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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…)
Author Interviews, Opiods, Race/Ethnic Diversity, University of Michigan / 03.05.2018

MedicalResearch.com Interview with: Matthew A. Davis, MPH, PhD Assistant Professor Department of Systems, Populations and Leadership University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: The premise for the study was based on prior work that demonstrated that the likelihood of being prescribed an opioid differs according to a patient’s race and ethnicity.  Collectively this work has shown that Non-Hispanic Whites are more likely to receive opioids than other groups for pain. We decided to look at trends in the prescribing of different pain medications over the last 16 years to see if we could detect any differences in prescribing patterns among racial and ethnic groups.  To do so we used national health data for a large sample of Americans who live with significant pain. (more…)
Addiction, Author Interviews, Opiods, Pharmacology / 30.04.2018

MedicalResearch.com Interview with: Maria Sullivan, M.D., Ph.D Senior Medical Director of Clinical Research and Development Alkermes MedicalResearch.com: What is the background for this study? Response: Extended release injectable naltrexone is approved for the prevention of relapse to opioid dependence after detoxification and when used with counseling. It is recommended that patients abstain from opioids for a minimum of seven to 10 days prior to induction onto XR-naltrexone to avoid precipitating opioid withdrawal. This requirement of detoxification represents a substantial clinical challenge, particularly in the outpatient setting. There is currently no single recognized best method for opioid detoxification prior to first dose of extended-release naltrexone (XR-naltrexone). A number of induction regimens have been explored, including the use of low doses of oral naltrexone to shorten the transition period from dependence on opioids to XR-naltrexone treatment. The goal of the study was to help establish an outpatient regimen to transition subjects from physiological opioid dependence to XR-naltrexone treatment and mitigate the severity of opioid withdrawal symptoms. We hypothesized that low-dose oral naltrexone, combined with buprenorphine and psychoeducational counseling, would assist with the transition of patients with opioid use disorder onto XR-naltrexone. In this 3-arm trial, we examined the utility of oral naltrexone, buprenorphine, and a fixed regimen of ancillary medications (oral naltrexone + buprenorphine vs. oral naltrexone + placebo buprenorphine vs. placebo +placebo), to determine whether any of these regimens was associated with higher rates of induction onto XR-naltrexone. (more…)
Author Interviews, Opiods / 25.04.2018

MedicalResearch.com Interview with: Peter Grace PhD Professor in the Department of Critical Care Research University of Texas MD Anderson Cancer Center. He was a NHMRC Postdoctoral Fellow University of Colorado Boulder in the lab of Prof Linda Watkins MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Opioids are effective for managing pain after surgery. However, we previously showed that opioids like morphine can have unexpected long-term effect when used to treat nerve pain in rats: just 5 days of morphine treatment shortly after nerve injury doubled the duration of pain (Grace et al., 2016; PNAS). Our current study shows that something similar happens in post-operative pain. When we gave daily morphine for a week after exploratory abdominal surgery (laparotomy), the postoperative pain lasted more than twice as long compared to rats that didn’t receive morphine at all. We also showed that the prolonged pain was correlated with immune signaling in the spinal cord, similar to what we showed in our previous study (Grace et al., 2016; PNAS). Importantly, this suggests that the long-term pain caused by morphine could be blocked while retaining short-term analgesia by inhibiting immune activation.  (more…)
Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, Johns Hopkins, Opiods / 24.04.2018

MedicalResearch.com Interview with: Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine  MedicalResearch.com: What is the background for this study Response: Most Americans know that the United States faces an epidemic of deaths due to drug overdose.  And many are also aware that there is a critical shortage of organs available for transplant.  Perhaps less widely known is that today, more than 1 in every 8 deceased organ donors died from a drug overdose.  The objective of our study was to look at the outcomes of patients who received transplants with organs donated after an overdose. (more…)
Author Interviews, Emergency Care, Opiods / 08.04.2018

MedicalResearch.com Interview with: Frank Scheuermeyer MD MHSc Clinical Associate Professor Department of Emergency Medicine St Paul’s Hospital and the University of British Columbia  MedicalResearch.com: What is the background for this study? Response: Mortality from the opioid epidemic is dramatically increasing and a main culprit appears to be illicit fentanyl. Current research states that patients with presumed fentanyl overdoses are at high risk of deterioration and death, and require prolonged emergency department stays or hospital admission to ensure a safe outcome. Our inner-city hospital adopted a protocol initially developed for patients with heroin overdose, modified it to account for the greater potency of fentanyl, and studied 1009 consecutive patients who arrived with an overdose. (more…)
Addiction, Author Interviews, Opiods, Pharmaceutical Companies / 04.04.2018

