United States: the pandemic has caused a record of overdose deaths

SIDE EFFECTS – According to preliminary data from the annual report on drug use in the United States, carried out by health authorities and released on Wednesday, the overdose death rate in the country has never been so high. This increase in the number of victims is directly linked to the pandemic.

In the United States, the collateral damage of the pandemic did not take long to surface. In 2020, the country experienced a record of overdose deaths, driven by isolation, precariousness or even smaller budgets allocated to associations helping drug addicts. Those deaths jumped 30% to 93,000, according to preliminary statistics from the Centers for Disease Control and Prevention (CDC), released on Wednesday. While this overdose death rate has been rising steadily since 2019, it is nevertheless the largest increase recorded in a single year.

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At the heart of this record, the CDC reports other unprecedented numbers: highest number of drug overdose deaths in a year; the highest number of deaths from opioid overdoses; the highest number of deaths from synthetic opioids, known as fentanyls; the highest number of deaths from overdoses of stimulants, such as methamphetamine.

Social distancing, or the forced isolation of drug addicts

These overdoses peaked in the spring of 2020, in the midst of the pandemic’s most severe economic downturn and lockdown. José Benitez, the executive director of the prevention center in Philadelphia (Pennsylvania), testifies to this period in the New York Times. He says in particular that it was not uncommon for two patients followed in his establishment, which notably provides help to drug addicts, die every week.

For him, public health warnings against the Covid concerning social distancing are not unrelated to these deaths. Drug users are generally encouraged to take them in the presence of other people, so that they can revive them in the event of an overdose. The number of appointments in his center, he fell by 20% during the health crisis. Part of the funding allocated to them was also diverted to support Covid services.

Young people and communities of color most affected

If the Covid-19 has taken the lives of the elderly, the majority of these overdoses have particularly affected young people. The 93,000 deaths linked to drug overuse have cost Americans an estimated 3.5 million years of life, according to an analysis by the New York Times. In comparison, deaths from coronaviruses in 2020 were responsible for around 5.5 million years of life.

Black and Hispanic populations were also more affected than whites. “The pandemic has been far more disruptive for communities of color than for white communities”, affirms to the American daily Joshua Sharfstein, vice-dean of the school of public health Johns Hopkins Bloomberg by relying on the rates of mortality, injection, unemployment and precariousness in these populations. “So many of the consequences of the pandemic have hit communities of color harder. So it is not illogical that overdoses should do the same.”

An increase in drug use globally

On June 24, a report by the United Nations Office on Drugs and Crime (UNODC) reported a general increase in drug consumption around the world, and in particular cannabis and drugs such as tramadol, benzodiazepines or barbiturates. The use of cocaine or MDMA, usually consumed during festive events, has however decreased due to lockdowns, curfews and the closing of nightclubs, measures adopted by many countries. In total, some 275 million people around the world used drugs in 2020, up from 269 million in 2018.

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According to the report’s authors, 42% of healthcare professionals surveyed in 77 countries said cannabis use increased as a result of environmental stress, decreased social interactions, or boredom. In France, a third of cannabis users have increased their consumption. The UNODC also reports an increase in the consumption of cocaine and MDMA during the summer months of 2020 in France, visible through analyzes of wastewater.

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Biliary tract tumors, affected over 5 thousand Italians every year – Medicine

Over 5,000 Italians are affected by biliary tract cancers every year. 25% of diagnoses are random, half of cases develop for no apparent reason with no or late symptoms. And the localization is in difficult or hidden locations, such as inside or near the liver and gallbladder, with the possibility of doubling the volume in just 28 days compared to 190 days for breast cancer. These are some alarming aspects mentioned by Ropi (Italian Oncology Patients Network) which will be explored in the new Notebook which will be presented with a webinar on Monday 5 July.

Early diagnosis of these types of tumors is ‘fortuitous’ (20-25% of cases) and often depends on an ultrasound of the liver or abdomen performed for other causes. In about 50% of cases, the disease develops for no apparent reason. Research today offers new and important therapeutic opportunities: at least four latest generation drugs that target two genes responsible for the disease, IDH1 and FGFR2, and capable of increasing survival, improving the quality of life and reducing mortality by about 30%.

“Tumors of the biliary tract including gallbladder tumors and cholangiocarcinomas – explains the president of the Aiom Foundation, Stefania Gori – have different manifestations depending on the location and type of growth. In most cases they are asymptomatic in the initial phase and then develop in case of intrahepatic or extrahepatic cholangiocarcinoma (inside or outside the liver). This is why this Ropi Notebook is particularly important “, explains the president of the Aiom Foundation, Stefania Gori. “In recent years – adds Giovanni Brandi, medical oncologist at the Sant’Orsola Malpighi University Hospital of Bologna and Founder of the Gico Group (Italian Cholangiocarcinoma Group) – the diagnosis of intrahepatic cholangiocarcinomas is more frequent. A growth presumably attributable to geographical differences and temporal changes in the risk factors associated with the different forms of cancer “. “Our Association – concludes Paolo Leonardi, President of APIC (Association of Italian Patients with Cholangiocarcinoma) – has collected on the website (www.apicinfo.it) useful information on the disease and above all on accredited and highly specialized centers to contact” .