Addiction

16 May

Posted at 22:58h in Author Interviews, Brigham & Women's - Harvard, Opiods, Orthopedics, Pain Research, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_49201" align="alignleft" width="135"]Marilyn M. Heng, MD, MPH, FRCSCOrthopaedic Trauma SurgeonAssistant Professor of Orthopaedic SurgeryHarvard Medical School Dr. Heng[/caption] Marilyn M. Heng, MD, MPH, FRCSC Orthopaedic Trauma Surgeon Assistant Professor of Orthopaedic Surgery Harvard Medical School  MedicalResearch.com: What is the background for this study?   Response: The ultimate background for this study does come from the larger context of the opioid epidemic that is seen worldwide but particularly in North America. Orthopaedic surgeons should take responsibility as being among the top prescribers of opioids. The more specific background that led to this specific study was the observation that several colleagues would insist that a drug like hydromorphone was so dangerous that they would not prescribe it but seemed okay prescribing large amounts of oxycodone.  It seemed like an urban myth that the type of opioid was what made it dangerous, so that led us to do the study to see if there was evidence for that. 

16 May

Posted at 12:19h in Addiction, Author Interviews, Coffee
MedicalResearch.com Interview with: [caption id="attachment_49187" align="alignleft" width="128"]Dr Lorenzo Stafford, PhD, CPsycholSenior Lecturer, Department of PsychologyUniversity of PortsmouthPortsmouth Stafford[/caption] Dr Lorenzo Stafford, PhD, CPsychol Senior Lecturer, Department of Psychology University of Portsmouth Portsmouth  MedicalResearch.com: What is the background for this study?   Response: The background to this work was that I had been thinking for sometime on the role of our sense of smell in drug consumption and addiction.  Most of the research in this area is dominated by visual processes, in particular showing how cues associated to drugs (e.g. packet of cigarettes, bottle of beer) become conditioned in such drug users. That work has been useful in explaining how in recovering addicts, long after the withdrawal symptoms have subsided, when exposed to such cues, they can nevertheless relapse to craving and consuming the drug; hence though a powerful driver, addiction is not just about reversing withdrawal symptoms. However, most of our richer experiences are multisensory, so it seems likely that other senses must also play a role in the addictive process. Years ago, I completed a PhD on the topic of caffeine and with the general importance placed on the sensory (especially smell) aspects of coffee, all planted the seed for a possible study. We completed two experiments that examined the lowest concentration at which participants (high, moderate and non-coffee consumers) could detect (Threshold test) a coffee associated chemical (exp 1) and in a separate task, how fast they were at identifying (Recognition test) the odour of real coffee. In experiment 2, participants (coffee consumers and non-consumers) completed the same Threshold test for the coffee odour but also completed a Threshold test for a control odour.

11 May

Posted at 21:22h in Author Interviews, JAMA, Opiods, Primary Care, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_49122" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.

09 May

Posted at 00:30h in Author Interviews, Cannabis, PLoS
MedicalResearch.com Interview with: Kyle Gardiner B.Pharm(Hons)PhD candidateDiscipline of PharmacyQueensland University of Technology | QUT · Brisbane, Australia Kyle Gardiner B.Pharm(Hons) PhD candidate Discipline of Pharmacy Queensland University of Technology | QUT · Brisbane, Australia MedicalResearch.com: What is the background for this study?   Response: The background to this study was a personal interest in behavioural science. I am often intrigued as to why health professional behave the way they do. Studies exploring health professional behaviour are seldom complete or comprehensive, however. Medicinal cannabis presents an interesting case point to explore health professional behaviours due to its topical nature. The socio-political discussion surrounding medicinal cannabis is often quite different from the medical discussion, yet for legal and regulated access to be achieved across most jurisdictions, a health professional is required to be involved in that process. Simply, if health professionals are not willing to behave, the delivery of medicinal cannabis does not occur. For purposes of transparency, I neither support or reject the use of medicinal cannabis and this paper has nothing to do improving or reducing access. This paper is about beginning to understand health professional behaviours within the context of medicinal cannabis. Yet, if we hope to change practice in the future, by definition, we need to change behaviour. We cannot change behaviour without first understanding the behaviour in context.

