Posts Tagged "addiction"

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Aging Minorities Struggle in Drug Treatment

For baby boomers who have abused drugs or alcohol for years or decades, the negative health consequences of addiction are particularly damaging.

But information about older Americans’ success in substance abuse programs is sparse, even though people between 55 and 75 now make up 22 percent of all U.S. overdose deaths, up from 9 percent in the late 1990s. And virtually no racial breakdown of treatment outcomes is available for this age group.

A new study by Jevay Grooms at Howard University and Alberto Ortega at Indiana University fills this gap. The researchers find that the number of older Black, white and Hispanic Americans admitted to treatment facilities and programs is steadily increasing.

The biggest growth in Black admissions was in cocaine and heroin treatment, while the rise for whites was concentrated in prescription opioids and alcohol treatment. The largest increase for Hispanics was for heroin addiction.

Amid rising admissions, however, the share of people 50 and older who completed treatment has generally trended down for each group during the period of this analysis, 2006 through 2017, though the rates bounce around quite a bit from year to year.

To gauge how each group fared over the period, the analysis controlled for various factors that determine success or failure, including education levels, employment status, and past attempts at treatment.

Older Blacks – and, to a lesser extent, Hispanics – are not as likely as older whites to successfully finish a substance abuse program. One reason is that minorities are more likely to be terminated by a treatment facility or program. Just as worrisome, however, are the widening disparities in the rates of treatment completion between each older minority group and their white counterparts – even as the disparities were closing for Blacks and Hispanics under 50.

The researchers did not dissect the reasons for treatments being terminated but noted that “lack of insurance, social stigma, distrust, lack of diversity and cultural incompetence among providers” are likely contributing factors in the racial differences. …Learn More

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Opioid Use Higher for Disability Applicants

With the nation still in the midst of an opioid crisis, a new study provides the first estimate of opioid use among people who apply for disability.

One out of every four applicants used opioids in 2017 – below the peak in 2012 but still significantly more than in the general population, according to researchers at Mathematica and the U.S. Social Security Administration.

And the researchers may be underestimating the extent of opioid use. Their data come from Social Security’s disability application forms. The forms ask applicants to list their prescriptions, including opioids taken for musculoskeletal pain such as a bad back, as well as their non-prescription drug use, and the stigma around use and abuse may encourage underreporting.

To estimate opioid use required creating a database because none existed. The researchers mined the text fields in each disability application using machine learning to find information about opioid use and then entered the information into the database.

Some interesting demographic trends emerged from the study. Opioid use is most prevalent in middle age, at around 30 percent of disability applicants in their 40s and 50s. “This is notable,” the researchers said, because if Social Security grants their requests for benefits, they “may remain on the [disability rolls] for 25 years.”

In a breakdown by education levels, the biggest opioid users had attended college but didn’t get a degree. Women’s use exceeded men’s throughout the study’s 10-year period, mirroring the population as a whole. And a state-by-state breakdown shows that applicants’ opioid use fell across the nation during that time. But Alabama, Arkansas, Michigan, and Nevada still had particularly high rates in 2017. …Learn More

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Automation of Jobs Fuels Overdose Deaths

The rise in opioid addiction has created an epidemic of drug overdose deaths in the United States. But what increases the risk that people develop the disorder in the first place?

Automation of the U.S. economy turns out to be a contributing factor, as workers lose good jobs to industrial robots and despair about being disengaged from the labor force, conclude researchers at the University of Pennsylvania and Yale in a study funded by the U.S. Social Security Administration.

Manufacturing jobs, often in unionized industries, used to be a major route to the middle class. But millions of factory jobs disappeared as U.S. companies moved operations overseas. Compounding the job losses, corporate employers began installing robots in their remaining domestic operations. Automation was blamed in one study for eliminating more than 700,000 jobs and causing wage stagnation in the 1990s and early 2000s.

Prior research has connected the flight of manufacturing to increasing deaths from drug overdoses. Now, the new study specifically ties technology – measured as an increase in robots per 1,000 workers – to the increase in overdose deaths.

The men who are most affected by the rise of automation are in their prime working years, and they are concentrated in more industrialized areas. Automation accounted for nearly one in five of their overdose deaths in manufacturing counties. For women, automation was responsible for one in 10 overdose deaths in manufacturing counties. …Learn More

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Opioid Abuse Tied to Where People Live

In 2019, the U.S. Attorney’s Office in northern Oklahoma detained one doctor charged with operating a pill mill that prescribed opioids to addicts for the simple reason that he presented “a danger to our community.”

While mental illness and unemployment are familiar culprits in the opioid crisis sweeping the country, the environment that people live in – including the prevalence of unscrupulous doctors – is actually important as well.

That’s one conclusion in a new study that found that people are more likely to become addicts if they move from an area with a relatively low level of prescription opioid abuse to a high-abuse area.

The research looked at more than 3 million people on federal disability insurance (DI) – a group that uses opioids at much higher rates than the general population. More than half of DI recipients are prescribed opioids in a given year. And since they are covered by Medicare, the researchers had access to the prescription records for Oxycontin, Vicodin, and morphine.

To gauge the impact of moving to a new location, the researchers created an index that estimated the extent of prescription opioid abuse in each U.S. county. The index took into account several factors, including the amount of opioids prescribed to patients and their use of multiple prescribers.

When DI recipients moved from a county at the low end of this index – the 25th percentile – to the high end – the 75th percentile – their rate of prescription opioid use increased nearly 5 percent, according to the study conducted for the Retirement and Disability Research Consortium.

People with a prior history of prescription opioid use were at particularly high risk of prescription opioid abuse if they moved to a high-use area. …Learn More