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Marijuana use disorders in adolescents on the decline
New findings show that marijuana use disorders are on the decline among U.S. adolescents, according to Richard A. Grucza, Ph.D., and his associates.
They examined National Survey on Drug Use and Health data for 2002-2013 from 216,852 adolescents aged 12-17 years. They divided the data into two age groups: 12-14 and 15-17.
The prevalence of past-year marijuana use of the adolescents declined steadily from 15.8% in 2002 to 12.5% in 2007. After that it began to climb, peaking at 14.2% to 14.3% in 2010 and 2011. Then it dropped back to 13.2% in 2013. The decline was significant for both age groups, with no significant difference in trends between the groups (ages 12-14 years, odds ratio, 0.978 per year; ages 15-17 years, OR, 0.987).
In examining risk factors and protective factors, the researchers observed significant negative trends for the three risk factors and significant positive trends for four of the six protective factors. The two protective factors that decreased over time were drug education and religious commitment. “Thus, seven of the nine risk/protective factors changed over time in a manner that might partially explain the downward trend in the prevalence of marijuana use disorders,” they noted.
“Our findings underscore the importance of adolescent mental health in conferring resilience to risk for substance use disorders,” the researchers concluded. “There are one or more environmental factors – yet to be identified – that may be changing over time in a manner that leads to both lower risk for marijuana use disorders and for other behavioral problems.”
Read the study in the Journal of the American Academy of Child & Adolescent Psychiatry (doi: 10.1016/j.jaac.2016.04.002).
New findings show that marijuana use disorders are on the decline among U.S. adolescents, according to Richard A. Grucza, Ph.D., and his associates.
They examined National Survey on Drug Use and Health data for 2002-2013 from 216,852 adolescents aged 12-17 years. They divided the data into two age groups: 12-14 and 15-17.
The prevalence of past-year marijuana use of the adolescents declined steadily from 15.8% in 2002 to 12.5% in 2007. After that it began to climb, peaking at 14.2% to 14.3% in 2010 and 2011. Then it dropped back to 13.2% in 2013. The decline was significant for both age groups, with no significant difference in trends between the groups (ages 12-14 years, odds ratio, 0.978 per year; ages 15-17 years, OR, 0.987).
In examining risk factors and protective factors, the researchers observed significant negative trends for the three risk factors and significant positive trends for four of the six protective factors. The two protective factors that decreased over time were drug education and religious commitment. “Thus, seven of the nine risk/protective factors changed over time in a manner that might partially explain the downward trend in the prevalence of marijuana use disorders,” they noted.
“Our findings underscore the importance of adolescent mental health in conferring resilience to risk for substance use disorders,” the researchers concluded. “There are one or more environmental factors – yet to be identified – that may be changing over time in a manner that leads to both lower risk for marijuana use disorders and for other behavioral problems.”
Read the study in the Journal of the American Academy of Child & Adolescent Psychiatry (doi: 10.1016/j.jaac.2016.04.002).
New findings show that marijuana use disorders are on the decline among U.S. adolescents, according to Richard A. Grucza, Ph.D., and his associates.
They examined National Survey on Drug Use and Health data for 2002-2013 from 216,852 adolescents aged 12-17 years. They divided the data into two age groups: 12-14 and 15-17.
The prevalence of past-year marijuana use of the adolescents declined steadily from 15.8% in 2002 to 12.5% in 2007. After that it began to climb, peaking at 14.2% to 14.3% in 2010 and 2011. Then it dropped back to 13.2% in 2013. The decline was significant for both age groups, with no significant difference in trends between the groups (ages 12-14 years, odds ratio, 0.978 per year; ages 15-17 years, OR, 0.987).
In examining risk factors and protective factors, the researchers observed significant negative trends for the three risk factors and significant positive trends for four of the six protective factors. The two protective factors that decreased over time were drug education and religious commitment. “Thus, seven of the nine risk/protective factors changed over time in a manner that might partially explain the downward trend in the prevalence of marijuana use disorders,” they noted.
“Our findings underscore the importance of adolescent mental health in conferring resilience to risk for substance use disorders,” the researchers concluded. “There are one or more environmental factors – yet to be identified – that may be changing over time in a manner that leads to both lower risk for marijuana use disorders and for other behavioral problems.”