MedicalResearch.com Interview with: http://usworldmeds.com/Mark Pirner, MD, PhD Senior Medical Director US WorldMeds   MedicalResearch.com: What is the background for this study? Would you briefly explain how lofexidine works? Response: LUCEMYRA (lofexidine) was studied in two phase 3 pivotal randomized, double-blind, placebo-controlled clinical studies, and a phase 3 open-label study. Clinical pharmacology studies included evaluation of drug-drug interaction studies that demonstrated lofexidine can be safely administered concomitantly with methadone, buprenorphine or naltrexone. LUCEMYRA is an alpha 2 adrenergic receptor agonist that reduces the surge of norepinephrine signaling in the brain which results from abrupt opioid withdrawal, and thereby reduces the severity of opioid withdrawal symptoms.  (more…)
Author Interviews, Cannabis, JAMA, Opiods / 02.04.2018

MedicalResearch.com Interview with: Hefei Wen, PhD Assistant Professor, Department of Health Management & Policy University of Kentucky College of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Marijuana is one of the potential, non-opioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose. Medical and adult-use marijuana laws, has made marijuana available to more Americans. Yet no study to date has focused on the effect of medical and adult-use marijuana laws on opioid prescribing in particular. Our study provides some of the first empirical evidence that the implementation of medical and adult-use marijuana laws between 2011 and 2016 was associated with lower opioid prescribing rates and spending among Medicaid enrollees.   (more…)
Author Interviews, Cannabis, JAMA, Opiods / 02.04.2018

MedicalResearch.com Interview with “Cannabis sativa” by Manuel is licensed under CC BY 2.0 David Bradford, Ph.D. Busbee Chair in Public Policy Department of Public Administration and Policy University of Georgia Athens, GA 30602 MedicalResearch.com: What is the background for this study? Response: To give you some background, in 2016, part of our research team (Bradford and Bradford) published the first study to directly examine the impact that medical cannabis laws (MCLs) may be having on prescription use. We used yearly physician-level Medicare Part D data, looked at nearly all prescription drugs used to treat 9 broad categories of illness/diagnoses, and found substantial reductions in prescriptions. We published a follow-up study in 2017, this time using data from Medicaid Fee-for-Service. Again, we found significant substitution away from prescription medications. In both of these studies, pain was included in the list of conditions for which cannabis may be used in patients, and in both studies, pain prescriptions fell. One of the unanswered questions from both of those studies, though, was what *type* of pain medications were being reduced.  From a public health standpoint, when we're worried about opioid overdose, it matters whether the substitution away from pain medications is coming from substitutions away from things like NSAIDs or whether there is substitution away from opioids. (more…)
Author Interviews, Opiods, Pediatrics / 28.03.2018

MedicalResearch.com Interview with: http://www.phc4.org/reports/researchbriefs/neonatal/17/ Joe Martin Executive Director PA Health Care Cost Containment Council Commonwealth of Pennsylvania Harrisburg, PA 17101 MedicalResearch.com: What is the background for this study? Response: Several years ago, our agency noted that while mortality data for opioid addition was being reported, it did not include hospitalizations where death did not occur.  We believed our agency could make a valuable contribution to the data by beginning to report that.  We began with adults hospitalized in PA for opioid addiction, and supplemented that over time with reporting about maternity cases and newborns. Today’s report covers babies born with neonatal abstinence syndrome. (more…)
Author Interviews, CMAJ, Opiods / 26.03.2018

MedicalResearch.com Interview with: Andrea Schaffer PhD Research Fellow Centre for Big Data Research in Health UNSW Sydney NSW Australia  MedicalResearch.com: What is the background for this study? Response: Use and misuse of opioids has increased dramatically in Australia over the past 20 years. In 2014, Australia introduced tamper-resistant controlled-release (CR) oxycodone, which forms a viscous gel when crushed, and is designed to deter its injection or snorting. However, this formulation does not prevent dependence, and can still be misused orally. Tamper-resistant oxycodone CR was also introduced in the US (2010) and Canada (2012), resulting in reductions in oxycodone CR use. However, no large population-level studies have looked at switching behaviour in individuals using oxycodone CR, either in Australia or abroad. (more…)
Author Interviews, Opiods, Pharmaceutical Companies / 23.03.2018

