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Deadly overdoses fell in U.S. for first time in five years, new estimates show

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Deadly overdoses fell in U.S. for first time in five years, new estimates show

Deaths from drug overdoses fell last year in the United States as fewer people lost their lives to fentanyl and other opioids, marking the first time the death toll had dropped in five years, according to newly released estimates from the Centers for Disease Control and Prevention.

Federal officials said the numbers show a 3% decline in the estimated overdose fatalities between 2022 and 2023. That downturn equates to nearly 3,500 fewer deaths across the U.S. than the year before.

The new figures are tentative and could still be updated. Even a slight decline could be a balm for a country where drug overdoses have taken a devastating toll: In one survey, more than 40% of adults said they knew someone who lost their life to a drug overdose, according to a Rand study published this year.

“I’m thrilled that there wasn’t an increase, but we’re still talking about 107,000 people dying, which is completely unacceptable,” said Beau Kilmer, co-director of the Rand Drug Policy Research Center. Kilmer said better data on drug use are needed to untangle exactly what is driving the changes.

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Community groups and health officials grappling with the devastating toll of fentanyl have pushed to equip more people with naloxone, a medicine that can stop opioid overdoses and is commonly sold as a nasal spray under the brand name Narcan. Los Angeles County officials, for instance, credited an effort to hand out Narcan on the streets when they announced last week that overdose deaths had stopped surging among homeless people. To try to reduce the deadly risks, people who use drugs have also turned to test strips to detect fentanyl and avoided using drugs by themselves, among other strategies.

Health researchers have also noted that broader changes in the population could be affecting the numbers: Many heroin users who switched to fentanyl have died, and if fewer people are newly turning to fentanyl use, that could mean fewer people are now at risk, said Dr. Daniel Ciccarone, a UCSF addiction medicine professor.

“Based on utterly anecdotal, street-level observations, I’ll say there aren’t a lot of newbies,” Ciccarone said. “We’re looking for them, but we don’t see them. We don’t see the 22-year-old who says, ‘Hey, I want to use fentanyl.’ This is an aging cohort.”

Even as U.S. deaths linked to fentanyl and other opioids dropped between 2022 and 2023, the country saw an uptick in deaths tied to stimulants such as methamphetamine and cocaine, according to the new estimates. Drug researchers said that in recent years, many deaths involving meth have also involved opioids.

And not all parts of the country saw an overall drop in fatal overdoses. “In the East Coast and in the Midwest, we are seeing declines, but on the West Coast — particularly in the upper Northwest — we’re still seeing increases,” said Farida Ahmad, a health scientist at the National Center for Health Statistics.

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The federal figures show that in California, the estimated number of overdose deaths continued to rise in 2023 compared with 2022, increasing by 4.1%. In Oregon and Washington, increases were significantly steeper — roughly 30% and 27% respectively.

Drug use can differ from region to region, shaping ensuing overdoses and deaths: Fentanyl hit the eastern U.S. before spreading west, and methamphetamine use generally has been more common on the West Coast.

Ciccarone lamented that the West Coast should have been better prepared for fentanyl after seeing it hit other parts of the country years earlier, calling it a “failure of public policy.”

“We saw this coming. So why didn’t we prepare for it better?”

Ciccarone credited states in the Midwest and East Coast that had seen notable decreases in overdose deaths, saying that although the exact reasons are unclear, there has been a panoply of efforts that could play a role, including ramping up naloxone distribution and easing access to buprenorphine to treat opioid addiction.

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“These are places that were hard hit by fentanyl,” Ciccarone said. “So they’re doing something right.”

The federal estimates released Wednesday do not detail how many deaths linked to methamphetamine also involved other drugs, a phenomenon that has gained growing attention as American mix drugs both knowingly and unknowingly.

Researchers drawing on both federal and local data have found substantial overlap in methamphetamine and opioid use: In L.A. County, for instance, a recent report indicated that in 2022, nearly half of overdose deaths among homeless people involved both methamphetamine and fentanyl.

People who use fentanyl may turn to stimulants for energy to get themselves through daily activities, said Chelsea Shover, an assistant professor at UCLA’s David Geffen School of Medicine. For those facing the dangers of living outside, “you know what helps you stay up at night and stay vigilant? Meth.”

