Weight Loss Procedures Can Double Blood Alcohol Absorption

MedicalResearch.com Interview with:

“Alcohol” by Takahiro Yamagiwa is licensed under CC BY 2.0


Marta Yanina Pepino PhD

Department of Food Science and Human Nutrition
College of Agricultural, Consumer and Environmental Sciences
University of Illinois
Urbana, IL 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study is not the first to look at whether sleeve gastrectomy affects alcohol absorption and metabolism. Before our study, there were three published studies in the literature on this issue. However, findings from these studies were discrepant. Two of the studies found that sleeve gastrectomy did not affect blood alcohol levels and one of the studies did found that peak blood alcohol levels were higher when people drink after having a sleeve gastrectomy. All these three studies used a breathalyzer to estimate blood alcohol levels.

Our study tested the following two related hypothesis.

First, that similar to Roux-en-Y- gastric bypass (RYGB), sleeve gastrectomy accelerates alcohol absorption, which cause peak blood alcohol levels to be higher and much faster than before surgery. Because the breathalyzer requires a 15 min of waiting time between drinking the last sip of alcohol and the time that you can read a good estimate of blood alcohol levels from the breath, we hypothesized that the breathalyzer was not a good technique to estimate peak blood alcohol levels in people who may reach a peak blood alcohol level before those 15 min have passed, such as people who underwent sleeve gastrectomy or RYGB.

We found these two hypothesis to be truth:

1) Sleeve gastrectomy, similar to RYGB, can double blood alcohol levels; and

2) The breathalyzer technique is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol (it underestimate blood alcohol levels by ~27% and it may miss peak blood alcohol levels).

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What Impact Have State-Level Laws Had on Marijuana Use?

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Christine Mauro PhD Assistant Professor Biostatistics Columbia University Medical Center   MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  As of November 2016, 28 states have legalized medical marijuana. Several previous studies have found an increase in use for adults after legalization, but not for adolescents.  We wanted to examine whether these age-specific findings varied by gender.  Consistent with past findings, we found past-month marijuana use did not increase after enactment of medical marijuana laws in men or women ages 12-25. Among people 26+, past-month marijuana use increased for men from 7.0% before to 8.7% after enactment (+1.7%, p<0.001) and for women from 3.1% before to 4.3% after enactment (+1.1%, p=0.013). Daily marijuana use also increased after enactment in this age group for both genders (men: 16.3% to 19.1%, +2.8 %, p=0.014; women: 9.2% to 12.7%, +3.4%, p=0.003). There were no statistically significant increases in past-year Marijuana Use Disorder prevalence for any age or gender group after medical marijuana law enactment.    MedicalResearch.com: What should clinicians and patients take away from your report? Response:  The readers should take away several things.  First, despite men being more likely to use marijuana than women are in all age groups, there were relatively few gender differences in terms of the impact of medical marijuana on marijuana use. Second, we found no evidence of an effect of medical marijuana law enactment in any marijuana use outcome for both men and women aged 12-17.  Lastly, we did see an increase in both past-month use and daily use among past-year users in both men and women aged 26+ after enactment, but no changes in past year marijuana used disorder.    MedicalResearch.com: What recommendations do you have for future research as a result of this study?  Response: Because most states in our sample more recently passed medical marijuana laws, it is possible that not enough time has elapsed to observe meaningful and significant changes in Marijuana Use Disorder. Given the impact Marijuana Use Disorder may have on individuals, families, and society, the prevalence of Marijuana Use Disorder should continue to be monitored regularly.   Second, there is considerable variation across provisions included in different states’ medical marijuana laws; some aspects, such as allowances on home cultivation or dispensaries, might have a role in changes in several health outcome indicators.  In addition, eight states have now legalized recreational marijuana, which may also have an impact on marijuana use outcomes over time. Future analyses should account for this variability in marijuana related policies.   MedicalResearch.com: Is there anything else you would like to add? Response: As marijuana use becomes more prevalent, monitoring state-wide trends in marijuana use by age and gender is important for public health planning. In particular, efforts to prevent and limit injury that may be associated with specific activities, such as driving, may be needed as daily marijuana use increases among adults. Downstream effects, either positive or negative, of a growing proportion of the adult population reporting daily marijuana use in states with medical marijuana laws warrants further attention. Disclosure: This work was supported by the National Institutes of Health, National Institute on Drug Abuse (grant R01 DA037866 to S. S. Martins).   MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.  Citation: Christine M. Mauro, Paul Newswanger, Julian Santaella-Tenorio, Pia M. Mauro, Hannah Carliner, Silvia S. Martins. Impact of Medical Marijuana Laws on State-Level Marijuana Use by Age and Gender, 2004–2013. Prevention Science, 2017; DOI: 10.1007/s11121-017-0848-3   Note:  Content is Not intended as medical advice.  Please consult your health care provider regarding your specific medical condition and questions.

Dr. Mauro

Christine Mauro PhD
Assistant Professor Biostatistics
Columbia University Medical Center 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As of November 2016, 28 states have legalized medical marijuana. Several previous studies have found an increase in use for adults after legalization, but not for adolescents.

We wanted to examine whether these age-specific findings varied by gender.  Consistent with past findings, we found past-month marijuana use did not increase after enactment of medical marijuana laws in men or women ages 12-25. Among people 26+, past-month marijuana use increased for men from 7.0% before to 8.7% after enactment (+1.7%, p<0.001) and for women from 3.1% before to 4.3% after enactment (+1.1%, p=0.013). Daily marijuana use also increased after enactment in this age group for both genders (men: 16.3% to 19.1%, +2.8 %, p=0.014; women: 9.2% to 12.7%, +3.4%, p=0.003).

There were no statistically significant increases in past-year Marijuana Use Disorder prevalence for any age or gender group after medical marijuana law enactment.

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No Clear Guidelines To Manage Pain After Surgical Procedures

MedicalResearch.com Interview with:
“Surgery” by mrpbps is licensed under CC BY 2.0
Sagar Patel MD
Facial Plastic Surgeon
Board Certified Otolaryngology, Head and Neck Surgeon
Facial Plastic Surgery Associates, Houston, Texas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While the majority of diverted opioids that are abused originate from pills prescribed for chronic conditions, with 214,000 rhinoplasties performed in the US in 2015, assessing opioid usage after rhinoplasty is an important view into prescription practices for acute pain after surgical procedures. Opioid use, pain control, and adverse effects were examined and opioid use was compared across patient demographic and surgical procedure characteristics, including rhinoplasty and septoplasty, open vs closed techniques, revision vs primary operations, reduction of turbinates, and use of osteotomies. Opioid use was self-reported as the number of prescribed tablets containing a combination of hydrocodone bitartrate (5 mg) and acetaminophen (325 mg) that were consumed. We them mathematically analyzed.

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Labels of Majority of Online Cannabidiol Extracts Contain Inaccuracies

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Marijuana plant (Cannabis sativa)

Marcel Bonn-Miller, PhD
Adjunct assistant professor
Department of Psychiatry
Leader of the Substance Abuse and Anxiety Program
U.S. Veterans Affairs Department 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A 2015 study found that edible cannabis products (e.g., brownies, cookies, drinks) are often mislabeled.  The FDA has also sent warning letters to a handful of companies selling cannabidiol extracts because of inaccurate labeling of content. This led us to conduct a systematic evaluation of the label accuracy of all cannabidiol extracts sold online.  We tested 84 products from 31 different companies.

