Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010–2014

December 20, 2016
Dr. Margaret Warner, Senior Epidemiologist

Dr. Margaret Warner, Senior Epidemiologist

Questions for Margaret Warner, Senior Epidemiologist  and Lead Author on “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010–2014.”

Q: Why did you decide to do a report on drugs most frequently involved in drug overdose deaths?

MW: From our routine mortality statistics, we know that drug overdose death rates are increasing, and we have some insight into the classes of drugs involved. This report presents findings from a new method we developed to identify the specific drugs involved in drug overdose deaths, which gives us a more complete and granular understanding of the problem.

Q: Do you have 2015 data on drug overdose deaths? If not, when do you anticipate this being released?

MW: NCHS just released the 2015 mortality data at the beginning of December. CDC released an MMWR last week describing drug overdose deaths in 2015 and some of the drug classes involved. NCHS is currently analyzing the 2015 literal text data using the new method to report on the specific drugs, and plan to have those results available soon.

Q: How has the number of drug overdose deaths changed from 2010 to 2014?

MW: From 2010 through 2014, the number of drug overdose deaths per year increased 23%. During this 5-year period, the age-adjusted rate of drug overdose deaths involving heroin more than tripled, and the rate of drug overdose deaths involving methamphetamine more than doubled.

The rate of drug overdose deaths involving fentanyl more than doubled in a single year (from 2013 to 2014). Fentanyl went from the 9th most common drug involved in overdose deaths in 2013 to the 5th most common in 2014.

Q: What are the most prevalent drugs involved in drug overdose deaths?

MW: The 10 drugs most frequently involved in overdose deaths included the following opioids: heroin, oxycodone, fentanyl, morphine, methadone, and hydrocodone; the following benzodiazepines: alprazolam and diazepam; and the following stimulants: cocaine and methamphetamine.

Q: Were there any findings that surprised you?

MW: We suspected that multidrug toxicity played a role in drug overdose deaths, and this analysis revealed that nearly half of these deaths where at least one drug was mentioned on the death certificate, involved more than one drug. We were surprised that the top 10 drugs were often mentioned in combination with each other. We were also pleasantly surprised to find that the reporting on specific drugs improved with the percentage of death certificates mentioning at least one specific drug increasing from 67% in 2010 to 78% in 2014.

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QuickStats: Use of Equipment or Assistance for Getting Around Among Persons Aged 50 Years or Older — National Health Interview Survey, 2014–2015

December 19, 2016

In 2014–2015, 13.9% of persons aged 50 years or older used equipment or received assistance for getting around. Specifically, 9.6% of persons aged 50 years or older used a cane or walking stick, 5.8% used a walker or Zimmer frame, and 5.3% had assistance from another person.

Wheelchairs or scooters were used by 3.5%, crutches by 0.7%, and artificial limbs by 0.6%.

Source: https://www.cdc.gov/mmwr/volumes/65/wr/mm6549a7.htm

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Confidentiality Concerns and Sexual and Reproductive Health Care Among Adolescents and Young Adults Aged 15–25

December 16, 2016

Confidentiality concerns can impact adolescent and young adults’ access to sexual and reproductive health services. Young people who are covered by their parents’ private health insurance may be deterred from obtaining these services due to concerns that their parents might find out about it.  Similarly, confidentiality concerns may arise because youth seeking such services may not have time alone during a visit with a health care provider.

A new NCHS report describes two measures related to confidentiality concerns and sexual and reproductive health care.

Findings:

  • About 7% of persons aged 15–25 would not seek sexual or reproductive health care because of concerns that their parents might find out about it.
  • For females aged 15–17 and 18–25, those who had confidentiality concerns were less likely to receive sexual and reproductive health services in the past year compared with those without these concerns.
  • Less than one-half of teenagers aged 15–17 (38.1%) spent some time alone in the past year during a visit with a doctor or other health care provider without a parent, relative, or guardian in the room.
  • Teenagers aged 15–17 who spent some time alone during a visit with a health care provider were more likely to have received sexual or reproductive health services in the past year compared with those who had not.

