Addiction, Author Interviews, Opiods, Pharmacology / 06.08.2018

MedicalResearch.com Interview with: Mark Pirner, MD, PhD Senior Medical Director Clinical Research and Medical Affairs US WorldMeds MedicalResearch.com: What is the background for this announcement? How does lofexidine differ from other opioid withdrawal medications? Response: LUCEMYRA™ (lofexidine) was FDA-approved on May 16 as the first and only non-opioid, non-addictive medication for the management of opioid withdrawal in adults. LUCEMYRA mitigates the acute and painful symptoms of opioid withdrawal by suppressing the neurochemical surge in the brain that occurs when opioids are abruptly discontinued. In clinical studies, patients receiving treatment with LUCEMYRA experienced greater symptom relief and were significantly more likely to complete their withdrawal. LUCEMYRA is not an opioid drug and is not a treatment for opioid use disorder; it should be used as part of a longer-term treatment plan. (more…)
Author Interviews, Cancer Research, Cannabis, Pancreatic / 01.08.2018

MedicalResearch.com Interview with: Prof Marco Falasca Head Metabolic Signalling Group School of Pharmacy & Biomedical Sciences Faculty of Health Sciences Curtin University Western University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Each year around 9,800 people in the UK are diagnosed with pancreatic cancer. The disease is particularly aggressive and has one of the lowest survival rates of all cancers. Indeed, the life expectancy for pancreatic cancer patients has barely changed in the last 40 years because there are very few, and mostly only palliative care, treatments available. Given the five-year survival rate for people with pancreatic cancer is less than seven per cent, the discovery of new treatments and therapeutic strategies is urgently needed. In this study, we decided to concentrate on a protein, named GPR55, found in high levels in pancreatic cancer. Our results show that GPR55 promotes pancreatic cancer progression. Consequently, we decided to use its inhibitor cannabidiol, a naturally occurring constituent of medicinal cannabis, as a pharmacological strategy to block GPR55 activity. Strikingly, mice with pancreatic cancer that were treated with cannabidiol alongside chemotherapy, survived almost three times longer than those treated with chemotherapy alone, our study reports.  (more…)
Author Interviews, Cannabis, McGill, Pulmonary Disease / 30.07.2018

MedicalResearch.com Interview with: Sara Abdallah, PhD Student, first author and Dennis Jensen, PhD Associate Professor, Department of Kinesiology and Physical Education Associate Dean – Infrastructure, Faculty of Education Director, McGill Research Center for Physical Activity and Health Canada Research Chair in Clinical Exercise & Respiratory Physiology Associate Member, Translational Research in Respiratory Diseases Program Research Institute of the McGill University Health Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many patients with chronic obstructive pulmonary disease (COPD) suffer from severe breathlessness at rest and on minimal exertion despite receiving optimal drug therapy for their underlying disease (e.g., bronchodilators). In these patients, breathlessness significantly diminishes exercise capacity and quality of life. Thus, research focused on identifying adjunct therapies for management of breathlessness in patients with advanced COPD is clinically relevant. A series of studies conducted in the 1970’s found that smoked cannabis caused bronchodilation (i.e., improved airway function) in healthy individuals and in patients with asthma. More recently, it has been demonstrated that delta-9 (∆9)-tetrahydrocannabinol (THC, the major cannabinoid constituent of cannabis) inhibits cholinergic contractions in isolated human bronchi and that a positive association exists between measure of lung function (e.g., forced expiratory volume in 1-sec) and cannabis use in patients with COPD. These studies lead us to hypothesize that inhalation of vaporized cannabis may alleviate exertional breathlessness and improve exercise tolerance in patients with advanced COPD by improving airway function at rest and during exercise. (more…)
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018

MedicalResearch.com Interview with: Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. (more…)
Addiction, Anesthesiology, Author Interviews, Emergency Care, Pain Research / 23.07.2018

