Reports Warn of Growing Opioid Crisis Among Seniors

WEDNESDAY, Sept. 19, 2018 — Against the backdrop of an unrelenting opioid crisis, two new government reports warn that America’s seniors are succumbing to the pitfalls of prescription painkillers.

Issued by the Agency for Healthcare Research and Quality (AHRQ), the reports reveal that millions of older Americans are now filling prescriptions for many different opioid medications at the same time, while hundreds of thousands are winding up in the hospital with opioid-related complications.

“These reports underscore the growing and under-recognized concerns with opioid use disorder in older populations, including those who suffer from chronic pain and are at risk for adverse events from opioids,” said Dr. Arlene Bierman. She is the director of AHRQ’s Center for Evidence and Practice.

Bierman was part of a team that focused on trends regarding opioid-related hospitalizations and emergency department visits among U.S. seniors.

The agency’s second report analyzed opioid prescription patterns among older Americans.

Bierman and her colleagues pointed out that chronic pain is common among seniors, as eight in 10 struggle with multiple health conditions, including heart disease, diabetes, arthritis and depression.

To cope, many seniors take opioids, which inevitably raises the risk for side effects and negative drug interactions.

And in fact, the team found, opioid-driven complications were the cause for nearly 125,000 hospitalizations — and more than 36,000 emergency department visits — among seniors in 2015.

The report also uncovered other alarming trends. Between 2010 and 2015, there was a 34 percent jump in the number of opioid-related inpatient hospital admissions among seniors, even as non-opioid-related inpatient hospitalizations dropped by 17 percent.

Similarly, AHRQ investigators found that opioid-related emergency department visits among seniors shot up by 74 percent, while non-opioid related emergency department visits only increased 17 percent.

At the same time, AHRQ’s second report found that nearly 20 percent of seniors filled at least one opioid prescription between 2015 and 2016, equal to about 10 million seniors. And more than 7 percent — or about 4 million seniors — filled prescriptions for four or more opioids, which was characterized as “frequent” use.

Frequent use was found to be notably more common among seniors who were either poor or low-income, insured through Medicare or another form of public insurance, and/or residents of rural areas.

Opioid use also went up dramatically depending on a person’s perceived health status. For example, only 9 percent of seniors in “excellent” health filled out opioid prescriptions, compared with nearly 30 percent in “fair” health and 40 percent in “poor” health.

The challenge, said Bierman, “is safe-prescribing for those who need opioids for pain, while avoiding overuse or misuse.”

Clinicians, she advised, could address that concern “by using non-opioid pain medications and non-pharmacologic treatments before considering the use of opioids.” And she suggested that if and when opioids are needed, “the lowest possible dose should be used.”

Dr. Anita Everett is chief medical officer for the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). She said that the findings shouldn’t come as a surprise.

“As a society, we don’t typically think of persons in the grandparent generation as having opioid use disorder,” she said. But when common chronic pain is paired with “the generation of physicians that were taught that opioid medication, when used for pain, was not likely to become addictive,” the result is a senior citizen opioid problem.

And, Everett said, the problem is likely more acute among the rural and the poor, who “often are in situations wherein they have fewer resources, less alternative treatments and may not know about the chances of becoming addicted to a prescription medication.”

Shame, stigma and social isolation among older people may also complicate efforts to prevent addiction or tackle it when it occurs, she added.

The solution? Everett suggested that caregivers have to be educated about the risk.

“SAMHSA supports early training for all health professionals so that addiction can be avoided, identified and treatment offered as early as possible,” she said.

More information

There’s more on opioid treatment among seniors at SAMHSA.

© 2018 HealthDay. All rights reserved.

Posted: September 2018




Seniors in pain hop aboard the canna-bus

Shirley Avedon, 90,­­ had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options.

“It’s very painful, sometimes I can’t even open my hand,” Avedon said.

So for the second time in two months, she’s climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, Calif., with a free shuttle to a nearby marijuana dispensary.

The retired manager of an oncology office says she’s seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago.

“At that time [marijuana] wasn’t legal, so they used to get it off their children,” she said with a laugh. “It was fantastic what it did for them.”

