Addiction, Author Interviews, Exercise - Fitness / 17.02.2017 Interview with: Laurie de Grace Master's graduate from the Faculty of Physical Education and Recreation University of Alberta What is the background for this study? Response: Little is known about the development of substance addiction in the context of sport. There is substantial evidence showing a positive association between sport participation and alcohol use, particularly the binge drinking that is more commonly associated with athletes than non-athletes. However, the connection between sport participation and the use of other substances is not clear. We undertook this study to learn from the perspective of those in recovery from substance addiction, how sport may or may not have played a role in their substance use and subsequent addiction. (more…)
Addiction, Author Interviews, Nature / 14.02.2017 Interview with: Andrea K. Globa, Ph.D. Candidate Graduate Program in Neuroscience Life Sciences Institute University of British Columbia Vancouver, BC, Canada What is the background for this study? Response: Addiction is a complex disease, characterized by continued substance use despite serious negative consequences, increased drug tolerance, and withdrawal. In fact, the statistics show that over 40 million Americans abuse or are addicted to nicotine, alcohol or other drugs. This is a huge public health issue, so naturally, scientists are interested in figuring out why people get addicted, and in particular why certain people are more prone to addiction than others. Studies examining genetic differences in addicted populations have shown that there are many mutations in genes that are important for brain function. One group of genes affected encode proteins that act as 'glue' to hold cells together. These proteins are called cadherins. In the brain, cadherins are important for holding brain cells together at spots where they communicate with one another – and these points where brain cells talk to one another are called synapses. Many neuroscientists believe that addiction is actually a type of "pathological" learning, where there are changes at synapses in a brain circuit involved in reward and motivation. So we decided to examine the molecular mechanisms that are important for the strengthening of synapses in this brain circuit. To put it very simply, to learn something you have to make your synapses stronger, and this involves adding more cadherin or 'glue' to the synapse. We wanted to see if these same rules held true in addiction. (more…)
Accidents & Violence, Alcohol, Author Interviews, Pediatrics / 14.02.2017 Interview with: Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston University School of Medicine Urban Health & Advocacy Track Director | Boston Combined Residency Program Boston, MA 02118 What is the background for this study? What are the main findings? Response: Studies to date have shown that states’ alcohol laws can help prevent young people from dying in car crashes. However, studies to date have usually only looked at a single policy at once. We wanted to build on these previous studies by looking at the overall effect of multiple alcohol laws acting at once. We also wanted to look at laws not necessarily only targeting drinking and driving among young people, but also policies aimed primarily at adults over 21. We studied deaths of young people under 21 who were killed in motor vehicle crashes across the United States between 2000 and 2013. We found that one-quarter of all young people died in a crash involving a driver who alcohol level was over the legal limit. One-half died in a crash in which the driver had any level of alcohol in their bloodstream above zero. We also found that most young people died on evenings and weekends, which is when people are most likely to have been drinking. Importantly, almost half of all young people died in a crash in which they were the passenger, not the driver. In 80% of cases in which they were the passenger, it was actually an adult >21, not a young person, who was driving the vehicle. We then looked at states’ alcohol laws, and found that the stronger the set of alcohol policies in a state, the lower the likelihood of young people dying in a crash that was alcohol-related. Policies included laws relating to alcohol taxes, alcohol availability and hours of sales, and graduated driver’s licensing for young people, among many others. (more…)
Addiction, Author Interviews, Pediatrics / 08.02.2017 Interview with: Kristi Roberts, M.S., M.P.H. Research Project Coordinator Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, Ohio What is the background for this study? What are the main findings?
  • We know that 74.1 million US households own at least one pet and one-half of households have a child age 19 years or younger living in the home so there is a potential for unintentional pediatric exposure to pet medication.
  • We realize that pets are common and an important part of families, especially those with young children. However, pets often require medications to keep them healthy and these medications could be dangerous to a child if the child is exposed (gets a hold of or swallows the medicine).
