Category Archives: Substance Abuse

Jul 29 2014
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Four States Join National Governors Association’s Prescription Drug Abuse Project

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 Content: Watch a one-minute video NewPublicHealth created on the scope of the prescription drug abuse epidemic in the United States.
Jul 29 2014
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Public Health News Roundup: July 29

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NCAA Reaches Preliminary Concussion Settlement, Including $70M Monitoring Program
The NCAA has reached a preliminary settlement in response to a class-action push to revise its head injury policies. The settlement includes a $70 million medical monitoring fund that would provide all former college athletes with the opportunity to receive neurological screenings, as well as a new national protocol which would require assessments by trained professionals and keep athletes from returning to games or practices the same day they suffer a head injury. “This offers college athletes another level of protection, which is vitally important to their health,” said the lead plaintiffs’ lawyer, Steve Berman, according to The New York Times. “Student-athletes—not just football players—have dropped out of school and suffered huge long-term symptoms because of brain injuries. Anything we can do to enhance concussion management is a very important day for student-athletes.” Read more on injury prevention.

Marijuana Legalization Not Linked to Rise in Teen Use
The gradual increase in marijuana use by U.S. teens over the past two decades is not linked to the legalization of medical marijuana in various states, according to a new research paper based on data from the U.S. Centers for Disease Control and Prevention. Researchers determined that the probability that a high school student had used marijuana in the previous 30 days was only 0.8 percent higher in states where use was legal. While marijuana is illegal under federal law, it has been legalized for medical purposes in 21 states and the District of Columbia, and legalized for recreational use in Colorado and Washington. "Our results are not consistent with the hypothesis that the legalization of medical marijuana caused an increase in the use of marijuana among high school students," wrote D. Mark Anderson of Montana State University, Daniel Rees of the University of Colorado and Benjamin Hansen of the University of Oregon, in the paper. Read more on substance abuse.

Study: 5-10 Minutes of Daily Running Can Add Three Years to Life Expectancy
As little as five to ten minutes of slow running every day can add up to an additional three years of life expectancy, according to a new study in the Journal of the American College of Cardiology. Researchers examined data on 55,137 adults 18-100 years of age (with a media age of 44 years), finding that running for the length of time at six miles an hour or slower was associated with markedly reduced risk of death from all causes, including heart disease. Researchers said the results should help drive inactive individuals to take up exercise programs. Read more on physical activity.

Jul 24 2014
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Public Health News Roundup: July 24

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FDA Approves New Oxycodone with Abuse-deterrent Properties
The U.S. Food and Drug Administration (FDA) has approved a new extended-release oxycodone with abuse-deterrent properties. Targiniq ER—which should be used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment—contains naloxone which blocks the euphoric effects of oxycodone when crushed and snorted, or crushed, dissolved and injected. The drug is consistent with the FDA’s 2013 draft guidance for industry, Abuse-Deterrent Opioids – Evaluation and Labeling. "The FDA is committed to combatting the misuse and abuse of all opioids, and the development of opioids that are harder to abuse is needed in order to help address the public health crisis of prescription drug abuse in the U.S.,” said Sharon Hertz, MD, deputy director of the Division of Anesthesia, Analgesia and Addiction Products in the FDA’s Center for Drug Evaluation and Research. “Encouraging the development of opioids with abuse-deterrent properties is just one component of a broader approach to reducing abuse and misuse, and will better enable the FDA to balance addressing this problem with meeting the needs of the millions of people in this country suffering from pain.” Read more on substance abuse.

HHS: 10.3 Million Adults Gained Coverage in the ACA’s First Open Enrollment Period
An estimated 10.3 million uninsured adults gained health care coverage following the first open enrollment period in the Health Insurance Marketplace, according to a new study from the U.S. Department of Health and Human Services appearing the New England Journal of Medicine. The study looked at insurance trends before and after the open enrollment period, finding that the uninsured rate for adults ages 18-64 dropped from 21 percent in September 2013 to 16.3 percent in April 2014, which corresponded to a 5.2 percentage-point change, or 10.3 million adults gaining coverage. Read more on the Affordable Care Act.

