Aspenti Health, VT Lab, is committed to remaining open through this ongoing epidemic. Click the button below for testing center locations and hours of operations during the Covid-19 pandemic
WP_Query Object
(
[query] => Array
(
[tag] => overdose-death
)
[query_vars] => Array
(
[tag] => overdose-death
[error] =>
[m] =>
[p] => 0
[post_parent] =>
[subpost] =>
[subpost_id] =>
[attachment] =>
[attachment_id] => 0
[name] =>
[pagename] =>
[page_id] => 0
[second] =>
[minute] =>
[hour] =>
[day] => 0
[monthnum] => 0
[year] => 0
[w] => 0
[category_name] =>
[cat] =>
[tag_id] => 1640
[author] =>
[author_name] =>
[feed] =>
[tb] =>
[paged] => 0
[meta_key] =>
[meta_value] =>
[preview] =>
[s] =>
[sentence] =>
[title] =>
[fields] =>
[menu_order] =>
[embed] =>
[category__in] => Array
(
)
[category__not_in] => Array
(
)
[category__and] => Array
(
)
[post__in] => Array
(
)
[post__not_in] => Array
(
)
[post_name__in] => Array
(
)
[tag__in] => Array
(
)
[tag__not_in] => Array
(
)
[tag__and] => Array
(
)
[tag_slug__in] => Array
(
[0] => overdose-death
)
[tag_slug__and] => Array
(
)
[post_parent__in] => Array
(
)
[post_parent__not_in] => Array
(
)
[author__in] => Array
(
)
[author__not_in] => Array
(
)
[ignore_sticky_posts] =>
[suppress_filters] =>
[cache_results] => 1
[update_post_term_cache] => 1
[lazy_load_term_meta] => 1
[update_post_meta_cache] => 1
[post_type] =>
[posts_per_page] => 10
[nopaging] =>
[comments_per_page] => 50
[no_found_rows] =>
[order] => DESC
)
[tax_query] => WP_Tax_Query Object
(
[queries] => Array
(
[0] => Array
(
[taxonomy] => post_tag
[terms] => Array
(
[0] => overdose-death
)
[field] => slug
[operator] => IN
[include_children] => 1
)
)
[relation] => AND
[table_aliases:protected] => Array
(
[0] => wp_term_relationships
)
[queried_terms] => Array
(
[post_tag] => Array
(
[terms] => Array
(
[0] => overdose-death
)
[field] => slug
)
)
[primary_table] => wp_posts
[primary_id_column] => ID
)
[meta_query] => WP_Meta_Query Object
(
[queries] => Array
(
)
[relation] =>
[meta_table] =>
[meta_id_column] =>
[primary_table] =>
[primary_id_column] =>
[table_aliases:protected] => Array
(
)
[clauses:protected] => Array
(
)
[has_or_relation:protected] =>
)
[date_query] =>
[queried_object] => WP_Term Object
(
[term_id] => 1640
[name] => overdose death
[slug] => overdose-death
[term_group] => 0
[term_taxonomy_id] => 1640
[taxonomy] => post_tag
[description] =>
[parent] => 0
[count] => 3
[filter] => raw
[term_order] => 0
)
[queried_object_id] => 1640
[request] => SELECT SQL_CALC_FOUND_ROWS wp_posts.ID FROM wp_posts LEFT JOIN wp_term_relationships ON (wp_posts.ID = wp_term_relationships.object_id) WHERE 1=1 AND (
wp_term_relationships.term_taxonomy_id IN (1640)
) AND wp_posts.post_type = 'post' AND (wp_posts.post_status = 'publish' OR wp_posts.post_status = 'acf-disabled') GROUP BY wp_posts.ID ORDER BY wp_posts.post_date DESC LIMIT 0, 10
[posts] => Array
(
[0] => WP_Post Object
(
[ID] => 59397
[post_author] => 13
[post_date] => 2019-02-21 11:54:12
[post_date_gmt] => 2019-02-21 16:54:12
[post_content] => Deaths related to opioid overdoses dropped from 35 (in Chittenden County) in 2017, to 17 deaths in 2018. That's a steady decline for Vermont's most populated county and the lowest level they have seen in six years. However, the rates across the rest of the counties in Vermont increased by 36 percent, totaling to 110 deaths this past year, which is up from 108 in 2017. That total is actually a new record for the state of Vermont.
The mayor of Burlington, Miro Weinberger, claims the decrease is due to the area's support of MAT, medication-assisted treatment, and joint efforts between Chittenden County Opioid Alliance, hospitals, and local law enforcement. For example, Burlington police have made a promise to not arrest those with buprenorphine found on them, a medication that is used to reduce symptoms of opioid withdrawal. Vermont uses a "hub and spoke" system for the MAT treatment, there are intensive treatment facilities acting as "hubs" and regional, local treatment that is continuous, "spokes".