Avedon, who doesn’t want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol, or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana’s psychoactive ingredient.

“It helped a little,” she said. “Now I’m going back for the second time hoping they have something better.”

As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among the fastest growing group of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternative treatments for their aches, pains and other medical conditions.

On this particular morning, about 35 seniors climb on board the free shuttle — paid for by Bud and Bloom, a licensed cannabis dispensary in Santa Ana. After about a half-hour drive, the large white bus pulls up to the parking lot of the dispensary.

About half of the seniors on board today are repeat customers; the other half are cannabis newbies who’ve never tried it before, said Kandice Hawes, director of community outreach for Bud and Bloom.

“Not everybody is coming to be a customer,” Hawes said. “A lot are just coming to be educated.”

Among them, Layla Sabet, 72, a first-timer seeking relief from back pain that keeps her awake at night, she said.

“I’m taking so much medication to sleep and still I can’t sleep,” she said. “So I’m trying it for the back pain and the sleep.”

Hawes invited the seniors into a large room with chairs and a table set up with free sandwiches and drinks. As they ate, she gave a presentation focused on the potential benefits of cannabis as a reliever of anxiety, insomnia and chronic pain and the various ways people can consume it.

Several vendors on site took turns speaking to the group about the goods they sell. Then, the seniors entered the dispensary for the chance to buy everything from old-school rolled joints and high-tech vaporizer pens to liquid sublingual tinctures, topical creams and an assortment of sweet, cannabis-infused edibles.

Jim Lebowitz, 75, is a return customer who suffers pain from back surgery two years ago.

He prefers to eat his cannabis, he said.

“I got chocolate and I got gummies,” he told a visitor. “Never had the chocolate before, but I’ve had the gummies and they worked pretty good.”

“Gummies” are cannabis-infused chewy candies. His contain both the CBD and THC, two active ingredients in marijuana.

Derek Tauchman rings up sales at one of several Bud and Bloom registers in the dispensary. Fear of getting high is the biggest concern expressed by senior consumers, who make up the bulk of the dispensary’s new business, he said.

“What they don’t realize is there’s so many different ways to medicate now that you don’t have to actually get high to relieve all your aches and pains,” he said.

But despite such enthusiasm, marijuana isn’t well researched, said Dr. David Reuben, the Archstone Foundation professor of medicine and geriatrics at UCLA’s David Geffen School of Medicine.

While cannabis is legal both medically and recreationally in California, it remains a Schedule 1 substance — meaning it’s illegal under federal law. And that makes it harder to study.

The limited research that exists suggests that marijuana may be helpful in treating pain and nausea, according to a research overview published last year by the National Academies of Sciences, Engineering and Medicine. Less conclusive research points to it helping with sleep problems and anxiety.

Reuben said he sees a growing number of patients interested in using it for things like anxiety, chronic pain and depression.

“I am, in general, fairly supportive of this because these are conditions [for which] there aren’t good alternatives,” he said.

But Reuben cautions his patients that products bought at marijuana dispensaries aren’t FDA-regulated, as are prescription drugs. That means dose and consistency can vary.

“There’s still so much left to learn about how to package, how to ensure quality and standards,” he said. “So the question is how to make sure the people are getting high-quality product and then testing its effectiveness.”

And there are risks associated with cannabis use too, said Dr. Elinore McCance-Katz, who directs the Substance Abuse and Mental Health Services Administration.

“When you have an industry that does nothing but blanket our society with messages about the medicinal value of marijuana, people get the idea this is a safe substance to use. And that’s not true,” she said.

Side effects can include increased heart rate, nausea and vomiting, and with long-term use, there’s a potential for addiction, some studies say. Research suggests that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder.

Still, Reuben said, if it gets patients off more addictive and potentially dangerous prescription drugs — like opioids — all the better.

Jim Levy, 71, suffers a pinched nerve that shoots pain down both his legs. He uses a topical cream and ingests cannabis gelatin capsules and lozenges.

“I have no way to measure, but I’d say it gets rid of 90 percent of the pain,” said Levy, who — like other seniors here — pays for these products out-of-pocket, as Medicare doesn’t cover cannabis.

