In a health advisory the agency sent out to health care providers, officials said any provider who has such a patient should report the case to local health authorities. The agency added that it is working with the US Food and Drug Administration and state and local partners to investigate the link. But there are already clues: State labs have found “extremely high” levels of lead in certain lots of cinnamon applesauce pouches that have since been recalled by WanaBana, Schnucks, and Weis.

In its initial alert on the recall issued late last month, the FDA said 4  children in North Carolina had been found to have high levels of lead in their blood that was linked to the WanaBana products. Cases of high blood lead levels in children have now been reported in 14 states: Alabama, Arkansas, Louisiana, Maryland, Missouri, New Mexico, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Washington.

The pouches were sold by retailers including Amazon, Dollar Tree, and Sam’s Club. The FDA has warned families not to eat or serve these products and encourages them to throw out the pouches or return them to the store where they bought them for a refund. Caregivers should take any children who may have eaten these products to have blood tests to check for lead exposure, the CDC added.

The companies involved are working to find the source of the contamination in these products, the agency added.

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The Food and Drug Administration (FDA) has approved Amphastar’s New Drug Application (NDA) for naloxone hydrochloride nasal spray 4mg for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression for adult and pediatric patients.

Naloxone hydrochloride nasal spray is an opioid antagonist designed using the Company’s proprietary nasal delivery device. It is a prescription medication intended for immediate administration as emergency therapy in settings where opioids may be present.

The product is supplied as a carton containing 2 unit-dose devices; each device delivers a single spray containing 4mg of naloxone hydrochloride (equivalent to 3.6mg of naloxone). The device is ready to use and does not require priming or testing prior to administration.

Commenting on the FDA nod, Dr Jack Zhang, Amphastar’s President and Chief Executive Officer, said: “The approval of our naloxone hydrochloride nasal spray marks an important step in helping alleviate the opioids crisis as patients can further broaden their access to a critical product.”

References

1. Amphastar Pharmaceuticals receives FDA approval for Naloxone Hydrochloride Nasal Spray 4mg. News release. Amphastar Pharmaceuticals. March 8, 2023. Accessed March 9, 2023. https://ir.amphastar.com/websites/amphastar/English/2110/news-detail.html?airportNewsID=fd568d0c-36f7-43b9-a888-87c8afa3e096.
2. Naloxone Hydrochloride Nasal Spray. Package insert. Amphastar Pharmaceuticals; 2023. Accessed March 9, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/208969s000lbl.pdf.

CSX-1004 works by binding to fentanyl and fentanyl analogs in the bloodstream, thereby sequestering the fentanyl molecules and neutralizing them before they reach the brain. The Fast Track designation was based on nonhuman data demonstrating that a single dose of CSX-1004 could block the respiratory depressant effects of high doses of fentanyl for up to 28 days.

A first-in-human study (ClinicalTrials.gov Identifier: NCT06005402) has been initiated and will evaluate the safety, tolerability, and pharmacokinetics of CSX-1004 in healthy volunteers. The study is expected to enroll 32 individuals aged 18 to 50 years. The investigational treatment will be administered as an intravenous infusion across a range of doses.

“Fast Track designation by the FDA is an important milestone and recognizes the potential for CSX-1004 to help address an unprecedented public health crisis that claims a life every seven minutes in the US,” said Andy Barrett, PhD, Chief Scientific Officer at Cessation. “We are encouraged by the FDA’s decision as it reflects the need for novel treatments that can potentially stem the tide of untimely fentanyl-related deaths.”

This is the second lawsuit that the plaintiffs, the African American Tobacco Control Leadership Council, Action on Smoking and Health and the National Medical Association, have filed against the US Food and Drug Administration over delays in banning menthol cigarettes.

The first lawsuit, filed in 2020, demanded that the FDA add menthol to its list of prohibited flavors for public health reasons. Once the agency began to take action on the issue, that lawsuit was dismissed.

In the latest lawsuit, the groups claim the agency missed a March deadline for issuing a final rule on a menthol ban. Menthol cigarettes are particularly popular in the Black community.