MedicalResearch.com Interview with: Vishal Bala Senior Quantitative Data Analyst CareDash MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research into physicians and their relationships with the pharmaceutical industry has typically retained a narrow scope, focusing on how payments may be associated with prescription habits (sometimes limited to specific regions) for specific categories of drugs. For example, Modi et al. 2017 and Bandari et al. 2017 explored these connections in the context of some urologic drugs specifically. Research conducted by ProPublica in 2016 studied the connection between industry payments and physician prescriptions across some of the largest medical specialties, but was only able to look at “brand-name” vs. “generic” categories and were limited by overlapping timeframes for payments and prescriptions. CareDash took this analysis further by using Open Payments and Medicare Part D data to investigate the relationship between payments made by individual companies for specific drugs and the prescribing habits of the recipient physicians for those drugs. CareDash’s main findings are that healthcare providers who received payments for a drug from a pharmaceutical company are 5 times more likely to be high prescribers for that drug than those physicians who did not receive a payment. Physicians are 5.3 times more likely to prescribe a drug than their peers after they have received a payment for that drug from the manufacturer. When physicians already prescribe a drug significantly more often than their peers, they are 5.6 times more likely to later receive payment for that drug from the drug's manufacturer. Looking at the opioid drug class specifically, CareDash found that physicians receiving payment on behalf of an opioid were 14.5 times more likely to prescribe that opioid over alternatives. (more…)
Author Interviews, Opiods / 19.03.2018

MedicalResearch.com Interview with: Brian J. Piper, PhD, MS Assistant Professor of Neuroscience Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton PA 18509  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The US is experiencing an opioid crisis. There were 63,800 drug overdose deaths in 2016 which is three-fold higher than in 1999. Drug overdose deaths involving synthetic opioids like fentanyl increased 27-fold. Overdoses may even have contributed to decreases in the US lifespan. Emergency Room visits involving opioids have also shown recent increases, particularly in the Southwest and Western US. The US accounts for less than 5% of the world’s population but consumed over two-thirds (69.1%) of the world’s supply of six opioids (fentanyl: 30.1%, methadone: 48.1%, morphine: 51.2%, hydromorphone: 53.0%, oxycodone: 73.1% and hydrocodone: 99.7%) in 2014. The goal of this study was to examine changes in medical use of ten opioids within the United States, and US Territories, from 2006 to 2016 as reported to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS). Prior estimates of the Morphine Mg Equivalent (MME), per person in the US (640), although much higher than most other developed countries, may be an underestimate because of a federal regulation (42 CFR Part 2) that prevents reporting methadone from narcotic treatment programs. We discovered that prescription opioid use peaked in 2011 (389.5 metric ton MMEs) and has been rapidly declining (346.5 in 2016). Relative to 2011, there were decreases in hydrocodone (–28.4%); oxymorphone (–28.0%); fentanyl (–21.4%); morphine (–18.9%); oxycodone (–13.8%); and meperidine (–58.0%). However, there was a pronounced increase in buprenorphine (75.2%). Similar changes were observed from 2015 to 2016 with a statistically significant reduction in all opioids except buprenorphine which was increased. There were substantial geographical variations in rates with a seven fold difference between the highest Morphine Milligram Equivalents in 2016 (Rhode Island = 2,624 mg/person) relative to Puerto Rico (351 mg/person). Two drugs used in treating an opioid use disorder (methadone and buprenorphine) accounted for over-half (52%) of the total MME in 2016.   (more…)
Aging, Alcohol, Author Interviews, JAMA, Stanford / 15.03.2018