MedicalResearch.com Interview with: Evan Schwarz, MD FACEP, FACMT Associate Professor of Emergency Medicine Medical Toxicology Fellowship Director Section Chief Medical Toxicology Advisory Dean in the Office of Student Affairs Division of Emergency Medicine Washington University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Ketamine is being increasingly used in the emergency department (ED) for a variety of conditions, including as an analgesic. While its usage continues to increase, there are limited studies evaluating ketamine as an analgesic in the emergency department. Most of the studies evaluating ketamine utilized it as an adjunct to an opioid, however, multiple recommendations on blogs and other websites recommend ketamine as a single agent. The purpose of the meta-analysis was to compare the analgesic effect of ketamine compared to an opioid in adult patients presenting with acute pain to the ED. In this study, we found that ketamine was non-inferior to opioids. We also found that the number of severe adverse events to be similar between both groups. (more…)
Alcohol, Author Interviews, Fertility / 19.07.2018

MedicalResearch.com Interview with: “sperm” by Iqbal Osman is licensed under CC BY 2.0Elena Ricci, ScD, PhD Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano MedicalResearch.com: What is the background for this study? What are the main findings? Response: The role of alcohol drinking on male fertility is still controversial. A negative association between alcohol intake and semen quality has been suggested by some authors, although other studies did not confirm this finding. We performed a cross-sectional analysis of baseline data from a cohort study on subfertile couples, and found that men with a moderate alcohol intake (4 to 7 units of ethanol per week - 1unit=12.5 grams ) had higher semen volume and sperm total count than men with both lower and higher intake. Abstainers had a better sperm concentration, but the small size of this group prevented us from drawing any significant conclusions. Alcohol was not associated to sperm motility.  (more…)
Addiction, Alcohol, Author Interviews / 18.07.2018

MedicalResearch.com Interview with: “undefined” by Iñaki Queralt is licensed under CC BY 2.0Richard Saitz, MD, MPH, FACP, DFASAM Chair and Professor,Department of Community Health Sciences Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most of what we know about the time course of drinking too much (at-risk use) is from people in treatment or special groups and not adults in the US population at large. That’s why we did this study. We need to know how often at-risk drinking persists, how often it resolves, and how often it appears de novo. Risky drinking means exceeding limits that are associated with health consequences. It includes people with an alcohol use disorder but the vast majority of people drinking risky amounts do not have a disorder, they are simply drinking amounts that can harm their health. Even low amounts can harm health (e.g. breast cancer risk increases at <1 drink a day) but substantial increases in risk occur over 7 in a week on average (for women, and 14 for men) or >5 for men (>4 for women) on an occasion. The latter are associated with acute consequences (e.g. injury, unwanted sex), and the former with chronic conditions (e.g. cirrhosis). People should be aware of their risks and then they can make choices about what risks they want to take (and for those with a disorder, they may need help with those choices and help changing behavior like treatment). These are all useful thing to talk to any young adults about before they set off on a stag do in Krakow or any other city! The main findings were….that 3 years later, 3/4ths of adults drinking risky amounts were still doing so. But importantly, a quarter had stopped drinking risky amounts. It is important to know that things change. One factor associated with that positive change was having kids—presumably a positive social change even if stressful. Of those adults not drinking risky amounts when first interviewed, 15% started doing so 3 years later. Again having children was protective but the main factor associated with starting was young age, particularly those who became of legal drinking age. Despite the fact that youth may be able to access alcohol illegally, this finding confirms that the drinking age of 21 in the US does in fact restrict access, and that turning 21 increases use and risky use by making alcohol more accessible. (more…)
Addiction, Author Interviews, Cocaine, Genetic Research / 17.07.2018