The primary take-home of this study is that nearly 70 percent of all cannabidiol extracts sold online had over 10% more or less cannabidiol than advertised; 26% of products were over-labeled (less cannabidiol than indicated) and 42% of products were under-labeled (more cannabidiol than indicated).

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Medical Tetrahydrocannabinol May Be Beneficial For Seizures and Chemotherapy Side Effects

MedicalResearch.com Interview with:

Dr. Wong

Dr. Wong

Shane Shucheng Wong, MD
Massachusetts General Hospital
Boston, Massachusetts 

MedicalResearch.com: What is the background for this study?

Response: Medical cannabis is now legal in 29 states and the District of Columbia, and in those areas with active programs, children and adolescents can legally access medical cannabis with certification from their doctor and consent from a parent. This means that doctors and families need to understand what we know and what we don’t yet know about medical cannabis in order to make the best decision for the health of the individual child. Two synthetic cannabinoids – compounds that act on specific receptors in the brain – have been approved for medical use in the U.S., both of which mimic a form of THC (tetrahydrocannabinol), the compound responsible for the “high” of recreational cannabis use. Dronabinol (Marinol) is approved to treat chemotherapy-induced nausea and vomiting in both children and adults, while the pediatric use of nabilone (Cesamet) carries a caution. A third cannabinoid, cannabidiol, is currently in phase 3 trials for treatment of seizures.

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Methadone As First Line Opioid in Cancer Pain Management

MedicalResearch.com Interview with:

Sebastiano Mercadante, MD Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit La Maddalena Cancer Center Department of Anesthesia, Intensive Care & Emergencies University of Palermo Palermo, Italy

Dr. Mercadante

Sebastiano Mercadante, MD
Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit
La Maddalena Cancer Center
Department of Anesthesia, Intensive Care & Emergencies
University of Palermo
Palermo, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are many clinical experiences suggesting that methadone, when optimally used by skilled physicians, has invaluable properties in the management of cancer pain. Methadone used as first opioid may provide interesting advantages due to the low tendency to induce tolerance, while providing a clinical profile similar to that of other opioids. Moreover, methadone possesses other extra-opioid effects that can be of interest.

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Marijuana Use Linked To Cognitive Impairment In HIV Patients

MedicalResearch.com Interview with:

Richard Saitz, MD, MPH, FACP, DFASAM Department of Community Health Sciences Boston University School of Public Health Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine, Department of Medicin Boston University School of Medicine and Boston Medical Center Boston , Massachusetts

Dr. Saitz

Richard Saitz, MD, MPH, FACP, DFASAM
Department of Community Health Sciences
Boston University School of Public Health
Clinical Addiction Research and Education (CARE) Unit
Section of General Internal Medicine, Department of Medicin
Boston University School of Medicine and Boston Medical Center
Boston , Massachusetts

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many people living with HIV infection use alcohol and other drugs including marijuana. People with HIV infection are also susceptible to cognitive dysfunction from many causes from HIV infection itself to aging.

The main findings were that among people with HIV and substance use disorder, lifetime marijuana and alcohol use were not associated with cognitive dysfunction, likely due to competing risks.  But current marijuana use was associated with cognitive dysfunction.

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Half Of People Who Died of Opioid Overdoses Tested Positive For Fentanyl

MedicalResearch.com Interview with:
“no drugs” by Anderson Mancini is licensed under CC BY 2.0
Julie K. O’Donnell, PhD
Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The opioid overdose epidemic has killed over 300,000 Americans from 1999 to 2015—including 33,091 in 2015. Over this time, the epidemic has evolved from being primarily driven by prescription opioids to increasingly being driven by illicit opioids. The first wave of the epidemic began in 1999 with a steep increase in deaths involving prescription opioids, such as hydrocodone, oxycodone, and morphine. The second wave began in 2010 with rapid increases in overdose deaths involving heroin. The third wave of the epidemic began in 2013, with significant increases in overdose deaths involving synthetic opioids—particularly those involving illicitly-manufactured fentanyl (IMF), which are commonly laced into heroin products. Most recently, the IMF market continues to evolve, with an ever-widening array of illicitly manufactured fentanyl analogs being distributed.

This report indicates that over half of people in 10 states who died of opioid overdoses tested positive for fentanyl during the second half of 2016. The report found that out of a total of 5,152 opioid overdose deaths, almost 3,000 tested positive for fentanyl, and over 700 tested positive for drugs that have similar chemical structures to fentanyl (fentanyl analogs) – including the extremely potent fentanyl analog, carfentanil, which is used to sedate large animals.

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Fewer Patients Receiving Opioids Alone Following Hip or Knee Replacement

MedicalResearch.com Interview with:
Philipp Gerner

MD Candidate – Class of 2018
University of Massachusetts Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over 1 million patients undergo total joint replacement surgery in the United States alone every year, with many experiencing significant pain postoperatively. These procedures often require large amounts of pain medication to keep patients comfortable, which historically has been treated with opioids. Currently, increasing awareness of safe opioid prescribing has created an increased interest in other ways to effectively treat post-operative pain without the dangers and side-effects of opioids.

As part of an analysis of the impact of multimodal pain management (i.e. multiple drug classes or procedures to treat post-operative pain) and opioid usage, we conducted this study to considered how trends have changed over the last 10 years. Our data shows that opioid use for post-operative pain has declined substantially in patients undergoing total hip and knee arthroplasty (THA & TKA), two very common and often painful orthopedic procedures. Patients being treated with opioids alone for THA decreased from 47.6% in 2006 to 7.5% in 2016, with similar trends being seen in TKA patients.

Importantly, our data also showed that patients are increasingly being treated with a multimodal approach to pain control; especially patients being treated with 3 or more different pain modalities increased sharply in the last 10 years for both procedures in our study. This allows patients the benefit of managing their pain without many of the side-effect associated with large doses of a single pain medication. This trend was found to be especially true in small and medium sized hospitals, compared to larger hospitals. With increasing emphasis on limiting opioid use, this data shows us that the medical community is actively pursuing alternate possibilities for successfully treating post-operative pain.

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Trends in Opioid-Related Inpatient Stays Shifted After Switch to ICD-10 Coding

MedicalResearch.com Interview with:

Anne Elixhauser, Ph.D. Senior Research Scientist Agency for Healthcare Research and Quality Rockville MD 20857

Dr. Elixhauser

Anne Elixhauser, Ph.D.
Senior Research Scientist
Agency for Healthcare Research and Quality
Rockville MD 20857

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hospital inpatient data began using ICD-10-CM (I-10) codes on October 1, 2015.  We have been doing analysis using the new codeset to determine to what extent we can follow trends crossing the ICD transition—do the trends look consistent when we switch from I-9 to I-10?  Tracking the opioid epidemic is a high priority so we made this one of our first detailed analyses.  We were surprised to find that hospital stays jumped 14% across the transition, compared to a 5% quarterly increase before the transition (under I-9) and a 3.5% quarterly increase after the transition (under I-10).  The largest increase (63.2%) was for adverse effects in therapeutic use (side effects of legal drugs), whereas stays involving opioid abuse decreased 21% and opioid poisoning (overdose) decreased 12.4%.

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Overdose Deaths Increase Across Urban Status, Sex and Race Lines

MedicalResearch.com Interview with:
“Pills” by Kurtis Garbutt is licensed under CC BY 2.0
Christopher M. Jones, PharmD
Office of the Assistant Secretary for Planning and Evaluation
Office of the Secretary
U.S. Department of Health and Human Services 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Although prescription drugs, in particular opioid pain relievers, were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies.

