Addiction, addiction-treatment, Author Interviews, Opiods / 13.10.2025
New Geisinger Study finds steep decline in hydromorphone use in America over the last decade
MedicalResearch.com Interview with:
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Krisha S. Patel[/caption]
Krisha S. Patel
Center For Pharmacy Innovation and Outcomes
Geisinger College Health Sciences
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Hydromorphone is a powerful opioid medication approved for treating moderate to severe acute pain, as well as chronic pain that doesn’t respond to other treatments. One brand name is Dilaudid. It is much more potent than morphine, about 5 to 10 times stronger, and crosses the blood-brain barrier more efficiently. Hydromorphone comes in several forms, including oral powders, solutions, immediate- and extended-release tablets, and injectable options like intravenous, intramuscular, and subcutaneous.
Like morphine, hydromorphone primarily targets the mu-opioid receptors, with some activity at delta receptors. Its higher fat solubility gives it a faster onset of action than morphine, though not as rapid as fentanyl. Due to its potency and risk for misuse and overdose, hydromorphone is typically prescribed only when other pain management options have failed. According to the RADARS StreetRx Program, in 2023, the black-market value of a 1 mg immediate-release tablet was about $15,000 annually, with extended-release tablets reaching $62,000 for a full-years supply.
While previous studies have explored regional differences in the use of opioids like morphine, oxycodone, and codeine, hydromorphone has not been examined. This study aims to fill that gap by analyzing state-level and temporal trends in hydromorphone use across the US from 2010 to 2023. It draws on data from three major sources: the Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS), Medicaid, and Medicare Part D. By comparing these datasets, this report also explores how hydromorphone distribution and prescribing patterns have evolved over time.
Krisha S. Patel[/caption]
Krisha S. Patel
Center For Pharmacy Innovation and Outcomes
Geisinger College Health Sciences
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Hydromorphone is a powerful opioid medication approved for treating moderate to severe acute pain, as well as chronic pain that doesn’t respond to other treatments. One brand name is Dilaudid. It is much more potent than morphine, about 5 to 10 times stronger, and crosses the blood-brain barrier more efficiently. Hydromorphone comes in several forms, including oral powders, solutions, immediate- and extended-release tablets, and injectable options like intravenous, intramuscular, and subcutaneous.
Like morphine, hydromorphone primarily targets the mu-opioid receptors, with some activity at delta receptors. Its higher fat solubility gives it a faster onset of action than morphine, though not as rapid as fentanyl. Due to its potency and risk for misuse and overdose, hydromorphone is typically prescribed only when other pain management options have failed. According to the RADARS StreetRx Program, in 2023, the black-market value of a 1 mg immediate-release tablet was about $15,000 annually, with extended-release tablets reaching $62,000 for a full-years supply.
While previous studies have explored regional differences in the use of opioids like morphine, oxycodone, and codeine, hydromorphone has not been examined. This study aims to fill that gap by analyzing state-level and temporal trends in hydromorphone use across the US from 2010 to 2023. It draws on data from three major sources: the Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS), Medicaid, and Medicare Part D. By comparing these datasets, this report also explores how hydromorphone distribution and prescribing patterns have evolved over time.
Dr. King[/caption]
Brett King, MD, PHD
Dr. King was named an American Academy of Dermatology (AAD) “Patient Care Hero”
for his work treating patients with severe alopecia areata
Dermatology Physicians of Connecticut
Fairfield, Connecticut
MedicalResearch.com: What is the background for this study? Would you briefly explain the condition of Alopecia Areata?
Response: Alopecia Areata (AA), an autoimmune form of hair loss, is common and its treatment has been revolutionized in the past ~3 years with approvals of 3 JAK inhibitors, bariticinib, ritlecitinib and deuruxolitinib. Prior to these approvals, off label treatments included the JAK inhibitors tofacitinib and ruxolitinib.
Prof. Lemesle[/caption]
Gilles Lemesle, M.D., Ph.D
Lille University Hospital, Lille, France
Dr. Casale[/caption]
Thomas B. Casale, M.D.
Professor of Medicine and Pediatrics
Chief of Clinical and Translational Research
Division of Allergy and Immunology
USF Health Morsani College of Medicine
University of South Florida
Tampa, Florida
MedicalResearch.com: What is the background for this study?
Response: The data leading to FDA approval of neffy came from extensive pharmacokinetic and pharmacodynamic studies. As with previous epinephrine delivery devices, the FDA asked for data showing that after delivery of neffy the epinephrine blood levels and expected changes in pulse and blood pressure were similar to those achieved with injectable formulations of epinephrine. neffy performed as expected with blood levels of epinephrine bracketed by those achieved with EpiPen and a needle and syringe along with increases in pulse and blood pressure compatible with the epinephrine levels measured.
Additionally, clinicians are interested in whether neffy would perform similarly in real clinical situations. The data from the neffy experience program provides real-world assurance that neffy can effectively treat acute allergic reactions. Given the large number of patients and the similar findings to those achieved with injectable epinephrine in previous studies, the data should provide assurance that neffy can be an effective substitute for injectable epinephrine in patients that desire a needle-free option.
Maria Tan[/caption]
MedicalResearch.com:
Maria Y. Tian, MBS
Department of Medical Education
Geisinger College of Health Sciences
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Schizophrenia-spectrum disorders are severe, disabling conditions that are associated with substantial economic burden. Approximately one-third of patients have treatment-resistant schizophrenia, which clozapine is the only evidence-based therapy for. Clozapine also provides unique benefits, including reduced suicide risk, aggression, and all-cause mortality. Despite this, it has historically been underutilized due to concerns over adverse effects, required blood monitoring, patient adherence, and limited clinician training. Previous research in Medicaid populations had demonstrated marked state-level variation in use, but little was known about prescribing trends in the U.S. Medicare system, which covers nearly half of individuals with schizophrenia. This study analyzed Medicare Part D data from 2015–2020 to assess national and regional trends in clozapine prescribing and to identify states with significantly different prescribing patterns.
Dr. Donofry[/caption]
Shannon D. Donofry Ph.D.
Behavioral Scientist
B.A.Sc. in psychology/neuroscience
University of Pittsburgh-Pittsburgh Campus;
Ph.D, University of Pittsburgh-Pittsburgh Campus
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Dr. Rancaño[/caption]
Katherine M. Rancaño, Ph.D
Associate Policy Researcher
RAND
MedicalResearch.com: What is the background for this study?
Response: GLP-1 medications were first used to help people with diabetes manage their blood sugar. Lately, they’ve become popular for helping people lose weight, too. Because of this, a lot more people have started using them. In our study, we asked over 8,000 adults from across the country about their use of GLP-1 medications and any side effects they had.