Shover said in recent years, national data have consistently shown the majority of methamphetamine deaths also involve opioids. Those findings were echoed in local research by Shover and other researchers, which found that between 2012 and mid-2021, the bulk of meth-related deaths in L.A. County also involved other drugs or medical conditions, rather than being driven solely by the stimulant.

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To help prevent such deaths, “we need to keep doing what we’re doing for opioid-related deaths — because a lot of meth-involved deaths are also opioid-involved,” Shover said.

Scholars have also urged more attention to methamphetamine itself: As it stands, there are no medications approved by the Food and Drug Administration to treat addiction to meth, although some existing medicines have shown promising results, as has offering incentives such as gift cards for people to stay off stimulants.

“The massive investment in reducing overdose deaths has been almost exclusively targeted to opioids,” said Steven Shoptaw, director of the UCLA Center for Behavioral and Addiction Medicine. “There’s been no systematic investment to reduce methamphetamine deaths” — a lapse that Shoptaw said had hindered effective interventions from being widely adopted.

Americans have been eager for any signs of hope amid the overdose crisis, but experts have cautioned against declaring victory too soon in reaction to year-to-year changes in overdose deaths.

For instance, University of Pittsburgh researchers found that the last time fatal overdoses dropped nationally in 2018, the downturn coincided with stricter regulations in China on carfentanil, a highly potent synthetic opioid. The following year, deaths from drug overdoses rose again.

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Dr. Donald Burke said that the estimated number of overdose deaths in 2023 was still above the level that researchers had forecast, based on the historic trajectory of such fatalities. The death numbers had jumped higher than expected during the COVID-19 pandemic, Burke said — and may just be returning to the same levels that would have happened in its absence.

“You can make a case that it’s come down, but it’s come down because the COVID impact is less now,” said Burke, dean emeritus of the University of Pittsburgh School of Public Health.

“Without knowing what are the drivers, it’s really hard to tell whether a reduction is a return to the expected trajectory or some other change,” said Dr. Hawre Jalal, an associate professor at the University of Ottawa who has partnered with Burke on such research.

Ciccarone was reluctant to even characterize the newly released estimates as a decrease in overdose deaths, instead referring to “a flattening of the curve.”

“Can we sing hosannas over that? No,” Ciccarone said. “We’re still fighting. We still have a lot of work to do to bend this overdose curve down.”

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Foundation honoring 'Star Trek' creator offers million-dollar prize to develop AI that's 'used for good'

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Foundation honoring 'Star Trek' creator offers million-dollar prize to develop AI that's 'used for good'

To boldly go where no man has gone before.

That’s the mission of the USS Enterprise — and arguably the aim of a $1-million prize being offered through a foundation created to honor the father of the “Star Trek” franchise.

The Roddenberry Foundation — named for Gene Roddenberry — announced Tuesday that this year’s biennial award would focus on artificial intelligence that benefits humanity.

Lior Ipp, chief executive of the foundation, told The Times there’s a growing recognition that AI is becoming more ubiquitous and will affect all aspects of our lives.

“We are trying to … catalyze folks to think about what AI looks like if it’s used for good,” Ipp said, “and what it means to use AI responsibly, ethically and toward solving some of the thorny global challenges that exist in the world.”

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The Roddenberry Prize is open to early-stage ventures — including nonprofits and for-profits — across the globe.

Each cycle, the focal point of the award changes. The spotlight on AI and machine learning arrives as recent strides in the technology have sparked excitement as well as fear.

Concerns abound that AI threatens privacy, intellectual property and jobs, including the work performed by this reporter. Although it can automate busywork, it may also replicate the harmful biases of the people who created it.

California legislators are racing to address anxieties through about 50 AI-related bills, many of which aim to install safeguards around the technology, which lawmakers say could cause societal harm. The proposed legislation targets AI-related fears ranging from data security to racial discrimination.

“We’ve seen with other technologies that we don’t do anything until well after there’s a big problem,” said state Sen. Scott Wiener (D-San Francisco), who wrote a bill that would require companies developing large AI models to do safety testing.

