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|July 23, 2015
Today’s Heroin Epidemic
The July issue of CDC’s Vital Signs addresses changing trends and risk factors for heroin use in the United States.
This Vital Signs highlights significant increases in heroin use, abuse, and dependence among a wider range of
demographic groups that have not been seen before. In addition, these increases parallel the sharp rise in heroin
overdose deaths seen in the past decade. The information contained in the Vital Signs provides critical new insight
that can help to better tailor prevention efforts.
Key points in the Vital Signs report include:
• The heroin epidemic is changing and heroin use has increased across the U.S. among women, the privately
insured, and people with higher incomes—groups with historically lower rates of heroin use.
• Nearly all (96 percent) people who reported heroin use also reported using at least one other drug in the past
year. More than half (61 percent) used at least three other drugs. About 45 percent of people who used heroin also
abused or had dependence on prescription opioid painkillers.
• As heroin use, abuse, and dependence have increased, so have heroin-related overdose deaths—almost
quadrupling in the U.S. from 2002 to 2013.
• The people most at risk of heroin abuse or dependence include non-Hispanic whites, men, 18-to-25 year-olds,
persons with an annual household income less than $20,000, people living in urban areas, Medicaid recipients, and
Responding to the Heroin Epidemic
PREVENT People From Starting Heroin
• Reduce prescription opioid painkiller abuse.
• Improve opioid painkiller prescribing practices and identify high-risk individuals early.
REDUCE Heroin Addiction
• Ensure access to Medication-Assisted Treatment (MAT).
• Treat people addicted to heroin or prescription opioid painkillers with MAT which combines the use of
medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.
REVERSE Heroin Overdose
• Expand the use of naloxone.
• Use naloxone, a life-saving drug that can reverse the effects of an opioid overdose when administered in time.
|July 23, 2015
The Real Cost Campaign
More than 10 million youth aged 12-17 in the United States are either open to trying smoking or are already
experimenting with cigarettes—meaning they have tried fewer than 100 cigarettes in their lifetime. In fact, every
day in the United States, nearly 2,900 youth under age 18 smoke their first cigarette—and more than 700 youth
under age 18 become daily cigarette smokers.
FDA's first youth tobacco prevention campaign, “The Real Cost,” launched in February 2014 and continues to reach
young people in more than 200 markets across the country through TV, radio, print, the web, social media, and out-
of-home sites such as bus shelters. Edgy, innovative, and featuring the young people it seeks to reach, the
campaign talks with youth by focusing on the issues they really care about, like loss of control due to addiction and
cosmetic health effects. This campaign is the first of many campaigns targeting key audiences that we will launch
in the next two years. The goal is to prevent young people who are open to smoking from trying it and to reduce
the number of youth who move from experimenting with tobacco to regular use.
"The Real Cost" campaign communicates across multiple media platforms including TV, radio, print, and digital.
|July 20, 2015
Antibiotic Stewardship Program Proposed for Nursing Homes Residents
A proposal announced at the White House Conference on Aging would make major changes to improve the care and
safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities or nursing homes that
participate in the Medicare and Medicaid programs. If finalized, unnecessary hospital readmissions and infections
would be reduced, quality care increased, and safety measures strengthened for the more than one million
residents in these facilities. One of the many proposed changes includes updating the nursing home’s infection
prevention and control program, including requiring an infection prevention and control officer, and an antibiotic
stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use.
The recommended reforms have been published in proposed rule CMS–3260–P, in the July 16, 2015 Federal
Register. The 60-day comment period ends on September 14, 2015. To submit a comment, visit
www.regulations.gov, enter the ID number CMS–3260–P (with long dashes), and click on “Submit a Comment.”
|July 16, 2015
Mark Your Calendar: DEA Announces Fall Date for Next National Rx Drug Take-Back Day
The next National Prescription Drug Take-Back Day will be held on September 26 from 10 a.m. to 2 p.m., the Drug
Enforcement Administration (DEA) has announced. The National Prescription Drug Take-Back Day aims to provide a
safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public
about the potential for abuse of medications. Collection sites will be announced on September 1, the DEA said.
During the ninth Prescription Drug Take-Back Day last September, DEA and its partners collected 209 tons of pills.
That brought the total amount of drugs collected over four years to 2,411 tons, or 4,823,251 pounds. According to
the DEA, unused prescription medications in homes create a public health and safety concern, because they can be
accidentally ingested, stolen, misused, and abused.
When the DEA began hosting National Prescription Drug Take-Back events, the Controlled Substances Act made no
legal provision for patients and their caregivers to rid themselves of unwanted controlled substance prescription
drugs except to give them to law enforcement. The law banned pharmacies and hospitals from accepting them.
most people flushed their unused prescription drugs down the toilet, threw them in the trash, or kept them in the
household medicine cabinet. This led to a contamination of the water supply and the theft and abuse of the
prescription drugs, the DEA noted.
Last September, the DEA announced it would allow unused narcotic painkillers such as OxyContin to be returned to
pharmacies. Consumers are also permitted to mail unused prescription medications to an authorized collector, in
packages that are available at pharmacies and locations including senior centers and libraries. The new regulations
are designed to curb the prescription drug abuse epidemic, the DEA said.
|July 9, 2015
FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes
The Food and Drug Administration (FDA) is strengthening an existing label warning that non-aspirin nonsteroidal
anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke. Based on our comprehensive
review of new safety information, we are requiring updates to the drug labels of all prescription NSAIDs. As is the
case with current prescription NSAID labels, the Drug Facts labels of over-the-counter (OTC) non-aspirin NSAIDs
already contain information on heart attack and stroke risk. We will also request updates to the OTC non-aspirin
NSAID Drug Facts labels. Patients taking NSAIDs should seek medical attention immediately if they experience
symptoms such as chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body,
or slurred speech.
NSAIDs are widely used to treat pain and fever from many different long- and short-term medical conditions such
as arthritis, menstrual cramps, headaches, colds, and the flu. NSAIDs are available by prescription and OTC.
Examples of NSAIDs include ibuprofen, naproxen, diclofenac, and celecoxib (see Table 1 for a list of NSAIDs).
The risk of heart attack and stroke with NSAIDs, either of which can lead to death, was first described in 2005 in
the Boxed Warning and Warnings and Precautions sections of the prescription drug labels. Since then, we have
reviewed a variety of new safety information on prescription and OTC NSAIDs, including observational studies, a
large combined analysis of clinical trials, and other scientific publications. Prescription NSAID labels will be revised
to reflect the following information:
• The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may
increase with longer use of the NSAID.
• The risk appears greater at higher doses.
• It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that
the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to
determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
• NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors
for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is
increased, depending on the drugs and the doses studied.
• In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke
following NSAID use than patients without these risk factors because they have a higher risk at baseline.
• Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the
heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
• There is an increased risk of heart failure with NSAID use.
FDA will request similar updates to the existing heart attack and stroke risk information in the Drug Facts labels of
OTC non-aspirin NSAIDs.
In addition, the format and language contained throughout the labels of prescription NSAIDs will be updated to
reflect the newest information available about the NSAID class. Patients and health care professionals should
remain alert for heart-related side effects the entire time that NSAIDs are being taken. We urge you to report side
effects involving NSAIDs to the FDA MedWatch program, using the information below (Contact FDA).
Report a Serious Problem to MedWatch: Complete and submit the report Online. Download form or call 1-800-
332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or
submit by fax to 1-800-FDA-0178.
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