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....
Youngeun Armbuster[/caption]
Youngeun Armbuster
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Cocaine is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II drug that can be used as an anesthetic in various types of surgery by otorhinolaryngologists, as well as in diagnosing Horner syndrome. Although controlled doses of cocaine used in topical anesthetics does not cause myocardial infarction as can occur with recreational dosages, intranasal administration of cocaine is absorbed systemically and it results in vasoconstriction of the coronary arteries via stimulation of adrenergic receptors. These potential adverse effects may disincentivize health care providers from medical cocaine use. Our objective was to quantify the trends in licit cocaine distribution in the United States using DEA data and to determine the usage of medical cocaine in Medicaid and Medicare, as well as based on electronic medical records [1].
Dr. Schmitz[/caption]
Joy M. Schmitz, Ph.D.
Professor of Psychiatry Faillace Chair
McGovern Medical School
The University of Texas Health Science Center at Houston
Director, Center for Neurobehavioral Research on Addiction (CNRA)
[caption id="attachment_57886" align="alignleft" width="120"]
Dr. Lane[/caption]
Scott D. Lane Ph.D.
McGovern Medical School
Vice Chair For Research
Director Of Neurobehavioral Laboratory
Center For Neurobehavioral Research On Addiction
Director Of Research
University of Texas Health Science Center at Houston
Houston, TX
MedicalResearch.com: What is the background for this study?
Response: Addiction science has made considerable progress in understanding how cocaine and other addictive drugs impair the brain. Over time, cocaine can disrupt brain regions that help us think, plan, solve problems, and exert self-control. These disruptions in brain structure can be seen in neuroimaging studies that reveal impairment in the nerve fibers or white matter (WM) tracts in the central and front parts of the brain. We conducted two systematic meta-analytic reviews of the literature to document the robustness of evidence showing alterations in WM integrity of chronic stimulant users relative to healthy control subjects who did not use cocaine or other drugs of abuse (Beard et al., 2019; Suchting et al., 2020). Importantly, WM impairments negatively predict treatment outcome, meaning individuals with greater levels of WM impairment are less likely to benefit from treatment and more likely to experience deficits in attention, working memory, and impulse control.
We reasoned that pharmacological interventions shown to protect WM integrity may help improve cognition and treatment outcomes in patients recovering from cocaine addiction. Pioglitazone, an approved medication for type 2 diabetes, has been shown to reduce inflammation and mediate protection after traumatic brain injury. The therapeutic potential of pioglitazone has prompted investigation of its role in neurodegenerative conditions, such as dementia, Alzheimer’s disease, and stroke. Similar to these brain diseases and injuries, pioglitazone might effectively protect the brain from the inflammatory damage created by cocaine use.
This study and abstract presentation evaluated opioid withdrawal symptoms, safety and tolerability of initiating SUBLOCADE 300 mg one hour after administering a single dose of 4 mg transmucosal (sublingual) buprenorphine (BUP-TM).
26 participants received BUP-TM, 24 follow by SUBLOCADE injection, and 20 completed the study.
Participants were evaluated for opioid withdrawal symptoms as well as safety and tolerability of SUBLOCADE 300 mg.
John Boyle[/caption]
John Boyle, BS
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Meperidine is an opioid analgesic which has been approved for use since the 1940s for moderate to severe pain. During the 1990s, concerns about adverse effects (e.g., serotonin syndrome) and CYP450 drug interactions (e.g., 3A4 inhibition of other metabolism of other common medications) were raised and by 2003 it was removed from the WHO’s List of Essential Medicines.
Despite increased awareness of adverse effects, meperidine is still used in the United States. It was the goal of this study1 to uncover pharmaepidemiological trends in its use.
Response: Adults with moderate or severe opioid use disorder (OUD) were randomized to SUBLOCADE monthly injections or placebo and studied for 24 weeks.
Participants receiving SUBLOCADE were given 2 monthly injections of 300 mg, followed by 4 monthly maintenance doses of 100 mg or 300 mg over the course of the study.
Don’t Endure It Alone Get your friends and family involved with the detox process so that you have people you can fall back on for support. It’s not an easy process, but there’s no reason you have to go through it all by yourself....
Dr. Peacock[/caption]
Frank Peacock, MD, FACEP, FACC
Professor of Emergency Medicine, Associate Chair
Research Director, Department of Emergency Medicine
Baylor College of Medicine
Houston, Texas
MedicalResearch.com: What is the background for this study?
Response: Emergency medicine (EM) physicians, like myself, are always looking for ways to improve the patient experience. Often times, we will encounter a patient in the emergency department (ED) who is presenting with one of the most common side effects of opioids, which is opioid-induced constipation (OIC). OIC impacts 40-80% of patients on long-term opioid therapy[i],[ii] and may lead to emergency room visits which are associated with a significant burden on patients and the healthcare system. We wanted to compare the impact of treating OIC patients with FDA-approved prescription medications for OIC versus the impact of not treating OIC patients with an FDA-approved prescription medication for OIC in the ED setting to better understand the impact to overall ED costs and the length of stay for a hospitalized patient.
