NCADD-SD News & Blog

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“It all comes down to your choices.”

“It all comes down to your choices.”

“It all comes down to your choices,” said a man in his fifties as he completed treatment following a brief return to drinking lots of alcohol.

In the company of supportive peers and an empathic treatment team, this man had immersed himself for three weeks in mindfulness practices structured by Acceptance and Commitment Therapy (ACT). He also maintained connections with his sponsor and Alcoholics Anonymous.

The man recounted how an offer of alcohol—made amid physical, interpersonal, and financial stressors—precipitated his most recent drinking episode. Similar situations had instigated previous binges.

In the future, he plans to minimize exposure to stressors and drinking opportunities. When stressors or alcohol are unavoidable, he anticipates choosing to notice them without reacting in ways that conflict with his values. “Personal responsibility” for “choices” protects his paramount value, sobriety.

Such clarity is too rare. Many others with addiction—and people around them—would do well to adopt this perspective. Choices represent the way out of active addiction, much as they represent the way in.

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Collaborative Care Shows Promise for Opioid and Alcohol Use Disorders

Collaborative Care Shows Promise for Opioid and Alcohol Use Disorders

A NIDA-funded randomized clinical trial found that primary care patients with opioid and alcohol use disorders (OAUD) who were offered a collaborative care intervention were more likely to receive evidence-based treatment and refrain from using opioids and alcohol six months later, compared to patients receiving usual care.

The collaborative care intervention increased both the proportion of patients receiving evidence-based treatment for OAUD (39.0% vs. 16.8%) and the number refraining from opioids or alcohol use at six months. (32.8% vs. 22.3%).

Collaborative care was designed to increase the delivery of either a six-session brief psychotherapy treatment, and/or medication-assisted treatment, with either buprenorphine/naloxone for opioid use disorders or long-acting injectable naltrexone for alcohol use disorders. Usual care participants were given a number for appointment scheduling and a list of community referrals for OAUD treatment.

The authors suggest the findings indicate that treatment for OAUDs can be integrated into primary care settings effectively.

For a copy of the paper go to — "Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care: The SUMMIT Randomized Clinical Trial"— published in JAMA Internal Medicine.

Original linkOriginal author: Ezra
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Bev Haberle, Executive Director of The Council Of Southeast Pennsylvania In Doylestown, to Retire at End Of Year

Bev Haberle, Executive Director of The Council Of Southeast Pennsylvania In Doylestown, to Retire at End Of Year

 

Beverly Haberle has, for thirty-two years, been the Executive Director of The Council of Southeast Pennsylvania, Inc. (formerly Bucks County Council on Alcoholism and Drug Dependence, Inc.), a non-profit education advocacy association.

And for the past twelve years, Ms. Haberle has been the Project Director for the Pennsylvania Recovery Organization/Achieving Community Together (PRO-ACT), a grass roots organization mobilizing the recovering community family members and other interested advocates.

Ms. Haberle holds a Master’s degree in Human Services, is a Licensed Professional Counselor, and a Certified Addictions Counselor. Ms. Haberle has been a past member of the Board of Directors for the National Council on Alcoholism and Drug Dependence, Inc. and currently sits on a number of Boards and state-wide drug and alcohol coalitions and committees. In addition, Ms. Haberle has been a part time faculty member at Penn State University since 1991. 2011 Elected National Board Member Faces and Voices of Recovery.

As Beverly Haberle is nearing the time to retire from her role as Executive Director of The Council of Southeast Pennsylvania, Inc, is embarking on a comprehensive leadership transition.

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Family Physicians Have a Better Chance Treating Substance Use Disorders

Family Physicians Have a Better Chance Treating Substance Use Disorders

AMA Source recently published an article noting that patients with substance use disorders may experience stigma that can interfere with treatment options.

But when substance use disorders are recognized and treated as a chronic disease, that stigma can be reduced.

The article goes on to note that treating patients with substance use disorders in a family medicine setting can be a unique situation because physicians are often treating other members of the patient’s family as well. At first, patients may be reluctant to discuss substance use but once the condition is out in the open, having the family involved can be beneficial.

