Category: Behavior & Population Health Emergencies

Preventive Interventions in Opioid Addiction: Adaptive Harm Reduction to Reduce Overdoses

In the previous report, we discussed the drastic decrease in mortality seen in South Florida after the establishment of the first needle exchange program in the state.


The very next day, the CDC released preliminary estimates  showing a significant rise in all-cause drug mortality nationwide — and particularly mortality secondary to opioid overdose — for many of the same reasons opioid mortality rose over the past decade in Florida:

  • the number of people using opioids has risen
  • the drugs themselves are becoming more deadly- that is to say, the active components have changed to powerful synthetic opioids.

Over 72,000 people died as a result of an drug overdose in 2017, up 24,000 from just two years prior.

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Reducing Mortality in the Opioid Epidemic: What is Miami Doing Differently from the Rest of Florida and the US?

Opioid-related mortality in the United States has soared in the past two decades. A combination of institutional shifts in approaches to pain management, widely publicized unscrupulous marketing and prescribing practices, and increases in the availability and heightened potency of illicit opioids has resulted in such broad loss of life that the US has seen a decrease in the national life expectancy two years in a row. The peak of the HIV/AIDS crisis resulted in a one-year drop in life expectancy in 1993, but a multi-year drop has not been seen since 1963, with the occurrence of the Hong Kong H3N2 influenza pandemic.

opiod graph

Age-adjusted drug overdose death rates by opioid category United States 1999-2016

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Gun Violence: A Public Health Epidemic?


Image by Flickr User Cerebralzero

This is not a discussion about the 2nd Amendment or about the “right to bear arms.”  This is an analysis of the public health impact of violence and scientific strategies to reduce injuries and deaths from firearms.  

Georges Benjamin, the Executive Director of the American Public Health Association, believes we have a gun violence “epidemic.” With over 30,000 people in America dying annually from firearm-related violence, he believes “we should track it, find the root causes, use science to find research gaps, create policy solutions and use mass public education campaigns to eradicate the threat.” He argues that scientific methods were used in the face of increasing deaths from automobile accidents to great success and that scientists should be allowed to study gun violence just as they did for Ebola.

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America’s Latest Battlefront in the War on Drugs: Heroin

(Courtesy of

Close your eyes and picture a heroin addict. Chances are you’re thinking of a young, uneducated, low-income youth with a significant criminal background. The face of heroin in America is changing and likely doesn’t look like whom you would expect. Communities across the nation are facing a staggering epidemic of heroin abuse. New York City had more deaths from heroin overdose in 2014 than in any year since 2003, in 2013 420 of 782 fatal drug overdoses in the city were due to this increasingly popular drug.

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Quarantine: Ethical & Legal Battle for Human Rights during Public Health Emergencies

As the Ebola Epidemic of 2014 continues, some officials are calling upon a centuries-old tactic to combat the disease: medical quarantine. In an effort that began on October 24th, New York and New Jersey state officials instituted a mandatory 21-day quarantine on all medical personnel returning from volunteer efforts to combat the disease in West Africa.

No Standard Protocols

While some states are embracing the idea and implementing quarantines of their own, other state and national officials are denouncing them. Medecins Sans Frontieres (MSF), the main humanitarian group coordinating volunteer efforts in Africa also denounced the quarantines:

There are other ways to adequately address both public anxiety and health imperatives, and the response to Ebola must not be guided primarily by panic in countries not overly affected by the epidemic,” said Sophie Delaunay, executive director of MSF-USA. “Any regulation not based on scientific medical grounds, which would isolate healthy aid workers, will very likely serve as a disincentive to others to combat the epidemic at its source, in West Africa.

International MSF staff members commit to burdensome four-to-six week assignments in the Ebola affected countries. The risk of being quarantined for 21 days upon completion of their work has already prompted some people to reduce their length of time in the field. Others will be less inclined to volunteer in the first place. This will present significant operational disruptions at the field level for MSF and other organizations, and lead to an overall shortage of desperately needed health workers, precisely when the Ebola outbreak is as out of control as ever.

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Mental Health Preparedness: Psychological Protection Prior to a Disaster

This is the second in a three-part series on post traumatic stress disorder following disasters. Part One, PTSD in Emergency Workers, can be found here.

General Public at Risk

Over 2/3 of the general population will experience some significant traumatic event in their lifetime, and 1/5 of Americans will undergo such an event in any year. One review of the literature found that the prevalence of PTSD in direct victims can range from 30-40%, in rescue workers 10-20%, and 5-10% in the general population.

PTSD in Natori Japan

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Public Health Crisis on the US Border: Health & Immigration Policies Collide

Children Escaping Violence & Poverty

Over 50,000 undocumented children (UAC) have entered the United States through the Southwestern border in the last 8 months, creating what some a calling a humanitarian crisis. As many as 90,000 children are expected to enter the country by the end of the year.

Child Hand Immigration Camp

Many children are being sent to the United States alone without any adult supervision by family members hoping that by entering the United States their children will be spared the harsh realities of gang violence, drug cartels and civil unrest in their home countries. Categorized as Unaccompanied Alien Children (UAC), these children hail mostly from Mexico, Guatemala, El Salvador, Honduras and Ecuador.

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PTSD in Emergency Workers

This is the first of a series of posts which will cover post-traumatic stress disorder (PTSD).

EMTs, Paramedics, Fire Fighters, Police Officers, Emergency Department Personnel. These brave individuals serve to protect, to save, and to heal us in times of our greatest need. Aid workers are dispatched around the world to respond to natural and man-made disasters such as earthquakes, hurricanes, and war. Just as our nation’s soldiers and veterans battle the effects of post-traumatic stress disorder (PTSD), so do our first responders. Worldwide 1 in 10 emergency workers have PTSD. Ambulance personnel are the hardest hit, with over 1 in 5 ambulance personnel meeting criteria.

Image courtesy of the LA Times

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