Daily on Healthcare: Alcohol deaths are climbing but proposed reforms are controversial

By | January 13, 2020

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ALCOHOL LIMITS ABSENT AMID OVERDOSE CRISIS: New federal data shows that alcohol deaths have been climbing steadily over time, but the policy tools that health agency officials have raised to address excessive drinking are controversial.

According to new data from the National Institute on Alcohol Abuse and Alcoholism, deaths from over-drinking have doubled in almost two decades, from 35,914 in 1999 to 72,558 in 2017.

This means that deaths from alcohol are even higher than deaths from opioids, which totalled 49,060 in 2017. And the data doesn’t account for other downsides of over-drinking, including being violent while under the influence, giving birth to babies with fetal alcohol syndrome, or the productivity costs of alcoholism.

But while Congress and the Trump administration have worked on ideas to reduce deaths from prescription drugs, heroin, and fentanyl, they have been notably silent about alcohol. They may be reluctant to propose limitations on alcohol because it’s far more likely to spur a backlash than doing so for other drugs would.

Tobacco-style limitations, such as restrictions on where and when alcohol is sold, taxes, or bans on certain types of marketing, get met with accusations of Prohibition-era methods, as they would affect people who drink only moderately and would potentially fail to address alcoholism altogether. The alcohol industry has instead supported policies to strengthen law enforcement and education, as well as targeted approaches aimed at people who have a dependency on alcohol.

But in recent years public health agencies, including the World Health Organization, have been far more vocal about calling for limits on alcohol. Under President Trump, the Centers for Disease Control and Prevention recommended limiting hours and locations for alcohol sales. The surgeon general under Barack Obama issued a report that recommended reducing problem drinking in states through restrictions, which, like the Trump administration guidelines, would also hit people who only drink occasionally. The CDC during Obama’s tenure also issued controversial guidance saying women of childbearing age shouldn’t drink alcohol unless they are also on birth control.

States don’t appear to be heading in the direction the CDC recommended. Even as deaths have climbed, states have largely moved to make alcohol more available in what many see as a more modernized approach to drinking. A quick look at recent state laws shows that more states are allowing alcohol to be sold on Sundays, or in grocery stores, or earlier in the day.

Plus, there isn’t all bad news on the drinking front. For example, underage drinking, including college binge drinking, is at record lows, and drunken driving deaths account for 29% of overall driving deaths, the lowest percentage since 1982.

We’ll be watching the rhetoric on this, particularly after the CDC releases its annual figures on life expectancy sometime in the next month. In recent years, excessive drinking has shown itself to be one of the big contributors to people dying younger.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

INDIANA MOUNTS DEFENSE OF ABORTION LAWS: Attorney General Curtis Hill has filed a brief in U.S. district court rebuttin arguments by Whole Woman’s Health Alliance, which provides abortions, to have 25 sections and sub-sections of Indiana law declared unconstitutional.

“Indiana’s abortion regulations are carefully designed to further our important and legitimate interests in expressing respect for fetal life and promoting women’s health,” Hill said in a statement. “At the same time, our laws respect the woman’s ultimate decision whether or not to bear a child. The federal district court should protect the delicate balance fashioned by the Supreme Court’s abortion precedents.”

Whole Woman’s Health filed suit in 2018 after Indiana regulators rejected its license to open a clinic in South Bend. Last summer, a court permitted the clinic to open as the broader challenges to Indiana restrictions went forward. Some of the restrictions Whole Woman’s Health is seeking to strike: preventing medical providers other than doctors from performing abortions, banning abortion clinics from using telemedicine, and requiring parental consent for abortions.

TRUMP ADMINISTRATION ASKS SCOTUS NOT TO RULE ON OBAMACARE BEFORE ELECTION: The Department of Justice requested that the Supreme Court put off deliberating the constitutionality of Obamacare until after the lower courts have decided, despite GOP members’ common argument that the law should be struck down. If the Supreme Court agrees with Solicitor General Noel Francisco’s written request, the GOP may be able to push off coming up with an Obamacare replacement plan in the middle of campaigning. Francisco told the court: “The accelerated review petitioners seek is unnecessary,” and that coming to a decision before the lower courts have finished deliberating would be “premature.”

LEGALLY MANDATING VACCINATIONS WORKED IN EUROPE: Twenty-nine European countries that mandated vaccines for measles and pertussis had markedly higher vaccination rates than other countries, according to a study by the American Academy of Pediatrics. Countries with mandatory vaccines had a nearly 4 percentage point higher rate of measles vaccination and over 2 percentage point higher rate of pertussis vaccination.

ATYPICAL FLU SEASON IS STILL GOING STRONG: The influenza B strain, which usually starts to hit later in the flu season, has already killed 21 children since July 2019 when the flu season began, according to the CDC. There have already been five pediatric deaths since the start of 2020, making a total of 32 pediatric deaths from both A and B strains and 4,800 deaths overall.

Researchers have to develop a flu vaccine well before flu season starts, which is usually in early autumn, and before they know which strains will be circulating the most. Still, the CDC says the vaccine developed for the 2019/2020 flu season will still be effective. Even though the strain in the vaccine differs from the one currently getting people sick, CDC officials say the strains are similar and the vaccine will help.

CALIFORNIA GUN OWNERS SUPPORT BUYBACK PROGRAMS AND PURCHASING RESTRICTIONS: The California Safety and Wellbeing Survey found that a slim majority of California gun owners support a five-year prohibition on firearm purchases for people with at least two DUIs in the past five years as well as a high-capacity magazine buyback program. About 50% of gun owners supported restricting purchasing power for those with DUIs and an overwhelming majority of non-gun owners, as well as those who live with gun owners, support the proposal — 72% and 67% respectively. Similarly, 51% of gun owners believe in buyback programs, which would allow owners of high-capacity magazines to sell their firearms to police.

The Rundown

U.S. News Heroin, fentanyl deaths drop in Medicaid expansion states

Boston Globe Cambridge startup debuts with a bold promise: To make drugs with dramatically lower prices

Associated Press Kansas GOP to stymie ban in reversing abortion-rights ruling

The New York Times Tighter food stamp rules crowded soup kitchens, not job rosters

The Wall Street Journal Inside Google’s quest for millions of medical records

Calendar

MONDAY | Jan. 13

Jan. 13-16. San Francisco. JPMorgan Chase & Co. 38th Annual Healthcare Conference. Details.

TUESDAY | Jan. 14

10 a.m. Rayburn 2123. House Energy and Commerce’s Oversight and Investigations Subcommittee hearing on “A Public Health Emergency: State Efforts to Curb the Opioid Crisis.” Details.

WEDNESDAY | Jan. 15

8:45 a.m. UnitedHealthCare fourth quarter earnings call. Details.

10 a.m. 2123 Rayburn. Energy and Commerce’s Health Subcommittee hearing on “Cannabis Policies for the New Decade.” Details.

Noon. Cato Institute event on “Needle Exchange Programs: Benefits and Challenges,” with Surgeon General Jerome Adams. Details.

THURSDAY | Jan. 16

8 a.m.-4 p.m. The Spy Museum. 700 L’Enfant Plaza SW. Council for Affordable Health Coverage event on “The Price of Good Health.” Details.

Healthcare