One way to stay motivated and on track is by setting small, achievable goals for yourself....
Alden Mileto, BA
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: The drug buprenorphine is a partial opioid agonist, originally developed in the 1960s as an alternative to the stronger full opioid mu receptor agonists like morphine. Today, the drug is sometimes used for pain, but is more often used as a treatment for Opioid Use Disorder (OUD). Since the 2002 federal approval for buprenorphine use in treatment of OUD, there has been an increase in buprenorphine prescription across all states.
However recent studies have showed a disproportionate increase in buprenorphine prescriptions to rural/ less populated areas in comparison to urban/densely populated areas. The objective of this study [1] was to analyze the trends in buprenorphine distribution, overall and by three-digit zip codes, in Pennsylvania from 2010-2020.
Anxiety, poor quality of sleep, and sleep apnea are all interrelated in many cases....
Prof. Isaacs[/caption]
Lyle Isaacs, Professor
University of Maryland Department of Chemistry and BiochemistryCollege Park, MD 20742
MedicalResearch.com: What is the background for this study?
Response: The Isaacs laboratory has a long-standing interest in molecular containers compounds and their molecular recognition properties toward chemically and biologically important targets. Molecular containers include well known pharmaceutical excipients that help dissolve and deliver drugs (e.g. sulfobutyl-beta-cyclodextrin (SBE-b-CD)) and even sequester active pharmaceutical ingredients (e.g. Sugammadex reverses the effects of neuromuscular blockers).
Our lab has previously studied a class of molecular containers called cucurbiturils and found that they bind tightly (nanomolar Kd) to hydrophobic cations in aqueous solution. Recently, we translated our knowledge of tight binding to design and synthesize a novel tight binding molecular container known as Pillar[6]MaxQ and showed that it has superior binding affinity toward hydrophobic cations.[reference = Angewandte Chemie International Edition 2020, 59, 13313]
In an intensive outpatient program, patients have the opportunity to meet with their therapist or case manager multiple times per week for extended periods of time. This increased contact can help ensure that patients are complying with their treatment plan and making progress toward their goals....
Dr. Harris[/caption]
MedicalResearch.com Interview with:
Rebecca Arden Harris, MD, MSc
Assistant Professor of Family Medicine and Community Health at the Hospital of the University of Pennsylvania
Senior Fellow, Leonard Davis Institute of Health Economics
Perelman School of Medicine, University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: The impact of the nationwide overdose epidemic on Black women has received little attention from policy-makers, researchers, or the press.
MedicalResearch.com: What are the main findings?
Response: Over the 7-year study period, preventable overdose deaths among Black women resulted in nearly 0.75 million years of life lost (YLL). Women aged 25-34 have suffered a rising proportion of this burden.
Medication Assisted Treatment can be used to treat a variety of substance use disorders including alcohol use disorder, heroin use disorder, and opioid use disorder....
Lavinia Harrison[/caption]
Lavinia Harrison
Geisinger Commonwealth School of Medicine
Scranton, PA 18509
MedicalResearch.com: What is the background for this study?
Response: The opioid meperidine (Demerol) was widely prescribed in the United States (US) as an analgesic to treat moderate to severe pain. Meperidine was the most used opioid in the US in 1987 and was considered safer than other opioids during acute pancreatitis. Over the past two decades, meperidine has shifted from being frequently prescribed to being used only when patients are experiencing atypical reactions to opioids (e.g., morphine and hydromorphone); to removal from the World Health Organization's essential medication list and receiving strong warnings against its use from many professional organizations including the American Geriatrics Society. The unfortunate Libby Zion (1965-1984) case increased concerns about serotonin syndrome with meperidine.
According to a prior pharmacoepidemiology report, the distribution of meperidine in the United States decreased by 95% between 2001 and 2019 [1]. The aim of the study was to include updated information (2020 and 2021) as well as examine the changes among Medicaid patients [2].
