Drug abuse trends: Deaths down, with an insidious twist

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I wrote this story for KPLU earlier this week and I’m sharing it here, as well.

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You’ve probably heard the under-world of drug abuse has taken on a new face over the past decade, with the rise of prescription pill addicts.

The story is more nuanced than that. But before looking at the nuance, here are a few surprising facts and a disturbing trend.

by Ashley Rose/Flickr

  • Overdose deaths in King County dropped last year, from 161 to 130. And the most recent state-wide data, from 2009, also showed a drop to 324.
  • The top 5 drugs involved in King County’s overdoses were, in order: Prescription opiates (painkillers)-130; Anti-anxiety and anti-depressant medications -79; Alcohol -62; Heroin -50; Cocaine -46
  • The number of dirty needles exchanged for clean ones in King County more than doubled between 2007 and 2010

These figures were compiled from various sources by Caleb Banta-Green, an epidemiologist at the University of Washington’s Alcohol and Drug Abuse Institute. He’s presenting the work this week to a panel of the National Institute on Drug Abuse’s Community Epidemiology Work Group, representing 21 major cities, which is meeting in Seattle.

From painkillers to heroin?

He also told me that his biggest concern, looking forward, is what happens to the people who get addicted to painkillers, such as oxycodone.

“Prescription type opiates are pretty potent, but they’re also quite expensive. Heroin is much cheaper. So, my concern is that as people run out of resources to afford prescription type drugs, they’re going to need to move on to heroin.”

And sure enough, nearly 40% of heroin addicts interviewed at a treatment clinic in King County say they started with prescription drugs first. Other data, from the state crime lab, show drug busts for heroin are on the rise in a number of smaller counties (particularly on the Olympic peninsula and in Whatcom County). Heroin abuse used to be confined to Washington’s cities — primarily Seattle, Tacoma, Spokane, Everett and Yakima. Now, it’s appearing in small towns and rural areas.

Continue reading →

But what does that faraway (e.g. Japanese) earthquake mean for me, in the Pacific Northwest?

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Every time an earthquake, somewhere, is big enough to dominate headlines, everyone here in this northwestern corner of the United States starts wondering what it means for us.

Travel times map for Honshu quake

Warning map from NOAA National Tsunami Warning Ctr, for a tsunami generated by the March 11, 2011, Honshu earthquake (yellow star is the epicenter, with the Americas to the right).

This has happened frequently enough (e.g. Haiti, Chile, New Zealand) that I’m thinking it would be useful to create a basic FAQ for earthquakes. Lots of FAQ’s exist, written by scientists, or emergency preparedness teams. But I haven’t come across one that’s written with the fears and fascinations of the public in mind. I guess I’d start with a basic fact:

Not all earthquakes are of the same kind.

Continue reading →

Shallow New Zealand quake a warning to Pacific Northwest

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Experts in the northwest warn the deadly earthquake in New Zealand was similar to what might happen here.

The quake hit Christchurch, New Zealand, a city comparable in size to Spokane, along a fault-line that was unknown until last September. That’s when an even larger quake hit New Zealand — but with limited damage, since it was centered farther from any city. Authorities in Christchurch were predicting the death-toll would rise to 300.

In recent years, scientists have found evidence of shallow faults across the northwest, such as the Seattle fault that runs beneath Qwest Field (the Seahawks stadium) and roughly follows Interstate-90. <--break->

“In fact, there’s sort of one per town,” says John Vidale, a professor of earth sciences at the University of Washington and director of the Pacific Northwest Seismic Network. “There’s the Tacoma fault, there’s the Olympia fault, there’s the Portland hills fault, there’s the south Whidbey fault, which runs up the east side of the Puget Sound.”

Just like in New Zealand, these shallow faults shake only rarely – perhaps once every 1,000 years, or even once in 10,000 years. Rare, but extremely deadly.

Comparing to Nisqually, ten years ago — smaller but stronger

In contrast, the most recent major earthquake in western Washington was the Nisqually earthquake. The tenth anniversary happens to be on Monday.

Fenix Underground club after Nisqually quake

Seattle's Pioneer Square shortly after the 2001 quake.

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Why snowstorms in Chicago can mean sunny in Seattle

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You might have wondered — as you gazed out your sunny Seattle-area window, and listened to news of record cold and snow sweeping the midwest and East coast — is there a connection?