  • We looked at 15 years’ worth of data and found that over 1,400 children were exposed to a veterinary pharmaceutical product. That is about 95 each year or 2 children every week that are being exposure to medications intended for pets.
  • Children under 5 years old are the age group most frequently exposed to medications intended for pets. These young children typically ate or swallowed the medication after they found it when climbing on the counter or while the parent was trying to give the medication to a pet. Most of the calls were for medications intended for dogs.
  • Teenagers were also exposed to medications intended for pets but for different reasons. Many teens mistakenly took pet medication instead of human medication.
  • The majority of exposures occurred at home (96%) and were not expected to result in long-term or long-lasting health effects (97%).
  • While many people don’t think of their pet’s medication as harmful some medications, both human and veterinary, could be highly dangerous even at low dosages, especially for small children.
Addiction, Author Interviews, JAMA / 07.02.2017 Interview with: Lin Lu, M.D. Ph.D. Director/Professor, Institute of Mental Health and Peking University Sixth Hospital Director/Professor, National Institute on Drug Dependence, Peking University Beijing China What is the background for this study? Response: Nicotine addiction is the leading preventable cause of mortality, and causes over 6 million deaths each year. One fundamental mechanism that maintain smoking relapse in smokers is the persistence of memories of both nicotine reward and nicotine-associated conditioned stimulus (CS, e.g. ashtray,cigarette lighters, etc.).Preclinical studies suggest that the drug reward memories can be reactivated by nicotine-associated CS undergo an unstable stage, named memory reconsolidation, and that pharmacological or behavioral manipulations that interfere with reconsolidation inhibit subsequent drug relapse. However, most of the translational studies targeting reconsolidation stages of the drug reward memory have not been successful.One important reason is that when participants were exposed to nicotine-associated CS to induce memory reconsolidation, the pharmacological or behavioral manipulations only interfere with the reconsolidation of memories selectively associated with the reactivated CS, without affecting other CSs. However, in real life, smoking is associated with multiple CSs that vary across individuals. Thus, a key question is how to interfere with reconsolidation of multiple nicotine-associated memories . In the present study, we introduce a novel memory reconsolidation interference procedure in which we reactivated multiple nicotine reward memories in rats and human smokers by acute exposure to nicotine (the UCS) and then interfered with memory reconsolidation using the noradrenergic blocker propranolol, an FDA-approved drug. (more…)
Addiction, Author Interviews, JAMA / 06.02.2017 Interview with: Guillaume Sescousse, PhD Senior post-doc Donders Centre for Cognitive Neuroimaging The Netherlands with collaborators Maartje Luijten, PhD, and Arnt Schellekens, MD PhD What is the background for this study? What are the main findings? Response: People with an addiction process rewards in their brain differently from people who are not addicted. However, whether this is associated with “too much” or “too little” brain activity is an open question. Indeed, past research has produced conflicting findings. In order to get a reliable answer, we have combined 25 studies investigating brain reward sensitivity in more than 1200 individuals with and without addiction to various substances such as alcohol, nicotine or cocaine but also gambling. By analyzing the brain images from these studies, we have discovered an important difference in brain activity between expecting a reward and receiving a reward. Compared with non-addicted individuals, individuals with substance or gambling addiction showed a weaker brain response to anticipating monetary rewards. This weaker response was observed in the striatum, a core region of the brain reward circuit, possibly indicating that individuals with an addiction have relatively low expectations about rewards. In contrast, this same region showed a relatively stronger response to receiving a reward in individuals with substance addiction compared with non-addicted individuals. Many addiction rehab centres, such as Avante, offer targeted addiction relief strategies to help a specific person with their addiction. This stronger response possibly indicates a stronger surprise to getting the reward, and is consistent with low expectations. This same effect was not found among people addicted to gambling. (more…)