07 May

Posted at 19:41h in Alcohol, Author Interviews, Hepatitis - Liver Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_48981" align="alignleft" width="140"]Robert Wong, MD, MS, FACGAssistant Clinical Professor of MedicineDirector, GI Education & ResearchHighland Hospital   I A member of Alameda Health SystemOakland, CA 94602 Dr. Wong[/caption] Robert Wong, MD, MS, FACG Assistant Clinical Professor of Medicine Director, GI Education & Research Highland Hospital   I A member of Alameda Health System Oakland, CA 94602  MedicalResearch.com: What is the background for this study?   Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S.  However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder.  Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease.  Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease.  Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression.

06 May

Posted at 12:47h in Author Interviews, Opiods, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_48970" align="alignleft" width="200"]Jan Klimas, PhD, MScSenior Postdoctoral FellowBC Centre on Substance Use (BCCSU) Vancouver, BC Dr. Klimas[/caption] Jan Klimas, PhD, MSc Senior Postdoctoral Fellow BC Centre on Substance Use (BCCSU) Vancouver, BC MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Some individuals prescribed opioid analgesic medications for pain develop opioid use disorder. So, much research has been conducted to develop strategies to identify patients who can be safely prescribed opioid analgesics. However, this research has not been critically reviewed through rigorous quality assessment. This study therefore sought to identify signs, symptoms & screening tools to identify patients with pain who can be safely prescribed opioids 

02 May

Posted at 11:42h in Author Interviews, CDC, Emergency Care, Occupational Health, Opiods
MedicalResearch.com Interview with: Sophia K. Chiu, MD Epidemic Intelligence Service, CDC Division of Surveillance, Hazard Evaluations, and Field Studies National Institute for Occupational Safety and Health CDC  MedicalResearch.com: What is the background for this study? Response:  Responders across the United States are reporting work-related health effects during incidents in which suspected opioids (including fentanyl) and other illicit drugs such as cocaine, methamphetamine, cathinones, and synthetic cannabinoids are present, often as a mixture. These health effects have interfered with responders’ ability to perform their job duties. Since 2018, a number of responder organizations have requested that NIOSH investigate the health effects experienced by emergency responders during these response incidents. These organizations are looking for ways to protect their responders and prevent the symptoms responders have reported experiencing, so that they can in turn better serve the public. NIOSH’s goal is to increase awareness among responders of how they can remain safe while providing the care the public needs.

30 Apr

Posted at 00:18h in Addiction, Author Interviews, Cannabis, Pediatrics, Smoking, Tobacco, Tobacco Research
MedicalResearch.com Interview with: [caption id="attachment_48927" align="alignleft" width="120"]Joan S. Tucker, Ph.D.Senior Behavioral ScientistRAND CorporationSanta Monica, CA Dr. Tucker[/caption] Joan S. Tucker, Ph.D. Senior Behavioral Scientist RAND Corporation Santa Monica, CA MedicalResearch.com: What is the background for this study?   Response: In light of young adults’ expanding access to cannabis through legalization for recreational use, there has been growing interest in the co-use of cannabis with tobacco/nicotine products.  Although existing data show that young adults who use cannabis products also tend to use tobacco/nicotine products, little is known about how these products are typically used together. Existing research on co-use has mostly focused on combustible products, not accounting for the recent proliferation in cannabis and tobacco/nicotine product types and methods of use (e.g., vaping). Further, not much is known about whether there are important differences between types of co-use (e.g., using both products on the same occasion, one right after another, but not mixing them vs. using both products by mixing them in the same delivery device) in terms of heaviness of use, consequences from use, or associations with young adult functioning. This study was designed as an important first step toward understanding cannabis and tobacco/nicotine co-use behavior among young adults and addressing these gaps in the research literature.

28 Apr

Posted at 13:35h in Author Interviews, JAMA, Opiods
MedicalResearch.com Interview with: [caption id="attachment_48846" align="alignleft" width="200"]Leah LaRue, PharmD, PMPAssociate Director, Clinical AffairsMillennium Health Dr. LaRue[/caption] Leah LaRue, PharmD, PMP Associate Director, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl. To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time.