Yes, there is.

“Our weather often is the just the opposite of what it is in the eastern part of the united states,” says Cliff Mass, professor of Atmospheric Sciences at the University of Washington.

“When we are cold, like it was just before Thanksgiving, they tend to be warm,” says Mass.

The reason we’re yin when they’re yang, and vice versa, has to do with the jet stream and “ridges” of high and low pressure in the sky, as Mass explains it.<--break->

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Hospital maneuvers: UW Medicine soon could include Valley Medical Center

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King County’s major medical centers continue jockeying for position in the emerging new health-care world.

U.W. Medicine and Valley Medical Center proposed this week what they call a “strategic alliance.” Valley wants to retain its name, although the news release says Valley would become “part of U.W. Medicine.”

Earlier this year, U.W. Medicine took over running Northwest Hospital (in north Seattle), without actually owning the hospital.

As Dean Radford writes in the Renton Reporter:

Public Hospital District No. 1, which owns [Valley] medical center and neighborhood clinics, would still exist. Its five commissioners would sit on a larger board that would oversee management of Valley Medical. The Valley board would continue to oversee the hospital district itself.

In essence Valley Medical Center would become part of the UW Medicine system, which owns and operates Harborview Medical Center and the University of Washington Medical Center. UW Medicine also shares ownership and governance of Seattle Cancer Care Alliance, Children’s Hospital and Medical Center and Fred Hutchinson Cancer Research Center.

The bigger picture: U.W. Medicine and Swedish Medical Center are competing to be top-dog in the greater Seattle area. All the other hospitals are nervously watching, trying to decide if they can survive independently, or if they need to affiliate. I alluded to this in an article last spring, as the same pressures are reflected in the mad scramble to build new Emergency Departments all over King County.

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Menu labels having no effect? Evidence from Taco Time

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Being a pioneer in adding calorie and nutrition labels to menus at fast-food restaurants has made King County a good place for researchers to visit.

A team based at Duke-National University of Singapore has been watching consumers at Taco Time restaurants, both in King County and in other counties, and found that adding all that info to the menus appeared to have no impact on people’s choices.  He published his results today (January 14, 2011) in the American Journal of Preventive Medicine.

As Shari Roan writes in the Los Angeles Times:

Thirteen months after the law went into effect, food purchases at the Taco Time restaurants in King County were identical to those at Taco Time restaurants where menu boards did not list nutritional information.

“Given the results of prior studies, we had expected the results to be small, but we were surprised that we could not detect even the slightest hint of changes in purchasing behavior as a result of the legislation,” the lead author of the study, Eric Finkelstein, of Duke-National University of Singapore Graduate Medical School, said in a news release. “The results suggest that mandatory menu labeling, unless combined with other interventions, may be unlikely to significantly influence the obesity epidemic.”

This will not be the last word on menu labeling.  The labels are coming soon to restaurants across the nation, Continue reading →

Michelle Obama’s “Obesity Task Force” – watch the details

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We’ll find out on Tuesday what the White House thinks we can achieve, regarding childhood obesity.   I just got this announcement:

Tuesday, May 11th – First Lady Michelle Obama and Domestic Policy Council Director Melody Barnes will unveil the findings of the Childhood Obesity Task Force report, the result of the 90-day review that the President ordered around the launch of the Let’s Move! initiative in February.

Several of the Cabinet members and administration officials who are part of the task force will also attend this press briefing and be available to the media afterwards: Office of Health Reform Director Nancy-Ann DeParle, Secretaries Donovan, Duncan, Sebelius, SBA Administrator Mills, and FTC Chairman Leibowitz.

If the findings emphasize physical activity without making major recommendations about diet, then you can call it a victory for the food and beverage companies.  But, I expect they’ll have a little of everything.  From what I’ve learned lately, I wonder …

  • Will it discuss ways to teach young families how to cook, especially using ingredients they’ve never tried?
  • Will it suggest ways to make sure produce is affordable?
  • Will it suggest a major tax on sugary beverages?
  • Will it tackle the issue of food labeling and food marketing (health claims on packages and advertising to children)?
  • Will it promote further study of the effects on obesity of hormone-mimicking chemicals on pregnant mothers and newborns?

