Sharp Rise in U.S. Drug Poisoning Deaths By County

Poisoning is now the leading cause of death from injuries in the United States

 nearly 9 out of 10 poisoning deaths are caused by drugs.

Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44% to 48%. The use of two or more drugs increased from 25% to 31%. The use of five or more drugs increased from 6% to 11%.

These statistics are good to keep in mind next time the media starts fanning the flames about an adverse reaction to a nutritional supplement. With well over half the U.S. population reporting usage of one or more nutritional supplements, only 275 adverse events were reported in 2006, and most of those involved caffeine.

It’s not surprising to see the latest statistics on poisoning deaths in an overly medicated and often drugged out U.S. consumer population.  The good news is that many of the prescriptions being written are for life style diseases that we already know how to treat by eating the right foods and getting the correct nutrition.

8 November 2013  Elsevier

Investigators Look at the Link Between Geographic Patterns and Death Rates in the New Issue of the American Journal of Preventive Medicine

San Diego, CA, November 12, 2013 – A new study published in the American Journal of Preventive Medicine gives new Age Adusted Death Rates from Posioning in U.S.insight into the geographic variation in drug poisoning mortality, with both urban centers and rural areas showing a large increase in death rates. While previous studies have looked at drug poisoning related deaths in broad strokes, this is the first study to examine them on the county level across the entire U.S.

Drug poisoning is now the leading cause of injury

death in the U.S. and has increased by more than 300 Predicted Age Adjusted Death Rates in U.S. percent over the last three decades. Almost 90 percent of poisoning deaths can be attributed to illicit or licit drugs, with prescription drugs accounting for the majority of drug overdose deaths.

According to reports from the National Survey of Drug Use and Health, about 2.1 percent of Americans—or roughly 5 million people—have used prescription painkillers non-medically in the past month. The rise in drug-related deaths correlates to the increase in the non-medical use of prescription drugs, especially opioid analgesics.

While there have been some reports that suggest the rise in deaths has been sharper in rural areas than in urban centers, data to support the claim had never been fully substantiated. In this new study, investigators used small area estimation techniques to produce stable estimates of drug-related poisoning deaths at a county level, which revealed more information about how geography plays a role in death rates.

Using data obtained from the National Vital Statistics Multiple Cause of Death Files, investigators found that in 1999 only 3 percent of counties had annual drug poisoning age adjusted death rates (AADRs) over ten per 100,000, but found that the rate rose to 54 percent of counties by 2008. Additionally, while drug poisoning AADRs increased across all geographic areas both large and small, there was a greater percentage increase for rural areas (394 percent) compared to large metropolitan counties (297 percent).

“The interaction suggests that both central metropolitan and rural areas experienced similar absolute rates of increase in drug-poisoning AADRs from 1999 to 2009 and that these rates were more rapid than those seen in fringe or small metropolitan or micropolitan areas,” explains lead investigator Lauren M. Rossen, PhD, MS. “However, since the AADRs in rural areas were substantially lower in 1999 as compared to central cities, the percentage increase was larger for rural areas over time.”

The study also reveals regional trends in drug poisoning related deaths. “Maps of drug-poisoning mortality over time illustrated that AADRs greater than 29 per 100,000 per year were largely concentrated in Appalachian counties in 1999-2000; by 2008-2009, counties across the entire U.S. displayed AADRs of more than 29 per 100,000 per year,” said Rossen. “These high rates could be seen in Alaska, Hawaii, the entire Pacific region, New Mexico, Oklahoma, Appalachia, the southern coasts of Louisiana and Mississippi, Florida, and across New England.”

“Mapping death rates associated with drug poisoning at the county level may help elucidate geographic patterns, highlight areas where drug-related poisoning deaths are higher than expected, and inform policies and programs designed to address the increase in drug-poisoning mortality and morbidity,” added Rossen.