And since many primary care physicians (especially those in family medicine) know many of their patients very well and have established a long-term relationship. That can be advantageous when a patient begins to show signs of a substance use disorder.

Once the physician and patient have had a conversation about substance use and have determined that it would be best to seek treatment, the primary care setting can be a great place for that treatment to occur. Some patients feel more comfortable when their substance use disorder is treated in the same way as any other medical condition, which can also reduce the stigma.

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Women Who Inject Drugs May Be At Greater Risk of HCV Than Men

Women Who Inject Drugs May Be At Greater Risk of HCV Than Men

There is a clear body of research assessing sex and gender differences in risk behaviors among people who inject drugs, however little or no research has investigated sex differences in hepatitis C (HCV) susceptibility.

A newly published analysis examining data from more than 1800 people suggests that women who inject drugs have a 38% higher risk of contracting HCV than their male counterparts.

Interestingly, while sharing of syringes and other injection equipment is a significant risk factor for HCV, differences in these behaviors did not account for the higher risk among women.

The research was funded by the National Institute on Drug Abuse (NIDA), part of the National institutes of Health.

The analysis used data from the International Collaboration of Incident HIV and HCV in Injecting Cohorts, a project of pooled biological and behavioral data from ten prospective cohorts of people who inject drugs, including the United States, Australia, Canada and the Netherlands. This study includes data from seven of the 10 cohorts.

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Meth Use Linked to Heightened Stroke Risk in the Young

Meth Use Linked to Heightened Stroke Risk in the Young

The stimulant methamphetamine, also popularly known as 'speed,' 'ice' and 'meth,' is linked to a heightened risk of stroke among young people, reveals a review of the available evidence, published online in the Journal of Neurology Neurosurgery & Psychiatry.

According to a recent article in Medical News Today, a stroke caused by a bleed into the brain (haemorrhagic) rather than a clot (ischaemic) is the most common type associated with taking this drug, with men twice as likely to succumb as women, the findings show.

Given the often disabling or fatal consequences of a stroke, and the increasing use of methamphetamine among young people, particularly in countries around the Pacific rim, the findings are a cause for concern, warn the researchers.

They base their findings on a comprehensive trawl of research looking at a potential link between methamphetamine use and associated stroke risk in young people (under the age of 45), and published up to February 2017. They found 77 relevant pieces of research out of 370, including epidemiological studies and case report series.

Methamphetamine can be swallowed, inhaled, or injected. Haemorrhagic strokes were equally associated with swallowing the drug and injecting it while inhalation was the most common method of getting high associated with ischaemic stroke.

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Marijuana Use Triples Risk of Death from Hypertension

Marijuana Use Triples Risk of Death from Hypertension

The risk of death from hypertension is three times greater in adults who use marijuana, compared with nonusers, based on data from a retrospective study of 1,213 adults.

According to an article in Cardiology News, the recent changes in the legalization of marijuana may promote increased recreational use, but data on the long-term effects of marijuana use on cardiovascular and cerebrovascular mortality are limited, wrote Barbara A. Yankey, PhD, of Georgia State University, Atlanta, and her colleagues.

The researchers collected data from the National Health and Nutrition Examination Survey from adults aged 20 years and older who were asked between 2005 and 2006 whether they had ever used marijuana, and those who answered “yes” were defined as users. Data on 686 users and 527 nonusers were combined with the 2011 mortality data from the National Center for Health Statistics.

Overall, marijuana users had a 3.42 times greater risk of death from hypertension than did nonusers (95% confidence interval, 1.20-9.79), and the risk increased by 1.04 for each year of use (95% CI, 1.00-1.07). The average duration of marijuana use was 11.5 years. At the time of study entry, the average age of the participants was 38 years, and the average body mass index was 29 kg/m2; 23% of marijuana users and 21% of nonusers had a prior diagnosis of hypertension.