Accidents & Violence, Addiction, Author Interviews, NIH, Opiods, Race/Ethnic Diversity / 27.01.2017 Interview with: Dr Meredith S Shiels Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda, MD What is the background for this study? Response: In most high-income countries, premature death rates have been declining, due to the overwhelming successes of public health efforts to prevent and treat chronic disease. The US is a major outlier, where death rates overall have plateaued, or even increased, as reported recently by our sister agency, the Centers for Disease Control and Prevention. Of particular concern are recent reports of increasing death rates among Americans during mid-life. To expand upon prior findings, we focused on premature death, which we defined as death occurring between the ages of 25 and 64. We examined finely detailed death certificate data for the entire U.S. population and described changes in death rates during 1999-2014 by cause of death, sex, race, ethnicity, and geography. To provide context to our findings, we compared trends in death rates in the U.S. to England and Wales and Canada. (more…)
Author Interviews, BMJ, End of Life Care, Opiods, Pain Research / 21.01.2017 Interview with: Dr. Katherine Irene Pettus, PhD, OSB Advocacy Officer International Association for Hospice and Palliative Care Vice Chair, Vienna NGO Committee on Drugs Secretary NGO Committee on Ageing, Geneva What is the background for this study? Response: The background for this study is analysis of the three international drug control treaties, official attendance and participation at meetings of the Commission on Narcotic Drugs for the past four years, ongoing discussion of national opioid consumption rates with INCB, and years of home hospice visits in developing countries. (more…)
Addiction, Author Interviews, Mental Health Research / 20.01.2017 Interview with: Emily Brignone, BS Informatics, Decision Enhancement, and Analytic Sciences Center VA Salt Lake City Health Care System, Salt Lake City, Department of Psychology Utah State University, Logan, Utah What is the background for this study? Response: Nearly 30% of active duty Veterans of post-9/11 conflicts in Iraq and Afghanistan are discharged from military service for reasons other than expired term of service or retirement. These non-routine discharges can occur for a variety of reasons, including disability, failure to meet or maintain qualifications, early release, or misconduct. Veterans discharged under non-routine conditions are at greater risk for several concerning outcomes during the reintegration period, including unemployment, incarceration, homelessness, and suicide. A better understanding of the context of the transition from military service to civilian life, including discharge type, may provide opportunities for mitigating risk for these negative outcomes. One potential indicator for the conditions surrounding this transition is the administrative code that the Department of Defense assigns to active duty military service members at the time of their separation from service. These codes describe the circumstances related to discharge, and can serve as clinically significant early markers for post-deployment mental illness, substance use disorders, and suicidality, and thereby subsequent adverse reintegration outcomes. (more…)
Author Interviews, CDC, Cost of Health Care, Opiods / 19.01.2017 Interview with: Dora Lin, MHS Sr. Research Assistant Johns Hopkins Bloomberg School of Public Health Center for Drug Safety and Effectiveness Baltimore, MD 21205 What is the background for this study? What are the main findings? Response: In response to the opioid epidemic and growing number of overdose deaths each year, the CDC released draft guidelines to improve the safe use of opioids in primary care. The draft guidelines were open to public comment, and many organizations, ranging from professional societies to consumer advocates to local governmental organizations, submitted comments regarding the guidelines. We examined the levels of support or non-support for the draft guidelines among the 158 organizations who submitted comments.   We also examined each organization’s relationship to opioid manufacturers. Most organizations supported the guidelines, regardless of whether or not they had a financial relationship to a drug company. However, organizations receiving funding from opioid manufacturers were significantly more likely to be opposed to the guidelines than those who did not receive such funding. (more…)