 

Nutritional Supplement Labels Influence Purchasing Decisions

Nutritional supplement products: Does the label information influence purchasing decisions for the physically active?

Nutritional Supplement LabelIn a study by Gary Gabriels and Mike Lambert in Nutrition Journal, 2013, 12:133 doi:10.1186/1475-2891-12-133, published October2, 2013, labels make all the difference when considering the purchase of nutritional supplements.

Purchasers of nutritional supplements span the range from interested first-time buyers looking for a result, to extremely savvy supplement users.You know people like them. They understand exactly what they’re buying and can tell you why they’re buying a particular supplement or nutritional formula and everything about the ingredients.

The conclusions reached by this study imply there is something deficient about nutritional supplements and that it’s chiefly because of marketing that consumers were influenced to answer the questions in this study. I’d love to see those questions.

It’s telling that the sub head for this study said purchasing decisions were by the “physically active”. How active they don’t say, but it would follow that if they were active at a competitive level, they would most definitely pay keen attention to the labels looking for banned substances.  They would also pay close attention not only to the label, but to any scientific studies that back up any claims about quality, performance or effectiveness.

The authors make the leap that any perceived or measured performance  enhancement is due to contaminants or adulterants and pointing to an opportunity to tighten up labeling requirements, communications and quality assurances.

Perhaps they aren’t aware of existing labeling requirements, quality assurance procedures, certification programs  and testing Natural Products Association Good Manufacturing Practices Seal of Approvalprotocols  that comprise good manufacturing practices followed by reputable  nutritional supplement companies.

It looks like yet another flawed study trying to make nutritional supplements look bad. The adverse effects reported in a one year term for the entire U.S. was 275, and most of those were caffeine related.

Pharmaceuticals and prescription drug deaths accounted for 37,485 fatalities in 2009 – more than all traffic accidents.

No one is talking about clamping down on those labels or the marketing that’s behind them. Pharmaceutical companies currently spend one-third of all sales revenue ($100 billion a year) on marketing their products – roughly twice what they spend on research and development. 

Some of that marketing buys ads in scientific journals and editorial influence. That makes it convenient to keep nutritional studies out of many journals, giving the impression there’s no science behind the claims.

Yet somehow we’re supposed to be worried about nutrition labels? Really?

Background

The increase in sales of nutritional supplement globally can be attributed, in part, to aggressive marketing by manufacturers, rather than because the nutritional supplements have become more effective. Furthermore, the accuracy of the labeling often goes unchallenged. Therefore, any effects of the supplement, may be due to contaminants or adulterants in these products not reflected on the label.

Methods

A self-administered questionnaire was used to determine how consumers of nutritional supplements acquired information to assist their decision-making processes, when purchasing a product. The study was approved by the University of Cape Town, Faculty of Health Sciences Human Research Ethics Committee. The questionnaire consisted of seven, closed and open-ended questions. The participants were asked to respond to the questions according to a defined list of statements. A total of 259 participants completed and returned questionnaires. The data and processing of the returned questionnaires was captured using Windows-based Microsoft? Office Excel 2003 SP 1 (Excel ? 1985?2003 Microsoft Corporation). Statistica Version 10 (copyright ? Stat Soft, Inc. 1984?2011) was used to calculate the descriptive statistics.

Results

The main finding of the study was that nearly 70% of the respondents who purchased supplements were strongly influenced by container label information that stipulated that the nutritional supplement product is free of banned substances. The second finding was that just over 50% of the respondents attached importance to the quality of the nutritional supplement product information on the container label. The third finding was that about 40% of the respondents were strongly influenced by the ingredients on the labels when they purchased nutritional supplements.

Conclusion

This study, (i) identifies short-comings in current labelling information practices, (ii) provides opportunities to improve label and non-label information and communication, and, (iii) presents the case for quality assurance laboratory ?screening testing? of declared and undeclared contaminants and/or adulterants, that could have negative consequences to the consumer.

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