“Because of defendants’ inaction, tobacco companies have continued to use menthol cigarettes to target youth, women and the Black community, all to the detriment of public health,” the lawsuit stated.

“As African American physicians, we are deeply disturbed at the continuing delays in FDA’s finalizing of the ban on menthol cigarettes,” Dr Yolanda Lawson, president of the National Medical Association, said in a news release announcing the lawsuit. “Our patients, more than any other group, become disabled and die prematurely due to the continued use of these cigarettes.”

All flavored cigarettes except menthols were first banned in 2009. The FDA has been considering a menthol ban for more than a decade, CNN reported.

“We’re extremely disappointed to be forced to file this second lawsuit against the FDA in support of protecting Americans from menthol cigarettes,” Laurent Huber, executive director of Action on Smoking and Health, said in the news release. “The FDA’s own research confirms that a menthol ban would save lives; there is no scientific reason to delay finalizing this rule.”

The FDA told CNN that it does not comment on pending litigation, but “remains committed to issuing the tobacco product standards for menthol in cigarettes and characterizing flavors in cigars as expeditiously as possible; these rules have been submitted to [the Office of Management and Budget] for review, which is the final step in the rule-making process.”

But the plaintiffs said the time for action is long past due.

“The relentless and racist tobacco industry targeting has killed too many members of the Black community,” Carol McGruder, co-chair of the African American Tobacco Control Leadership Council, said in the news release. “If Black lives truly matter, then we must end the sale of menthol cigarettes and do it now!”

Studies on the benefits of a menthol ban are plentiful.

Over a 20-year period, it could lower health care costs among all adult smokers by about $1.62 billion, a recent study found. It would also save up to 654,000 lives within 40 years, including 255,000 Black lives, a 2022 study found.

Meanwhile, a 2020 study showed that while 43% of all adult smokers smoked menthols, more than 83% of Black smokers did. But within five years, the elimination of menthol cigarettes could close the gap in lung cancer deaths, another report found.

“The administration continues to miss the opportunity to leave a significant, lasting public health legacy, save lives and reach their Cancer Moonshot goals by not finalizing these rules,” Dr Karen Knudsen, CEO of the American Cancer Society and the Cancer Action Network, said in a news release supporting the move.

The American Lung Association (ALA) is also not part of the lawsuit, but expressed its support.

“The FDA’s findings show that menthol cigarettes are not appropriate for the protection of public health. It is frustrating that the continued delay of the menthol rules compelled our partners to go back to court,” ALA President and CEO Harold Wimmer said in a news release.

The FDA will likely have about two months to respond to the lawsuit in court, the groups’ attorney, Christopher Leung, told CNN.

The White House did not respond to a request for comment on the lawsuit, CNN reported.

More information

The American Lung Association has more on menthol cigarettes.

SOURCES: African American Tobacco Control Leadership Council, Action on Smoking and Health and the National Medical Association, news release, April 1, 2024; CNN

Gregory Yates and Emily Melon, from Manchester Royal Infirmary in the United Kingdom, gathered descriptive data on the use of psychedelic trip killers by analyzing posts made on Reddit, a publicly available, anonymous social media website. A total of 128 relevant threads were identified from 2015 to 2023, yielding 709 posts.

The researchers found that the most commonly recommended trip killers were benzodiazepines and antipsychotics (46 and 18%, respectively). Trip killers were mainly discussed in reference to lysergic acid diethylamide, psilocybin mushrooms, and 3,4-methylenedioxymethamphetamine (235, 143, and 21, respectively). Of the posts, only 58 included warnings relating to the potential adverse effects of trip killers.

“We recommend that emergency physicians ask patients about trip killers if psychedelic drug use is suspected. This conversation should occur promptly on arrival to hospital, and before any benzodiazepines or antipsychotics are prescribed,” the authors write. “Doing so could offset an indirect risk to these patients, iatrogenic overdose, and will improve understanding of their mixed toxidrome.”

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Called the Challenge to Save Lives from Overdose, the initiative urges organizations and businesses to commit to train employees on how to use opioid overdose medications, to keep naloxone in emergency kits and to distribute the drug to employees and customers so they might save a life at home, work or in their communities.