MedicalResearch.com Interview with: “Cocaine concealed in washing powder” by The National Crime Agency is licensed under CC BY 2.0 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Drug addiction is a chronically relapsing neuropsychiatric disease that affects 15.5 million people in Europe at a cost of 65.7 billion euros per year. All addictive drugs have in common to cause an artificial increase in the release of a neurotransmitter called dopamine, a very basic effect that can be found in all studied animal species from the fly to the man. The release of dopamine takes place in a region of the brain called the ventral striatum, or Nucleus Accumbens (NAc), which is directly involved in reward and reinforcement processes. An excess of dopamine release by the dopaminergic neurons projecting to the NAc from the Ventral Tegmental Area (VTA) triggers long-term changes in the brain, which can lead to addiction. Cocaine is a prototypical addictive drug, since it is heavely abused in Western societies and extensively studied in animal models as well as humans. We discovered that mice lacking the Maged1 gene showed a marked decrease in cocaine-elicited release of dopamine in the NAc and were entirely unresponsive to cocaine at behavioral level. In fact, they did not show any behavioral reaction normally observed after cocaine treatment, such as cocaine-elicited hyperlocomotion, sensitization (an increased effect of the drug following repeated administrations) or addictive behaviors, such as increased preference for places where the animal expects to obtain a cocaine reward or cocaine self-administration. In a subsequent set of experiments, the researchers tried to identify what brain regions are responsible for Maged1 influence on cocaine effects and found that Maged1 expression is specifically required in the prefrontal cortex, and not in the neurons producing dopamine in the VTA, for the development of cocaine sensitization and dopamine release.  (more…)
Author Interviews, JAMA, Opiods / 09.07.2018

MedicalResearch.com Interview with: Tyler Winkelman MD, MSc  Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota MedicalResearch.com: What is the background for this study? Response: Opioid overdose deaths continue to escalate, and there have been reports that jails and prisons are bearing the brunt of the opioid epidemic. However, it wasn’t known, nationally, how many people who use opioids were involved in the criminal justice system. We also didn’t have recent estimates of common physical and mental health conditions among people with different levels of opioid use. We used two years of national survey data to understand these associations, which are critical in developing a public health response to the opioid epidemic. (more…)
Alcohol, Author Interviews, Endocrinology, Genetic Research / 28.06.2018

MedicalResearch.com Interview with: Toni Pak, Ph.D. Professor and Department Chair Department of Cell and Molecular Physiology Loyola University Chicago Maywood, Ill  MedicalResearch.com: What is the background for this study? Response: We have known for many years that drinking alcohol during pregnancy can lead to developmental delays and birth defects in offspring. However, our data demonstrate that drinking large quantities of alcohol in a “binge” fashion before pregnancy can also impact future offspring and importantly, this is true for drinking behaviors of both parents, not just the mother. Our previous data support the idea that alcohol is affecting the parental sperm and eggs to induce these modifications in the offspring, but this most recent work shows the extent of those effects on social behavior, pubertal maturation, and stress hormones as the offspring grow to adulthood. This means that the risky behaviors of young people, such as the extremely popular practice of binge drinking, have potentially far-reaching consequences for generations to come. (more…)
Author Interviews, Opiods, University of Pittsburgh / 27.06.2018

MedicalResearch.com Interview with: Jeanine M. Buchanich, Ph.D. Research associate Professor in the University of Pittsburgh Graduate School of Public Health’s Department of Biostatistics MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., cause of death codes are assigned by the National Center for Health Statistics (NCHS) using information reported by the coroner or medical examiner completing the death certificate. Drug-specific overdose deaths are identified by the contributory causes of death, which are categorized as “T codes” and are assigned based on the specific drugs recorded by the coroner or medical examiner completing the death certificate. A code of T50.9 means “other and unspecified drugs, medicaments and biological substances.” My colleagues and I extracted death data by state for 1999 through 2015 from the NCHS’s Mortality Multiple Cause Micro-data Files. We grouped overdose deaths into opioid-related, non-opioid-related and unspecified codes. In five states – Alabama, Indiana, Louisiana, Mississippi and Pennsylvania – more than 35 percent of the overdose deaths were coded as unspecified. We then calculated the change in percentage of overdose deaths that fell into each category from 1999 to 2015 by state. In those 17 years, opioid-related overdose deaths rose 401 percent, non-opioid-related overdose deaths rose 150 percent and unspecified overdose deaths rose 220 percent. This allowed us to extrapolate how many of the unspecified overdose deaths were likely opioid-related. By our calculations, potentially 70,000 opioid-related overdose deaths were not included in national opioid-related mortality estimates since 1999 because coroners and medical examiners did not specify the drug that contributed to the cause of death when completing the death certificates.  (more…)
Author Interviews, Opiods, Pediatrics, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: Gary A. Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Buprenorphine is a prescription opioid medication commonly used to treat opioid use disorder. From 2005 to 2010, the annual number of individual patients who received a buprenorphine prescription increased from 100,000 to more than 800,000. Although buprenorphine is important for the treatment of opioid use disorder, pediatric exposure to this medication can result in serious adverse outcomes. (more…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 26.06.2018

