(l-r) Dr. Zhenhua Shao and Dr. Daniel Rosenbaum UT Southwestern[/caption]
Dan Rosenbaum, Ph.D.
Principal Investigator
Department of Biophysics
The University of Texas Southwestern Medical Center
Dallas, Texas
MedicalResearch.com: 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.
Dr. Amitoj Singh[/caption]
Amitoj Singh MD
Chief Cardiology Fellow
St. Luke’s University Health
Bethlehem, Pennsylvania
MedicalResearch.com: 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.
Dr. Barry Sample[/caption]
Dr. Barry Sample PhD
Senior director, science and technology
Quest Diagnostics Employer Solutions
A business of Quest Diagnostics
MedicalResearch.com: 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.
MedicalResearch.com Interview with: [caption id="attachment_29330" align="alignleft" width="144"] Dr. Kelly Quinn[/caption] Kelly Quinn, PhD, MPH Assistant Professor Department of Population Health NYU Langone Medical Center New York, NY 10016-6481 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prescription pain reliever misuse epidemic in the United States has contributed to a dramatic increase...
Dr. Julie R Gaither[/caption]
Julie R Gaither, PhD, MPH, RN
Postdoctoral Fellow in Biostatistics
Yale School of Medicine
MedicalResearch.com: 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.
Prof. Tim Slade[/caption]
Tim Slade, PhD
Associate Professor
National Drug and Alcohol Research Centre
University of New South Wales
MedicalResearch.com: 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.
Dr. Brett Wolfson-Stofko[/caption]
Brett Wolfson-Stofko, PhD Post-Doctoral Fellow
Behavioral Science Training Program
Center for Drug Use and HIV/HCV Research
Rory Meyers College of Nursing
New York University New York, NY 10003
Research Associate Institute for Special Populations
National Development & Research Institutes, Inc.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Drug overdose mortality rates per year continue to rise in the US. Previous research suggests that public bathrooms are among the most popular public injection locations for people who inject drugs (PWID) in New York City. Though syringe exchange programs provide sterile injection equipment they are not authorized to offer a safe and sanitary space for injection which leads many, particularly those that are unstably housed, to inject in public spaces. This study interviewed 86 business managers throughout NYC and 58% (n = 50) of these managers had encountered drug use in their business bathroom within the past 6 months. Over one-third found improperly disposed syringes and 14% encountered unresponsive individuals. Only 10% of managers reported some form of overdose recognition and naloxone training while 64% of managers thought overdose recognition and naloxone training would be useful for them and their staff.
Dr. Steven A. Sumner[/caption]
Steven A. Sumner, MD, MSc
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control, Division of Violence Prevention
Atlanta GA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In 2014, CDC was invited to Wilmington, Delaware, to conduct a study because the city had been experiencing a high level of homicides and shootings. Our investigation looked at multiple risk factors for youth violence involvement across a wide variety of areas of young people’s lives. For example, youth who had previously experienced a gunshot wound injury were 11 times more likely to later commit a gun crime than youth who had not been similarly injured. Study investigators looked at histories of violence victimization, educational problems, unemployment histories, child welfare experiences, and prior criminal involvement. The more adverse life experiences a young person had, the more likely they were to commit firearm violence.
Megan Ryan[/caption]
Megan Ryan M.B.A.
Clinical Program Director, DMD
Technology Development Coordinator
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
Bethesda, MD
MedicalResearch.com: What is the background for this study?
Response: Alcohol use disorder (AUD) has been linked to the dysregulation of the brain stress systems (e.g. corticotropin-releasing factor, glucocorticoids, and vasopressin) creating a negative emotional state leading to chronic relapsing behavior. Several pre-clinical studies have shown that by blocking the V1b receptor with a V1b receptor antagonist, dependence induced compulsive-like alcohol intake is also blocked. This is the first multi-site trial to assess the efficacy of the V1b receptor antagonist novel compound (ABT-436) for the treatment of alcohol dependence.
Dr. Rebecca Lacey[/caption]
Dr Rebecca Lacey, PhD
Research Associate
Epidemiology & Public Health
Institute of Epidemiology & Health
Faculty of Pop Health Sciences
University College London
MedicalResearch.com: What is the background for this study?
Response: We know from previous research that children who experience parental absence, whether due to death, divorce or some other reason, are more likely, on average, to have poorer health in later life. This includes being more likely to smoke and drink as an adult. However, what we didn’t know before we conducted our study was whether children who experienced parental absence were more likely to engage in the early uptake of risky health behaviours in childhood. This is what we looked at in our study.
Dr. Elizabeth Osuch[/caption]
Elizabeth Osuch, M.D.