Alcohol, Author Interviews, Cannabis / 17.01.2017 Interview with: Kathleen K. Bucholz, Ph.D. Professor, Department of Psychiatry Washington University School of Medicine St. Louis MO 63110-1547 What is the background for this study? Response: We know that development of alcohol use disorder progresses through several stages of alcohol use, from beginning to drink, to engaging in problem drinking, and then to developing alcohol use disorder, but we don’t know whether the same factors are associated with each step in this progression. Stage-specific associations have implications for prevention, where targeting certain characteristics might stave off progression to the next level of alcohol involvement, potentially. That is what this particular study set out to investigate. The data were from nearly 3600 adolescents and young adults, the majority of whom came from families with alcohol use disorder in their relatives. Thus, this sample was enriched with individuals who were at high risk for progressing to more severe stages of alcohol involvement. In studying the associations at each stage, we strengthened our analysis by defining wherever possible variables as risk factors only if they occurred before or at the same age as the particular alcohol stage. For example, we counted cannabis use as a risk factor for starting to drink only if it either preceded or occurred at the same age as taking the first drink. With this definition, we can infer that a particular factor is antecedent and not simply a correlated influence. (more…)
Addiction, Author Interviews, Nutrition, Weight Research / 13.01.2017 Interview with: Nicholas V. DiPatrizio, Ph.D. Assistant Professor of Biomedical Sciences University of California, Riverside School of Medicine Riverside, California, 92521 What is the background for this study? What are the main findings? Response: Endocannabinoids are a group of lipid signaling molecules that serve many physiological roles, including the control of food intake, energy balance, and reward. Previous research by my group found that tasting specific dietary fats drives production of the endocannabinoids in the upper small intestine of rats, and inhibiting this signaling event blocked feeding of fats (DiPatrizio et al., Endocannabinoid signaling in the gut controls dietary fat intake, Proceedings of the National Academy of Sciences, 2011). Thus, gut-brain endocannabinoid signaling is thought to generate positive feedback to the brain that promotes the intake of foods containing high levels of fats. We now asked the question of what role peripheral endocannabinoid signaling plays in promoting obesity caused by chronic consumption of a western diet (i.e., high levels of fats and sugar), as well as the role for endocannabinoids in overeating that is associated with western diet-induced obesity. When compared to mice fed a standard low-fat/sugar diet, mice fed a western diet for 60 days rapidly gained body weight and became obese, consumed significantly more calories, and consumed significantly larger meals at a much higher rate of intake (calories per minute). These hyperphagic responses to western diet were met with greatly elevated levels of endocannabinoids in the small intestine and circulation. Importantly, blocking elevated endocannabinoid signaling with pharmacological inhibitors of cannabinoid receptors in the periphery completely normalized food intake and meal patterns in western diet-induced obese mice to levels found in control lean mice fed standard chow. This work describes for the first time that overeating associated with chronic consumption of a Western Diet is driven by endocannabinoid signals generated in the periphery. (more…)
Addiction, Author Interviews, Dermatology / 10.01.2017 Interview with: Dr Anthony Bewley FRCP Consultant Dermatologist Whipps Cross University Hospital & The Royal London Hospital What is the background for this study? Response: Delusional infestation (DI) is a very disabling condition, whereby patients hold a fixed, unshakeable false belief of being infested with insects or other inanimate objects such as fibres and threads. Previous studies have indicated a high rate of recreational drug use amongst patients with delusional infestation (DI). The aim of our pilot study was to look at the prevalence of recreational drug use in patients with delusional infestation who attended clinic over a three year period (Group 1). We also prospectively offered a urine drugs test to 24 consecutive patients over a three month period (Group 2). (more…)
Author Interviews, Methamphetamine / 07.01.2017 Interview with: Zoe M. Weinstein MD Assistant Professor of Medicine, Boston University Director, Addiction Consult Service Boston Medical Center Boston MA 02118 What is the background for this study? What are the main findings? Response: Like other chronic, life-long medical conditions such as hypertension or diabetes, opioid use disorder (OUD) requires long-term engagement in therapy; however many individuals who participate in Office Based Addiction Treatment are not able to be retained in care long-term. This observational study followed more than 1,200 patients over 12 years with the goal of identifying patient-specific factors associated with retention in the treatment program for longer than one year. While the study found that older age, female, and co-morbid psychiatric diagnosis were associated with greater odds of treatment retention beyond one year, patients who were black or Hispanic, unemployed, and had evidence of hepatitis C viral infection were associated with decreased odds of treatment retention beyond one year. (more…)
