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New study: Drug-caused suicides in Utah could be underestimated by 33%

Utah’s number of drug overdose suicides has potentially been underreported by 33%, according to a recently published study.

The research, “Discovering the Unclassified Suicide Cases Among Undetermined Drug Overdose Deaths Using Machine Learning Techniques,” was published in Suicide and Life-Threatening Behavior and looked at 2,665 overdose deaths that occurred from 2012 to 2015 in Utah.

The nation’s opioid epidemic has clouded suicide classification across the nation, according to Paul Nestadt, one of the paper’s authors and an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.

“If you work in mental health, it is pretty clear there is a lot of overlap in the symptoms of someone who is using opiates and someone who may be suicidal,” Nestadt said.

Every year, about 627 Utahns die from suicide and 4,574 attempt suicide, according to the Utah Department of Health.

Utah County had 118 drug-related deaths in 2018, with 90 deaths by suicide that same year. Suicide was the seventh leading cause of death in Utah County in 2018, taking more lives than kidney disease, diabetes and birth complications.

Utah’s suicide rate is above the national average, causing the deaths of 22.7 per 100,000 people in 2017, compared to a national rate of 14 people per 100,000, according to information in the study.

According to the study, that rate could be significantly higher. Utah’s rate of undetermined deaths is double the national rate, with the majority of those undetermined deaths caused by poisoning or drug overdoses.

“Compared with other causes of suicide, drug-intoxication (or poisoning) suicides are particularly prone to be misclassified as accident or undetermined,” the study reads.

The study looked at data from the Utah Department of Health and the National Violent Death Reporting System in order to create models that could determine if a death was a suicide.

The result was that there was potentially 229 additional deaths by suicide over the four years of data the study looked at than had previously been counted, and that the total suicide rate in Utah was underreported by 9.2%.

Nestadt said having more accurate data on suicides will allow for better targeted interventions in order to prevent deaths. If someone is known to have poor mental health, then he said that person’s access to medications that they could stockpile can be restricted.

“We can’t target any intervention until we know what is causing it,” he said.

Nestadt said that 20% of overdose deaths in Utah are left undetermined. Only a small percentage of those who die by suicide leave a note, and it can be hard for a medical examiner or a coroner to know that a death is intentional.

“There can be a lot of unanswered questions and medical examiners and coroners of the world aren’t trained specifically for this,” Nestadt said.

Psychological autopsies are expensive, he said, and an algorithm avoids human bias — which can include coroners who don’t want to declare that someone died by suicide due to their religious beliefs or family members who push against ruling a death as a suicide.

The algorithm looked at more than 100 variables, such as if the individual had previously attempted to die by suicide or if they had a recent job loss. It looked to Utah due to the state’s high number of overdose deaths that are classified as having an undetermined intent, because Utah’s statewide, centralized medical examiner system gives more details than systems used elsewhere and because of work on the topic previously completed by the study’s first author — a Salt Lake City high school student.

Daphne Liu, a junior at West High School, has been working on machine learning projects since middle school. She presented the overdose data at the Intel International Science and Engineering Fair and received a national award for her work.

Nestadt wanted to cite Liu’s research, but it hadn’t been published yet.

“It is really, really crazy because I think of a published paper as generating new knowledge and it’s really weird for me that I am generating new knowledge that other people are learning from, when I am still in school and learning,” Liu said.

She’s learned about high suicide rates in school and wanted to do research into a topic that could have a societal impact.

“It was really interesting to me that even though those numbers are already super high, they aren’t as high as they should be because there is some suicide underreporting to some extent, always,” she said.

She plans to extend the research to other states.

UDOT launches opt-in mileage charge for alternative-fuel vehicles

For decades, the Utah Department of Transportation has relied on gas tax revenue to fund transit, road maintenance and transportation projects. But with more drivers switching to electric and hybrid vehicles every year and the purchasing power of the gas tax consistently decreasing, UDOT is exploring other ways to bring in money.

A program launched on the first day of the year aims to do just that. The Road Usage Charge program started by UDOT gives Utah drivers of alternative-fuel vehicles the option of paying by the number of miles driven instead of paying an annual fee. As of 2019, drivers of these vehicles pay a flat fee when they register their car.

Last year’s fees were $60 for electric vehicles, $26 for plug-in hybrids and $10 for gas hybrids according to UDOT. Those numbers will increase to $90, $39 and $15 respectively this year, and to $120, $52 and $20 in 2021.

