Wednesday, September 22, 2021

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Opioid addiction kills as many people in U.S. as heart attack, study says


By HealthDay News


People who have been hospitalized with opioid addiction-related issues in the United States die at rates similar to those for heart attack, according to new research. File Photo by chuck stock/Shutterstock

Hospitalized opioid addicts die at a rate similar to people who have a heart attack after leaving the hospital.

Nearly 8% of patients addicted to opioids died within 12 months of hospital discharge, according to researchers from Oregon Health & Science University.

"We need systems that can address comprehensive needs of people with substance use disorder and serious medical illness," said study co-author Dr. Honora Englander. She is an associate professor of medicine at OHSU in Portland.

"That means trauma-informed systems that destigmatize addiction to make health care systems more trustworthy and more effective for our patients," Englander explained in a university news release.

RELATED Rising number of U.S. cardiac arrests linked to opioid abuse, study says

The study looked at data on more than 6,600 Medicaid patients treated in Oregon hospitals between April 2015 and December 2017.

Drug-related causes, including overdoses, accounted for 58% of the 522 deaths that occurred within a year of leaving the hospital.

The other deaths were from diseases of the circulatory, respiratory and endocrine systems, the researchers found.

RELATED Study: Some seniors at increased risk for opioid misuse after hip surgery

According to study co-author Caroline King of OHSU's department of biomedical engineering, "A lot of the research has focused on overdose deaths.

We found that overdoses are really just the tip of the iceberg for these patients, representing 13% of deaths in the year after discharge."

A one-year death rate of 8% is similar to that from conditions like a heart attack.

Englander pointed out that, "for heart attacks, hospital systems across the U.S. have universally accepted standards, metrics, and quality reporting that drives performance. The same should be true for opioid use disorder, where death rates are similar."

King said health systems need to do a better job of integrating and removing the stigma from the medical care these patients need.

And, Englander stressed, "It should be easier to access methadone than heroin. Right now, that is not the case -- systems are such that people have to work so hard just to get life-saving treatment."

The findings were published online recently in the Journal of Addiction Medicine.

More information

There's more about opioid addiction at the U.S. National Institute on Drug Abuse.

Copyright © 2021 HealthDay. All rights reserved.

Animal sedative driving rise in fatal drug overdoses, CDC says

The animal sedative xylazine is increasingly being seen as a driver behind drug overdose deaths in the United States, the CDC said in a recent report.


An animal tranquilizer, xylazine, is increasingly linked to drug overdose deaths across the United States, health officials say.

According to a new report from the U.S. Centers for Disease Control and Prevention, xylazine has turned up in overdose deaths in 25 of 38 states examined.

In 2019, xylazine contributed to death in 64% of cases and almost always also involved fentanyl.

The drug is mixed with opioids, such as fentanyl or heroin, to enhance their effects, but this cocktail can increase sedation and respiratory depression.

RELATEDAnimal tranquilizer driving deadly rise in opioid ODs in Philadelphia

That, in turn, increases the risk of a fatal overdose, CDC researchers explained.

"The detection of xylazine in multiple jurisdictions is concerning and warrants continued surveillance to inform overdose response and prevention efforts given that naloxone administration may not be as effective when xylazine is mixed with opioids," wrote Mbabazi Kariisa, from CDC's division of overdose prevention at the National Center for Injury Prevention and Control, and colleagues.

The drug naloxone can reverse effects of an opioid overdose, but xylazine is not an opioid, so naloxone may not work well in these users.

RELATEDDrug overdose deaths up nearly 30% in U.S. during pandemic-scarred 2020

Still, since xylazine is usually paired with opioids, it should always be given, Kariisa said.

"As there is no pharmaceutical antidote for xylazine, immediate supportive care such as respiratory and cardiovascular support is especially critical," Kariisa said.

Xylazine is used in veterinary medicine to sedate animals and is not meant for use in humans.

Another report in Friday's issue of the CDC's Morbidity and Mortality Weekly Report, highlighted the increase of xylazine overdose deaths in Connecticut.

Between 2019 and July 2020, deaths from the combination of fentanyl with xylazine rose from 6% to 11%, the researchers reported.

Pat Aussem is associate vice president at the Partnership to End Addiction. She said, "People who use xylazine may unknowingly consume it, as it can be added to the drug supply either to enhance drug effects or as a cutting agent to increase volume and reduce costs."

Combined with opioids, xylazine's sedating effects, especially at bedtime, seem to be part of the appeal for people who seek it out, hence the slang name "sleep cut" or "tranq," she noted.

"The combination of opioids and xylazine increases the risk of an overdose, as both drugs are central nervous system depressants. It can depress breathing, blood pressure and heart rate to dangerous levels or result in a fatality," Aussem said.

Special care may be needed if xylazine is involved in an overdose, she added, since naloxone's effectiveness may be diminished.

"Calling 911 is always important when a suspected overdose occurs, but maybe more so for supportive respiratory and cardiovascular care related to xylazine," Aussem said.

"Xylazine also appears to cause painful skin ulcers, so keeping wounds clean and/or getting professional treatment may be needed," Aussem said.

People using substances and the health care providers who work with them need to be educated on additives and their harmful effects, Aussem said.

"Further, when an overdose occurs, offering quality care is needed rather than merely stabilizing the person and discharging them to the street," she added

.More information

For more on drug dangers, head to the U.S. National Institute on Drug Abuse.

Copyright © 2021 HealthDay. All rights reserved.


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