MedicalResearch.com Interview with: alcohol-cdc-imageEdith V. Sullivan, Ph.D. Professor Department of Psychiatry & Behavioral Sciences Stanford University School of Medicine Stanford, CA 94305-5723  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alcohol misuse is a major public health problem worldwide with profound health consequences on the body, brain, and function. Our research group has conducted naturalistic yet controlled studies of alcohol dependence for several decades to further our understanding of when and how alcohol misuse affects specific parts of the brain.  In addition, we wanted to know how alcohol misuse interacts with the typical changes in the brain as we grow older.  The studies are controlled in that we recruit healthy, non-alcohol dependence men and women from the community to undergo the same screening and neuroimaging procedures as our alcoholic recruits.  The studies are quantitative because we use neuroimaging methods (Magnetic Resonance Imaging) that enable us to measure specific regions of brain structural volumes.  Consistent collection of such data over the years positioned us to ask whether age and alcohol dependence interact to produce regional brain volume loss beyond the loss that occurs in normal aging. A number of cross-sectional studies pointed to the likelihood that the effects of alcohol dependence on brain structure would be exacerbated by normal aging, which we do know from longitudinal neuroimaging studies results in shrinkage of cortical gray matter volume and thinning of the cortex. What was particularly striking about our longitudinal study of men and women with alcohol dependence was the acceleration of the aging of brain structure that was especially prominent in the frontal cortex.  Critically, even those who initiated dependent drinking at an older age showed accelerated loss. Because our study sample was large enough, we could also test whether our findings were attributable to conditions that commonly co-occur with alcohol dependence, namely, illicit drug use and hepatitis C.  Although both drug use and hepatitis C infection may have exacerbated brain volume loss, these factors did not fully account for the alcoholism-aging interaction we identified. (more…)
Accidents & Violence, Addiction, Author Interviews, JAMA / 14.03.2018

MedicalResearch.com Interview with: Dr. Laura Dwyer-Lindgren PhD Assistant Professor at IHME Institute for Health Metrics and Evaluation  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study in the latest in a series of studies IHME has conducted on health and disease on the county level in the United States. We analyzed data provided by the National Center for Health Statistics, the U.S. Census Bureau, and other sources. Main findings include:
  • Nearly 550,000 deaths were attributed to drug use over the 35 years. Nationally, the age-standardized death date increased 238% between 1980 and 2000, and 112% between 2000 and 2014. The death rate from drug use disorders increased in every county, but some counties in Kentucky, West Virginia, Ohio, Indiana, and eastern Oklahoma has increases exceeding 5000%.
  • There were more than a quarter million deaths in the U.S. due to alcohol use; Western counties generally has higher levels than those in other parts of area of the nation, with especially high death rates in Wisconsin, North Dakota, South Dakota, Nebraska, Montana, New Mexico, Arizona, Utah, and Alaska.
  • Neatly 1.3 million suicides were recorded, with especially high rates in Alaska, Nevada, South Dakota, Utah, New Mexico, Arizona, Montana, North Dakota, Oregon, Wyoming and one county in Maryland. While the national death rate due to suicide decreased between 1980 and 2014, there was an increase in the death rate due to suicide in most counties.
  • More than three quarters of a million deaths by homicide occurred in the US between 1980 and 2015. Nationally, the age-standardized death rate due to homicide decreased by about 35% between 1980 and 2000, and by nearly 16% between 2000 and 2014. Counties with the largest decreases were found in Virginia, Florida, Texas, California and New York. 
(more…)
Addiction, Race/Ethnic Diversity, Social Issues / 28.02.2018

MedicalResearch.com Interview with: Khary Rigg, Ph.D. Assistant Professor Department of Mental Health Law & Policy University of South Florida  MedicalResearch.com: What is the background for this study? Response: Over the past two decades, the demographic profile of MDMA (ecstasy/molly) users has changed. In particular, African American MDMA use has risen in some cities. One possible explanation of this new trend is the drug’s recent popularity (as molly) in hip-hop/rap (HHR) music. Several top rappers endorse the drug as a way to have fun or get women “loose.” There are currently no studies, however, that investigate the extent to which African American MDMA users listen to. hip-hop/rap music or the influence that these pro-MDMA messages have on their use of the drug. This study used survey and interview data to identify the extent to which hip-hop/rap music is listened to by African American MDMA users and assess the perceived influence of HHR music on their decision to begin using. (more…)
Author Interviews, Cannabis, Columbia, Pediatrics / 22.02.2018

