Health & Fitness (205)
CHICAGO (AP) -- Most people who abuse addictive prescription painkillers get them for free from friends or relatives, while drug dealers are a relatively uncommon source for those at highest risk for deadly overdoses, a government study found.
People who abuse the most frequently often doctor-shop; more than 1 in 4 who used these drugs almost daily said they had been prescribed by one or more physicians. Almost as many said they got them for free from friends or relatives; only 15 percent of the most frequent abusers said they bought the drugs from dealers or other strangers.
Those abusers "are probably using at much greater volumes and simply asking a friend for a pill now and then is not going to be sufficient," said Dr. Leonard Paulozzi, a researcher at the federal Centers for Disease Control and Prevention.
According to the study, two-thirds of abusers said they used the drugs infrequently and well over half of these users said they got them free from friends or relatives.
Paulozzi and CDC colleagues analyzed four years of nationwide health surveys on nonmedical use of pain relievers including oxycodone and hydrocodone. These include the brand-name pills OxyContin and Vicodin, in a family of drugs called opioids - chemically similar to opium.
The study was published online Monday in JAMA Internal Medicine.
Paulozzi said overall prevalence of nonmedical use of prescription opioid painkillers has held steady in recent years, at about 12 million, or 1 in 20 people aged 12 and older.
But previous CDC data show overdose deaths involving these drugs more than tripled from 1999 to 2010, with more than 16,000 deaths that year. By contrast, overdose deaths that involved heroin and cocaine totaled less than 8,000, and deaths that involved often-abused prescription drugs that include anti-anxiety medication totaled about 6,500.
A separate study in the same journal presents Tennessee - among states hardest hit by prescription drug abuse - as a snapshot of the problem. From 2007 through 2011, one-third of Tennessee's population filled an opioid prescription each year, the study found. Nearly 8 percent had used more than four prescribers and these abusers were more than six times more likely to have fatal overdoses than the least frequent users.
The larger nationwide study included data from annual government health surveys for 2008-2011 that included questions about use of these powerful painkillers.
"Nonmedical use was defined as use without a prescription or use with a prescription for the feeling or experience caused by the drug," the researchers said.
Paulozzi said the data don't indicate whether friends and relatives who offered free drugs shared their own prescriptions or had obtained the medication in some other way.
Public health messages have urged patients with legitimate prescriptions for addictive painkillers not to share the drugs and to turn in any leftovers to designated drop-off sites.
The new data suggest a need to strengthen messages to doctors to be on the watch for signs of prescription misuse, Paulozzi said.
LONDON (AP) -- A Swedish doctor says four women who received transplanted wombs have had embryos transferred into them in an attempt to get pregnant.
He would not say on Monday whether any of the women had succeeded. In all, nine women in Sweden have received new wombs since 2012, but two had to have them removed because of complications.
The women received wombs donated by their mothers or other close relatives in an experimental procedure designed to test whether it's possible to transfer a uterus so a woman can give birth to her own biological child. The women had in vitro fertilization before the transplants, using their own eggs to make embryos.
"We have already begun transferring embryos into four of the women and plan to make attempts with the others when they are ready," said Dr. Mats Brannstrom, a professor of obstetrics and gynecology at the University of Goteburg, who is leading the research.
Brannstrom predicted that three or four of the seven women might successfully give birth.
"One or two more will perhaps get pregnant and miscarry, and one or two won't be able to get pregnant," he said.
There have been two previous attempts to transplant a womb - in Turkey and Saudi Arabia - but both failed to produce babies. Doctors in Britain and Hungary also are planning similar operations, but using wombs from women who had just died.
Brannstrom said any woman in the study who does get pregnant will be on a low dose of drugs to keep from rejecting the transplanted womb and will be monitored as a high-risk pregnancy.
The transplants are intended to benefit women unable to have children because they lost a uterus to cancer or were born without one.
Some doctors said women who got pregnant with a new uterus would have to be watched carefully for how the womb progresses throughout pregnancy.
"There are questions about how the physiological changes in the uterus will affect the mother and whether the transplanted uterus will be conducive to a growing baby," said Dr. Charles Kingsland, a spokesman for Britain's Royal College of Obstetricians and Gynaecologists and a gynecologist at Liverpool Women's Hospital.
In a study published last week, Brannstrom and colleagues described the procedures used to transplant the nine wombs and said there were "mild rejection episodes" in four patients.
He said the transplanted wombs would be removed after a maximum of two pregnancies.
Other experts called it a promising step but said it would be crucial that babies get enough nutrients from the mother's blood supply.
