Category Archives: Prescription drugs
EBOLA UPDATE: CDC Increases Deployments to West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Centers for Disease Control and Prevention (CDC) has announced an increase in its deployments and efforts in West Africa in response to the ongoing Ebola outbreak, which is the largest in the history of the disease. The public health agency has activated its Emergency Operations Center to its highest response level and plans on adding 50 disease control experts to the region within the next month.
As of Monday, CDC deployments are:
- Guinea: 6 currently deployed,
- Liberia: 12 currently deployed
- Nigeria: 4 currently deployed
- Sierra Leone: 9 currently deployed
“The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away,” said CDC Director Tom Frieden, MD, MPH, in a release. “To keep America safe, health care workers should isolate and evaluate people who have returned from Guinea, Liberia, and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.” Read more on Ebola.
Study: About Half of All Physicians Utilize EHRs
Electronic health records (EHRs) are increasingly being utilized by physicians and hospitals, according to two new studies in the journal Health Affairs. Researchers from the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology determined that in 2013 approximately 78 percent of office-based physicians used some form of EHRs and about 48 percent of all physicians used an EHR system with advanced functionalities. They also found that 59 percent of hospitals in 2013 were using an EHR system with certain advanced functionalities. “Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” said Karen DeSalvo, MD, MPH, national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.” Read more on technology.
Number of Suicide Attempts Using Prescription Drugs Up Dramatically
Suicide attempts involving prescription medications and other drugs climbed 51 percent among people ages 12 and older from 2005 to 2011, according to two new reports from the Substance Abuse and Mental Health Services Administration. The greatest increase was seen in people between the ages of 45 and 64, with a 104 percent increase, followed by adults younger than 30, with a 58 percent increase. "We probably are seeing an increase in overall suicide attempts, and along with that we are also seeing an increase in drug-related suicide attempts," said Peter Delany, director of the agency's Center for Behavioral Health Statistics and Quality, in a release. "People have access to medications, and they are using both prescription and over-the-counter meds. It is clear that there are more drugs out there." Read more on prescription drugs.
Michigan, Minnesota, North Carolina and Wisconsin have been tapped to join the second round of the National Governors Association’s (NGA) Prescription Drug Abuse Project, tasked with developing comprehensive, evidence-based statewide action plans to help combat the growing public health problem. Nevada Gov. Brian Sandoval and Vermont Gov. Peter Shumlin will lead the project, with their states also taking part.
Over the next year, the states participating in the project will accomplish the following:
- Attend two, two-day meetings with other policy academy states;
- Host an in-state workshop coordinated by NGA Center for Best Practices staff;
- Develop a strategic plan for reducing prescription drug abuse;
- Participate in regular conference calls and other meeting activities; and
- Receive state-specific technical assistance from NGA staff and national experts.
“We are united by a common goal to reduce prescription drug abuse,” said Sandoval, in a release. “Bringing states together will help each of us learn ways to combat this growing problem. It is an honor to serve as co-lead on this timely and important issue.”
“Communities across the country continue to be affected by the abuse of prescription drugs,” added Shumlin. “That is why this initiative remains so important for governors. As the leaders of our states, our primary concern is for the health and safety of our citizens.”
According to the U.S. Centers for Disease Control and Prevention (CDC), prescription drug overdose is now the leading cause of death from injury, with approximately 113 U.S. deaths each day and 6,748 people treated daily for misuse or abuse in the nation’s emergency departments (EDs).
Additional data on prescription drug abuse from the CDC includes:
- In 2011, among people ages 25 to 64, drug overdose caused more deaths than motor vehicle traffic crashes;
- Drug overdose death rates have been rising steadily since 1992, with a 118 percent increase from 1999 to 2011 alone;
- In 2011, 33,071 (80 percent) of the 41,340 drug overdose deaths in the United States were unintentional, 5,298 (12.8 percent) were of suicidal intent, 80 (0.2 percent) were homicides, and 2,891 (7 percent) were of undetermined intent;
- In 2011, drug misuse and abuse caused approximately 2.5 million ED visits, with more than 1.4 million of these related to pharmaceuticals;
- Between 2004 and 2005, an estimated 71,000 children were seen in EDs annually because of medication overdose (excluding self-harm, abuse and recreational drug use); and
- Among children under age 6, pharmaceuticals account for roughly 40 percent of all exposures reported to poison centers.
