Opioid-related deaths in England and Wales in the past decade were 55% or 13,000 deaths higher than previously recorded between 2011-2022

Bad news, if confirmed! This is quite an upward correction, if performed properly! What can be done to reduce the high number of addictive drug casualties? Something Western societies have been struggling with for over 50 years.

"Opioid-related deaths in England and Wales in the past decade were 55% higher than previously recorded, amounting to 13,000+ heroin and opioid deaths missed in official statistics from 2011 to 2022 ..."

"... Research from King's College London, shared exclusively with BBC News, found that there were 39,232 opioid-related deaths between 2011 and 2022, more than 50% higher than previously known. ..."

"... Whilst the total number of drug deaths is accurate, the count for deaths due to specific substances is limited by the fact the ONS does not have access to post-mortem reports or toxicology results.

Instead, the accuracy of figures depends on the information provided by the coroner on the death certificate. If that is missing information, such as when an individual dies from using multiple drugs at the same time – known as polydrug use – and it is recorded with ambiguous terms such as ‘multidrug overdose’, the ONS cannot determine the individual substances involved. As a result of this incomplete information, the ONS warns that figures for drug misuse for specific substances are underestimates. ..."

From the highlights and abstract:

"Highlights

• ONS underestimates opioid deaths due to limitations in their classification system.

• Triangulating ONS and NPSUM data enabled better estimations of opioid deaths.

• Polypharmacy has likely contributed to increased undercounting of opioid deaths.

Abstract

Background

In 2023, the Office for National Statistics (ONS) attributed 46.8 % of fatal drug poisonings in England and Wales to opioids. However, this figure likely underrepresents the true scale of opioid-related deaths, as ONS cannot identify opioid involvement when ambiguous causes (e.g., multidrug toxicity) are used. This study used ONS and National Programme on Substance Use Mortality (NPSUM) data to provide a more comprehensive estimate of opioid-related deaths in England and Wales from 2011–2022.

Methods

Deaths were identified as opioid-related by ONS and NPSUM where opioids were explicitly named as a cause. Further cases with ambiguous causes were identified by NPSUM as opioid-related by referring to the accompanying toxicology report.

Findings

ONS has increasingly underestimated opioid-related deaths. In 2011, 574 heroin/morphine-related deaths were identified by ONS; while the estimated number was 813 (95 % CIs 765–866), reflecting a 29 % underestimate. By 2022, the underestimate had extended to 36 % (1264 deaths identified by ONS; estimated number 1980 [95 % CIs 1894–2074]). This correlates with increasing polypharmacy (median number of co-administered drugs: four in 2011, six in 2022, ρ=0.81).

Similar trends were observed for other specific opioids for which ONS data were available: methadone, dihydrocodeine, codeine, tramadol, and fentanyl.

Conclusions

Increasing polydrug use in England and Wales is likely leading to the use of ambiguous drug-related causes of death instead of every drug being individually named, resulting in an underestimation of opioid-related deaths. This discrepancy has significant implications for funding, policy and public health initiatives aimed at addressing the UK’s escalating opioid-related death crisis."

Global Health NOW: UN Accuses Israel of Genocide in Gaza; Researchers’ Growing Resistance; and Gaming Addiction Treatment in Australia

Thousands of opioid deaths missed off official figures

Opioid-related deaths in past decade 55% higher than recorded (original news release)

Comparison of Office for National Statistics (ONS) and National Programme on Substance Use Mortality (NPSUM) data suggests that opioid-related deaths in England & Wales have been systematically underestimated (open access) "Opioid-related deaths from 2011 to 2022 are 54.7% higher than recorded, according to new research by King’s. Analysis by researchers puts the estimated number of deaths at 39,232 compared to 25,364 deaths previously reported."

Fig. 1. Year-on-year trends in proportion of deaths due to specific opioids estimated to be captured by ONS (blue) and the median number of drugs detected at post-mortem in deaths reported to the NPSUM (orange)

New Research Lays Groundwork for Early Detection of Alzheimer’s Disease beginning at age 24

Good news! Seems to be a very comprehensive study of people younger than 40 and their risk to affected Alzheimer's Disease.

Apparently, some well established biomarkers identified for older people also apply to younger people.

"A new study by researchers ... suggests that risk factors and biomarkers related to Alzheimer’s disease are associated with cognition much earlier in life than previously recognized. The study highlights significant associations between cognition and Alzheimer’s disease risk factors as young as ages 24 to 44 and underscores the importance of early prevention.

This is the first study to systematically examine Alzheimer’s disease risk factors, including biomarkers related to cognitive impairment, in a large group of generally healthy middle-aged individuals in the U.S.  ...

“Previously, research on Alzheimer’s disease risk factors has focused on individuals aged 50 and older,” ...

the results reveal that several well-established risk factors and blood biomarkers are linked to cognitive function even before midlife. These earlier life associations provide a baseline for predicting long-term trajectories of cognitive decline. “Additionally, we learned that certain Alzheimer’s risk factors—such as cardiovascular health, ATN (amyloid, tau, neurodegeneration), and immune biomarkers—are present and related to cognition in individuals in their forties and even earlier.” ...

ATN biomarker and several immune markers showed associations with cognitive function before midlife. However, a key genetic risk factor, APOE, did not appear to affect participants in these middle years and may not become evident until later in life. ..."

From the abstract:

"Background

Alzheimer’s disease is a major health concern in the U.S., but most research has focused on older populations. We examined whether established risk factors and blood biomarkers are associated with cognition before midlife.