"We really don't know if the blood flow to the uterus will increase and adapt in the same way," as in a regular pregnancy, said Dr. Yacoub Khalaf, director of the Assisted Conception unit at Guy's and St. Thomas' hospital in London.
"It is a good sign they have done the (embryo) transfers," Khalaf said. "But a live birth will be the best validation that this works."
WASHINGTON (AP) -- Sick of hearing about the health care law?
Plenty of people have tuned out after all the political jabber and website woes.
But now is the time to tune back in, before it's too late.
The big deadline is coming March 31.
By that day, for the first time, nearly everyone in the United States is required to be signed up for health insurance or risk paying a fine.
Here's what you need to know about this month's open enrollment countdown:
ALREADY COVERED? NO WORRIES
Most people don't need to do anything. Even before the health care law passed in 2010, more than 8 out of 10 U.S. residents had coverage, usually through their workplace plans or the government's Medicare or Medicaid programs. Some have private policies that meet the law's requirements.
If you're already covered that way, you meet the law's requirements.
Since October, about 4 million people have signed up for private plans through the new state and federal marketplaces, the Obama administration says, although it's not clear how many were already insured elsewhere. In addition, many poor adults now have Medicaid coverage for the first time through expansions of the program in about half the states.
President Barack Obama is urging people who have coverage to help any uninsured friends and relatives get signed up.
NEED COVERAGE? IT'S CRUNCH TIME
Chances are you'll hear more reminders about health care this month. The push is on to reach millions of uninsured people.
The administration, insurers, medical associations and nonprofit groups are teaming up with volunteers to get the word out and guide people through the sometimes-rocky enrollment process. They plan special events at colleges, libraries, churches and work sites.
Singing cats, dogs, parrots - even a goldfish - are promoting the message in TV and online spots from the Ad Council.
A big hurdle for the effort: As recently as last month, three-fourths of the uninsured didn't know there was a March 31 deadline, according to polling conducted for the Kaiser Family Foundation. Most said they didn't know much about the law and had an unfavorable opinion of it.
Plus, many worry they won't be able to afford the new plans.
The enrollment campaign is emphasizing that subsidies are available on a sliding scale to help low-income and middle-class households pay for their insurance.
How to enroll? Start at HealthCare.gov or by calling 1-800-318-2596. Residents of states running their own marketplaces will be directed there; people in other states go through the federal exchange.
After March 31, many people won't be able to get subsidized coverage this year, even if they become seriously ill.
The next open enrollment period is set to begin Nov. 15, for coverage in 2015.
There are exceptions. The big one is the Medicaid program for the poor. People who meet the requirements can sign up anytime, with no deadline.
Also, people remain eligible for Medicare whenever they turn 65.
If you are insured now and lose your coverage during the year, by getting laid off from your job, for example, you can use an exchange to find a new policy then. People can sign up outside the open enrollment period in special situations such as having a baby or moving to another state.
You can choose to buy insurance outside the marketplaces and still benefit from consumer protections in the law.
People who do that wouldn't normally be eligible for premium subsidies. But the Obama administration says exceptions will be made for people whose attempts to buy marketplace insurance on time were stymied by continuing problems with some enrollment websites.
MILLIONS OF PEOPLE WON'T GET COVERED
Some 12 million people could gain health coverage this year because of the law, if congressional auditors' predictions don't prove overly optimistic.
Even so, tens of millions still would go without.
That's partly because of immigrants in the country illegally; they aren't eligible for marketplace policies.
Some of the uninsured will not find out about the program in time, will find it confusing or too costly, or will just procrastinate too long. Some feel confident of their health and prefer to risk going uninsured instead of paying premiums. Others are philosophically opposed to participating.
Figuring out just how many of the uninsured got coverage this year won't be easy because the numbers are fuzzy.
The administration's enrollment count includes people who already were insured and used the exchanges to find a better deal, or switched from private insurance to Medicaid, or already qualified for Medicaid before the changes.
Some who sign up will end up uninsured anyway, if they fail to pay their premiums.
The budget experts predict enrollment will grow in future years and by 2017 some 92 percent of legal residents too young for Medicare will have insurance.
But even then, about 30 million people in the United States would go uncovered.
SOME ARE LEFT OUT
A gap in the law means some low-income workers can't get help.
The insurance marketplaces weren't designed to serve people whose low incomes qualify them for expanded Medicaid instead. But some states have declined to expand their Medicaid programs. That means that in those states, many poor people will get left out.
People who fall into the gap won't be penalized for failing to get covered.