Alcohol, Author Interviews, Heart Disease, JACC, UCLA / 02.01.2017 Interview with: Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco What is the background for this study? What are the main findings? Response: Moderate alcohol consumption has previously been associated with a decreased risk of heart attack. However, as we have previously shown that individuals who believe alcohol to be good for the heart tend to drink more, there is a concern that these previous data might appear to justify excessive alcohol consumption. In addition, previous research on the topic of alcohol consumption and heart disease has relied almost entirely on participant self-report, which is known to be particularly unreliable among heavy drinkers. Finally, previous research has sought to study relationships between alcohol and various types of heart disease, but there has not been an emphasis on individual-level characteristics that might influence these relationships. (more…)
Author Interviews, Cannabis, JAMA, Pediatrics, UC Davis / 02.01.2017 Interview with: Magdalena Cerda, DrPH, MPH Vice Chancellor's Chair in Violence Prevention Associate Director, Violence Prevention Research Program UC Davis Violence Prevention Research Program What is the background for this study? What are the main findings? Response: The potential effect of legalizing marijuana for recreational use has been a topic of considerable debate since Washington and Colorado first legalized its use for adults in 2012. Alaska, Oregon and Washington, D.C., followed suit in 2014, and voters in California, Massachusetts and Nevada approved recreational use this past November. In our study, we examined changes in perceived risk of marijuana use, and in use of marijuana among school-attending adolescents, in Washington and Colorado, following legalization of recreational marijuana use, and compared pre- to post-legalization changes in these two states to changes in the 45 contiguous US states that had not legalized recreational marijuana use. Marijuana use significantly increased and its perceived harm decreased among eighth- and 10th-graders in Washington state following enactment of recreational marijuana laws. There was no change in use or perceived harm among 12th graders or among similar grades in Colorado. In particular, the data showed that legalization of recreational marijuana use significantly reduced perceptions of marijuana’s harmfulness by 14 percent and 16 percent among eighth and 10th graders and increased their past-month marijuana use by 2 percent and 4 percent in Washington state but not in Colorado. Among states without legalized marijuana use, the perceived harmfulness also decreased by 5 percent and 7 percent for students in the two grades, but marijuana use decreased by 1.3 percent and .9 percent. Among older adolescents in Washington state and all adolescents surveyed in Colorado, there were no changes in perceived harmfulness or marijuana use in the month after legalization. (more…)
Addiction, Author Interviews, Hepatitis - Liver Disease, Lancet / 27.12.2016 Interview with: Naveed Zafar Janjua, MBBS, MSc, DrPH Senior Scientist, Clinical Prevention Services BC Centre for Disease Control Clinical Associate Professor, School of Population and Public Health University of British Columbia What is the background for this study? Response: Hepatitis C is a viral infection that affects the liver. About quarter of people infected with hepatitis C clear their infection spontaneously rest develop chronic infection. Left untreated, hepatitis C could results in scarring of liver (liver cirrhosis), liver cancer or death. New anti-viral drugs are highly effective in curing hepatitis C, about than 95 per cent of those treated can be cured. However, people who engage in high risk activities such as people who inject drugs (PWID) remain at risk of reinfection. As the cost of treatment is very high, re-infection is a concern among physicians and policy makers in Canada and around the world. (more…)
