By George Citroner
- Recent research finds that official government figures may be underestimating drug deaths by half.
- Researchers estimate that 142,000 people died due to drug use in 2016.
- Drug use decreases life expectancy after age 15 by 1.4 years for men and by just under 1 year for women, on average.
Government records may be severely underreporting how many Americans die from drug use, according to a new study by researchers from the University of Pennsylvania and Georgetown University.
Drug Epidemic More Serious Than Previously Thought<p>According to the National Center for Health Statistics (NCHS), the <a href="https://www.cdc.gov/nchs/products/databriefs/db294.htm" target="_blank">reported</a> rate of drug-related deaths among 15- to 64-year-olds was 9 percent in 2016. This is already a significant rise from about 4 percent 7 years earlier, when the NCHS classified 63,000 deaths as drug-related.</p><p>However, that estimate didn't include deaths that aren't related to overdose but can still involve drug use, such as HIV, suicide, and blood vessel damage.</p><p>Including these factors, researchers estimate the actual figure is more than double the NCHS figures, at 142,000 people dead due to drug use in 2016.</p><p>"These findings should be accentuating the wakeup call that has already been announced year after year, as the drug overdose deaths are revealed by the National Center [for] Health Statistics. The fact is that, apparently, the drug epidemic is twice as serious as indicated by those analyses," <a href="https://sociology.sas.upenn.edu/people/samuel-preston" target="_blank">Samuel Preston</a>, PhD, professor of sociology at the University of Pennsylvania and one of the study authors, told Healthline.</p><p>In 2017, more than <a href="https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates" target="_blank">70,000 Americans</a> died from drug overdoses, according to the National Institute on Drug Abuse.</p>
‘Deaths of Despair,’ Infectious Disease, and Heart Disease<p>According to Preston's findings:</p><ul><li>More than 20,000 men and almost 10,000 women died of circulatory diseases, like heart failure, linked to drug use.</li><li>Nearly 3,000 men and about 1,000 women died of infectious or parasitic diseases, which include HIV and hepatitis, due to drug use.</li></ul><p>Also, drugs were the likely cause of death from mental health or behavioral causes, like suicide.</p><p>Suicide is included with drug and alcohol overdoses as "<a href="https://www.jec.senate.gov/public/index.cfm/republicans/2019/9/long-term-trends-in-deaths-of-despair" target="_blank">deaths of despair</a>," something that affects <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607702/" target="_blank">rural areas</a> of Middle America in particular.</p><p>Preston admits he wasn't surprised by the findings.</p><p>"I think we believed that there would be residual effects of drug use that were not showing up in overdose deaths, and that's what we found. We didn't know what the multiplier would be exactly, but I think two [double the NCHS number] is not an unreasonable, unexpected outcome," he said.</p>
Reasons Why Unknown<p>While this study reveals the magnitude of a disturbing trend, researchers say it doesn't establish the reasons why. However, there are two prevailing theories:</p><ul><li>The drug supply has increased with the introduction of prescription opioids like fentanyl and oxycontin as well as nonprescription drugs like heroin.</li><li>Deaths that stem from the misuse of alcohol, other drugs, and suicide may be impacted by depression.</li></ul><p>"It's not just about the supply of drugs, but that there's something else behind all of it that causes people to either use drugs or alcohol or commit suicide because they've lost interest in their life," co-study author Dana Glei, senior research investigator at Georgetown University, explained in a <a href="https://www.eurekalert.org/pub_releases/2020-01/uop-del011420.php" target="_blank">statement</a>.</p>
Impact Varies by State<p>Researchers found the drug epidemic seems to have had little impact on the Plains states like Nebraska, Iowa, Kansas, and the Dakotas.</p><p>However, the regions experiencing higher drug death rates are dispersed across the country. They include the Appalachian states, parts of New England, and most of the Southwest, including Utah.</p><p>"Among deaths at ages 15–64 in 2016, the drug-associated fraction is highest in West Virginia at 39% for men and 27% for women and lowest in Nebraska," the study authors <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226732" target="_blank">wrote</a>.</p><p>The study also finds that drug use decreases life expectancy after age 15 by 1.4 years for men and by just under 1 year for women, on average.</p><p>However, the researchers found the figures are more than twice as high in West Virginia, one of the states hit hardest by the <a href="https://www.ecowatch.com/tag/opioids" rel="noopener noreferrer">opioid</a> crisis.</p><p>Preston points out that Pennsylvania is another state especially affected by the current drug crisis.</p><p>The study found that in 2016, Pennsylvania deaths attributable to drugs were 34 percent in males and almost 25 percent in women, between ages 15 and 64 years.</p><p>"It's saying something fairly deep about what's going on in this country, isn't it?" Preston concluded.</p>