Fentanyl-related deaths increased and the dangerous synthetic opioid was involved in 75 percent of the opioid related deaths last year. That number was triple the amount from 2015 and heroin was involved in 55 percent of the fatalities, often mixed with fentanyl. A majority of these deaths were accidental, and the remaining were not conclusive.
References:
Seven Days (2018)."Opioid Deaths Rise in Vermont but Plummet in Chittenden County" https://www.sevendaysvt.com/OffMessage/archives/2019/02/14/opioid-deaths-rise-in-vermont-but-plummet-in-chittenden-county
Burlington Free Press (2018). "Opioid Deaths down 50 percent in Chittenden County" https://www.burlingtonfreepress.com/story/news/2019/02/15/opioid-deaths-down-50-percent-chittenden-county-vermont/2882146002/
[post_title] => Opioid-Related Deaths Dropped 50 Percent in Chittenden County in 2018
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => chittenden-county-opioid-death-decrease
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:29:55
[post_modified_gmt] => 2019-10-21 20:29:55
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59397
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[1] => WP_Post Object
(
[ID] => 59348
[post_author] => 13
[post_date] => 2019-01-17 15:33:22
[post_date_gmt] => 2019-01-17 20:33:22
[post_content] => The National Safety Council released a study stating that Americans are more likely to die from an accidental opioid overdose than a vehicle crash.
“The group analyzed preventable injuries and deaths in 2017 and found the odds of dying by accidental opioid overdose to be 1 in 96 and the odds of a motor vehicle crash 1 in 103.”
Each day, 130 Americans die after overdosing on opioids, according to the Centers for Disease Control and Prevention. The drug headlining many of these overdose deaths is illicit fentanyl; a powerful and dangerous synthetic opioid that has spread like wildfire in black markets for drugs.
How did we get to this point? How did we arrive at a point in US history where more people are dying from an opioid overdose than a car accident?
In the 1990’s pain pills were aggressively marketed by pharmaceutical companies to doctors, and marketed as being “safe”. This led doctors to prescribe pain pills more often, and in higher amounts. Eventually, many patients became addicted and the federal government brought criminal charges to companies for marketing their pain pills as being safer and less addictive then other opioids. In the last 15 years, the DEA and CDC have worked hard to create regulations surrounding pain pills and prescribing them.
The CDC has reported that the national life expectancy rate is declining as the number of fatal opioid overdoses rise. Those born in 2017 are expected to live to be 78.6 years old, whereas babies born in 2016 had a 1.2 month higher life expectancy. Stats like this one make the epidemic a very real and scary crisis.
However, there are many solutions that can be applied such as expanding access to addiction treatment, giving easier access to medications such as buprenorphine, that treat addiction and reduce mortality rate for patients.
“Vermont saw its overdose death rate drop by around 6 percent in 2017 with the continued expansion of a hub and spoke system that integrates addiction treatment into the rest of health care. Rhode Island also saw a roughly 2 percent drop, as it implemented, among other changes, better access to opioid addiction medications in its prisons and jails. And Massachusetts saw a roughly 3 percent drop, along with a public health campaign that has emphasized more addiction treatment, including in emergency rooms, and fewer painkiller prescriptions.”
References:
Beth Leipholtz (2018). Opioid Overdose Deaths Surpass Vehicle Crash Deaths For First Time. https://www.thefix.com/opioid-overdose-deaths-surpass-vehicle-crash-deaths-first-time
German Lopez (2018). Americans are now more likely to die from opioid overdoses than car crashes. https://www.vox.com/science-and-health/2019/1/15/18183815/opioid-epidemic-car-crashes-national-safety-council
Jessica Bursztynsky (2018) Americans more likely to die from opioid overdose today than car accident. https://www.cnbc.com/2019/01/15/americans-more-likely-to-die-from-opioid-overdose-than-car-accident.html
[post_title] => Surprisingly, Americans Are More Likely to Perish from an Opioid Overdose Than This...
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => opioid-overdose-death
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:30:35
[post_modified_gmt] => 2019-10-21 20:30:35
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59348
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[2] => WP_Post Object
(
[ID] => 59325
[post_author] => 13
[post_date] => 2018-12-05 13:37:30
[post_date_gmt] => 2018-12-05 18:37:30
[post_content] => Methamphetamine has always been an issue in more rural states, but recently Massachusetts has seen an influx of meth overdoses in the Boston area. In a recent study from the National Emerging Threats Initiative (NETI), most of the meth sold in the United States is produced in Mexico, then shipped through suppliers that are also dealing in cocaine, fentanyl, and heroin.
