. An amendment to exempt state-certified medical marijuana patients from the limit failed.

Some of the bill’s critics said more than 90 percent of the state’s drugged-driving criminal cases end in convictions, and argued that instituting the legal limit would be unlikely to change behavior. Others said the measure should have targeted more than just marijuana.

More than a dozen states have a zero-tolerance policy for driving with any presence of an illegal substance, the article notes.
Nevada and Ohio have a 2 nanogram THC limit for driving. In Washington state, voters will consider a 5 nanogram THC driving limit, as part of a ballot measure about marijuana legalization in November.

The White House Office of National Drug Control Policy has asked all states to adopt drugged driving laws that set blood limits, but has not told states what nanogram limit to set for illegal drugs.

“Prescription drug abuse is an epidemic in Ohio, and we are working with all our law enforcement colleagues and partners in the medical community to address the problem,” said U.S. Attorney Steven Dettelbach. He said that in recent months, the U.S. Attorney’s office in Cleveland has prosecuted the largest “pill mill” trafficking case in the nation.

Fatal overdoses of prescription drugs are having a devastating effect in Ohio. In the last decade, fatal overdoses have more than quadrupled and are now more common than car crashes as a cause of accidental death in the state. Last year, Ohio Governor John R. Kasich announced the state would spend $36 million in new funding to fight prescription drug abuse.

The new unit was announced at a conference that included an address by Gil Kerlikowske, head of the Office of National Drug Control Policy. He noted that in Ohio, from 1999 to 2010, prescription drug overdose deaths increased 372 percent. “It’s the fastest-growing drug problem in the United States,” Kerlikowske said. “Our success will come from coordination and collaboration at the federal, state and local levels.”

“Mental disorders accounted for more hospital bed days than any other morbidity category and two-fifths (40.1 percent) of all hospital bed days,” the Pentagon’s Medical Surveillance Monthly Report stated.

According to the report, hospitalizations for mental disorders have increased by more than 50 percent since 2007. The report notes that the recent sharp increase in hospitalizations for mental disorders probably is due to many factors, including repeated deployments and prolonged exposures to combat stresses. Other reasons may include increased awareness about mental health issues in the military, more screening for and detection of mental disorders after combat, and decreasing stigmas and removal of barriers to seeking and receiving mental disorder diagnoses and care.

Three studies published in January show active-duty military personnel and veterans are prone to substance abuse, depression and suicide.

One study of almost 600 veterans returning from Iraq or Afghanistan found 39 percent of veterans screened positive for probable alcohol abuse, 3 percent for probable drug use, and 14 percent for probable post-traumatic stress syndrome.

A second study, of 678,382 active personnel, found major depression and substance use disorders have increased. A third study found suicide rates for all U.S. military services rose between 2005 and 2007, particularly for members of the regular Army and National Guard.

Teaching new skills to substitute for learned patterns can help break the intergenerational cycle of substance abuse, says Robert Neri, MA, LMHC, CAP, Senior Vice President/Chief Clinical Officer of the WestCare Foundation in St. Petersburg, Florida.

“We see a number of clients who have learned to be compliant because of how unpredictable the adults were in their life—they realized the best strategy was to blend into the woodwork, and not to make waves or test anyone,” he says. “Most kids test the adults around them, to stretch and make their world bigger, but in children living in families with substance abuse, compliance is a survival tool.”

Neri teaches his counseling staff that if a client does everything in treatment correctly, that can be a sign they are not internalizing, but rather simply adapting. “We see that with people who have been in treatment settings a lot—they learn not to make mistakes. But as the saying goes, ‘If you make an A in treatment, you make an F in recovery.’ We have to realize that mistakes are a wonderful opportunity to learn.” He encourages his staff to tell clients that making mistakes allows them to learn how to tolerate frustration.

Compliance is one key reason so many people with substance use disorders do well while in the criminal justice system, but relapse, often only days after they are released. “They do well in a structured environment, but when that structure goes away, the person hasn’t built any internal structure to rely on.”

Learning how to play is another coping skill Neri teaches clients. “Children who grow up in a family with substance abuse become pseudo-adults, learning how to take care of their parents,” Neri says. “They’ve missed their childhood. When we get them into treatment, they often avoid leisure-time activities. They are uncomfortable with these activities, because they never experienced them as children,” Neri observes.

Knowing who to trust is also a vital coping skill, according to Neri. “First, we have to acknowledge that not trusting people has, in many cases, probably kept them alive, but now they need to expand their interpersonal tools to learn how to trust,” he says. Clients learn how to evaluate who is trustworthy through exercises such as making a list of qualities they would want in a potential business partner, and interviewing members of their treatment group to see who matches the qualifications.

Clients who have spent years viewing themselves as victims can break the cycle of substance abuse by learning they are free to make choices, Neri states. “This gives them a model of empowerment, so they can take control and change the script.”

The company, Coventry Cares, is one of four companies hired by Kentucky to manage Medicaid. It announced last week that while it would no longer pay for the medicine, it did not intend to immediately stop coverage for patients already taking the drug, sold under the brand name Suboxone.