Read the study in the Journal of the American Academy of Child & Adolescent Psychiatry (doi: 10.1016/j.jaac.2016.04.002).
FROM JOURNAL OF THE AMERICAN ACADEMY OF CHILD & ADOLESCENT PSYCHIATRY
Rise in Neisseria meningitidis–associated urethritis among men
An increase in Neisseria meningitidis (Nm)-associated urethritis among men at two U.S. sexual health clinics warrants raised awareness among clinicians, according to investigators affiliated with the CDC’s Gonococcal Isolate Surveillance Project.
During January-September 2015, a total of 52 cases of urethritis were confirmed in male patients at a Columbus, Ohio clinic, and were found to be caused by Nm by Analytic Profile Index Neisseria-Haemophilus (API NH) testing and sodC polymerase chain reaction (PCR). During the same time period, an Oakland County, Mich., clinic documented 15 cases of urethritis in male patients, also caused by Nm. Both clinics are participant sites in CDC’s Gonococcal Isolate Surveillance Project, through which urethral isolates from the first 25 men evaluated each month with Ng urethritis undergo antibiotic susceptibility testing.
Nm urogenital infections are less common than infections caused by Neisseria gonorrhoeae (Ng), but have been associated with urethritis, cervicitis, proctitis, and pelvic inflammatory disease. Nm can appear similar to Ng on Gram stain analysis. The CDC reports that, because Nm colonizes the nasopharynx, men who receive oral sex can acquire urethral Nm infections.
Among all of the confirmed cases at both clinics, 99% of patients reported heterosexual orientation, and 97% had symptomatic urethritis. Oral sex was reported by 100% of Columbus patients and by 93% of Oakland County patients. Also, 84% of Columbus patients reported two or more sex partners within the preceding 90 days, while 56% of Oakland County patients reported two or more partners within the preceding 60 days. Up to 90% of patients were treated with an appropriate treatment for Nm urethritis for presumed Ng infection with the CDC-recommended regimen.
“Until more data are available on transmission and sequelae, sex partners of patients with Nm urethritis should be treated as they would be for exposure to urogenital Ng,” the researchers concluded. “Increases in Nm urethritis cases above baseline should be reported to CDC.”
Find the full report in Morbidity and Mortality Weekly Report (doi: 10.15585/mmwr.mm6521a5).
An increase in Neisseria meningitidis (Nm)-associated urethritis among men at two U.S. sexual health clinics warrants raised awareness among clinicians, according to investigators affiliated with the CDC’s Gonococcal Isolate Surveillance Project.
During January-September 2015, a total of 52 cases of urethritis were confirmed in male patients at a Columbus, Ohio clinic, and were found to be caused by Nm by Analytic Profile Index Neisseria-Haemophilus (API NH) testing and sodC polymerase chain reaction (PCR). During the same time period, an Oakland County, Mich., clinic documented 15 cases of urethritis in male patients, also caused by Nm. Both clinics are participant sites in CDC’s Gonococcal Isolate Surveillance Project, through which urethral isolates from the first 25 men evaluated each month with Ng urethritis undergo antibiotic susceptibility testing.
Nm urogenital infections are less common than infections caused by Neisseria gonorrhoeae (Ng), but have been associated with urethritis, cervicitis, proctitis, and pelvic inflammatory disease. Nm can appear similar to Ng on Gram stain analysis. The CDC reports that, because Nm colonizes the nasopharynx, men who receive oral sex can acquire urethral Nm infections.
Among all of the confirmed cases at both clinics, 99% of patients reported heterosexual orientation, and 97% had symptomatic urethritis. Oral sex was reported by 100% of Columbus patients and by 93% of Oakland County patients. Also, 84% of Columbus patients reported two or more sex partners within the preceding 90 days, while 56% of Oakland County patients reported two or more partners within the preceding 60 days. Up to 90% of patients were treated with an appropriate treatment for Nm urethritis for presumed Ng infection with the CDC-recommended regimen.
“Until more data are available on transmission and sequelae, sex partners of patients with Nm urethritis should be treated as they would be for exposure to urogenital Ng,” the researchers concluded. “Increases in Nm urethritis cases above baseline should be reported to CDC.”