Some others are exempt from the insurance mandate, too: American Indians, those with religious objections, prisoners, immigrants in the country illegally, and people considered too poor to buy coverage even with financial assistance.
THE IRS IS WATCHING YOU
The law says people who aren't covered in 2014 are liable for a fine. That amounts to $95 per uninsured person or approximately 1 percent of income, whichever is higher. The penalty goes up in later years.
A year from now, the Internal Revenue Service will be asking taxpayers filing their forms for proof of insurance coverage. Insurance companies are supposed to provide that documentation to their customers.
If you owe a penalty for being uninsured, the IRS can withhold it from your refund.
The agency can't put people in jail or garnishee wages to get the money. But it can withhold the penalty from a future year's tax refund.
Follow Connie Cass on Twitter at HTTPS://TWITTER.COM/CONNIECASS
ATLANTA (AP) -- Toddler obesity shrank sharply in the past decade, a new study suggests. While promising, it's not proof that the nation has turned a corner in the battle against childhood obesity, some experts say.
The finding comes from a government study considered a gold-standard gauge of trends in the public's health. The researchers found that obesity among children ages 2 to 5 decreased - to 8 percent, from 14 percent a decade ago. That would represent a 43 percent drop.
But the only decline was seen in preschoolers, not in older children. And some experts note that even the improvement in toddlers wasn't a steady decline, and say it's hard to know yet whether preschooler weight figures are permanently curving down or merely jumping around.
It is enough of a decline to be optimistic, said Cynthia Ogden, one of the study's authors.
"There's a glimmer of hope," said Ogden, an epidemiologist with the Centers for Disease Control and Prevention.
The report was published online Tuesday in the Journal of thecs American Medical Association.
Health officials have long been hoping for more substantial evidence that they've turned a corner in the fight against childhood obesity.
Obesity is seen as one of the nation's leading public health problems - health officials call it a longstanding epidemic. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.
Officials are particularly worried about the problem in young children. Preschoolers who are overweight or obese are five times more likely than other children to be heavy as adults, which means greater risks of high cholesterol, high blood sugar, asthma and even mental health problems.
After decades on the rise, childhood obesity rates recently have been flat. But a few places - including New York City and Mississippi - reported improvements in the last couple of years. Seattle joined that list last week, with a report of recently declining obesity in older school children in low-income school districts.
More broadly, health officials last year reported at least slight drops in obesity for low-income preschoolers in 18 states. But they mainly were children enrolled in the federal Women, Infants and Children (WIC) program, which provides food vouchers and other services. Experts attributed the improvement to WIC policy changes in 2009 that eliminated juice from infant food packages, provided less saturated fat, and made it easier to buy fruits and vegetables.
The new study is a national survey of about 9,100 people - including nearly 600 infants and toddlers - in 2011-2012, in which participants were not only interviewed but weighed and measured. The results were compared to four similar surveys that stretched back to 2003.
"I think it's fair to say that (this study) is probably the best source of data we have on whether the prevalence of obesity is increasing with time," said Dr. Robert C. Whitaker, a Temple University expert of childhood obesity.
The main finding was that, overall, both adult and childhood obesity rates have held flat in the past decade. And there were no significant changes in most age groups.
But there were two exceptions: For some reason experts aren't sure about, the obesity rate in women age 60 and older rose from 31.5 percent to more than 38 percent. And the preschool obesity rate dropped.
Some health leaders in Washington, D.C., and Atlanta celebrated the latter finding. They say it's an early sign of a pay-off from campaigns to increase breastfeeding rates and cut consumption of sodas and other sugary beverages. First lady Michelle Obama issued a statement that her `Let's Move!' initiative - which promotes youth exercise and good nutrition - is causing healthier habits "to become the new norm."
Some experts were more cautious about the results.
The preschooler obesity numbers fell from 14 percent in 2003-2004 to 10 percent in 2007-2008, then jumped to 12 in 2009-2010, then slipped to 8 in the most recent survey.
So it seems to have been jumping around a little. "We're going to need more" years of data to see if the apparent trend is really nosing downward, said John Jakicic, director of the University of Pittsburgh's Physical Activity and Weight Management Research Center.
Some wondered whether it makes sense that preschoolers would be the ones leading a downward trend in childhood obesity. For years, most childhood anti-obesity initiatives were older-kid efforts removing soda vending machines from schools and increasing physical education.
Apart from the WIC policy change, there's been less of a push regarding preschoolers. "Relative to older children, less has been done" to fight obesity in toddlers, Whitaker said.
Lingering questions aside, Jakicic said he was still glad to see the numbers. "I think we should be excited it's not getting worse," he said.