Category: From Newswise – Substance Abuse

Newswise — Cardiovascular disease remains a top cause of sickness and death in the U.S. and worldwide. Doctors and researchers have it especially high on their radar because it’s more modifiable and preventable than many other diseases and causes of death.

Importantly, though, modification and prevention rely on early detection and mitigation of risk factors like hypertension and high cholesterol. Unfortunately, detection and mitigation are suboptimal throughout the U.S. population: Experts estimate that up to 75% of young adults who have risk factors such as hypertension and high cholesterol are unaware of their conditions.

A recent study led by researchers at the University of Chicago found that boys and men who enact behaviors more closely aligned with stereotypical gender norms in their social environment are less likely to report receiving diagnoses or treatment for cardiovascular disease risk factors. Their findings build on existing research showing that sociocultural pressures to perform male gender identity are linked to detrimental health-related behaviors, such as substance use and rejection of medical therapies and recommendations.

“It’s well known that male gender and male sex are associated with lower help-seeking for a range of health conditions — especially mental health and primary care. But previous studies haven’t probed further into the social processes through which male gender is iteratively created through an interplay between the individual and their surroundings,” said Nathaniel Glasser, MD, a general internist and pediatrician at UChicago Medicine and lead author on the paper. “In this new paper, we used innovative measurement techniques to look at the construction of male gender and how it’s associated with cardiovascular disease prevention.”

Glasser and his colleagues analyzed data from Add Health, a nationally representative, longitudinal study that collected health measurements and survey responses from more than 12,300 people at multiple points over the course of 24 years (1994-2018). They quantified Add Health participants’ male gender expressivity by identifying a subset of survey questions that were answered most differently by self-identified male versus female participants, then measuring how closely male participants’ answers to those questions matched those of their same-gendered peers.

“When we talk about gender expression, we’re not looking at anything physiologic that could be affected by the Y chromosome,” Glasser pointed out. “We’re purely focused on self-reported behaviors, preferences and beliefs, and how closely these reported behaviors and attitudes resemble those of same-gendered peers.”

Zeroing in on cardiovascular disease, the researchers compared the Add Health biological measurements with health-related survey responses to see if men with detectable risk factors like high blood pressure reported receiving diagnoses or treatment for those conditions. They found that men who showed more stereotypical gender expression were significantly less likely to report that a healthcare professional had ever told them about certain cardiovascular disease risk conditions. Even when these men did report having previously received a diagnosis, they were still less likely to report that they were taking medication to treat these conditions.

The risk factors examined in the study are all conditions that would normally be detected by screenings that are part of basic primary care. It’s unclear whether the decrease in reported diagnosis and treatment among those with higher male gender expression indicates that men aren’t going in to get screened; that they aren’t paying attention to their diagnoses even when they do get screened; or that they are simply downplaying their diagnoses when asked about them. Whatever the underlying reason, the findings highlight a missed opportunity to prevent or alleviate serious cardiovascular conditions later in life.

“Our hypothesis is that social pressures are leading to behavioral differences that impact cardiovascular risk mitigation efforts, which is concerning because it could be leading to worse long-term health outcomes,” Glasser said.

Ultimately, the authors see the implications of this research reaching far beyond the topic of traditional masculinity.

“We’re seeing how pressures to convey identity — whether it’s rooted in gender, race, sexuality or something else — impact health behaviors,” Glasser said. “Fitting in and achieving belonging is a complicated task, and we feel strongly that increased societal sympathy, empathy and patience for others undertaking that task would be good for people’s health.”

“Male Gender Expressivity and Diagnosis and Treatment of Cardiovascular Disease Risks in Men” was published in JAMA Network Open in October 2024. Authors include Nathaniel Glasser, Jacob Jameson, Elbert Huang, Ian Kronish, Stacy Tessler Lindau, Monica Peek, Elizabeth Tung and Harold Pollack.

WASHINGTON—A new Scientific Statement released today by the Endocrine Society highlights research gaps associated with the negative effects of opioid use on the endocrine system.

The use and misuse of opioids are a growing global problem. Opioids are used to treat pain in people with cancer or other conditions (e.g., after an injury or surgery), however, they are highly addictive and people can develop opioid use disorder (OUD). The World Health Organization estimates 125,000 people died of opioid overdose in 2019.

