Analyzing ‘Stamp Bags’ in Real-Time May Serve as Early Warning System in Opioid Crisis

Analyzing 'Stamp Bags' in Real-Time May Serve as Early Warning System in Opioid Crisis

Stamp bags are small wax packets that contain mixtures of illicit drugs, most commonly heroin. These bags are packaged for sale and sometimes stamped with a graphic logo by drug dealers to market their contents.

A new University of Pittsburgh study suggests that analyzing these stamp bags on a regular basis can serve as an early warning system in the current opioid crisis by alerting local officials to new lethal drugs that have come into the community.

“The face of the current opioid overdose epidemic changes quickly from month to month. The ability to rapidly analyze drugs causing these overdoses, and make that knowledge available to all stakeholders, is critical to efforts to deal with the crisis,” said co-author Karl E. Williams, M.D., M.P.H., Allegheny County Medical Examiner.

For example, in just two years, the deadly drug fentanyl — an opioid that is 20 to 50 times more potent than heroin — went from nonexistent to detected in more than one in seven stamp bags analyzed by the Allegheny County Office of the Medical Examiner, according to an analysis led by the University of Pittsburgh Graduate School of Public Health.

“We believe this way of examining drug evidence could be expanded upon for use in public health surveillance and monitoring in other regions,” said lead author Kathleen Creppage, M.P.H., C.P.H., a doctoral candidate in Pitt Public Health’s Department of Epidemiology.

“It could be used to inform educational campaigns, allocate limited resources, and devise prevention strategies. First responders also could benefit from knowing what drugs are in circulation so they can take proper precautions to protect themselves and be prepared with overdose reversal medications, such as naloxone.”

In the last decade, fatal heroin overdoses have increased by 300 percent in the U.S., with fentanyl and its analogs acting as major contributors to these deaths. Fentanyl is often implicated in clusters of overdose deaths when it is mixed with heroin, primarily because users do not realize what they are taking is more powerful than usual.

In Allegheny County, stamp bags seized as evidence by law enforcement authorities are submitted to the county’s Office of the Medical Examiner for testing. The drugs are sorted into batches based on similar characteristics, such as the stamp and color of the drug, and a single bag is randomly chosen from each batch to be tested.

For the study, the researchers compiled the medical examiner’s drug chemistry laboratory test results of stamp bag contents from 2010 through 2016. A total of 16,594 stamp bags were tested by the lab during that period.

Before 2014, fentanyl was nonexistent in these tested bags. By 2016 it was found in 15.5 percent of the tested stamp bags, with 4.1 percent containing fentanyl as the only controlled substance present.

Toxicology results from overdose victims take weeks or months, and state and national mortality data lag by about 18 months. Drug evidence testing is usually available much more quickly — in Allegheny County, for example, it is available for the current month.

Stamp bag testing and monitoring should not replace other drug surveillance systems, such as overdose mortality data and toxicology reports, said Creppage. “But it can be a powerful complement to these surveillance systems,” she said. “The data are available, and we need to identify and explore these different data sources as part of our efforts in understanding and combating the opioid epidemic.”

Senior author Anthony Fabio, Ph.D., M.P.H., associate professor of epidemiology at Pitt Public Health, added that the work “is an important step in developing multi-disciplinary tools to quickly identify current and future sources of new drugs that enter the illegal market.”

The findings are published in the journal Public Health Reports.

Source: University of Pittsburgh Schools of the Health Sciences

Wealth Accumulation Reduces Anxiety Among Seniors

Juggling Bills Often Accompanies Food Insecurity

New research suggests that financial literacy helps people make better saving and investment decisions. The financial activity often enhances wealth accumulation which appears to lessen anxiety about life in old age.

Investigators from Hiroshima University say the study is the first of its kind to examine how understanding about money influences anxiety about life in old age in the United States.

“Anxiety is bad for one’s health, and it is bad for the economy,” says Yoshihiko Kadoya, an Associate Professor of Health Economics and primary author of this study.

Indeed, nearly 75 percent of Americans report feeling anxious about old age.

“If you have a high level of anxiety about the future, you tend to spend less and be more cautious about saving money, which negatively affects the national economy. We predicted that financial literacy would help to reduce this anxiety.”

Kadoya and Mostafa Saidur Rahim Khan, who is a study coauthor and a Ph.D. student, looked at the answers of surveys sent to adults across the United States. Respondents answered questions that tested their financial literacy, including basic calculation skills and understanding the pricing behavior of bonds.

They also reported to what degree they felt anxious about life after turning 65 years old.

Taken as a whole, the researchers did not find a direct causal link between levels of financial literacy and anxiety about life in old age. So, in order to understand how the two are related, the researchers examined household characteristics like wealth, education, and number of children.

Kadoya’s group found that people with high financial literacy are significantly less anxious by way of accumulating assets, such as savings, bonds, and insurance.

Less financially literate people, meanwhile, are less likely to have gathered enough assets to reduce anxiety, possibly because they rely more on social security income for assurance in old age.

Additionally, the researchers found that having a child and doing regular exercise also reduced concern about life in old age.

In 2017, Kadoya’s group conducted a similar study on Japanese people. Even with differences in cultural orientations and social norms between Japan and the United States, results from both countries appear similar among gender, education, and age.

Financial literacy was higher among male, more educated, and older adults compared to female, less educated, and younger adults.