We found that the prevalence of self-reported past-month use of illicit drugs increased significantly across urban status (large metropolitan, small metropolitan, and nonmetropolitan) between 2003-2005 and 2012-2014. Prevalence was higher for males than females, however, in the large metropolitan group, the percentage increase in prevalence from 2003–2005 to 2012–2014 was greater for females (23.4%) than for males (21.6%). There were notable differences by age. During 2012–2014, respondents aged 18–25 years had the highest prevalence of past-month use of illicit drugs for all urban levels. For respondents in this age group, the prevalence increased slightly from 2003–2005 to 2012–2014 in large metropolitan areas while the prevalence remained stable among small metropolitan area respondents and nonmetropolitan area respondents. Past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years), with the largest decline among small metropolitan area youth.

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Edible Marijuana Preferred By Consumers Due To Lack of Smoke and Convenience

MedicalResearch.com Interview with:

Sheryl Cates RTI International

Sheryl Cates

Sheryl Cates
RTI International
Durham, NC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The goal of this research was to provide a better understanding of consumer perceptions of edible marijuana products, including why users prefer edibles relative to other forms of marijuana such as smoking and vaping and concerns regarding the consumption of edibles. This is important as more states legalize the use of recreational marijuana products. With the increasing popularity of edibles, concerns exist that do not exist with other methods of using marijuana, such as smoking or vaping. These concerns include delayed activation time; accidental ingestion, particularly by children and older adults; and dose titration.

The study team conducted eight focus groups (four groups in Denver, Colorado, and four groups in Seattle, Washington) with users of edibles. Most participants preferred edibles to smoking marijuana because there is no smell from smoke and no secondhand smoke. Other reasons participants like edibles included convenience, discreetness, longer-lasting highs, less intense highs, and edibles’ ability to aid in relaxation, reduce anxiety, and alleviate pain more so than smoking marijuana. Concerns and dislikes about edibles included delayed effects, unexpected highs, the unpredictability of the high, and inconsistency of distribution of marijuana in the product. No participants in either location mentioned harmful health effects from consuming edibles as a concern.  Although focus group findings are not generalizable, the findings are useful for helping inform policy makers and regulators as they establish regulations regarding the manufacture, labeling, and sale of edibles.

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Vaporizing Cannabis May Lead To Release Of Benzene Carcinogens

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Marijuana plant (Cannabis sativa)

Jiries Meehan-Atrash
Department of Chemistry, Portland State University
Portland, Oregon 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The need for this study stems from the rising popularity of cannabis, and specifically the fact that many consumers are under the belief that vaporizing extracts thereof is safer than smoking. While this may in fact have some truth to it, it is clear that we must assess the safety of vaporization a route of administration.

The main findings are that vaporizing terpenes under dabbing conditions generates some levels of methacrolein (a noxious irritant) at all temperatures that are hot enough to vaporize cannabinoids, but significant levels arise at higher temperatures that are more commonly used.

At the highest temperature used by consumers, significant levels of benzene arise, a compound that is a potent carcinogen and should be avoided at all costs.

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Opioid Overdoses Biggest Cause of Decreasing Life Expectancy

MedicalResearch.com Interview with:
Dr. Deborah Dowell, MD MPH
Senior Medical Advisor
Division of Unintentional Injury Prevention
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: Increases in U.S. life expectancy at birth have leveled off from an average of 0.20 years gained per year from 1970 to 2000 to 0.15 years gained per year from 2000 to 2014. U.S. life expectancy decreased from 2014 to 2015 and is now lower than in most high-income countries, with this gap projected to increase.
Drug poisoning (overdose) death rates more than doubled in the United States from 2000-2015; those involving opioids more than tripled. Increases in poisoning have been reported to have reduced life expectancy for non-Hispanic white Americans from 2000-2014. Specific contributions of drug, opioid, and alcohol poisoning to changes in U.S. life expectancy since 2000 were unknown.

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Washington-Oregon Study Shows Frequent Inter-State Diversion of Recreational Marijuana

MedicalResearch.com Interview with:
Benjamin Hansen, Keaton Miller, Caroline Weber

A dried Cannabis bud, typical of what is sold for drug use- Wikipedia image

A dried Cannabis bud, typical of what is sold for drug use- Wikipedia image

Department of Economics
University of Oregon

MedicalResearch.com: What is the background for this study?

Response: Recreational marijuana is now, or will soon be, legally available to 21%
of the United States population. A major concern among policy makers at
all levels of government is the trafficking or “diversion” of marijuana
from states where it is legal to other states. Though significant
measures are in place to prevent large scale drug trafficking by
licensed producers, consumers may easily purchase in one state and
travel to a different state for consumption or re-sale. Though this
policy concern has existed since medical marijuana became available in
the 1990s, the extent of this diversion by consumers has been unknown.

We take advantage of a unique natural experiment in the Pacific
Northwest: Oregon opened a recreational market on October 1, 2015, well
after Washington’s market opened on July 8, 2014. By examining the sales
of Washington retailers along the Washington-Oregon border in the months
before and after Oregon’s market opened, we can measure the extent to
which consumers from Oregon crossed state lines to purchase marijuana in
Washington.

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Heavy Marijuana Use May Harm Kidneys, But More Study Needed

MedicalResearch.com Interview with:

Dr. Julie H. Ishida MD Division of Nephrology, Department of Medicine San Francisco and San Francisco Veterans Affairs Medical Center University of California

Dr. Ishida

Dr. Julie H. Ishida MD
Division of Nephrology, Department of Medicine
San Francisco and San Francisco Veterans Affairs Medical Center
University of California

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Marijuana is becoming increasingly accepted in the United States, and animal studies suggest that marijuana could affect kidney function. However, data in humans are limited to case reports of acute kidney injury related to synthetic cannabinoid use and small cohort studies of relatively short duration.

Among 3,765 participants with normal kidney function in the Coronary Artery Risk Development in Young Adults or CARDIA study, my colleagues and I found that higher marijuana use was associated with lower kidney function at the start of the our study. However, we did not find that marijuana was associated with change in kidney function or albuminuria, which is a sign of kidney damage, over long-term follow-up.

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Medicaid Patients Who Overdose Likely To Get More Opioids

MedicalResearch.com Interview with:

Julie M. Donohue, Ph.D. Associate professor in Pitt Public Health’s Department of Health Policy and  Management and Director of the Medicaid Research Center Pitt’s Health Policy Institute University of Pittsburgh

Dr. Donohue

Julie M. Donohue, Ph.D.
Associate professor in Pitt Public Health’s Department of Health Policy and
Management and Director of the Medicaid Research Center
Pitt’s Health Policy Institute
University of Pittsburgh 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Medicaid enrollees have three times higher risk of opioid overdose than non-enrollees, and for every fatal opioid overdose, there are about 30 nonfatal overdoses, according to the U.S. Centers for Disease Control and Prevention (CDC). My colleagues and I analyzed claims data from 2008 to 2013 for all Pennsylvania Medicaid enrollees aged 12 to 64 years with a medical record of a heroin or prescription opioid overdose and who had six months of continuous enrollment in Medicaid before and after the overdose claim. The 6,013 patients identified were divided into two groups—3,945 who overdosed on prescription opioids and 2,068 who overdosed on heroin, all of whom received treatment for overdose in a hospital or emergency department setting.

We found that Pennsylvania Medicaid recipients who suffer an opioid or heroin overdose continue to be prescribed opioids at high rates, with little change in their use of medication-assisted treatment programs after the overdose. Opioid prescriptions were filled after overdose by 39.7 percent of the patients who overdosed on heroin, a decrease of 3.5 percentage points from before the overdose; and by 59.6 percent of the patients who overdosed on prescription opioids, a decrease of 6.5 percentage points.