The use and misuse of opioids has a negative effect on our hormones and can lead to reproductive, bone and adrenal health complications.

“Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement,” reviews data related to the use and misuse of opioids and the effects of these drugs on the endocrine system. The Statement discusses recent research on the clinical consequences of opioids, especially on the hypothalamic-pituitary system and bone health.

“We address the many research gaps associated with the effects and clinical consequences of opioids on the endocrine system within this Scientific Statement,” said lead Statement author Niki Karavitaki, M.Sc., Ph.D., F.R.C.P., of the University of Birmingham, Birmingham Health Partners, and the University Hospitals Birmingham National Health Service Foundation Trust in Birmingham, U.K. “We hope bringing attention to recent research in the space, including opioid use’s impact on gonadal, bone and adrenal conditions, will improve the endocrine health of people using or misusing opioids worldwide.”

The Statement reviews research related to the impact of opioids on gonadal and adrenal function, and bone health. The authors report male hypogonadism, a reproductive health condition that causes low testosterone, as a well-recognized side effect of opioids, and provide more clarity around the drug’s lesser-known effects on other parts of the hypothalamic-pituitary system and bone health. They discuss the link between opioids and the development of hyperprolactinemia and how more research is needed to understand their effect on secondary adrenal insufficiency. 

The Statement authors also assessed how opioids affect the secretion of certain hormones to better understand the connection between opioid use and endocrine disease. These hormones include growth hormone, arginine vasopressin (regulates the body’s water balance), and oxytocin (plays a crucial role in the childbirth process).

They also reviewed research into opioid’s actions on bone metabolism and their negative impact on bone mineral density and risk of fracture.

“Clinicians need to be aware of these endocrine health consequences and monitor patients who are using opioids more closely for signs and symptoms of them,” Karavitaki said.

Other statement authors are Jeffrey Bettinger of Saratoga Hospital Medical Group in Saratoga Springs, N.Y.; Nienke Biermasz of Leiden University Medical Center in Leiden, The Netherlands; Mirjam Christ-Crain of the University Hospital Basel and the University of Basel in Basel, Switzerland; Monica Gadelha of the Universidade Federal do Rio de Janeiro in Rio de Janeiro, Brazil; Warrick Inder of Princess Alexandra Hospital, Brisbane, and the University of Queensland, Brisbane, in Queensland, Australia; Elena Tsourdi of Technische Universität Dresden in Dresden, Germany; Sarah Wakeman of Massachusetts General Hospital, Mass General Brigham and Harvard Medical School in Boston, Mass.; and Maria Zatelli of the University of Ferrara in Ferrara, Italy.

The statement, “Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement,” was published online in the Society’s journal, Endocrine Reviews.

The Endocrine Society develops Scientific Statements to explore the scientific basis of hormone-related conditions and disease, discuss how this knowledge can be applied in practice, and identify areas that require additional research. Topics are selected on the basis of their emerging scientific impact. Scientific Statements are developed by a Task Force of experts appointed by the Endocrine Society, with internal review by the relevant Society committees and expert external reviewers prior to a comment period open to all members of the Society.

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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

BYLINE: Marta Wegorzewska

Newswise — The opioid epidemic claims more 70,000 lives each year in the U.S., and lifesaving interventions are urgently needed. Although naloxone, sold as an over-the-counter nasal spray or injectable, saves lives by quickly restoring normal breathing during an overdose, administrating the medication requires a knowledgeable bystander ­– limiting its lifesaving potential.

A team from Washington University School of Medicine in St. Louis and Northwestern University in Chicago has developed a device that may rescue people from overdose without bystander help. In animal studies, the researchers found that the implantable device detects an overdose, rapidly delivers naloxone to prevent death and can alert emergency first responders.

The findings are available Oct. 23 in Science Advances.

“Naloxone has saved many lives,” said Robert W. Gereau, PhD, the Dr. Seymour and Rose T. Brown Professor of Anesthesiology and director of the WashU Medicine Pain Center. “But during an overdose, people are often alone and unable to realize they are overdosing. If someone else is present, they need access to naloxone — also known as Narcan — and need to know how to use it within minutes. We identified an opportunity to save more lives by developing a device that quickly administers naloxone to at-risk individuals without human intervention.”