Study: Parents of Obese Kids Often Don’t Realize They’re Unhealthy
Parents of obese children often don’t see their child’s weight as unhealthy and are more likely to make changes in their eating habits than to increase exercise, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 200 families in 2008 and 2009 to evaluate their readiness to help their children lose weight, researchers found that 28 percent of the parents did not see their child's weight as a health problem and 31 percent thought their child’s health was excellent or very good. The study also found that while 61 percent said they were trying to improve eating habits, only 41 percent were attempting to increase their child's activity level. Read more on obesity.

 

Jul 23 2014
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Public Health News Roundup: July 23

New EPA Tool Helps Communities Become More Flood Resilient
The U.S. Environmental Protection Agency (EPA) has released a new tool, the Flood Resilience Checklist, to help communities prepare for, deal with and recover from floods. The checklist includes strategies that communities can consider, such as conserving land in flood-prone areas; directing new development to safer areas; and using green infrastructure approaches, such as installing rain gardens, to manage storm water. “Flooding from major storms has cost lives and caused billions of dollars in damage,” said EPA Administrator Gina McCarthy. “With climate change, storms are likely to become even more powerful in many regions of the country. Where and how communities build will have long-term impacts on their flood resilience, and on air and water quality and health and safety. This checklist will help flood-prone communities think through these issues and come up with the solutions that work best for them.” Find more resources on EPA’s Disaster Recovery and Resilience page.

Home Blood Pressure-Monitoring Devices Lower Health Care Costs 
A new study in the journal Hypertension finds that home blood pressure monitors can improve health care quality and save money. In the United States, more than 76 million adults have been diagnosed with hypertension and many more are undiagnosed. The researchers analyzed 2008-11 data from two health insurance plans—a private employer plan and a Medicare Advantage plan where 60 percent of members had high blood pressure. Net savings associated with home blood pressure monitoring ranged from $33 to $166 per member in the first year, and $415 to $1,364 over 10 years. Researchers found reasons for the savings differed by age groups and whether the monitors were used for treatment or diagnosis. In people 65 and older, home monitoring saved more when used to track high blood pressure treatment, by helping them avoid future adverse cardiovascular events. In people younger than 65, savings were higher in diagnostic use of the monitors, with fewer false positive diagnoses and fewer people starting unnecessary treatment. Read more on prevention.

New Mobile App Helps Parents Discuss Underage Drinking with their Kids
The Substance Abuse and Mental Health Services Administration (SAMHSA) has launched a new mobile app that features a simulated video game-like tool to help parents practice having conversations about underage drinking. SAMHSA experts say the timing of the release is intentional, as the rate of youth alcohol use rises during the summer. The mobile app is the newest component of “Talk. They Hear You,” SAMHSA’s underage drinking prevention campaign that launched last year to provide parents and caregivers with information and tools to start talking to youth early—as early as nine years old—about the dangers of alcohol. The new app uses avatars to engage in interactive conversations and each virtual role-play conversation is structured as a 10- to 15-minute interactive, video game-like experience. Users engage in a conversation with an intelligent, fully animated, emotionally responsive avatar that models human behavior and adapts its responses and behaviors to the user’s conversation decisions. Read more on substance abuse.

Jul 7 2014
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Liquor Ads Taking Aim at Young Binge Drinkers

Binge drinking is an increasing concern in the United States. A recent report from the U.S. Centers for Disease Control and Prevention (CDC) finds that one in ten adult deaths is linked to binge drinking through illnesses the binge drinker contracts—such as hepatitis—or accidents that happen to the drinker or that he or she causes—including homicide and domestic abuse. The CDC defines binge drinking as five or more drinks in a row for males and four or more drinks in a row for females.

Binge drinking also remains a concern among young adults. A new report from the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health finds that liquor now trumps beer as the drink of choice for underage (ages 13 to 20) binge drinkers, likely because of increased marketing by alcohol companies.

