'Tranq dope' poses a new, rising overdose threat

Philadelphia is one area of the U.S. where the veterinary tranquilizer xylazine has spread through the drug supply. (SPENCER PLATT/GETTY IMAGES)

It was in the mid-2010s, the researchers heard, when “tranq dope” — opioids that contained the veterinary tranquilizer xylazine — took off in Philadelphia. But now, in some places across the U.S., it was appearing in 1 in 5 overdose deaths. A recent study also found the powerful synthetic opioid fentanyl in nearly every xylazine-involved death as well, indicating it wasn’t just the tranquilizer causing these overdoses. Experts are still trying to understand the risks of xylazine, but they’re worried because the drug is not an opioid but acts as a sedative, which can increase the risk of a fatal overdose. It might also make it harder to reverse those overdoses with naloxone, which is designed to work on opioids. STAT’s Andrew Joseph has more on how adulterated — and in turn, increasingly dangerous — the U.S. drug supply has become.

After depression screening picks up patients who need care, timely follow-up falls short

In a routine checkup, primary care physician Lucinda Leung asks all the patients she sees about symptoms of depression. To her, it’s as important as measuring blood pressure or listening to a patient’s lungs. In a new research published in JAMA Network Open, Leung and her colleagues analyzed data from more than 600,000 Veterans Affairs patients to trace the path of care after screening. They found that most patients who screened positive for depression didn't get timely follow-up care and almost a quarter didn’t receive even minimal treatment. “Depression can affect work, family, and physical health,” co-author Lisa Rubenstein of UCLA told STAT’s Tino Delamerced. “It’s like uncontrolled diabetes. You have to follow up on a patient, or they may go downhill very fast.” Read more.

In a light flu season, vaccines were a poor match

Lab-confirmed flu hospitalizations fell far short of pre-pandemic years. (MMWR)

This graph shows what dodging a bullet looks like. Preliminary CDC estimates released yesterday show flu vaccines were not a good match for the most common strain circulating through the current 2021-2022 flu season, which peaked in December. Shots did not reduce the risk of mild or moderate flu caused by the H3N2 virus, the analysis concludes. We should know more about whether vaccination prevented severe flu outcomes later this year, after ongoing studies are completed, but it’s already certain that flu activity is once again far lower than before the Covid-19 pandemic. (A year ago flu was too light to even generate vaccine effectiveness data.) As of Feb. 26, flu hospitalizations were 5.2 per 100,000 people, or the lowest rate since before the pandemic, excluding last season, and even lower than the unusually mild 2015-2016 season.

Closer look: To save lives and keep nurses, 'listen to them,' a daughter says

Ann MacDonald wishes she had listened more closely to a nurse when her mother was in the hospital. Five days before her mother died of septic shock, a nurse tried to alert her that something might be wrong. But MacDonald thought her mother was just having a bad day — and a doctor said she was healing well from surgery for colon cancer. Her death a day later illustrates a phenomenon known as “failure to rescue”: lack of timely recognition and effective intervention. “Nurses play a vital role in both,” MacDonald writes in a STAT First Opinion. “But, as my mother’s experience shows, they need enough time with patients to spot complications, and they must feel empowered to voice their concerns.” As hospitals weather staffing shortages, it’s not just the pandemic. MacDonald argues that health care leaders should support nurses with adequate staffing — and listen to what they say. Read more.

'Scum of the earth': Families have their say on Purdue's Sackler family at hearing

Years of anguish and anger spilled over yesterday as more than two dozen people whose lives were upended by the opioid crisis unloaded their emotions on members of the Sackler family, whom they blame for fueling the crisis as owners of the OxyContin maker Purdue Pharma. The unusual hearing was conducted virtually in U.S. Bankruptcy Court at the suggestion of a mediator who helped broker a deal, tentatively approved by a judge Wednesday, that could settle thousands of lawsuits against Purdue over the toll of opioids. Under court rules, Richard, Theresa, and David Sackler were not allowed to respond to the victims. Kristy Nelson played for the Sacklers a tense recording of a 911 call in which she summoned police to her home the day her son Brian died of an opioid overdose. “You have truly benefited from the death of children,” she said. "You are scum of the earth.”

Rising high blood pressure in early adulthood tied to poor brain health later

High blood pressure in middle age is a known risk for later cognitive impairment. But what about younger adults? A study in JAMA Network Open links early, gradually increasing blood pressure to poorer brain health later in life. The researchers followed 853 people, starting when they were 18 to 30 years old. After 25 or 30 years (at an average age of 50), they had brain MRIs to examine brain structure and cerebral blood flow. People with blood pressure that was moderately high and rising or elevated and rising were more likely to have more abnormal brain matter and less cerebral blood flow than those with lower blood pressure that was stable or moderate and rising gradually. “Preventing [blood pressure] increases during young adulthood to middle age may be a promising strategy for prevention of dementia,” the authors write.

What to read around the web today

Vaccinating kids has never been easy. The Atlantic
Pharmacists push for enhanced role in post-pandemic life. Axios
'My children love being Texans': A father of a trans teen weighs whether his family can stay. Vox
As a med student, he saw women nearly die from illegal abortions. At 83, he sees no end to his work. Los Angeles Times
Federal government allows program to pay substance abusers for staying clean. Washington Post