Medication-assisted treatment includes coupling prescriptions for buprenorphine, methadone or naltrexone—medications that can reduce opioid cravings—with behavioral therapy in an effort to treat the opioid use disorder. Our team found that such treatment increased modestly among the patients using heroin by 3.6 percentage points to 33 percent after the overdose, and by 1.6 percentage points to 15.1 percent for the prescription opioid overdose patients.

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Almost 40% US Adults Used Prescription Opioids In Course of One Year

MedicalResearch.com Interview with:
Beth Han, MD, PhD, MPH

From Substance Abuse and Mental Health Services Administration, Rockville, Maryland
National Institute on Drug Abuse, Bethesda, Maryland and
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services
Washington, DC. 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Using the 2015 National Survey on Drug Use and Health (NSDUH), this is the first study examining the prevalence of overall prescription opioid use in addition to misuse, use disorders, and motivations for misuse in the U.S. adult population. The 2015 NSDUH collected nationally representative data on prescription opioid use, misuse, use disorder, and motivations for misuse among the U.S. civilian, noninstitutionalized population aged 12 or older. In 2015, NSDUH started to collect data on overall prescription opioid use as well as data on motivations for prescription opioid misuse.

This study found that in 2015, 91.8 million (37.8%) U.S. civilian, non-institutionalized adults used prescription opioids, 11.5 million (4.7%) misused them, and 1.9 million (0.8%) had a prescription opioid use disorder. Among adults who used prescription opioids, 12.5% reported misuse and, of those reporting misuse, 16.7% reported a prescription opioid use disorder.

The most common reported misuse motivation was to relieve physical pain (63.4%). Misuse and use disorders were most commonly reported in adults who were uninsured, were unemployed, had low income, or had behavioral health problems. Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids free from friends or relatives for their most recent misuse.

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Acupuncture and Electrotherapy Following Knee Replacement May Limit Opioid Use

MedicalResearch.com Interview with:

Tina Hernandez-Boussard, PhD MPH, MS Associate Professor of Medicine, Biomedical Data Science, and Surgery Stanford School of Medicine Stanford, CA 94305-5479

Dr. Hernandez-Boussard

Tina Hernandez-Boussard, PhD MPH, MS
Associate Professor of Medicine, Biomedical Data Science, and Surgery
Stanford School of Medicine
Stanford, CA 94305-5479

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Opioid addiction is a national crisis.  As surgery is thought to be a gateway to opioid misuse, opioid-sparing approaches for pain management following surgery are a top priority.

We conducted a meta-analysis of 39 randomized clinical trials of common non-pharmalogical interventions used for postoperative pain management.

We found that acupuncture and electrotherapy following total knee replacement reduced or delayed patients’ opioid use.

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Opioid Prescriptions Common Among Cancer Survivors

MedicalResearch.com Interview with:

Rinku Sutradhar, Ph.D. Senior Scientist, Institute for Clinical Evaluative Sciences Associate Professor, Dalla Lana School of Public Health University of Toronto, Canada

Dr. Sutradhar

Rinku Sutradhar, Ph.D.
Senior Scientist, Institute for Clinical Evaluative Sciences
Associate Professor, Dalla Lana School of Public Health
University of Toronto, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

  • We suspected that pain was prevalent among survivors of cancer, but there were no comprehensive estimates on the magnitude of this prevalence. For example, recent work had reported pain prevalence among cancer survivors to be anywhere from 5% to 56%, which is quite a wide range.
  • To our knowledge, there has been no prior research conducted at the individual-level that specifically examines opioid prescribing rates for cancer survivors, compared to matched control groups who have no prior cancer diagnosis.
  • We also know that socio-economically disadvantaged populations are more at risk for opioid dependency, but previous studies have not examined cancer survivors who a part of this disadvantaged group, so this is an important knowledge gap to fill.
  • We found that cancer survivors have significantly higher rates of opioid prescriptions compared with their matched controls (who had no prior cancer diagnosis). In fact, after adjusting for other study factors, we found that the rate of opioid prescriptions was 22% higher among survivors.
  • MOST SURPRISING: This higher rate of opioid prescriptions persisted even among survivors who were 10 or more years past their cancer diagnosis (compared to matched control individuals who had no prior cancer diagnosis).
  • When we broke the cohort down based on the type of cancer, we didn’t see a significant spike in opioid prescriptions for breast cancer survivors compared to their non-cancer controls, but we did see higher opioid prescriptions for survivors of lung, gastrointestinal, genitourinary, or gynaecological cancers, compared to their controls.

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More Babies Experiencing Neonatal Drug Withdrawal After Exposure To Opioids and Psychotropic Meds

MedicalResearch.com Interview with:

Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120

Dr. Krista Huybrechts

Krista F. Huybrechts, MS PhD
Assistant Professor of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02120

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Neonatal drug withdrawal is common; in the U.S. about 1 infant is born every 25 minutes with signs of drug withdrawal. Neonatal drug withdrawal is a well-recognized complication of intrauterine exposure to illicit or prescription opioids, but other psychotropic medications can also cause signs of withdrawal. Psychotropic medications are frequently co-prescribed with opioids in pregnancy, and the use of both has increased significantly, raising concerns about an increase in the incidence and severity of neonatal drug withdrawal due to potential drug-drug interactions, but these risks are not well understood.

In this study, we found a 30-60% increase in the risk of neonatal drug withdrawal associated with co-exposure to antidepressants, benzodiazepines and gabapentin, compared to opioids alone; no significant increase in risk was observed for atypical antipsychotics and Z-drugs. Exposure to psychotropic polypharmacy along with opioids was associated with a two-fold increased risk of withdrawal.

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Chronic Cannabis Users Have Blunted Response To Stress

MedicalResearch.com Interview with:

Carrie Cuttler, Ph.D. Clinical Assistant Professor Washington State University Department of Psychology Pullman, WA, 99164-4820

Dr. Cuttler

Carrie Cuttler, Ph.D.
Clinical Assistant Professor
Washington State University
Department of Psychology
Pullman, WA, 99164-4820

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: One of the most common reasons cannabis users report using cannabis is to cope with stress. In support of this, previous research has shown that acute administration of THC or cannabis dampens affective responses and subjective stress ratings. However, our study is the first to compare the stress response of sober cannabis users to non-users. More specifically, we randomly assigned 42 non-cannabis users and 40 cannabis users (who abstained from using cannabis for at least 12 hours prior to the study) to either a stress or no stress condition. Participants in the stress condition were required to perform multiple trials of placing their hand in ice water and counting backwards from 2043 by 17s. Each time they made an error they were given negative feedback and told to start again. Further, they were being video recorded and their image was displayed in front of them. Participants who were assigned to the no stress condition were simply required to perform multiple trials of placing their hand in lukewarm water and counting from 1 to 25. They were not given feedback or recorded. Participants were asked to rate their level of stress and to provide a saliva sample, from which the stress hormone cortisol was measured.

The results showed that, as expected, non-users in the stress condition had higher cortisol levels and higher self-reported stress than non-users in the no stress condition. In contrast, cannabis users in the stress condition demonstrated the same levels of cortisol as cannabis users in the no stress condition and their increase in self-reported stress was smaller than that of the non-users.

