Widespread Consequences of Overdose Deaths

Evolving Substance Use & Overdoses

A recent survey by the RAND Corporation underscores the far-reaching impacts of drug overdose deaths on communities. The overdose crisis continues to evolve, with a recent Centers for Disease Control and Prevention (CDC) report demonstrating how drug overdose deaths increased among middle-aged and older adults. Another concerning trend is the rise in deaths from excessive alcohol use, which surpass deaths from all drug overdoses combined. Learn more about substance use below:

• Alcohol: CDC data shows that women’s deaths from excessive alcohol use are increasing at greater rates than men’s. There is growing concern about women’s alcohol use, with another study reporting the risk of coronary heart disease alcohol poses for women. Alcohol-associated liver disease in the US is projected to increase in its annual cost from $31 billion in 2022 to $66 billion in 2040.
• Changing Crisis: Adults aged 65 and older experienced the most significant rise in overdose deaths involving opioids and stimulants, with a 10% increase from 2021 to 2022. Additionally, routes of drug use are changing. More people are overdosing from smoking fentanyl while fewer are from injecting heroin.
• Treatment & Recovery: STAT’s new series “The War on Recovery” covers how people with opioid use disorder face barriers to receiving medications and new challenges to the treatment industry, including private equity ownership. A KFF analysis examines substance use disorder treatment in Medicaid and finds that Black enrollees are treated at lower rates than their White counterparts.
• Harm Reduction: Efforts to address the overdose crisis include increasing access to Narcan, the opioid reversal drug. Narcan and fentanyl testing strips are being distributed through vending machines in a growing number of areas. Additionally, states such as California and Pennsylvania are debating new syringe programs.

Resources & Initiatives

• See NIHCM’s recent webinar on growing combination drug use, as well as our infographic that shows the data on the emerging trends in overdose deaths.
• April 27th is National Prescription Drug Take Back Day, which promotes the disposal of unneeded medications to prevent misuse and opioid addiction. Learn more from this resource from Horizon Blue Cross Blue Shield of New Jersey.
• Blue Cross and Blue Shield of Louisiana created a series of free educational videos on the dangers of fentanyl and have dubbed the videos in Spanish.
• See the Substance Abuse and Mental Health Services Administration’s (SAMSHA’s) resources to get help, including for alcohol and overdoses.

Artificial Intelligence & Health

NIHCM’s Artificial Intelligence and Health webinar series explores the potential for artificial intelligence (AI) to reshape health care, while also addressing concerns about mitigating bias in the algorithms used. The topic is also getting regulatory attention as the Food & Drug Administration (FDA) shares information on the intersection of AI and medical products. In February, members of the Senate heard testimony from AI experts on the responsible use of the technology in health care. Learn more about AI in health care:

• Use in Care: The FDA authorized the first AI-driven test to assess risk of sepsis, a condition that affects roughly 1 in 3 people who die in a hospital. Providers are also having success utilizing AI technology in eye examinations. According to researchers, AI could also be used to predict COVID vaccine uptake, potentially serving as a useful tool for future pandemics.
• Mental Health: There is an emergence of AI chatbot apps aimed at supporting mental health, but there is a lack of regulatory oversight and evidence on how this technology improves mental health. A new study sponsored by the National Institutes of Health found that AI models could accurately predict depression severity in White people, but not Black people.
• Concerns: A report recently released by Stevens Institute of Technology found that many Americans are concerned about the regulation of AI. Physicians are also grappling with the influence of AI on malpractice lawsuits and the issue of compensating patients if the technology compromises their care.

Resources & Initiatives

• The Duke-Margolis Institute for Health Policy released a commentary on AI’s potential to transform health care with input from international leaders.
• Independence Blue Cross and Premera Blue Cross have signed on to the White House’s Healthcare AI Commitments to support the appropriate adoption of AI in the future.
• Learn more about how machine learning can improve health and lower costs of care from this Blue Cross and Blue Shield of North Carolina resource.
• The Mayo Clinic provides information on what to consider when AI is used in health care.

In Other Public Health News…

Costs & Quality of Care

Exaggerated facility fees tacked onto outpatient medical bills are increasing the cost of care. Nonprofit hospitals are showing interest in concierge care, which includes annual membership fees and attracts wealthier patients. A report from the Lown Institute found that the estimated value of nonprofit hospitals’ tax breaks exceeds their contributions to community investments. The merging of Appalachian hospitals into a monopoly resulted in ~11 hour patient wait times before being admitted.

Resources & Initiatives

• Blue Cross Blue Shield of Massachusetts is prioritizing and taking steps to address the growth of high health spending.
• The Association of Health Care Journalists, a NIHCM Grantee, and Investigative Reporters and Editors have released a webinar on strategies for reporting on hospitals and health care costs.
• For more information on provider consolidation, visit NIHCM’s resources.

Social Media & Public Health

Congress continues to learn more about the impact of social media on children by replenishing $15.1 million in funding. Social psychologist Jonathan Haidt documents the negative effects of social media on teen mental health, while there is additional concern about social media companies censoring public health campaigns.

Resources & Initiatives

• New York City declared social media as an “environmental health toxin."
• State-level efforts in Tennessee aim to prohibit minors from signing up for social media platforms without guardian consent.
• An advisory report by the US Surgeon General, Dr. Vivek Murthy, contains recommendations for policymakers to address the effects of social media on youth mental health.
• Blue Cross Blue Shield of South Carolina discusses how parents can help teens navigate social media.

Water Quality and Health

In Chicago, nearly 70% of children under 6 may be exposed to lead in tap water. Incarcerated people are also at increased exposure to toxic substances in drinking water. In a new CDC report, bacteria in drinking water stemming from public water systems has resulted in numerous disease outbreaks. For the first time, the Environmental Protection Agency has issued enforceable limits to the amount of 'forever chemicals', better known as PFAs, in drinking water.

Resources & Initiatives

• The Biden Administration is infusing $5.8 billion into remediating and upgrading the US water system.
• Infrastructure investments in Pennsylvania and Wisconsin improve access to safe drinking water.