MedicalResearch.com Interview with: Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation MedicalResearch.com: What is the background for this study? Response: Increasing use of medication treatment for individuals with opioid use disorders, with medications like methadone and buprenorphine, is a critical piece of the nation’s response to the opioid crisis. Buprenorphine was approved by the FDA in 2002 for treatment of opioid use disorders, but there was little information about to what extent buprenrophine’s approval increased the number of Medicaid-enrollees who received medication treatment in the years following FDA approval nor to what extent receipt of such treatment was equitable across communities. (more…)
Author Interviews, JAMA, Opiods, University of Pittsburgh / 25.06.2018

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 15261 MedicalResearch.com: What is the background for this study? Response: Prior research has found that taking opioids and benzodiazepines simultaneously increases the risk of overdose by 2 to 3 fold, when compared to opioid-use only. However, prior to our study, it was unclear how the risk of overdose changes over time with the concurrent use of opioids and benzodiazepines. (more…)
Alcohol, Author Interviews, Cancer Research, PLoS / 20.06.2018

MedicalResearch.com Interview with: “Alcohol” by zeevveez is licensed under CC BY 2.0Andrew Kunzmann Research Fellow Queen's Universit Belfast MedicalResearch.com: What is the background for this study?   Response: We decided to conduct this research because the messages about the health effects linked to light-moderate drinking are less consistent. Previous studies suggest that light-moderate drinking is linked to an increased risk of cancer but a lower risk of mortality than never drinking. The international guidelines around what constitutes drinking in moderation also differ, with UK guidelines now recommending intakes below 6 pints of beer or 175ml glasses of wine per week (equivalent to less than 1 per day) but other guidelines recommending intakes of 2 drinks or less per day. We wanted to see what the risk of getting either of these conditions (cancer or mortality) were to give a more comprehensive and less confusing message about the health effects of light-moderate drinking. This was part of a well-established collaboration between Queen’s University Belfast and the National Cancer Institute in the US. We used data from a cancer screening trial in the US that contained data on over 100,000 people from the US, who were free from cancer at the start of the study and who completed a questionnaire asking how much alcohol they consumed at different periods of their adult life. This was then linked to data over an average of 9 years after they completed the questionnaire to see which individuals developed cancer or died from any cause. We then assessed whether risk of cancer and mortality differed based on lifetime alcohol intakes after accounting for a number of other factors such as age, educational attainment, smoking and dietary intakes. (more…)
Addiction, Annals Internal Medicine, Author Interviews, Opiods / 19.06.2018

MedicalResearch.com Interview with: Marc R. Larochelle, MD, MPH Assistant Professor of Medicine Boston University School of Medicine Boston MD  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study we examined more than 17,000 individuals who survived an opioid overdose in Massachusetts between 2012 and 2014. We were interested in identifying how many went on to receive one of the three FDA-approved medications for opioid use disorder (MOUD), and whether or not they were associated with mortality. We found that only 3 in 10 received MOUD and that receipt of buprenorphine and methadone were associated with 40-60% reduction in all-cause and opioid-related mortality. We found no association between naltrexone and mortality though the confidence of this conclusion is limited by the small number who received naltrexone in this cohort. (more…)
Author Interviews, Emergency Care, Opiods / 16.06.2018