>>Bonus Links: Read more of NewPublicHealth’s coverage of prescription drugs and prescription drug abuse. Below is a selection of our most recent coverage of the public health crisis:
- CDC: Physicians are Fueling Prescription Painkiller Overdoses
- Study: Today’s Drugged Drivers More Likely to Mix Alcohol and Drugs, Have Taken Multiple Prescription Medicines
- New NIH Pain Research Database Could Be a Key Tool in the Fight Against Prescription Drug Abuse
- Saturday is National Prescription Drug Take-Back Day
- Recommended Reading: FDA Approves Handheld Treatment for Prescription Drug Overdose
RWJF Analysis of ACA Effects Finds No Increase in New Patient Visits
A new report, ACAView, from the Robert Wood Johnson Foundation (RWJF) and athenahealth, finds that in the first five months of 2014 there was no increase in new patient visits, when compared to the same time last year. The ACAView initiative was created to measure the impact of the Affordable Care Act (ACA) on providers, patients and physicians from 2014 through 2016. The report focuses on the provider perspective, showcasing how the ACA affects the practice patterns and economics of physicians and other care team members around the country. Potential reasons for the lack of an increase in visits include the newly insured being unfamiliar with the health care system, or even the winter weather. Read more on the Affordable Care Act.
Study: Nickel in an iPad Linked to Boy’s Allergic Skin Reaction
An ever-increasing reliance on consumer electronics may also mean rarer allergies are becoming more common, according to researchers who linked an 11-year-old boy’s allergic skin reaction to the nickel found in a first-generation Apple iPad. The study was published in the journal Pediatrics. Previous studies have linked the nickel in computers, smartphones and other electronics to allergic reactions; other common sources of nickel include ear piercings, clothing fasteners and dental work. “With the increasing prevalence of nickel allergy in the pediatric population, it is important for clinicians to continue to consider metallic-appearing electronics and personal effects as potential sources of nickel exposure,” according to the study. Read more on pediatrics.
Study: Changing Generic Pill Color, Shape Can Decrease Prescription Adherence
In addition to known considerations such as side effects and cost, the change in the appearance of prescription medications may also lead some people to stop taking their prescriptions, according to a new study in the Annals of Internal Medicine. In a study of more than 11,000 patients, researchers determined that a change in pill color would increase the odds that a patient would stop taking their heart medication by 34 percent, while a change in pill shape would increase the chances by 66 percent. This adds another wrinkle to the series problem of medication adherence; the American Heart Association estimates that three out of four Americans do not take their medication as directed. Read more on prescription drugs.
Inappropriate and dangerous prescription practices for painkillers are driving high addiction and overdose rates—46 people die of a prescription painkiller overdose every day—according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC).
The CDC has also found wide variation in prescription practices across the country:
- Southern states had the most prescriptions per person for painkillers, especially Alabama and Tennessee.
- The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting and high-dose painkillers.
- Nearly 22 times as many prescriptions were written for oxymorphone (a specific type of painkiller) in Tennessee than were written in Minnesota.
In total, doctors wrote 259 million prescriptions for painkillers in 2012—or enough for a bottle of prescription pain pills for every American adult in the country.
“Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,” said CDC Director Tom Frieden, MD, MPH. “Overdose rates are higher where these drugs are prescribed more frequently. States and [medical] practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”
According to the CDC, deaths from drug overdoses have been rising steadily over the past two decades and have become the leading cause of injury death in the United States—linked strongly to the overuse of prescription painkillers. In 2011, of the 41,340 drug overdose deaths in the United States, 55 percent were related to pharmaceuticals, and almost three quarters of those were from prescription painkillers.
Study: Today’s Drugged Drivers More Likely to Mix Alcohol and Drugs, Have Taken Multiple Prescription Medicines
The profile of a drugged driver has changed substantially since 1993, according to a new study released today in the journal Public Health Reports, which shows that more drivers are now testing positive for prescription drugs, marijuana and multiple drugs.
“While we’ve seen a decrease over the years in motor vehicle fatalities involving people under the influence, the nature of those crashes is changing,” said study author Fernando Wilson, PhD, an associate professor at the University of Nebraska Medical Center.