Find the full report in Morbidity and Mortality Weekly Report (doi: 10.15585/mmwr.mm6521a5).
An increase in Neisseria meningitidis (Nm)-associated urethritis among men at two U.S. sexual health clinics warrants raised awareness among clinicians, according to investigators affiliated with the CDC’s Gonococcal Isolate Surveillance Project.
During January-September 2015, a total of 52 cases of urethritis were confirmed in male patients at a Columbus, Ohio clinic, and were found to be caused by Nm by Analytic Profile Index Neisseria-Haemophilus (API NH) testing and sodC polymerase chain reaction (PCR). During the same time period, an Oakland County, Mich., clinic documented 15 cases of urethritis in male patients, also caused by Nm. Both clinics are participant sites in CDC’s Gonococcal Isolate Surveillance Project, through which urethral isolates from the first 25 men evaluated each month with Ng urethritis undergo antibiotic susceptibility testing.
Nm urogenital infections are less common than infections caused by Neisseria gonorrhoeae (Ng), but have been associated with urethritis, cervicitis, proctitis, and pelvic inflammatory disease. Nm can appear similar to Ng on Gram stain analysis. The CDC reports that, because Nm colonizes the nasopharynx, men who receive oral sex can acquire urethral Nm infections.
Among all of the confirmed cases at both clinics, 99% of patients reported heterosexual orientation, and 97% had symptomatic urethritis. Oral sex was reported by 100% of Columbus patients and by 93% of Oakland County patients. Also, 84% of Columbus patients reported two or more sex partners within the preceding 90 days, while 56% of Oakland County patients reported two or more partners within the preceding 60 days. Up to 90% of patients were treated with an appropriate treatment for Nm urethritis for presumed Ng infection with the CDC-recommended regimen.
“Until more data are available on transmission and sequelae, sex partners of patients with Nm urethritis should be treated as they would be for exposure to urogenital Ng,” the researchers concluded. “Increases in Nm urethritis cases above baseline should be reported to CDC.”
Find the full report in Morbidity and Mortality Weekly Report (doi: 10.15585/mmwr.mm6521a5).
FROM MMWR
Improvement needed for U.S. acute care hospitals implementing ASPs
There is more room for improving U.S. acute care hospitals’ antibiotic stewardship programs (ASPs) and implementing the seven core elements, according to findings from the 2014 National Healthcare Safety Network (NHSN) Annual Hospital Survey.
In univariate analyses, Dr. Lori A. Pollack, of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention, and her associates looked at 4,184 acute care hospitals. Of those acute care hospitals, 1,642 (39%) reported implementing all seven CDC-defined core elements – leadership commitment, a single program leader responsible for outcomes, a pharmacy leader, specific interventions to improve prescribing, tracking antibiotic use and resistance, reporting data back to provider, and education – for hospital ASPs. In the hospitals with more than 200 beds, 775 (56%) were more likely to report all seven core elements, compared with 672 (39%) hospitals with 51-200 beds, and 328 (22%) of hospitals with 50 or fewer beds.
The hospitals with 50 or fewer beds were less likely to report leadership support (40%) or antibiotic stewardship education (46%), compared with facilities with greater than 50 beds (69% leadership, 69% education). Also, the major teaching hospitals were more likely to report all seven core elements (54%) than were hospitals that had only undergraduate education or no teaching affiliation (34%).
The study also conducted a final multivariate model and found that the strongest predictor for meeting all seven core elements was support from the facility administration (adjusted relative risk, 7.2; P less than .0001).
“Our findings suggest that many hospitals need to add infrastructure and measurement support to their current actions to improve antibiotic use,” the researchers concluded. “CDC is committed to on-going work with partners to help all hospitals implement effective antibiotic stewardship programs, and future years of this survey will help monitor progress toward that goal.”
Read the full study in Clinical Infectious Diseases (doi: 10.1093/cid/ciw323).
There is more room for improving U.S. acute care hospitals’ antibiotic stewardship programs (ASPs) and implementing the seven core elements, according to findings from the 2014 National Healthcare Safety Network (NHSN) Annual Hospital Survey.