Not All Experts Agree<p>"It's an interesting analysis. But my initial reaction is that drug-related is highly complex and vague. There are so many drugs, from prescription to illegal drugs, and drug-related is nebulous," said <a href="https://scholar.harvard.edu/ericding/home" target="_blank">Eric Feigl-Ding</a>, a health economist, epidemiologist, and nutrition scientist at the Harvard T.H. Chan School of Public Health and an expert adviser to the World Health Organization (WHO).</p><p>"It includes not just opioids but also HIV-fighting drugs, chronic disease drugs, and others. Also, this analysis covers so many diseases too. It's hard to interpret, and hard to use to inform the drug crisis," he said.</p><p>Feigl-Ding adds it's very tricky to interpret data between states because, as researchers noted in the study's limitations, "the practice of identifying, or capacity to determine, intent for drug poisonings varies across states."</p><p>Feigl-Ding also specifies this study is ecologic, and it uses another approximation method that has many assumptions in indirect modeling.</p><p>Feigl-Ding clarifies that "ecologic means the analysis is done at the generic state level and not county (better) or individual level (best)."</p><p>He emphasizes the study authors used drug deaths as a proxy of other nondrug deaths that are likely drug-related, and that makes the results very difficult to interpret.</p><p>"This method is not used at all by major U.S. Burden of Disease expert groups or WHO-supported Global Burden of Disease groups," Feigl-Ding said.</p><p>"For example, 'alcohol and drug use' are lumped together, and percent mortality in the U.S. is presented here," he said.</p>
The Bottom Line<p>As the opioid epidemic continues to affect Americans, recent research finds that official government figures may be underestimating drug deaths by half.</p><p>Researchers included drug deaths due to infectious or cardiovascular disease and "deaths of despair," like suicide, in their estimate.</p><p>Although deaths due to drug use are increasing nationwide, West Virginia and Pennsylvania are among the states most severely affected.</p><p>However, not all experts agree with the research method that was used to produce these findings.</p>
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By Jillian Kubala
A new year often signifies a fresh start for many people. For some, this means setting health goals, such as losing weight, following a healthier diet, and starting an exercise routine.
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The Center for Disease Control's (CDC) latest survey found that an increasing number of Americans are taking the wheel under the influence of marijuana, according to a new report released on Thursday.
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Christmas celebrations turned sour when 11 people died and over 300 were hospitalized in the Philippines after drinking a batch of poisonous coconut wine, local police said on Monday.
Having a drink at a holiday party but don't want to have too much?
Why Holiday Boozing Is a Thing<p>While people may binge drink for various reasons during this time of year, people who have higher expectations about the beneficial effects of drinking are more likely to binge.</p><p>In other words, you may be more likely to consume too much if you think it will help you have more fun at a party. Other personality traits and age can also lead to a higher likelihood of binge drinking, Vena says.</p><p>"Social pressure mixed with a brain chemistry deficiency provides a perfect storm for binge drinking," added <a href="https://drshosh.com/" target="_blank">Shoshana Bennett</a>, PhD, a psychologist from California.</p><p><a href="https://www.medicalnewstoday.com/articles/323432.php#1" target="_blank">Research</a> has indicated that having low levels of dopamine may put people at risk for binge drinking.</p><p>"If a larger number of drinks in a short period of time is needed in order to receive the same chemical effect that most people get with one drink, it can easily lead to binge drinking," she added.</p>
Harms of Holiday Drinking<p>Overindulging may only cause a bad hangover, but it can lead to risky decision making, vomiting, and alcohol poisoning — not to mention the effects of intoxicated behavior.</p><p>Frequent binge drinking is a risk factor of alcohol use disorder and can have detrimental effects on numerous organs, including the liver, pancreas, intestines, heart, and brain.</p><p>Binge drinking during the holidays has specifically been linked to a phenomenon known as "holiday heart syndrome," which is a cardiac arrhythmia that occurs in people without a history of cardiovascular problems.</p><p>"Such cases are more prevalent during holidays as a result of increases in excessive alcohol consumption," Koob said.</p>