The study examines trends in the characteristics of U.S. drivers who were involved in fatal crashes between 1993 and 2010 and tested positive for drugs. The study, funded by the Public Health Law Research program of the Robert Wood Johnson Foundation, was set up to investigate the relationship between state laws and the consumption of alcohol and other drugs in fatal car crashes. It found that the percentage of drugged drivers with three or more drugs in their system nearly doubled from 1993 to 2010, increasing from 11.5 percent to 21.5 percent.
“In 1993, about one in eight drivers were using multiple drugs concurrently. By 2010, it was closer to one in five. That’s a large increase in drug use,” Wilson said. “Beyond that, we’re also seeing more and more people using drugs and alcohol together. About 70 percent of drivers who tested positive for cocaine had also been consuming alcohol, and almost 55 percent of drivers who tested positive for cannabis also had alcohol in their systems.”
- Almost 60 percent of cannabis-only users were younger than 30 years.
- Thirty-nine percent of prescription drug users were 50 years old or older, which seems to be in line with an overall increase in the use of prescription drugs by Americans, and the older population in general.
“These trends are likely to continue into the future given the aging U.S. population, an increasing reliance on prescription medications by medical providers and increasing initiatives to legalize marijuana,” said Wilson. “However, it is unclear whether current state policies are completely up to the challenge of addressing the growing issue of drugged driving.”
NewPublicHealth recently spoke with Wilson about the study. He said he embarked on the research because of the tens of thousands of motor vehicle crashes each year and the need to figure out the most effective policies to curb distracted driving. According to Wilson, eighteen states have zero-tolerance laws for drugged drivers, but recent studies suggest that these laws may not be effective enough in decreasing traffic deaths.
CDC: Induced Births Down for the First Time in Two Decades
The rate for the induction of labor for single births is down for the first time in two decades, according to data from the U.S. Centers for Disease Control and Prevention. While the decrease is small—down to 23.3 percent in 2012 from 23.7 percent in 2011—it is also positive, as induced labor can increase the risk of cesarean section, neonatal infections and neonatal respiratory complications. Induction rates at 38 weeks were also lower for 36 states and the District of Columbia, ranging from a low of 5 percent to as high as 48 percent. Induced labor for non-medical reasons is not recommended before 39 weeks of gestation. Read more on maternal and infant health.
Study: Antidepressant Warnings Linked to Rise in Teen Suicide Attempts
An effort to improve public safety by warning patients about the potential dangers of antidepressants may have had the unintended consequence of actually increasing teen suicide attempts, according to a new study in the journal BMJ. Researchers determined that antidepressant prescriptions for young people dropped approximately 20 percent after the U.S. Food and Drug Administration’s (FDA) 2003 warning mandate. At the same time, teen suicide attempts climbed nearly 22 percent, with researchers pointing to untreated depression as a likely explanation. "To a certain extent, the FDA's black box warning was legitimate, but the media emphasis was really on suicide without noting the potential risk of undertreatment of depression,” said lead author Christine Lu, an instructor in population medicine at the Harvard Pilgrim Health Care Institute in Boston, according to HealthDay. “Because of that, there has been an overreaction, and that overreaction has sent alarming messages to parents and young people.” Read more on mental health.
FDA: Voluntary Recall of Generic High Blood Pressure Medication
India's Dr Reddy's Laboratories Ltd. has begun a voluntary recall of 13,560 bottles of a high blood pressure drug in the United States. The U.S. Food and Drug Administration (FDA) announced that the metoprolol succinate—which is a generic form of AstraZeneca Plc's Toprol XL—failed a dissolution test, which calculates how long it takes a drug’s active ingredient to be released into the body. The recall began on May 23. In March, Dr Reddy's recalled nearly 60,000 bottles of a heartburn drug because of microbial contamination. Read more on prescription drugs.
A new database on pain research established by the National Institutes of Health (NIH) and several other federal agencies might help practitioners choose more effective and safer options for their patients dealing with pain. It could also potentially reduce reliance on opioid drugs, which often turns patients into addicts and creates an easy source of the drugs for potential abusers.