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Drug-Related Deaths Among Whites Soar But Alcohol and Suicide Mortality Stable

MedicalResearch.com Interview with:
Andrea M. Tilstra
Doctoral Student, Department of Sociology
Population Program, Institute of Behavioral Science
University of Colorado Boulder and
Ryan K. Masters
Assistant Professor, Department of Sociology
Faculty Associate, Population Program and Health & Society Program
Institute of Behavioral Science
University of Colorado Boulder

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  “Despair” deaths – deaths from suicides, alcohol poisonings, and drug overdoses – have been a topic of interest in recent mortality research. For instance, existing findings suggest that mortality among white Americans has increased as a result of middle-aged whites experiencing elevated levels of despair and distress. These factors supposedly are driving white Americans to cope in unhealthy ways – excessive drinking, drug use, and suicides.

However, there were two major problems with the existing research that supported this narrative. First, men and women were analyzed together, despite the knowledge that overall mortality levels and trends differ significantly by gender. Second, all three of the aforementioned causes of death were pooled together and analyzed as one group. This is highly problematic if deaths from suicides, alcohol use, and drug use are not, in fact, moving in conjunction with one another. We addressed these issues and expanded previous analyses by analyzing cause-specific death rates for men and women separately, for years 1980-2014, and decomposing the trends into period- and cohort- based analyses.

We find that there are huge gender differences in U.S. white mortality rates and that trends in mortality from the three causes of death are quite distinct from one another. Recent increases in U.S. white mortality are largely driven by period-based increases in drug poisoning deaths and cohort-based increases in metabolic disease deaths.

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Prescription Opioids Increasingly Found In Fatally Injured Drivers

MedicalResearch.com Interview with:

Stanford Chihuri, MPH Staff Associate/Data Analyst Department of Anesthesiology, College of Physicians and Surgeons Columbia University Medical Center NY, NY 10032

Stanford Chihuri

Stanford Chihuri, MPH
Staff Associate/Data Analyst
Department of Anesthesiology, College of Physicians and Surgeons
Columbia University Medical Center
NY, NY 10032 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In the past 2 decades, consumption of prescription opioids has substantially increased in the U.S. Prescription drugs may cause drowsiness and impaired cognition which may interfere with psychomotor functioning necessary during the operation of a motor vehicle. The current study assessed time trends in prescription opioids detected in drivers killed in motor vehicle crashes from 1995 to 2015 in 6 states in the U.S.

Results of the study showed that the prevalence of prescription opioids detected in fatally injured drivers has increased 700% in the past 2 decades.

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Primary Care Practice Interventions Helped Maintain Adherence to Opioid Prescription Guidelines

MedicalResearch.com Interview with:

Jane M. Liebschutz, MD, MPH Associate Professor of Medicine Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts

Dr. Liebschutz

Jane M. Liebschutz, MD, MPH
Associate Professor of Medicine
Section of General Internal Medicine
Boston University School of Medicine
Boston, Massachusetts

MedicalResearch.com: What is the background for this study?

Response: The number of patients receiving opioids for chronic pain has risen over the past 2 decades in the US, in parallel with an increase in opioid use disorder. The CDC and professional medical societies have created clinical guidelines to improve the safety of opioid prescribing, yet individual prescribers can find them onerous to implement.

We developed an intervention to change clinical practice to support primary care physicians who prescribe the majority of opioids for chronic pain. The intervention included 4 elements- a nurse care manager to help assess, educate and monitor patients, an electronic registry to keep track of patient data and produce physician level reports, an individualized educational session for the physician by an opioid prescribing expert based on the physician-specific practice information and online resources to help with decision-making for opioid prescribing (www.mytopcare.org). We tested whether the intervention would improve adherence to guidelines, decrease opioid doses and decrease early refills, as a marker of potential prescription opioid misuse among 985 patients of 53 primary care clinicians in four primary care practices.

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Aldosterone-Mineralocorticoid Pathway Linked To Craving For Alcohol

MedicalResearch.com Interview with:

Lorenzo Leggio, M.D., Ph.D. Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory 

Dr. Leggio

Lorenzo Leggio, M.D., Ph.D.
Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory

MedicalResearch.com: What is the background for this study?

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Aldosterone is an important hormone involved in the control of blood pressure and electrolytes via its mineralcorticoid receptor (MR). In addition to its roles in the periphery in our body, aldosterone also acts on the brain where the MR is particularly present in regions like the amygdala. The amygdala plays an important role in stress, anxiety and excessive alcohol drinking. Back in 2008, we conducted a small pilot study where we found that alcohol-dependent patients with higher blood aldosterone concentrations have higher alcohol craving.

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Opioid Prescriptions Decrease But Still Elevated Compared To 20 Years Ago

MedicalResearch.com Interview with:

Deborah Dowell, MD, MPH Chief Medical Officer, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention

Dr. Dowell

Deborah Dowell, MD, MPH
Chief Medical Officer, Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study?

Response: CDC analyzed retail prescription data from QuintilesIMS which provides estimates of the number of opioid prescriptions dispensed in the United States from approximately 59,000 pharmacies, representing 88% of prescriptions in the United States. CDC assessed opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015.
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Optimistic Results From Phase 3 Study of RBP-6000 Buprenorphine Monthly Depot for Treatment of Opioid Use Disorder

Medical Research.com Interview with:

Dr. Christian Heidbreder, PhD Chief Scientific Officer Indivior Inc. Richmond, VA 23235, USA

Dr. Heidbreder

Dr. Christian Heidbreder, PhD
Chief Scientific Officer
Indivior Inc.
Richmond, VA 23235, USA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This pivotal Phase 3 clinical trial (RB-US-13-0001) evaluated the efficacy and safety of RBP-6000, an investigational once-monthly injectable buprenorphine in the ATRIGEL® delivery system for the treatment of adults with moderate-to-severe opioid use disorder (OUD) as part of a complete treatment plan to include counseling and psychosocial support1.

The 24-week Phase 3 study met its primary and key secondary endpoints, demonstrating statistically significant differences in percentage abstinence and treatment success across both dosage regimens of RBP-6000 versus placebo1.

The findings also showed that outcomes with RBP-6000 are consistent across other secondary clinical endpoints, including control of craving and withdrawal symptoms, as compared to placebo. These outcomes were associated with buprenorphine plasma concentrations ≥ 2 ng/mL and predicted whole brain mu-opioid receptor occupancy of ≥ 70%, and were also maintained for the one-month dosing intervals and for the entire treatment duration1.

The results were confirmed by exposure-response analyses demonstrating a relationship between buprenorphine plasma concentrations, abstinence, withdrawal symptoms and opioid craving1.

RBP-6000 was generally well tolerated and had a safety profile consistent with that of transmucosal buprenorphine. Injection site reactions were not treatment-limiting. The most common (reported in ≥ 5% of subjects) treatment-emergent adverse events (TEAEs) reported in the active total group were constipation, headache, nausea, injection site pruritus, vomiting, increased hepatic enzyme, fatigue and injection site pain1.

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Lost Your Connection? Internet Withdrawal Can Mirror Addiction Symptoms

MedicalResearch.com Interview with:

Dr. Phil Reed,  D.Phil. Professor Psychology Swansea University

Dr. Reed

Dr. Phil Reed,  D.Phil.
Professor Psychology
Swansea University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Problematic internet use has been a growing concern for many people and bodies over the last decade, and more study has been requested into various aspects of this possible disorder.  One of the key questions is whether people overuse the internet, due to an addiction.  If it is an addiction, then there should be signs of withdrawal when people, who report having this problem, stop using the internet.  In this study, 144 participants, aged 18 to 33, had their heart rate and blood pressure measured before and after a brief internet session.  Their anxiety and self-reported internet addiction were also assessed.

