Drug overdose deaths hit record numbers

Over 47,000 deaths last year, mostly due to opioid pain relievers and heroin

From 2000 to 2014 nearly half a million Americans died from drug overdoses. Opioid overdose deaths, including both opioid pain relievers and heroin, hit record levels in 2014, with an alarming 14 percent increase in just one year,

The most commonly prescribed opioid pain relievers, those classified as natural or semi-synthetic opioids such as oxycodone and hydrocodone, continue to be involved in more overdose deaths than any other opioid type. These deaths increased by 9 percent (813 more deaths in 2014 than 2013).

Increases in prescription opioid pain reliever and heroin deaths are the biggest driver of the drug overdose epidemic. Deaths from heroin increased in 2014, continuing a sharp rise that has seen heroin overdoses triple since 2010. Deaths involving illicitly made fentanyl, a potent opioid often added to or sold as heroin, also are on the upswing.

“The increasing number of deaths from opioid overdose is alarming,” said CDC Director Tom Frieden, M.D., M.P.H. “The opioid epidemic is devastating American families and communities. To curb these trends and save lives, we must help prevent addiction and provide support and treatment to those who suffer from opioid use disorders. This report also shows how important it is that law enforcement intensify efforts to reduce the availability of heroin, illegal fentanyl, and other illegal opioids.”

Drug overdose deaths are up in both men and women, in non-Hispanic whites and blacks, and in adults of nearly all ages. Rates of drug overdose deaths were highest among five states: West Virginia, New Mexico, New Hampshire, Kentucky, and Ohio. A map of drug overdose deaths by state (2013 and 2014) is available at http://www.cdc.gov/drugoverdose/data/statedeaths.html.

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Expanding Naloxone use could reduce drug overdose deaths

Where you live makes a difference

Allowing more basic emergency medical service (EMS) staff to administer naloxone could reduce drug overdose deaths that involve opioids, according to a Centers for Disease Control and Prevention (CDC) study, “Disparity in Naloxone Administration by Emergency Medical Service Providers and the Burden of Drug Overdose in Rural Communities,” published in the American Journal of Public Health.

In 2013, more than 16,000 deaths in the United States involved prescription opioids, and more than 8,000 others were related to heroin.  Naloxone is a prescription drug that can reverse the effects of prescription opioid and heroin overdose, and can be life-saving if administered in time.

According to the study findings, advanced EMS staff were more likely than basic EMS staff to administer naloxone.  A majority of states have adopted national guidelines that prohibit basic EMS staff from administering the drug as an injection. As of 2014, only 12 states allowed basic EMS staff to administer naloxone for a suspected opioid overdose; all 50 states allow advanced EMS staff to administer the overdose reversal treatment.

“Opioid overdose deaths are devastating families and communities, especially in rural areas,” said CDC Director Tom Frieden, M.D., M.P.H.  “Many of these deaths can be prevented by improving prescribing practices to prevent opioid addiction, expanding the use of medication-assisted treatment, and increasing use of naloxone for suspected overdoses. Having trained EMS staff to administer naloxone in rural areas will save lives.”

To reduce opioid overdose deaths, particularly in rural areas, CDC recommends expanding training on the administration of naloxone to all emergency service staff, and helping basic EMS personnel meet the advanced certification requirements.

“Naloxone can be given nasally to a person suspected of overdose, allowing basic EMS staff to administer the drug without injection,” said CDC Senior Health Scientist Mark Faul, Ph.D., M.A. “Naloxone is non-addictive, and expanding training on how to administer the drug can help basic emergency medical service staff reverse an opioid overdose and save more lives.”

National Emergency Medicine Service Information System data for 2012 were reviewed to better understand factors associated with naloxone administration, including demographic data, 911 call information, and details about the scene of an injury or illness as reported by EMS staff.

The findings indicate naloxone was most likely to be administered to women, people between the ages of 20 and 29, and people living in suburban areas.

In general, the rate of opioid overdose death was 45 percent higher in rural areas compared with urban areas. The use of naloxone by rural EMS staff, however, was only 22.5 percent higher when compared with urban EMS naloxone use.