26 Apr

Posted at 20:04h in Accidents & Violence, Author Interviews, Cannabis
MedicalResearch.com Interview with: Angela Eichelberger, Ph.D. Senior Research Scientist Insurance Institute for Highway Safety MedicalResearch.com: What is the background for this study? Response: Dr. Romano and Dr. Kelley-Baker have previously studied the problem of child endangerment in alcohol-related crashes. In the United States, each year, about 200 children die and another 4,000 are injured while being driven by a drinking adult. For this study, we wanted to take the opportunity to look at the prevalence of alcohol and cannabis use among drivers who participated in a roadside survey in Washington State. To our knowledge, this is the first study to examine cannabis use among drivers transporting a child.

25 Apr

Posted at 14:08h in Alcohol, Author Interviews, Hepatitis - Liver Disease, Lifestyle & Health, Sugar
MedicalResearch.com Interview with: E. van Eekelen, MSc | PhD Candidate Leiden University Medical Center Dept. Clinical Epidemiology Leiden, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Fatty liver, defined as excess accumulation of fat within the liver, covers a broad clinical spectrum and is the leading cause of chronic liver diseases. It has also been linked to type 2 diabetes and cardiovascular disease. The consumption of alcohol is a well-established risk factor for fatty liver. However, we hypothesized that consumption of non-alcoholic energy-containing beverages also leads to liver fat accumulation. We analysed data from the Netherlands Epidemiology of Obesity (NEO) study, which is a prospective population-based cohort study including non-invasive measurements of liver fat content by magnetic resonance spectroscopy. Besides consumption of alcoholic beverages, sugar sweetened beverages were associated with more liver fat. We specifically showed that replacement of alcoholic beverages with milk was associated with less liver fat, whereas replacement with sugar sweetened beverages was associated with a similar amount of liver fat, even when taking calories into account. 

24 Apr

Posted at 16:23h in Author Interviews, Cannabis, Psychological Science, Social Issues, Weight Research
MedicalResearch.com Interview with: "Chocolate Brownies" by Kurtis Garbutt is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Jessica S. Kruger PhD Clinical Assistant Professor Department of Community Health and Health Behavior School of Public Health and Health Professions University of Buffalo Daniel J. Kruger PhD Adjunct Faculty Associate, Population Studies Center. Michigan's Population Studies Center  MedicalResearch.com: What is the background for this study? Response: The legal environment for cannabis is changing rapidly and an increasing proportion of people are using cannabis for medical and recreational purposes. All policy and practice should be informed by science, yet there is a large gap between evidence and existing practices, and the current scope of research on cannabis users is limited. Public Health has the responsibility of protecting the public, maximizing benefits and minimizing harm in any area. However, the Public Health approach to cannabis has largely been limited to a focus on abstinence, and Federal regulations have restricted the scope of cannabis-related research.

19 Apr

Posted at 00:11h in Addiction, Author Interviews, Tobacco Research
MedicalResearch.com Interview with: [caption id="attachment_48651" align="alignleft" width="200"]Dr Nicola Lindson PhD CPsycholCochrane Tobacco Addiction Group (TAG) Managing Editor & Senior Researcher Nuffield Department of Primary Care Health Sciences,University of Oxford  Dr. Lindson[/caption] Dr Nicola Lindson PhD CPsychol Cochrane Tobacco Addiction Group (TAG) Managing Editor & Senior Researcher Nuffield Department of Primary Care Health Sciences, University of Oxford   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: People have been using nicotine replacement therapy, otherwise known as NRT, to quit smoking for more than 20 years. NRT is available in a range of forms: skin patches, chewing gum, nasal and oral sprays, inhalators, and lozenges. We have good evidence that it is safe and that it helps more people to quit than trying to stop smoking using no medication. We carried out a systematic review to try and find out what the best ways are to use NRT to maximise a person’s chances of quitting successfully. We did this by looking at studies that compared at least two different types of NRT use, such as higher versus lower doses, or longer versus shorter use. The takeaway message from the review is that using more nicotine (in the form of nicotine replacement therapy, ) to aid quitting can help more people to stop smoking in the long-term. There is high quality evidence that using two forms of nicotine replacement at the same time – a patch as well as a faster-acting form such as gum - increases chances of quitting, and evidence also suggests that starting to use nicotine replacement before the day you give up cigarettes can help more people quit than beginning use on the day you stop. There is no evidence that using more nicotine replacement is harmful when used as directed.