Of the study participants, 20% used marijuana and smoked cigarettes, 16% used marijuana and were past smokers, 5% were past smokers, and 4% only smoked cigarettes. “In our study, increase in risk for hypertension, [heart disease], or cerebrovascular disease mortality associated with cigarette use was not significant,” the researchers wrote. They attributed this factor to the small sample size and noted that the dangers of cigarette smoking to the cardiovascular system are well established.

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Study Finds Large Increase in Alcohol Use, High-Risk Drinking and Alcohol Use Disorders

Study Finds Large Increase in Alcohol Use, High-Risk Drinking and Alcohol Use Disorders

The percentage of Americans who use alcohol, engage in high-risk drinking or have an alcohol use disorder has risen substantially, a new study finds.

The study, which included face-to-face interviews with 40,000 Americans, found alcohol use disorders increased 49 percent between 2001-2002 and 2012-2013, according to CNN.

Alcohol use has increased most among women, older adults, racial/ethnic minorities and the socioeconomically disadvantaged, the researchers report in JAMA Psychiatry. Alcohol use disorders rose 106.7 percent among individuals age 65 and older during the study period.

The researchers conclude that almost 30 million Americans are struggling with an alcohol use disorder.

Original linkOriginal author: Ezra
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Cities Across U.S. Report Increase in Drug Overdoses Related to Fentanyl

Cities Across U.S. Report Increase in Drug Overdoses Related to Fentanyl

Cities across the United States are seeing a steep increase in the number of overdose-related deaths related to fentanyl, The Washington Post reports.

Fentanyl-related overdose deaths rose almost 600 percent from 2014 to 2016 in 24 of the nation’s largest cities and surrounding counties. In 2014 there were 582 fentanyl-related fatal overdoses.

That number jumped to 3,946 last year. Officials expect a much larger number of deadly fentanyl-related overdoses this year, the article notes.

“If anything can be likened to a weapon of mass destruction in what it can do to a community, it’s fentanyl,” said Michael Ferguson, the special agent in charge of the Drug Enforcement Administration’s New England Division. “It’s manufactured death.”

Original linkOriginal author: Ezra
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Democrats Ask Drug Policy Office to Do More to Combat Opioid Epidemic

Democrats Ask Drug Policy Office to Do More to Combat Opioid Epidemic

Twenty Democratic senators are asking the Office of National Drug Control Policy (ONDCP) to do more to combat the opioid epidemic, according to the Associated Press.

In a letter to ONDCP Acting Director Richard Baum, the senators urged the Trump Administration to implement recommendations made by former Surgeon General Vivek Murthy.

The senators criticized an administration budget proposal that would cut almost $400 million from drug and mental health programs. They also voiced opposition to the Department of Justice’s increasing insistence on treating drug addiction as a criminal justice issue.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Governor Chris Christie, recently pushed back its deadline to release a report. It was the second such delay for the commission.

Senators who signed the letter included Chuck Schumer, Dianne Feinstein, Sherrod Brown, Elizabeth Warren, Kamala Harris and Cory Booker.

Original linkOriginal author: Ezra
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NIH-Funded Mouse Study Sheds Light on Neural Risks Associated With Prenatal Alcohol Exposure

NIH-Funded Mouse Study Sheds Light on Neural Risks Associated With Prenatal Alcohol Exposure

Prenatal exposure to even low doses of alcohol may lead to severe and highly variable deficits in the brain of a fetus, according to a new study conducted in mice.

Researchers report that the unpredictable nature of the deficits may be due to inconsistencies in how fetal brain cells activate a protective response to alcohol and other harmful compounds.

The new findings may help explain the range of behavioral and learning deficits and other symptoms observed in individuals with fetal alcohol spectrum disorders (FASD) and other congenital brain disorders. The study, supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, is now online in Nature Communications.

FASD is an umbrella term for a range of effects caused by prenatal alcohol exposure. Individuals with FASD may experience growth retardation, facial abnormalities, and organ damage, including to the brain, which can result in a range of neurobiological deficits that contribute to physical, cognitive, behavioral, and social challenges throughout a person's life.