MedicalResearch.com Interview with: Herbie Duber, MD, MPH, FACEP Associate Professor, Emergency Medicine Adjunct Associate Professor Department of Global Health Adjunct Associate Professor Institute for Health Metrics and Evaluation University of Washington MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Opioid use disorder (OUD) and opioid overdose deaths are a rapidly increasing public health crisis.  In this paper, we review and synthesize current evidence on the identification, management and transition of patients from the emergency department (ED) to the outpatient setting and present several key recommendations. For patients identified to haveOpioid use disorder, we recommend ED-initiated mediation-assisted therapy (MAT) with buprenorphine, an opioid agonist.  Current evidence suggests that it safe and effective, leading to improved patient outcomes.  At the same time, a coordinated care plan should be put into motion which combines MAT with a rapid transition to outpatient care, preferably within 72 hours of ED evaluation.  Where possible, a warm handoff is preferred, as it has been shown in other settings to improve follow-up.  Outpatient care should combine MAT, psychological interventions and social support/case management in order to maximize impact (more…)
Addiction, Author Interviews, Cannabis, Mental Health Research / 15.06.2018

MedicalResearch.com Interview with: “Cannabis sativa” by Manuel is licensed under CC BY 2.0 Leen Naji, BHSc, MD Family Medicine Resident McMaster University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cannabis use has consistently been linked to suicide attempt in the general population, but little data exists linking the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. This is important data as we know that patients with psychiatric disorders are both more likely to use cannabis and to attempt suicide. Therefore, our goal was to study the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. Additionally, since we know that women are more likely to suffer from mental health disorders, are more likely to attempt suicide and are more likely to incur the deleterious consequences of drug use at lower doses, we sought to compare the association between cannabis use and suicide attempt in men and women amongst our study population. We conducted our analysis on a large sample of over 900 adults with psychiatric disorders (465 men, 444 women), of whom 112 men and 158 women had attempted suicide. The average age of our study sample was 40 years. We found that cannabis use is not associated with an increased risk of suicide in patients with psychiatric disorders, though this association may vary when looking at specific subpopulations and/or amount of cannabis use. For instance, we found that heavier cannabis use is associated with an increased risk of suicide attempt amongst men with psychiatric disorders. Specifically, there was a 3% increased risk of suicide attempt for every day of cannabis use per month in men with psychiatric disorders. We also found that amongst those with psychiatric conditions, women, unemployed individuals and those with a mood disorder were at increased risk of suicide attempt.   (more…)
Addiction, Author Interviews, Smoking, Tobacco, Tobacco Research / 15.06.2018

MedicalResearch.com Interview with: e-cigarette CDC imageDr Lynne Dawkins, PhD Associate Professor London South Bank University MedicalResearch.com: What is the background for this study? Response: Many people think that it’s the nicotine that’s harmful so they opt for using a low strength in their e-liquid. We know from tobacco smoking that when people switch to using a lower nicotine yield cigarette, they compensate in order to maintain a steady blood nicotine level by taking longer, harder drags and this can increase exposure to toxins in the smoke. We also know from some of our other work with vapers (e-cigarette users) that they tend to reduce the nicotine strength of their e-liquid over time. We therefore wanted to explore whether vapers also engage in this compensatory puffing and whether this has any effect on exposure to potentially harmful chemicals. (more…)
Addiction, Author Interviews, Mental Health Research / 13.06.2018

MedicalResearch.com Interview with: Scott J. Russo PhD Fishberg Dept. of Neuroscience Friedman Brain Institute, and Center for Affective Neuroscience Icahn School of Medicine at Mount Sinai New York, NY  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is increasing evidence that aggressive behavior might share key features with addiction.  For example, aggressive mice develop positive associations with environmental cues associated with previous aggressive encounters (ie. they find aggression rewarding) and aggressive animals will work very hard to obtain access to a subordinate animal in order to attack them. Some of the same brain regions that are activated in response to addictive drugs, like cocaine and morphine, are also activated by aggressive experience.  Thus we hypothesized that there may be shared neurobiological mechanisms between addiction and aggression. Our study showed that there is accumulation of the addiction-related transcription factor, ΔFosB, in the nucleus accumbens, a brain region well know to regulate the rewarding and addictive properties of drugs of abuse. (more…)
Addiction, Author Interviews / 11.06.2018