16 Apr

Posted at 22:09h in Addiction, Author Interviews, Education, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_48618" align="alignleft" width="200"]Lina Begdache, PhD, RDN, CDN, CNS-S, FANDAssistant ProfessorHealth and Wellness Studies Department GW 15Decker School of NursingBinghamton University Dr. Begdache[/caption] Lina Begdache, PhD, RDN, CDN, CNS-S, FAND Assistant Professor Health and Wellness Studies Department GW 15 Decker School of Nursing Binghamton University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: College students engage in activities such as binge drinking, abuse of ADHD medications as "study drugs" or use of illicit drugs during a critical brain developmental window that supports maturation of the brain (the prefrontal cortex) necessary for emotional control, cognitive functions and regulation of impulsive behaviors. These activities not only affect brain function, thus mental health and cognitive functions, but may dampen brain development with potential long-lasting effects. As for findings, we were able to identify neurobehavioral patterns that associate with mental wellbeing and mental distress in young adults. Based on evidence from the literature, we constructed conceptual models that describe how one behavior may lead to another until virtuous or vicious cycles set-in. 

16 Apr

Posted at 00:24h in Author Interviews, Cost of Health Care, Opiods
MedicalResearch.com Interview with: [caption id="attachment_48576" align="alignleft" width="92"]Joel Segel, Ph.D.Assistant ProfessorDepartment of Health Policy and AdministrationThe Pennsylvania State UniversityUniversity Park, PA 16802 Dr. Segel[/caption] Joel E. Segel, Ph.D. Assistant Professor Department of Health Policy and Administration The Pennsylvania State University University Park, PA 16802 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Earlier research has shown that the societal costs of opioid misuse are high, including the impact on employment. However, previous work to understand the costs of opioid misuse borne by state and federal governments has largely focused on medical costs such as care related to overdoses and the cost of treating opioid use disorder. Our main findings are that when individuals who misuse opioids are unable to work, state and federal governments may bear significant costs in the form of lost income and sales tax revenue. We estimate that between 2000 and 2016, state governments lost $11.8 billion in tax revenue and the federal government lost $26.0 billion. 

09 Apr

Posted at 17:48h in Author Interviews, Opiods
MedicalResearch.com Interview with: [caption id="attachment_48417" align="alignleft" width="180"]Joanne Spetz, PhDProfessorPhilip R. Lee Institute for Health Policy StudiesSan Francisco, CA 94143-0936 Dr. Spetz[/caption] Joanne Spetz, PhD Professor Philip R. Lee Institute for Health Policy Studies San Francisco, CA 94143-0936  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Medication treatment is an important component of treatment for opioid use disorder. Buprenorphine has been the focus of policies designed to increase access to treatment and is the most widely-used medication due to well-established evidence of its efficacy and its accessibility outside licensed narcotics treatment programs. The most common brand name for this medication is Suboxone. There is a shortage of providers authorized to prescribe it, in part because only physicians were permitted to obtain waivers from the Drug Enforcement Agency to prescribe it outside of licensed narcotics treatment programs until the opioid bill of 2016. That bill granted nurse practitioners (NPs) and physician assistants (PAs) the ability to apply for waivers. However, in states that require NPs and/or PAs to be supervised by or collaborate with a physician, there are additional requirements regarding the training of the physician before the NP or PA can apply for a waiver. This affects nearly half of states for NPs, and all states for PAs. We found that the average percentage of NPs with waivers was 5.6% in states that do not require physician supervision, but only 2.4% in more restrictive states. Even after adjusting for other factors, we found that the percentage of NPs with waivers was 75% higher when physician oversight is not required. We didn’t find a similar result for PAs, probably because they must have physician oversight in all states. 

08 Apr

Posted at 01:45h in Addiction, Author Interviews, Mental Health Research, Occupational Health, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_48428" align="alignleft" width="200"]Hefei Wen, PhDAssistant Professor, Department of Health Management & PolicyUniversity of Kentucky College of Public Health Dr. Wen[/caption] 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? Response: Work requirements condition Medicaid eligibility on completing a specified number of hours of employment, work search, job training, or community service. Little is known about how behavioral health and other chronic health conditions intersect with employment status among Medicaid enrollees who may be subject to work requirements.