It was once thought that the arrest of "Chapo" Guzman in 2016 would create a substantial decline in methamphetamine manufacturing. However, the emergence of the Jalisco New Generation Cartel and the re-organization of the Sinaloa Cartel increased the problem within the last 2 years.
“New initiates of methamphetamine use (people who had not previously used methamphetamines) increased by 47% from 133,000 in 2010 to 195,000 in 2017. At the same time, HIDTA seizures of methamphetamine increased from 256% from 8,021kg in 2011 to 28,558 kg in 2017.”
[caption id="attachment_59335" align="aligncenter" width="600"] The above graph reflects the change in methamphetamine/ice seizures, in terms of amount seized (in kilograms) and the total number of incidents (reported in Kg, dosage units and liter forms) within all HIDTA counties from 2011[/caption]
Individuals usually start with heroin that is being cut with meth, and then move on to straight meth. Meth users don’t feel as sick when they are coming down from the high and meth is cheaper than heroin. However, despite meth being an easier option for it’s users, it is not for treatment options within hospitals and clinics.
Meth overdoses have increased across the United States, and while we may not see the full impact of the influx of meth in Boston right now, it'll show up in a few years. The meth issue is compounding the opioid epidemic, because while patients addicted to fentanyl or heroin are usually prescribed a medication to curb cravings, patients have been trying to use meth while in treatment for their opioid addiction to help cope. It appears the opioid epidemic has set itself on a larger scale, with cocaine and methamphetamines and is becoming more of a drug epidemic.
References:
Martha Bebinger (2018). Meth Use Is Rising In Boston, Intensifying The Opioid Crisis. http://www.wbur.org/commonhealth/2018/11/21/meth-worsening-opioid-epidemic
National Emerging Threats Initiative (2018). Emergening Threats Report 2018: Status and Factors Affecting the United States. https://d279m997dpfwgl.cloudfront.net/wp/2018/11/1120_emerging-threats-report.pdf
[post_title] => Why is Meth Use on the Rise in Boston?
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => meth-in-boston
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:31:06
[post_modified_gmt] => 2019-10-21 20:31:06
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59325
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 1
[filter] => raw
)
)
[post_count] => 3
[current_post] => -1
[in_the_loop] =>
[post] => WP_Post Object
(
[ID] => 59397
[post_author] => 13
[post_date] => 2019-02-21 11:54:12
[post_date_gmt] => 2019-02-21 16:54:12
[post_content] => Deaths related to opioid overdoses dropped from 35 (in Chittenden County) in 2017, to 17 deaths in 2018. That's a steady decline for Vermont's most populated county and the lowest level they have seen in six years. However, the rates across the rest of the counties in Vermont increased by 36 percent, totaling to 110 deaths this past year, which is up from 108 in 2017. That total is actually a new record for the state of Vermont.
The mayor of Burlington, Miro Weinberger, claims the decrease is due to the area's support of MAT, medication-assisted treatment, and joint efforts between Chittenden County Opioid Alliance, hospitals, and local law enforcement. For example, Burlington police have made a promise to not arrest those with buprenorphine found on them, a medication that is used to reduce symptoms of opioid withdrawal. Vermont uses a "hub and spoke" system for the MAT treatment, there are intensive treatment facilities acting as "hubs" and regional, local treatment that is continuous, "spokes".
Fentanyl-related deaths increased and the dangerous synthetic opioid was involved in 75 percent of the opioid related deaths last year. That number was triple the amount from 2015 and heroin was involved in 55 percent of the fatalities, often mixed with fentanyl. A majority of these deaths were accidental, and the remaining were not conclusive.