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“Social media had contributed many good things to society … but we know there have been significant downsides to social media, and we did nothing to reduce or to mitigate those harms,” he said. “And now we’re playing catch-up. I prefer not to play catch-up.”

Ipp said the foundation shares the broad concern about AI and sees the award as a means to potentially contribute to creating those guardrails.

The language of the application states that it’s seeking ethical proposals. And much like the multicultural, multi-planetary cast of “Star Trek,” it’s supposed to be inclusive.

“Any use of AI or machine learning must be fair, transparent, respectful of individual rights and privacy, and should explicitly design against bias or discrimination against individuals, communities or groups,” according to the prize website.

Inspiration for the theme was also borne out of the applications the foundation received last time around. Ipp said the prize, which is “issue-agnostic” but focused on early-stage tech, produced compelling uses of AI and machine learning in agriculture, healthcare, biotech and education.

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“So,” he said, “we sort of decided to double down this year on specifically AI and machine learning.”

The most recent winner was Sweden-based Elypta, which Ipp said is using liquid biopsies, such as a blood test, to detect cancer early.

Though the foundation isn’t prioritizing a particular issue, the application states that it is looking for ideas that have the potential to push the needle on one or more of the United Nations’ 17 sustainable development goals, which include eliminating poverty and hunger as well as boosting climate action and protecting life on land and underwater.

“Star Trek,” which first aired in 1966, featured tons of enviable tech, including the universal translator, the tricorder — a handheld device that performed environmental scans, data recording and data analysis — and the transporter, useful for when you need to hop to an alien planet in a pinch.

And you could always trust Capt. Kirk, Mr. Spock and Dr. McCoy to employ the gadgets for good.

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Those who meet the eligibility criteria for the Roddenberry Prize can apply through July 12. The grant will be awarded to one winner in November.

The foundation was launched by Gene Roddenberry’s family after his death in 1991.

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What Americans want from food: Energy, muscle strength, better health and less stress

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What Americans want from food: Energy, muscle strength, better health and less stress

What’s for dinner?

It’s a deceptively simple question, asked millions of times each day. But consider the myriad factors that go into answering it — from cost to convenience to climate change — and it’s no wonder we spend so much time thinking about the food we eat.

And that doesn’t even account for breakfast, lunch or snacks.

Quite a lot rides on Americans’ food choices, including trillions of dollars in spending and our collective risk of developing a slew of chronic diseases. That’s why the International Food Information Council conducts an annual survey on food and health.

“It’s about understanding the mindset of the consumer,” said Kris Sollid, a registered dietitian and senior director of nutrition communications for the industry-funded nonprofit.

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Over nearly two decades of IFIC surveys, taste has consistently ranked as the most important factor in food-buying decisions, followed by price, healthfulness, convenience and environmental sustainability.

In the 2024 survey — which was answered by 3,000 Americans in March — about 30% of respondents said an item’s sustainability mattered a lot when making purchasing decisions about what to eat and drink.

That may seem low, considering that scientists are already scrambling for ways to feed the nearly 10 billion people expected to live on the planet by 2050 while simultaneously reducing heat-trapping greenhouse gas emissions.

But to Sollid, the fact that 30% of those surveyed gave sustainability a score of 4 or 5 on a 5-point scale counts as a strong showing.

“Of course I’d like to see that number higher, there’s no doubt about that,” he said.

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Here’s a look at the state of the American diet, based on data from IFIC’s new findings.

What’s on our minds when we decide what to eat?

For starters, we are looking for something to give us energy or help fight fatigue. But health considerations are top of mind as well.

What kinds of foods are we choosing?

Protein is the most popular nutrient du jour — 20% of those surveyed said they were following a “high protein” diet in the past year, up from just 4% five years earlier. But it’s hardly the only thing we want in our food.

At the same time, Americans are trying to cut back on ingredients that are bad for us.

For instance, 50% of those surveyed said they were trying to limit or avoid sodium, or salt. Too much salt can cause your blood pressure to rise, and high blood pressure (also known as hypertension) is a risk factor for serious health problems like heart disease and stroke.

In addition, 44% of those surveyed said they were trying to limit or avoid saturated fat. This is the type of fat that can cause LDL cholesterol — the bad kind — to build up in your blood vessels, which also increases the risk of heart disease and stroke.