Interestingly, Japanese respondents reported anxiety differently than their American counterparts.

Kadoya and Khan classified the level of anxiety on a scale of one to five, with one being lowest. “In Japan, people tended to avoid one extreme answer, like one or five,” Kadoya said.

“In the US, on another hand, many people tended to pick an extreme answer. These answers may be strongly influenced by culture.” For both countries, though, financial literacy seems to play some role in reducing anxiety about life in the old age.

The relationships between financial literacy and economic outcomes are intricate. As such, having a better understanding of money does not cause low anxiety about life in old age. Rather, the two are associated with one another through wealth accumulation.

For Kadoya’s group, this study is the first in a series that seeks to investigate how financial literacy influences anxiety about life in old age and economic outcomes in the US.

Source: Hiroshima University/EurekAlert

Dishonest People Seen as Less Competent

Is a person’s moral behavior directly tied to his or her performance at work? Most people believe it is, according to a new study published in the Journal of Personality and Social Psychology.

“Although arguments can be made that an individual’s moral behavior is, or should be, irrelevant to their overall competence, we found consistent support that immoral behavior reduced judgments of people’s competence,” said lead author Jennifer Stellar, Ph.D., of the University of Toronto.

For the study, Stellar and co-author, Robb Willer, Ph.D., of Stanford University, conducted a series of six experiments involving more than 1,500 participants. Throughout these experiments, the researchers depicted individuals acting immorally in hypothetical scenarios, such as shoplifting, stealing money from a donation jar, acting selfishly in economic games, cheating on a lab task, or receiving low morality ratings from coworkers. In other cases, the person was depicted as acting morally, such as donating money to charity.

Participants were then asked to rate how competent they believed each person to be at a particular task. For example, in one experiment, participants were asked how good they believed the hypothetical individual was at his or her job on a scale of one to 10.

In each of these experiments, participants consistently rated individuals who had committed moral transgressions as less capable of doing their jobs, completing specific tasks or being generally competent.

In general, people who were depicted as immoral were less well-liked and therefore perceived as worse in every way, including being less competent.

Stellar said she was surprised by these findings because in one of their early experiments, the researchers asked participants if morality was associated with competence, and most said it didn’t matter.

“We found that most people rated immoral behavior in one’s private life as irrelevant to determining how good that person was at their job. Essentially, people said they didn’t think they would use moral information in that way, but when they were provided with it, they did.”

Further evidence suggested that people engaged in immoral behaviors were seen as less competent because their actions caused them to be viewed as low in social intelligence.

“Social intelligence is often conceived of as the ability to manage complex social situations,” said Stellar. “It includes characteristics such as taking the others’ perspectives, being adaptable, managing impressions of oneself, and adhering to established social norms.”

“A person who is socially intelligent would understand when and why a coworker is angry and effectively manage their coworker’s potentially destructive emotional response.”

In one experiement, however, the researchers counteracted the concerns about social intelligence by telling some participants that the hypothetical individual’s coworkers rated him or her high in social intelligence.

“We found that when targets received high social intelligence ratings, immoral targets were no longer perceived as less competent than moral targets,” said Stellar.

While more studies are needed, Stellar believes that the findings suggest that people view immoral but socially intelligent individuals as Machiavellian, cunning, and strategic, rather than socially incompetent.

Source: American Psychological Association

Online Support Can Improve Quality of Life for Cancer Patients

New research finds that an online stress management program can significantly improve an individual’s quality of life and improve care after a cancer diagnosis.

Researchers from the University of Basel and University Hospital Basel in Swtizerlan said a cancer diagnosis always causes psychological distress. If the mental component of the diagnosis is not managed, quality of life may suffer and even more, the negative psychological state may have a negative impact on treatment and disease progression.

Ideally cancer treatment is coupled with psychological support. However, currently only a minority of cancer patients receive professional psychological support, particularly during the difficult time immediately after diagnosis.

In order to reach cancer patients early after diagnosis and offer a low-threshold tool to overcome distress, researchers developed the online stress management program STREAM.

During the eight week online program, patients were provided with information, individual exercises on downloadable audio-files, and specific strategies on managing life with cancer. Patients logged in using a secured personal account. Once a week, they participated in a written exchange with a psychologist via an integrated email platform.

The study, which appears in the Journal of Clinical Oncology, is the first to show that newly diagnosed cancer patients significantly benefit from a web-based intervention and report better quality of life and less distress.

In total, 129 patients from Switzerland, Germany, and Austria were allocated to either an intervention or a control group within 12 weeks of starting their cancer treatment. The control group only received access to the program after an eight-week waiting period, enabling a comparison between the two groups.

People who completed the STREAM program (mostly breast cancer patients) assessed their quality of life as significantly higher than the control group. Also, distress, measured on a scale from zero to 10, was significantly lower in the online group than in the control group after the intervention.

“The results show that web-based self-help with regular email contact with a psychologist has the potential to efficiently support newly diagnosed cancer patients and thereby decisively improves cancer care,” said Professor Viviane Hess, Professor of Medical Oncology and Senior Oncologist in Basel.

Online interventions present new opportunities to support people affected by cancer who previously could not be reached. “Digital natives are reaching the age at which the risk for age-related diseases such as cancer increases. Approaches that integrate the internet into patient care will therefore continue to increase in importance,” said Hess.

Source: University of Basil