Promoting physical activity is a good idea, too, for a lot of health reasons separate from weight-loss.  Mostly, I wonder if the report will spur any new action, beyond what’s already been attempted over the past decade.

(If you missed my story on why cooking classes might be important, here’s the link to KPLU.

Healthiest children … in wealthy zip-codes

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It’s a little provocative sounding, but the research from Adam Drewnowski at the University of Washington shows most of the obesity and overweight epidemic is closely tied to poverty.

I’ve been blogging about obesity issues all week (see “recent posts” or the tag “obesity”).  Today, I talked to Drewnowski.  I’ll share more about his ideas later. But, this one merits re-stating.  In work that was published in 2008, he took the basic federal data on obesity trends, and overlaid that onto a map of King County.  The wealthier the zip code, as measured by property values, the lower the obesity rates, and vice versa.

He told me the data might have been even more dramatic, because it turns out that the wealthiest areas (such as Medina) are not even represented.  As he put it, Rich people don’t answer surveys.

For the past two years, he’s been digging into some of the reasons why poor people are less healthy.  His baseline theory is the most obvious: eating well and taking care of yourself can be expensive, in time and money.

In work to be presented soon, he’ll argue against the idea that poor people need more grocery stores and fresh produce sold in their neighborhoods.  It turns out, most people will go several miles to get their groceries (except for the very poorest 1%).  Some people drive to the cheapest store, others drive to what they see as the better quality store. So, having more grocery stores wouldn’t make a difference.

You might get different results in Los Angeles, or Detroit — two cities where a lot of the research was conducted re.  lack of access to grocery stores.  He says that work doesn’t hold for Seattle/King County.

He does see a role for better food education (such as, cooking classes).  I’ll have that report Friday morning on KPLU.

Sodas and sugary drinks, an obesity culprit

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How much blame goes to the beverage industry?  NPR’s All Things Considered is looking into this topic (yesterday and today).

Many states are planning to tax sodas.  Washington has jumped on this one, too. The taxes are mostly to help fill budget gaps, and way too small to make a meaningful health difference.

The man who’s studied this the most, and made it into a crusade, says the tax needs to be much higher than any state is considering: a penny-an-ounce.  That would add 12 cents to a can of soda, and more than 60 cents to those 2-liter bottles.  Kelly Brownell, of Yale University’s Rudd Center on Food Policy and Obesity, argues this would compel Americans to make healthier choices.

Yesterday’s NPR reports included a good overview from Jeff Brady, plus a pair of interviews by Michelle Norris.  Several listeners told me they felt Norris was too easy on the beverage industry spokesperson.

Studies have shown a pretty strong correlation between soft-drink consumption and weight gain.  And, the beverage industry response that Americans just need more exercise?  Exercise is good, but it’s not a major factor in the obesity crisis and can’t compensate for the big jump in calorie consumption.  The scientific evidence is pretty strong on that.  But, nutritionists will also tell you it’s too simplistic to think that cutting down on sodas by itself will solve the weight-gain problem.  It’s an important step, but there are additional dietary problems.

Why eating in America may be less healthy than in Mexico

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Another angle on obesity.  I just got back from interviewing Marian Neuhouser, a nutritional scientist at the Fred Hutchinson center.  She’s launching a new study of Mexican-American women.  She says more than 76% of Hispanic women in the U.S. are overweight or obese (the overall rate for women in the U.S. is 64%).  The experience of Mexican immigrants is similar to Japanese immigrants – within one generation in this country, the rates of obesity skyrocket.  That’s why many scientists say there’s something about living in modern America that is “obesogenic” – causing people to become obese.  The most likely and most important factor: diet.

Neuhouser’s hypothesis is that the switch in diet is a trigger, going from typical rural Mexican meals dominated by beans, rice and fresh-made tortillas, to a more American diet that’s full of processed foods, white flour, fatty meats, and sugary drinks.  But, she also suspects the problem for Mexican immigrants is exacerbated by their genetic profile and how it reacts to the American foods.

She just received funding to study this in detail, by getting 50 Seattle-area Mexican women to eat their meals at the Hutch for a month, so she can control their diet, while monitoring their blood for a number of biomarkers.

The biomarkers might also help explain why Hispanic women tend to get a more virulent, hard-to-treat form of breast cancer.