“Today, we’re calling on organizations and businesses, big and small, public and private, across the country to help ensure all communities are ready to use this lifesaving tool to reduce opioid deaths,” the White House said in a fact sheet announcing the new initiative. “As the drug supply has gotten more dangerous and lethal, we’re asking allies to join us because we all must do our part to keep communities safe.”

Naloxone, sometimes sold under the brand name Narcan, is a medication that can rapidly reverse the effects of an opioid overdose. Research has shown that using the nasal spray doesn’t call for medical expertise and requires only minimal training.

In March 2023, the US Food and Drug Administration approved an over-the-counter Narcan spray, following that in July with the approval of the first generic nasal spray. Americans can now buy the sprays at pharmacies, grocery stores and vending machines.

Still, public health officials say naloxone can be hard to find and the price can be prohibitive for some, CNN reported.

Organizations that have already answered the White House challenge include the American Library Association, which is providing libraries with overdose response training for staff members and the public, as well as supporting the distribution of naloxone and overdose aid kits to the public, the White House said.

Meanwhile, Southwest Airlines has put naloxone in emergency medical kits on 65% of its planes and plans to stock 100% of its medical kits by the end of the year.

The need for naloxone is great: Overdose deaths spiked 30% between 2019 and 2020 and another 15% between 2020 and 2021, according to the U.S. Centers for Disease Control and Prevention, and synthetic opioids like fentanyl fueled the increase.

And provisional data published by the CDC in February suggests 2023 will be no different: More than 111,000 people died from a drug overdose in the 12-month period ending last September. Synthetic opioids, primarily fentanyl, were involved in more than two-thirds of those deaths.

More information

The National Institute on Drug Abuse has more on naloxone.

SOURCE: White House, news release, March 13, 2024; CNN

Faculty and students should be prepared to use it to help others, Rahul Gupta, MD, director of the White House Office of Drug Control Policy, and Miguel Cardona, secretary of education, said in a joint letter to educators. “We want to share resources that could help your school and community prevent drug use before it begins and keep students alive long enough to get the help they need in the event of an overdose or poisoning,” Gupta and Cardona wrote.

More than 5000 children and teens have died of drug overdoses involving fentanyl in the past 2 decades, according to data published recently in JAMA Pediatrics. More than half of those deaths occurred during the first 2 years of the COVID-19 pandemic. About 1500 children and teens died from fentanyl in 2021. That was 30 times higher than in 2013, when opioid deaths in the US began to rise. Most pediatric deaths from fentanyl are in 15- to 19-year-olds.

“A teenager today can log onto social media with a smartphone and buy what they think is an opioid pain medicine or a prescription stimulant to help them study — and instead die from one pill that actually has fentanyl in it,” Gupta and Cardona emphasized in their letter.

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HealthDay News — During the COVID-19 pandemic in 2020, 2021, and 2022, the mean weekly cannabis-involved emergency department visit rates among young persons were higher than the corresponding periods in 2019, according to research published in the July 14 issue of the US Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Douglas R. Roehler, PhD, from the CDC in Atlanta, and colleagues used National Syndromic Surveillance Program data to examine changes in cannabis-involved emergency department visits among young persons (younger than 25 years) during 2019 to 2022.

The researchers found that among all young people, mean weekly cannabis-involved emergency department visits were higher during the COVID-19 pandemic in 2020, 2021, and 2022 compared with corresponding periods in 2019. Among persons aged 10 years and younger, there were large increases seen in cannabis-involved emergency department visits throughout the COVID-19 pandemic compared with prepandemic surveillance periods in 2019. Among children and adolescents aged 11 to 14 years, emergency department visit rates did not differ by sex until the first half of the 2020-2021 school year when emergency department visit rates among females surpassed those among males.

“Cannabis-involved emergency department visits among young persons increased during the COVID-19 pandemic and remained elevated above prepandemic levels,” the authors write. “To protect against unintentional ingestions of cannabis, it is important for adults who use cannabis to safely and securely store cannabis products in places inaccessible to children.”