MedicalResearch.com Interview with: Professor, Rita Z. Goldstein, PhD Department of Psychiatry (primary) and Department of Neuroscience, Friedman Brain Institute (secondary) Chief, Neuropsychoimaging of Addiction and Related Conditions (NARC) Research Program Anna Zilverstand PhD Assistant Professor, Psychiatry Icahn School of Medicine at Mount Sinai The Leon and Norma Hess Center for Science and Medicine New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In comparison to previous reviews that often focused on investigating select brain circuits, such as the reward network, our review is the first to systematically discuss all brain networks implicated in human drug addiction. Based on more than 100 neuroimaging studies published since 2010, we found that six major brain networks showed altered brain function in individuals with addiction. These brain circuits are involved in a person’s ability to select their actions (executive network), in directing someone’s attention (salience network), in adaptive learning of new behaviors (memory network), in the automatization of behaviors (habit network), in self-reflection (self-directed network) and the valuation of different options (reward network). When individuals with addiction are confronted with pictures of drug taking, all of these networks become very highly engaged; however, when the same individuals are confronted with scenes depicting other people, their brains show a reduced reaction as compared to healthy individuals, indicating less involvement. Similarly, the brain of an addicted individual is less engaged when making decisions (that are not relevant to their drug taking) or when trying to inhibit impulsive actions. We further found that some impairments of brain functions, such as alterations underlying the difficulty to inhibit impulsive actions, seem to precede drug addiction, as we observe similar impairments in adolescents that later go on to abuse drugs. However, particularly the impairments in the executive network (involved in the ability to inhibit impulsive actions), the valuation network (which computes the value of an option) and the salience network (that directs attention towards events) seem to be getting worse with more severe drug use and also predict if someone is likely to relapse or not. The good news is that we also found that it is possible to (partially) recover and normalize brain function in these networks through treatment. Importantly, the widespread alterations of brain function were independent of what drug an individual was addicted to (marijuana, alcohol, cigarettes, cocaine, methamphetamine, heroin, amongst others). (more…)
Addiction, Alcohol, Author Interviews, Opiods / 07.06.2018

MedicalResearch.com Interview with: Dr. Katie Witkiewitz PhD Professor, Department of Psychology University of New Mexico MedicalResearch.com: What are the main findings? Response: The main findings from our study indicate that individuals with alcohol dependence who misused opioids (e.g., used without a prescription or not as prescribed) had a significantly higher likelihood of relapse to heavy drinking during alcohol treatment and were drinking more alcohol during and following alcohol treatment. (more…)
Addiction, Author Interviews, JAMA, Race/Ethnic Diversity / 06.06.2018

MedicalResearch.com Interview with: Randall C. Swaim, Ph.D. Senior Research Scientist and Director Linda R. Stanley, Ph.D. Senior Research Scientist Tri-Ethnic Center for Prevention Research Department of Psychology Colorado State University                           MedicalResearch.com: What is the background for this study? Response: American Indian adolescents consistently report the highest levels of substance use compared with other US racial/ethnic groups. The harm associated with these high rates of use include higher risk of developing a substance use disorder, more alcohol-related problems, including alcohol-attributable death, and other negative outcomes such as school failure. These findings point to the importance of continuing to monitor this group, particularly given changing trends in perceived harmfulness of illicit substances as new statutes alter access to medical and recreational use of cannabis. (more…)
Addiction, Author Interviews, Opiods, Pain Research / 23.05.2018

MedicalResearch.com Interview with: Dr. Stuart Lustig, M.D., M.P.H National Medical Executive for Behavioral Health Cigna Dr. Lustig discusses Cigna’s efforts to curb the opioid epidemic. MedicalResearch.com: What is the background for the Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data study? Response: In 2016 Cigna announced a collaboration with the American Society of Addiction Medicine (ASAM) to improve treatment for people suffering from substance use disorders and establish performance measures and best practices for addiction treatment. Mining anonymized data from Cigna’s administrative data, Brandeis University researchers have validated a new way to hone in on trouble spots where substance use disorder treatment for opioid, alcohol and other drug dependence is suboptimal, like the way police departments use computers to identify high crime areas in need of greater scrutiny and attention. The technique uses ASAM-defined performance measures to assess substance use disorder treatment patterns, giving researchers the ability to sort through administrative data and measure to the extent to which patients being treated for opioid or alcohol use disorder are receiving and using evidenced-based medications proven to be effective in improving outcomes and retention in treatment. It also measures whether those patients received support during substance withdrawal – a critical factor in the success of addiction treatment plans. The performance measures were first tested on the Veterans’ Health Administration in 2016 and now, on data from Cigna. (more…)
Addiction, Author Interviews, Opiods / 22.05.2018

