Evolving Trends in US Mortality from Opioid Overdose: Heroin and Beyond.

OBJECTIVE: Our objective was to explore evolving trends in US drug overdose mortality, overall and by age, sex, race, urbanization, and geography from 1999-2020. METHODS: This is a descriptive epidemiologic study. We used the US Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research and Multiple Cause of Death files from the National Center for Health Statistics. We used crude and age-adjusted cause of death and mortality rate ratios as measures of effects and 95% confidence limits to test for significance. RESULTS: From 1999-2020, drug overdoses caused 1,013,852 deaths and 4.3-fold increase in mortality rate ratios. Subgroup findings were sex (4.5 men, 4.0 women), race (4.6 White, 3.9 Black or African American, 4.0 Asian or Pacific Islanders, 5.1 Native Americans or Alaskan Natives), age (highest 5.6 in 25-34 years, lowest 1.1 in 75-84, and 0.77 in 85+), geography (highest 6.0 in Midwest, lowest 2.6 in West), and urbanization (highest 6.2 in non-metro, lowest 3.7 in metro). CONCLUSIONS: Drug overdoses in the United States from 1999-2020 increased 4.3-fold, with the highest increase in White and Native American or Alaskan Native populations, and Midwest and non-metro areas. The data create preventive and therapeutic challenges, including restrictions on pharmaceutical industries and enhanced efforts by health care providers in safer prescribing. Addiction care should be integrated into all clinical practices, regardless of specialty, and into undergraduate, graduate, and continuing medical education. Targeted interventions are needed to adequately assess patients and provide care. Analytic studies designed a priori are necessary to test hypotheses formulated from these data.

Author Correction: Overcoming Bias: Cognitive Control Reduces Susceptibility to Framing Effects in Evaluating Musical Performance.

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Overcoming Bias: Cognitive Control Reduces Susceptibility to Framing Effects in Evaluating Musical Performance.

Prior expectations can bias evaluative judgments of sensory information. We show that information about a performer's status can bias the evaluation of musical stimuli, reflected by differential activity of the ventromedial prefrontal cortex (vmPFC). Moreover, we demonstrate that decreased susceptibility to this confirmation bias is (a) accompanied by the recruitment of and (b) correlated with the white-matter structure of the executive control network, particularly related to the dorsolateral prefrontal cortex (dlPFC). By using long-duration musical stimuli, we were able to track the initial biasing, subsequent perception, and ultimate evaluation of the stimuli, examining the full evolution of these biases over time. Our findings confirm the persistence of confirmation bias effects even when ample opportunity exists to gather information about true stimulus quality, and underline the importance of executive control in reducing bias.