A Disparity beneath a Paradox: Cancer Mortality among Young Hispanic Americans in the US-Mexico Border Region.

The age-adjusted mortality rate for cancer in the US Hispanic population is two thirds that of the non-Hispanic white population, probably because of differences in smoking rates. We aimed to determine whether Hispanic white (HW) cancer mortality in the US-Mexico Border Region was also lower than that of the non-Hispanic white (NHW) border population, particularly in the younger population less likely to develop smoking-related cancer. We obtained age-adjusted cancer mortality rates from 1999 to 2017 for the 44 border counties, the four US-Mexico border states, and the rest of the US.

Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016.

Problem/condition: In 2017, a total of 70,237 persons in the United States died from a drug overdose, and 67.8% of these deaths involved an opioid. Historically, the opioid overdose epidemic in the United States has been closely associated with a parallel increase in opioid prescribing and with widespread misuse of these medications.

Mortality, Ethnicity, and Urbanization Among Children Aged 1-4 Years on the US-Mexico Border.

Objectives: Little is known about the mortality of children along the US-Mexico border. The objective of our study was to determine whether mortality rates among Hispanic children along the border ("border Hispanic children") exceeded mortality rates among non-Hispanic white children along the border.

Methods: We examined mortality rates from 2001-2015 for children aged 1-4 years in US-Mexico border counties and in the United States overall.

Parsing the Paradox: Hispanic Mortality in the US by Detailed Cause of Death.

US Hispanics are a disadvantaged population that paradoxically has lower mortality rates than non-Hispanic whites. We conducted a descriptive analysis of age-adjusted mortality rates for 113 causes of death for US Hispanics (USH) and US non-Hispanic whites (USNHW) during 1999-2015. All-cause, age-adjusted mortality rates per 100,000 were: 581.

A Randomized Controlled Trial of a Citywide Emergency Department Care Coordination Program to Reduce Prescription Opioid Related Emergency Department Visits.

Background: Increasing prescription overdose deaths have demonstrated the need for safer emergency department (ED) prescribing practices for patients who are frequent ED users.

Objectives: We hypothesized that the care of frequent ED users would improve using a citywide care coordination program combined with an ED care coordination information system, as measured by fewer ED visits by and decreased controlled substance prescribing to these patients.

Methods: We conducted a multisite randomized controlled trial (RCT) across all EDs in a metropolitan area; 165 patients with the most ED visits for complaints of pain were randomized.

Recognition and response to opioid overdose deaths-New Mexico, 2012.

Purpose: Drug overdose deaths are epidemic in the U.S. Prescription opioid pain relievers (OPR) and heroin account for the majority of drug overdoses.

Changes in the medical management of patients on opioid analgesics following a diagnosis of substance abuse.

Purpose: When providers recognize that patients are abusing prescription drugs, review of the drugs they are prescribed and attempts to treat the substance use disorder are warranted. However, little is known about whether prescribing patterns change following such a diagnosis.

Methods: We used national longitudinal health claims data from the Market Scan® commercial claims database for January 2010-June 2011.

Controlled Substance Prescribing Patterns--Prescription Behavior Surveillance System, Eight States, 2013.

Problem/condition: Drug overdose is the leading cause of injury death in the United States. The death rate from drug overdose in the United States more than doubled during 1999-2013, from 6.0 per 100,000 population in 1999 to 13.

A Randomized Controlled Trial of an Emergency Department Intervention for Patients with Chronic Noncancer Pain.

Background: Emergency Departments (EDs) are beginning to notify their physicians of patients reporting chronic noncancer pain (CNCP) who frequent EDs, and are suggesting that the physicians not prescribe opioids to these patients.

Objectives: We hypothesized that this intervention would reduce both the number of opioids prescribed to these patients by their ED physicians and the number of these patients' return visits to the ED.

Methods: We conducted a randomized controlled trial of this intervention in 13 electronically linked EDs.

Use of Naloxone by Emergency Medical Services during Opioid Drug Overdose Resuscitation Efforts.

Naloxone administration is an important component of resuscitation attempts by emergency medical services (EMS) for opioid drug overdoses. However, EMS providers must first recognize the possibility of opioid overdose in clinical encounters. As part of a public health response to an outbreak of opioid overdoses in Rhode Island, we examined missed opportunities for naloxone administration and factors potentially influencing EMS providers' decision to administer naloxone.

