This Week's News in Substance Use: 11/30/18

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‘The Numbers Are So Staggering.’ Overdose Deaths Set a Record Last Year. The New York Times

A class of synthetic drugs has replaced heroin in many major American drug markets, ushering in a more deadly phase of the opioid epidemic.

New numbers Thursday from the Centers for Disease Control and Prevention show that drug overdoses killed more than 70,000 Americans in 2017, a record. Overdose deaths are higher than deaths from H.I.V., car crashes or gun violence at their peaks. The data also show that the increased deaths correspond strongly with the use of synthetic opioids known as fentanyls.

Since 2013, the number of overdose deaths associated with fentanyls and similar drugs has grown to more than 28,000, from 3,000. Deaths involving fentanyls increased more than 45 percent in 2017 alone.

Quitting Alcohol Can Be Deadly: Hundreds in The US Die Each Year, USA Today

For those experiencing the most serious symptom of [alcohol] withdrawal – the shaking, shivering, sweating and confusion of delirium tremens, or the DTs – the death rate has been estimated as high as 4 percent, or 1 in 25.

Of patients admitted to one hospital in Spain with alcohol withdrawal syndrome from 1987 to 2003, a research team there found, 6.6 percent died. That's roughly 1 in 15.

The Centers for Disease Control and Prevention counted 831 deaths in 2016 that could be characterized as related to alcohol withdrawal. The National Institutes of Alcohol Abuse and Alcoholism do not have an estimate of deaths from alcohol detox.

One of The Biggest Challenges of Kicking Addiction Is Getting and Keeping a Job, The Washington Post

Research has shown that working helps people overcome substance [misuse] and stay sober. It provides income and health benefits, of course, but also can instill meaning and purpose in their lives, which are powerful incentives to stay off drugs.

In some cases, work also provides the sense of being part of a team. It can make former users feel like they are shedding their roles as outcasts and rejoining their communities.

“One of the most important things that people in recovery talk about is how it feels, with their self-worth and identity, getting employed again,” said David Mara, New Hampshire’s drug czar.

5 Tips for Managing Your Health if Your Family Has a History of Addiction, US News and World Report

There's wide consensus among substance use disorder clinicians that genetics predisposes some people to alcoholism and addiction. Given that, if you have family members who have a problem with drugs or alcohol, you should do everything possible to protect yourself from developing substance use disorder as well, says Deni Carise, chief scientific officer at Recovery Centers of America. That's because research strongly suggests that there's a genetic component to substance misuse disorder, says Carise, who's based in Philadelphia. "The science is clear: (genetics) play a very real role in the development of alcohol or drug disorders," she says. "If you have any family members who currently have or have had alcohol or drug problems, you are likely to be at higher risk (for addiction). Additionally, some genes may make it more difficult for someone to quit once he or she starts using a drug."

This City’s Overdose Deaths Have Plunged. Can Others Learn From It? The New York Times

Overdose deaths in Montgomery County, anchored by Dayton, have plunged this year, after a stretch so bad that the coroner’s office kept running out of space and having to rent refrigerated trailers. The county had 548 overdose deaths by Nov. 30 last year; so far this year there have been 250, a 54 percent decline.

Dayton, a hollowed-out manufacturing center at the juncture of two major interstates, had one of the highest opioid overdose death rates in the nation in 2017 and the worst in Ohio. Now, it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands of people in the United States over the last decade, including nearly 50,000 last year.

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