MedicalResearch.com Interview with: “medical marijuana : strains and varieties” by torbakhopper is licensed under CC BY 2.0Professor Deborah Hasin PhD Department of Epidemiology in Psychiatry Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: We began to think about this study after we published an earlier report (Hasin et al., The Lancet Psychiatry 2015) showing that after state medical marijuana laws (MML) were passed, U.S. teen marijuana use did not increase compared to the period before the laws were passed and to overall national trends. However, people continued to question whether MML led to teen increases in marijuana use. Therefore, in the present study, we combined findings from 11 large-scale national studies of teens to provide a more definite answer. The findings were clear that teen marijuana use did not increase after passage of medical marijuana laws. Medical marijuana is widely available from stores like kush guys, yet despite this prevalence, there is no conclusive evidence of abuse. Rather the benefits are plain to see. (more…)
Alcohol, Author Interviews, Dental Research, Probiotics / 22.02.2018

MedicalResearch.com Interview with: “Wine” by Uncalno Tekno is licensed under CC BY 2.0M.Victoria Moreno-Arribas Spanish National Research Council | CSIC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent discoveries indicate polyphenols might also promote health by actively interacting with bacteria in the gut. Also, the intake of specific polyphenol-rich beverages and foods helps the maintenance of digestive health and prevention of disease status. However, the knowledge of the effects of polyphenols in relation to the prevention of dental diseases is still at an early stage. The use of antiseptics and/or antibiotics in the prevention and treatment of periodontal diseases can lead to unwanted effects. Therefore, there is a need to develop novel antimicrobial strategies useful for the prevention and management of these diseases. Oral epithelial cells normally constitute a physical barrier that prevents infections, but bacterial adhesion to host tissues constitutes a first key step in the infectious process. With the final goal to elucidate the health properties of wine polyphenols at oral level, we studied their properties as an anti-adhesive therapy for periodontal and cariogenic prevention, as well as the combined action between wine polyphenols and oral probiotic strains in the management of microbial-derived oral diseases. In particular, we checked out the effect of two red wine polyphenols, as well as commercially available grape seed and red wine extracts, on bacteria that stick to teeth and gums and cause dental plaque, cavities and periodontal disease. Also, oral metabolism of polyphenols, including both oral microbiota and human mucosa cells, was investigated.  (more…)
Addiction, Author Interviews, Opiods, Vaccine Studies / 22.02.2018

MedicalResearch.com Interview with: “Syringe and Vaccine” by NIAID is licensed under CC BY 2.0Candy Hwang, Ph.D. The Scripps Research Institute La Jolla, CA 92037 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our heroin vaccine is designed to stimulate antibodies to recognize and bind heroin, preventing passage of drug molecules to the brain. By essentially blocking the “high” from heroin, we believe this will assist recovering addicts from relapsing. Last year, we reported a heroin vaccine that was shown to be effective in both mouse and non-human primate models. In this current study, we were interested in enhancing our heroin vaccine by exploring different vaccine components and dosages. Once we discovered the most promising vaccine formulations, we wanted to see if our vaccines would be stable under different storage conditions. We found that our heroin vaccine was shelf stable under different temperatures and as a powder or in liquid form, meaning that the vaccine will remain stable for transport and storage. The best vaccine formulation from these studies showed protection against lethal doses of heroin. (more…)
Alcohol, Author Interviews, Cognitive Issues, Lancet / 21.02.2018

MedicalResearch.com Interview with: “undefined” by Iñaki Queralt is licensed under CC BY 2.0Michaël Schwarzinger, MD, PhD Translational Health Economics Network (THEN) Paris MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of heavy drinking with dementia has been known for decades. For instance, there is about no Wernicke–Korsakoff syndrome without heavy drinking and the syndrome was described in 1890. But this type of dementia is very rare. Also, heavy drinking is knowingly associated with multiple risk factors for dementia onset such as hypertension or diabetes. But heavy drinkers generally refuse to participate to cohort studies and declaration of alcohol use among participants is generally biased downward... So the study rationale is very strong, but supporting empirical evidence is quite scarce. This nationwide study included all 31+ million adults discharged from hospitals over 6 years, i.e., 50% of the French population before 65 years old and 80% above that age. Of 1.1+ million adults diagnosed with dementia, one in twenty had an early-onset (before 65 years old). Heavy drinking was recorded in most (56%) early-onset dementia cases: two-third in men; one-third in women. In addition, the association of heavy drinking with dementia goes far beyond 65 years old, both directly (>3 times higher risk for dementia onset after controlling for more than 30 known risk factors for dementia) and indirectly as heavy drinking was associated with all other independent risk factors for dementia onset. Accordingly, heavy drinking had the largest effect on dementia risk of all independent modifiable risk factors such as hypertension or diabetes. The effects were found whatever dementia case definition or population studies. (more…)
Alcohol, Author Interviews / 14.02.2018