MedicalResearch.com Interview with: Christopher J. Ruhm, PhD Frank Batten School of Leadership and Public Policy University of Virginia Charlottesville, VA MedicalResearch.com: What is the background for this study? What are the main findings? Response: I have been interested for some time in understanding the extent to which the rise in drug fatalities can explaining the rising mortality rates of midlife whites that have been experienced since the turn of the century. The primary findings are as follows:
  1. The rise in drug mortality is sufficiently large to explain the entire growth in mortality rates and years of potential life lost experienced by 22-56 year old non-Hispanic whites (NHW) from 1999-2015. This does not imply that there are not other sources of concern related to this decline in life expectancy but indicate a key role of drug deaths.
  2. The growth in drug deaths is particularly pronounced for males in their 20s and 30s, in contrast to some earlier research focusing on NHW in their 40s and 50s.
  3. Deaths involving illicit opioids are the primary driver for young NHW males, with more equal contributions of illicit and prescription opioids for some what older NHWs. These results also indicate that prior studies focusing on persons in their 40s and 50s may provide a misleading picture of the pattern of deaths for the group experiencing the greatest increases.
(more…)
Author Interviews, Cannabis, Pediatrics / 21.05.2018

MedicalResearch.com Interview with: Natalie Castellanos Ryan, PhD École de Psychoéducation Université de Montréal Outremont Canada  MedicalResearch.com: What is the background for this study? Response: Our study followed a group of boys living in low socioeconomic neighbourhoods in Montreal (N=1030) from early childhood to 28 years of age to investigate: 1) whether the age at which one starts to use cannabis across adolescence is associated with the risk of developing drug abuse by early adulthood, when one controls for  arrange of known risk factors for cannabis use and problems assessed across development (risk factors in childhood, adolescence and early adulthood); and 2) the developmental pathways from early risk factors to drug abuse problems. To examine these associations, the study collected  self-reported cannabis use information from these boys annually from ages 13 to 17 years and drug abuse symptoms at 28 years, as well as teacher, parent and child reported information on a number of environmental (family and friend) and child characteristics (e.g., impulsivity, delinquency, school performance) across childhood and adolescence. Alcohol and other drug use was also assessed across adolescence and early adulthood. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Opiods, University of Pittsburgh / 21.05.2018

MedicalResearch.com Interview with: Jason Kennedy, MS Research project manager Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Most previous studies of opioid use in health care have focused on the outpatient setting. But opioids are often introduced during hospitalization. That’s something clinicians can control, so we looked at inpatient prescription of these drugs to identify targets that may reduce opioid use once patients are out of the hospital. We analyzed the medical records of 357,413 non-obstetrical adults hospitalized between 2010 and 2014 at 12 University of Pittsburgh Medical Center (UPMC) hospitals in southwestern Pennsylvania. The region is one of the areas of the country where opioid addiction is a major public health problem. We focused on the 192,240 patients who had not received an opioid in the year prior to their hospitalization – otherwise known as “opioid naïve” patients. Nearly half (48 percent) of these patients received an opioid while hospitalized.  After discharge, those patients receiving hospital opioids were more than twice as likely to report outpatient opioid use within 90-days (8.4 percent vs. 4.1 percent). Patients who receive an opioid for most of their hospital stay and patients who are still taking an opioid within 12 hours of being discharged from the hospital appear more likely to fill a prescription for opioids within 90 days of leaving the hospital.  (more…)
Addiction, Author Interviews, JAMA, Opiods, Pharmaceutical Companies / 14.05.2018

MedicalResearch.com Interview with: “Big Lunch Extras Reading” by Big Lunch Extras is licensed under CC BY 2.0Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Boston Medical Center Director of Urban Health & Advocacy Track | Boston Combined Residency Program Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids. In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing. We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be. (more…)