Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Dinwiddie AT[original query] |
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Routes of drug use among drug overdose deaths - United States, 2020-2022
Tanz LJ , Gladden RM , Dinwiddie AT , Miller KD , Broz D , Spector E , O'Donnell J . MMWR Morb Mortal Wkly Rep 2024 73 (6) 124-130 Preliminary reports indicate that more than 109,000 drug overdose deaths occurred in the United States in 2022; nearly 70% of these involved synthetic opioids other than methadone, primarily illegally manufactured fentanyl and fentanyl analogs (IMFs). Data from the western United States suggested a transition from injecting heroin to smoking IMFs. CDC analyzed data from the State Unintentional Drug Overdose Reporting System to describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths that occurred during January 2020-December 2022, overall and by region and drugs detected. From January-June 2020 to July-December 2022, the percentage of overdose deaths with evidence of injection decreased 29.1%, from 22.7% to 16.1%, whereas the percentage with evidence of smoking increased 73.7%, from 13.3% to 23.1%. The number of deaths with evidence of smoking increased 109.1%, from 2,794 to 5,843, and by 2022, smoking was the most commonly documented route of use in overdose deaths. Trends were similar in all U.S. regions. Among deaths with only IMFs detected, the percentage with evidence of injection decreased 41.6%, from 20.9% during January-June 2020 to 12.2% during July-December 2022, whereas the percentage with evidence of smoking increased 78.9%, from 10.9% to 19.5%. Similar trends were observed among deaths with both IMFs and stimulants detected. Strengthening public health and harm reduction services to address overdose risk related to diverse routes of drug use, including smoking and other noninjection routes, might reduce drug overdose deaths. |
Drug overdose deaths with evidence of counterfeit pill use - United States, July 2019-December 2021
O'Donnell J , Tanz LJ , Miller KD , Dinwiddie AT , Wolff J , Mital S , Obiekwe R , Mattson CL . MMWR Morb Mortal Wkly Rep 2023 72 (35) 949-956 Using data from CDC's State Unintentional Drug Overdose Reporting System, this report describes trends in overdose deaths with evidence of counterfeit pill use during July 2019-December 2021 in 29 states and the District of Columbia (DC) and characteristics of deaths with and without evidence of counterfeit pill use during 2021 in 34 states and DC. The quarterly percentage of deaths with evidence of counterfeit pill use more than doubled from 2.0% during July-September 2019 to 4.7% during October-December 2021, and more than tripled in western jurisdictions (from 4.7% to 14.7%). Illicitly manufactured fentanyls were the only drugs involved (i.e., caused death) in 41.4% of deaths with evidence of counterfeit pill use and 19.5% of deaths without evidence. Decedents with evidence of counterfeit pill use, compared with those without evidence, were younger (57.1% versus 28.1% were aged <35 years), more often Hispanic or Latino (18.7% versus 9.4%), and more frequently had a history of prescription drug misuse (27.0% versus 9.4%). Smoking was the most common noningestion drug use route among deaths with evidence of counterfeit pill use (39.5%). Overdose prevention messaging that highlights the dangers of pills obtained illicitly or without a prescription (because they might be counterfeit), encourages drug product testing by persons using drugs, and is tailored to persons most at risk (e.g., younger persons) could help prevent overdose deaths. |
Drug overdose deaths among persons aged 10-19 years - United States, July 2019-December 2021
Tanz LJ , Dinwiddie AT , Mattson CL , O'Donnell J , Davis NL . MMWR Morb Mortal Wkly Rep 2022 71 (50) 1576-1582 U.S. drug overdose deaths increased 30% from 2019 to 2020 and 15% in 2021, resulting in an estimated 108,000 deaths in 2021.* Among persons aged 14-18 years, overdose deaths increased 94% from 2019 to 2020 and 20% from 2020 to 2021 (1), although illicit drug use declined overall among surveyed middle and high school students during 2019-2020 (2). Widespread availability of illicitly manufactured fentanyls (IMFs),() proliferation of counterfeit pills resembling prescription drugs but containing IMFs or other illicit drugs,() and ease of purchasing pills through social media() have increased fatal overdose risk among adolescents (1,3). Using CDC's State Unintentional Drug Overdose Reporting System (SUDORS), this report describes trends and characteristics of overdose deaths during July 2019-December 2021 among persons aged 10-19 years (hereafter referred to as adolescents). From July-December 2019 to July-December 2021, median monthly overdose deaths increased 109%, and deaths involving IMFs increased 182%. Approximately 90% of overdose deaths involved opioids, and 83.9% involved IMFs; however, only 35% of decedents had documented opioid use history. Counterfeit pill evidence was present in 24.5% of overdose deaths, and 40.9% of decedents had evidence of mental health conditions or treatment. To prevent overdose deaths among adolescents, urgent efforts are needed, including preventing substance use initiation, strengthening partnerships between public health and public safety to reduce availability of illicit drugs, expanding efforts focused on resilience and connectedness of adolescents to prevent substance misuse and related harms, increasing education regarding IMFs and counterfeit pills, expanding naloxone training and access, and ensuring access to treatment for substance use and mental health disorders. |
