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Wednesday, April 25, 2012

Pill Probabilities: "Dancing With Mr. D"

The "Youth Bulge"

First of all it is important to understand the definition of the word adolescent. Researchers now refer to adolescents as those aged 10 to 19, due to growing trends in the earlier onset of puberty and delayed transition into adult roles.

A decrease in child mortality rates worldwide is leading to the largest generation of adolescents in history: 1.2 billion to be exact. This has become known as the "Youth Bulge." As many of those teens face poverty, natural disasters and wars in addition to overwhelming physical and emotional changes, researchers worry about the lack of available health resources.

"The high income world has been grappling with a rising tide of risks for non-communicable diseases, including the problems of obesity, physical inactivity, alcohol, tobacco and illicit drug use," write the authors of a paper published in The Lancet this week. "That tide is now overwhelming many [lower-to-middle-income countries] who have yet to bring in measures to control the problems of injury, infectious disease and maternal mortality in this young age group.” ("Mortality Rates Still Too High for World's Teens," CNN Health, April 24 2012)

Believe it or not, the U.S. has the worst adolescent mortality rate out of 27 high income countries. Its rates of violent deaths (gang-related, homicides, etc.) are 10 to 20 times higher than other developed countries.

America's Youth Population

Over 64 million adolescents ages 10 to 24 live in the United States, representing roughly 21% of Americans.1 In the past ten years, the adolescent population has grown by more than 7%, with the largest gains seen among young adults ages 20 to 24. (Howden LM, Meyer JA. 2011. "Age and Sex Composition: 2010." United States Census Bureau.

Young people in the United States reflect the increasing diversity of American society, as racial and ethnic minority groups continue to expand. Latinos and African Americans account for 20% and 16% of adolescents aged 10 to 19, compared to 18% and 15% of young adults ages 20 to 24. Conversely, while White youth represent 61% of young adults, they account for 58% of adolescents. (United States Census Bureau. 2010. "Annual Estimates of the Resident Population by Race, Hispanic Origin, Sex and Age for the United States: April 1, 2000 to July 1, 2009."

This growth of minority communities is expected to continue in the coming decades, with estimates projecting that white youth will account for 48% of adolescents by 2040.
Other trends seen among adolescent populations in the United States include a rising number of young people living in immigrant families (19% in 1990 to 24% in 2008), increasing school enrollment, and declining high school dropout rates. Further, 10.2 million young people lived in poverty in 2006, accounting for 23% of all Americans living in poverty.

Youth Mortality Rate Trends in the United States

The very good news is that the rate of unintentional injury – the No. 1 cause of death for adolescents (and children) in the United States plunged nearly 30 percent in the past decade, according to a recent report from the Centers for Disease Control and Prevention. ("Death Rates From Unintentional Injury Among Children Dropped by Nearly 30 Percent in 10 years," Press Release from the Centers for Disease Control and Prevention)

Vehicular deaths remain the primary cause of mortality for youth in the United States, with contributing factors including lack of driving experience as well as presence of other teenage passengers and alcohol use.

And more good news is that the death rates from motor vehicle crashes dropped by 41 percent from 2000-2009. Several factors have played a role in this reduction, including improvements in child safety and booster seat use and use of graduated drivers licensing systems for teen drivers.

The horrible news is that poisoning death rates increased 91 percent among teens aged 15 to 19 between 2000 and 2009, largely a result of prescription-drug overdose, the CDC report said. (Andrew Mach, "Fatal Accident Rate for U.S. Children and Teens Plunges Since 2000," Christian Science Monitor, April 24 2012)

According to CDC research, appropriate prescribing, proper storage and disposal, discouraging medication sharing, and state-based prescription drug monitoring programs could reduce these deaths.

Do teens also seek street drugs today? Of course, some do. But, more and more teens are turning to prescription drugs and over the counter medicines to get high. These drugs include pain killers that might be prescribed after a person undergoes surgery, depressants that are taken for sleep aid, depression or anxiety or stimulants such as those used for ADHD.

The over the counter medicines include cough medicine and cold remedies. Narcotic pain killers like Vicodin, OxyContin, Percocet or Lortab, including the generics such as methadone and hydrocodone are highly addictive and are very dangerous. 

Sadly, each day 2,500 students from 12 to 17 abuse a pain relieving drug for the first time. In fact, prescription medicine is the second most abused drug other than marijuana. Most teenagers obtain these prescription meds by stealing them from their parent’s medicine cabinets and even share them with friends or sell them at school. (Richard Hastings, "Prescription Drug Abuse Kills More Teens," Darien Patch,, April 24 2012)

Thank God Most Young Adults Stop Abuse As They Age, Right?

Every young death is so tragic. Each causes unbearable pain and suffering for the family and friends of the deceased. Yet, the facts show that as terrible as statistics are for adolescent deaths, the highest poisoning death rates from drug abuse actually occur later in life.

The vast majority of unintentional poisoning deaths occur in older age groups. In 2007 unintentional poisoning was the leading cause of death from all causes for ages 35-44, the number two cause from 25-34 and the third leading cause of death from 45-54. Death due to drug abuse is taking place most often well beyond the age when people should "know better" and before their judgement begins to decline. (Tom LeDuc, "America's Poison Problem,"

According to the Centers For Disease Control and Prevention, nearly 82 Americans die as a result of unintentional poisoning, and another 1,941 are treated in emergency departments every single day. 
Imagine this:

The number of U.S. deaths due
to unintentional drug overdoses in 2006
exceeds that of a large jet crash
killing 350 people every day
for 2.5 months in a row.     

CDC Chart illustrating the massive growth in death by poison while
other leading causes of unintentional injury deaths decline

Excellent Slide Presentation from the Ohio Department of Health Violence and Injury Prevention Program: "Alarming Rise In Unintentional Drug Overdose Deaths In Ohio"

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