The database, launched last week, is called the Interagency Pain Research Portfolio (IPRP) and offers information on federal pain research projects. According to the NIH, pain is a symptom of many disorders and can be a disease itself; the economic cost of pain is estimated to be hundreds of billions of dollars annually in lost wages and productivity.
“This database [allows] the public and the research community...to learn more about the breadth and details of pain research supported across the federal government. They can search for individual research projects or sets of projects grouped by themes uniquely relevant to pain,” said Linda Porter, PhD, Policy Advisor for Pain at the National Institute of Neurological Disorders and Stroke (NINDS), part of the NIH.
Both in public speeches and private briefings with reporters, U.S. Centers for Disease Control and Prevention Director Tom Frieden, MD, MPH, has called on physicians to find alternatives to narcotics for pain patients when medically advisable, such as guided imagery and other forms of relaxation. He’s also called for starting with less potent medications than narcotics, in order to reduce the chance of addiction and to introduce far fewer amounts of prescription drugs into the community where they are often taken from medicine cabinets by people—especially young adults—for whom they’re not prescribed. According to the Substance Abuse and Mental Health Administration, approximately 22 million people nationwide have taken narcotic pain relievers for non-medical reasons.
U.S. Food and Drug Administration head Margaret Hamburg, MD, also spoke on the subject during a town hall meeting last week on prescription drug abuse, hosted by the Johns Hopkins School of Public Health and the Clinton Foundation. Hamburg said that “we need to recognize that opiates are... probably most often not the treatment strategy of first choice...but it may be the option a provider knows best. We need to actively engage with the scientific research community and industry to try to develop new non-opiate, non-addictive pain strategies...”
FDA Requires Lunesta Manufacturer to Lower Recommended Dosage
The U.S. Food and Drug Administration (FDA) is requiring the manufacturer of Lunesta to lower the current recommended starting dose. The current recommended dose of the sleep drug, also known as eszopiclone, may be high enough to impair activities that require alertness the following morning, even if the user feels fully awake, according to the agency. Any patient currently taking the 2 mg or 3 mg doses should contact their physician for instructions. “To help ensure patient safety, health care professionals should prescribe, and patients should take, the lowest dose of a sleep medicine that effectively treats their insomnia,” said Ellis Unger, MD, director, Office of Drug Evaluation I in the FDA's Center for Drug Evaluation and Research. Read more on prescription drugs.
CDC: Nearly 5,000 Preventable Injuries Related to Pool Chemicals in 2012
There were nearly 5,000 emergency department visits related to preventable injuries from pool chemicals in 2012, according to the U.S. Centers for Disease Control and Prevention (CDC). Almost half of the injuries were to children and teenagers; the injuries were most common during the summer swim season, from Memorial Day to Labor Day. The CDC provided these tips to help pool owners and operators prevent pool chemical injuries:
- Read and follow directions on product labels.
- Wear appropriate safety equipment, such as goggles and masks, as directed, when handling pool chemicals.
- Secure pool chemicals to protect people and animals.
- Keep young children away when handling chemicals.
- NEVER mix different pool chemicals with each other, especially chlorine products with acid.
- Pre-dissolve pool chemicals ONLY when directed by product label.
- Add pool chemical to water, NEVER water to pool chemicals.
“Chemicals are added to the water in pools to stop germs from spreading. But they need to be handled and stored safely to avoid serious injuries,” said Michele Hlavsa, chief of CDC’s Healthy Swimming Program. Read more on injury prevention.
Study: Hookahs Not a Safe Alternative to Smoking
Hookahs produce significant amounts of nicotine and compounds that can cause cancer, heart disease and other health problems, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. "Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free," said study author Gideon St. Helen, a postdoctoral fellow in the division of clinical pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, according to HealthDay. In the study, researchers examined the urine of 55 men and women, who were regular hookah smokers, once after they avoided all smoking for a week and then again after an evening of smoking hookahs. After that single evening the found that the urine samples had: 73 times higher nicotine levels; four times higher levels of cotinine; two times higher levels of NNAL, a breakdown product of a tobacco-specific chemical called NNK; and 14 percent to 91 percent higher levels of breakdown products of volatile organic compounds such as benzene and acrolein. Read more on tobacco.