Prescription opioids – such as oxycodone – have helped people manage the physical and mental challenges of daily debilitating pain. But the addictive properties of painkillers can lead to their misuse and abuse, which are among the driving forces behind the opioid epidemic. In addition, cheap and easy-to-access synthetic drugs – fentanyl, for example – have flooded the illicit market. Such ultrapotent drugs have accelerated the rise in overdose deaths in the U.S. and were responsible for roughly 70% of such deaths in 2023.

The researchers worked with experts in engineering and material sciences led by John A. Rogers, PhD, a professor of materials science and engineering, biomedical engineering and neurological surgery at Northwestern University, to develop a device ­– the Naloximeter – that uses a drop in oxygen levels as a signal for a potential overdose. Overdosing on opioids leads to slow and shallow breathing. Minutes after the drugs begin to impact respiratory function, breathing stops. Implanted under the skin, the Naloximeter senses oxygen in the surrounding tissues, sending a warning notification to a mobile application if the levels drop below a threshold. If the user doesn’t abort the rescue process within 30 seconds, the device releases stored naloxone.

Implanted under the skin, the Naloximeter, developed by researchers at WashU Medicine and Northwestern University, senses dropping oxygen in the surrounding tissues and sends a warning notification to a mobile application. If the user doesn’t engage with the warning message within 30 seconds, the device releases stored naloxone and can send an alert to first responders.

The researchers implanted the device in the neck, chest or back of small and large animals. The device detected signs of overdose within a minute of dropping oxygen levels, and all animals fully recovered within five minutes of receiving naloxone from the devices.

Naloxone displaces harmful opioids from receptors on the surface of brain cells, altering the cells’ activity. But the drug doesn’t stick around; when the opioids reoccupy and reactivate the receptors, overdose symptoms can return. To provide additional support, the device relays an emergency alert to first responders.

“An additional benefit of calling first responders is that it helps people re-engage with health-care providers,” said Jose Moron-Concepcion, PhD, the Henry E. Mallinckrodt Professor of Anesthesiology at WashU Medicine and an author on the study. “We want to save people from dying from an overdose and also reduce harm from opioids by helping people access the resources and treatments to prevent future overdoses from occurring.”

The researchers were awarded a patent – with some help from the Office of Technology Management at WashU – to protect the intellectual property of the device.

“The Naloximeter is a proof-of-concept platform that isn’t limited to the opioid crisis,” said Joanna Ciatti, a graduate student in Rogers’ lab. “This technology has far-reaching implications for those threatened by other emergent medical conditions such as anaphylaxis or epilepsy. Our study lays important groundwork for future clinical translation. We hope others in the field can build off of these findings to help make autonomous rescue devices a reality.”

COLUMBUS, Ohio – Expanded treatment options, increased naloxone distribution and targeted education campaigns likely led to a 37% reduction in overdose deaths from opioids combined with stimulant drugs other than cocaine, according to the results of a large federally funded study. 

The finding came from a planned study of secondary outcomes of the HEALing (Helping to End Addiction Long-Term) Communities Study (HCS), which tested an intervention encompassing data-driven adoption of evidence-based practices for reducing overdose deaths in Kentucky, Massachusetts, New York and Ohio. 

Death rates from specific combinations of opioids with stimulants other than cocaine, most commonly fentanyl mixed with methamphetamine, were 8.9 per 100,000 adults in intervention communities compared to 14.1 per 100,000 adults in comparison communities that did not receive the intervention – a statistically significant difference. 

The findings were published today (Oct. 21, 2024) in JAMA Network Open. 

With the prescription medications that started the opioid crisis harder to obtain by the time the trial began, fentanyl was rapidly entering the illicit drug market in combination with methamphetamine, cocaine, counterfeit pills and other stimulants, said Bridget Freisthler, lead author of the new study and a professor at The Ohio State University. 

“Now we have a whole new group of people developing addiction to opioids,” said Freisthler, Ohio’s principal investigator for the HEALing Communities Study. “It was nice to see that we were able to achieve reductions in overdose deaths involving this combination of opioids, primarily fentanyl and psychostimulants, not including cocaine, because that’s the most recent wave in the epidemic that we’re seeing.” 