Associate Professor; Rea Chair
Department of Psychiatry
FEMAP--London Health Sciences Centre
London, ON
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As a researcher and psychiatrist doing clinical work in youth aged 16-25 with mood and anxiety disorders I often see patients who are depressed and believe that using marijuana (MJ) improves their mood. Yet they remain depressed. This was the clinical inspiration for this brain imaging study, where we investigated emerging adults with Major Depressive Disorder (MDD). Subject groups included patients with MDD who did and did not use MJ frequently. Our results showed that the MDD+MJ group did not have significantly less depression than the MDD alone group, and the brain abnormalities found in MDD were not corrected by MJ use in the MDD+MJ group. In fact, some of the brain differences were worse with the addition of MJ, while others were just different.
Dr. Michael Weitzman[/caption]
Professor Michael Weitzman MD
New York University's College of Global Public Health and
The Departments of Pediatrics and Population Health
New York University School of Medicine
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study?
Response: There is a marked and rapidly increasing epidemic of hookah (waterpipe) use in the US. Hookah use appears to be as, or even more, dangerous than cigarette use. There are data suggesting that one hookah session is comparable to smoking 5 packs of cigarettes in terms of exposure to toxins. The CDC and WHO both have issued warnings that hookah pipe use may eradicate much or all of the progress of the past 50 years of tobacco control efforts.
Dr. Silvia Martins[/caption]
Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Response: Given the high probability of nonmedical use among adolescents and young adults, the potential development of prescription opioid use disorder secondary to nonmedical use among youth represents an important and growing public health concern. Still, no study had investigated time trends, specifically if prescription opioid use disorder has increased in the past decade among adolescents, emerging adults and young adults who are nonmedical users of prescription opioids.
Dr. Ursula H. Winzer-Serhan[/caption]
Ursala. H. Winzer-Serhan Ph.D.
Associate Professor
Department of Neuroscience and Experimental Therapeutics
Texas A&M Health Science Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Nicotine is a plant alkaloid that is naturally occurring in the tobacco plant. Smoking delivers nicotine to the brain where it acts as a stimulant. Tobacco and electronic cigarette smoking delivers many other chemicals to the body, which are harmful and can cause cancer.
However, the drug nicotine by itself is relatively benign and poses few health risks for most people. Nicotine acts in the brain on nicotinic receptors, which are ion channels that are widely expressed in the brain. They play an important role in cognitive functions. Research with rodents and in humans has shown that nicotine can enhance learning and memory, and furthermore, can protect neurons during injuries and in the aging brain. With the increasingly older population, it becomes more and more important to delay cognitive decline in the elderly. Right now, there is no drug available that could delay aging of the brain.
Dr. Jared Howard[/caption]
Jaren Howard, PharmD, BCPS
Associate Director
Medical Affairs Strategic Research
Purdue Pharma L.P.
MedicalResearch.com: What is the background for this study?
Response: The existing scientific literature estimating the healthcare burden of opioid misuse disorders often combines all patients within the broad category of “opioid abuse,” defined as opioid abuse, dependence, or overdose/poisoning.
Collectively, these three conditions can significantly increase healthcare costs among commercially insured patients.
• Real world medical coding practices present challenges to researchers aiming to separately analyze excess costs by diagnosis, though combining these diagnoses may mask some variation in excess costs.
• Furthermore, little is known about the specific drivers of excess costs in terms of medical conditions driving excess costs or places of service at the diagnosis-level.
Dr. Bradley Stein[/caption]
Bradley D. Stein, MD, MPH, PhD
RAND Corporation
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The United States is in the midst of a serious opioid abuse epidemic and we know that medically assisted treatment is one of the best ways to help people with addiction to opioids. The drug buprenorphine has advantages over methadone, the historic medical treatment, because it can be prescribed by physicians in the community who receive a waiver allowing them to prescribe it after undergoing eight hours of training.. Methadone is dispensed at special clinics that many people with opioid addition may be unable to get to with the frequency required by effective treatment.
To better understand patterns of the use of buprenorphine, we examined treatment patterns in the states with the most buprenorphine-waivered physicians (California, Florida, Massachusetts, Michigan, New York, Pennsylvania and Texas). Our data came from a prescription records that account for over 80 percent of the retail pharmacies in the nation. We examined use patterns among 3,200 physicians who treated 250,000 patients.
We had two surprising findings:
First, the median length of treatment with buprenorphine was 53 days, which is much shorter than the duration that most individuals are likely to need for optimal results. Second, despite concerns that federal limits on the number of patients and waivered physician can treat being a significant barrier for many individuals obtaining treatment, we found that most physicians were treating far fewer patients than would be allowed by the patient limits. In fact, 22 percent of the physicians treated an average of 3 patients per month and just 9 percent treated 75 or more patients per month.