Prevent Holiday Binge<p>Even if you don't drink enough to be legally drunk, there are a few things you can do to avoid drinking too much:</p><h4>Be Mindful of Your Limits</h4><p>Know how alcohol affects you, and be aware of any medications you're taking that could increase the effects of alcohol.</p><p>While most of us are aware about the dangers of drinking too much, alcohol can lead to a distorted sense of confidence.</p><p>"People might truly believe they're fine to drive, while the truth is they are not," Bennett added. "Sometimes the self-awareness is clear, but embarrassment asking for a ride becomes a barrier."</p><h4>Make a Plan</h4><p>Monitor how much and how quickly you're consuming your drinks. If you know you may drink more than you want to, decide at the beginning of a party how many drinks you'll have and stick with the plan, Koob says.</p><p>A <a href="https://www.rethinkingdrinking.niaaa.nih.gov/" target="_blank">single serving of alcohol</a> is defined as:</p><ul><li>12 ounces of beer with 5 percent alcohol</li><li>5 ounces of wine with 12 percent alcohol</li><li>1.5 ounces of spirits with 40 percent alcohol</li></ul><p>"It is common to accidentally overpour drinks, and the extra alcohol can derail your plans to keep consumption to a minimum," Koob added.</p><h4>Eat Before or While You Drink</h4><p>This can help delay alcohol from entering your bloodstream.</p><p>"This will not prevent someone from becoming intoxicated, but it can slow the absorption of alcohol into the body and reduce the peak amount of alcohol that makes it to the brain," Koob said.</p><h4><span></span>Pace Yourself With Nonalcoholic Drinks</h4><p>Like having a drink in hand? Alternate alcoholic drinks with a glass of water or club soda, Vena suggests. This way, you can still drink but won't be filling up on alcohol so quickly, and can hopefully avoid having too much of it.</p>
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By Marion Nestle
Nature, the prestigious science magazine from Great Britain, has just published a commentary with a provocative title–The toxic truth about sugar—and an even more provocative subtitle—Added sweeteners pose dangers to health that justify controlling them like alcohol.
The authors, Robert Lustig, Laura Schmidt and Claire Brindis, are researchers at the University of California medical center in San Francisco (UCSF).
They argue that although tobacco, alcohol and diet are critically important behavioral risk factors in chronic disease, only two of them—tobacco and alcohol—are regulated by governments to protect public health.
Now, they say, it’s time to regulate sugar. By sugar, they mean sugars plural—sucrose as well as high fructose corn syrup (HFCS). Both are about half fructose.
- Consumption of sugars has tripled over the last 50 years.
- Many people consume as much as 500 calories a day from sugars (average per capita availability in the U.S. is about 400 calories a day)
- High intake of fructose-containing sugars induce metabolic syndrome (high blood pressure, insulin resistance), diabetes, and liver damage.
- Sugars have the potential for abuse.
- Sugars have negative effects on society (mediated via obesity).
- Too much of a good thing can be toxic.
Therefore, they argue, societies should intervene and consider the kinds of policies that have proven effective for control of tobacco and alcohol:
- Distribution controls
- Age limits
- Bans from schools
- Licensing requirements
- Zoning ordinances
- Bans on TV commercials
- Labeling added sugars
- Removal of fructose from GRAS status
In a statement that greatly underestimates the situation, they say:
We recognize that societal intervention to reduce the supply and demand for sugar faces an uphill political battle against a powerful sugar lobby, and will require active engagement from all stakeholders.
But, they conclude:
These simple measures—which have all been on the battleground of American politics—are now taken for granted as essential tools for our public health and well-being. It’s time to turn our attention to sugar.
What is one to make of this? Sugar is a delight, nobody is worried about the fructose in fruit or carrots, and diets can be plenty healthy with a little sugar sprinkled here and there.
The issue is quantity. Sugars are not a problem, or not nearly as much of a problem, for people who balance calorie intake with expenditure.
Scientists can argue endlessly about whether obesity is a cause or an effect of metabolic dysfunction, but most people would be healthier if they ate less sugar.
The bottom line? As Corinna Hawkes, the author of numerous reports on worldwide food marketing, wrote me this morning, “there are plenty of reasons for people to consume less sugar without having to worry about whether it’s toxic or not!”
For more information, click here.