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Network for Public Health Law

This document, issued on March 7, 2016, provides a template for a Memorandum of Understanding (MOU) for secure, electronic exchange of immunization information among governmental entities that operate a population-based Immunization Information System (IIS). It suggests terms and conditions that might be included in an MOU. However, laws that govern IIS vary among jurisdictions and modification may be needed to address specific laws.

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Prescription Drug Monitoring Programs (PDMPs) can help clinicians improve decisions regarding opioid prescribing. However, since state laws and regulations governing access to these systems often apply only to providers licensed in the states in which the PDMP is located, and many federal health care workers are not so licensed, many federal providers are not subject to requirements. This fact sheet outlines the policies of the three federal health care institutions with regard to the use of PDMPs when prescribing opioids.

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Drug overdose claimed the lives of more than 63,000 Americans in 2016. The majority of these deaths, over 42,000, involved opioids such as heroin, prescription painkillers, and, increasingly, illicitly manufactured fentanyl. Indiana is not immune to this national crisis. In 2003, for example, only three Indiana residents died from heroin-related overdose. In 2016, the number was 296.

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The overdose crisis continues unabated. While the epidemic was originally fueled largely by prescription opioid pain relievers, around 2010 a dramatic increase in heroin-related overdoses began. After remaining essentially stable for years, overdose deaths involving heroin spiked rapidly, more than tripling between 2010 and 2014. Starting in 2014, the epidemic began another transformation. Black market drug products—both heroin and counterfeit pills - became increasingly adulterated with illicitly—manufactured synthetic opioids, mainly fentanyl analogues.

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Unused, expired and leftover medicines that accumulate in homes represent a significant public health problem by increasing the risk of drug misuse and preventable poisonings. According to the National Survey on Drug Use and Health, nearly 75% percent of people who reported misusing painkillers in 2013-2014 most recently got the medication from a friend, family member, or dealer. Improper disposal of unwanted medications also poses a heightened risk to the environment.

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This Primer, published by the Network for Public Health Law on November 17, 2017, and updated on August 1, 2018, on Opioid-related Public Health Emergencies provides key information and visual snapshots of federal, state, tribal, and local emergency declarations in response to the opioid crisis across the U.S. 

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Eighteen states have adopted Limited Access Marijuana Product Laws permitting only low (or zero) Tetrahydrocannabinol (THC) and high Cannabidiol (CBD) products to treat several, often specified conditions, usually uncontrolled epilepsy disorders. THC is the psychoactive substance in marijuana that alters users’ senses and cause mood changes, and can lead to changes in behavior. Cannabidiol, however, has mild psychoactive effects.

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