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But Public Enemy No. 1 is sugar.

What’s so bad about sugar?

Our bodies need some sugar for energy. But when we consume too much of it at once — which is easy to do when downing soft drinks, breakfast cereals and all kinds of ultra-processed foods — it gets stored as fat, which can lead to obesity, diabetes and heart disease, among other problems.

Two-thirds of those who took the IFIC survey said they were trying to limit their sugar intake, and 11% said they were trying to avoid it entirely. Their main targets were added sugars in packaged foods and beverages, though some were also cutting back on the natural sugars present in foods like fruits and plain dairy products.

The reasons motivating this retreat from sugar were a combination of current and future health concerns.

What other concerns factor into our food choices?

We’re not just thinking about ourselves when we decide what to eat. For many people, concerns about the way our food is produced matter when they decide whether to buy a particular food or beverage.

That concern extends to animals, to the people involved in all aspects of getting food onto our plates — from farmers to factory workers to grocery store or restaurant staff — and to the planet itself.

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How do we gauge whether a food was made with the environment in mind?

The good news is that this is something more than 70% of survey-takers care about. The bad news is that there’s no easy way to tell.

“There’s no true definition of what makes a food environmentally sustainable,” Sollid said. “There’s not one thing someone can look to on a food package to tell them whether or not this choice is better than that one.”

Instead, eco-conscious consumers use the following clues to guide them:

Will people pay more for an eco-friendly product?

Producing foods and beverages in a sustainable way often means added costs. So IFIC posed this hypothetical scenario:

Imagine you go to the store to buy a specific item and find three options. One costs $3 and has an icon indicating it is “not very eco-friendly.” Another costs $5 and is labeled as “somewhat eco-friendly.” The third costs $7 and is “very eco-friendly.”

Which would you choose?

What’s the relationship between food and stress?

It goes in both directions, the survey found: Stress affects the foods we choose, and the foods we choose can cause stress.

It’s a topic IFIC began asking about following the onset of the COVID-19 pandemic, which created both economic insecurity and food insecurity.

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“COVID uncovered a lot of angst or potential sources of stress that a lot of people had to face,” Sollid said.

Four years in, nearly two-thirds of those surveyed are grappling with a significant amount of stress, up from 60% in 2023.

What are we so stressed about?

Money and health issues remain the biggest sources of stress among those who said they were “very” or “somewhat” stressed. Food choices are weighing on the minds of nearly 1 in 4 people in this category.

Are we eating our feelings?

Some of us are. Nearly two-thirds of people said their mental and emotional well-being had a significant or moderate impact on their diet.

Among those who were at least somewhat stressed, about half said their food and beverage choices suffered as a result. However, a small number responded to stress by seeking out healthier options.

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Peanuts! Get your peanuts! Kids who eat them early are much less likely to develop an allergy, studies conclude

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Peanuts! Get your peanuts! Kids who eat them early are much less likely to develop an allergy, studies conclude

Allergist and immunologist Dr. Gideon Lack’s first inkling that some peanut allergies might be preventable came more than 20 years ago while he was giving a talk in Tel Aviv.

Lack, a professor of pediatric allergies at King’s College London, asked an audience of roughly 200 Israeli allergists how many children with peanut allergies they had treated in the last year. When he asked that question during similar talks in the U.S. and U.K., nearly every hand in the room shot up. To his surprise, only two or three Israeli doctors raised their hands.

He did some research and zeroed in on a key difference: Parents in the U.S. and U.K. were told not to give their infants any peanut products until the age of 3 as a precaution against future peanut allergies. In contrast, puffy peanut snacks were a favorite staple of many Israeli babies’ diets.

Lack and colleagues decided to test the theory that early oral exposure could actually prevent children from developing peanut allergies. After tracking hundreds of children from infancy to early adolescence, they recently concluded that babies who eat the stuff early and often in their first five years of life are 71% less likely to be allergic to peanuts at age 12.

The Learning Early About Peanut Allergy (LEAP) clinical trial ultimately overturned the official guidance given to new parents and has potentially prevented countless new cases of a serious and potentially deadly allergy.