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HealthDay News — From 2018 to 2021, there was an increase in the age-adjusted rate of drug overdose deaths involving xylazine, from 0.03 to 1.06 per 100,000 standard population, according to a June Vital Statistics Rapid Release report, a publication from the US Centers for Disease Control and Prevention.

Merianne Rose Spencer, MPH, from the National Centers for Health Statistics in Hyattsville, Maryland, and colleagues identified drug overdose deaths involving xylazine for US residents from 2018 through 2021 overall and by sex.

The researchers found that from 2018 to 2021, the age-adjusted rate of drug overdose deaths involving xylazine increased from 0.03 to 1.06 per 100,000 standard population. For each year between 2018 and 2021, the rates for males were at least twice that of females. The rates increased across all age group and reportable race and Hispanic origin categories between 2020 and 2021. Rates were highest among those aged 25 to 34 and 35 to 44 in 2020, while in 2021, the highest rates were seen for those aged 35 to 44. The highest rates were seen among non-Hispanic Black or African American people in 2020 and 2021 (0.68 and 1.82, respectively). However, compared with other groups, the largest increases in rates occurred among Hispanic or Latino people (0.21 and 0.64 in 2020 and 2021, respectively). The most frequently co-occurring drug mentioned on xylazine death records between 2018 and 2021 was fentanyl.

“This study highlights the increase in drug overdose deaths involving xylazine since 2018,” the authors write. “Overall, the age-adjusted rate of drug overdose deaths involving xylazine increased 35 times.”

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Benjamin Q. Huynh, PhD, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues examined the extent of lead-contaminated drinking water in Chicago and modeled its impact on children younger than 6 years in a cross-sectional study. Tests were obtained from households in Chicago that registered for a free self-administered testing service for lead exposure; 38,385 household tests were collected.

The researchers found that an estimated 68% of children younger than 6 years (corresponding to 129,000 children) were exposed to lead-contaminated water. A 10% increase in block-level Black and Hispanic populations was associated with decreases of 3 and 6%, respectively, in the odds of being tested for lead and with increases of 4 and 11%, respectively, in having lead-contaminated drinking water.

“Levels of widespread childhood lead exposure, such as those found in this study, are symptomatic of structural marginalization and are likely preventable through large-scale interventions to replace lead service lines and improve access to testing,” the authors write. “The benefits of harm-reduction strategies, such as lead filtration technology and anticorrosive agents to prevent lead leaching into water, should also be studied and explored.”

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Pharmacist Gets Prison Time for Illegally Selling Prescription Cough Syrup

A Michigan pharmacist has been sentenced to 3 years in federal prison for illegally dispensing promethazine cough syrup. The pharmacist ordered more than $2.5 million dollars worth of the prescription syrup from various wholesale distributors and then sold it to drug dealers. When consumed at higher than recommended dosages, promethazine cough syrup can produce tranquilizing and euphoric effects. On the illegal street market, the drug is often referred to as “Green Drink” or “Purple Drink.” The pharmacist was ordered to forfeit approximately $9 million dollars of his earnings from these illegal transactions. 

Doctor Fraudulently Issues Over 500 Prescriptions for Opioids

A former doctor from Texas was sentenced to 30 months in federal prison for dispensing controlled substances without a legitimate medical purpose. The doctor admitted that he fraudulently issued more than 500 prescriptions, most of which were for opioids, in the names of family members (both living and deceased), former patients and other individuals after his medical license had expired and then been suspended. He then conspired with others to distribute the medications to unknown individuals.

Distributing Misbranded Drug Lands Clinician in Hot Water

A doctor from Louisiana was charged with distributing misbranded drugs, including medroxyprogesterone. According to the US Attorney’s Office, Eastern District of Louisiana, the physician had introduced the misbranded drugs, which lacked adequate directions for use, into interstate commerce between April 2018 and March 2023. A conviction could result in 1 year of prison time for the doctor and up to 1 year of supervised release.