Analysis of other drug combinations showed that intervention communities had lower rates of overdose deaths from an opioid mixed with cocaine (6%) and an opioid mixed with benzodiazepine (1%), but that these differences did not reach statistical significance. 

The National Institutes of Health (NIH) launched the HEALing Communities Study in 2019. Participating community coalitions implemented 615 strategies to address opioid-related overdose deaths across health care, justice and behavioral health settings. Based on data indicating which interventions were best suited to areas they served, agencies selected from three “menus” of evidence-based practices focused on overdose education and naloxone distribution, increasing exposure to medication for opioid use disorder, and safer opioid prescribing.  

Researchers reported in June on the main outcome of HCS – that the intervention did not result in a statistically significant reduction in opioid overdose death rates during the evaluation period. In this study, the authors found that intervention communities had an 8% lower rate of all drug overdoses compared to control communities, which was estimated to represent 525 fewer drug overdose deaths. 

In the new paper, researchers reported that more than 40% of overdose deaths in the study involved the combination of at least one opioid and a stimulant. 

The evidence of higher prevalence of fentanyl in the illicit drug market led coalition agencies to adjust communication efforts accordingly, said Freisthler, also the Cooper-Herron Professor in Mental Health at the University of Tennessee, Knoxville. 

“We were already shifting to where psychostimulants had fentanyl in them and messages weren’t reaching the right folks because people who use psychostimulants think of themselves as using meth or cocaine, not opioids,” she said. “So we had to make it clear that fentanyl could be in every drug and that nobody was really immune from the possibility of an overdose. Communities emphasized that this is a multiple-drug issue, not just a fentanyl issue or an opioid issue. 

“In many ways, the fact we’re looking at this particular outcome is because communities were so invested in it and so concerned, and wanted it to be a focus of the study.”

The potential for naloxone to prevent overdose deaths in people who use multiple drugs was also incorporated into communication campaigns implemented by all intervention communities, which may have helped prevent deaths, researchers said. 

Participating agencies were very good at advocating for themselves, Freisthler said, and the front-end work ideally will leave communities even better prepared to address overdoses going forward. 

“The HCS was beneficial to Brown County in numerous ways,” said Deanna Vietze, executive director of the Brown County Board of Mental Health and Addiction Services in southwest Ohio. “It affirmed the work already underway, allowed for expansion of best practices, helped engage new partners, strengthened existing partnerships, and allowed innovative purchases that forged outreach opportunities that will continue to positively impact Brown County citizens for years to come.” 

Ohio study leaders are intent on making sure lessons and success stories from the study are widely available through a website providing a range of materials, and are meeting with groups interested in implementing the evidence-based practices in their own communities.

“The drug overdose crisis is pervasive in our communities, and we’ve got multigenerational and intergenerational trauma affecting families. That’s not going to change overnight,” Freisthler said. “That means we need to continue to improve understanding of this crisis, and reduce overdose deaths so we don’t have another generation experiencing the same sort of trauma.” 

The HEALing Communities Study was supported and carried out in partnership between the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration through the NIH HEAL Initiative.  

A $65.9 million NIH award funding Ohio State’s leadership of the Ohio portion of the study was housed in the university’s College of Medicine. Co-authors of the paper included study site principal investigators Sharon Walsh of the University of Kentucky, Nabila El-Bassel of Columbia University, T. John Winhusen of the University of Cincinnati, Jeffrey Samet of Boston Medical Center and Emmanuel Oga of RTI International.

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Contact: Bridget Freisthler, [email protected]

Written by Emily Caldwell, [email protected]

STONY BROOK, NY, October 16, 2024 – A study that used a specialized type of magnetic resonance imaging (MRI), named neuromelanin-sensitive MRI, showed that this type of MRI signal was increased in regions of the midbrain in young adults ages 20 to 24 who had an extensive alcohol and drug use history. The research was conducted by a team of investigators in the Department of Psychiatry and Behavioral Health in the Renaissance School of Medicine at Stony Brook University. The findings are published early online in the American Journal of Psychiatry.