Department of Health and Human Services Secretary Sylvia M. Burwell has made addressing opioid abuse, dependence, and overdose a priority and work is underway at multiple HHS agencies on this important issue. HHS’ Health Resources Services Administration recently released a grant opportunity aimed at reducing opioid overdose deaths in rural communities through funding for communities to purchase naloxone and train healthcare professionals and emergency medical staff on its use.

CDC works with states, communities, and prescribers to prevent opioid misuse and overdose by tracking and monitoring the epidemic and helping states scale up effective programs.  CDC also improves patient safety by equipping healthcare providers with data, tools, and guidance so they can make informed treatment decisions. Learn more at www.cdc.gov/DrugOverdose.

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Seat Belt Use Among Long-Haul Truck Drivers

Seat Belt Use Among Long-Haul Truck Drivers

In 2012, motor vehicle crash fatalities (1,153) accounted for 25% of all occupational fatalities (4,628) in the United States. Of these motor vehicle crash fatalities, 46% of the decedents were truck drivers. In 2012, 2.6 million truck drivers were employed in the United States; 1.7 million drove heavy trucks and tractor-trailers with gross vehicle weight rating (GVWR) >26,000 pounds, and another 840,000 drove medium-sized trucks with GVWR between 10,001 and 26,000 pounds.† The majority of heavy and tractor-trailer truck drivers were long-haul truck drivers (LHTDs), meaning they delivered goods over intercity routes that can span more than one state.

After decreasing to the lowest level ever in 2009, large-truck (GVWR greater than 10,000 pounds 0 occupant deaths have been increasing. In 2012, 697 occupants of large trucks died in crashes, and another 26,000 were injured . About 41% of truck drivers who lost ≥1 work day from a motor vehicle crash in 2012 missed ≥31 days

Federal regulations require drivers of large trucks to wear a seatbelt But at least 35% of the truck drivers who died in 2012 were not wearing a seatbelt). This report estimates the prevalence of seat belt use and identifies factors associated with nonuse of seat belts among LHTDs.

Using a seatbelt has been proven to reduce injury and death in the event of a motor vehicle crash for drivers of passenger vehicles and trucks, and LHTDs are required by federal regulations to use a seat belt

Findings from this survey suggest, however, that approximately 14% of LHTDs never or only sometimes use a seat belt. This, coupled with the fact that 34.9% of LHTDs had been involved in at least one U.S. Department of Transportation recordable crash while working as an LHTD and 11.9% had been involved in two or more crashes, underscores the importance of wearing a seat belt.

Never using a seatbelt was significantly associated with the absence of a primary enforcement seat belt law in the LHTD's state of residence. As more states have added primary enforcement seat belt laws, observed seat belt use for drivers of large trucks and buses also has increased (48% in 2003 to 84% in 2013). Similar findings have also been reported for belt use by auto drivers by state . Belt use among LHTDs might increase further if all states were to adopt primary enforcement belt laws.

Results of this survey also showed a significant association between never using a seat belt and the absence of a written employer safety program. A requirement that drivers and all passengers use their seat belts is an important component of a comprehensive motor vehicle safety management program. Companies can establish and enforce belt-use requirements and give incentives or recognition for compliance or consequences for noncompliance. Involving workers in development and implementation of these programs can increase their effectiveness. In a 2005 survey of truck drivers, 44% reported that their employer imposed no penalties for nonuse of seat belts, and 43% indicated that their employer offered no educational or incentive programs to promote seat belt use. Comprehensive safety programs also can address unsafe driving behaviors such as speeding and other moving violations, both of which were found in this survey to be associated with never using a seat belt.

Engineering and design changes also might increase seat belt use among LHTDs. Previous studies identified personal choice and discomfort related to belt positioning, tightness, range of motion, and rubbing as primary reasons not to wear a seatbelt. It was also reported that seat belts in trucks were uncomfortable for women and shorter drivers. CDC recently collected anthropometric data from a nationally representative sample of 1,950 truck drivers (1,779 males and 171 females). These new data can be used by vehicle manufacturers to develop better fitting and more comfortable seat belt systems. Improvements in belt design might help increase belt use among LHTDs, especially female truck drivers, who were shown in this survey to be more likely than males to never use a seat belt.