“Spirit firms have taken a page from the beer playbook in their marketing to young people,” said David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at Johns Hopkins in a conversation with NewPublicHealth.

The report on youth binge drinking was published in the Journal of Substance Use and found that spirits accounted for 43.8 percent of binge episodes, while beer accounted for less than one-third (31.4 percent) of binge episodes. “The inclusion of some relatively expensive brands in the top twenty-five binge brand list suggests that variables other than price are driving youth brand preferences with respect to binge drinking,” said Jernigan.

“Binge drinking accounts for most of the alcohol consumed by youth in the United States, and is associated with a host of negative consequences, including drunk driving, sexual assaults and suicide,” according to Timothy Naimi, MD, MPH, a lead author of the study and an associate professor at the Boston University School of Public Health.

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Jul 3 2014
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Public Health News Roundup: July 3

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Widely Used HIV Drug Linked to Higher Suicide Risk
People infected with HIV whose treatment includes the widely used antiretroviral drug efavirenz appear to have double the risk of suicidal thoughts, attempts and completion compared to HIV patients not taking the medication, according to a study by several researchers at the Harvard School of Public Health and the University of North Carolina at Chapel Hill. The study was published in the Annals of Internal Medicine.

“When efavirenz is used as a component of antiretroviral therapy, patients should be monitored carefully for exacerbation of depression or evidence of suicidal thoughts or behavior,” according to the study.

The drug has been previously linked to central nervous system side effects and suicide, but until now a clear link to suicidal thinking, attempted suicide, or completed suicide was not clear. The effects persist for the time patients are on the drug. The researchers recommend that patients with HIV use alternative drugs, if possible, if they are at risk for depression. Read more on HIV.

Nutrition Screenings Should Be Regular Part of Geriatric Health Assessment
Most older adults typically have one or more chronic health conditions that can affect their food intake and should be asked about their food intake during health exams, according to a new study in Nutrition in Clinical Practice. The researchers said that health care providers should also look for signs of malnutrition, such as loss of subcutaneous fat, muscle loss and fluid accumulation. Read more on aging.

Many American Teens Follow Pro-Marijuana Twitter Feeds and Receive Pro-Marijuana Tweets
Hundreds of thousands of American teens are following marijuana-related Twitter accounts and getting pro-marijuana tweets several times each day, according to researchers at the Washington University School of Medicine in St. Louis. The researchers say the tweets are cause for concern because young people are especially responsive to social media influences and because patterns of drug use tend to be established in a person’s late teens and early 20s. The study was published in the Journal of Medical Internet Research and relied on tweets sent and received between May 1 and Dec. 31, 2013, from a single popular pro-marijuana Twitter feed. During the study period, the feed posted an average of 11 pro-marijuana tweets per day. Read more on substance abuse.

Jul 2 2014
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CDC: Physicians are Fueling Prescription Painkiller Overdoses

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.

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“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.

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Jun 30 2014
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Public Health News Roundup: June 30

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AHA to Fund Research Network for the Prevention of Heart Disease, Stroke
With a $15 million grant from the American Heart Association (AHA), four major medical institutions are coming together to form a research network with the goal of preventing heart disease and stroke. The Strategically Focused Prevention Research Network Centers will include investigators at Northwestern University in Chicago, Vanderbilt University in Nashville, the Icahn School of Medicine at Mount Sinai in New York City and the University of Texas-Southwestern Medical Center in Dallas. “Heart attack and stroke can strike suddenly, and frequently without warning. The best way to reduce premature mortality from cardiovascular diseases and stroke is to prevent the development of the risk factors that lead to these conditions,” said AHA President Elliott Antman, MD, professor of medicine at Harvard Medical School and a senior physician in the cardiovascular division of the Brigham and Women’s Hospital in Boston, in a release. “Scientists working in these research centers are helping to discover the mechanisms that will allow all Americans to live healthier lives, helping lead us to a culture of health.” Read more on heart health.