AHRQ, Author Interviews, Opiods / 27.12.2016 Interview with: Claudia Steiner, M.D., MPH. Agency for Healthcare Research and Quality (AHRQ) Rockville, MD What is the background for this study? Response: The Agency for Healthcare Research and Quality (AHRQ) has a longstanding project and partnership, The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup"). HCUP is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership. HCUP databases bring together the data collection efforts of State data organizations, hospital associations, and private data organizations (HCUP Partners) and the Federal government to create a national information resource of encounter-level health care data. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information. These databases enable research on a broad range of health policy issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels. The HCUP Partners recognized the urgency of providing descriptive statistics to help inform the growing opioid epidemic in the U.S., and therefore agreed to supporting this statistical brief as well as the Opioid-Related Hospital Use path on Fast Stats: (more…)
Addiction, Author Interviews, Opiods, Pediatrics / 12.12.2016 Interview with: Nicole Villapiano, MD, MSc Robert Wood Johnson Clinical Scholar Internal Medicine/Pediatrics Institute for Healthcare Policy & Innovation University of Michigan What is the background for this study? What are the main findings? Response: Over the past few years, research has highlighted that the opioid epidemic is accelerating at a rapid pace across the United States, including in rural areas. What we don’t know is how the opioid crisis is affecting rural moms and their infants. As a doctor that takes care of kids, I was concerned about this. So our team took on this study to explore the differences in rates of maternal opioid use and neonatal abstinence syndrome in rural and urban areas of the US from 2004-2013. Neonatal abstinence syndrome is what happens to babies who are exposed to opioids in their mothers’ womb. When these babies are born and no longer have opioid exposure from mom, they go through a period of opioid withdrawal. These babies can have symptoms that range from difficulty taking a bottle, jitteriness, difficulty sleeping, irritability, and discomfort to more serious problems like prematurity, difficulty breathing, and seizures. Symptoms can last several days to many weeks. Babies with neonatal abstinence syndrome are in the hospital longer than the average newborn, and sometimes require special treatment to help control their symptoms. (more…)
Addiction, Author Interviews, CDC, Opiods / 09.12.2016 Interview with: Cyprian Wejnert, Ph.D. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention CDC What is the background for this study? What are the main findings? Response: Our country is dealing with a devastating epidemic of opioid misuse and overdose that affects individuals, families and communities. We have long known that sharing needles and syringes is an incredibly efficient route for HIV, hepatitis and other infections to spread. Yet, about 10% of annual HIV diagnoses in the United States occur among people who inject drugs, and there are clusters of hepatitis C infections across the country. These infections can be prevented when people who inject drugs use sterile needles, syringes and other injection equipment. One of the main findings of this study is that use of syringe services programs (SSPs) has increased substantially during the past decade, but most people who inject drugs still don’t always use sterile needles. The analysis finds that more than half (54%) of people who inject drugs in 22 cities with a high number of HIV cases reported in 2015 they used an SSP in the past year, compared to only about one-third (36%) in 2005. Although syringe services program use has increased, findings indicate that too few people who inject drugs use only sterile needles. One in three (33%) reported in 2015 that they had shared a needle within the past year – about the same percentage that reported sharing a decade ago (36% in 2005). The report also highlights some successes in HIV prevention among African Americans and Latinos who inject drugs, as well as concerning trends in whites who inject drugs. From our study of 22 urban areas, it appears that fewer African Americans are injecting drugs. However, it also appears there has been an increase in white Americans injecting drugs. (more…)
Alcohol, Author Interviews, CT Scanning, Heart Disease / 02.12.2016 Interview with: Pál Maurovich-Horvat MD, PhD, MPH, FSCCT Assistant Professor of Cardiology Director of the MTA-SE Cardiovascular Imaging Research Group Heart and Vascular Center, Semmelweis University Budapest, Hungary What is the background for this study? What are the main findings? Response: Several studies have been published on alcohol consumption and its association with the presence of coronary artery disease, however the data remains controversial. Some studies suggested that moderate alcohol consumption reduces the risk of heart disease and others found no protective effect. Our study is the first investigation that aims to assess the effect of alcohol on the coronary arteries using coronary CT angiography. We found no association between regular alcohol consumption and the presence of coronary disease. (more…)