Brain cells use numerous mechanisms to protect against damage from alcohol and other environmental stressors. One mechanism involves the activation of Heat Shock Factor 1 (Hsf1), explained senior author Kazue Hashimoto-Torii, Ph.D., of Children's National Medical Center in Washington, D.C.

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SAMHSA Issues Report on Understanding Adolescent Inhalant Use

SAMHSA Issues Report on Understanding Adolescent Inhalant Use

A recent Substance Abuse and Mental Health Services Administration (SAMHSA) report found that:

In 2015, about 684,000 adolescents aged 12 to 17 used inhalants in the past year.Adolescents were more likely than adults aged 18 or older to have used inhalants in the past year to get high (2.7 vs. 0.4 percent).Female adolescents were more likely than male adolescents to have used inhalants in the past month (3.2 vs. 2.3 percent).In 2015, more than half of adolescents who used inhalants in the past year (59.0 percent) had used 1 to 11 days in the past year; about 1 in 5 (19.3 percent) had used 12 to 49 days.

The report notes that the types of inhalants adolescents used to get high varied. Felt-tip pens/markers, or magic markers were the most commonly identified types of inhalants adolescents used to get high in 2015.

Inhalants are highly accessible, cheap, and easy to hide; they are also addictive and deadly. Inhalants are particularly appealing to adolescents for many reasons; they are legal, low cost, and easy to acquire.7 In addition, inhalants can give users a fast but short-term high, which makes it easy for adolescents to use inhalants and conceal their use.1,7 Using inhalants is also associated with many negative outcomes. Adolescents who engage in inhalant use are at an increased risk of delinquency, depression, suicidal thoughts, and drug and alcohol use.7 Inhalants also have the special risk of being deadly any time they are used—even the first time.

Although this report highlights that the majority (97.3 percent) of adolescents aged 12 to 17 have not used inhalants in the past year to get high, there were the 684,000 adolescents who did use inhalants in the past year to get high.

The results in the report underscore that adolescents of all race/ethnicities, across the country, and in rural and metropolitan settings are vulnerable to inhalant use. Therefore, continuing efforts are needed to educate adolescents, parents, teachers, physicians, service providers, and policymakers about the dangers and health risks of inhalant use.

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NDEWS Report Finds Shift in Patterns of Heroin Poisoning Death

NDEWS Report Finds Shift in Patterns of Heroin Poisoning Death

National Drug Early Warning System (NDEWS) recently issued a report titled “Geospatial Analysis of Drug Poisoning Deaths Involving Heroin in the USA, 2000–2014”.

The report found that the geographic pattern of poisoning deaths involving heroin has shifted from the west coast of the USA in the year 2000 to New England, the MidAtlantic region, and the Great Lakes and central Ohio Valley by 2014.

The evolution over space and time of clusters of drug poisoning deaths involving heroin is confirmed through the SaTScan analysis. For this period, White males were found to be the most impacted population group overall; however, Blacks and Hispanics are highly impacted in counties where significant populations of these two groups reside.

Their results show that while 35–54-year-olds were the most highly impacted age group by county from 2000 to 2010, by 2014, the trend had changed with an increasing number of counties experiencing higher death rates for individuals 25–34 years.

The percentage of counties across the USA classified as large metro with deaths involving heroin is estimated to have decreased from approximately 73% in 2010 to just fewer than 56% in 2014, with a shift to small metro and non-metro counties.

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Fort Worth’s Recovery Resource Council Turns 60

Fort Worth’s Recovery Resource Council Turns 60

The Fort Worth Recovery Resource Council recently celebrated its 69th anniversary.

The Recovery Resource Council began in 1957, but its roots date back to 1944, the year that the National Committee for Education on Alcoholism (now known as the National Council on Alcoholism and Drug Dependence) was formed.

That year, the Council became an affiliate of NCADD and has since grown its presence as one of the leading recovery centers in North Texas. On average, the council services over 75,000 people each year.