“I got something they say is wonderful and I hope it works,” said Shirley Avedon. “It’s a cream.”

The price tag: $90. Avedon said if it helps ease the carpal tunnel pain she suffers, it’ll be worth it.

“It’s better than having surgery,” she said.

Precautions To Keep In Mind

Though marijuana use remains illegal under federal law, it’s legal in some form in 30 states and the District of Columbia. And a growing number of Americans are considering trying it for health reasons. For people who are, doctors advise the following cautions.

Talk to your doctor. Tell your doctor you’re thinking about trying medical marijuana. Although he or she may have some concerns, most doctors won’t judge you for seeking out alternative treatments.

Make sure your prescriber is aware of all the medications you take. Marijuana might have dangerous interactions with prescription medications, particularly medicines that can be sedating, said Dr. Benjamin Han, a geriatrician at New York University School of Medicine who studies marijuana use in the elderly.

Watch out for dosing. Older adults metabolize drugs differently than young people. If your doctor gives you the go-ahead, try the lowest possible dose first to avoid feeling intoxicated. And be especially careful with edibles. They can have very concentrated doses that don’t take effect right away.

Elderly people are also more sensitive to side effects. If you start to feel unwell, talk to your doctor right away. “When you’re older, you’re more vulnerable to the side effects of everything,” Han said. “I’m cautious about everything.”

Look for licensed providers. In some states like California, licensed dispensaries must test for contaminants. Be especially careful with marijuana bought illegally. “If you’re just buying marijuana down the street … you don’t really know what’s in that,” said Dr. Joshua Briscoe, a palliative care doctor at Duke University School of Medicine who has studied the use of marijuana for pain and nausea in older patients. “Buyer, beware.”

Bottom line: The research on medical marijuana is limited. There’s even less we know about marijuana use in older people. Proceed with caution.

Jenny Gold and Mara Gordon contributed to this report.

This story is part of a partnership that includes NPR and Kaiser Health News.

KHN’s coverage of these topics is supported by John A. Hartford Foundation and The SCAN Foundation

Stephanie O’Neill: [email protected], @ReporterSteph

Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.




New review highlights shortage of fall detection devices for seniors

The high-tech aids seniors rely on to summon help if they fall might not be as effective as they’d like to believe.

A new review co-written by University of Alberta researchers concludes that fall detection technologies–monitors like wearable wristbands and pendants or at-home sensors–need to be more extensively explored and tested outside lab settings for how people actually use them.

“There seems to be a knowledge gap between fall detection technology and the use of it,” said study co-author Lili Liu, a professor in the Faculty of Rehabilitation Medicine.

Even though the market is already filled with such products, their readiness for use by the general public is questionable, she added.

“It’s disturbing to think that these technologies aren’t properly tested for the real world, to be used by people who very much depend on them.”

In Canada, falls are responsible for 85 per cent of hospitalizations for seniors. After a serious fall, 20 per cent of older adults will die within a year.

Liu, PhD student Noelannah Neubauer and researchers from the Université de Montréal and Universidad del Rosario sifted through 118 peer-reviewed studies, published worldwide in three languages, that focused on development and evaluation of fall detection devices. Ten types of monitoring technology were identified, including wearable devices and in-home sensors. Though the quality of the research was strong overall, it only went so far, Liu said.

“Most of the studies didn’t describe whether the technologies were ready for use in the real world,” she added.

Most were tested only in lab settings using available students, said Neubauer. Some studies even used mannequins to simulate falls. None tested the technology with seniors or in real-life environments.

The review also revealed gaps in feedback from real users. Only three studies explored user acceptance, and none focused on their preferences, leaving fall detection tech research out of step with the World Health Organization’s recommendation to address what older adults want.

“Most of the technology being researched was either wearable or situated in the home, but most people want a combination of both,” Neubauer said.

“None of the studies addressed the fact that just because you have a piece of technology that works, doesn’t mean it works for the older adult,” Liu noted.

One of the studies showed that 80 per cent of older adults were reluctant to push the button on their devices after a fall, either because they had difficulty activating it or because they didn’t want to disturb a caregiver.

“Not everyone who falls wants an immediate emergency dispatch. They might want to contact a neighbour instead or get up themselves. We need to have their input into what happens when they fall, and the technology doesn’t capture that,” said Liu.