Alcohol, Author Interviews, Biomarkers, Genetic Research / 28.11.2016 Interview with: Chunyu Liu, PhD The Population Sciences Branch, Division of Intramural Research The Framingham Heart Study, National Heart, Lung and Blood Institute Framingham, MA Department of Biostatistics Boston University School of Public Health Boston, MA What is the background for this study? What are the main findings? Response: Excessive alcohol consumption contributes to many diseases as well as to injuries and deaths. The lack of reliable measures of alcohol intake is a major obstacle to the diagnosis and treatment of alcohol-related diseases. Our study has identified a group of DNA markers in blood that could provide the basis for a reliable blood test to detect heavy alcohol use. (more…)
Author Interviews, Cannabis, Nature, UT Southwestern, Weight Research / 19.11.2016 Interview with: Dan Rosenbaum, Ph.D. Principal Investigator Department of Biophysics The University of Texas Southwestern Medical Center Dallas, Texas What is the background for this study? What are the main findings? Response: This study focuses on the structure of the human CB1 cannabinoid receptor. The CB1 protein is a membrane-embedded G protein-coupled receptor (GPCR) in the brain and peripheral tissues that responds to a variety of different compounds, including endogenous lipid messengers (‘endocannabinoids’), plant natural products (such as THC from the Cannabis sativa plant i.e. marijuana), and synthetic antagonists (such as the taranabant ligand used for this study). The CB1 receptor is involved in regulating neurotransmission in vertebrates, and is a potential therapeutic target for numerous conditions including obesity, pain, and epilepsy. The main findings of this study entailed the solution of the high-resolution crystal structure of human CB1 receptor bound to the inhibitor taranabant. This structure revealed the precise shape of the inhibitor binding pocket, which is also responsible for binding THC and endocannabinoids. In addition to helping explain the mechanism of inhibitor and THC binding, our structure provides a framework for computational studies of binding to a large diversity of cannabinoid modulators of therapeutic importance. (more…)
Author Interviews, Cannabis, Gender Differences, Heart Disease / 14.11.2016 Interview with: Amitoj Singh MD Chief Cardiology Fellow St. Luke’s University Health Bethlehem, Pennsylvania What is the background for this study? Response: Marijuana use in steadily increasing and it is the most commonly used illicit drug in the US and worldwide. There has been a recent increase in reports of heart and vascular complications associated with its use. These include Myocardial infarctions, stroke and takotsubo. We had two questions that we wanted to answer with our study: a) Is there an association between marijuana use and development of Transient Regional Ventricular Ballooning [TVRB] (aka Stress Cardiomyopathy /Broken Heart Syndrome/ Takotsubo)? b) If the above is true, what are the differences between Marijuana users (MU) and Non Marijuana Users (NMU) who developed Stress Cardiomyopathy. (more…)
Addiction, Author Interviews, Occupational Health / 04.11.2016 Interview with: Dr. Barry Sample PhD Senior director, science and technology Quest Diagnostics Employer Solutions A business of Quest Diagnostics What is the background for this study of drug testing of the U.S. workforce? Response: As a leader in the drug testing industry, our primary goal at Quest Diagnostics Employer Solutions is to help employers maintain drug-free workplaces and combat the impacts of substance abuse such as higher absenteeism, increased risk of injury and lower productivity and performance. One way we support these efforts is to offer analysis and information from resources like the Quest Diagnostics Drug Testing Index™, which we publish as a public service for government, media, and industry. We’ve published the Drug Testing Index since 1988, which is also the year that Congress passed the Drug-Free Workplace Act. The Drug Testing Index examines positivity rates – the proportion of positive drug test results – among three major testing populations: federally-mandated, safety-sensitive workers; the general (private sector) U.S. workforce; and the combined U.S. workforce. Thresholds for positivity are determined by cutoff levels as established by the administrating authority; these cutoff levels determine the threshold for positivity for a specific substance. Should a metabolite appear at or above the level of the cutoff, a test is determined to be positive. Over the last few decades, testing policies have evolved to serve a dual purpose of protecting the health, safety, and welfare of both employees and the general