Doctor Establishes Pain Management Clinic for Unlawful Purposes

A Florida doctor has been convicted of unlawfully dispensing and distributing controlled substances. The doctor established a pain management clinic from which he then issued prescriptions for controlled substances such as oxycodone, morphine, and alprazolam to patients without a legitimate medical need. Some prescriptions were even prewritten and handed to office managers to sell for cash payments of $250 to patients. Data from Florida’s prescription drug monitoring program showed that the doctor prescribed opioids to more than 1000 patients, almost a third of whom were found to have criminal records related to drug dealing.

Two Doctors Rack Up Multiple Charges for Illegal Ketamine Administration

Two Missouri doctors, a psychiatrist and an internal medicine specialist, were indicted and accused of illegally administering ketamine to patients. Though the psychiatrist was authorized by the Drug Enforcement Administration (DEA) to administer controlled substances, the clinic that was set up to provide the intravenous ketamine infusions for patients with serious mental health illnesses was not registered for this type of treatment. The indictment also alleges that the psychiatrist allowed the internal medicine specialist to use his DEA registration to administer ketamine infusions and esketamine nasal spray without direct supervision and that the ketamine and esketamine were unlawfully stored in the facility. The internal medicine specialist was also charged with Medicare fraud because he falsely used the psychiatrist’s name to bill for the services.

Foot Bath Medication Scheme Lands Podiatrist in Hot Water

A podiatrist from Tennessee was convicted of 5 counts of health care fraud related to a scheme where he prescribed and dispensed medically unnecessary foot bath medications.  The podiatrist owned and operated a podiatry clinic and 2 in-house pharmacies; these pharmacies submitted nearly $4 million in claims to Medicare and TennCare for dispensing expensive antibiotic and antifungal drugs to be mixed into a tub of water for patients to soak their feet. These medications, which were dispensed as capsules, creams, and powders, were not even water soluble. The pharmacies were reimbursed over $3 million for these unnecessary treatments. The podiatrist faces up to 10 years in prison on each count of fraud.

Nurse Practitioner Trades Opioids for Money, Sex, and Fame 

A Tennessee nurse practitioner (NP) was sentenced to 20 years in prison for illegally prescribing medically unnecessary controlled substances to patients through his medical practice. Known locally as the “Rock Doc”, the NP prescribed more than 100,000 doses of hydrocodone, oxycodone, and fentanyl to his patients, including a pregnant woman. According to the US Attorney’s Office for the Western District of Tennessee, the NP maintained “a party-type atmosphere” at his medical practice and was known to engage in inappropriate physical relationships with some of his female patients. It is believed that part of the reason he prescribed these drugs was to improve his popularity on social media and promote a self-produced reality TV show pilot.

Drug Dealing Pharmacist Gets Prison Time for Unlawful Distribution

A Michigan pharmacist was sentenced to 8 years and 4 months in federal prison for filling fake prescriptions for controlled substances that totalled over 300,000 dosage units. These prescriptions were issued by a local doctor who was charged with unlawfully writing for controlled substances. The doctor pleaded guilty to the charge but died before sentencing. The pharmacist made over $780,000 from the distribution of these drugs from her pharmacy; the estimated street value was reported to be between $1.8 and $3.3 million. In addition to prison time, she was ordered to forfeit the proceeds of her drug dealing scheme.

Doctor Writes Undercover Agent Opioid Rx Without Legit Medical Purpose

A California doctor was sentenced to 1 year and 1 day in federal prison for distributing opioids outside the scope of medical practice. The internal medicine physician operated her practice from her home and was authorized to prescribe controlled substances. Concerning information obtained from a family member of one of the doctor’s former patients prompted an investigation into the doctor’s prescribing practices. An undercover agent was sent to her home complaining of leg pain and asking for hydrocodone 10mg tablets. The doctor prescribed the undercover agent 60 high dose hydrocodone tablets. No physical examination was conducted and no follow-up questions were asked; the doctor did not obtain medical records or provide an alternative treatment plan. In court, the doctor admitted that she knew she was prescribing an addictive medication outside the usual course of medical practice. According to the US Attorney’s Office of the Northern District of California, the doctor wrote these prescriptions in exchange for cash and street drugs, including cocaine and methamphetamine. In addition to her prison sentence, she was ordered to forfeit her medical license and pay a $4000 fine.

