Drug-related losses of the working-age population of Moscow: official levels and real scale

Introduction. Drugs and the resulting health loss are a global problem. At the same time, residents of megalopolises, mainly of working age, fall into the risk group. The purpose is to assess the scale of losses of the working-age population of Moscow due to drug use. Materials and methods. The data of Rosstat on mortality of the population were used. We have calculated standardized mortality rates by causes of death in the selected age groups. We used a direct method of standardization, the European standard for age structure. To characterize the social status of the deceased, we used the data of the RFS-UMIAS of Moscow (the period of data analysis is July-December 2018 − January-June 2019). Results. We analyzed the dynamics of mortality among the working-age population of Moscow from the main causes of drug etiology (accidental drug poisoning and drug poisoning with unspecified intentions, mental disorders caused by drug use) against the background of Russia in the 2010s. It is shown that the dynamics of mortality from these causes was characterized by a sharp change in trends during 2015−2016. There was a sharp increase in mortality in the capital during the same period from cardiovascular diseases, due to unspecified cardiomyopathy. We pointed out that these shifts are synchronous with the dynamics of mortality from symptoms, signs, and ill-defined conditions. Discussion. It is hypothesized that, with a high degree of probability, the abnormal increase in mortality from unspecified cardiomyopathy is a statistical artifact - a consequence of the transfer of drug-related deaths to a latent form. Conclusions. Masking losses from drug addiction in ill-defined conditions and unspecified cardiomyopathy leads to the fact that mortality from drug poisoning in Moscow is not assessed as a serious problem.

Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016

Better understanding of the dynamics of the current U.S. overdose epidemic may aid in the development of more effective prevention and control strategies. We analyzed records of 599,255 deaths from 1979 through 2016 from the National Vital Statistics System in which accidental drug poisoning was identified as the main cause of death. By examining all available data on accidental poisoning deaths back to 1979 and showing that the overall 38-year curve is exponential, we provide evidence that the current wave of opioid overdose deaths (due to prescription opioids, heroin, and fentanyl) may just be the latest manifestation of a more fundamental longer-term process. The 38+ year smooth exponential curve of total U.S. annual accidental drug poisoning deaths is a composite of multiple distinctive subepidemics of different drugs (primarily prescription opioids, heroin, methadone, synthetic opioids, cocaine, and methamphetamine), each with its own specific demographic and geographic characteristics.

Pattern of pediatric poisoning in the east Karadeniz region between 2002 and 2006: increased suicide poisoning

In the present study, 386 patients with the diagnosis of poisoning admitted to the Pediatric Emergency Unit of Farabi Hospital of Medical Faculty of Karadeniz Technical University between January 2002 and December 2006 were retrospectively evaluated with respect to gender, age, cause of poisoning, type of substance used, route of exposure, reason for the intake, signs and symptoms, time of referral to the hospital, hospitalization period, and prognosis. The age group of most poisoning cases was <5 years of age and constituted 51% (n = 197) of all cases. The main toxic agent was drugs (70.2%), followed by foods (8.8%), rodenticides (7%), insecticides/pesticides (4.9%), and carbon monoxide (4.7%). In childhood poisonings, accidental drug poisoning was frequent in toddlers, whereas suicidal poisoning was frequent in adolescents. The suicidal poisoning rate was 23.8% among all poisoning patients, and 98.9% of these patients were adolescents. The suicidal poisoning rates for males and females were 30% and 70%, respectively. An increase in suicidal and inhalation poisonings was observed when compared with previous studies that have been conducted in the same region. The results of the present study suggest that poisonings still represents an important health problem that could be prevented by safe drug storage at home, as well as parental education on adolescence issues, particularly those regarding females.

The pharmacologic stability of 35-year old theophylline

The propensity to preserve and to hoard drugs over the years at home is a well-known phenomenon and offers the possibility for intentional and accidental drug poisoning in man. We report a case of acute theophylline poisoning in an 80-year old women after ingestion of ‘Asthmo-Kranit1 ’, a 35-year old combined preparation containing theophylline and aminopyrine as the main ingredients. The patient developed the typical clinical picture of a symptomatic theophylline poisoning with flush, tremor, tachycardia, hyperventilation, hypotonia, and hyperglycaemia. The clinical course after treatment with beta-blockers was without complications. The determination of theophylline in tablets showed stability of 90% of the labelled amount of the drug 30 years beyond the expiration date. The case illustrates the prolonged shelf stability and pharmacological potency of some pharmaceuticals and points to the risk of longoutdated prescriptions. Physicians should primarily not underestimate drug toxicity in consequence of old-age pharmaceuticals.

SOCIAL HEALTH

During the past four decades, while our knowledge of physical disease has increased enormously, the scope of concern in pediatrics has broadened to inelude the intellectual development, school performance, emotional maturation, and behavioral disorders of children. Pediatricians are increasingly aware that much of the pathology of whatever nature in the children they treat has causes which lie in the social environment of their families and ultimately in the ill health of society itself—often, and most especially, in poverty. This paper is about these latter problems and about our responsibility, as mdividuals in society, as physicians, and as members of the American Academy of Pediatrics, to promote-by all the means at our disposal social health—that condition of the environment which will allow for the optimum functioning of tile individuals within it. We may think of the etiology of much childhood ill health as a series of steps, each one further removed from the actual illness. The chain of causality leading to disease could be illustrated by a multitude of illnesses : prematurity, cerebral palsy, enteric diseases, drug abuse, teenage pregnancy. Accidental drug poisoning will be used as an example because it is simple and familiar to us all and because its relation to social health may not be clear initially. The traditional area of medical activity is the diagnosis and treatment of the poisoning itself. Physicians attempt as well to prevent such poisoning by dealing with its immediate cause, the child's finding and ingestion of the toxic substance. We substitute acetaminophen for aspirin, provide safety closures for medicine bottles, and urge locked medicine cabinets.