Sept. 21, 2018 – SCIENCE – The epidemic of substance use disorders and drug overdose deaths is a growing public health crisis in the United States. Every day, 174 people die from drug overdoses. Currently, opioids (including prescription opioids, heroin, and synthetic opioids such as fentanyl and its chemical analogs) are the leading cause of overdose deaths. The overdose mortality data can reveal the complex and evolving dynamics of drug use in the United States.
In an effort to understand the epidemic dynamics and perhaps predict its future course, we analyzed records of 599,255 deaths from 1979 through 2016 from the National Vital Statistics System where unintentional drug poisoning was identified as the main cause of death.
The overall mortality rate for unintentional drug poisonings in the United States grew exponentially from 1979 through 2016. This exponentially increasing mortality rate has tracked along a remarkably smooth trajectory (log linear R2 = 0.99) for at least 38 years. By contrast, the trajectories of mortality rates from individual drugs have not tracked along exponential trajectories. Cocaine was a leading cause in 2005–2006, which was overtaken successively by prescription opioids, then heroin, and then synthetic opioids such as fentanyl. Until 2010, most deaths were in 40- to 50-year-old persons, from cocaine and increasingly from prescription drugs. Deaths from heroin and then fentanyl have affecting younger persons, ages 20 to 40.
Mortality rates for males have exceeded those for females for all drugs. Rates for whites exceeded those for blacks for all opioids, but rates were much greater among blacks for cocaine. Death rates for prescription drugs were greater for rural than urban populations. The geographic patterns of deaths also vary by drug. Prescription opioid deaths are widespread across the United States, whereas heroin and fentanyl deaths are predominantly located in the northeastern United States and methamphetamine deaths in the southwestern United States. Cocaine deaths tend to be associated with urban centers.
Trump admin awards over $1 billion in grants to fight opioid epidemic
Daily use of marijuana among non-college young adults at all time high
Sept. 5, 2018 — The National Institute on Drug Abuse (NIDA) announced that the latest Monitoring the Future (MTF) survey results on substance use trends as teens transition to adulthood are now available online, comparing substance use patterns of full-time college students to their non-college peers. Most notably, more than 13 percent of young adults not in college report daily, or near daily, marijuana use; alcohol use is more common among college students; some opioid use is declining in both groups, and the most sizeable difference is the higher rate of cigarette smoking in the non-college group.
Below are the highlights from the 2017 MTF survey results on drug use among college students compared to their peers not attending college (ages 19-22).
- Past month marijuana use appears to be higher among non-college young adults than among college students (7.8 percent vs. 5.2 percent).
- With respect to past month use, alcohol use in college students is higher than in non-college peers (62 percent vs. 56.4 percent). Additionally, mixing alcohol with energy drinks appears to be higher among college students than the non-college group (31.5 percent vs. 26.7 percent) in the past year.
- Past year misuse of Vicodin® in both college and non-college peers dropped dramatically since 2009 (8.4 percent in 2009 to 1.1 percent in 2017 and 11.2 percent to 1.8 percent, respectively).
- Synthetic drug use over the last year is lower in college students than in non-college peers. Synthetic cannabinoids (K2/spice) use is 0.5 percent vs. 2.4 percent and synthetic cathinones (bath salts) is 0.2 percent vs. 1.5 percent, respectively.
How the opioid crackdown is backfiring
Aug. 28, 2018 – Politico – Last August, Jon Fowlkes told his wife he planned to kill himself. The former law enforcement officer was in constant pain after his doctor had abruptly cut off the twice-a-day OxyContin that had helped him endure excruciating back pain from a motorcycle crash almost two decades ago that had left him nearly paralyzed despite multiple surgeries.
“I came into the office one day and he said, ‘You have to find another doctor. You can’t come here anymore,’” Fowlkes, 58, recalled. The doctor gave him one last prescription and sent him away. Like many Americans with chronic, disabling pain, Fowlkes felt angry and betrayed as state and federal regulators, starting in the Obama years and intensifying under President Donald Trump, cracked down on opioid prescribing to reduce the toll of overdose deaths. Hundreds of patients responding to a POLITICO reader survey told similar stories of being suddenly refused prescriptions for medications they’d relied on for years — sometimes just to get out of bed in the morning — and left to suffer untreated pain on top of withdrawal symptoms like vomiting and insomnia.
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Travis Co. opioid recovery program leading addicts to sobriety
Aug. 3, 2018 – SpectrumNews – A pilot program in Travis County is helping recovering opioid addicts, and has a success rate higher than the national average. For 34-year-old Ryan Bell, the road to recovery has been years in the making. He started using drugs when he was 16 or 17.
“I had to have a pill every day when I woke up or I didn’t want to live. Now I’m happy to wake up and drink coffee, you know what I mean? Pray and just be connected to the earth,” said Bell.
During a chance encounter with staff from the Community Care Collaborative, Bell enrolled in the Medication Assisted Therapy program, or MAT. “What the MAT program offers that is unique is a full integration into a primary care clinic so that we can add the primary care services that so many of these patients require,” said Dr. Nicholas with Yagoda Community Care. The program tackles addiction on several fronts: medication, behavioral therapy and case management. The program has recorded 45 patients who are on their way to sobriety.