Dr. Mezue[/caption]
Kenechukwu Ndubisi Mezue, M.D
Fellow in Nuclear Cardiology
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: Observational studies have shown that moderate alcohol intake may have beneficial effects on cardiovascular disease. However, the mechanisms through which this benefit occurs is mostly unknown. Chronic stress is also known to associate with increased risk of cardiovascular disease and our group has shown in previous work that increased activity in the stress-associated regions of the brain (such as the amygdala) is significantly associated with increased bone marrow activity, arterial inflammation, and cardiovascular events.
Our current study hypothesizes that moderate alcohol intake reduces cardiovascular events by reducing chronic stress-associated brain activity.
Future randomized controlled studies are needed to determine dosing, efficacy, and safety of medical marijuana for the treatment of various forms of itch....
Sarah Windle[/caption]
Sarah Windle, MPH
PhD Student in Epidemiology
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University (Montréal, Québec, Canada)
MedicalResearch.com: What is the background for this study?
Response: Concerns have been raised about the potential for increases in impaired driving following the legalization of recreational cannabis use in Canada in October 2018. Data from Statistics Canada suggest that cannabis use in the previous three months increased among adults (15 and older) from 14% before legalization in 2018 to 17% in 2019. Among those users with a driver’s license, 13% reported driving within two hours of cannabis use. While this proportion remained the same before and after legalization, this indicates that the absolute number of individuals who reported driving within two hours of use has increased following legalization (due to an increase in the number of users).
Dr. Wymore[/caption]
Erica M. Wymore, MD MPH
Assistant Professor, Neonatal- Perinatal Medicine
Department of Pediatrics, Section of Neonatology
University of Colorado School of Medicine
Children's Hospital Colorado
[caption id="attachment_56868" align="alignleft" width="161"]
Dr. Bunik[/caption]
Maya Bunik, MD, MPH | Professor, Pediatrics
Medical Director, Child Health Clinic, Primary Care | Breastfeeding Management Clinic
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)
School of Medicine| University of Colorado Anschutz Medical Campus
Children's Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure.
As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum.
Response: The background for the study is the steady rise of cannabis use as a therapeutic in Israel and in many countries around the world. This largest increasing population of patients treated with medical cannabis is the older adults. However, very little data was published about cannabis treatment in older adults, and specifically about the cardiovascular and metabolic implications. T
he main finding of the study is that cannabis treatment for 3 months was associated with a reduction in both systolic and diastolic blood pressure values, as measured by consequent 24-hours ABPM tests. In addition, no significant changes were found in blood lipids profile, hemoglobin A1C, fasting insulin, C-reactive protein, kidney function tests, electrolytes, anthropometric measurements, and ECG parameters.
Elodie Warren[/caption]
Elodie C. Warren, MPH
Columbia University Mailman School of Public Health Graduate
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that the US has been experiencing an opioid crisis for the past two decades. And we know that among communities of color, rates of overdose deaths are continuing to increase, even though overall national rates decreased between 2017 and 2018.
To better understand how the opioid crisis has differently affected racial/ethnic groups, we looked at how heroin treatment admissions changed over time by race/ethnicity, age, and sex. We found that there were stark differences when comparing non-Hispanic Black men and women to non-Hispanic White men and women.
Importantly, our study suggests the existence of an aging cohort of Black men and women (likely including survivors of a heroin epidemic that hit urban areas more than 40 years ago) that continues to struggle with heroin addiction. This points to the need for targeted interventions in chronically underserved communities.
Dr. Warnick[/caption]
Benjamin J. Warnick, PhD
Assistant Professor of Entrepreneurship
Carson College of Business
Washington State University Vancouver
MedicalResearch.com: What is the background for this study?
Response: Popular culture has perpetuated a notion that cannabis users are more creative. Along these lines, some successful CEOs and entrepreneurs—like Steve Jobs, for example—have claimed that cannabis use has benefitted their creativity at work.
Despite such claims and increased legalization and use of cannabis, the implications of cannabis use for entrepreneurs’ creativity has yet to be rigorously tested. My coauthors and I were very intrigued to dive into the implications of cannabis use for entrepreneurs, whether good or bad. This seemed all the more relevant given the increasing legalization, destigmatization, and use of cannabis.
Dr. Kovács[/caption]
Balázs Kovács PhD
Associate Professor of Organizational Behavior
Yale School of Management
MedicalResearch.com: What is the background for this study?
Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S. We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates. We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older. The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs.
Dr. Pedersen[/caption]
Eric R. Pedersen, Ph.D.
Adjunct Behavioral Scientist, RAND
Associate Professor of Psychiatry and Behavioral Sciences
Keck School of Medicine
University of Southern California
MedicalResearch.com: What is the background for this study?
Response: In November of 2016, CA voted to legalize cannabis for sale and possession to adults 21 and older for recreational use. It wasn’t until January of 2018 that stores in most parts of LA County (we call these “outlets”) were legally able to begin selling recreational cannabis. We were collecting data from about 2,500 young adults in LA County as part of a longitudinal study (Principal Investigator Elizabeth D’Amico at RAND) and were able to look at cannabis use and intentions assessed at a period prior to the opening of the recreational cannabis outlets (pre-January 2018) to a period when those outlets were open (after January 2018). It has been suggested that once cannabis was more available for recreational purchase (and not just for medical purposes among those enrolled in CA’s medical marijuana program), use of cannabis among young adults would increase.