Some of the Council’s major accomplishments include the Enduring Families program and Project New Start, as well as its youth programs like the Sunshine Club and Camp L4. Enduring Families provides counseling to servicemen and women with PTSD-related issues. To date, the Council has served more than 450 veterans and family members. Project New Start, a housing program for homeless or disabled men and women, is celebrating its 10th year.

The Recovery Resource Council also has programs for at-risk youth. The Sunshine Club, for example, has been around since 1986, helping elementary school children dealing with trauma. Camp L4, which stands for Live, Learn, Laugh and Love, takes children in shelters to Camp Carter for activities like horseback riding, arts and crafts, and life skills classes. According to the council, about 79 percent of those served by the organization are under age 18.

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Amount of Opioids Prescribed Declined from 2010-2015, But Remains High

Amount of Opioids Prescribed Declined from 2010-2015, But Remains High

There was an overall decline in the amount of opioids prescribed in the United States between 2010 and 2015, but the quantity of prescriptions is still extremely high, according to a new government report.

The Centers for Disease Control and Prevention (CDC) reported that the amount of opioids prescribed was three times higher in 2015 than in 1999, The New York Times reports.

The amount of opioids prescribed varies county by county, the CDC found.

Half of U.S. counties have seen a decrease in the amount of opioids prescribed from 2010 to 2015.

The highest prescribing counties still dispense six times more opioids than the lowest prescribing counties. Far more opioids are prescribed per capita in parts of Maine, Nevada and Tennessee than in most of Iowa, Minnesota and Texas.

Original linkOriginal author: Ezra
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“Molly” Sold at Music Festivals Often Contains Other Drugs

“Molly” Sold at Music Festivals Often Contains Other Drugs

People who think they are buying “Molly” at music festivals often end up with pills or powder that contain other drugs, according to a new study.

Researchers studied data collected by the organization DanceSafe, which tested samples of pills or powder sold as Molly at music festivals in the United States between 2010 and 2015, The Washington Post reports.

They found Molly, or MDMA, was present in only 60 percent of the samples collected. The rest contained a mix of ingredients.

While most of the chemicals could not be identified, some samples contained methamphetamine. Several contained a potent form of the amphetamine PMA, which is more likely than many other drugs to be lethal with a single dose.

The findings are published in the Journal of Psychopharmacology.

Original linkOriginal author: Ezra
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A.G Says He Supports Bringing Back D.A.R.E. Anti-Drug Program

A.G Says He Supports Bringing Back D.A.R.E. Anti-Drug Program

Attorney General Jeff Sessions voiced support this week for bringing back the anti-drug program D.A.R.E.

The program has been criticized for not providing effective results, the New York Daily News reports.

“D.A.R.E. is, I think, as I indicated, the best remembered anti-drug program today,” Sessions said at a training conference in Texas. “In recent years, people have not paid much attention to that message, but they are ready to hear it again.” He added, “We know it worked before and we can make it work again.”

In 2003, the Government Accountability Office issued a report that looked at six long-term evaluations of the D.A.R.E. elementary school curriculum and found “all of the evaluations suggested that D.A.R.E. had no statistically significant long-term effect on preventing youth illicit drug use.”

Original linkOriginal author: Ezra
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NIH Findings Link Aldosterone with Alcohol Use Disorder

NIH Findings Link Aldosterone with Alcohol Use Disorder

A new study led by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, demonstrates that aldosterone, a hormone produced in the adrenal glands, may contribute to alcohol use disorder (AUD).

The novel research, conducted in collaboration with a team of investigators in the United States and Europe, appears in the journal Molecular Psychiatry.

Aldosterone helps regulate electrolyte and fluid balance by binding to mineralocorticoid receptors (MRs), which are located throughout the body. In the brain, MRs are mainly located in the amygdala and the prefrontal cortex -- two key brain areas involved in the development and maintenance of AUD. In AUD, amygdala dysfunction heightens activation of brain stress systems resulting in anxiety and other negative emotions, while disruption of the prefrontal cortex impairs executive control systems involved in the ability to make decisions and regulate one's actions, emotions, and impulses.