In addition to nonuse of seat belts, other risk factors, notably drowsy and distracted driving, have been linked to fatal large-truck crashes.

A case-control study comparing fatal and nonfatal truck crashes using collision reports for 1998–2002 in Kentucky found that the odds of a fatal crash were 8.2 times higher when the truck driver was unbelted, 3.2 times higher when the truck driver was distracted, and 21 times higher when the truck driver was fatigued or fell asleep. In addition to ensuring that truck drivers follow federal regulations that limit hours of driving, employers can help reduce drowsy driving by allowing enough time for regular rest. Employers can provide education to increase drivers' awareness of the impact of long work hours and driving at night on driver fatigue. Free online fatigue management training is available for managers and drivers.

One in 10 Deaths Among Working-age Adults Due to Excessive Drinking

One in 10 deaths among working-age adults 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 Centers for Disease Control and Prevention

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.  These 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).

“Excessive alcohol use is a leading cause of preventable death that kills many Americans in the prime of their lives,” said Ursula E. Bauer, Ph.D., M.P.H., director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “We need to redouble our efforts to implement scientifically proven public health approaches to reduce this tragic loss of life and the huge economic costs that result.”

Excessive drinking includes binge drinking (4 or more drinks on an occasion for women, 5 or more drinks on an occasion for men), heavy drinking (8 or more drinks a week for women, 15 or more drinks a week for men), and any alcohol use by pregnant women or those under the minimum legal drinking age of 21.  Excessive drinking cost the United States about $224 billion, or $1.90 per drink, in 2006.  Most of these costs were due to lost productivity, including reduced earnings among excessive drinkers as well as deaths due to excessive drinking among working age adults.

To estimate deaths due to excessive drinking, CDC scientists analyzed data from the Alcohol-Related Disease Impact (ARDI) application for 2006-2010.  ARDI provides national and state-specific estimates of alcohol-attributable deaths and years of potential life lost.  ARDI currently includes 54 causes of death for which estimates of alcohol involvement were either directly available or could be calculated based on existing scientific information.

“It’s shocking to see the public health impact of excessive drinking on working-age adults,” said Robert Brewer, M.D., M.S.P.H., head of CDC’s Alcohol Program and one of the report’s authors. “CDC is working with partners to support the implementation of strategies for preventing excessive alcohol use that are recommended by the Community Preventive Services Task Force, which can help reduce the health and social cost of this dangerous risk behavior.”

The independent HHS Community Preventive Services Task Force recommends several evidence-based strategies to reduce excessive drinking.  These include increasing alcohol taxes, regulating alcohol outlet density, and avoiding further privatization of alcohol retail sales.

For more information about excessive drinking, including binge drinking, and how to prevent this dangerous behavior, visit the CDC’s Alcohol and Public Health website at http://www.cdc.gov/alcohol/index.htm.  Members of the public who are concerned about their own or someone else's drinking can call 1-800-662-HELP to receive assistance from the national Drug and Alcohol Treatment Referral Routing Service.  

4/2/14 Health News; EPA STOPS SALE OF FOOD CONTAINERS MADE WITH NANO SILVER ♦ ‘HISTORIC WINS’ FOR ORGANIC INDUSTRY ♦ Air Pollution Linked to Seven Million Deaths

EPA STOPS SALE OF FOOD CONTAINERS MADE WITH NANO SILVER

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‘HISTORIC WINS’ FOR ORGANIC INDUSTRY IN NEW FARM BILL

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Air Pollution Linked to Seven Million Deaths Globally

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Nurse Staffing and Education Linked to Reduced Patient Deaths

Hospitals in Europe where nursing staff care for fewer patients and have a higher proportion of bachelor’s degree-trained nurses had significantly fewer surgical patients die while hospitalized according to a new study. These findings underscore the potential risks to patients when nurse staffing is cut and suggests an increased emphasis on bachelor’s education for nurses could reduce hospital deaths.

