American journal of public health
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We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g., Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes. The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and cessation of prescribing for patients at risk of abuse and misuse (suicide). We conducted time-series analyses of nationwide propoxyphene use data 1974-83 and analyzed data on drug overdose death rates covering a combined population of about 83 million. ⋯ The no-refill recommendation had no impact on refill rates. The risk of overdose death per propoxyphene prescription filled has remained about constant since 1979. Sharper declines in misuse of such drugs will require stronger, more sustained regulatory or educational measures.
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This paper examines the mortality experience in 1979-81 of three first generation Hispanic subpopulations in the United States, as defined by area of birth (Cuba, Mexico, Puerto Rico). Numerators were derived from National Center for Health Statistics (NCHS) mortality tapes, which included codes for selected places of birth appearing on the death certificate. ⋯ Generally, mortality is relatively high among Cuban-born, Mexican-born and Puerto Rican-born adolescents and young adults, particularly males, largely due to violent deaths. Aged migrants, despite their disadvantaged socioeconomic status, exhibit relatively low death rates from heart disease and cancer.