 

 

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Mortality in the United States, 2015

December 8, 2016

Questions for Jiaquan Xu, Epidemiologist and Lead Author on “Mortality in the United States, 2015.”

Q: Is it true that death rates in the U.S. have been increasing over the past few years?

JX: Not exactly. The age-adjusted death rate for total US population increased 1.2% from 724.6 per 100,000 standard population in 2014 to 733.1 in 2015. This was the first significant increase since 1999. We have seen the decrease in mortality for most race/ethnic groups in most of years since 2006. Especially the rates decreased significantly for all male, all female, non-Hispanic white male, non-Hispanic white female, non-Hispanic black male, non-Hispanic black female, Hispanic male, and Hispanic female in 2014 from 2013.

Q: What are some of the reasons why the death rate increased between 2014 and 2015?

JX: We don’t know exactly what caused the increase in mortality in the United States from 2014 to 2015. The results have shown that the age-adjusted death rates increased for 8 (heart disease, chronic lower respiratory, unintentional injuries, stroke, Alzheimer’s disease, diabetes, kidney disease, and suicide) of the 10 leading causes of death. Only decrease in mortality among 10 leading causes of death in 2015 from 2014 was for cancer. Death rates increased significantly for 20 states and decreased for 1. The change for the rest of states were not significant.

Q: Do your findings for 2015 suggest we have reached a peak as far as increases in life expectancy goes?

JX: We don’t think we have reached a peak in life expectancy. Many people died of non-age-related causes because they have aged. Those deaths are preventable. For example, there are 146,571 deaths caused by accidents which accounted for 5.4% of total deaths in 2015. About 65% of deaths from these unintentional injuries were those aged under 65. Among accidental deaths, unintentional poisoning accounted for 32.4 % and motor vehicle traffic accidents accounted for 24.5%. We also don’t know if the increase in mortality in 2015 will continue in 2016. But preliminary data have shown that the mortality for most of the 10 leading causes of death in 2015 went down in second quarter from first quarter, 2016 (http://www.cdc.gov/nchs/products/vsrr/mortality-dashboard.htm#trends). But it is too early to say that the mortality in 2016 will go down or continue going up. We will see what happens when the 2016 final file is available.

Q: What accounts for the decline in life expectancy at birth in 2015 from 2014?

JX: For the total US population, life expectancy decreased 0.1 year from 78.9 years in 2014 to 78.8 in 2015, mainly because of increases in mortality from the 13 causes of death among the 15 leading causes of death, such as heart disease, chronic lower respiratory disease, unintentional injuries, stroke, Alzheimer’s disease, diabetes, kidney disease, suicide, septicemia, , chronic liver disease, hypertension, Parkinson’s disease, and pneumonitis due to solids and liquids. From 2014 to 2015, life expectancy decreased 0.1 year for females largely because of increases in mortality from 12 of 15 leading causes of death such as heart disease, chronic lower respiratory disease, stroke, Alzheimer’s disease, unintentional injuries, influenza and pneumonia, septicemia, hypertension, chronic liver disease, Parkinson’s disease, suicide, and pneumonitis due solids and liquids. The deaths from those 12 leading causes of death accounted for 52.9% of total female deaths.

Life expectancy declined 0.2 year for males largely because of increases in mortality from 11 of 15 leading causes of death such as unintentional injuries, chronic lower respiratory disease, stroke, diabetes, suicide, Alzheimer’s disease, chronic liver disease, septicemia, Parkinson’s disease, Homicide, and hypertension. And about 65% of accidental deaths were under 65 years old, while 81% of suicides were aged 15-64, and 95% of homicides were under 65 years. More young people dying from preventable causes drags life expectancy down.

Q: Is it unusual that mortality rates for so many leading causes of death increased in 2015?

JX: We haven’t seen the increase in mortality from so many leading causes of death for a long time. The age-adjusted death rates increased significantly for 3 of 10 leading causes of death in 2014, 2 in 2013, 1 in 2012, and 5 in 2011. It is an unusual year. Again we don’t know why.