The study, supported by the European Union’s Seventh Framework Programme and the National Institute of Nursing Research (NINR), part of the National Institutes of Health, is the largest and most detailed analysis to date of patient outcomes associated with nurse staffing and education in Europe. Known as Registered Nurses Forecasting (RN4CAST), the study estimated that an increase in hospital nurses’ workloads by one patient increases the likelihood of in hospital death by 7 percent. Also, a better educated nurse workforce was associated with fewer deaths. For every 10 percent increase in nurses with bachelor’s degrees, there was an associated drop in the likelihood of death by 7 percent.

“Building the scientific foundation for clinical practice has long been a crucial goal of nursing research and the work supported by NINR,” said NINR Director Dr. Patricia A. Grady. “This study emphasizes the role that nurses play in ensuring successful patient outcomes and underscores the need for a well-educated nursing workforce.”

For the RN4CAST study, a consortium of scientists led by Dr. Linda Aiken of the University of Pennsylvania School of Nursing, Philadelphia, and Dr. Walter Sermeus of the Catholic University of Leuven in Belgium, reviewed hospital discharge data of nearly 500,000 patients from nine European countries who underwent common surgeries. They also surveyed over 26,500 nurses practicing in study hospitals to measure nurse staffing and education levels. The team analyzed the data and surveys to assess the effects of nursing factors on the likelihood of patients dying within 30 days of hospital admission.

Based on their analysis, the researchers estimated that patients in hospitals where 60 percent of nurses had bachelor’s degrees and cared for an average of six patients had a nearly one-third lower risk of dying in the hospital after surgery than patients in hospitals where only one-third of nurses had bachelor’s level education and cared for an average of eight patients each.

“Our study is the first to examine nursing workforce data across multiple European nations and analyze them in relation to objective clinical outcomes, rather than patient or nurse reports,” said Dr. Aiken. “Our findings complement studies in the U.S. linking improved hospital nurse staffing and higher education levels with decreased mortality.”

In the U.S., analysis of patient outcomes associated with nurse staffing practices has informed proposed or actual legislation in nearly 25 states. These types of analyses also informed the recommendation of the Institute of Medicine that 80 percent of nurses in the U.S. have a bachelor’s degree by 2020. Hospitals have responded to this recommendation with preferential hiring of bachelor’s degree-trained nurses.

The RN4CAST study was designed to provide scientific evidence for decision makers in Europe to guide planning for the nurse workforce for the future. The study’s findings provide evidence to guide important decisions about improving hospital care in the context of scarce resources and health care reforms.

“This study is another example of how nursing science can help inform policies that promote positive patient outcomes not only in the U.S., but around the world,” added Dr. Grady.

2/21/14 Health News: US is Failing to Protect Children - Test for Toxic Genes - Measles Deaths Plunge 78% - Mercury Pollution Closes Part of Maine Coast to Lobster Fishing

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Report: U.S. Failing to Protect Kids From HPV

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A Digital Test for Toxic Genes

Allon Wagner, Uri Gophna, and Eytan Ruppin of Tel Aviv University's Blavatnik School of Computer Science and Department of Molecular Microbiology and Biotechnology, along with researchers at the Weizmann Institute of Science, have developed a computer algorithm that predicts which metabolic genes are lethal to cells when overexpressed. The findings, published in Proceedings of the National Academy of Sciences, could help guide metabolic engineering to produce new chemicals in more cost-effective ways..Continue Reading

Measles Deaths Plunge 78% Since 2000 as Elimination Target Nears

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CDC Study; Child Passenger Deaths Decreased 43 % From 2002 - 2011

CDC study shows that child passenger deaths have decreased 43 percent from 2002 - 2011

Black and Hispanic children who died in crashes were less likely to be buckled up

Motor vehicle crash deaths are down, but still a leading cause of death among children.

Motor vehicle crash deaths among children age 12 and younger decreased by 43 percent from 2002-2011; however, still more than 9,000 children died in crashes during that period, according to a new Vital Signs report from the Centers for Disease Control and Prevention. Research has shown that using age- and size-appropriate child restraints (car seats, booster seats, and seat belts) is the best way to save lives and reduce injuries in a crash. Yet the report found that almost half of all black (45 percent) and Hispanic (46 percent) children who died in crashes were not buckled up, compared to 26 percent of white children (2009-2010).