Methods

Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed. Participants were enrolled in 1994–95 (grades 7–12) and followed through 2018.

We cross-sectionally analyzed weighted survey and biomarker data from Waves IV and V.

We measured the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score comprised of age, education, sex, systolic blood pressure, body mass index, cholesterol, and physical activity and apolipoprotein E ε4 allele (APOE ε4) status.

We also measured total Tau and Neurofilament light (NfL), high sensitivity C-reactive protein (hsCRP), Interleukin (IL)-1β, IL-6, IL-8, IL-10, and Tumor necrosis factor alpha (TNF-α). Outcomes included immediate word recall, delayed word recall, and backward digit span.

Findings

Analytic sample sizes ranged from 4507 to 11,449 participants in Wave IV and from 529 to 1121 participants in Wave V.

The survey-weighted median (IQR) age was 28 (26–29) years in Wave IV and 38 (36–29) years in Wave V.

About half of the survey-weighted Wave IV participants were female (48.4–52.1% across analytic samples), 71.4–72.5% were White, 12.5–14.9% were Black, and 9.3–10.2% were Hispanic. In Wave V, 43.6–46.8% were female, 68.7–69.3% were White, 17.1%–20.0% were Black, and 7.3%–9.6% were Hispanic.

The CAIDE score was associated with all cognition measures in Wave IV. For example, among adults aged 24–34, each 1-point increase in CAIDE was associated with a 0.03 standard deviation lower backward digit span score (95% CI: −0.04, −0.02).

Total Tau was associated with immediate word recall in Wave V (β = −0.13, 95% CI: −0.23, −0.04). Wave IV hsCRP and IL-10 and Wave V IL-6, IL-1β, and IL-8 were also associated with lower cognitive scores.

Interpretation

Key risk factors for Alzheimer’s Disease are linked to cognitive function as early as ages 24–44, highlighting the need for early prevention in the US."

New Research Lays Groundwork for Early Detection of Alzheimer’s Disease | Columbia University Mailman School of Public Health "Established risk factors and biomarkers were associated with cognitive function as early as 24 years of age"

Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based study 

RAND: Combating America's Chronic Disease Epidemic. Really!

Food for thought! RAND is ranting again!

Once more are Americans perhaps overdiagnosed? Too many doctors, too many diagnoses?

This article contains the usual terms of art like "food deserts" or "low health literacy". A long litany of the usual suspects.

"... Six out of 10 Americans have one chronic disease and four out of 10 have two or more chronic diseases that account for ninety percent of the $4.5 trillion annual health care costs in the nation. ...

The United States has the greatest rate of people with multiple chronic conditions in spite of much higher rate of health care spending in comparison to other wealthy countries. In 2024, more than 23 percent of U.S. adults reported experiencing a mental illness—often considered a chronic disease that can worsen other chronic diseases. Mental illness can be amplified by other chronic conditions. ...

Although investments in preventative care in the United States have declined over time, the United States still spends more on disease prevention than other wealthy nations. ...

About nine out of 10 American adults have low health literacy—that is they lack the ability to understand health-related information. Low health literacy is associated with poor health outcomes. Boosting health literacy in the United States may require amplifying health education efforts in K—12 educational settings, through employers, health insurance vendors, places of worship, and campaigns funded through public-private collaboration. ...

For some Americans the cost of healthy foods may not be an issue, but access is. Some communities in the United States are “food deserts” with no grocery stores with fresh produce for many miles. ...

Importantly, public health campaigns need to address America's addiction to ultra-processed foods head-on given that 60 percent of calories consumed by many Americans come from ultra-processed foods compared to 14 to 44 percent in Europe.

Communities also need safe and accessible locations for exercise. ...

In 2024, about 83 million people lived in areas with insufficient access to primary care. ..."

Combating America's Chronic Disease Epidemic | RAND

Will single-molecule protein sequencing be the next generation of proteomics?

Good news!

"... The proteins circulating in a person’s plasma can reveal early warning signs of a variety of diseases—and the majority of drugs for those diseases act on protein targets. Beyond medicine, protein identification can inform ecology studies, detect food fraud, shed light on how natural products are made, and let archaeologists peer into the deep past.

These applications make proteins tantalizing analytes for high-throughput biology. Proteomic assays measure all of the proteins in a sample. A growing trend known as multiomics combines proteomic assays with genomic and transcriptomic studies, which assay DNA and RNA, respectively, to bring scientists insights that they couldn’t get otherwise. But multiomic studies are often limited by the throughput of current proteomic approaches.

Several companies are developing technologies to identify the sequence of amino acids in huge numbers of individual protein molecules from a sample. Those companies use a variety of different chemistries, but all aim to make single-molecule protein sequencing cheap, high scale, and user friendly.  ..."

Will single-molecule protein sequencing be the next generation of proteomics?

New cystic fibrosis drug Trikafta could make deadly disease manageable

Good news! Well written Washington ComPost article! Perhaps, the Washington ComPost should write more articles about advances in medicine instead of publishing highly distorted political articles to aide and abet in an unprecedented scandalous coup attempt against a sitting president!

What is the kicker here that under President Trump, the FDA is finally approving new drugs much faster!

Trikafta is a great name for a drug! Does it mean cured by triple Franz Kafka? :-)

New cystic fibrosis drug Trikafta could make deadly disease manageable - The Washington Post: Thirty years after scientists discovered the defective gene that causes cystic fibrosis, two new trials show a therapy could help 90 percent of patients. The FDA approved the triple drug, Trikafta, five months ahead of its deadline.