05 Apr

Posted at 12:39h in Alcohol, Author Interviews, Genetic Research, Nature, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_48375" align="alignleft" width="160"]Henry R. Kranzler, MDProfessor of PsychiatryPerelman School of MedicineUniversity of Pennsylvania Dr. Kranzler[/caption] Henry R. Kranzler, MD Professor of Psychiatry Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alcohol consumption and alcohol use disorder (AUD) are moderately heritable traits.  To date, genome-wide association studies (GWAS) have not examined these traits in the same sample, which limits an assessment of the extent to which genetic variation is unique to one or the other or shared. This GWAS examined a large sample (nearly 275,000 individuals) from the U.S. Veterans Affairs Million Veteran Program (MVP) for whom data on both alcohol consumption and alcohol use disorder diagnoses were available from an electronic health record.  We identified 18 genetic variants that were significantly associated with either alcohol consumption, AUD, or both. Five of the variants were associated with both traits, eight with consumption only, and five with alcohol use disorder only. 

28 Mar

Posted at 22:06h in Author Interviews, Cancer Research, Cannabis, End of Life Care, NYU/NYMC
MedicalResearch.com Interview with: [caption id="attachment_48264" align="alignleft" width="200"]Arum Kim, MDAssistant professor of Medicine and Rehabilitation MedicineNYU School of MedicineDirector of the Supportive Oncology ProgramPerlmutter Cancer Center Dr. Kim[/caption] Arum Kim, MD Assistant Professor Medicine and Rehabilitation Medicine NYU School of Medicine Director of the Supportive Oncology Program Perlmutter Cancer Center MedicalResearch.com: What is the background for this study?   Response: There is increasing interest in medical marijuana and its applications for patients with cancers. Despite increasing access, little is known regarding doses of cannabinoids - specifically delta-8-tetrahydrocannabinol (delta-8-THC)  and cannabidiol (CBD), methods of drug delivery, and differences in patterns of use between cancer and non-cancer patients.

28 Mar

Posted at 00:22h in Author Interviews, Cannabis, JAMA, Mental Health Research, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_48215" align="alignleft" width="160"]Jeremy FineB.A. in Philosophy, Neuroscience, and PsychologyWashington University in St. Louis, Class of 2019 Jeremy Fine[/caption] Jeremy Fine B.A. in Philosophy, Neuroscience, and Psychology Washington University in St. Louis, Class of 201 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea. Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy. Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future.

20 Mar

Posted at 00:27h in Addiction, Author Interviews, CDC, Emory
[caption id="attachment_48017" align="alignleft" width="145"]CDR Andrew Geller, MDMedical Officer, Medication Safety ProgramDivision of Healthcare Quality Promotion,CDCAtlanta GA 30329 Dr. Geller[/caption] MedicalResearch.com Interview with: CDR Andrew Geller, MD Medical Officer, Medication Safety Program Division of Healthcare Quality Promotion, CDC Atlanta GA 30329 MedicalResearch.com: What is the background for this study? Response: There has been a lot of recent attention on drug overdoses in the United States, particularly fatal overdoses which involve opioids. But the overall frequency with which patients end up in the emergency department (ED) due to nonmedical use of medications across the US is unknown.
  • Nonmedical use refers to a spectrum of circumstances, including intentionally using more medication than is recommended in an attempt to treat a health condition (therapeutic misuse) to using medication to attain euphoria or get “high” (abuse).
With this analysis, we wanted to focus on the acute harms to individual patients from nonmedical use of all medications, in order to help target prevention efforts.
  • Specifically, we used data from a nationally-representative sample of hospital EDs to identify the medications with the highest numbers of emergency visits for harms following nonmedical use of medications and to identify the patient groups with the highest risks. 