In univariate analyses, Dr. Lori A. Pollack, of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention, and her associates looked at 4,184 acute care hospitals. Of those acute care hospitals, 1,642 (39%) reported implementing all seven CDC-defined core elements – leadership commitment, a single program leader responsible for outcomes, a pharmacy leader, specific interventions to improve prescribing, tracking antibiotic use and resistance, reporting data back to provider, and education – for hospital ASPs. In the hospitals with more than 200 beds, 775 (56%) were more likely to report all seven core elements, compared with 672 (39%) hospitals with 51-200 beds, and 328 (22%) of hospitals with 50 or fewer beds.
The hospitals with 50 or fewer beds were less likely to report leadership support (40%) or antibiotic stewardship education (46%), compared with facilities with greater than 50 beds (69% leadership, 69% education). Also, the major teaching hospitals were more likely to report all seven core elements (54%) than were hospitals that had only undergraduate education or no teaching affiliation (34%).
The study also conducted a final multivariate model and found that the strongest predictor for meeting all seven core elements was support from the facility administration (adjusted relative risk, 7.2; P less than .0001).
“Our findings suggest that many hospitals need to add infrastructure and measurement support to their current actions to improve antibiotic use,” the researchers concluded. “CDC is committed to on-going work with partners to help all hospitals implement effective antibiotic stewardship programs, and future years of this survey will help monitor progress toward that goal.”
Read the full study in Clinical Infectious Diseases (doi: 10.1093/cid/ciw323).
There is more room for improving U.S. acute care hospitals’ antibiotic stewardship programs (ASPs) and implementing the seven core elements, according to findings from the 2014 National Healthcare Safety Network (NHSN) Annual Hospital Survey.
In univariate analyses, Dr. Lori A. Pollack, of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention, and her associates looked at 4,184 acute care hospitals. Of those acute care hospitals, 1,642 (39%) reported implementing all seven CDC-defined core elements – leadership commitment, a single program leader responsible for outcomes, a pharmacy leader, specific interventions to improve prescribing, tracking antibiotic use and resistance, reporting data back to provider, and education – for hospital ASPs. In the hospitals with more than 200 beds, 775 (56%) were more likely to report all seven core elements, compared with 672 (39%) hospitals with 51-200 beds, and 328 (22%) of hospitals with 50 or fewer beds.
The hospitals with 50 or fewer beds were less likely to report leadership support (40%) or antibiotic stewardship education (46%), compared with facilities with greater than 50 beds (69% leadership, 69% education). Also, the major teaching hospitals were more likely to report all seven core elements (54%) than were hospitals that had only undergraduate education or no teaching affiliation (34%).
The study also conducted a final multivariate model and found that the strongest predictor for meeting all seven core elements was support from the facility administration (adjusted relative risk, 7.2; P less than .0001).
“Our findings suggest that many hospitals need to add infrastructure and measurement support to their current actions to improve antibiotic use,” the researchers concluded. “CDC is committed to on-going work with partners to help all hospitals implement effective antibiotic stewardship programs, and future years of this survey will help monitor progress toward that goal.”
Read the full study in Clinical Infectious Diseases (doi: 10.1093/cid/ciw323).
FROM CLINICAL INFECTIOUS DISEASES
FDA Is Investigating Zecuity Sumatriptan Patch for Reports of Serious Burns
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
FDA is investigating Zecuity sumatriptan patch for reports of serious burns
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
The Food and Drug Administration is evaluating patient reports of serious burns and potential permanent scarring that have occurred with the use of the Zecuity patch (sumatriptan iontophoretic transdermal system) to relieve migraine headaches.
Since September 2015, a large number of patients using the Zecuity patch have reported that they have experienced burns or scars on the skin where the patch was worn. Severe redness, pain, skin discoloration, blistering, and cracked skin were reported, according to the agency’s June 2 drug safety announcement.
The Zecuity patch contains sumatriptan which is a prescription medicine used to treat acute migraine headaches in adults. It is designed to give a dose of medicine by way of a single-use, battery-powered patch that is wrapped around the upper arm or thigh.
“Health care professionals should advise patients who complain of moderate to severe pain at the application site to remove the Zecuity patch immediately,” the safety report states. “Consider a different formulation of sumatriptan or switch these patients to an alternative migraine medicine.”
It is advised that patients should not bathe, shower, or swim while wearing the patch. Patients and health care professionals should report possible side effects involving the Zecuity patch to the FDA MedWatch program.