CDC: Half of Americans Reported Prescription Drug Use in the Past Month
A new report from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics takes a comprehensive look at the use of prescriptions drugs in the United States from 2007 to 2010. Prepared for the Secretary of the U.S. Department of Health and Human Services, the report compiled health data from state health agencies, federal health agencies and the private sector. Among the findings:
- About half of all Americans in 2007-2010 reported taking one or more prescription drugs in the past 30 days
- Cardiovascular agents (used to treat high blood pressure, heart disease or kidney disease) and cholesterol-lowering drugs were two of the most commonly used classes of prescription drugs among adults aged 18-64 years and 65 and over in 2007-2010.
- The use of antidepressants among adults aged 18 and over increased more than four-fold, from 2.4 percent to 10.8 percent between 1988-1994 and 2007-2010.
- Drug poisoning deaths involving opioid analgesics among those aged 15 and over more than tripled in the past decade, from 1.9 deaths per 100,000 population in 1999-2000 to 6.6 in 2009-2010.
- The annual growth in spending on retail prescription drugs slowed from 14.7 percent in 2001 to 2.9 percent in 2011.
Read more on prescription drugs.
Study: Emergency Department Visits for TBIs Jumped Nearly 30 Percent from 2006 to 2010
Emergency department visits for traumatic brain injuries (TBIs) jumped nearly 30 percent from 2006 to 2010, with researchers pointing to increased awareness as a potential explanation for the increase, according to a new study in JAMA. The past few years has seen growing awareness about the dangers and realities of TBIs, including public campaigns and legislation to help prevent injuries. Researchers used data from the Nationwide Emergency Department Sample database, finding that in 2010 there were approximately 2.4 million emergency department visits for TBIs, up 29 percent from 2006, with children younger than three and adults over the age of 60 seeing the highest increases. Researchers noted that this disparity may indicate that current TBI awareness and prevention efforts do not benefit the very young and the old. Read more on injury prevention.
WHO: MERS-CoV Not Yet a Public Health Emergency of International Concern
While saying that its concerns have greatly increased, the Middle East respiratory syndrome coronavirus (MERS-CoV) does not yet constitute a Public Health Emergency of International Concern, according to a statement released today by a World Health Organization’s emergency committee. According to the statement, their concerns center on the “recent sharp rise in cases; systemic weaknesses in infection prevention and control, as well as gaps in critical information; and possible exportation of cases to especially vulnerable countries.” Thirteen countries have reported cases since December 2013: Egypt, Greece, Jordan, Kuwait, Lebanon, Malaysia, Oman, Philippines, Qatar, Saudi Arabia, United Arab Emirates, United States of America and Yemen. The United States has so far reported two cases—both this month. Read more on global health.
This Saturday, April 26, is The National Prescription Drug Take-Back Day, an effort led by the U.S. Drug Enforcement Administration (DEA) for the eighth time in three years to safely dispose of potentially dangerous expired, unused and unwanted prescription drugs.
Last October, Americans turned in more than 647,000 pounds of prescription drugs at more than 4,100 sites operated by the DEA in partnership with state and local law enforcement offices. More than 3.4 million pounds of pills have been collected since the initiative began. The goal is to help reduce the huge cache of prescription pills that pose a risk of poisoning and death for young children, as well as the potential for abuse, overdose and death by the millions of people who take prescription drugs not prescribed for them in an effort to get high.
Every state has put resources into reducing prescription drug abuse in the last few years and recent surveys indicate abuse rates are dropping—though the problem is still significant. The 2013 National Survey on Drug Use and Health produced by the Substance Abuse and Mental Health Services Administration found that that 5.3 percent of young adults used prescription drugs for nonmedical purposes in the past month, similar to rates in several previous years, but lower than 2009, when 6.4 percent of young adults used prescription drugs for nonmedical purposes.
DEA studies show that a majority of abused prescription drugs are obtained from family and friends, often from home medicine cabinets. Contributing to the pileup is the fact that people are advised not to put many drugs in the trash or down the toilet so as to avoid contaminating water supplies and harming animals.
New laws are being proposed in many states to help families and facilities more easily get rid of unused drugs. Health departments in many communities, including the State of Colorado, can refer people to sites that will accept some unused prescription pills—though often not narcotics—at various times of the year for disposal.