Monday, November 18, 2024

One reason overdose deaths are dropping

The ideas and innovators shaping health care
Nov 18, 2024 View in browser
 
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By Carmen Paun, Ruth Reader, Daniel Payne and Erin Schumaker

AROUND THE NATION

A pile of fentanyl-laced fake oxycodone pills is shown.

Fewer fentanyl-laced pills contain a lethal dose of the synthetic opioid. | U.S. Attorney’s Office for Utah via AP Photo

Mexican drug cartels are mixing weaker batches of illicit fentanyl, a likely reason behind the nearly 15 percent drop in overdose deaths in the last year, according to DEA Administrator Anne Milgram.

Milgram claimed credit before a gathering Friday of family members of those who have died from fentanyl poisoning from counterfeit pills or overdoses, citing pressure the Drug Enforcement Administration is putting on the cartels by targeting their criminal networks — from their chemical supply chains in China to their money-laundering operations.

“So, we have gone from 7 out of 10 being lethal to 5 out of 10 being lethal,” Milgram said of fentanyl pills seized and tested by DEA labs nationwide over the past year.

The DEA deems at least 2 milligrams of fentanyl as a deadly dose, but some people can survive it, depending on their body size, tolerance and past fentanyl use.

Why it matters: Government officials and drug policy experts have speculated about the drivers behind the recent drop in fatal overdoses after years of steady increases.

Last week, CDC Director Mandy Cohen said increased awareness about the potential presence of fentanyl in counterfeit pills purporting to be some other drug and the use of test strips to detect fentanyl, as well as efforts to connect people to care after a nonfatal overdose, were bringing death rates down.

Milgram’s data on fentanyl potency is the first explanation buttressed by hard evidence.

Nearly 97,000 people died of drug overdoses between June 2023 and June 2024, dropping from a peak of more than 113,000 people between the summers of 2022 and 2023, according to CDC provisional data. Fentanyl, an illicit opioid 50 times stronger than heroin, was responsible for most of the deaths.

Still, Milgram believes public health efforts play a role, such as expanded access to the overdose-reversing drug naloxone and medication for opioid use disorder.

She called for naloxone to be available nationwide, from libraries to schools and sports stadiums.

“We are just starting to see a cultural shift,” she said of families’ awareness-raising work about fentanyl’s dangers, which Milgram listed as another reason for declining overdose deaths.

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This is where we explore the ideas and innovators shaping health care. 

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Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com.

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DIAGNOSIS

A 11-year-old boy plays with his father's phone outside school in Barcelona, Spain, Monday, June 17, 2024. Parents across Europe are rallying to make it normal for young kids to live smartphone-free. From Spain to Ireland and the UK, groups are ballooning on chat groups like WhatsApp and agreeing to link arms and refuse to buy children younger than 12 smartphones. (AP Photo/Emilio Morenatti)

Researchers will examine connections between device ownership, time spent on social media and the prevalence of sleep deprivation, anxiety and other critical wellness indicators. Emilio Morenatti | AP

Researchers at the University of South Florida have a bold plan: Track young people for the next 25 years to learn how smartphone use, social media and other digital tools affect their well-being.

How so? The project, called the Life in Media Survey, will collect information from thousands of children between 11 and 13 years old on their use of digital media. Researchers will track them until 2050 to observe the impact.

The survey will include questions about social media use and addiction, cyberbullying, news consumption, streaming services, parental controls, media literacy, artificial intelligence and more, the University of South Florida said in a statement Thursday.

Researchers will examine connections between device ownership and time spent on social media with the prevalence of sleep deprivation, anxiety, depression and other critical wellness indicators.

“Let’s say kids who spend more time on social media and devices have higher rates of depression, which is what some of the data is telling us,” Wendy Rote, a psychology professor at the university and an expert on adolescent development, said.

“Is it because of the device and media itself, or is it because time spent with digital media means kids have less time for sports, clubs and other socialization activities?” she wondered.

The first step is a survey this month of 1,500 Florida teens to provide researchers with baseline data. The findings will be published next spring.

The research team will then start a nationwide, long-term survey of up to 9,000 children, whom they’ll survey twice a year.

The researchers plan to use the data collected every six months to provide insight to parents, teachers, researchers, health providers and others on the impact of digital media use on children through their adulthood.

Why it matters: U.S. Surgeon General Vivek Murthy last year warned about the harmful impact of social media on children’s and teenagers’ mental health and well-being.

But the researchers are still looking for funding from the university and federal agencies to support the study’s first few years, Justin Martin, the study’s lead researcher, said.

 

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WORLD VIEW

doctor at laptop

Like their American counterparts, European doctors want a liability regime that protects them from paying for mistakes made by AI tools. | Mark Humphrey/AP Photo

Doctors in Europe have some thoughts on how to speed the adoption of artificial intelligence in their work, our colleagues across the pond report.

The Standing Committee of European Doctors, a group that represents national medical associations across the continent, has issued recommendations for those designing and buying AI tools for health care.

Like their American counterparts, European doctors want a liability regime that protects them from paying for mistakes made by AI tools and assures that AI won’t replace them in patient care.

Among the ideas the group suggests:

— AI systems should be used to support decision making by assisting and complementing diagnosis; identifying patterns, abnormalities and trends; and offering insights into a patient’s predisposition to certain diseases and conditions.

— Measures must be taken to ensure that critical thinking continues in medical practice so doctors don’t become overly reliant on AI decision making.

— Health systems must develop strategies to avoid “automation bias” in which doctors blindly trust AI tools.

Tech developers should involve physicians from the start of their design processes, committee President Christiaan Keijzer, a Dutch anesthesiologist, said in a release: “Those developing the digital tools need to learn the real needs of healthcare professionals, patients and their carers and guardians.”

 

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