One of the main reasons for developing fall detection devices is to offer an option for people who want to remain independent, yet not one of the studies measured that as an outcome, she added.

In addition, 90 per cent of the reviewed studies didn’t include any input from professional or family caregivers, but it’s vital to designing technology that they’re willing to use, said Neubauer.

“There are too many devices available in the market that are sitting on shelves collecting dust because they did not address the varying wants and needs of the consumer, and caregivers are often the ones who purchase these technologies to assist in their duties.”

The cost of the technology was another area that was barely explored: 80 per cent of the studies didn’t address the question at all, while 15 per cent mentioned it without specifying a cost, only recommending that systems be low-priced.

More medical research needed

Scientific research into fall detection technology is often limited by grant funding, noted Liu, a member of AGE-WELL, a Canadian technology and aging research network.

“Logistical issues around privacy and ethical considerations come into play when involving members of the public in research projects, and that’s a lengthy process that takes time and can often extend beyond grant timelines,” Liu said.

There’s a need for researchers and networks like AGE-WELL to work more closely with industry to extend the research beyond a lab setting and have that work reflected in the products people are using, she believes.

“It’s not an unreasonable ask for industry to validate their products,” she said.

Many fall detection products on the market stem from the development of information technology, not necessarily from medical knowledge, she noted.

“These are consumer products versus medical products, so we don’t really know how reliable they are.”

And while that’s “discouraging in one way, it’s also encouraging to know that there’s so much more than can be done in this field,” Liu added.




five.four million American citizens age 60 or older are meals insecure, displays new record

Starvation does no longer appreciate age. A up to date record evaluating information from 2007 to 2015 reveals five.four million other people age 60 or older within the U.S., or eight.1 p.c, are meals insecure. Even supposing this share went down from 2014 to 2015, it is nonetheless unacceptable, in step with a College of Illinois economist.

“After six consecutive years of higher starvation in seniors because the Nice Recession started, the slight drop in 2014 is excellent news, however no longer excellent sufficient,” says Craig Gundersen, who coauthored the record. “And it is important to remember the fact that the lower is in starvation at the nationwide scale. Some person states noticed an building up.”

The record identifies the highest 10 states relating to senior meals lack of confidence charges. “Seven of the ones 10 states are within the South, plus New Mexico, New York, and Indiana,” Gundersen says. The record states that once seniors who revel in marginal meals safety are incorporated, the charges range from 6.1 p.c in North Dakota to 24.three p.c in Mississippi.

Gundersen says seniors who reported a incapacity have been disproportionately affected, with 25 p.c reporting meals lack of confidence and an extra 13 p.c reporting marginal meals safety.

“Meals lack of confidence is understood to adversely have an effect on an individual’s well being, and the consequences will also be specifically problematic for seniors,” Gundersen says. “In comparison to food-secure seniors, food-insecure seniors devour fewer energy, nutrients, and different key vitamins. They’re additionally much more likely to revel in adverse well being stipulations, together with despair, bronchial asthma, and chest ache.”

Gundersen says the Supplemental Diet Help Program (SNAP, previously referred to as the Meals Stamp Program) has been demonstrated to cut back meals lack of confidence. He recommends that policymakers and program directors pursue efforts to extend participation in SNAP, with a selected emphasis on older adults.

Supply:

http://information.aces.illinois.edu/information/decade-later-older-americans-are-still-going-hungry




Youngster Drivers Take Extra Possibilities as Senior 12 months Starts

HealthDay news image

FRIDAY, Aug. four, 2017 (HealthDay Information) — Older teenagers are much more likely to do dangerous issues whilst riding and feature a better price of crashes and close to misses than their more youthful classmates, a brand new survey unearths.

Researchers surveyed 2,800 highschool scholars throughout the USA. Whilst three out of four seniors thought to be themselves protected drivers, they had been much more likely than more youthful teenagers to have interaction in unhealthy or distracted riding — particularly the use of mobile phones whilst at the back of the wheel, the survey discovered.