The results showed increases in heart rate and systolic blood pressure on terminating the internet session for those with problematically-high internet usage.  These increases in physiological arousal were mirrored by increased feelings of anxiety.  However, there were no such changes for those participants who reported no internet-usage problems.

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Most Youth With Opioid Disorders Do Not Receive Medications For Addiction

MedicalResearch.com Interview with:

Scott Hadland, MD, MPH, MS Youth Addiction Specialist Assistant Professor of Pediatrics Boston University School of Medicine

Dr. Hadland

Scott Hadland, MD, MPH, MS
Youth Addiction Specialist
Assistant Professor of Pediatrics
Boston University School of Medicine
Director, Urban Health and Advocacy Track, Boston Children’s Hospital and Boston Medical Center
Associate Program Director, Boston Combined Residency Program in Pediatrics, Boston Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Almost no data have been available on this topic to date.  A recent study showed that teens in subspecialty treatment for opioid addiction were significantly less likely than adults to receive a medication.  Our study was the first to comprehensively look across the health care system, including looking at adolescents and young adults diagnosed with opioid use disorder in outpatient clinics, emergency departments, and inpatient hospitals.

We had three important findings.  First, looking at a large sample of 9.7 million adolescents and young adults between the age of 13 and 25 years, we found that the number of youth diagnosed with opioid use disorder increased six-fold from 2001 to 2014.  This is perhaps not surprising given the national opioid crisis we know to be occurring.

Second, we found that only a minority of youth (1 in 4) received buprenorphine or naltrexone, the two medications available for opioid addiction that can be prescribed in usual medical settings.  These two medications are evidence-based and their use is recommended by the American Academy of Pediatrics.  Utilizing them is critical to ensure that we offer effective treatment early in the life course of addiction, which can help prevent the long-term harms of addiction.

Third, we found significant differences in who received medications.  Whereas approximately 1 in 3 young adults in our study received a medication, only 1 in 10 of the 16- and 17-year-olds we studied received one, and among adolescents under 15 years of age, 1 in 67 received a medication.  Females were less likely than males to receive medications, as were black youth and Hispanic youth relative to white youth.

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Peeling Back the Curtain on Regional Variation in the Opioid Crisis

MedicalResearch.com Interview with:

Robin Gelburd, JD President FAIR Health

Robin Gelburd

Robin Gelburd, JD
President
FAIR Health

MedicalResearch.com: What is the background for this study?

Response: The opioid crisis is affecting the entire nation, but not in the same way in every location. Although a number of studies have been conducted on geographic variations in the opioid epidemic, there remains a need for more information on the regional level. To help meet that need, FAIR Health consulted its database of more than 23 billion privately billed healthcare claims, the largest such repository in the country. Focusing on the most recent complete ten-year period (2007-2016), FAIR Health examined claims data from rural and urban settings, the country’s five most populous cities (Chicago, Houston, Los Angeles, New York and Philadelphia) and the states where those cities are located.

When the term “opioid-related diagnoses” is used in this study, it refers to opioid abuse, opioid dependence, heroin overdose and opioid overdose (i.e., overdose of opioids excluding heroin).
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Opioids Withdrawal in Babies Adding Millions To Health Care Costs

MedicalResearch.com Interview with:

Tammy E. Corr, D.O. Assistant Professor of Pediatrics Division of Newborn Medicine Penn State Hershey College of Medicine

Dr. Corr

Tammy E. Corr, D.O.
Assistant Professor of Pediatrics
Division of Newborn Medicine
Penn State Hershey College of Medicine

MedicalResearch.com: What is the background for this study?

Response: Recent literature has revealed hospital charges related to neonatal abstinence syndrome (NAS) have increased. However, there are no data available regarding costs of an NAS admission. Because charges are variable and influenced by a number of factors, provider costs to care for a patient offer more meaningful information.

Therefore, we endeavored to determine the incidence of NAS in the United States and estimate the total annual costs and hospital length of stay for an neonatal abstinence syndrome admission as well as the incremental costs and hospital days of admission for an NAS patient compared to a non-NAS admission.

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College Binge Drinkers Also Smoking More Pot In States Where Marijuana Legal

MedicalResearch.com Interview with:

David Kerr PhD Associate professor in the School of Psychological Science College of Liberal Arts Ohio State University 

Dr. Kerr

David Kerr PhD
Associate professor in the School of Psychological Science
College of Liberal Arts
Ohio State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oregon legalized sale and use of marijuana for recreational purposes and the part of the law (regarding use) took effect in July 2015. However, there have been no controlled studies of which we’re aware of the possible effects of the Oregon law that take into account the trends toward increased marijuana use across the country and differences in use rates between states that predated the law.

We used survey data on college students in Oregon and in 6 states without recreational legalization to examine the issue.

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Pot Plus Alcohol Raises Fatal Traffic Accident Risk Over 500%

MedicalResearch.com Interview with:

Guohua Li DrPH, MD Professor and Director Center for Injury Epidemiology and Prevention Department of Epidemiology Mailman School of Public Health Columbia University

Dr. Li

Guohua Li DrPH, MD
Professor and Director
Center for Injury Epidemiology and Prevention
Department of Epidemiology
Mailman School of Public Health
Columbia University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drugged driving has become a serious problem in the United States in the recent years due to increased consumption of marijuana and opioids. About 20% of fatally injured drivers used two or more substances, with alcohol-marijuana being the most commonly detected polydrug combination.

Our study of over 14000 fatal 2-car crashes indicates that drivers testing positive for alcohol, marijuana, or both are significantly more likely to be responsible for initiating these crashes than those using neither of the substances. Specifically, compared to drivers not using alcohol and marijuana, the risk of being responsible for initiating fatal crashes increases 62% for those testing positive for marijuana and negative for alcohol, 437% for those testing positive for alcohol and negative for marijuana, and 539% for those testing positive for both alcohol and marijuana. These results suggest that when used in combination, alcohol and marijuana have a positive interaction on the risk of fatal crash initiation.

The most common driver error leading to fatal 2-car crashes is failure to keep in proper lane, followed by failure to yield right of way and speeding.

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Regular Adolescent Cannabis Users More Likely To Have Later Problems with Drugs, Alcohol and Tobacco

MedicalResearch.com Interview with:
Dr Michelle Taylor PhD
Senior Research Associate in Epidemiology
MRC Integrative Epidemiology Unit (IEU)
School of Social and Community Medicine
University of Bristol
Bristol UK

MedicalResearch.com: What is the background for this study?

Response: Many previous studies have looked at adolescent cannabis use, however most of these look at use at a single time point, for example whether an individual has ever used cannabis at age 16 years, or how regularly a person uses cannabis at age 18. However, as young people do not initiate use at the same time or follow the same pattern of use, using measures at a single time point does not always tell the whole story.
We used a form of statistical modelling using data taken over the course of adolescence to try and characterise underlying patterns of cannabis use across adolescence. We used data from the Avon Longitudinal Study of Parents and Children which had information on cannabis use at six time points between the ages of 13 and 18 years.

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Heroin Epidemic Costs US Over $50 Billion Per Year

MedicalResearch.com Interview with:

A. Simon Pickard, PhD

Dr. Pickard

A. Simon Pickard, PhD
Professor, Dept of Pharmacy Systems, Outcomes and Policy
University of Ilinois at Chicago
College of Pharmacy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The heroin epidemic, which has left virtually no part of American society unscathed, can be viewed as an illness.  Unlike some illnesses, however, it was largely manufactured by stakeholders in the healthcare system, wittingly or unwittingly.