Dr. Wong[/caption]
Mitchell Wong, MD PhD
Professor of Medicine
Executive Vice Chair for Research Training
Department of Medicine
Executive Co-Director, Specialty Training and Advanced Research (STAR) Program
Director, UCLA CTSI KL2 Program
UCLA Division of General Internal Medicine and Health Services Research Los Angeles, CA 90024
MedicalResearch.com: What is the background for this study?
Response: It is estimated that social factors like poverty, education, and housing have a large impact on health. Yet, there are few interventions that exist to directly address those issues. Schools are a promising solution since society already invests heavily in education and schools are an everyday part of most children’s lives.
Dr. Roth[/caption]
Bryan Roth, MD, PhD
Michael Hooker Distinguished Professor
Pharmacology Director, NIMH Psychoactive Drug Screening Program
Eshelman School of Pharmacy
[caption id="attachment_59376" align="alignleft" width="125"]
Gavin Schmitz[/caption]
Gavin P. Schmitz
Department of Pharmacology
University of North Carolina at Chapel Hill School of Medicine
Chapel Hill, North Carolina
Department of Pharmacology, School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is undoubtably a lot of enthusiasm for psychedelics as therapeutic tools right now both in research and more broadly; however, there are still so many questions that need to be answered. It has been established that SNPs are clinically relevant when considering how patients may respond to various atypical antipsychotic drugs, so we wanted to see if they also could impact psychedelic assisted treatment strategies.
What we found is that genetics do matter; namely, our results indicate that patients with different genes will react differently to psychedelics.
Colleen Jordan[/caption]
Colleen G. Jordan, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Opioid addiction and misuse remain a prevalent issue in the United States (U.S.). There have been more than one-million drug overdoses in the U.S. since 1999 [1], largely driven by opioids, which exacerbate the strain on resources in hospitals, treatment centers, first responders, patients, and their families. The existing pharmacotherapies for opioid use disorder (OUD) are not working.
Naloxone is a competitive mu opioid receptor antagonist used to reverse respiratory and CNS depression in those experiencing an opioid overdose but requires further dosing to prevent subsequent overdose. Naltrexone is a competitive mu opioid receptor antagonist, and has extended-release formulations intended to reduce relapse and promote adherence, yet patient noncompliance and retention continue to be limiting factors. Methadone is commonly used to treat opioid addiction as a replacement for illicit opiates but is itself an addictive substance which can result in overdoses [2] and can lead to withdrawal if not closely monitored by a licensed professional. Buprenorphine is currently used to treat opioid use disorder (OUD), and while it reduces illicit drug use, it is less effective than methadone for retaining patients in treatment. For these reasons, there is an urgent need for new opioid misuse interventions.
The objectives of this study [3] were to understand the implications of OUD and overdose treatments and determine the strengths and shortcomings of current treatments in comparison with the novel drug candidate methocinnamox (MCAM). These were completed through an extensive literature review into the history of the opioid epidemic in the United States, opioid receptors in the brain, current pharmacological treatments, and the pharmacological properties of MCAM.
MedicalResearch.com Interview with:
[caption id="attachment_58805" align="alignleft" width="150"] Harriet De Wit, PhD[/caption]
Harriet De Wit, PhD Professor of Psychiatry and Behavioral Neuroscience University of Chicago
MedicalResearch.com: What is the background for this study? Response: There are numerous reports that psychedelics like LSD, taken in very small ‘microdoses’, help boost mood, cognitive function and productivity. The practice is popular in Silicon Valley and among media figures, who report remarkable beneficial effects from regular use of these microdoses. The possible antidepressant effects of LSD are plausible from a neurobiological perspective, as the drug acts directly on serotonin receptors, the same systems where SSRI’s act. However, the effects of microdosing have not yet been validated in controlled research. In our study, we recruited healthy men and women to ingest repeated, low doses of LSD under double blind conditions. They attended four laboratory sessions, separated by three to four days. They were randomly assigned to one of three groups who received the same drug on all four sessions: placebo, 13 micrograms of LSD or 26 micrograms of LSD. Subjects were not told exactly what drug they were receiving until the end of the study. We measured their mood, emotional reactivity and cognition.
