Recent trends in fatal poisoning by opiates in the United States.

Abstract

For all ages combined, 63 per cent of fatal unintentional poisonings from solids and liquids involve drugs, licit and illicit. In 1978, 1,906 deaths in the United States were ascribed to unintentional poisoning by drugs.2 An observation that such deaths had declined sharply since 1975 led us to review published mortality data for the 1970s. Our preliminary study suggested intriguing similarities between epidemiologic trends in unintentional drug poisoning from 1970-1978* and trends in acute narcotism deaths in several cities,3-8 opiate abuse,5'9-11 and heroin availability and purity:3'6"10"12 all of these phenomena followed U-shaped curves in the first half of the decade, then dropped precipitously to their lowest values in 1978. A more detailed study of mortality data was therefore undertaken. Deaths were subdivided by poisoning agent and by sex, race, and five-year age intervals. Annual mortality rates were calculated using estimates of the appropriate mid-year populations. 13

Recent changes in drug poisoning mortality in the United States by urban–rural status and by drug type

“…Although the earliest epidemics of fatal drug overdoses in the United States were associated with prescription drugs, 1 most drug overdoses since the 1970s have been a consequence of the abuse of illicit drugs such as heroin. 2,3 Most of the scientific knowledge about drug overdose epidemics in the United States has therefore come from studies of illicit drug use in urban populations. 1,[4][5][6][7] Recent reports, however, indicate that the misuse and abuse of prescription drugs may have once again become more common than illicit drug poisoning in the United States.…”

Menstrual cycle length during methadone maintenance

“…Opiate dependence is associated with significant morbidity and mortality[1–4], much of which is reduced by methadone maintenance [5–9]. One form of morbidity that has been clearly demonstrated in heroin users is disruption of menstrual function [10–12].…”

“…A MEDLINE search of the terms ‘methadone’ and ‘menstruation’ from 1969 to 2003 yielded only eight references. Some studies have shown little or no improvement [11–12], while others report definite improvement [1,3–14]. Furthermore, there is little published on whether other factors such as age, race, concurrent cocaine use or weight could contribute to menstrual cycles of maintained women.…”

Macro Implementation: Testing the Causal Paths from U.S. Macro Policy to Federal Incarceration

“…Unfortunately, direct measures of drug use are not available for the time period of my study. The best indirect measure of over‐time drug use is the annual drug mortality rate (Paulozzi and Xi ; Samkoff and Baker ), which assumes that an increase in drug‐related deaths coincides with increased drug use. I employ this proxy to control for Drug Use .…”