References:
Seven Days (2018)."Opioid Deaths Rise in Vermont but Plummet in Chittenden County" https://www.sevendaysvt.com/OffMessage/archives/2019/02/14/opioid-deaths-rise-in-vermont-but-plummet-in-chittenden-county
Burlington Free Press (2018). "Opioid Deaths down 50 percent in Chittenden County" https://www.burlingtonfreepress.com/story/news/2019/02/15/opioid-deaths-down-50-percent-chittenden-county-vermont/2882146002/
[post_title] => Opioid-Related Deaths Dropped 50 Percent in Chittenden County in 2018
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => chittenden-county-opioid-death-decrease
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:29:55
[post_modified_gmt] => 2019-10-21 20:29:55
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59397
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[comment_count] => 0
[current_comment] => -1
[found_posts] => 3
[max_num_pages] => 1
[max_num_comment_pages] => 0
[is_single] =>
[is_preview] =>
[is_page] =>
[is_archive] => 1
[is_date] =>
[is_year] =>
[is_month] =>
[is_day] =>
[is_time] =>
[is_author] =>
[is_category] =>
[is_tag] => 1
[is_tax] =>
[is_search] =>
[is_feed] =>
[is_comment_feed] =>
[is_trackback] =>
[is_home] =>
[is_privacy_policy] =>
[is_404] =>
[is_embed] =>
[is_paged] =>
[is_admin] =>
[is_attachment] =>
[is_singular] =>
[is_robots] =>
[is_favicon] =>
[is_posts_page] =>
[is_post_type_archive] =>
[query_vars_hash:WP_Query:private] => 32712b4d92eeea8c9c3007b34eb335ca
[query_vars_changed:WP_Query:private] =>
[thumbnails_cached] => 1
[stopwords:WP_Query:private] =>
[compat_fields:WP_Query:private] => Array
(
[0] => query_vars_hash
[1] => query_vars_changed
)
[compat_methods:WP_Query:private] => Array
(
[0] => init_query_flags
[1] => parse_tax_query
)
)
References:
Seven Days (2018)."Opioid Deaths Rise in Vermont but Plummet in Chittenden County" https://www.sevendaysvt.com/OffMessage/archives/2019/02/14/opioid-deaths-rise-in-vermont-but-plummet-in-chittenden-county
Burlington Free Press (2018). "Opioid Deaths down 50 percent in Chittenden County" https://www.burlingtonfreepress.com/story/news/2019/02/15/opioid-deaths-down-50-percent-chittenden-county-vermont/2882146002/
[post_title] => Opioid-Related Deaths Dropped 50 Percent in Chittenden County in 2018
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => chittenden-county-opioid-death-decrease
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:29:55
[post_modified_gmt] => 2019-10-21 20:29:55
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59397
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[1] => WP_Post Object
(
[ID] => 59348
[post_author] => 13
[post_date] => 2019-01-17 15:33:22
[post_date_gmt] => 2019-01-17 20:33:22
[post_content] => The National Safety Council released a study stating that Americans are more likely to die from an accidental opioid overdose than a vehicle crash.
“The group analyzed preventable injuries and deaths in 2017 and found the odds of dying by accidental opioid overdose to be 1 in 96 and the odds of a motor vehicle crash 1 in 103.”
Each day, 130 Americans die after overdosing on opioids, according to the Centers for Disease Control and Prevention. The drug headlining many of these overdose deaths is illicit fentanyl; a powerful and dangerous synthetic opioid that has spread like wildfire in black markets for drugs.
How did we get to this point? How did we arrive at a point in US history where more people are dying from an opioid overdose than a car accident?
In the 1990’s pain pills were aggressively marketed by pharmaceutical companies to doctors, and marketed as being “safe”. This led doctors to prescribe pain pills more often, and in higher amounts. Eventually, many patients became addicted and the federal government brought criminal charges to companies for marketing their pain pills as being safer and less addictive then other opioids. In the last 15 years, the DEA and CDC have worked hard to create regulations surrounding pain pills and prescribing them.
The CDC has reported that the national life expectancy rate is declining as the number of fatal opioid overdoses rise. Those born in 2017 are expected to live to be 78.6 years old, whereas babies born in 2016 had a 1.2 month higher life expectancy. Stats like this one make the epidemic a very real and scary crisis.
However, there are many solutions that can be applied such as expanding access to addiction treatment, giving easier access to medications such as buprenorphine, that treat addiction and reduce mortality rate for patients.
“Vermont saw its overdose death rate drop by around 6 percent in 2017 with the continued expansion of a hub and spoke system that integrates addiction treatment into the rest of health care. Rhode Island also saw a roughly 2 percent drop, as it implemented, among other changes, better access to opioid addiction medications in its prisons and jails. And Massachusetts saw a roughly 3 percent drop, along with a public health campaign that has emphasized more addiction treatment, including in emergency rooms, and fewer painkiller prescriptions.”
References:
Beth Leipholtz (2018). Opioid Overdose Deaths Surpass Vehicle Crash Deaths For First Time. https://www.thefix.com/opioid-overdose-deaths-surpass-vehicle-crash-deaths-first-time
German Lopez (2018). Americans are now more likely to die from opioid overdoses than car crashes. https://www.vox.com/science-and-health/2019/1/15/18183815/opioid-epidemic-car-crashes-national-safety-council
Jessica Bursztynsky (2018) Americans more likely to die from opioid overdose today than car accident. https://www.cnbc.com/2019/01/15/americans-more-likely-to-die-from-opioid-overdose-than-car-accident.html
[post_title] => Surprisingly, Americans Are More Likely to Perish from an Opioid Overdose Than This...