public. That’s especially important in certain industries, such as transportation, where an impaired driver, pilot, or operator can create substantial public risk. The positivity rate in 1998, the year of the first Drug Testing Index, was 13.6 percent. Over the last 25 years, as we have tracked the overall positivity rate, we have noted other significant trends in the American workforce based on workplace drug tests. For example, our 2003 analysis revealed that amphetamine positivity had grown by 70 percent over the previous five years. The 2011 Drug Testing Index found that hydrocodone and oxycodone led U.S. general workforce positives. In both 2010 and 2011, the overall drug positivity rate was 3.5 percent, the lowest rate since we began publishing the Drug Testing Index. This year, we found positivity is at a ten-year high. What that tells us is that trends come and go, and that we cannot rely on assumptions about drug use. (more…)
Addiction, Author Interviews, CHEST, Toxin Research / 01.11.2016 Interview with: Guy Soo Hoo, MD West Los Angeles VA Medical Center Los Angeles, CA What is the background for this study? What are the main findings? Response: Wound botulism occurs as a result of infection by material contaminated with C. botulinum. While typically associated with trauma and crush injury, it is also an infection associated with injection drug users especially with “skin popping”. Black tar heroin is an especially common vehicle for the development of wound botulism. Black tar heroin is the predominant form of heroin used in the western United States and there has been an epidemic of wound botulism cases associated with black tar heroin users especially in California. In fact, the vast majority of wound botulism cases in California occurs in injection drug users, specifically those who inject the drug subcutaneously or intramuscularly. The typical presentation in wound botulism in an acute neurologic illness with cranial nerve palsies, flaccid descending paralysis. Respiratory failure requiring mechanical ventilation may occur and may require an extended period of ventilator support for recovery. A high index of suspicion as well as general supportive care is needed for optimal treatment and recovery. Optimal treatment includes wound debridement, early administration of botulinum antitoxin and penicillin therapy. This case is unique in that the initial presentation was bilateral vocal cord paralysis and cranial nerve function was initially intact. The patient subsequently developed a flaccid paralysis that included cranial nerve palsies, functional quadriplegia and respiratory failure. He recovered to be discharged to a rehabilitation facility about six weeks after his initial presentation. (more…)
Addiction, Author Interviews, Opiods, Pediatrics / 30.10.2016 Interview with: Julie R Gaither, PhD, MPH, RN Postdoctoral Fellow in Biostatistics Yale School of Medicine What is the background for this study? Response: In light of the prescription opioid epidemic that has affected the adult US population in recent years, our objective with this study was to examine how hospitalization rates for prescription opioid poisonings have changed over time in the pediatric population. In addition, because prescription opioids are thought to be a precursor to illicit opioid use, we examined in older adolescents hospitalization rates for heroin overdose. In all children, we determined whether the poisoning was of an accidental nature or could be attributed to suicidal intent. To address these questions, we used the Kids’ Inpatient Database, a nationally representatives sample of pediatric hospital records released every three years, starting in 1997. (more…)
Alcohol, Author Interviews, BMJ, Gender Differences / 27.10.2016 Interview with: Tim Slade, PhD Associate Professor National Drug and Alcohol Research Centre University of New South Wales What is the background for this study? What are the main findings? Response: Historically, men have been more likely to drink alcohol than women and to drink in quantities that damage their health. However, evidence points to a significant shift in the drinking landscape with rates of alcohol use converging among men and women born in more recent times. In a bid to quantify this trend over time, we pooled data from 68 published research studies in 36 countries around the world. We looked at how the ratio of men’s to women’s alcohol use differed for people born in different time periods and found that the gap between the sexes consistently narrowed over the past 100 years or so. For example, among cohorts born in the early 1900s men were just over two times more likely than women to drink alcohol. Among cohorts born in the late 1900s this ratio had decreased to almost one meaning that men’s and women’s drinking rates have reached parity. (more…)