How opioid abuse is lowering our average life expectancy
Normally, life expectancy increases every year. For Americans, the opioid epidemic is changing that.
- Americans' life expectancy dropped between 2014 and 2017, a significant downtrend that hasn't been seen since World War I.
- An analysis by the CDC identified the opioid epidemic as the cause.
- How did the opioid epidemic get so bad, and what can we do to stop it?
The collective health of Americans is taking a turn for the worse. In 2014, the average life expectancy for an American was 78.8 years, which is already lower than many other developed countries such as Japan, France, and the UK. Since then, that number has been steadily dropping. In 2017, the last year for which data is available, the average life expectancy was 78.6 years. To put this in perspective, life expectancy has always generally increased; the last time there was a significant drop in life expectancy occurred between 1915 and 1918 as a result of World War I and a devastating flu pandemic.
What's our lifespans to drop this time? According to Robert Redfield, the director of the Centers for Disease Control, opioid overdoses are to blame.
The three waves of the opioid epidemic
The number of deaths due to drug overdoses have doubled in a decade, with 36,010 deaths in 2007 and 70,237 in 2017. To account for this sharp increase, we have to look back to the 1990s, when opioids first started being prescribed en masse. There are three reasons why opioids became so frequently prescribed during this time.
First, the US's private health insurance system incentivizes the prescription of pills. Paying for pills is an attractive option for health insurance companies, as they're often cheaper and faster acting than repeat treatments, like physical therapy — though often less effective in the long term.
Second, pharmaceutical companies spend a considerable amount of effort on making their products attractive to doctors and health insurance companies. They often buy dinners and host conferences in an effort to convince doctors to prescribe their medication more frequently. Research has shown that this tactic is effective; doctors who receive free lunches from pharmaceutical representatives are more likely to prescribe the related medication.
Third, as part of their effort to sell more of their product, pharmaceutical manufacturers exaggerated the benefits of opioids, minimized the downsides, and lobbied the government to loosen regulation. Combined, these three factors caused the 90s' absurdly high levels of opioid prescription. But this was only the first wave of the opioid epidemic.
The second wave occurred around 2010, once we started to realize the considerable harm we were inflicting on ourselves by overprescribing opioids. We became stricter when it came to prescribing opioids, cutting off the supply for a number of addicted individuals. This restriction in access coupled with pharmaceutical pills' comparatively higher price tag persuaded addicted people to use heroin instead. Between 2002 and 2013, heroin-related overdoses increased by 286%.
The third and current wave of the opioid epidemic began around 2013 when synthetic opioids began to hit the market. The most infamous of these is fentanyl. Two milligrams of fentanyl, an incredibly small amount, can be a fatal dose for most people. It is also significantly cheaper to manufacture than heroin, and heroin is often laced with fentanyl as a result.
A lethal dose of fentanyl is presented next to a penny for scale.
United States Drug Enforcement Administration
What can be done?
Though the opioid epidemic may have grown into a beast large enough to reduce overall life expectancy, this doesn't mean it can't be stopped. Experts believe there are some sound strategies to ending the opioid epidemic once and for all, such as by rethinking opioid prescription practices and regulation. The current opioid epidemic began because of the over-prescription of pain relievers — these drugs are medically necessary, but only for a limited number of conditions. Regulation should be based on the medical evidence of prescription pills' efficacy.
In addition to preventing addiction from happening in the first place, we can do more to help those already addicted to opioids. For instance, we can increase funding for and the availability of naloxone, a drug that's remarkably efficacious at reversing opioid overdoses, and by implementing needle exchange programs.
When treating addiction, we also need to acknowledge that it's a condition that doesn't end once an individual is "clean." Addiction is a chronic condition, one that often lasts for a lifetime. This understanding needs to be reflected both within the medical community and health insurance companies. Medication-assisted treatment, or MAT, combines behavioral therapy with medication like methadone, buprenorphine, and naltrexone, and its been shown to be remarkably effective at treating opioid addiction. However, not all insurance plans support treatments like MAT. At the very least, it should be covered under state Medicaid programs. Some Medicaid programs do cover the medications needed for MAT, though the implementation leaves much to be desired.
There are numerous additional ways that we can combat the addiction epidemic, like criminal justice reform or health care reform, but none of these changes will occur overnight, and certainly none will occur without sufficient political will. The question is, are our shrinking lifespans motivation enough?
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Scientists discover the inner workings of an effect that will lead to a new generation of devices.
- Researchers discover a method of extracting previously unavailable information from superconductors.
- The study builds on a 19th-century discovery by physicist Edward Hall.
- The research promises to lead to a new generation of semiconductor materials and devices.
Credit: Gunawan/Nature magazine
Students who think the world is just cheat less, but they need to experience justice to feel that way.
- Students in German and Turkish universities who believed the world is just cheated less than their pessimistic peers.
- The tendency to think the world is just is related to the occurence of experiences of justice.
- The findings may prove useful in helping students adjust to college life.