“Older teenagers are nonetheless green drivers — although they really feel differently — as they simply have one to 2 years of real-world apply beneath their belts,” stated Mike Pattern, lead riding protection knowledgeable and technical marketing consultant at Liberty Mutual Insurance coverage, a learn about sponsor.

“That is why it is very important proceed to emphasise the consequences and doable penalties of telephone use whilst riding to this age crew,” he added in a information unlock from Liberty Mutual and learn about co-sponsor Scholars In opposition to Harmful Selections (SADD).

Seniors had been much more likely to make use of a telephone whilst riding than sophomores, 71 % vs. 55 %, the survey confirmed. This happens maximum steadily at a crimson gentle or give up signal and in stop- and-go visitors.

As well as, 67 % of seniors admitted the use of apps whilst riding, when compared with 58 % of juniors and 49 % of sophomores.

Different unhealthy behaviors additionally was extra not unusual as teenager drivers were given older, together with:

  • Converting tune by the use of telephone or app: Seniors, 40 %; juniors, 32 %; sophomores, 26 %.
  • Dashing: Seniors, 35 %; juniors, 23 %; sophomores, 18 %.
  • Riding when drowsy: Seniors, 26 %; juniors, 15 %; sophomores, 13 %.

Seniors had been additionally much more likely to have 3 or extra passengers within the automobile.

The learn about additionally discovered that they’d extra crashes and close to misses (57 %) than sophomores (34 %).

The survey sponsors stated oldsters would possibly unwittingly play an element in older teenagers’ behind-the-wheel risk-taking.

Just about 70 % of 15- and 16-year-olds stated they’d lose riding privileges if they’d a crash, when compared with 55 % of the ones 18 and older.

Dr. Gene Berlin, senior marketing consultant on adolescent psychiatry with SADD, stated it is herbal for youths to realize self belief as they grow older and pressure extra. However overconfidence could cause bother.

“This age crew is much more likely to check the limits as penalties for unhealthy riding behaviors lower and their freedoms and obligations at house building up, making them really feel extra like adults,” he stated. “In consequence, it’s much more essential for fogeys and teenagers to have conversations about protected riding practices to keep away from doubtlessly hanging themselves and others in danger at the street.”

SOURCE: information unlock, Aug. 2, 2017

Information tales are written and equipped via HealthDay and don’t replicate federal coverage, the perspectives of MedlinePlus, the Nationwide Library of Drugs, the Nationwide Institutes of Well being, or the U.S. Division of Well being and Human Products and services.




Youngster Drivers Take Extra Possibilities as Senior Yr Starts

FRIDAY, Aug. four, 2017 — Older teenagers are much more likely to do dangerous issues whilst riding and feature a better fee of crashes and close to misses than their more youthful classmates, a brand new survey reveals.

Researchers surveyed 2,800 highschool scholars throughout the US. Whilst three out of four seniors regarded as themselves protected drivers, they had been much more likely than more youthful teenagers to have interaction in unhealthy or distracted riding — particularly the use of cell phones whilst in the back of the wheel, the survey discovered.

“Older teenagers are nonetheless green drivers — despite the fact that they really feel differently — as they simply have one to 2 years of real-world apply beneath their belts,” stated Mike Pattern, lead riding protection knowledgeable and technical guide at Liberty Mutual Insurance coverage, a find out about sponsor.

“That is why it is very important proceed to emphasise the consequences and possible penalties of telephone use whilst riding to this age team,” he added in a information unlock from Liberty Mutual and find out about co-sponsor Scholars In opposition to Harmful Choices (SADD).

Seniors had been much more likely to make use of a telephone whilst riding than sophomores, 71 % vs. 55 %, the survey confirmed. This happens maximum continuously at a pink mild or give up signal and in stop- and-go site visitors.

As well as, 67 % of seniors admitted the use of apps whilst riding, when put next with 58 % of juniors and 49 % of sophomores.

Different unhealthy behaviors additionally was extra not unusual as teenager drivers were given older, together with:

  • Converting track by way of telephone or app: Seniors, 40 %; juniors, 32 %; sophomores, 26 %.
  • Dashing: Seniors, 35 %; juniors, 23 %; sophomores, 18 %.
  • Using when drowsy: Seniors, 26 %; juniors, 15 %; sophomores, 13 %.