The main finding, that heroin addiction costs us just over $50 billion per year, is likely a conservative estimate.

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Roadside Oral Fluid Testing for Marijuana Intoxication

MedicalResearch.com Interview with:

Mitchell L. Doucette, MS PhD Candidate The William Haddon Jr Fellowship in Injury Prevention 2017 Co-Fellow Center for Injury Research and Policy Department of Health Management and Policy Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205

Mitchell Doucette

Mitchell L. Doucette, MS
PhD Candidate
The William Haddon Jr Fellowship in Injury Prevention 2017 Co-Fellow
Center for Injury Research and Policy
Department of Health Management and Policy
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205

MedicalResearch.com: What is the background for this study?

Response: Currently in the U.S., 8 states have legalized marijuana for recreational use and an additional 28 states permit marijuana for medical use. Some states have instituted a legal driving limit for marijuana intoxication, 5 ng/mL, and for Colorado specifically, research indicates the average time from law enforcement dispatch to blood sample collection was 2.32 hours—a period of time outside the window of legal sample collection under state law and peak THC detectability. Countries with similar marijuana driving limits perform roadside oral fluid testing for establishing intoxication at point of arrest.

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Moderate Drinking Linked To Faster Cognitive Decline

MedicalResearch.com Interview with:

Dr. Anya Topiwala, BA (Hons) BMBCh (Oxon) MRCPsych DPhil Clinical lecturer Department of Psychiatry University of Oxford

Dr. Topiwala

Dr. Anya Topiwala, BA (Hons) BMBCh (Oxon) MRCPsych DPhil
Clinical lecturer
Department of Psychiatry
University of Oxford

MedicalResearch.com: What is the background for this study?

Response: I thought the question of whether moderate alcohol consumption is harmful or protective to the brain was a really interesting and important one, particularly because so many people drink this amount. There were a few studies reporting that a little alcohol may protect against dementia or cognitive decline, but the few brain imaging studies were conflicting in their results and had methodological limitations.

We examined whether alcohol consumption over a 30-year period was associated with brain imaging and memory decline in a group of 550 non-alcohol dependent individuals from the remarkable Whitehall II cohort. Subjects completed questionnaires and had clinical examinations approximately every 5 years over the 30 years of the study, and had detailed brain scans at the end.

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Kids From High Achieving Schools Can Be At Risk of Substance Abuse and Addiction

MedicalResearch.com Interview with:

Suniya S. Luthar, Ph.D. Foundation Professor of Psychology, Arizona State University Professor Emerita, Columbia University's Teachers College President-elect, American Psychological Association's Div.7 (Development

Dr. Luthar

Suniya S. Luthar, Ph.D.
Foundation Professor of Psychology
Arizona State University
Professor Emerita
Columbia University’s Teachers College
President-elect, American Psychological Association’s Div.7 (Developmental)

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over the last 20 years, we have found that kids in high achieving schools report higher use of drugs and alcohol than do their counterparts in national normative samples. This particular study was the first in which we followed up samples of high school students through young adulthood, to track levels of substance abuse and addiction.

Our findings showed consistently elevated use of various substances across the years. Of greatest concern were diagnoses of dependence (that is, not just abuse of substances but actual addiction to them); among 26 year olds, rates of these diagnoses were two to three times those in national norms.

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Opioid Agonist Therapy Found Cost Effective In Preventing HIV in People Who Inject Drugs

MedicalResearch.com Interview with:

Cora Bernard, MS, PhD candidate Pre-doctoral Student in Management Science and Enginnering Affiliate, Center for Health Policy and the Center for Primary Care and Outcomes Research Stanford Health Policy

Cora Bernard

Cora Bernard, MS, PhD candidate
Pre-doctoral Student in Management Science and Enginnering
Affiliate, Center for Health Policy and the Center for Primary Care and Outcomes Research
Stanford Health Policy

MedicalResearch.com: What is the background for this study?

Response: The US opioid epidemic is leading to an increase in the US drug-injecting population, which also increases the risks of HIV transmission. It is critical to public health that the US invests in a coherent and cost-effective suite of HIV prevention programs. In our model-based analysis, we considered programs that have the potential both to prevent HIV and to improve long-term health outcomes for people who inject drugs. Specifically, we evaluated opioid agonist therapy, which reduces the frequency of injection; needle and syringe exchange programs, which reduce the frequency of injecting equipment sharing; enhanced HIV screening and antiretroviral therapy programs, which virally suppress individuals and decrease downstream transmission; and oral HIV pre-exposure prophylaxis (PrEP), which is taken by an uninfected individual and lowers the risk of infection.

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Does Alcohol Really Protect Against Heart Disease? Evidence Not Clear Cut

MedicalResearch.com Interview with:

Dr. Jinhui Zhao PhD Scientist, Centre for Addictions Research of BC University of Victoria

Dr. Jinhui Zhao

Dr. Jinhui Zhao PhD
Scientist, Centre for Addictions Research of BC
University of Victoria

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  There are now many studies questioning the validity of the theory that moderate alcohol consumption protects against heart disease. We provided an up to date and comprehensive review of the evidence from ‘cohort’ studies i.e. those that assess health risk behaviours of people then follow them up for a number of years to see what characteristics predict death from a particular condition. We wished to test the theory that the appearance of health benefits in relation to heart disease is due to biases that accumulate and become more severe when cohorts are recruited at older ages (e.g. over 55 years). We found evidence to support this hypothesis. Moderate drinkers recruited before 55 years of age did not show any evidence of reduced risk of heart disease even when followed up into old age. Moderate drinkers from the older cohorts, however, did appear to have significant benefits – a finding we attribute to selection biases that accumulate across the life-course.

Several published meta-analyses showed inconsistent findings about how alcohol consumption affects the risk of coronary heart disease (CHD). Most systematic reviews find associations between low-volume alcohol consumption and reduced CHD risk, while some also find increased CHD risk for higher levels of consumption (Maclure 1993, Corrao, Rubbiati et al. 2000, Corrao, Bagnardi et al. 2004, Ronksley, Brien et al. 2011, Roerecke and Rehm 2012). More recent evidence has accumulated to suggest that the case for cardio-protection may be less straightforward. The association of alcohol consumption with CHD may be confounded or modified by other factors such as age and sex and / or biased by those factors which have not been investigated or controlled for in these previously published studies.

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Frequent Marijuana Use Linked To Increased Risk of Severe Periodontal Disease

MedicalResearch.com Interview with:

Jaffer A Shariff DDS MPH cert.DPH Periodontal Resident | Research Scientist Division of Periodontics, Columbia University College of Dental Medicine New York

Dr. Shariff

Jaffer A Shariff DDS MPH cert.DPH
Periodontal Resident | Research Scientist
Division of Periodontics,
Columbia University College of Dental Medicine
New York

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Marijuana use for both medical and recreational purposes has become increasingly common in recent years; it is the most commonly used recreational drug in the United States. Subsequent increase in its legalization among countries including the United States for recreational purposes, poses an emergent oral and periodontal health concerns.

Our study revealed that frequent recreational marijuana users exhibited deeper periodontal probing depths, clinical attachment loss and higher odds of having severe periodontal disease than the non-frequent users, even after controlling for other risk factors linked to gum disease, such as cigarette smoking.

