Fueled by fentanyl, rate of fatal teen overdoses doubled in 2020

After staying flat for a decade, the overdose death rate among U.S. adolescents nearly doubled from 2019 to 2020 — an alarming climb that continued into 2021, a study in JAMA shows. It’s not a surge of 14- to 18-year-olds using drugs, researchers said. If anything, survey data indicate that fewer teens experimented with drugs during the pandemic. Rather, a main factor is the supply of increasingly deadly drugs, one that has driven overall overdose deaths to more than 100,000 per year and has now trickled down to adolescents. What teens may think is an opioid painkiller or Xanax diverted from the legal supply is now more likely to be a counterfeit tablet containing fentanyl or similar synthetic opioids. “Drug use is becoming more dangerous, not more common” among adolescents, study co-author Joseph Friedman told STAT’s Andrew Joseph. Read more.

Early research aims at a new Covid-19 vaccine for cancer patients

Covid-19 has meant near-isolation for millions of people immunocompromised by cancer or other conditions who haven’t produced adequate — or any — antibodies from the Covid vaccines. But researchers at the University Hospital Tübingen are designing a vaccine to elicit a deeper T cell response than the currently approved vaccines by targeting several key points on viral proteins — epitopes — that are good at stirring up immune T cells. The researchers, who presented early clinical data at the American Association of Cancer Research conference yesterday, said they hoped their approach would protect immunocompromised patients from Covid, even if they still cannot make antibodies. Other experts said it was an intriguing idea, though whether it’ll actually protect against Covid has yet to be shown. STAT’s Angus Chen has more.

Task force says too soon for routine suicide screening for young people

Even as others call for urgent attention to youth mental health, the influential U.S. Preventive Services Task Force is raising doubts about routine suicide screening for children and teens. In draft guidance posted yesterday, the group said there’s not enough evidence to recommend routinely screening kids who show no obvious signs of being suicidal. The document is open for public comment until May 9, and opposing voices are already weighing in. Many experts agree with the group’s assessment that more research is urgently needed but argue that there’s no evidence that screening — asking kids if they’ve ever considered or attempted suicide — could cause harm. “In the meantime, what are you going to do with this mental health crisis? You cannot turn a blind eye,” psychologist Lisa Horowitz of the National Institute of Mental Health told the Associated Press. Read more.

Closer look: Machine learning can flag high-cost patients. Does it help?

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Health systems and payers eager to trim costs think the answer to saving money lies in a small group of patients who account for the most spending. If they can catch these “high utilizers” before their conditions worsen, providers and insurers can refer them to primary care or social programs that could keep them out of the emergency department. To find them, they’re whipping up algorithms that draw on previous claims information, prescription drug history, and demographic factors. But there's no guarantee that these models work as they’re intended to. If they rely only on past spending as a predictor of future spending and medical need, they risk skipping sick patients who haven't had access to health care. And the predictions won’t help if providers, payers, and social services aren’t getting those patients into preventive programs, experts tell STAT’s Mohana Ravindranath. Read more.

STDs continue to rise in pandemic's shadow

As strapped public health departments pivoted to the pandemic, another epidemic of sexually transmitted diseases continued unabated, a new CDC analysis says. Recorded STDs fell during the early months of Covid, almost certainly because of fewer doctors’ visits, reduced testing, and less reporting, but numbers rebounded by the end of the year. Gonorrhea, syphilis, and congenital syphilis exceeded 2019 levels. Chlamydia cases, usually the majority of STIs, fell by 13%, likely because of less screening and more underdiagnosis rather than fewer infections from the often-asymptomatic disease. Some racial and ethnic minority groups, gay and bisexual men, and young people had higher STD rates, likely linked to poverty and health insurance status, CDC’s Leandro Mena said in a call with reporters. “Discrimination and stigma continue to stand in the way of quality sexual health care for everyone who needs it,” he said.

A pediatrician on clinical medicine, community work, and tattoo removal

Rhea Boyd is both a physician and a researcher, but she never wants to separate high-level academic questions from the direct needs of those around her. A pediatrician in the Bay Area and a STATUS List honoree, Boyd talked with STAT’s Theresa Gaffney about clinical work meeting community needs.

How do clinical experience and community work meet?
One of my projects during residency training was in the tattoo removal clinic at our county hospital. The goal isn’t just to remove unsightly tattoos. It’s actually a violence-intervention program for gang-affiliated young folks and young adults. Other times, it’s less obvious, to be frank.

What drew you to research on police violence?
My interest first came just as somebody who lives in a community who has questions about how law enforcement is serving our community’s interests. I was able to see where I could bring some of my clinical understanding to the space.

You can read the full interview here.

If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

On this week's episode of the "First Opinion Podcast," First Opinion editor Patrick Skerrett speaks with NYU psychiatrist Christin Drake about how to solve the dire shortage of psychiatrists. Listen here.

What to read around the web today

America created its own booster problems. The Atlantic
Oklahoma just passed a near-total abortion ban. More restrictions are likely coming. The 19th
Trying not one, but a three-drug combination to help engineered T cells fight cancer. STAT+
University culture wars over race theory recall 1920s fight to teach evolution. Nature
U.K. readies a Netflix-style subscription payment model for badly needed antibiotics. STAT+