Physician Forks Over Thousands of Dollars for Genetic Testing Scheme

A Pennsylvania physician was ordered to pay a large sum of money for violating the False Claims Act by ordering unnecessary genetic testing for Medicare beneficiaries. The doctor referred more than 400 patients, with whom he had no medical relationship with, for these medically unnecessary genetic tests. Most referrals were done through brief telemedicine consultations and some were done without consultation at all. These genetic tests were reported to cost thousands of dollars per patient and were paid for by Medicare. According to the US Attorney’s Office for the Eastern District of Pennsylvania, the physician is responsible for paying $95,000 to resolve the allegations. Commenting on the case, Maureen R. Dixon, Special Agent in Charge for the US Department of Health and Human Services, Office of the Inspector General, Region III, said: “Accurately billing for services provided to Medicare beneficiaries is required of all health care providers. HHS-OIG and the US Attorney’s Office will continue to evaluate and pursue allegations of medically unnecessary services.”

On Tuesday, Cadden pleaded no contest to the charges against him, the Associated Press reported.

His sentence will be served concurrently with the 14 1/2-year sentence he is already serving under a federal conviction for fraud and other crimes.

Cadden co-founded the New England Compounding Center in Massachusetts. Twelve years ago, about 100 people died and 800 in total were made ill across 20 states after receiving injections of mold-contaminated steroids sourced from the company. Most had needed the injections for back pain.

Speaking in a federal court in Boston in 2017, Cadden said: “I am sorry for the whole range of suffering that resulted from my company’s drugs,” the AP reported.

At the time, prosecutors said Cadden’s company failed consumers in multiple ways, cutting back on lab disinfecting, shipping products before testing they were safe and ignoring repeated warnings about the safety of methods used in the lab. All of this was done to save the company costs, prosecutors said.

Cadden appeared Monday in Livingston County court, northwest of Detroit. He pleaded no contest to each of the 11 counts of involuntary manslaughter leveled against him, one for each Michigan resident who died, according to the AP.

“Patients must be able to trust their medications are safe, and doctors must be assured they aren’t administering deadly poison,” Michigan Attorney General Dana Nessel told the AP.

A criminal case for the company’s pharmacist, Glenn Chin, is pending. His next court date is set for March 18, the AP said.

More information

Find out more about meningitis at the Mayo Clinic.

SOURCE: Associated Press

What This Means for You

The co-founder of a Massachusetts drug company behind a deadly 2012 meningitis outbreak was sentenced to up to 15 years in prison by a Michigan judge.

HealthDay News — Deaths due to opioid toxicity increased during the COVID-19 pandemic, according to a study published online July 7 in JAMA Network Open.

Tara Gomes, PhD, from St. Michael’s Hospital in Toronto, and colleagues characterized the societal burden of unintended opioid-related deaths in the US. The proportion of all deaths that were attributable to unintentional opioid toxicity were examined by year and age group. In addition, the total years of life lost (YLL) due to unintentional opioid toxicity was estimated, overall, and by sex and age group.

Data were included for 422,605 unintentional deaths due to opioid toxicity between 2011 and 2021. The researchers found that there was a 289% increase in the number of unintentional deaths due to opioid toxicity, from 19,395 to 75,477. From 2011 to 2021, the percentage of all deaths that were attributed to opioid toxicity increased from 1.8 to 4.5%. By 2021, opioid toxicity was responsible for 10.2, 21.7, and 21.0% of deaths among those aged 15 to 19, 20 to 29, and 30 to 39 years, respectively. Over the study period, the YLL due to opioid toxicity increased 276%. YLL plateaued between 2017 and 2019 (7.0 and 7.2 YLL per 1000) but then increased by 62.9% between 2019 and 2021, reaching 11.7 YLL per 1000.

“The crisis of deaths due to opioid toxicity across the U.S. worsened substantially during the COVID-19 pandemic, with 1 in 22 deaths in 2021 attributable to unintentional opioid toxicity,” the authors write

One author disclosed past employment with Sanofi Pasteur.