Those who participate in the voluntary program will be charged 1.5 cents per mile driven, according to Tiffany Pocock, manager of the Road Usage Charge program. Opting in will mean they don’t have to pay the extra registration fee and won’t be charged any higher than what the fee would have been, regardless of the number of miles traveled.

Pocock said electric car users, who travel an average of 8,000 miles a year, are unlikely to see any savings this year through program participation. But when the registration fees increase in 2021, the voluntary program would save drivers money.

“You could, in theory, drive less, pay less at that point,” Pocock said.

In 2018, the Utah Legislature passed transportation governance amendments that, among other things, required UDOT to implement a road usage charge system for alternative-fuel vehicles by 2020.

UDOT fulfilled that requirement and, in doing so, became the second state in the country to have a fully-fledged pay-per-mile alternative-fuel vehicle program, Pocock said.

Around two-dozen states have adopted annual flat fees for alternative-fuel vehicles, but only Oregon and Utah give the option of paying by the mile.

The mileage tracking works by using an OBD2 device that plugs into a vehicles diagnostic port and captures sensor data, said Pocock. This data is sent to a third party that collects and reports the number of miles driven.

“And then you would just drive,” the program manager said.

Payments are made using a prepaid wallet that is set up once participants put a credit or debit card on file. Mileage fees are automatically deducted periodically, according to an information sheet about the program.

People concerned about privacy and how their data is used can opt for short-term data retention, the sheet said.

In 2019, the gas tax rate at the state level was 30 cents per gallon and 18.4 cents per gallon at the federal level, according to UDOT data. A conventional sedan that gets 25 miles to the gallon would pay, on average, $301 in total fuel taxes, with $187 of that going to the state. At the same time, electric vehicles paid zero in gas taxes.

Only 2% of vehicles in the state are electric, gas-hybrid or otherwise alternatively fueled, according to UDOT.

But these numbers are growing quickly. In 2018, the amount of alternative-fuel vehicles in Utah grew by more than 50%.

“The gas tax is doing what it needs to do here in the short term,” Pocock said. “But (with) the growth of electric vehicles we’re seeing … (they) will probably be what the majority of the cars are on the road here in the future.”

Nobody likes increased fees, said Pocock, but this program operates on a “pay for what you use” basis and, in a few years, will be necessary to adequately fund Utah’s roads and transportation infrastructure.

“We’re just trying to plan ahead and figure out what that funding structure and revenue needs to look like,” Pocock said.

Focus New Year's resolutions on healthy habits, not grand goals, Provo clinic recommends

Those making New Year’s resolutions should evaluate how important it is for them to reach their goal, if it is important to them and if they are confident in their ability to achieve it, according to one health professional.

“People often make these goals that they are really not ready to put effort into,” said Brad Edgington, the director of behavioral medicine at the Merrill Gappmayer Family Medicine Center in Provo.

Edgington said some of the most detrimental things a New Year’s resolutioner can do is to create very rigid expectations for themselves and to make goals around things they can’t control. He advises to develop healthy habits instead of setting large, unachievable resolutions.

He suggests rating how important reaching a particular goal is and to examine what will happen if they don’t reach it.

“If it isn’t very important and you don’t have enough confidence to do it, it probably isn’t going very far, anyway,” Edgington said.

Simpler goals are better, he said. Getting support from others will also encourage a resolutioner along the way.

“The more isolated you are, the less likely you are to achieve it,” Edgington said.

Goals like losing weight, he said, are often made under the false assumption that it will lead to better relationships. Edgington said a resolutioner would be better off putting that effort into improving their relationships.

Small cracks have appeared in GOP unity on impeachment trial

WASHINGTON — The Senate seems certain to keep President Donald Trump in office thanks to the overwhelming GOP support expected in his impeachment trial. But how that trial will proceed — and when it will begin — remains to be seen.

Democrats are pushing for the Senate to issue subpoenas for witnesses and documents, pointing to reports that they say have raised new questions about Trump’s decision to withhold military aid from Ukraine.

Once the House transmits the articles of impeachment, decisions about how to conduct the trial will require 51 votes. With Republicans controlling the Senate 53-47, Democrats cannot force subpoenas on their own.

For now, Republicans are holding the line behind Senate Majority Leader Mitch McConnell’s position that they should start the trial and hear arguments from House prosecutors and Trump’s defense team before deciding what to do.