18 Mar

Posted at 13:27h in Author Interviews, Heart Disease, Infections, Opiods
MedicalResearch.com Interview with: [caption id="attachment_47941" align="alignleft" width="200"]Serena Day, MDOhio State University. Dr. Serena Day[/caption] Serena Day, MD Ohio State University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The idea for this research came from my own observations of patients that I was caring for in the hospital first as an Internal Medicine Resident and now as a senior Cardiology Fellow. I did my residency here at Ohio State and noticed a marked increase in the number of patients with endocarditis that we were caring for just in my short time here as a trainee. Over 5 years, we saw an increase of 436% in intravenous drug use related endocarditis. How this disease is treated as changed as well. It used to be that if a patient was a good surgical candidate, we would offer a replacement valve. Now, we see that these patient's have such a high rate of recurrent intravenous drug use and reinfection of their heart valves that we now treat with antibiotics only rather than surgery. In many cases, the infection never goes away because we can't offer definitive therapy with surgery due to their high relapse and reinfection rates of nearly 50%.

18 Mar

Posted at 12:06h in Author Interviews, Opiods, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_47877" align="alignleft" width="130"]Paul Cagle, Jr. MDAssistant Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Cagle[/caption] Paul Cagle, Jr. MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings ie What are some of the significant comorbidities?  Response: In this study our goal was to better understand what medical issues (medical comorbidities) can cause trouble or issue for patients with a proximal humerus fracture (shoulder fracture).  To tackle this issue we used a large national sample of patients and sorted our the different medical issues the patients had. We found that patients with increased medical issues had longer hospital stays and higher use of opioid medications (pain medications).

18 Mar

Posted at 11:53h in Author Interviews, Opiods, Orthopedics, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_47736" align="alignleft" width="130"]Dr. Alexis Colvin, MDAssociate Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Colvin[/caption] Dr. Alexis Colvin, MD Associate Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: 40% of all opioid overdose deaths involve a prescription opioid and orthopaedic surgeons are the 3rd highest prescribers of opioids.  Set guidelines for post surgery opioid prescriptions have not been established.  Arthroscopic knee meniscectomy is one of the most common orthopaedic procedures.  The purpose of this study was to determine how many opioids were being prescribed  among a group of six sports fellowship trained orthopaedic surgeons versus how many patients were actually using.

13 Mar

Posted at 21:24h in Author Interviews, Brigham & Women's - Harvard, NEJM, Opiods
MedicalResearch.com Interview with: [caption id="attachment_47869" align="alignleft" width="125"]Wenjia Zhu, PhD. Marshall J. Seidman FellowDepartment of Health Care PolicyHarvard Medical School Dr. Zhu[/caption] Wenjia Zhu, PhD. Marshall J. Seidman Fellow Department of Health Care Policy Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The current opioid epidemic continues to cause deaths and tremendous suffering in the United States, driven in large part by overuse of prescription opioids. Of special concern are new opioid prescriptions, i.e. opioids given to patients who have not used opioids before, which research tells us are an important gateway to long-term opioid use, misuse, overdoes and death. Recently, in their efforts to curb over prescribing of opioids, the CDC issued guidelines (December 2015 in draft form; March 2016 in final version) to encourage opioid prescribers to limit the use, duration and dose of opioids, particularly opioids to first-time users. Despite these, little is known about the prescribing of opioids to first-time users on a national scale, particularly among commercially insured patients. In this study, we examined national monthly trends in the rate at which opioid therapy was started among commercially insured patients. Using administrative claims from Blue Cross Blue Shield Association commercial insurers from 2012 to 2017, we analyzed more than 86 million commercially insured patients across the United States.

12 Mar

Posted at 17:16h in Author Interviews, Cost of Health Care, Gastrointestinal Disease, Opiods
MedicalResearch.com Interview with: [caption id="attachment_47904" align="alignleft" width="133"]Howard Franklin, MD, MBAVice President of Medical Affairs and StrategySalix Pharmaceuticals Dr. Franklin[/caption] Howard Franklin, MD, MBA Vice President of Medical Affairs and Strategy Salix Pharmaceuticals MedicalResearch.com: What is opioid-induced constipation? Response: Opioid-induced constipation (OIC) is a side effect in as many as 80 percent of chronic pain patients on opioids. OIC is unlikely to improve over time without treatment and can lead to suffering and discomfort. More importantly, the insufficient treatment of OIC can have negative implications for patients, both those on opioid therapy for chronic non-cancer pain as well as advanced illness, and for hospitals. 