“No child should die in a motor vehicle crash because they were not properly buckled up and yet, sadly, it happens hundreds of times each year in the U.S.,” said CDC Director Tom Frieden, M.D., M.P.H. “Many of these tragedies are preventable when parents use age-and size-appropriate child restraints every time their child rides in a motor vehicle.”  

CDC analyzed 2002–2011 data from the Fatality Analysis Reporting System, collected by the National Highway Traffic Safety Administration, to determine the number and rate of motor-vehicle occupant deaths, and the percentage of child deaths among children age 12 and younger who were not buckled up.

The Vital Signs report also found that:

• One in three children who died in crashes in 2011 was not buckled up.
• Only 2 out of every 100 children live in states that require car seat or booster seat use for children age 8 and under.

Child passenger restraint laws result in more children being buckled up. A recent study by Eichelberger et al, showed that among five states that increased the required car seat or booster seat age to 7 or 8 years, car seat and booster seat use tripled, and deaths and serious injuries decreased by 17 percent.

“Parents and caregivers play an important role in keeping children safe in the car,” said Daniel M. Sosin, M.D., M.P.H., F.A.C.P., acting director of CDC’s National Center for Injury Prevention and Control. “Children often imitate their parents; so it’s important that parents model safe behavior and buckle up on every trip. Parents also should always buckle children in age- and size-appropriate car seats, booster seats and, seat belts.”

To help keep children safe on the road, parents and caregivers can:

• Use car seats, booster seats, and seat belts in the back seat—on every trip, no matter how short.
• Rear-facing car seat from birth up to age 2
• Buckle children in a rear-facing seat until age 2 or when they reach the upper weight or height limit of that seat.
• Forward-facing car seat from age 2 up to at least age 5 When children outgrow their rear-facing seat, they should be buckled in a forward-facing car seat until at least age 5 or when they reach the upper weight or height limit of that seat.
• Booster seat from age 5 up until seat belt fits properly Once children outgrow their forward-facing seat, they should be buckled in a booster seat until seat belts fit properly. The recommended height for proper seat belt fit is 57 inches tall.
• Seat belt once it fits properly without a booster seat Children no longer need to use a booster seat once seat belts fit them properly. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck).

• Install and use car seats according to the owner’s manual or get help installing them from a certified Child Passenger Safety Technician.
• Buckle children age 12 and under in the back seat.

3 Young People Died From Lyme Disease

The sudden deaths of 3 young people in the Northeastern United States have been attributed to complications of Lyme disease, Boston.com reported.

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system.

Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. There were 30,000 over cases of lyme disease in 2012.

According to the Centers for Disease Control and Prevention (CDC), each of the fatalities resulted from undetected heart inflammation -- also known as carditis -- caused by the tick-borne illness. About one percent of Lyme disease sufferers develop carditis, which is typically treatable with antibiotics or, in some cases, a pacemaker.

According to medical reports, only 4 other deaths can be attributed to heart inflammation caused by Lyme disease. While the illness is a growing problem in the Northeast, the CDC says that deaths related to the disease are still rare, Boston.com reported.

The victims in the CDC's report were not identified, but each of the deaths occurred between November 2012 and July 2013. The deceased were between 26 and 38 years old. None of the victims had been diagnosed with Lyme disease prior to their deaths.

One of the victims died in a car accident after his car veered off the road. The victim was an organ donor, and the inflammation around his heart was discovered during a pathology exam. It is believed he went into cardiac arrest while driving, Boston.com reported. The other 2 victims also died after seemingly unexplainable collapses.

Medical professionals say these deaths should bring new urgency to the search for a Lyme disease vaccine. "I think it is unconscionable and a discredit to all parties -- public health, manufacturers, Lyme activists -- that no Lyme vaccine is available to humans while there is one for dogs," Stanley Plotkin, emeritus professor of pediatrics at the University of Pennsylvania and a vaccine expert, told Boston.com in an email.