MedicalResearch.com Interview with: “Alcohol” by zeevveez is licensed under CC BY 2.0Thomas Denson PhD University of New South Wales Australia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Decades of research have shown that alcohol is a powerful psychotropic contributor to aggressive behaviour. Researchers have long suspected that alcohol increases aggression because it dampens activation in the prefrontal cortex, which leads to reduced inhibition, narrows attentional processing, and exaggerates hostile thinking. However, direct evidence has been lacking. We compared brain activity in intoxicated versus sober participants when they were given the opportunity to behave aggressively in the scanner against other men who provoked them. We gave 50 healthy young men alcohol or a placebo. Participants who consumed alcohol breathalysed at .05. They did show decreased activation in the prefrontal cortex as expected. This was the first evidence to show that when intoxicated participants behave aggressively, they show reduced prefrontal activity. Interestingly, we found a positively correlation between prefrontal cortex activity and aggression, but only among intoxicated men. We think this reflects the fact that the participants in the alcohol condition were likely engaging in more hostile thinking about the provoking men.  (more…)
Alcohol, Author Interviews, Compliance / 13.02.2018

MedicalResearch.com Interview with: “Alcohol” by zeevveez is licensed under CC BY 2.0Sarah Dermody PhD Assistant professor School of Psychological Science College of Liberal Art Oregon State University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Naltrexone is an FDA-approved medication to treat alcohol use disorder. We know that people have difficulty adhering to the prescribed daily medication regimen, and that people who do not adhere to the medication tend not to fair as well in treatment as people who take the medication regularly. This particular study attempted to address the question of why do people with alcohol use disorder have difficulty taking the medication daily? What we found was that people were less likely to take naltrexone after days of heavy drinking or strong alcohol craving versus typical drinking and craving levels. Furthermore, individuals were less likely to take the medication on weekends versus weekdays, which is particularly worrisome because heaviest drinking episodes tend to happen on the weekends. (more…)
Author Interviews, Infections, Opiods, Vanderbilt / 13.02.2018

MedicalResearch.com Interview with: Andrew Wiese, PhD Postdoctoral Research Fellow Department of Health Policy Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: As opioid use has increased in the U.S., the safety of prescription opioids has come under further scrutiny. In animal studies, use of certain opioids has been associated with increased susceptibility to bacterial infections, including infectious due to Streptococcus pneumoniae, the pathogen that causes invasive pneumococcal disease. Invasive pneumococcal disease includes bacteremia, meningitis, and invasive pneumonia, all of which are associated with high mortality. Although those associations have been well established in animal experiments, it is important to understand the risk of serious infections among humans taking prescription opioid analgesics. We found that prescription opioid use is associated with a significantly increased risk for laboratory-confirmed invasive pneumococcal diseases, and that this association was strongest for opioids used at high doses, those classified as high potency and long-acting formulations. The data also showed that opioids previously described as immunosuppressive in prior experimental studies conducted in animals had the strongest association with invasive pneumococcal diseases in humans. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 12.02.2018

MedicalResearch.com Interview with: Dr. John A Staples, MD, FRCPC, MPH Scientist, Centre for Health Evaluation and Outcome Sciences Clinical Assistant Professor University of British ColumbiaDr. John A Staples MD, FRCPC, MPH Scientist, Centre for Health Evaluation and Outcome Sciences Clinical Assistant Professor University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Around 64 million Americans live in states that have legalized recreational marijuana. Many policymakers are trying to figure out what that means for traffic safety. On April 20th, some Americans participate in an annual "4/20" counterculture holiday that celebrates and promotes the use of cannabis. Some 4/20 events such as those in Denver and San Francisco involve thousands of participants. Much like celebrations at midnight on New Year's eve, public 4/20 events sometimes mark 4:20 p.m. by a countdown followed by synchronized mass consumption of cannabis. We thought this was a perfect natural experiment to evaluate the influence that cannabis intoxication has on the risk of motor vehicle crash. To examine this question, we analyzed 25 years of data on all fatal traffic crashes in the United States. We compared the number of drivers in crashes between 4:20 p.m. and midnight on April 20th to the number of drivers in crashes during the same time interval on control days one week earlier and one week later. We found that the risk of crash involvement was 12% higher on April 20th than on control days. In the subgroups of drivers younger than 21 years of age, the risk of crash involvement was 38% higher on April 20th than on control days. Assuming fewer than 12% of Americans celebrate 4/20, our results suggest that substance use at April 20th celebrations more than doubles the risk of fatal crash. (more…)
Author Interviews, Cannabis, Cost of Health Care, Opiods / 07.02.2018

