Science
What We Know About Children and Opioids
A 1-year-old boy died on Friday and three other children were hospitalized after all four were apparently exposed to an opioid at a state-licensed day care in the Bronx, city officials said. The police said they later found a packaging device typically used by drug dealers there.
The New York City medical examiner’s office said on Saturday afternoon that it had completed an autopsy but that further examination was needed to determine the 1-year-old’s cause of death. It was not clear whether health officials had tested any of the children for drugs.
But the suspicions of police officials about opioid exposure — prompted, they said, by the children’s symptoms and by the discovery of a so-called kilo press at the day care site — drew attention to the threat from opioids such as fentanyl to children.
Do we know whether opioids were responsible?
The police have released little information about their investigation of the episode or why they homed in so quickly on opioid exposure as the likely explanation.
But reports that some of the children were revived with the overdose-reversal medication Narcan suggested that they probably had been exposed to opioids, a class of synthetic drugs that includes prescribed pain relievers and narcotics such as heroin and fentanyl, said Dr. Sharon Levy, the chief of the division of addiction medicine at Boston Children’s Hospital.
Opioids generally kill by binding to a receptor in the portion of the brain that controls breathing and heart rate, causing a person’s breathing to slow or stop. Narcan binds to the same receptors, effectively blocking the effects of opioids.
If some of the children in the Bronx responded to being treated with Narcan, that “is sort of making the diagnosis that there was an opioid on that receptor,” Dr. Levy said.
How can children be exposed?
It is not clear how the children at the Bronx day care might have come into contact with any drugs.
But nearly all cases of children being exposed to opioids involved their ingesting the drug, a study published in The Journal of Pediatrics in 2019 found.
The study looked at more than 80,000 records of children under 18 who had been exposed to drugs containing an opioid over a five-year period. Three-quarters of the children had unintentionally come into contact with the drug. The study found that roughly 99 percent of the exposures involved children orally ingesting it.
Other, much rarer routes of exposure included inhalation or contact with children’s eyes, ears or rectums. But the data in the study was largely self-reported, making it difficult to determine if those types of exposure would have been enough to poison children.
Can touching opioids sicken children?
Reports of police officers or emergency medical workers becoming sick after accidentally absorbing fentanyl through their skin or inhaling airborne powder have periodically received media attention and become the subject of warnings from federal drug officials.
But the scientific consensus remains that poisonings from that kind of unintentional exposure to opioids are extremely unlikely. They say that opioids are not easily absorbed through the skin and are not usually carried in the air.
Researchers who have looked into child opioid overdoses have urged more study of how those poisonings happen. But even children, they said, were unlikely to be sickened by touching opioids or accidentally inhaling them in the air.
If the children in the Bronx were exposed to opioids, Dr. Levy said, they had probably orally ingested the drug.
“I don’t think it’s actually well absorbed enough through the skin to do this kind of thing,” she said. An airborne poisoning was also unlikely, she said.
“Whether enough could get in from an environmental exposure, I would really doubt it, even in a small child where it’s true that you need much less of a dose,” she said.
Why are children at higher risk of overdoses?
A small child and an adult given the same amount of opioids would be exposed to significantly different degrees of harm because of children’s smaller bodies, which puts them at higher risk of an overdose, scientists said.
Children are treated with opioids, including after dental or surgical procedures. But Dr. Levy said doctors settle on a dose only after carefully accounting for a patient’s body weight, which is the case for most drugs.
“Someone who weighs 10 or 12 kilos, compared to a 70-kilo person, is going to get a much smaller amount,” she said. “An adult dose is going to be a big problem.”
Young brains also have lower concentrations of a protein that can help prevent many different chemical compounds from crossing the blood-brain barrier. That, too, may help account for the increased toxicity in children exposed to certain opioids, studies have suggested.
How common are child overdoses?
Opioids were the leading cause of poisoning deaths in children 5 years old and younger from 2005 to 2018, a study in the journal Pediatrics found.
The study, published in March, looked at 731 poisoning-related deaths from 40 states. The authors found that opioids contributed to 47 percent of those deaths.
Over the past decade, children have been exposed to new opioid sources, the authors of the study said. Children have lately been exposed not just to the usual prescription opioids, but also to heroin and synthetic opiates like fentanyl and buprenorphine, a drug used in medication-assisted treatments to curb opiate reliance.
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight
President-elect Donald Trump joined Elon Musk in Texas and watched the launch from a nearby location on Tuesday. While the Starship’s giant booster stage was unable to repeat a “chopsticks” landing, the vehicle’s upper stage successfully splashed down in the Indian Ocean.
-
Business1 week ago
Column: Molly White's message for journalists going freelance — be ready for the pitfalls
-
Science6 days ago
Trump nominates Dr. Oz to head Medicare and Medicaid and help take on 'illness industrial complex'
-
Politics1 week ago
Trump taps FCC member Brendan Carr to lead agency: 'Warrior for Free Speech'
-
Technology1 week ago
Inside Elon Musk’s messy breakup with OpenAI
-
Lifestyle1 week ago
Some in the U.S. farm industry are alarmed by Trump's embrace of RFK Jr. and tariffs
-
World1 week ago
Protesters in Slovakia rally against Robert Fico’s populist government
-
Health2 days ago
Holiday gatherings can lead to stress eating: Try these 5 tips to control it
-
News1 week ago
They disagree about a lot, but these singers figure out how to stay in harmony