12 Mar

Posted at 14:33h in Alcohol, Author Interviews, JAMA, Weight Research
MedicalResearch.com Interview with: Alice R Carter MSc Doctor of Philosophy Student MRC Integrative Epidemiology Unit Population Health Science, Bristol Medical School University of Bristol MedicalResearch.com: What is the background for this study?   Response: Higher body mass index and alcohol intake have been shown to increase the risk of liver disease. Some studies have looked at their combined effect by comparing the risk of liver disease between individuals with both high BMI and high alcohol intake and individuals with low BMI and low alcohol intake. However, these studies have produced mixed results. Some possible reasons for that are errors in self-reported BMI and alcohol intake, other factors confounding the association of BMI & alcohol intake with liver disease risk and changes in lifestyle that individuals with ill health may have been advised to adopt. One way to overcome these limitations is to use a technique called Mendelian randomisation. This method uses genetic differences between individuals that influence their characteristics (e.g. their body mass and how much alcohol they drink) to help understand whether these characteristics are causally related to diseases. Our study used this method to explore the joint effects of BMI and alcohol consumption on liver disease and biomarkers of liver injury. 

28 Feb

Posted at 19:30h in Author Interviews, Health Care Systems, Opiods
MedicalResearch.com Interview with: [caption id="attachment_47704" align="alignleft" width="200"]Cory E. Cronin PhDDepartment of Social and Public HealthOhio University College of Health Sciences and ProfessionsAthens, Ohio Dr. Cronin[/caption] Cory E. Cronin PhD Department of Social and Public Health Ohio University College of Health Sciences and Professions Athens, Ohio MedicalResearch.com: What is the background for this study? What are the main findings?  Response: One of my primary areas of research is exploring how hospitals interact with their local communities. My own background is in health administration and sociology, and I have been working with colleagues in the Heritage College of Osteopathic Medicine here at Ohio University (Berkeley Franz, Dan Skinner and Zelalem Haile) to conduct a series of studies looking at questions related to these hospital-community interactions. This particular question occurred to us because of the timeliness of the opioid epidemic. In analyzing data collected from the American Hospital Association and other sources, we identified that the number of hospitals offering in-patient and out-patient substance use disorder services actually dropped in recent years, in spite of the rising number of overdoses due to opioid use. Other factors seemed to matter more in regard to whether a hospital offered these services or not.

27 Feb

Posted at 18:06h in Addiction, Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_43721" align="alignleft" width="144"]Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan  Dr. Harbaugh[/caption] Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow Michigan Opioid Prescribing Engagement Network University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nonmedical prescription opioid use and prescription opioid-related overdose remain significant concerns among adolescents and young adults. Among adolescents and young adults prescribed an opioid after surgery, prior work found that 4.8% of opioid-naïve patients develop new persistent use, filling additional opioid prescriptions at 3-6 months after surgery. This work found associations of persistent use with diagnoses such as chronic pain disorders, depression, anxiety, and prior substance use disorder. It is likely that for young patients, family members may also play an important role in development of new persistent use, but this has not previously been explored. We performed this study to evaluate whether long-term opioid use among family members was associated with prescription opioid fills among adolescents and young adults perioperatively – and we found that opioid-naïve adolescents and young adults who have 1 or more family members with long-term opioid use are more likely to fill at the time of surgery, during recovery, and in the long-term with a near-doubling of rates of new persistent use.

25 Feb

Posted at 12:53h in Author Interviews, Opiods
MedicalResearch.com Interview with: [caption id="attachment_47585" align="alignleft" width="200"]Dr-Mathew Vinhhoa Kiang Dr. Kiang[/caption] Mathew Vinhhoa Kiang, PhD Postdoctoral Research Fellow Primary Care and Outcomes Research Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nationally, opioid-related mortality has continued to climb for decades and resulted in over 42,000 deaths in 2016 — more than the number of deaths from car accidents or firearms. However, there are substantial differences across states and by opioid type. We sought to systematically describe these differences by examining state-level opioid mortality by opioid type. Deaths from synthetic opioids, such as fentanyl, are rapidly increasing in the eastern half of the US. Specifically, 28 states have synthetic opioid mortality rates that are more than doubling every two years. Twelve of those states already have high levels of synthetic opioid mortality — above 10 deaths per 100,000. Lastly, the opioid epidemic has reached our nation's capital — Washington DC has the fastest rate of increase, more than tripling every year, and a high opioid mortality rate.