Dr. Myran[/caption]
Daniel Myran, MD, MPH, CCFP, FRCPC
Family and Public Health and Preventive Medicine Physician
CIHR Fellow, Ottawa Hospital Research Institute
Department of Family Medicine Innovation Fellow
University of Ottawa
MedicalResearch.com: What is the background for this study?
Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events.
Dr. O'Donnell[/caption]
Julie O’Donnell, PhD MPH
Division of Overdose Prevention
National Center for Injury Prevention and Control
CDC
National Network of Public Health Institutes
New Orleans, Louisiana
MedicalResearch.com: What is the background for this study?
Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System.
The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention.
Dr. Thakrar[/caption]
Ashish Thakrar, MD
Internal Medicine & Addiction Medicine
National Clinician Scholars Program
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release.
Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.
Dr. Howard[/caption]
Jeffrey Howard, PhD
Associate Professor
Department of Public Health
College for Health, Community and Policy
University of Texas at San Antonio
MedicalResearch.com: What is the background for this study?
Response: Drug and alcohol related mortality has been on the rise in the US for the past decade, which has drawn a lot of focus from researchers. At the same time maternal mortality, deaths caused by pregnancy complications, is recognized to be higher in the US than in other developed nations.
Very little has been reported about deaths among pregnant and recently pregnant women that are not caused by pregnancy complications, so my collaborators and I wanted to explore this. We did not anticipate that drug and alcohol deaths and homicides would account for so many deaths among pregnant and recently pregnant women.
Dr. Zorrilla Vaca[/caption]
Andres Zorrilla Vaca, MD
Resident Physician
Brigham and Women’s Hospital
Boston, Massachusetts
MedicalResearch.com: What is the background for this study?
Response: The background for this study was Enhanced Recovery After Surgery, also known as ERAS protocols. They basically consisted of a bundle of interventions that are performed preoperatively, intraoperatively and postoperatively with the aim of enhancing patient recovery and reducing complications.
This protocol in our institution started with a thorough preoperative counseling which includes, smoking cessation, pain and analgesia education, ERAS program expectations, pulmonary rehabilitation based on pulmonary function tests and incentive spirometry. On the day of surgery, prolonged fasting is avoided and a carbohydrate loading is given orally 2 hours before surgery. Our protocol also included a standardized multimodal analgesic regimen consisting of tramadol ER 300mg p.o. and gabapentin 300mg p.o., intraoperative acetaminophen 1gm i.v., posterior intercostal nerve blockade with liposomal bupivacaine 266mg prior to incision, intraoperative 30mg ketorolac upon wound closure and scheduled postoperative acetaminophen 1g p.o. q 6hrs and ketorolac 15mg i.v. q 6 hrs, as well as additonal interventions recommended by ERAS Society Guidelines.
As a general rule, preoperative sedatives (midazolam) are avoided as premedication and prophylaxis against nausea and vomiting (ondansetron, dexamethasone and scopolamine) is administered. Patients are kept euvolemic by using validated goal-directed fluid therapy algorithms (stroke volume variation and cardiac output) and normothermia is maintained throughout the procedure.
You should always see a doctor first if you have poor sleep quality, have trouble falling asleep, or staying asleep before you start self-medicating with CBD....
Dr. Anderson[/caption]
Mark Anderson, Ph.D.
Associate Professor
Department of Agricultural Economics and Economics
Montana State University, IZA, and NBER
MedicalResearch.com: What is the background for this study?
Response: In a previous study that was published in JAMA Pediatrics, we used Youth Risk Behavior Survey (YRBS) data and found that the adoption of recreational marijuana laws (RMLs) was associated with an 8% decrease in the odds of marijuana use among high school students. This earlier study, however, had pre-legalization and post-legalization data from only 7 states and pre- and post-recreational sales data from only 3 states, calling into question the generalizability of our findings.
Despite the ongoing efforts of all stakeholders to address the opioid epidemic, the United States continues to see worsening mortality data related to overdoses especially synthetic opioids like fentanyl....