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“It was revolutionary,” said Dr. Rita Kachru, a UCLA allergist and immunologist. “It really completely shifted the paradigm and the understanding of food allergy.”

The team recently published the third and final report of their longitudinal study.

In the first phase, whose results were published in 2015, the team recruited 640 babies between the ages of 4 and 11 months deemed at high risk for developing allergies, either because they were already allergic to eggs or had severe eczema.

Half the babies were prohibited from consuming any peanut product in their first five years. The other half had to eat at least 6 grams of peanut protein per week.

At the five-year mark, 13.7% of peanut-avoiding kids who had no sensitivity to peanuts at the start of the trial had peanut allergies by the end.

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But only 1.9% of the peanut-eaters in this group did — an 86% relative reduction in peanut allergy risk. For kids who showed some initial sensitivity to peanuts at the start of the test, eating peanuts was associated with a 70% relative reduction in developing a full-blown allergy.

“The results have the potential to transform how we approach food allergy prevention,” Dr. Anthony Fauci said at the time. Fauci was then director of the National Institute of Allergy and Infectious Diseases, which helped fund the study.

In the second phase, the researchers asked 556 participants from the original study to avoid peanuts entirely for a year, to see if continuous peanut exposure was necessary to prevent allergies from forming. Only a few kids who had previously eaten peanuts without issue developed an allergy after going without them for 12 months.

In the third phase, published last month in the New England Journal of Medicine, the researchers tested 508 children who had participated in the first two studies.

Participants had been free to eat or avoid peanuts as they wished in the six years since they were last studied. The team found that 15.4% of participants from the group that avoided peanuts in early childhood had peanut allergies at age 12, while only 4.4% of those who ate peanuts early on did.

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“It was doubly gratifying because our hypothesis was correct, but more importantly, we now have a strategy to prevent — and I would argue, nearly eradicate — the development of peanut allergy in the population,” Lack said over Zoom from London.

Incidence of food allergies began rising sharply in the 1980s, particularly in industrialized Western nations. In 1997, 0.4% of people in the U.S. had diagnosed peanut allergies. Today, about 1.8% do.

Amid the search for explanations, one 1989 study found that infants whose exposure to common allergenic foods was severely restricted in their first two years of life ended up with fewer allergies than those in a control group.

Largely based on that research, in 1998 the U.K. instructed women to not eat peanuts during pregnancy or while breastfeeding if they or their partner had a family history of allergies, and to prevent their child from eating peanuts until the age of 3. The American Academy of Pediatrics adopted similar guidelines in 2000.

After the first two LEAP reports came out, both the American Academy of Pediatrics and British Society for Allergy and Clinical Immunology issued new guidelines in 2017 incorporating the results. They now advise children at greater risk of developing a food allergy — those with eczema, egg allergies or both — to start eating peanut products between 4 and 6 months. For children without risk factors, the AAP says, peanuts can be introduced whenever the baby starts eating solid foods.

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“Previous guidance and recommendations prior to the LEAP study, where we were just avoiding peanuts because we were afraid of peanut allergy, was completely thrown out the window,” said Dr. Jenny Lee, a UC Irvine allergist and immunologist. “It changed the way that we practice.”

Nine years after the initial findings were published, there are signs that the approach is preventing new allergy diagnoses. In Australia, where guidelines also now encourage early peanut consumption, a large study published in 2022 found that 2.6% of 1-year-olds were allergic to peanuts in 2018-2019, compared with 3.1% in 2007-2011.

Despite the strong evidence, the updated AAP guidelines haven’t translated into clear communications to all parents that early peanut introduction prevents allergies, said Dr. Katie Marks-Cogan, an allergist and immunologist who practices in Culver City.

Marks-Cogan says she asks parents of children with newly diagnosed food allergies if their pediatrician talked to them about early introduction of allergenic foods. Most of the time, they say no.

“They will still say … ‘Aren’t you supposed to wait until a year for milk, and three years for tree nuts and peanuts?’ So a lot of parents still think that, and it’s because it’s slow to change things in medicine,” Marks-Cogan said. “Introducing early is actually safer and it’s better.”

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Times staff writer Karen Kaplan contributed to this report.

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