Notes from the Field: Antihistamine Positivity and Involvement in Drug Overdose Deaths - 44 Jurisdictions, United States, 2019-2020
Dinwiddie AT , Tanz LJ , Bitting J . MMWR Morb Mortal Wkly Rep 2022 71 (41) 1308-1310 Antihistamines are frequently used to treat allergy symptoms (1). Misuse of antihistamines has been documented primarily in adolescents and young adults (2); however, antihistamine involvement in overdose deaths has not been widely studied. Among the various antihistamine subtypes, the first-generation H1 subtype can cause anticholinergic effects, including strong sedation (3) that might be exacerbated when co-used with other sedative drugs (e.g., opioids).* Diphenhydramine, a common over-the-counter first-generation H1 antihistamine, has been combined with opioids as an adulterant† in illicit drug supply (4) and can be used to reduce opioid-related side effects (e.g., itchy skin because of histamine release from opioid use). |
Notes from the field: Increase in drug overdose deaths among Hispanic or Latino persons - Nevada, 2019-2020
Thomas SA , Dinwiddie AT , Monroy E . MMWR Morb Mortal Wkly Rep 2022 71 (19) 667-669 Reports have documented national and state-level increases in drug overdose–related emergency department visits, emergency medical services incidents, and deaths among racial and ethnic minority groups in the United States during 2020 amid the COVID-19 pandemic (1–3). In June 2021, the Nevada Department of Health and Human Services reported an increase in drug overdose deaths during 2020 among Hispanic or Latino (Hispanic) persons, who make up approximately one third of Nevada’s population (4). To better understand this increase, investigators analyzed 2019–2020 State Unintentional Drug Overdose Reporting System (SUDORS) data.* | | SUDORS is a CDC surveillance system containing detailed information on death scene investigations, toxicology, and other risk factors associated with fatal drug overdoses of unintentional or undetermined intent. Hispanic persons were identified through the SUDORS ethnicity variable, which considers persons with Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin as Hispanic, regardless of race. Chi-square pairwise comparisons with Bonferroni adjustment were used to assess differences between 2019 and 2020 in characteristics and circumstances for all overdose deaths and for those among Hispanic persons (5). |
Comprehensive viral enrichment enables sensitive respiratory virus genomic identification and analysis by next generation sequencing.
O'Flaherty BM , Li Y , Tao Y , Paden CR , Queen K , Zhang J , Dinwiddie DL , Gross SM , Schroth GP , Tong S . Genome Res 2018 28 (6) 869-877 Next generation sequencing (NGS) technologies have revolutionized the genomics field and are becoming more commonplace for identification of human infectious diseases. However, due to the low abundance of viral nucleic acids (NAs) in relation to host, viral identification using direct NGS technologies often lacks sufficient sensitivity. Here, we describe an approach based on two complementary enrichment strategies that significantly improves the sensitivity of NGS-based virus identification. To start, we developed two sets of DNA probes to enrich virus NAs associated with respiratory diseases. The first set of probes spans the genomes, allowing for identification of known viruses and full genome sequencing, while the second set targets regions conserved among viral families or genera, providing the ability to detect both known and potentially novel members of those virus groups. Efficiency of enrichment was assessed by NGS testing reference virus and clinical samples with known infection. We show significant improvement in viral identification using enriched NGS compared to unenriched NGS. Without enrichment, we observed an average of 0.3% targeted viral reads per sample. However, after enrichment, 50%-99% of the reads per sample were the targeted viral reads for both the reference isolates and clinical specimens using both probe sets. Importantly, dramatic improvements on genome coverage were also observed following virus-specific probe enrichment. The methods described here provide improved sensitivity for virus identification by NGS, allowing for a more comprehensive analysis of disease etiology. |
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