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Cocaine overdose deaths tripled in five years, CDC says

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While opioids were grabbing the headlines, cocaine overdose deaths in the United States have marched upward, nearly tripling over five years, a new government report shows.

After a period of stability, cocaine-induced deaths rose by about 27% per year, on average, from 2013 through 2018, researchers at the U.S. Centers for Disease Control and Prevention said.

“While much attention has been given to the increase in drug overdose deaths involving opioids, it’s also important to recognize that deaths involving other drugs, such as cocaine, have also increased in recent years,” said Dr. Holly Hedegaard, lead researcher and injury epidemiologist at the CDC’s National Center for Health Statistics.

In 2018, those most likely to die from cocaine were men, adults aged 35 to 44, Black people and city dwellers in the Northeast. Knowing who’s most vulnerable can help in forming prevention strategies, Hedegaard said.

Given this alarming rise, “focused efforts are needed to better understand why the rate of drug overdose deaths involving cocaine has tripled in recent years,” she said.

According to the report:

  • Cocaine overdose deaths were stable from 2009 to 2013, but by 2018 had jumped from about two to nearly five per 100,000 people.
  • Americans aged 35 to 44 were most likely to die of a cocaine overdose in 2018. Those 65 and over were least vulnerable.
  • In 2018, Black people had nearly double the rate of cocaine-related deaths compared to white people, and three times that of Hispanics at nine per 100,000 versus five and three, respectively.
  • The rate of cocaine deaths in 2018 was nine times higher in Northeast urban counties than in Western rural counties.

Pat Aussem, associate vice president at the Partnership to End Addiction, said several factors may have contributed to the dramatic rise in cocaine overdose deaths.

“In recent years, countries like Colombia have had bumper crops of coca, and the prices of cocaine have fallen dramatically, resulting in a cheap, abundant product for export. With its increase in purity and decrease in price, cocaine can be a less expensive alternative to prescription stimulants like Ritalin and Adderall,” Aussem said.

Cocaine is also often laced with fentanyl, a powerful synthetic opioid, which significantly increases the probability of an overdose, she noted.

Indeed, the report found that between 2014 and 2018, the rate of drug overdose deaths from cocaine plus opioids increased faster than the rate of cocaine deaths without opioids.

“When mixing cocaine and opioids intentionally, the desired result is to experience the high of cocaine while easing its after-effects with the depressant qualities of an opioid,” Aussem explained. “If the person using the drug is unaware that the cocaine they are consuming is laced with fentanyl and lacks a tolerance for opioids, they are more likely to experience an adverse reaction or an overdose.”

Cities have been the centers of the cocaine epidemic, Aussem said. “Historically, urban areas such as New York and Miami have been key markets for the cocaine suppliers and are notably along ports of entry. Urban markets have also been plagued by fentanyl, which is being used to cut cocaine,” she said.

For urban Black people, the greater purity, lower price and widespread availability of cocaine may make it more attractive to use than other stimulants, she said. “This may account for the alarming increase in fatalities noted in the report amongst different subgroups,” Aussem suggested.

A comprehensive strategy to address addiction is necessary to reverse this trend, she noted.

“That includes prevention, treatment and recovery supports,” Aussem explained. People need affordable access to evidence-based care that includes mental and physical health needs, housing supports, employment and more, she said.

Also, “proven pharmacological interventions are needed to complement behavioral strategies,” she added, noting that trials of anti-addiction medications and even a vaccine are under way.

Cocaine users should also be educated on the risks of the drug being cut with fentanyl. “Using fentanyl test strips and having naloxone on hand are additional safety measures that could help reduce overdose deaths,” Aussem said, referring to the overdose treatment marketed as Narcan.

The report was published online Oct. 7 in the CDC’s NCHS Data Brief.

More information

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

Copyright 2020 HealthDay. All rights reserved.



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Study: Restricting promotions of sweet foods cuts sugar, not profits

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Limiting marketing of high-sugar foods in supermarkets doesn’t cut into store profits, but it may improve public health, Australian researchers report.

Price promotions, end-of-aisle displays and putting products at eye level can stimulate sales. Ending these practices reduced purchase of sugar-sweetened drinks and candy in participating stores by the equivalent to nearly two tons of sugar, the researchers said. These included foods and drinks with added sugars, as well as natural sugar in honey, syrups and fruit juices.

The reductions in soft drink and candy purchases were particularly large, researchers said. Even so, profits were not affected, they added.

The study, published Oct. 7 in The Lancet Planetary Health, ran for 12 weeks and focused on 20 randomly selected stores in rural Australia. Some stores restricted promotion of sugary foods, others did not.

“Our novel study is the first to show that limiting [promotional] activities can also have an effect on sales, in particular, of unhealthy food and drinks,” said researcher Julie Brimblecombe, an associate professor of nutrition, dietetics and food at Monash University in Melbourne.

“This strategy has important health implications and is an opportunity to improve diets and reduce associated non-communicable diseases. It also offers a way for supermarkets to position themselves as responsible retailers, which could potentially strengthen customers’ loyalty without damaging business performance,” she said in a journal news release.