The research involved 135 individuals, 105 women and 30 men. Neuromelanin accumulates naturally in areas of the midbrain where the neurotransmitter dopamine is produced. Dopamine plays important roles in many cognitive and bodily functions and is central to the reward/motivation system in the brain. Dopamine can be difficult to study in young people. This has hindered researchers’ understanding of early stages of certain neurological diseases and mental health conditions, such as adolescent-onset addictive behavior. However, neuromelanin accumulation in young people can be safely and easily studied using neuromelanin-sensitive MRI.

“Young adults who regularly engage in substance use appear to show greater than normal levels of neuromelanin accumulation on this type of MRI scan, especially young women,” says Greg Perlman, PhD, Assistant Professor of Psychiatry and Behavioral Health and Lead Author.

“This is important because much of the biomedical research on the effects of drug and alcohol use on the dopamine system has examined older adults after years or decades of chronic substance use. In contrast, there is very little information about the dopamine system in adolescent or young adult populations after just a few years of habitual alcohol and drug use. The potential of neuromelanin-sensitive MRI to provide new insights about the health of the dopamine system in young people was a key motivation for our study.”

Perlman indicated that the association between substance use and neuromelanin MRI signal was especially strong in certain midbrain regions of young women, such as the ventral tegmental area. In addition, increased neuromelanin was associated with substance use generally, but not with use of one type of drug.

The research team is currently conducting a new study using neuromelanin-sensitive MRI in teenagers ages 14 to 17 to better understand neuromelanin accumulation over those three years of life. The study will use yearly MRI scans to evaluate the effect of life experiences reported by teenagers, such as alcohol use, social media use, and stressful events, on neuromelanin accumulation measured by neuromelanin-sensitive MRI.

The work is supported in part with funding from the National Institute of Health’s National Institute on Drug Abuse.

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Injuries and substance abuse are leading causes of adolescent deaths. Screening adolescents for substance use can reduce the risk of future drug and alcohol use and reinjury. But how are clinicians deciding who to screen?

A team of researchers from Children’s Hospital Los Angeles collaborating with Keck School of Medicine of USC, Stanford University, and the David Geffen School of Medicine at UCLA examined a national sample of 85,362 injured adolescents at 121 pediatric trauma centers. They wanted to identify any socio-economic disparities in biochemical screening for substance use. This screening is a key way to flag adolescents in trouble who targeted interventions could help.

Examining the 2017-2021 American College of Surgeons Trauma Quality Programs (TQP) dataset—the largest aggregation of U.S. trauma registry data ever assembled—the researchers found that rates of biochemical alcohol and drug screening were disproportionately higher in Black, American Indian and Hispanic adolescents than for White adolescents. Female adolescents and those with Medicaid or no insurance were also more likely to be screened than males. Their findings were published in JAMA Network Open.

Inconsistent screening

“These inequities were still there even after we adjusted for differences in clinical characteristics and screening practices between institutions,” says Lorraine Kelley-Quon, MD, MSHS, FACS, FAAP, Division of Pediatric Surgery at CHLA and senior author on the paper. “We know that screening for substance and alcohol use can uncover key red flags that prompt interventions. We don’t want to see kids fall through the cracks who we could help.”

The researchers recommended standardization of screening protocols and definition of criteria for biochemical as well as interview-based screening. They also suggested expanding the TQP dataset to include interview-based screening and to indicate whether subsequent treatment is conducted, which the dataset currently does not. “Connecting evidence-based screening protocols to treatment for substance use will help us get injured teens that we see in the emergency room the necessary follow-up,” says Dr. Kelley-Quon.     

BYLINE: Steven Infanti

Newswise — The Rothman Orthopaedic Institute Foundation for Opioid Research & Education announces a symposium titled “The Next Chapter of the Opioid Epidemic in Pennsylvania: The Xylazine Crisis” to be held on November 23, 2024, from 8:30 am to 12:30 pm at the Bluemle Life Science Building at Jefferson Med in Philadelphia.

This free event is open to all medical professionals and students. Representatives from the Governor’s office, Pennsylvania policymakers, physicians, and surgeons will attend to discuss the current state of the xylazine crisis and evidence-based medical and surgical treatment strategies.

Xylazine, commonly known as “tranq,” is a veterinary tranquilizer that has been found in illicit drug supplies, often mixed with fentanyl without users’ knowledge. The drug can cause dangerous decreases in breathing, heart rate, and blood pressure and is not affected by traditional overdose reversal medications.  Repeated xylazine use is associated with skin wounds, including open sores and abscesses.