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Blake Thomson, DPhil, and Farhad Islami, MD, PhD, from the American Cancer Society in Atlanta, examined the association between years since quitting smoking and mortality. Self-reported current and never smokers were compared to former smokers who had quit 1 to 9, 10 to 19, 20 to 29, and 30 or more years before recruitment for cardiovascular, cancer, and respiratory deaths at ages 25 to 89 years.

The researchers identified 11,860 cardiovascular, 10,935 cancer, and 2060 respiratory deaths during 5.0 million person-years of follow-up in the 438,015 included adults. The current versus never smoker rate ratios were 2.30, 3.38, and 13.31 for cardiovascular, cancer, and respiratory mortality, respectively. Former smokers avoided an estimated 64, 53, and 57% of excess cardiovascular, cancer, and respiratory mortality associated with current smoking within the first decade after quitting, respectively, with further benefits accruing over time. Little to no excess cardiovascular mortality was seen at 20 to 29 years after quitting among former smokers. Former smokers avoided an estimated 100, 93, and 97% of the excess cardiovascular, cancer, and respiratory mortality associated with continued smoking after 30 or more years of smoking cessation, respectively.

“These findings emphasize that with sustained cessation, cause-specific mortality rates among former smokers may eventually approximate those of never smokers,” the authors write.

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(HealthDay News) —There is no evidence of an association between legal changes that removed or substantially reduced criminal penalties for drug possession in Oregon and Washington and subsequent fatal drug overdose rates, according to a study published online Sept. 27 in JAMA Psychiatry.

Spruha Joshi, PhD, MPH, from New York University in New York City, and colleagues examined whether laws that fully or partially decriminalized drug possession in Oregon and Washington were associated with fatal drug overdose rates 1 year postimplementation. Using a synthetic control method approach, rates were compared to those in 48 states and the District of Columbia that did not implement similar policies during the study period (Jan 1, 2018, to March 31, 2022).

The researchers found that following the implementation of Measure 110, absolute monthly rate differences between Oregon and its synthetic control were not statistically significant (probability, 0.26). Postimplementation, the average rate difference was 0.268 fatal drug overdoses per 100,000 state population.

Results were similar in Washington, with a nonsignificant difference in the absolute monthly rate differences between Washington and synthetic Washington following the Supreme Court decision in State v. Blake (probability, 0.06), with an average rate difference postimplementation of 0.112 fatal drug overdoses per 100,000 state population.

“Additional research could examine potential other outcomes as well as longer-term associations with fatal drug overdose overall and across racial and ethnic groups,” the authors write.

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HealthDay News — Specific health care workers have an increased risk for drug overdose death, according to a study published online August 8 in the Annals of Internal Medicine.

Mark Olfson, MD, MPH, from the Mailman School of Public Health at Columbia University in New York City, and colleagues conducted a prospective cohort study involving 176,000 health care workers and 1,662,000 non-health care workers aged 26 years or older surveyed in 2008 and followed through 2019 for cause of death. Drug overdose deaths were determined for physicians, registered nurses, other treating or diagnosing health care workers, health technicians, health care support workers, and social or behavioral health workers and non-health care workers.

The researchers found that during follow-up, about 0.07% of the study sample died of a drug overdose. The annual standardized rates of drug overdose death per 100,000 persons ranged from 2.3 to 15.5 for physicians and social or behavioral health workers, respectively, among health care workers. The adjusted hazards of total drug overdose deaths were significantly increased for social or behavioral health workers, registered nurses, and health care support workers, but not for physicians, other treating or diagnosing health care workers, or health technicians compared with those for non-health care workers. For opioid-related overdose deaths and unintentional overdose deaths, the results were generally similar.

“Our study suggests that certain groups of health care workers, specifically registered nurses, social or behavioral health workers, and health care support workers, are at increased risk for drug overdose death, indicating the need to identify and intervene on those at high risk,” the authors write.

Abstract/Full Text (subscription or payment may be required)