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Recreational Cocaine Use Activates Addiction Related Brain Mechanisms Sooner Than Previously Realized

MedicalResearch.com Interview with:

Marco Leyton, Ph.D. Professor, Department of Psychiatry McGill University

Dr. Marco Leyton

Marco Leyton, Ph.D.
Professor, Department of Psychiatry
McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drug-related cues are potent triggers for eliciting conscious and unconscious desire for the drug. In people with severe substance use disorders, these cues also activate dopamine release in the dorsal striatum, a brain region thought to be involved in hard-to-break habits and compulsions.

In the present study we found evidence that drug cues also activate this same dopamine response in non-dependent ‘recreational’ cocaine users.

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Post-Surgical Medications Are Major Cause Of New Chronic Opioid Use

MedicalResearch.com Interview with:

Chad M. Brummett, M.D. Associate Professor Director, Clinical Anesthesia Research Director, Pain Research Department of Anesthesiology Division of Pain Medicine University of Michigan Medical School Ann Arbor, MI  48109

Dr. Brummett

Chad M. Brummett, M.D.
Associate Professor
Director, Clinical Anesthesia Research
Director, Pain Research
Department of Anesthesiology
Division of Pain Medicine
University of Michigan Medical School
Ann Arbor, MI  48109 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The opioid epidemic has received tremendous attention in recent years, but most of the focus has been on chronic pain, opioid abuse and overdose. Far less attention has been paid to the importance of acute care prescribing (e.g. surgical pain) in patients that are not chronic opioid users.

We found that 5-6% of patients not using opioids prior to surgery continued to fill prescriptions for opioids long after what would be considered normal surgical recovery. Moreover, the rates of new chronic use did not differ between patients having major and minor surgeries, suggesting that patients continue to use these pain medications for something other than simply pain from surgery. Building on other work by our group, and the few additional studies done on the topic to date, these data suggest that pain medications written for surgery are a major cause of new chronic opioid use for millions of Americans each year.

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New Marijuana Laws Associated With Increase in Cannabis-Related Health Problems

MedicalResearch.com Interview with:

Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032

Dr. Hasin

Deborah S. Hasin, Ph.D.
Professor of Epidemiology
Columbia University
New York, New York 10032

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Among adults, the prevalence of cannabis use and cannabis use disorders has increased in recent years. Concerns have been raised that for various reasons, medical marijuana laws would promote use of cannabis and consequently, cannabis-related consequences.

Many studies show that this didn’t happen among adolescents, but very little was known about the relationship between medical marijuana laws and adults. Using data from three surveys spanning the years 1991-2013, the study findings suggested that medical marijuana laws did play a role in increasing rates of cannabis use and cannabis use disorders.

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Cannabis Exacerbates Schizophrenia Symptoms and Prolongs Recovery

MedicalResearch.com Interview with:
Ian Hamilton

Department of Health Sciences
University of York
York, UK 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This review looked back over 40 years of research on the links between cannabis and psychosis to examine how knowledge has developed on this issue.

The review found that there is sufficient evidence to suggest a dose response relationship exists in the risk for developing a psychosis that would not have happened if the individual had not been exposed to cannabis. Also for people with schizophrenia cannabis exacerbates their symptoms and prolongs recovery.

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Proove Opioid Risk Profile Predictive of Opioid Use Disorder

MedicalResearch.com Interview with:

Maneesh Sharma, M.D</strong> Director of Pain Medicine MedStar Good Samaritan Hospital Medical Director of the Interventional Pain Institute Baltimore, Maryland

Dr. Maneesh Sharma

Maneesh Sharma, M.D
Director of Pain Medicine
MedStar Good Samaritan Hospital
Medical Director of the Interventional Pain Institute
Baltimore, Maryland

MedicalResearch.com: What is the background for this study?

Response: Opioid abuse in chronic pain patients is a major public health issue, with rapidly increasing addiction rates and deaths from unintentional overdose more than quadrupling since 1999. Just in the last year alone according to the CDC, synthetic opioid deaths have increased 72%. As a practicing interventional pain specialist, I am confronted with the challenge of assessing patient risk for opioids as I evaluate multi-modal approaches to effective pain management. Existing tools are inadequate, as they either rely on a urine toxicology test to evaluate a patient’s current potential substance abuse as a predictor of future abuse, or on a patient’s honesty to fill out a questionnaire. We know that many patients who are not currently abusing illicit drugs or misusing prescription medications can develop prescription opioid tolerance, dependence, or abuse—especially with prolonged opioid therapy. Furthermore, we know that patients who are looking to abuse medications or divert those prescriptions will obviously lie on questionnaires.
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Outbreak of Severe Fungal Eye Infections Linked To IV Opioid Epidemic

MedicalResearch.com Interview with:
Aubrey Tirpack, PGY3

New England Eye Center
Tufts Medical Center 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Intravenous drug abuse is a known risk factor for the development of endogenous fungal endophthalmitis (EFE), a severe intraocular infection cause by the seeding of mycotic organisms to the eye.

Our institution noted a marked increase in cases of EFE beginning in May 2014, which correlates to increasing rates of opioid abuse throughout the New England region. Ten patients were found to have intravenous drug abuse related EFE over the two year time period studied. The most common presenting symptoms were floaters, decreased vision, and pain. All patients were treated with systemic antifungals and nine patients underwent intravitreal antifungal injection. All patients were ambulatory at presentation and the majority were without systemic signs of infection.

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Topical Cannabinoids May Fight Itch and Inflammatory Skin Diseases

MedicalResearch.com Interview with:
Jessica S. Mounessa, BS

University of Colorado School of Medicine
Aurora, Colorado and
Robert Dellavalle, MD, PhD, MSPH
Professor of Dermatology and Public Health
University of Colorado School of Medicine
Colorado School of Public Health
Chief, Dermatology Service
US Department of Veterans Affairs
Eastern Colorado Health Care System
Denver, CO 80220 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: One in 10 adult cannabis users in the U.S. use it for medicinal purposes. Medicinal cannabis is well studied for its uses in chronic pain, anorexia, and nausea. Numerous recent studies have highlighted other medicinal uses for cannabinoids and related compounds.

We conducted a comprehensive review of the literature on the potential role of cannabinoids in conditions affecting the skin.

Our study reveals the potential benefit of topically prepared cannabinoid compounds, especially for pruritus and eczema.  For example, creams containing Palmitoylethanolamide (PEA), which enhances cannabinoid-receptor binding, have been successful in relieving itch both in the literature, and anecdotally in our clinics.

Though not strictly considered an endocannabinoid, as it does not directly bind to CB1 and CB2 receptors, PEA works by enhancing endocannabinoid binding to these receptors.** Furthermore, the majority of the cannabinoid compounds we studied did not contain psychoactive effects.

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Millions of Americans Become Chronic Opioid Users After Surgery

MedicalResearch.com Interview with:

Chad M. Brummett, MD Division of Pain Medicine, Department of Anesthesiology University of Michigan Medical School Ann Arbor, MI 48109

Dr. Brummett

Chad M. Brummett, MD
Division of Pain Medicine, Department of Anesthesiology
University of Michigan Medical School
Ann Arbor, MI 48109 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The opioid epidemic has received considerable attention, but most of the focus has been on chronic pain and primary care. However, surgeons prescribe ~40% of the opioids in the US, and little attention has been given to the importance of prescribing after surgery.

In this study, we found that among patients not using opioids in the year prior to surgery, ~6% of patients continued to use opioids long after what would be considered normal surgical recovery. Furthermore, there was no difference between patients undergoing minor and major surgeries, thereby suggesting that some patients continue to use opioids for reasons other than pain related to surgery.

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