Dr. Jared Howard[/caption]
Jaren Howard, PharmD, BCPS
Associate Director,
Medical Affairs Strategic Research
Purdue Pharma L.P.
MedicalResearch.com: What is the background for this study?
Response: Opioid abuse, dependence, overdose, and poisoning (referred to collectively for the purposes of this study as “abuse”) represent a costly public health concern to payers. Excess annual costs for a diagnosed opioid abuser range from $10,000-$20,000 per patient. Current literature does not sufficiently address the drivers of excess costs in terms of medical conditions driving costs or places of service.
June Kim[/caption]
June H. Kim
Doctoral candidate,Department of Epidemiology
Mailman School Public Health
Columbia University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A previous study indicated that states with medical marijuana laws had a reduced rate of opioid overdoses. If this is true, we'd expect to see similar reductions in opioid use associated with these laws. For this study, we used data from the FARS, a national surveillance system that records any crash events on US public roads that result in a fatality. Some states provide uniform testing of the majority of their deceased drivers, year to year. Among these states, we found that there was a lower prevalence of positive opioid toxicology tests among drivers crashing in states with an operational medical marijuana versus drivers crashing in states before a future medical marijuana law is implemented, particularly among drivers aged 21-40.
Dr. Kristina J. Berglund[/caption]
Kristina J. Berglund
Department of Psychology
University of Gothenburg
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In Sweden, care providers do offer different treatment strategies for individuals who have alcohol problems, where some offer a treatment where the goal is abstinence and other offer a treatment where the goal is low-risk consumption. We wanted to investigate how important it was for having a successful treatment when there was congruence between the patient’s goals and the advocated goal of the treatment, and when there was not.
The main findings was that that if the patient had a goal of abstinence than it was much more likely to reach that goal if the patient went to a treatment that advocated abstinence. It was less likely to reach the goal if a patient had a goal of low-risk consumption and went to a treatment that advocated low-risk consumption. The treatment that advocated abstinence was also more effective when the patient were ambivalent of his/her own goal.
Curtis Florence, PhD[/caption]
Curtis Florence, PhD
National Center for Injury Prevention and Control and
Assistant professor, Department of Health Policy Management
Rollins School of Public Health
Emory
MedicalResearch.com: What is the background for this study?
Response:
Dr. Wilson Compton[/caption]
Dr. Wilson Compton MD, Deputy Director
National Institute on Drug Abuse
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The study found that overall past year marijuana use by adults in the U.S. increased by more than 30% in the past dozen years, and 10 million more people were using marijuana in 2014 than in 2002. Use of marijuana on a daily (or near daily) basis increased even more markedly. In 2002, 3.9 million adults in the U.S. reported using marijuana daily or nearly every day, and the number more than doubled to 8.4 million by 2014. Along with this increase in use, we found that U.S. adults perceptions of the potential harms from using marijuana greatly decreased. Despite scientific evidence of potential harms, adults are much less convinced about dangers associated with using marijuana. These reductions in perceived harm were strongly associated with the increases in use.
Dr. N. Nick Knezevic[/caption]
N. Nick Knezevic, MD, PhD
Vice Chair for Research and Education
Associate Professor of Anesthesiology and Surgery at University of Illinois
Advocate Illinois Masonic Medical Center
Department of Anesthesiology
Chicago, IL 60657
MedicalResearch.com: What is the background for this study?
Response: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic non-cancer pain, still many Americans seek pain relief through opioid consumption. The purpose of this study was to accurately assess compliance of chronic opioid consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing could improve compliance.
Alexis B. Peterson, PhD[/caption]
Alexis B. Peterson, PhD
(Epidemic Intelligence Service Officer)
[caption id="attachment_27435" align="alignleft" width="125"]
Dr. R. Mathew Gladden[/caption]
R. Matthew Gladden, PhD (Behavioral Scientist)
MedicalResearch.com What is the background for this study?
Response: In March and October 2015, the Drug Enforcement Administration and the Centers for Disease Control and Prevention (CDC) issued nationwide alerts identifying fentanyl, particularly illicitly manufactured fentanyl, as a threat to public health and safety. During 2013-2014, Ohio and Florida reported significant increases in fentanyl-involved overdose deaths (fentanyl deaths) and fentanyl submissions (drug products obtained by law enforcement that tested positive for fentanyl).
Fentanyl is a synthetic opioid 50-100 times more potent than morphine. The University of Florida and the Ohio Department of Public Health with CDC assistance compared trends in fentanyl deaths, fentanyl submissions, and fentanyl prescribing during January 2013–June 2015.
In-depth review of medical examiner and coroner reports of fentanyl deaths occurring in Ohio’s 14 high-burden counties were performed to identify circumstances surrounding fentanyl overdose death.