Coventry made its decision in response to legal threats over its drug coverage, the newspaper reports. SelfRefind, a network of substance abuse treatment clinics, had said it would file a lawsuit alleging Coventry violated its state contract and federal law by refusing to pay for buprenorphine.

The company initially said it was halting coverage of buprenorphine because under Kentucky’s Medicaid program, only pregnant women, women who recently gave birth and those under age 21 are eligible for addiction treatment.

The governor’s plan, which would make New Jersey the first state to require treatment for nonviolent offenders who are addicted to drugs,  has been praised by addiction experts, The Philadelphia Inquirer reports.

Some providers point out that the plan would give priority to criminals, some of whom do not want treatment. Providers say that their centers often have waiting lists, and state money to pay for those who cannot afford treatment sometimes runs out before the end of the year, or is frozen.

Michael Drewniak, a spokesman for Governor Christie, disputed the claim that the governor’s plan takes away services from others. “What we’re attempting to do is to address a very serious societal problem,” he said. “In doing that, we are not diminishing the addiction services outside the criminal justice system.”

The system that would require drug treatment for low-level offenders, called drug court, could cost up to $35 million, the article notes. The mandatory program would double the court’s current 4,000 participants. Governor Christie has proposed spending $2.5 million for fiscal 2013 to create the mandatory program.

California will vote on the measure June 5. Proposition 29 would add $1 to the price of each cigarette pack, to raise money for research on tobacco-related illnesses and smoking prevention and cessation programs.

Tobacco companies are spending millions of dollars to oppose the measure.

“Every day, tobacco kills. Right now, big tobacco is pouring tens of millions into California to defeat a common-sense measure that would help reduce tobacco use, and something has to be done about it, so I’m making a $500,000 donation to stand up to Big Tobacco, pass Prop 29, and help save lives,” Bloomberg said in a statement.

Proponents of the tax say it is expected to raise more than $800 million for research on tobacco-related diseases and prevention programs. They estimate the tax raise will prevent 220,000 young people from starting to smoke, and encourage 100,000 smokers to quit.

So far, Philip Morris USA and RJ Reynolds Tobacco, two of the nation’s biggest tobacco companies, and their affiliates, have spent more than $30 million against the proposal. In addition to criticizing it for not including funds for treatment, they have attacked the initiative for allowing the proceeds of the tax to be used out of state.

Supporters of the measure have raised $4 million. One backer of the proposal is seven-time Tour de France winner and cancer survivor Lance Armstrong, whose Livestrong Foundation contributed $1.5 million to the campaign. Other supporters include the American Cancer Society and the American Heart Association.

Assistant Secretary of Defense Jonathan Woodson sent a memo to all U.S. military branches in February, warning of the overprescribing of antipsychotic medications for treating PTSD, according to The Philadelphia Inquirer.

Antipsychotic drugs such as Seroquel are not approved by the Food and Drug Administration (FDA) for PTSD treatment. While drug companies cannot market these drugs for uses other than those approved by the FDA, doctors can legally prescribe them for other conditions. This is known as off-label use.

The number of prescriptions for antipsychotics rose tenfold from 2002 to 2009, from 0.1 percent to 1 percent, the Army Times reports. In fiscal 2010, Seroquel was prescribed to 1.4 percent of Army personnel, and 0.7 percent of Marines. As of March 27, any service member who takes an antipsychotic cannot deploy to Iraq or Afghanistan without explicit permission from the Central Command surgeon. Previously, the drug was approved as a sleep aid, without any oversight.

The Army’s Office of the Surgeon General issued a memo for PTSD in April that included a warning about antipsychotic drugs. “There are numerous concerns with potential long-term adverse health effects,” the memo said, “and these medications have shown disappointing results in clinical trials in the treatment of PTSD.”

The revisions are being proposed for the new edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for release in May 2013. The manual would enlarge the list of recognized symptoms for drug and alcohol addiction, and reduce the number of symptoms needed for a diagnosis.

The new manual would include gambling as an addiction for the first time, and may introduce a category called “behavioral addiction—not otherwise specified,” that some public health experts say might be used too often to diagnose various addictions, including shopping, video games, sex or the Internet.

The DSM is important because it determines whether insurers, including Medicare and Medicaid, will pay for treatment, and whether schools will finance specific special-education services. The court system uses the DSM to evaluate whether criminal defendants are mentally impaired. Drug manufacturers rely on the manual when making decisions about research.

Some economists predict the new definition of addiction could add 20 million people, leading to additional costs running into the hundreds of millions of dollars.

“The chances of getting a diagnosis are going to be much greater, and this will artificially inflate the statistics considerably,” Thomas F. Babor, an editor of the journal Addiction, told the newspaper. He said many people receiving a diagnosis of addiction under the new guidelines would have only a mild problem, siphoning off scarce drug treatment resources in schools, prisons and health care settings.

While the American Psychiatric Association scientific review panel has asked for more evidence to support the revisions on addiction, several researchers involved with the manual noted the panel is unlikely to significantly alter the proposed revisions.