Category Archives: Substance Abuse
Later this week a final rule goes into effect from the U.S. Drug Enforcement Agency (DEA) aimed at reducing the misuse of controlled substances. The new rule will allow pharmacies and other approved outlets to accept unused controlled substances from people who want them out of their home so they can’t be abused by people with no medical need for the medications.
Previously, the drugs could only be disposed of at home, brought to a law enforcement agency or brought to one of two annual community “take back” days that the DEA started in 2011. Unused drugs are often found in homes because physicians typically prescribe thirty days’ worth of painkillers after surgery or illness, which can lead to addiction or to the drugs being left in home medicine cabinets where they are ripe for misuse.
Under the rule, certain outlets (including manufacturers, distributors, narcotic treatment programs, retail pharmacies and hospitals/clinics with an on-site pharmacy) can apply to the DEA to become authorized collectors. The public can find authorized collectors in their communities by calling the DEA Office of Diversion Control’s Registration Call Center at 1-800-882-9539.
Experts say the rule is a good start toward getting millions of controlled substances out of the hands of abusers and potential abusers. Data clearly demonstrates the need:
- According to the 2012 National Survey on Drug Use and Health, almost twice as many Americans (6.8 million) currently abuse pharmaceutical controlled substances than those using cocaine, hallucinogens, heroin and inhalants combined.
- Nearly 110 Americans die every day from drug-related overdoses, and about half of those overdoses are related to opioids, a class of drug that includes prescription painkillers and heroin.
- More than two-thirds of people who misuse prescription painkillers for the first time report obtaining the drugs from friends or relatives, including from a home medicine cabinet.
Writing for the Network for Public Health Law blog, lawyer Corey Davis said that while the new rule doesn’t address some key issues—such as who will pay for the returned drugs to be destroyed and whether pharmacies will face any liability if returned drugs are stolen—“it’s an important step forward in drug abuse and overdose prevention.”
EBOLA UPDATE: Obama to Commit as Many as 3,000 Troops to Epidemic Response
(NewPublicHealth is monitoring the public health crisis in West Africa.)
President Obama will today announce an expansion of military and medical resources that could send as many as 3,000 people to West Africa to help combat the ongoing Ebola outbreak. According to The New York Times, the United States will help train health workers and build as many as 17 Ebola treatment centers, which will house approximately 1,700 treatment beds. The U.S. Department of Defense will also open a joint command operation in Liberia in order to coordinate an international response to the outbreak. Read more on Ebola.
Report: 1 in 9 People Worldwide are Chronically Undernourished
An estimated 805 million people in the world are chronically undernourished, according to a new report, The State of Food Insecurity in the World 2014, from the Food and Agriculture Organization of the United Nations. While that means that approximately one in every nine people are undernourished, the number is down more than 100 million over the past decade and 209 million since 1990-1992. In the past two decades the prevalence of undernourishment has also dropped from 23.4 percent to 13.5 percent in developing countries. According to the health agency, the eradication of hunger requires a sustained political commitment that emphasizes food security and nutrition. Read more on global health.
SAMHSA: Percentage of Youth Using Illegal Drugs is Down Over the Past Decade
The percentage of U.S. teens using illegal drugs is down over the past decade, according to a new study from the Substance Abuse and Mental Health Services Administration’s (SAMHSA). The report, the 2013 National Survey on Drug Use and Health, found that the rate of illicit drug use in the past month for adolescents ages 12-17 was 8.8 percent, down from 9.5 percent in 2012 and 11.6 percent in 2002. From 2002 to 2013, the percentage of youth in that age group with a substance abuse or dependence problem dropped from 8.9 percent to 5.2 percent. “This report shows that we have made important progress in some key areas, but that we need to rejuvenate our efforts to promote prevention, treatment and recovery to reach all aspects of our community,” said SAMHSA Administrator Pamela S. Hyde, in a release. “The real lives represented by these statistics deserve our protection and help from the ravages of substance use disorders. Through a comprehensive, national effort we can help people avoid, or recover from substance use problems and lead, healthy, productive lives.” Read more on substance abuse.
