Years of Life Lost to Unintentional Drug Overdose Rapidly Rising in the Adolescent Population, 2016-2020.

PURPOSE: Years of life lost (YLL) is an epidemiological estimate of premature death which provides increased weight to mortality at younger ages. This study aims to quantify the impact of overdose mortality in adolescents from 2016 to 2020 using YLL and document the role of illicitly manufactured fentanyl in rising overdose rates. METHODS: Data were obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research mortality file for years 2016-2020 to investigate unintentional overdose in adolescents aged 10-19. Unintentional overdose rates were investigated by year, gender, age, and substances involved. YLL was calculated using the Social Security Period of Life Table by age and year. YLL to unintentional overdoses was then compared to other leading causes of adolescent death. RESULTS: The number of adolescent YLL to unintentional drug overdose in the United States more than doubled from 2019 to 2020 after remaining relatively stable between 2016 and 2019. In 2020, YLL to unintentional overdose accumulated to 84,179 YLL, surpassing that of cancer. Synthetic opioids including primarily illicitly manufactured fentanyl contributed to 81% of overdose deaths and 68,356 YLL, compared to 67% (26,628 YLL) in 2019. YLL to unintentional overdose during 2020 was higher for males (59,274) compared to females (24,905). DISCUSSION: Mortality due to unintentional overdose in adolescents reached an all-time high in 2020. The majority of deaths (81%) involved fentanyl and other synthetic opioids. The trends depicted in this study signify the need for increased harm reduction approaches and treatment of opioid use disorder in adolescents.

The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years.

BACKGROUND: Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States. METHODS: Data from the 1998-2014 waves of the Health and Retirement Study were analyzed. At each wave, participants indicated if they were diagnosed with the following 10 conditions: cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Years lived with a disability and years of life lost to premature mortality were summed for calculating DALYs. Sample weights were utilized in the analyses to make the DALY estimates nationally-representative. Results for the DALYs were presented in thousands. RESULTS: There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip)-to-178,055 (hypertension) for men and 13,621 (fractured hip)-to-200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined over the study period. CONCLUSIONS: The burden of these health conditions accounted for over a million years of healthy life lost for middle-aged and older Americans over the 16 year study period. Our results should be used to inform healthcare providers and guide health interventions aiming to improve the health of middle-aged and older adults. Moreover, shifting health policy and resources to match DALY trends may help to improve quality of life during aging and longevity.