Category Archives: Addiction and substance abuse
For the last several years, each incoming president of the Association of State and Territorial Health Officials (ASTHO) has introduced a President’s Challenge for the year of their presidency to focus attention on a critical national health issue. Previous challenges have included injury prevention, health equity and reducing the number of preterm births. This year, incoming ASTHO president Terry Cline, PhD, will focus his President’s Challenge on prescription drug abuse, a national public health crisis that results in tens of thousands of deaths each year.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
Just before the ASTHO annual meeting began, NewPublicHealth spoke with Cline about the scope of the issue and steps Cline will introduce to help health officers collectively focus their attention on reducing this public health crisis.
NPH: Why have you chosen prescription drug abuse as your President’s Challenge?
Terry Cline: If you look at the trend lines in the United States, we’ve seen a very rapid increase in the number of deaths from the misuse of prescription drugs. We’ve also seen a huge increase in the number of children born with neonatal abstinence syndrome, which has actually tripled in the last decade. Prescription drug abuse has created an incredible burden on the health of people in the United States. Deaths are just one indicator; others include lost productivity, absenteeism and health care costs. Just using neonatal abstinence syndrome as an example, in 2000 the total hospital charges were about $190 million and in 2009, which is the last year we have that data, it was $720 million. Because in many states Medicaid pays for a large percentage of the births, in 2000 that amount was about $130 million out of the $190 million, and in 2009 it was $560 million of the $720 million. So that is becoming a larger and larger financial burden on states as well, and that does not include the long-term effects on babies.
The President’s Challenge will be looking at the absolute number—bringing down the number of deaths, which stand at more than 16,000 deaths per year. We’ve seen opioid deaths increase and continue every year over the last decade. And in most states now, the number of deaths from prescription drugs is actually greater than the number of deaths from automobile accidents, which has steadily gone down over the last decade. So, one is an example of a public health success; the decrease in motor vehicle deaths stems from a comprehensive approach and work with multiple sectors to bring that death rate down. The other, prescription drug deaths, is an alarming increase. My hope is that with the President’s Challenge, we can really increase awareness and leverage public health agencies across the country to mobilize around this issue.
The first Vital Signs health indicators report of 2013 from the U.S. Centers for Disease Control (CDC) and Prevention finds that binge drinking is too often not recognized as a women’s health problem. The report found that nearly 14 million U.S. women binge drink about three times a month, and consume an average of six drinks per binge. CDC researchers determined the rate of binge drinking among U.S. women and girls by looking at the drinking behavior of approximately 278,000 U.S. women aged 18 and older for the past 30 days through data collected from the 2011 Behavioral Risk Factor Surveillance System, and for approximately 7,500 U.S. high school girls from the 2011 National Youth Risk Behavior Survey.
For women and girls, binge drinking is defined as consuming four or more drinks on one occasion. Drinking excessively, including binge drinking, causes about 23,000 deaths among women and girls in the United States each year. About 1 in 8 women and 1 in 5 high school girls report binge drinking, with the practice most common among women ages 8-34, high school girls, whites, Hispanics and women with household incomes of $75,000 or more. Half of all high school girls who drink alcohol report binge drinking.
A recent article in the New York Times looks at a shift in thinking to combat drug abuse from efforts to prevent drugs such as heroin and cocaine from entering the U.S. illegally, to combating the rising, more significant problem in the fifty states—abuse of prescription drugs.
>>Bonus Link: Read a NewPublicHealth interview with R. Gil Kerlikowske, director of the Office of National Drug Control Policy.