But small cracks in GOP unity have appeared, with two Republican senators criticizing McConnell’s pledge of “total coordination” with the White House during the impeachment trial.

Alaska Sen. Lisa Murkowski said she was “disturbed” by the GOP leader’s comments, adding that there should be distance between the White House and the Senate on how the trial is conducted. Maine Sen. Susan Collins, meanwhile, called the pledge by McConnell, R-Ky., inappropriate and said she is open to seeking testimony.

Democrats could find their own unity tested if and when the Senate reaches a final vote on the two House-approved impeachment charges — abuse of power and obstruction of Congress.

It would take 67 votes to convict Trump on either charge and remove him from office, a high bar unlikely to be reached. It’s also far from certain that all 47 Democrats will find Trump guilty.

Democratic Sen. Doug Jones of Alabama said he’s undecided on how he might vote and suggested he sees merits in the arguments both for and against conviction.

A look at some of the senators to watch once the impeachment trial begins:

Mitt Romney, R-Utah

Romney, a freshman senator and on-again, off-again Trump critic, has criticized Trump for his comments urging Ukraine and China to investigate Democrat Joe Biden, but has not spoken directly about he thinks impeachment should proceed.

Romney is overwhelmingly popular in a conservative state where Trump is not beloved, a status that gives Romney leverage to buck the president or at least speak out about rules and procedures of a Senate trial.

Lisa Murkowski, R-Alaska

In her fourth term representing Alaska, Murkowski is considered a key Senate moderate. She has voted against GOP leadership on multiple occasions and opposed Brett Kavanaugh’s nomination to the Supreme Court in 2018.

Murkowski told an Alaska TV station last month there should be distance between the White House and the GOP-controlled Senate in how the trial is conducted.

“To me it means that we have to take that step back from being hand in glove with the defense, and so I heard what leader McConnell had said, I happened to think that that has further confused the process,” she said.

Murkowski says the Senate is being asked to cure deficiencies in the House impeachment effort, particularly when it comes to whether key witnesses should be brought forward to testify, including White House acting chief of staff Mick Mulvaney and former national security adviser John Bolton.

“How we will deal with witnesses remains to be seen,” she said, adding that House leaders should have gone to court if witnesses refused to appear before Congress.


The four-term senator said she is open to calling witnesses as part of the impeachment trial but calls it “premature” to decide who should be called until evidence is presented.

“It is inappropriate, in my judgment, for senators on either side of the aisle to prejudge the evidence before they have heard what is presented to us,’’ Collins told Maine Public Radio.

Senators take an oath to render impartial justice during impeachment — an oath lawmakers should take seriously, Collins said.

Collins, who is running for reelection and is considered one of the nation’s most vulnerable GOP senators, also faulted Democrats for saying Trump should be found guilty and removed from office. “There are senators on both sides of the aisle, who, to me, are not giving the appearance of and the reality of judging that’s in an impartial way,’’ she said.


Jones, a freshman seeking reelection in staunchly pro-Trump Alabama, is considered the Democrat most likely to side with Republicans in a Senate trial. In a Washington Post op-ed column, Jones said that for Americans to have confidence in the impeachment process, “the Senate must conduct a full, fair and complete trial with all relevant evidence regarding the president’s conduct.’’

He said he fears that senators “are headed toward a trial that is not intended to find the whole truth. For the sake of the country, this must change.’’

Unlike what happened during the investigation of President Bill Clinton, “Trump has blocked both the production of virtually all relevant documents and the testimony of witnesses who have firsthand knowledge of the facts,’’ Jones said. “The evidence we do have may be sufficient to make a judgment, but it is clearly incomplete,’’ he added.

Jones and other Democrats are seeking testimony from Mulvaney and other key White House officials to help fill in the gaps.

Cory Gardner, R-Colo.

Gardner, like Collins is a vulnerable senator up for reelection in a state where Trump is not popular. Gardner has criticized the House impeachment effort as overly partisan and fretted that it will sharply divide the country.

While Trump is under water in Colorado, a GOP strategist says Gardner and other Republicans could benefit from an energized GOP base if the Senate, as expected, acquits Trump of the two articles of impeachment approved by the House. An acquittal “may have a substantial impact on other races in Colorado, up to and including Sen. Cory Gardner’s re-election,” Ryan Lynch told Colorado Public Radio.