Seniors had been additionally much more likely to have 3 or extra passengers within the automobile.

The find out about additionally discovered that they’d extra crashes and close to misses (57 %) than sophomores (34 %).

The survey sponsors stated oldsters might unwittingly play a component in older teenagers’ behind-the-wheel risk-taking.

Just about 70 % of 15- and 16-year-olds stated they’d lose riding privileges if they’d a crash, when put next with 55 % of the ones 18 and older.

Dr. Gene Berlin, senior guide on adolescent psychiatry with SADD, stated it is herbal for teenagers to realize self belief as they grow older and power extra. However overconfidence could cause hassle.

“This age team is much more likely to check the bounds as penalties for unhealthy riding behaviors lower and their freedoms and obligations at house building up, making them really feel extra like adults,” he stated. “In consequence, it’s much more essential for folks and youths to have conversations about protected riding practices to keep away from probably placing themselves and others in danger at the highway.”

Additional information

The U.S. Facilities for Illness Regulate and Prevention has extra on teenager drivers.

Posted: August 2017

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Falls result in declines in seniors

Greater than part of aged sufferers (age 65 and older) who visited an emergency division on account of accidents sustained in a fall suffered antagonistic occasions – together with further falls, hospitalization…




NIHSeniorHealth

Supply: Nationwide Institute on Growing older – From the National Institutes of Health Video
Similar MedlinePlus Pages: Seniors’ Well being




Maximum Seniors Use Mobile phones Whilst In the back of the Wheel

FRIDAY, April 28, 2017 — While you call to mind cell phones and riding, you most likely image a chatty youngster at the back of the wheel. However new analysis means that seniors are frequently responsible of this unhealthy apply, too.

And that is the reason true even supposing they have got youngsters within the automobile, a brand new survey discovered.

“Of the ones senior drivers who’ve a cellular phone, 60 p.c of them discuss at the telephone whilst at the back of the wheel. And seniors with a skewed sense in their multitasking talents are possibly to have interaction on this conduct,” Dr. Linda Hill, of the College of California, San Diego, mentioned in a college information liberate. Hill is a professor within the Faculty of Medication’s division of circle of relatives medication and public well being.

For the find out about, the researchers performed an nameless survey of virtually 400 adults, elderly 65 and older. Hill’s crew requested the seniors about their riding conduct and probably distracting behaviors. Of the respondents, 82 p.c owned a smartphone.

“The survey effects discovered older adults are riding distracted lower than their more youthful opposite numbers, however are nonetheless attractive on this unhealthy conduct,” Hill mentioned.

Cell phone use apart, some older drivers have well being issues that have an effect on their talent to power safely, corresponding to imaginative and prescient issues, frailty and pondering/reminiscence impairment. Additionally, some drugs could cause negative effects that impair riding talents. Older drivers may additionally have lowered consideration and mental-processing velocity, the researchers famous.

The usage of a cellular phone whilst riding will increase the chance of a crash fourfold, the find out about authors mentioned, including that hands-free and handheld units are similarly unhealthy. This greater chance is equal to riding with a nil.08 blood alcohol content material, which is the prison restrict for intoxication, consistent with the find out about authors. Texting is related with an 8 to 16 instances greater chance of a crash.

“There may be fear that including distraction to the lowered talents of a few older adults will building up those crash charges even additional,” Hill mentioned.

However older drivers do not appear to concentrate on the raised doable for injuries: 75 p.c mentioned they might power safely whilst speaking on a hands-free tool.

The find out about additionally discovered that previously month, 27 p.c of respondents drove with youngsters more youthful than age 11 within the automobile. Of the ones drivers, 42 p.c talked at the telephone whilst at the back of the wheel.

“When adults are riding distracted with youngsters within the automobile, now not simplest does it put youngsters in peril, however they’re additionally modeling dangerous conduct,” Hill mentioned. “No name is so pressing that it cannot wait till the motive force is in a position to pull over to a secure position.”

April is Nationwide Distracted Using Consciousness month.

Additional information

The U.S. Facilities for Illness Keep watch over and Prevention has extra on distracted riding.

Posted: April 2017

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