The symposium will cover topics such as understanding the xylazine crisis, public policy related to xylazine, and medical and surgical management of xylazine-related issues. The event’s chairpersons are Dr. Asif Ilyas, President of the Rothman Opioid Foundation and Professor of Orthopaedic Surgery at Drexel University College of Medicine, and Dr. Katherine Woozely, Head of Orthopaedic Hand and Nerve Surgery and Associate Professor of Orthopaedic Surgery at Cooper Medical School of Rowan University.

The program will feature presentations from experts in various fields, including toxicology, addiction medicine, orthopaedic surgery, plastic surgery, and family medicine.  Speakers include Rachel Haroz, MD, Head of Toxicology and Addiction Medicine and Associate Professor of Emergency Medicine at Cooper Medical School of Rowan University; Andrew Miller, Assistant Professor of Orthopaedic Surgery at Thomas Jefferson University; Lisa Rae, MD, Associate Professor of Surgery at Temple University School of Medicine; Rick Tosti, MD, Assistant Program Director of Hand Surgery and Associate Professor of Orthopaedic Surgery at Thomas Jefferson University; Lara Weinstein, MD; Program Director of Addiction Medicine and Professor of Family Medicine at Thomas Jefferson University; and Jason Wink, MD, Assistant Professor of Plastic Surgery at the University of Pennsylvania School of Medicine.

Interested participants can register for the symposium at https://www.rothmanopioid.org/. While the symposium will not grant CME credit, it offers a valuable opportunity for medical professionals and students to gain insights into the emerging xylazine crisis and its impact on public health in Pennsylvania.

About the Rothman Institute Foundation for Opioid Research and Education.

The Rothman Orthopaedic Foundation, for short, is a non-profit 501c3 organization dedicated to raising awareness of the ongoing opioid crisis, educating physicians and patients on safe opioid prescribing and use – respectively, and advising policymakers on sound opioid and pain management policy. Most importantly, the Rothman Opioid Foundation performs and supports the highest quality research on opioids and alternative pain modalities to yield findings that can better inform patients, physicians, and the greater healthcare community in the most evidenced-based pain management strategies while working to mitigate opioid abuse and addiction. https://www.rothmanopioid.org/

Gay and lesbian adults over age 65 are nearly 28 times more likely than heterosexual peers to engage in polysubstance use, a Yale team finds in a new study published in Drug and Alcohol Dependence Reports.

Researchers say polysubstance use – i.e., use of more than one substance – is a major public health concern that disproportionately affects those in marginalized groups. “Polysubstance use is related to adverse health outcomes, including mental health illnesses (e.g., depression and anxiety disorders) and increased risk of death,” said Luis Miguel Mestre, PhD, postdoctoral fellow in the Yale Department of Psychiatry and principal investigator of the study.

Researchers from Yale School of Medicine and Yale School of Public Health examined data from over 86 thousand participants in the National Survey of Drug Use and Health, 2021-2022, to compare polysubstance use among lesbian, gay and bisexual (LGB) older adults with their heterosexual same-age peers and younger counterparts.

They found gay and lesbian adults over age 65 were 27.94 times more likely to report polysubstance use in the last 30 days than their heterosexual peers. Researchers say polysubstance use among gay and lesbian older adults didn’t differ significantly from their younger counterparts: “Older heterosexual adults significantly decrease their polysubstance use prevalence compared to their younger heterosexual counterparts,” Mestre said. “We don’t see the same reduction in polysubstance use for older bisexual and gay/lesbian adults compared to their younger bisexual and gay/lesbian counterparts.”

The team says polysubstance use was not as common in bisexual older adults: “Older bisexual adults do not have a significant difference in polysubstance use prevalence compared with their heterosexual or younger counterparts,” Mestre said. 

Researchers say the discrimination, victimization and lower community engagement faced by older gay and lesbian adults likely plays a role. “We recommend implementing anti-discrimination policies, including in housing and other services, that can address these concerns,” Mestre said, “as well as promoting trust among healthcare services through training and education campaigns and by promoting identity affirmation for older LGB adults.”