MedicalResearch.com Interview with: David Powell PhD Economist; Core Faculty, Pardee RAND Graduate School RAND, Santa Monica MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been some research suggesting that the adoption of state medical marijuana laws leads to reductions in prescriptions for opioid analgesics among certain populations and opioid-related overdoses overall. However, medical marijuana laws are very different across states and they have changed over time as well. We wanted to understand what components of a medical marijuana law could potentially lead to reductions in overdoses and substance abuse. We focused specifically on the role of dispensaries, given their importance in providing access to medical marijuana, and tested for different effects in states with and without legally-protected and operational dispensaries. We found that dispensaries are critical to reduce opioid-related overdoses and substance abuse. We also found evidence that more recently-adopting states have experienced smaller reductions in overdoses and opioid substance abuse, potentially because the more recent adopters tend to enforce more stringent guidelines for dispensaries than the early adopters. (more…)
Addiction, Author Interviews, Opiods, University of Pittsburgh / 05.02.2018

MedicalResearch.com Interview with: “MEXICO-DRUGS/” by Claudio Toledo is licensed under CC BY 2.0Kathleen Creppage, M.P.H., C.P.H. Doctoral candidate Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., fatal heroin overdoses have increased in the past decade by 300 percent, with fentanyl – a substance that is 20 to 50 times more potent than heroin – and its analogs increasingly contributing to overdoses. The drug often is implicated in clusters of overdose deaths when it is mixed with heroin and users do not realize what they are taking is more powerful than usual. We analyzed the test results of 16,594 stamp bags seized as evidence by law enforcement authorities in Allegheny County that were submitted to the county’s Office of the Medical Examiner for laboratory testing from 2010 through 2016. Stamp bags are small wax packets that contain mixtures of illicit drugs, most commonly heroin, packaged for sale and sometimes stamped with a graphical logo by drug dealers to market their contents. Before 2014, none of the tested bags contained fentanyl. By 2016 it was found in 15.5 percent of the tested stamp bags, with 4.1 percent containing fentanyl as the only controlled substance present. (more…)
Addiction, Author Interviews, JAMA, Opiods / 01.02.2018

MedicalResearch.com Interview with: “Drugs” by Ben Harvey is licensed under CC BY 2.0William G. Honer, MD, FRCPC, FCAHS Jack Bell Chair in Schizophrenia Professor and Head, Department of Psychiatry University of British Columbia Vancouver, BC MedicalResearch.com: What is the background for this study? Response: The Province of British Columbia, Canada, has experienced a tremendous increase in the number of opioid related overdoses and deaths. In 2012, there were 269 drug overdose deaths, five years later in 2017 the overdose deaths are predicted to have increased 500%. Toxicology studies of deaths, and examination of seized drugs indicate fentanyl is the major cause. These indirect measures suggest widespread exposure to fentanyl in opioid users, however direct studies of the extent of exposure of opioid users to fentanyl in the community are lacking. We carried out a community-based, longitudinal study using fentanyl testing in urine samples from volunteer participants. (It is called the “Hotel Study” since many of the participants live, or have lived in single room occupancy hotels)  (more…)
Addiction, Alcohol, Author Interviews / 25.01.2018

MedicalResearch.com Interview with: “Alcohol Poisoning PSA Video Shoot” by Stop Alcohol Deaths, Inc. is licensed under CC BY 2.0Dr. Frank de Vocht Senior Lecturer in Epidemiology and Public Health Research Academic Lead Year 1 MBChB (MB21) ‘Foundations of Medicine’ Programme Population Health Sciences Bristol Medical School University of Bristol  MedicalResearch.com: What is the background for this study? Response: We were interested in prospectively investigating whether people who drink alcohol in the general population (so not patients), and who indicated that the were planning to reduce their consumption or complete stop drinking in the near future would, on average, succeed and have reduced consumption six months later.  (more…)