Author Interviews, Cannabis, Ophthalmology, Race/Ethnic Diversity, Social Issues / 09.11.2020
Ophthalmology: Identifying Racial and Socioeconomic Disparities in Eye Health
MedicalResearch.com Interview with:
[caption id="attachment_55891" align="alignleft" width="200"] Dr. Uhr[/caption]
Joshua Uhr MD
Ophthalmologist
Philadelphia, PA
MedicalResearch.com: What is the background for this study?
Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology.
Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.
Dr. Uhr[/caption]
Joshua Uhr MD
Ophthalmologist
Philadelphia, PA
MedicalResearch.com: What is the background for this study?
Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology.
Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status. 
Dr. Lanza[/caption]
Isabella Lanza, PhD
Associate Professor of Human Development
California State University, Long Beach
MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is the first study to examine both nicotine vaping and cannabis vaping trajectories across adolescence and young adulthood, which allowed us to assess whether poly-substance vaping is common among adolescents and young adults. Poly-substance vaping (nicotine and cannabis vaping) was reported among a significant proportion of participants in the study (25% were identified as poly-substance vapers). For those that either escalated to frequent nicotine vaping use in adolescence or initiated frequent nicotine vaping use in young adulthood, the probability of engaging in cannabis vaping was very high (85%+).
Dr. Pollard[/caption]
Michael S. Pollard, Ph.D.
Professor, Pardee RAND Graduate School
Senior Sociologist
RAND Corporation
Santa Monica, CA 90407-2138
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are ample anecdotal jokes and stories about increased alcohol use during COVID-19 and stay-at-home orders. Our study provides robust longitudinal evidence that people drank more frequently, and for women in particular, more heavily, and with more negative consequences, during the initial stages of COVID-19 compared to their own behaviors from a year earlier (May/June 2020 compared to May/June 2019). Women’s alcohol consumption was most significantly changed, with a 17% increase in number of days drinking, and a 41% increase in days of binge drinking (when they had four or more drinks in a couple of hours). This means that, nationally, one in five women drank heavily one more day a month than the same time in 2019, on average. Women also reported a 39% increase in alcohol-related problems, such as “I took foolish risks” or “I failed to do what was expected of me” because of drinking alcohol.
Dr. Ellingson[/caption]
Jarrod Ellingson PhD
Assistant Professor
Department of Psychiatry
Anschutz Medical Campus
University of Colorado Denver
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that cannabis use is associated with many negative outcomes, but there could be many of reasons for that. For example, socioeconomic factors and peer influences both affect adolescent cannabis use and poorer cognitive functioning. To account for some of those risk factors, we studied nearly 600 sibling pairs with moderate to heavy cannabis use. We found that, as a person uses more cannabis than their sibling, they tend to have worse memory recall than their sibling.
Response: It is well known that marijuana usage impairs driving ability, yet the early studies of the effects of recreational marijuana legalization on traffic fatalities were inconclusive.
MedicalResearch.com: What are the main findings?
Response: By analyzing data over a longer time period, we found that the legalization of recreational marijuana increased traffic deaths in the first four states to legalize. Traffic fatalities increased about 20% in those states. If we apply these numbers to the nation as a whole, nationwide legalization would be associated with about 7,000 excess traffic fatalities each year.
Dr. Desai[/caption]
Nimesh D. Desai, MD, PhD
Director, Thoracic Aortic Surgery Research Program
Associate Professor of Surgery
Hospital of the University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Dr. Chase Brown: Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain.
Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery. 
Dr. Vandrey[/caption]
Ryan Vandrey, Ph.D.
Associate Professor
Behavioral Pharmacology Research Unit
Johns Hopkins University School of Medicine
Baltimore, MD 21224
MedicalResearch.com: What is the background for this study?
Response: The background for this study is that 33 states in the U.S. have legalized medicinal cannabis use and millions of people are using cannabis for therapeutic purposes, but we have very little data on the broad health impacts of medicinal cannabis use.
We surveyed medicinal cannabis users and non-using controls who had a variety of health problems and found that the cannabis users reported better health, quality of life, and less healthcare utilization compared with controls. Because we worried about group characteristics accounting for the differences observed, we then did an analysis of people who switched groups over time (e.g. non-users who later initiated cannabis use or cannabis users who later quit) and found the same differences emerged in the same individuals over time. Important to note here is that not all individuals who used cannabis benefited from it and that most participants were using high CBD varieties of cannabis in conjunction with more traditional treatments.
Dr. Filbey[/caption]
Francesca Filbey, PhD
Associate Provost and Professor of Cognition and Neuroscience
Bert Moore Chair
The University of Texas at Dallas
MedicalResearch.com: What is the background for this study?
Response: Studies have reported differences in how males and females respond to cannabis and how they develop problems related to cannabis use. We sought to determine whether craving may underlie this difference in male and female cannabis users.
Dr. Hollingsworth[/caption]
Alex Hollingsworth PhD
Assistant Professor
O'Neill School of Public and Environmental Affairs
Indiana University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use.
Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products.
Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful.
We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate.
