NIHCM Newsletter / July 2023
Drug Overdose Trends
Substance Use: Prevention, Treatment, & Pregnancy
Drug overdoses are continuing to increase, largely driven by fentanyl. A recent study shows medication for treating opioid use disorder is underprescribed in the United States, particularly for Black patients. Additionally, xylazine, or “tranq,” is increasingly being mixed with fentanyl. Addiction treatment centers don’t have the expertise to treat the severe wounds xylazine causes, limiting treatment options for people who are addicted. Learn more about efforts to address the overdose crisis and substance use disorder:
- Harm Reduction: Fentanyl test strips are a cost-effective means of preventing overdoses and a growing number of states are adopting them. Overdose prevention centers remain unpopular, despite evidence of the harm reduction strategy.
- Opioid Antidote: The White House is working with manufacturers to reduce the cost of the opioid overdose reversal drug, naloxone. A drug similar to naloxone, called Opvee, recently received FDA approval.
- Approach to Xylazine: Xylazine has no known antidote, but naloxone should be administered even if it is suspected to be present because xylazine is usually found in synthetic opioids, which do respond to naloxone. There is a new dual drug test strip that can detect fentanyl and xylazine.
- Pregnancy & Addiction: Experts are calling to change laws that criminalize drug use during pregnancy to improve access to treatment. Overdoses among pregnant women have hit record highs in recent years. A new study found Black pregnant women were more likely to be tested for drug use.
Resources & Initiatives:
- The CDC has resources on substance use during pregnancy, fentanyl, and more on stopping overdoses.
- Elevance Health partnered with Shatterproof to reduce stigma around addiction and increase access to treatment and recovery.
- NIHCM Grantee, Diva Communications, produced a documentary about women in the opioid epidemic.
- Through Mobilize AZ, Blue Cross Blue Shield of Arizona is supporting moms in recovery and access to treatment. Blue Cross of North Carolina supports Wilkes Recovery Revolution, a peer recovery program that is increasing access to support in a rural area.
- A new study found incorporating exercise into treatment may improve addiction recovery.
- See NIHCM’s work on substance use, including our Research Insights on a low-cost intervention for better-informed opioid prescribing.
Extreme Weather: Impact on Human Health
Canadian wildfires are expected to continue impacting US air quality throughout the summer. Much of the US is also coping with dangerous levels of heat and the Atlantic hurricane season, which began June 1st. Heatwaves are the deadliest weather-related event in the US and can cause serious health consequences for people with high blood pressure and heart disease.
- Wildfires: Rising temperatures are causing wildfires to be stronger and longer, which increases the amount of pollutants in the air. This can increase rates of heart attacks, strokes, and emergency room visits for respiratory conditions.
- Extreme Heat: Hotter than average temperatures may lead to an “extreme heat belt” by 2053, where parts of the US experience a heat index of 125 degrees or above at least once a year. Heat has a variety of effects on human health, from impacting mental and physical conditions to the environments hospitable for vector-borne diseases.
- Hurricane Season: Of the ten deadliest hurricanes between 1963 and 2022, seven have happened this century. Studies have shown that rising temperatures have led to hurricanes staying stronger longer over land and worsening outcomes.
Resources & Initiatives:
- This Office of Climate Change and Health Equity resource informs addressing patients’ social determinants of health and programs to mitigate climate-related health harms.
- NIHCM’s infographic details the health impacts of extreme heat.
- Horizon Blue Cross Blue Shield of New Jersey shares tips on how to protect yourself from skin cancer, especially among people of color.
- Older adults are especially vulnerable to heat-related illnesses and the National Institute on Aging provides resources on staying safe.
- Learn more about how to prepare for hurricanes.
The State of Reproductive Health
A recent report found that maternal mortality increased during the pandemic, particularly for Black and American Indian/Alaska Native women. At least 26 states have imposed restrictions since the Dobbs decision last year and the report provides a baseline for assessing future performance. In response to worsening maternal health outcomes, more than half of states have extended the duration of postpartum Medicaid coverage.
- Impact on the Delivery of Care: A report surveyed OBGYNs on how the Dobbs decision impacted care delivery. It found that nationally, over 36% of OBGYNs say their ability to practice within the standard of care has worsened.
- Expanded Postpartum Coverage: Medicaid pays for roughly four in ten US births. NIHCM Grantee, Maria Steenland, and colleagues recently found that in Arkansas, expanded coverage narrowed racial disparities in postpartum coverage.
- Fibroids: As many as 70% of women develop fibroids and 30% become symptomatic. Black women are diagnosed with fibroids about three times as frequently as White women. The reasons for the disparity are unclear, as research has pointed to many factors, including patterns of gene expression. A recent study also found that endometriosis and fibroids are associated with greater risk of ovarian cancer in women.
Resources & Initiatives:
- Researchers from Elevance Health found that certified doulas are effective at improving maternal and baby health outcomes
- Track Medicaid expansion of postpartum care with the Kaiser Family Foundation.
- NIHCM Grantee, PBS NewsHour, examines the health care challenges facing pregnant women of color in rural areas.
- Learn more about fibroids and who's at risk and 7 things to know about living with them. Also, here are the symptoms that can warrant a trip to a fibroid specialist.
- This woman’s story emphasizes the need for doctors to take fibroid symptoms seriously and self-advocacy plays a crucial role in receiving care.