Trends and characteristics of heroin overdoses in Wisconsin, 2003-2012.

Background: Heroin abuse has increased substantially during the past decade in the United States. This study describes trends and demographic shifts of heroin overdoses and heroin-related fatalities in Wisconsin and contrasts these with prescription opioid overdoses.

Methods: This study was cross-sectional using databases of emergency department (ED) visits, hospital admissions, and death certificates in Wisconsin, United States, during 2003-2012.

Disparity in naloxone administration by emergency medical service providers and the burden of drug overdose in US rural communities.

Objectives: We determined the factors that affect naloxone (Narcan) administration in drug overdoses, including the certification level of emergency medical technicians (EMTs).

Methods: In 2012, 42 states contributed all or a portion of their ambulatory data to the National Emergency Medical Services Information System. We used a logistic regression model to measure the association between naloxone administration and emergency medical services certification level, age, gender, geographic location, and patient primary symptom.

Trends in Opioid Analgesic-Prescribing Rates by Specialty, U.S., 2007-2012.

Introduction: Opioid analgesic prescriptions are driving trends in drug overdoses, but little is known about prescribing patterns among medical specialties. We conducted this study to examine the opioid-prescribing patterns of the medical specialties over time.

Methods: IMS Health's National Prescription Audit (NPA) estimated the annual counts of pharmaceutical prescriptions dispensed in the U.

Prescription opioid analgesic use among adults: United States, 1999-2012.

Prescription opioid analgesics are used to treat pain from surgery, injury, and health conditions such as cancer. Opioid dependence and opioid-related deaths are growing public health problems. Opioid analgesic sales (in kilograms per 10,000) quadrupled from 1999 to 2010 (1), and from 1999 to 2012, opioid-related deaths (per 100,000) more than tripled (2).

Prescription practices involving opioid analgesics among Americans with Medicaid, 2010.

Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. We examined claims from enrollees aged 18-64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states.

Vital signs: alcohol poisoning deaths - United States, 2010-2012.

Background: Alcohol poisoning is typically caused by binge drinking at high intensity (i.e., consuming a very large amount of alcohol during an episode of binge drinking).

What we know, and don't know, about the impact of state policy and systems-level interventions on prescription drug overdose.

Background: Drug overdose deaths have been rising since the early 1990s and is the leading cause of injury death in the United States. Overdose from prescription opioids constitutes a large proportion of this burden. State policy and systems-level interventions have the potential to impact prescription drug misuse and overdose.

Variation among states in prescribing of opioid pain relievers and benzodiazepines--United States, 2012.

Introduction: Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods: CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs.

Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010.

The abuse of prescription drugs has led to a significant increase in emergency department (ED) visits and drug-related deaths over the past decade. Opioid pain relievers (OPRs) and benzodiazepines are the prescription drugs most commonly involved in these events. Excessive alcohol consumption also accounts for a significant health burden and is common among groups that report high rates of prescription drug abuse.

Increases in heroin overdose deaths - 28 States, 2010 to 2012.

Nationally, death rates from prescription opioid pain reliever (OPR) overdoses quadrupled during 1999-2010, whereas rates from heroin overdoses increased by <50%. Individual states and cities have reported substantial increases in deaths from heroin overdose since 2010. CDC analyzed recent mortality data from 28 states to determine the scope of the heroin overdose death increase and to determine whether increases were associated with changes in OPR overdose death rates since 2010.

Decline in drug overdose deaths after state policy changes - Florida, 2010-2012.

During 2003-2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam. In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend.

Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines - United States, 2012.

Background: Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods: CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs.

Risk of adverse health outcomes with increasing duration and regularity of opioid therapy.

Purpose: The purpose of this study was to examine trends in frequency and daily dosage of opioid use and related adverse health outcomes in a commercially insured population.

Methods: We examined medical claims from the Truven Health MarketScan commercial claims database for 789,457 continuously enrolled patients ages 18 to 64 years to whom opioids were dispensed during the first half of 2008. We tracked them every 6 months until either opioid use was discontinued or the end of 2010.

High-risk use by patients prescribed opioids for pain and its role in overdose deaths.

Importance: From January 1, 2003, through December 31, 2010, drug overdose deaths in Tennessee increased from 422 to 1059 per year. More of these deaths involved prescription opioids than heroin and cocaine combined.

Objective: To assess the contribution of certain opioid-prescribing patterns to the risk of overdose death.