Martha McSally, R-Ariz.

McSally, who was appointed to her seat after losing a Senate bid in 2018, is another vulnerable Republican seeking election this fall. She calls impeachment a serious matter and said she hopes her constituents would want her to examine the facts without partisanship. The American people “want us to take a serious look at this and not have it be just partisan bickering going on,” she told The Arizona Republic.

Lamar Alexander, R-Tenn.

A three-term senator and former governor, Alexander is retiring next year. A moderate who’s respected by both parties as an old-school defender of Senate prerogatives, Alexander has called Trump’s conduct “inappropriate,” but says he views impeachment as a “mistake.’’

An election, which “is just around the corner, is the right way to decide who should be president,’’ Alexander said last fall. “Impeachment has never removed a president. It will only divide the country further.”

Spanish Fork woman places third in 'world's strongest' competition, discusses body image

Nov. 3 at the Ocean Center Arena Daytona Beach, Florida, is a date Rebecca Rowley of Spanish Fork won’t soon forget. After three days of competing against women from all over the world at the Strongman Games, Rowley beat out all but two, bringing home the title of third strongest woman on the planet.

The three-day competition consisted of events including progressive deadlifts in the 200-, 300- and 400-pound range; lifting over 200-pounds in overhead weight presses; walking three times across a 50-foot floor while carrying 200-pounds of dead weight, only to drag the combined 600-pounds back to the start; and lifting over 200-pounds up four large stairs three times.

According to Rowley, she has been preparing for this event for several months and years — perhaps even her entire life.

It was in second grade when Rowley noticed she was different from other girls. She had crooked teeth and hair she described as difficult to manage, and found herself being the subject of a lot of bullying. If these things weren’t hard enough for a child to deal with, Rowley was built differently from other girls, and said it was in elementary school when she began struggling with body dysmorphia.

“I was a thick, athletic girl, and wasn’t like many of the other girls,” she said. “I got teased, and I remember setting weight loss goals in elementary school. I remember people commenting on how dedicated I was at physical exercise, but if they only knew what was behind it all.”

A turning point happened in junior high when she joined track and field, focussing on the throwing events. This is when Rowley said she found a use for her strong build.

“When I was in seventh grade, I joined the track and field team, so my focus shifted from losing weight to becoming stronger,” she said. “I was good at it and it gave me confidence. I had to eat to be strong, and I had to train to be strong.”

Rowley’s newfound confidence and abilities earned her star athlete status as a thrower for Spanish Fork High School and then at the collegiate level at Weber State and Utah Valley universities throwing the discus and hammer.

She soon had her sights set on having a family and becoming a mother, and in time gave birth to two sons. And while she kept in good shape, even being a personal fitness trainer, Rowley sad she longed to be a competitive athlete at the top of her game again.

“I spent 7½ years away from competitive sports,” she said. “Being fit wasn’t enough for me because I have always been attached to a sport. I need to be part of something.”

In her profession as a fitness trainer, Rowley trained men to compete in the Strongman Games, and while doing so, decided she wanted to see how she would fair in competition. She eventually worked up to competing on a national level with Olympic Lifting. In 2017, she entered the Strongman Games finishing seventh place, and in 2018, she missed the podium by one, bringing home fourth place. She refocused for 2019, setting her sights on a podium finish, and achieved her goal.

Even after having achieved her goal, Rowley said being one of the strongest women in the world is so much more than that. The single mother of two who spent years being bullied and even more time working to define what it is to be a woman, said she wants to change how other girls see themselves.

“I love weight lifting because it’s a sport that allows for more body types to be celebrated,” she said. “Being part of competitive weight lifting has given me the chance to surround myself with other women who were ready to abandon society’s idea of what a woman should look like. It’s awesome to celebrate that my shoulders are bigger than the average man’s, and that the body I was embarrassed to have is beautiful. I can honestly say that I don’t want to look like that; I want to look like me.’”

As far as whether or not Rowley has her sights on another World Class standing is yet to be determined, but she says she’s not ruling it out.

“Training for these competitions takes a lot of time and money,” she said. “As a single mother and business owner, it is hard to know what to expect year to year, but you never know; I may try again. Right now, I am focusing on my family, my fitness and the fitness of those I train everyday.”

To continue to follow Rowley’s story, you can find her on Facebook on her Elevated Personal Training page or on Instagram @rebecca_rowleybear.