Women prescribed opioids during pregnancy have outcomes similar to those of illicit users
WASHINGTON – Women using chronic prescription opioids while pregnant have obstetrics outcomes similar to those of women chronically using illegal opioids and/or other forms of opioid substitution therapy.
Dr. Kaitlin Hanmer of Brigham & Women’s Hospital and Massachusetts General Hospital, Boston, analyzed 76 women who presented to the medical center for care between 2000 and 2015, comparing 22 women in the prescription opioid group and 54 women in the illicit opioid/opioid substitution therapy group. Among the 22 women in the prescription group, 13.6% of those pregnancies had a neonatal intensive care unit (NICU) consult, compared with 44.4% of the 54 women in the illicit opioid/opioid substitution therapy. She presented the findings at the annual meeting of the American College of Obstetricians and Gynecologists.
“The surprising finding was that women who used prescription opioids were less likely to be offered, or to have, an NICU consult during their pregnancy – prior to the birth – than were the women in the illicit opioid/opioid substitution therapy group, even though infants from both groups were significantly more likely to have longer hospital stays than their mothers,” Dr. Hanmer said in an interview.
In both groups, the hospital stays for the infants were significantly longer than for their mothers. Among infants born to mothers in the prescribed opioids group, 54.5% were hospitalized for more than 4 days longer than their mothers. This was true for 83.3% of infants born to mothers in the illicit opioid/opioid substitution therapy group.
The study also examined neonatal abstinence syndrome and found that 50% of infants of mothers using prescribed opioids were likely to be diagnosed with neonatal abstinence syndrome, compared with 81.5% of the infants of mothers in the illicit opioid/opioid substitution therapy group.
“Regardless of type of opioid use in pregnancy or preconceived notions about certain patients, we as practicing doctors need to use our points of care during the antenatal period to maximize the success of transition to the post partum period for both mom and baby,” Dr. Hanmer said. “At the end of the day, the goal is healthy mom and healthy baby.”
Dr. Hanmer reported having no financial disclosures.
WASHINGTON – Women using chronic prescription opioids while pregnant have obstetrics outcomes similar to those of women chronically using illegal opioids and/or other forms of opioid substitution therapy.
Dr. Kaitlin Hanmer of Brigham & Women’s Hospital and Massachusetts General Hospital, Boston, analyzed 76 women who presented to the medical center for care between 2000 and 2015, comparing 22 women in the prescription opioid group and 54 women in the illicit opioid/opioid substitution therapy group. Among the 22 women in the prescription group, 13.6% of those pregnancies had a neonatal intensive care unit (NICU) consult, compared with 44.4% of the 54 women in the illicit opioid/opioid substitution therapy. She presented the findings at the annual meeting of the American College of Obstetricians and Gynecologists.
“The surprising finding was that women who used prescription opioids were less likely to be offered, or to have, an NICU consult during their pregnancy – prior to the birth – than were the women in the illicit opioid/opioid substitution therapy group, even though infants from both groups were significantly more likely to have longer hospital stays than their mothers,” Dr. Hanmer said in an interview.
In both groups, the hospital stays for the infants were significantly longer than for their mothers. Among infants born to mothers in the prescribed opioids group, 54.5% were hospitalized for more than 4 days longer than their mothers. This was true for 83.3% of infants born to mothers in the illicit opioid/opioid substitution therapy group.
The study also examined neonatal abstinence syndrome and found that 50% of infants of mothers using prescribed opioids were likely to be diagnosed with neonatal abstinence syndrome, compared with 81.5% of the infants of mothers in the illicit opioid/opioid substitution therapy group.
“Regardless of type of opioid use in pregnancy or preconceived notions about certain patients, we as practicing doctors need to use our points of care during the antenatal period to maximize the success of transition to the post partum period for both mom and baby,” Dr. Hanmer said. “At the end of the day, the goal is healthy mom and healthy baby.”
Dr. Hanmer reported having no financial disclosures.
WASHINGTON – Women using chronic prescription opioids while pregnant have obstetrics outcomes similar to those of women chronically using illegal opioids and/or other forms of opioid substitution therapy.