The world is just? That’s news to a lot of people.<p>The study is the most recent addition to a long line of work focusing on the belief in justice, our behavior, and our reactions to evidence that might suggest injustice occasionally occurs. This study focuses on a personal belief in a just world, (PBJW) rather than a general belief in a just world (GBJW). The difference between them must be highlighted.</p><p>GBJW is the stance that justice prevails all over the world and that people tend to get what they deserve. PBJW is more focused on the individual's social environment and their belief that they tend to be treated justly. While several studies show PBJW correlates with a higher sense of well-being and a variety of other positive effects, a high GBJW is associated with less life satisfaction, negative behavior, and callousness towards the suffering of <a href="https://link.springer.com/book/10.1007%2F978-1-4939-3216-0" target="_blank">others</a>. This study controlled for GBJW, and focused on PBJW as much as possible. </p><p>To assure that culture was not a factor, the study included students at universities in both Germany and Turkey. </p><p>The researchers gave students at the four participating universities a series of questionnaires that asked if they ever cheated in class, if they perceived the world to be just, if they though that justice always prevailed everywhere, their tendencies towards socially appropriate behavior, their life satisfaction, and if they felt like they were treated justly by their teachers and fellow students. </p><p>The answers were statistically analyzed for relationships. While some of the connections seem trivially true, others were surprising. <strong></strong></p><p>PBJW turned out to only be an indirect predictor of if a student was likely to cheat. Both a belief in a just world and a lower likelihood of cheating were mediated by the justice experiences of the students, with more of these positive experiences lowering the rate of cheating and improving their belief in justice. This was also associated with higher levels of life satisfaction. </p><p>These effects existed across all demographics in both countries. </p>
What does this mean? Is a belief in justice a self-fulfilling prophecy?<iframe width="730" height="430" src="https://www.youtube.com/embed/6oMv-azHNCA" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p>In a way, it seems to be. People who have reason to think the world is just to them tend to interpret events in a way to sustain that belief and behave in a just manner. In a larger sense, the take away from this study is that experiences of justice, both from peers and instructors, is vital to student's wellbeing and understanding that the rules that exist about cheating are part of a larger, legitimate, system. </p><p>The researchers, citing previous studies on the perception of justice, note that "justice experiences (1) signal that university students are esteemed members of their social group, which in turn conveys feelings of belonging and social inclusion and (2) motivate them to accept and observe university rules and norms. These cognitive processes may thus strengthen their well-being and decrease the likelihood that they cheat."</p><p>The authors also suggest that if you want people (not only students) to act justly; consider treating them with "civility, respect, and dignity."</p><p>Sometimes, all it can take to help somebody act virtuously is to treat them well. Likewise, people treated harshly can rarely find reason to play by rules that don't protect them. The findings of this study will certainly add to the literature on how we perceive justice in the world around us, but might also help us remember that there are real consequences to our actions which can be much larger than we imagine. <strong></strong></p>
This could change how researchers approach vaccine development.
- The reason children suffer less from the novel coronavirus has remained mysterious.
- Researchers identified a cytokine, IL-17A, which appears to protect children from the ravages of COVID-19.
- This cytokine response could change how researchers approach vaccine development.
A member of staff wearing personal protective equipment (PPE) takes a child's temperature at the Harris Academy's Shortland's school on June 04, 2020 in London, England.
Photo by Dan Kitwood/Getty Images<p>Experts don't want to place kids at the back of the line, regardless of how strong their immune systems appear. At least one company, Moderna, <a href="https://www.businessinsider.com/coronavirus-vaccine-for-kids-moderna-plans-pediatric-trial-2020-9" target="_blank">hopes to begin testing</a> vaccines in pediatric volunteers by year's end.</p><p>Innate immune response is especially high during childhood (compared to adaptive immunity). This makes evolutionary sense: nature wants an animal to survive until its ready to procreate. Turns out the children in the study possessed high levels of cytokines that boost their immune response. The biggest impact is made by IL-17A, which appears to protect the youngest cohort from the ravages of the coronavirus. </p><p>While both age groups produced antibodies to fight off the infamous spike protein, adults that produce neutralizing antibodies actually suffer a <em>worse</em> fate. Herold says this "over-vigorous adaptive immune response" might promote inflammation, triggering acute respiratory distress syndrome (ARDS). </p><p>This matters for vaccine development. As Herold says, </p><p style="margin-left: 20px;">"Our adult COVID-19 patients who fared poorly had high levels of neutralizing antibodies, suggesting that convalescent plasma—which is rich in neutralizing antibodies—may not help adults who have already developed signs of ARDS. By contrast, therapies that boost innate immune responses early in the course of the disease may be especially beneficial."</p><p>Herold says current vaccine trials are focused on boosting neutralizing-antibody levels. With this new information, researchers may want to work on vaccines that boost the innate immune response instead. </p><p>With <a href="https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html" target="_blank">at least 55 vaccine trials</a> underway, every piece of data matters. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank" rel="noopener noreferrer">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Researchers from the University of Toronto published a new map of cancer cells' genetic defenses against treatment.