The changes affected sugar-sweetened drinks, candy and other sweets, table sugar and sweet biscuits or cookies. Among other things, these restricted price promotions, removed end-of-aisle and counter displays, and reduced refrigerator space for sugary drinks while placing large-size soft drinks elsewhere. Stores also promoted water and listed the amount of sugar in soft drinks.

As a result, added sugars purchased in foods and drinks fell 3%. Sugars in purchased sugar-sweetened drinks were cut by 7%, and from soda purchases it dropped 13%. Sugars from candy sales fell 7.5%, the researchers found.

Co-author Emma McMahon, a research fellow at Menzies School of Health Research in Casuarina, Australia, said researchers expected the strategy would work best on impulse items like sweet biscuits rather than on staples like table sugar.

“A different strategy for biscuits and items like table sugar should be explored to stimulate change in those buying behaviors,” she said in the release.

More information

To learn more about sugar and your health, see Harvard University.

Copyright 2020 HealthDay. All rights reserved.



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COVID-19 may have prolonged effect for pregnant women

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COVID-19 symptoms can last a long time in pregnant women, researchers say.

The new study included 594 pregnant women, with average age 31, across the United States who tested positive for the new coronavirus but were not hospitalized. Nearly one-third were health care workers.

On average, the women were about 24 weeks’ pregnant when they joined the study.

The most common early symptoms were cough, at 20%, sore throat, at 16%, body aches, at 12%, and fever, at 12%. By comparison, fever occurs in 43% of hospital patients who are not pregnant.

For 6%, loss of taste or smell was the first symptom. Other symptoms included shortness of breath, runny nose, sneezing, nausea, sore throat, vomiting, diarrhea or dizziness.

While six out of 10 women had no symptoms after four weeks, symptoms lasted eight or more weeks for 25%, the study found.

Thirty-seven days was the median time for symptoms to resolve, meaning half took longer, half took less time. The findings were published this month in the journal Obstetrics and Gynecology.

“COVID-19 symptoms during pregnancy can last a long time, and have a significant impact on health and well-being,” said senior author Dr. Vanessa Jacoby. She is vice chairwoman of research in the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.

Jacoby’s team also found that COVID-related symptoms were complicated by overlapping signs of normal pregnancy, including nausea, fatigue and congestion.

The majority of participants had mild disease and were not hospitalized, said first author Dr. Yalda Afshar, assistant professor in the division of maternal fetal medicine, department of obstetrics and gynecology at the University of California, Los Angeles.

Despite the potential risks of COVID-19 for pregnant women and their newborns, large gaps in knowledge about the disease’s course and prognosis remain, Afshar noted in a UCSF news release.

“Our results can help pregnant people and their clinicians better understand what to expect with COVID-19 infection,” Afshar said.

More information

There’s more on COVID-19 and pregnancy at the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Pregnant women with COVID-19 don’t pass the virus to their newborns, study finds

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Oct. 12 (UPI) — New mothers infected with COVID-19 during pregnancy didn’t pass the virus to their babies, even if they breastfed and shared the same hospital room, according to a study published Monday by JAMA Pediatrics.

Mothers with severe COVID-19, however, delivered their babies, on average, one week earlier than healthy mothers, and their babies were four times as likely to need phototherapy to treat jaundice, the data showed.

“Between our findings and other studies, it is now known that there is a relatively low likelihood of vertical transmission from [COVID-19]-positive mothers to their newborns,” study co-author and pediatrician Melissa Stockwell told UPI.

“We also show that the risk remains low even with newborns rooming-in and direct breastfeeding practices, both of which had been concerns early in the pandemic,” said Stockwell, division chief of child and adolescent health at NewYork-Presbyterian/Columbia University Irving Medical Center.

Pregnant women may be at increased risk for severe illness from COVID-19, and reports have appeared that the risk for preterm delivery is higher among women infected with the virus, according to data released in June by the U.S. Centers for Disease Control and Prevention.

“There remains a concern for the effect of this virus on pregnant women,” study co-author Dr. Cynthia Gyamfi-Bannerman, a maternal-fetal medicine specialist at NewYork Presbyterian, told UPI.

However, no indication exists — at least to date — that their newborns are at any risk from the virus.

To explore the issue further, the Columbia University researchers tested 101 babies born to infected mothers in New York City between March 13 and April 24 — the height of the COVID-19 outbreak in the region.

Two of the babes had low levels of the virus in their nasal and throat samples initially, but neither developed symptoms, and they later tested negative, the researchers said.

The remainder all tested negative at birth and, and the 31 infants who were retested several days later remained negative. All 101 babies “roomed in” — or shared the same hospital rooms as their mothers — and bathing was delayed, the researchers said.

Some studies have recommended early bathing of babies born to mothers with COVID-19 as a way to reduce risk for virus spread, but early bathing has other health risks, including hypothermia, they said.

Three of the 10 babies born to mothers with severe COVID-19, however, required phototherapy, while six of 91 born to mothers with mild to moderate disease required the treatment, the data showed.

“Treating babies as babies seems safe during the COVID-19 pandemic,” study co-author Dr. Dani Dumitriu told UPI.

“This is particularly important given the continued spread of COVID-19 throughout the country and around the world,” said Dumitriu, a neonatologist at New York-Presbyterian.



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