EBOLA UPDATE: Death Toll Now to at Least 2,296
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll from the ongoing Ebola outbreak in West Africa is now at least 2,296, according to the World Health Organization. However, the global health agency does not have the latest figures from Liberia—the country that has been hit hardest by the disease—making the true toll likely much higher. "It remains a very grave situation," said Liberian President Ellen Johnson Sirleaf on Tuesday, according to Reuters. "It is taking a long time to respond effectively .... We expect it to accelerate for at least another two or three weeks before we can look forward to a decline." As of Sept. 6 there were 4,293 recorded cases in five countries. Read more on Ebola.
Johns Hopkins Bloomberg School of Public Health, Clinton Foundation Announce Consensus Statement on Treating Prescription Drug Abuse and Misuse
The Johns Hopkins Bloomberg School of Public Health and the Clinton Foundation have released a consensus statement calling for a public health frame to analyze and disseminate proven, evidence-based intervention to combat prescription drug abuse and misuse. The statement is in response to President Clinton’s call-to-action on the subject in May of this year. “Prescription drug abuse and misuse, as well as widespread addiction and diversion of these products to the illicit market, represents one of the greatest challenges to our country’s public health in recent memory,” said Michael J. Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health, in a release. “This consensus statement marks a continuation of our school’s commitment, as well as that of the Clinton Foundation, to address epidemic rates of poisonings and deaths that are occurring due to prescription opioids and other prescription drugs that are highly prone to abuse and misuse.” According to the U.S. Centers for Disease Control and Prevention, drug overdoses killed 41,430 people in 2011, making it the leading cause of injury deaths. Read more on substance abuse.
CDC: 90% of Youth Ages 6-18 Consume Too Much Sodium
Approximately 9 in 10 U.S. children ages 6-18 consume more than the recommended amount of sodium, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). The report also found that approximately 43 percent of the sodium comes from the ten foods they eat the most often: pizza; bread and rolls; cold cuts/cured meats; savory snacks; sandwiches; cheese; chicken patties/nuggets/tenders; pasta mixed dishes; Mexican mixed dishes; and soups. “Too many children are consuming way too much sodium, and the result will be risks of high blood pressure and heart disease in the future,” said CDC Director Tom Frieden, MD, MPH, in a release. “Most sodium is from processed and restaurant food, not the salt shaker. Reducing sodium intake will help our children avoid tragic and expensive health problems.” Read more on nutrition.
EBOLA UPDATE: WHO Planning 6-9 Month Treatment Strategy
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The World Health Organization (WHO) is putting together a draft strategy to combat the ongoing Ebola outbreak in West Africa, with a spokesperson saying that while the strategy acknowledges the estimate that the Ebola response will continue into 2015, "Frankly no one knows when this outbreak of Ebola will end." "WHO is working on an Ebola road map document, it's really an operational document how to fight Ebola," WHO spokesperson Fadela Chaib told a news briefing in Geneva. "It details the strategy for WHO and partners for six to nine months to come." Read more on Ebola.
HHS Launches ‘Million Hearts’ Challenge to Identify Successful Blood Pressure Reduction Efforts
The U.S. Department of Health and Human Services has for the third straight year launched a nationwide challenge to identify and celebrate practices, clinicians and health systems working to reduce high blood pressure and improve heart health. Nine public and private practices and health systems were recognized as Hypertension Control Champions in last year’s “Million Hearts Hypertension Control Challenge”; they cared for more than 8.3 million adult patients overall. “Controlling blood pressure prevents heart attacks and strokes and saves lives,” said CDC Director Tom Frieden, MD, MPH. “Providers and health care systems that focus on improving hypertension control with their patients get great results. It’s important that we recognize those providers and patients that been successful and learn from them.” Read more on heart and vascular health.