Study: One-Third of U.S. Total Knee Replacements ‘Inappropriate’
Approximately one-third of all total knee replacements in the United States are unnecessary and “inappropriate” under a patient classification system used in Spain, according to a new study in the journal Arthritis & Rheumatology. Researchers said the findings demonstrate a need for the United States to develop similar patient selection criteria so as to limit the unneeded surgeries. There are more than 600,000 total U.S. knee replacements annually—meaning that approximately 200,000 are unnecessary, according to the study—and from 1991 to 2010 the number of Medicare-covered replacements climbed by approximately 162 percent annually. Read more on aging.

Kids’ ADHD Medications Not Linked to Increase Risk of Substance Abuse
While children with attention-deficit/hyperactivity disorder (ADHD) are twice as likely to abuse drugs, the medications prescribed to treat ADHD do not play a role in the increased risk, according to a new study in the journal Pediatrics. In fact, researchers determined that the combination of behavioral techniques and ADHD medications actually lowers the risk of substance abuse. "Obviously, the medications that are used to treat ADHD have the potential for abuse, but the vast majority of children with ADHD do not develop a substance abuse problem," said Michael Duchowny, MD, a pediatric neurologist at Miami Children's Hospital. "More research has to be done to find out why some children are more susceptible than others." Common ADHD medications include amphetamines such as Adderall or Dexedrine, and methylphenidates such as Concerta, Metadate CD or Ritalin. Read more on substance abuse.

Jun 27 2014
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Public Health News Roundup: June 27

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FDA Approves for Marketing a Motorized Walking Suit for People with Spinal Cord Injuries
The U.S. Food and Drug Administration has approved for marketing a device called the ReWalk, which is the first motorized device intended to act as an exoskeleton for people with lower body paralysis from a spinal cord injury. According to the U.S. Centers for Disease Control and Prevention, there are about 200,000 people in the United States living with a spinal cord injury. ReWalk consists of a fitted, metal brace that supports the legs and part of the upper body; motors that supply movement at the hips, knees and ankles; a tilt sensor; and a backpack that contains the computer and power supply. Crutches provide the user with additional stability when walking, standing and rising up from a chair. Using a wireless remote control worn on the wrist, the user commands ReWalk to stand up, sit down or walk. Read more on disability.

One in 10 Deaths Among Working-Age Adults is Due to Excessive Drinking
Excessive alcohol use accounts for one in 10 deaths among working-age adults ages 20-64 years in the United States, according to a report from the U.S. Centers for Disease Control and Prevention and published in Preventing Chronic Disease. Excessive alcohol use led to approximately 88,000 deaths per year from 2006 to 2010, and shortened the lives of those who died by about 30 years. The deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease and heart disease; and health effects from drinking too much in a short period of time, such as violence, alcohol poisoning and motor vehicle crashes. In total, there were 2.5 million years of potential life lost each year due to excessive alcohol use. Nearly 70 percent of deaths due to excessive drinking involved working-age adults, and about 70 percent of the deaths involved males. About 5 percent of the deaths involved people under age 21. The highest death rate due to excessive drinking was in New Mexico (51 deaths per 100,000 population) and the lowest was in New Jersey (19.1 per 100,000). Read more on substance abuse.

Men and Women Use Mental Health Services Differently
Women with chronic physical illnesses are more likely to use mental health services than men with similar illnesses, and they also seek out mental health services six months earlier than those same men, according to new study from St. Michael's Hospital in Toronto, Canada and published in the Journal of Epidemiology & Community Health. The study looked at people diagnosed with at least one of four physical illnesses: Diabetes, high blood pressure, asthma or chronic obstructive pulmonary disease. The researchers found that among those with at least one of these four illnesses, women were 10 percent more likely to use mental health services than men, and within any three-year period women with physical illness used medical services for mental health treatment six months earlier than men. The researchers say the results may imply that women are more comfortable than men with seeking mental health support; that symptoms are worse among women, requiring more women to seek help and sooner; or that men defer seeking treatment for mental health concerns. Read more on mental health.

Jun 23 2014
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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. 

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“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.”

Additional findings:

  • 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.

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