Dr. Kaitlin Hanmer of Brigham & Women’s Hospital and Massachusetts General Hospital, Boston, analyzed 76 women who presented to the medical center for care between 2000 and 2015, comparing 22 women in the prescription opioid group and 54 women in the illicit opioid/opioid substitution therapy group. Among the 22 women in the prescription group, 13.6% of those pregnancies had a neonatal intensive care unit (NICU) consult, compared with 44.4% of the 54 women in the illicit opioid/opioid substitution therapy. She presented the findings at the annual meeting of the American College of Obstetricians and Gynecologists.
“The surprising finding was that women who used prescription opioids were less likely to be offered, or to have, an NICU consult during their pregnancy – prior to the birth – than were the women in the illicit opioid/opioid substitution therapy group, even though infants from both groups were significantly more likely to have longer hospital stays than their mothers,” Dr. Hanmer said in an interview.
In both groups, the hospital stays for the infants were significantly longer than for their mothers. Among infants born to mothers in the prescribed opioids group, 54.5% were hospitalized for more than 4 days longer than their mothers. This was true for 83.3% of infants born to mothers in the illicit opioid/opioid substitution therapy group.
The study also examined neonatal abstinence syndrome and found that 50% of infants of mothers using prescribed opioids were likely to be diagnosed with neonatal abstinence syndrome, compared with 81.5% of the infants of mothers in the illicit opioid/opioid substitution therapy group.
“Regardless of type of opioid use in pregnancy or preconceived notions about certain patients, we as practicing doctors need to use our points of care during the antenatal period to maximize the success of transition to the post partum period for both mom and baby,” Dr. Hanmer said. “At the end of the day, the goal is healthy mom and healthy baby.”
Dr. Hanmer reported having no financial disclosures.
AT ACOG 2016
Key clinical point: Use of chronic prescription opioids in pregnancy results in similar obstetrics outcomes, compared with use of illegal opioids and other forms of opioid substitution therapy.
Major finding: Half of infants whose mothers used prescribed opioids were likely to be diagnosed with neonatal abstinence syndrome, compared with 81.5% of the infants of mothers using illicit opioid and/or opioid substitution therapy.
Data source: A retrospective chart review of 76 pregnancies between 2000 and 2015.
Disclosures: Dr. Hanmer reported having no financial disclosures.
Age Influences ED Visits for Mental Health Among American Indian Children
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
FROM THE JOURNAL OF PEDIATRICS
Age Influences ED Visits for Mental Health Among American Indian Children
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
FROM THE JOURNAL OF PEDIATRICS
Age influences ED visits for mental health among American Indian children
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
Age plays an influential role in the number of emergency department (ED) visits for mental health concerns among American Indian children, according to Wyatt J. Pickner and his associates.
The researchers analyzed 26,004 pediatric ED visits by 20,413 patients over a 12-month study period in the Upper Midwest. Among these, there were 1,545 visits (5.94%) by 1,287 patients for mental health reasons.
American Indian children had higher odds of having ED visits for mental health concerns, compared with white children (10.8% vs. 5.1%; P less than .0001), the researchers noted.
Visits by older American Indian children were more likely to be for mental health reasons, compared with younger children (P less than .0001). Within the 5- to 10-year-old group, these children had lower odds of a mental health visit (odds ratio, 0.40), while the 11- to 17-year-old American Indian children had higher odds of a mental health visit (OR, 1.62).
“Visits to the ED for mental health reasons by American Indian children are a complex problem and not fully understood,” the researchers concluded. “We believe our data can help to inform clinicians and policymakers on the appropriate resources and interventions that can be used to improve care for American Indian children.”
Read the study in The Journal of Pediatrics (doi: 10.1016/j.jpeds.2016.03.064).
FROM THE JOURNAL OF PEDIATRICS
Methadone programs allowed pregnancy outcomes similar to nonusers
Methadone users under professional programs have similar pregnancy outcomes as nonmethadone users, according to a study of more than 34,000 deliveries.
Dr. Conisha Holloman of Winnie Palmer Hospital Orlando, Fla., analyzed 34,482 deliveries from 2010 to 2013, comparing women enrolled in methadone programs, those with cocaine or heroine use but no treatment or self medication with methadone, and a large group of controls.
“What we found was a significant difference between preterm births in the groups,” Dr. Holloman said at the annual meeting of the American College of Obstetricians and Gynecologists.