Q: Does the increase in mortality among white females suggest another drop in life expectancy for that group?

JX: We don’t have life expectancy numbers for white females yet. It is possible that the life expectancy numbers in 2015 for white women will drop again in 2015 since the life expectancy decreased 0.1 year for all females in 2015 from 2014 and mortality from 12 of 15 leading causes of death for white females increased significantly in 2015 from 2014 (heart disease, chronic lower respiratory diseases, Alzheimer’s disease, stroke, unintentional injuries, diabetes, influenza and pneumonia, hypertension, chronic liver disease, Parkinson’s disease, suicide, pneumonitis due to solids and liquids).

 

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Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015

December 6, 2016
Maria A. Villarroel, Ph.D., Health Statistician

Maria A. Villarroel, Ph.D., Health Statistician

Questions for Maria A. Villarroel, Ph.D., Health Statistician and Lead Author on “Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015.”

Q: Why did you decide to look at vaccination coverage with diagnosed diabetes?

MV: Persons with diabetes are at an increased risk for complications from vaccine-preventable infections, and a number of these of vaccines are recommended for adults living with diabetes. We wanted to examine the vaccine coverage among different segments of adults with diagnosed diabetes. This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status.

Q: Overall, which vaccinations were more prevalent for adults with diagnosed diabetes?

MV: We examined vaccination coverage for influenza, pneumococcal, hepatitis B and shingles among adults with diagnosed diabetes. Among adults aged 18 and over with diagnosed diabetes, influenza vaccination (61.6%) was more prevalent than pneumococcal (52.6%) and hepatitis B (17.1%) vaccination. The shingles vaccine is indicated for those aged 60 and older and we found that fewer than 3 in 10 (27.2%) adults aged 60 and over with diagnosed diabetes had been vaccinated for shingles.

Q: How did the vaccination rates for adults with diagnosed diabetes vary by age?

MV: We compared vaccination coverage for influenza, pneumococcal and hepatitis B among adults diagnosed with diabetes who were aged 18-44, 45-59, 60-74 and 75 and over. Vaccination coverage was not the same across age groups. Vaccination for influenza and pneumococcal disease increased with age. In contrast, vaccination for Hepatitis B decreased with age. We also examined vaccination coverage for shingles among adults aged 60 and over, and those who were aged 75 and over were likely to have been vaccinated than those aged 60-74.

Q: How did the vaccination rates for adults with diagnosed diabetes vary by race and ethnicity?

MV: We compared vaccination coverage among adults with diagnosed diabetes who were Hispanic, Non-Hispanic white, non-Hispanic black and Non-Hispanic Asian. Non-Hispanic white adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza in the past year and to have ever been vaccinated for pneumococcal disease and shingles at some point in the past. Non-Hispanic Asian adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza, but these groups did not differ from one another on pneumococcal and shingles vaccination.

Q: Were there any findings that surprised you?

MV: It was surprising to see the difference in the vaccination coverage for vaccines that are recommended for all adults with diabetes. In addition to differences by age and race and ethnicity, we observed wide differences in vaccination coverage by income status. Adults with diagnosed diabetes who were not living in poverty were consistently the most likely group to have been vaccinated for influenza, pneumococcal disease, hepatitis B, and shingles. From other reports, diagnosed diabetes is more common among poor and near poor adults, yet this report showed that these group are the least likely to get vaccinated.

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QuickStats: Percentage of Adults Who Cannot or Find It Very Difficult to Stand or Be on Their Feet for About 2 Hours Without Using Special Equipment

December 2, 2016

A reported 10.2% of adults aged 18 years or older cannot, or find it very difficult to, stand or be on their feet for about 2 hours without using special equipment.

The percentage of adults who reported this difficulty increased with age: 2.9% of those aged 18–44 years, 11.8% of those aged 45–64 years, 19.1% of those 65–74 years, and 33.2% of those aged 75 years or older.

Overall, women were more likely (11.9%) than men (8.3%) to report this difficulty, and higher percentages were noted for women within each age group.

https://www.cdc.gov/mmwr/volumes/65/wr/mm6547a6.htm

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