The study’s senior author was Krysten Bold. Other study authors included Marney A. White and Rebecca R. Levy.

A dog’s pain medication, a grandparent’s pill organizer, even a discarded tissue: Rutgers Health research reveals they’re all potential sources of opioid poisoning for young children.

Researchers at the New Jersey Poison Control Center examined 230 cases of opioid exposure in children ages 1 month to 6 years over a five-year period. Their findings in the Journal of Pediatrics show how children access these dangerous drugs.

“We’re seeing this in our clinical practice,” said Diane Calello, the medical director of the poison control center and senior author of the study. “I’ve seen too many kids in my practice at University Hospital who have gotten severely poisoned because they got opioids in their house.”

An overwhelming majority of exposures (97 percent) were unintentional. More than 91 percent occurred in the child’s home, and 84.3 percent resulted in the child being admitted to a health care facility.

While many cases involved a child accessing a parent’s medication, the study uncovered several unexpected sources of exposure. Grandparents’ medications were implicated in 17.4 percent of cases, highlighting what the researchers described as an often-overlooked risk factor: exposure to older adults who may not be as vigilant as parents about securing their medications.

Another significant risk came from pet medications, which were involved in 4.3 percent of cases. Children sometimes accessed these opioids directly and sometimes accessed pet medication that had been mixed with food, such as peanut butter, and then left out.

Children ages 2 and under accounted for 80 percent of all exposures. Kids in this age group face particularly high risk because of their exploratory behavior and inability to distinguish between safe and dangerous substances.

The study drew data from reports to the New Jersey Poison Control Center between January 2018 and December 2022. Researchers manually extracted and analyzed information from the center’s database, focusing on single opioid exposures in young children.

While prescription opioid pills were the most common source of danger, the study uncovered other scenarios. Children accessed used fentanyl patches, illicit drug paraphernalia and even opioid residue left on discarded items such as tissue paper and cotton balls.

The study highlights the importance of proper medication storage and disposal, Calello said.

“One opioid pill could actually kill a 2-year-old,” she said. “And yet, a parent who may take that opioid pill every day may not realize that even though it’s very familiar to them, it is deadly.”

The study authors said there is a need for more comprehensive education about the dangers of opioids in the home. Calello suggested it should include grandparents and anyone who might bring medications into a home where children are present.

One potential solution is increasing access for parents and caregivers to naloxone, a medication that can reverse opioid overdoses, Calello said.

“I’ve seen several cases of young children where I thought that if this mom or dad had naloxone with them, they could have given it, and this child may have had a better outcome,” she said.

Looking forward, the study team is preparing to publish data on how children nationwide are exposed to opioids. Those figures show more pediatric exposures to illicit opioids and medications for treating opioid addiction.

Calello added that she hopes to study the effects of distributing naloxone more widely to parents.

“That would be a good next step,” she said. “It could make a big difference.”

Newswise — Behavioral health professionals at Rutgers will work with the state to increase and improve the delivery of mental health and substance use services to the underserved communities of Newark and Elizabeth under a $4.5 million federal grant.

The New Jersey Division of Mental Health and Addiction Services has received the funding and will work with the Rutgers University Behavioral Health Care’s Center for Integrated Care (CIC).

The center will assist in a plan to bring more behavioral care providers directly into primary care offices. Those in the industry refer to this particular integrated care system as the  Collaborative Care Model. The idea is to assess the patient and connect him with behavioral health and psychiatry immediately without the need for referrals. The approach would save patients time, increase their access to care, ease the workload of the primary care doctors and save medical costs.

“This is an exciting partnership with the state that allows us to not only improve treatment and treatment access in medically underserved areas, but to also have the opportunity to impact state planning and advance collaborative care across state health programs,” said Holly Lister, a psychologist and program manager for the center.

The project is designed to increase the identification and treatment of people with behavioral health disorders, improve engagement and retention in care and use measurement-based care to improve the treatment of serious mental illness, child and adolescent emotional disturbance and co-occurring physical health conditions – directly in primary care.

This is the fourth grant to assist the CIC in increasing integrated behavioral health services and promote education about integrated care models throughout New Jersey.

The funding will also include educating healthcare providers and the public about the collaborative care approach to providing care.