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U.S. opioid addiction crisis is top health story of 2018

(HealthDay)—The scourge of opioid addiction and related deaths cut through American society again in 2018, capturing headlines and making it the year's top health story.

Rates of opioid-linked fatal overdoses have nearly doubled over the past decade and topped 70,000 in 2017, according to data released in November by the U.S. Centers for Disease Control and Prevention.

Many of those tragic deaths occurred among young adults and were linked to fentanyl, a synthetic opioid that's 50 times more potent than heroin.

All of this means that for three years in a row, U.S. average life expectancy reversed a long-term upward trend and actually dropped—from nearly 79 years in 2014 to 78.6 years now.

"We've been talking about the fact that our children will live less long than we will, and that's clearly coming to pass," said Dr. Georges Benjamin, executive director of the American Public Health Association.

Other top health stories of 2018, as compiled by editors at HealthDay:

Vaping rates soar among the young

Even as smoking rates fell to all-time lows among teens, another form of addictive nicotine intake, the e-cigarette, was poised to take its place.

The latest federal data on youth behaviors found vaping among American teenagers rising dramatically in 2018, with nearly two of every five high school seniors (37 percent) reporting they've tried an e-cigarette during the past year. That's up from 28 percent the year before.

Many worry that the sleek "cool" factor of the leading e-cigarette brand, Juul, may be luring the young to take up vaping—which many experts worry is a merely a bridge to traditional smoking.

Seeking to reverse these trends, the U.S. Food and Drug Administration in November announced that it would take steps to limit or ban access to flavored e-cigarettes, much favored by teens.

A deadly flu season

A virulent dominant strain of influenza, relatively low uptake of the flu shot, and a poor match between the vaccine and the dominant strains of virus combined to make 2017-2018 one of the worst flu seasons in recent memory.

Over 80,000 people—many of them the frail elderly or the very young—died from complications of flu, the CDC reported, and hospitals were jammed with patients battling the virus.

So far, the new season seems milder, but CDC experts warn that influenza can still bring surprises, so they urge vaccination.

With growing acceptance, marijuana use rises

By 2018, 33 U.S. states had legalized marijuana for medical use, and neighboring Canada also legalized the drug for recreational use. Aging baby boomers seemed to embrace pot, and in a HealthDay/Harris Poll conducted in July, 85 percent of U.S. adults agreed that pot should be allowed for medical purposes, while 57 percent supported recreational use.

One legal marijuana derivative product, medicinal CBD oil, became hugely popular in 2018. A form of CBD liquid, Epidiolex, became the first marijuana-derived drug ever approved by the FDA. It is used to help ease certain forms of epilepsy.

Not everyone was happy about widening access to marijuana, however.

"The problem here is we're at the beginning of this massive experiment with unknown outcomes," said Fred Muench, president and CEO of the Partnership for Drug-Free Kids.

Obamacare holds on another year

Despite promises by the Trump White House and Republicans in Congress to repeal it, the Affordable Care Act (ACA)—also known as "Obamacare"—kept providing health care to Americans in 2018.

In fact, despite pessimistic mid-year predictions, ACA sign-ups for 2018 held steady at near 12 million, and were only down slightly for 2019.

However, threats to the program remained: In December, a federal judge in Texas deemed the ACA unconstitutional—a ruling that could end up before the Supreme Court.

Gene-targeted 'personalized' medicine brings new hope against cancer

When former President Jimmy Carter announced that a gene-focused immunotherapy drug called Keytruda had pushed back his metastatic brain tumor, Americans began to understand the potential of this new generation of medicines.

Drugs like Keytruda, Yervoy, Opdivo and others target genes specific to an individual patient's tumor. This greatly improves treatment success rates while minimizing side effects.

The field is expanding to a wide range of drugs fighting a host of tumor types, said one oncologist.

"I'm a lung cancer doc. We just had our fifth drug for a specific genomic driver in lung cancer approved last week. That started out from zero in 2004," noted Dr. Bruce Johnson, past president of the American Society of Clinical Oncology.

Tainted lettuce puts a damper on Thanksgiving

Americans sitting down for their Thanksgiving dinners had to forgo Caesar salads this year. That's because E. coli contamination in irrigation water at one California farm (but possibly more) caused the FDA to urge Americans to avoid the leafy green.

The outbreak caused 59 illnesses so severe that dozens were sent to the hospital, although no deaths were reported.

Big changes to common cancer screens

In May, expert cancer panels made two big revisions to screening protocols used by millions. First, the U.S. Preventive Services Task Force (USPSTF) re-opened the door for men to once again use the prostate-specific antigen (PSA) blood test for prostate cancer, saying that men aged 55 to 69 should decide for themselves whether to undergo the test.

Next, the American Cancer Society lowered the starting age for colon cancer screening from 50 to 45, citing a rise in the cancer among the young.

Finally, in August, another USPSTF panel said that women over 30 now have a range of cervical cancer screening options. These include an HPV (human papillomavirus) test just once every five years— dispensing with the traditional Pap test.

Mysterious 'polio-like' illness strikes kids

Cases of a rare but devastating illness called acute flaccid myelitis (AFM) grew among U.S. children again in 2018, with numbers affected by the paralyzing illness approaching 300 by year's end. The condition appears linked to infection with enteroviruses, which typically cause only mild illnesses such as common colds. For now, AFM's origins and treatment remain unclear, the CDC has said.

December 27, 2018

 https://medicalxpress.com/

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