The preterm birth rate was 15% among the 55 patients enrolled in methadone programs. The preterm birth rate rose to 36% among the 34,408 patients in the control group, who had no addiction issues. Comparatively, the preterm birth rate was 53% among the 19 patients who tested positive for cocaine, heroine, or methadone use and were either self treating or not enrolled in a treatment program.
The study also noted neonatal intensive care unit (NICU) admission rates were higher for infants of drug-using patients who were self treating or who were not enrolled in methadone programs. The NICU admission rate for infants of those patients was 26%, compared with 16% for the women in the methadone program and 7% for the control group.
The demographics in the groups were comparable, with no significant difference between age, primigravida, and class III obesity status.
“We encourage women to get into a methadone assisted program, because a lot of these women end up getting earlier prenatal care and better social situations as far as high-risk behavior and improved nutrition for maternal health,” said Dr. Holloman.
Dr. Holloman reported having no relevant financial disclosures.
Methadone users under professional programs have similar pregnancy outcomes as nonmethadone users, according to a study of more than 34,000 deliveries.
Dr. Conisha Holloman of Winnie Palmer Hospital Orlando, Fla., analyzed 34,482 deliveries from 2010 to 2013, comparing women enrolled in methadone programs, those with cocaine or heroine use but no treatment or self medication with methadone, and a large group of controls.
“What we found was a significant difference between preterm births in the groups,” Dr. Holloman said at the annual meeting of the American College of Obstetricians and Gynecologists.
The preterm birth rate was 15% among the 55 patients enrolled in methadone programs. The preterm birth rate rose to 36% among the 34,408 patients in the control group, who had no addiction issues. Comparatively, the preterm birth rate was 53% among the 19 patients who tested positive for cocaine, heroine, or methadone use and were either self treating or not enrolled in a treatment program.
The study also noted neonatal intensive care unit (NICU) admission rates were higher for infants of drug-using patients who were self treating or who were not enrolled in methadone programs. The NICU admission rate for infants of those patients was 26%, compared with 16% for the women in the methadone program and 7% for the control group.
The demographics in the groups were comparable, with no significant difference between age, primigravida, and class III obesity status.
“We encourage women to get into a methadone assisted program, because a lot of these women end up getting earlier prenatal care and better social situations as far as high-risk behavior and improved nutrition for maternal health,” said Dr. Holloman.
Dr. Holloman reported having no relevant financial disclosures.
Methadone users under professional programs have similar pregnancy outcomes as nonmethadone users, according to a study of more than 34,000 deliveries.
Dr. Conisha Holloman of Winnie Palmer Hospital Orlando, Fla., analyzed 34,482 deliveries from 2010 to 2013, comparing women enrolled in methadone programs, those with cocaine or heroine use but no treatment or self medication with methadone, and a large group of controls.
“What we found was a significant difference between preterm births in the groups,” Dr. Holloman said at the annual meeting of the American College of Obstetricians and Gynecologists.
The preterm birth rate was 15% among the 55 patients enrolled in methadone programs. The preterm birth rate rose to 36% among the 34,408 patients in the control group, who had no addiction issues. Comparatively, the preterm birth rate was 53% among the 19 patients who tested positive for cocaine, heroine, or methadone use and were either self treating or not enrolled in a treatment program.
The study also noted neonatal intensive care unit (NICU) admission rates were higher for infants of drug-using patients who were self treating or who were not enrolled in methadone programs. The NICU admission rate for infants of those patients was 26%, compared with 16% for the women in the methadone program and 7% for the control group.
The demographics in the groups were comparable, with no significant difference between age, primigravida, and class III obesity status.
“We encourage women to get into a methadone assisted program, because a lot of these women end up getting earlier prenatal care and better social situations as far as high-risk behavior and improved nutrition for maternal health,” said Dr. Holloman.
Dr. Holloman reported having no relevant financial disclosures.
At ACOG 2016
Key clinical point: Women enrolled in supervised methadone programs had similar preterm birth rates to healthy controls.
Major finding: Preterm birth rates were 15% among methadone users and 36% among controls.
Data source: A retrospective study of 34,482 deliveries from 2010 to 2013.
Disclosures: Dr. Holloman reported having no relevant financial disclosures.