"Previous studies, including a pilot clinical study that we published in 2008, illustrate the possible role for aldosterone in AUD," said senior author Lorenzo Leggio, M.D., Ph.D., chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory jointly funded with the National Institute on Drug Abuse, also part of NIH. "Our overall hypothesis has been that aldosterone may play a role in AUD via its MR receptor and that this neuroendocrine pathway may be particularly important in anxiety, stress and stress-induced alcohol drinking."

The new report describes three separate studies, conducted with non-human primates, rats, and humans, that investigated the potential contribution of the aldosterone/MR pathway to AUD.

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CDC Awards $12 Million to Help States Fight Opioid Overdose Epidemic

CDC Awards $12 Million to Help States Fight Opioid Overdose Epidemic

Support will strengthen state efforts to prevent and track opioid overdoses

The Centers for Disease Control and Prevention (CDC) will be awarding more than $12 million to 23 states and the District of Columbia to support their responses to the opioid overdose epidemic.

The funds will be used to strengthen prevention efforts and better track of opioid-related overdoses. CDC expects to announce additional funding awards for state opioid overdose prevention programs later in the summer.

Increased funding for opioids in the fiscal year (FY) 2017 Omnibus Appropriations bill is allowing CDC to support all states that have applied for funding through the Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality and Mortality (ESOOS) program and the Prescription Drug Overdose: Prevention for States (PfS) program.

Under the ESOOS program, $7.5 million will go to 20 additional states and the District of Columbia to better track and prevent opioid-involved nonfatal and fatal overdoses. This cooperative agreement already provides funds to 12 states to develop and adapt surveillance systems to address the rising rate of overdoses attributable to opioids, including a specific focus on heroin and synthetic opioids such as illicitly manufactured fentanyl.

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Suffolk County: Highest Rate of Overdose Deaths in New York State

Suffolk County: Highest Rate of Overdose Deaths in New York State

Opioid misuse and overdose deaths in the United States have been rising for two decades. Between 2000 and 2013, the opioid overdose rate—among all ages, races, genders, and ethnicities—nearly quadrupled, increasing from 0.7 to 2.7 deaths per 100,000 individuals. Drug overdose is now the single greatest cause of unintentional deaths in America.

Suffolk County, in downstate New York, has been hit particularly hard. With 337 heroin-related deaths between 2009 and 2013, Suffolk County reported more such deaths than any other county in New York State. And in 2014, the age-adjusted opioid-related death rate in Suffolk County was 12.6 per 100,000, compared to the New York State average of 7.2 per 100,000. This article explores why Suffolk County residents are at greater risk for overdose deaths and, more important, how they are now protecting themselves.

The Community

Suffolk County occupies the easternmost two-thirds of Long Island. Its population size of 1.5 million is larger than that of several individual states (Vermont, Rhode Island, Delaware, North & South Dakota, Montana, Wyoming, and Alaska). Compared to the rest of New York State, Suffolk County residents are generally more prosperous (inflation-adjusted median annual household income $85,886 in 2014; third highest of New York’s 62 counties) and less diverse. The income gap between the county’s upper and lower socioeconomic classes is smaller than the state average. In 2015, 68.6 percent of Suffolk County identified as “non-Hispanic white,” compared to 56.0 percent for New York State.

Suffolk and Opioids

The high percentage of Caucasians in Suffolk County may help to explain that county’s high rate of opioid deaths. The following graph of national statistics from a Centers for Disease Control and Prevention (CDC) publication shows that, between 2000 and 2013, the most dramatic jump in heroin-related overdoses was in non-Hispanic white persons aged 18 to 44. New York State statistics are similar—in 2014, the heroin-related mortality rate for all residents of New York State was 6.5 per 100,000, whereas the rate for only non-Hispanic whites was significantly higher (9 per 100,000).

“Drug-Poisoning Deaths Involving Heroin: United States, 2000-2013.” Holly Hedegaard, Li-Hui Chen, & Margaret Warner. NCHS Data Brief #190, March 2015. http://www.cdc.gov/nchs/data/databriefs/db190.htm

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