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => opioid-overdose-death
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:30:35
[post_modified_gmt] => 2019-10-21 20:30:35
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59348
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[2] => WP_Post Object
(
[ID] => 59325
[post_author] => 13
[post_date] => 2018-12-05 13:37:30
[post_date_gmt] => 2018-12-05 18:37:30
[post_content] => Methamphetamine has always been an issue in more rural states, but recently Massachusetts has seen an influx of meth overdoses in the Boston area. In a recent study from the National Emerging Threats Initiative (NETI), most of the meth sold in the United States is produced in Mexico, then shipped through suppliers that are also dealing in cocaine, fentanyl, and heroin.
It was once thought that the arrest of "Chapo" Guzman in 2016 would create a substantial decline in methamphetamine manufacturing. However, the emergence of the Jalisco New Generation Cartel and the re-organization of the Sinaloa Cartel increased the problem within the last 2 years.
“New initiates of methamphetamine use (people who had not previously used methamphetamines) increased by 47% from 133,000 in 2010 to 195,000 in 2017. At the same time, HIDTA seizures of methamphetamine increased from 256% from 8,021kg in 2011 to 28,558 kg in 2017.”
[caption id="attachment_59335" align="aligncenter" width="600"]
The above graph reflects the change in methamphetamine/ice seizures, in terms of amount seized (in kilograms) and the total number of incidents (reported in Kg, dosage units and liter forms) within all HIDTA counties from 2011[/caption]
Individuals usually start with heroin that is being cut with meth, and then move on to straight meth. Meth users don’t feel as sick when they are coming down from the high and meth is cheaper than heroin. However, despite meth being an easier option for it’s users, it is not for treatment options within hospitals and clinics.
Meth overdoses have increased across the United States, and while we may not see the full impact of the influx of meth in Boston right now, it'll show up in a few years. The meth issue is compounding the opioid epidemic, because while patients addicted to fentanyl or heroin are usually prescribed a medication to curb cravings, patients have been trying to use meth while in treatment for their opioid addiction to help cope. It appears the opioid epidemic has set itself on a larger scale, with cocaine and methamphetamines and is becoming more of a drug epidemic.
References:
Martha Bebinger (2018). Meth Use Is Rising In Boston, Intensifying The Opioid Crisis. http://www.wbur.org/commonhealth/2018/11/21/meth-worsening-opioid-epidemic
National Emerging Threats Initiative (2018). Emergening Threats Report 2018: Status and Factors Affecting the United States. https://d279m997dpfwgl.cloudfront.net/wp/2018/11/1120_emerging-threats-report.pdf
[post_title] => Why is Meth Use on the Rise in Boston?
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => meth-in-boston
[to_ping] =>
[pinged] =>
[post_modified] => 2019-10-21 16:31:06
[post_modified_gmt] => 2019-10-21 20:31:06
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://aspenti.com/?p=59325
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 1
[filter] => raw
)
)
[post_count] => 3
[current_post] => -1
[in_the_loop] =>
[post] => WP_Post Object
(
[ID] => 59397
[post_author] => 13
[post_date] => 2019-02-21 11:54:12
[post_date_gmt] => 2019-02-21 16:54:12
[post_content] => Deaths related to opioid overdoses dropped from 35 (in Chittenden County) in 2017, to 17 deaths in 2018. That's a steady decline for Vermont's most populated county and the lowest level they have seen in six years. However, the rates across the rest of the counties in Vermont increased by 36 percent, totaling to 110 deaths this past year, which is up from 108 in 2017. That total is actually a new record for the state of Vermont.
The mayor of Burlington, Miro Weinberger, claims the decrease is due to the area's support of MAT, medication-assisted treatment, and joint efforts between Chittenden County Opioid Alliance, hospitals, and local law enforcement. For example, Burlington police have made a promise to not arrest those with buprenorphine found on them, a medication that is used to reduce symptoms of opioid withdrawal. Vermont uses a "hub and spoke" system for the MAT treatment, there are intensive treatment facilities acting as "hubs" and regional, local treatment that is continuous, "spokes".
Fentanyl-related deaths increased and the dangerous synthetic opioid was involved in 75 percent of the opioid related deaths last year. That number was triple the amount from 2015 and heroin was involved in 55 percent of the fatalities, often mixed with fentanyl. A majority of these deaths were accidental, and the remaining were not conclusive.