Study: Counseling Has Little Effect on Young People with Drinking Problems
Motivational interviewing, a common counseling technique used to help people with drinking problems, may have little effect on young people who abuse alcohol, according to a new study in The Cochrane Library. Researchers looked at 66 studies covering almost 18,000 people age 25 and younger, finding that people who underwent counseling had only an average of 1.5 fewer drinks per week than those who did not (12.2 vs. 13.7), had only slightly fewer drinking days per week (2.57 vs. 2.74) and their maximum blood alcohol level fell only slightly (0.144 percent vs. 0.129 percent). "The results suggest that for young people who misuse alcohol there is no substantial, meaningful benefit of motivational interviewing," said lead researcher David Foxcroft, from the Faculty of Health and Life Sciences at Oxford Brookes University, United Kingdom, in a release. "There may be certain groups of young adults for whom motivational interviewing is more successful in preventing alcohol-related problems. But we need to see larger trials in these groups to be able to make any firm conclusions.” Read more on alcohol.
HHS: $250M to Expand Access to High-Quality Preschools
The U.S. Department of Health and Human Services (HHS) has announced that applications are now available for the $250 million Preschool Development Grants competition, which was established to build, develop and expand voluntary, high-quality preschool programs in high-need communities for children from low- and moderate-income families. “When we invest in early education, the benefits can last a lifetime,” said HHS Secretary Sylvia M. Burwell, in a release. “Children who attend high-quality early learning and preschool programs are more likely to do well in school and secure good jobs down the road. We all gain when our country has a stronger, more productive workforce, lower crime rates, and less need for public assistance. These Preschool Development Grants will help put more children on the path to opportunity.” Read more on education.
Study: Three Common Respiratory Illnesses Linked to Higher Risk of Lung Cancer
Chronic bronchitis, emphysema and pneumonia are all tied to an increased risk of lung cancer, according to a new study in the American Journal of Respiratory and Critical Care Medicine. Researchers analyzed data on more than 250,000 people, concluding that the reason for the increased risk could relate to underlying disease mechanisms. They also said that a better understanding of the respiratory diseases could affect how doctors monitor and help patients. Read more on prevention.
FDA: More Data Needed on Painkiller’s Abuse-Deterrent Capability
The U.S. Food and Drug Administration (FDA) has requested additional study and information to determine the effectiveness of an abuse-deterrent capability in an experimental painkiller. Acura Pharmaceuticals states that its drug, which contains the common painkillers hydrocodone bitartrate and acetaminophen, cannot be abused by snorting. The drug is designed to cause a burning sensation when snorted or form a gelatinous mixture when prepared for injection. However, the drug failed in a mid-stage trial to show a statistically significant likelihood of reducing abuse. Read more on substance abuse.
The focus on military concerns in the last few weeks has understandably been on events in the Middle East, Ukraine and Afghanistan. But a new study from the Mailman School of Public Health at Columbia University is shining a light on the continuing problems faced by returning U.S. military personnel—in particular their increased risk of abusing alcohol.
The study found that regardless of whether they experienced traumatic events during deployment, returning National Guard soldiers were more likely to develop a drinking problem when faced with civilian life setbacks, including job loss, legal problems, divorce, and serious financial or legal problems. The study authors say these are all very common for military families. The study was published in the American Journal of Preventive Medicine.
Previous studies have shown that alcohol abuse is a major concern for reservists returning home. While almost 7 percent of Americans abuse or are dependent on alcohol, the rate of alcohol abuse among reserve soldiers returning from deployment is 14 percent, or almost double that of the civilian population, according to the Mailman researchers.
The study looked at 1,095 Ohio National Guard soldiers who had primarily served in either Iraq or Afghanistan in 2008 and 2009. The soldiers were interviewed three times over three years via telephone about their alcohol use, exposure to deployment-related traumatic events and stressors such as land mines, vehicle crashes, taking enemy fire and witnessing casualties. They were also questioned about any stress related to everyday life since returning from duty.
More than half (60 percent) of the soldiers who responded experienced combat-related trauma, 36 percent of soldiers experienced civilian stressors and 17 percent reported being sexually harassed during their most recent deployment. The researchers found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders; combat-related traumatic events were only marginally associated with alcohol problems.
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
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.
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.
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.