Addiction

25 Apr

Posted at 14:24h in Addiction, Author Interviews, Cocaine, Methamphetamine, Opiods, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_23746" align="alignleft" width="133"]Jeanine Buchanich, Ph.D. Deputy director of the Graduate School of Public Health’s Center for Occupational Biostatistics and Epidemiology Research assistant professor in Pitt Public Health’s Department of Biostatistics University of Pittsburgh Dr. Jeanine Buchanich[/caption] Jeanine Buchanich, Ph.D. Deputy director of the Graduate School of Public Health’s Center for Occupational Biostatistics and Epidemiology Research assistant professor in Pitt Public Health’s Department of Biostatistics University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buchanich: Using the Mortality and Population Data System, a unique repository and retrieval system for detailed death data from the National Center for Health Statistics, housed at the University of Pittsburgh Graduate School of Public Health, my team examined overdose deaths in the U.S. from 1979 to 2014. We started with 1979 because changes in reporting cause of death make it impossible to make comparisons with previous years. 2014 is the most recent year for which data are available. The counties with the largest increases in overdose death rates were clustered in southern Michigan; eastern Ohio and western Pennsylvania; eastern Pennsylvania, New Jersey and much of southeastern New York; and coastal New England. Counties in the Midwest, California and Texas have seen little to no increase in overdose death rates. We cross-referenced the mortality data with counties in the High Intensity Drug Trafficking Areas program, which was created by Congress in 1988 to provide 31 high drug-trafficking areas of the U.S. with coordinated law enforcement resources dedicated to reducing trafficking and production. High Intensity Drug Trafficking Areas with high overdose death rates were mostly concentrated in Appalachia and the Southwest U.S., whereas such areas with lower death rates were near the borders in California, Texas and southern Florida.

20 Apr

Posted at 18:28h in Author Interviews, Cannabis, FASEB, Fertility
MedicalResearch.com Interview with: [caption id="attachment_23611" align="alignleft" width="180"]Paola Grimaldi, PhD Associate Professor of Anatomy Department of Biomedicine and Prevention, School of Medicine, University of Rome Tor Vergata Rome, Italy Dr. Paola Grimaldi[/caption] Paola Grimaldi, PhD Associate Professor of Anatomy Department of Biomedicine and Prevention, School of Medicine, University of Rome Tor Vergata Rome, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Grimaldi: Our previous studies reported that mouse mitotic germ cells, spermatogonia, express type 2 cannabinoid receptor (CB2) and its stimulation promoted differentiation and meiotic entry of these cells in vitro. In this study we demonstrate that CB2 plays a role of in regulating the correct progression of spermatogenesis in vivo and we found that the use of exogenous agonist or antagonist of this receptor disrupts the normal differentiation of germ cells. This suggests that a basal and finely regulated level of endocannabinoids in male germ cells activate CB2, thus maintaining the homeostasis of spermatogenesis. Another important novelty of our study is that CB2 activation in developing germ cells determines the appearance of modifications in DNA-bound proteins, which are known to impact on gene expression and inheritance of specific traits in developing germ cells. An exciting idea could be that these modifications might be maintained in the mature spermatozoa and transmitted to the offspring.

17 Apr

Posted at 15:12h in Author Interviews, CMAJ, Opiods
MedicalResearch.com Interview with: [caption id="attachment_23464" align="alignleft" width="171"]Dr. Zainab Samaan, MBChB, MSc, DMMD, PhD, MRCPsych Associate Professor Dept of Psychiatry and Behavioural Neurosciences Member Population Genomics Program Member Peter Boris Centre for Addiction Research Associate Faculty Dept of Clinical Epidemiology and Biostatistics McMaster University Hamilton, ON, Canada Dr. Samaan[/caption] Dr. Zainab Samaan, MBChB, MSc, DMMD, PhD, MRCPsych Associate Professor Dept of Psychiatry and Behavioural Neurosciences Member Population Genomics Program Member Peter Boris Centre for Addiction Research Associate Faculty Dept of Clinical Epidemiology and Biostatistics McMaster University Hamilton, ON, Canada Medical Research: What is the background for this study? Response: Opioid addiction has become a leading public health concern in North America with Canada leading the way in the amount of opioid use per capita. Opioid addiction has moved from heroin use by young men to prescription pain killers such as oxycodone and fentanyl with devastating impact on individuals and society including increasing number of deaths due to opioid overdose. In addition many people on treatment will also relapse (go back using drugs). We wanted to understand the problem of opioid addiction by investigating the factors that increase the risk of relapse in people with opioid addiction receiving methadone treatment. Medical Research: What are the main findings? Response: People who injected drugs and used benzodiazepines (BDZ) are more likely to relapse faster than people who did not use injection or benzodiazepines.

06 Apr

Posted at 22:39h in Addiction, Author Interviews, JAMA, Opiods
MedicalResearch.com Interview with: [caption id="attachment_23240" align="alignleft" width="133"]Dr. Eugenia Oviedo-Joekes PhD Assistant Professor, School of Population and Public Health University British Columbia Centre for Health Evaluation and Outcome Sciences Providence Health Care, St Paul’s Hospital, Vancouver British Columbia, Canada Dr. Oviedo-Joekes[/caption] Dr. Eugenia Oviedo-Joekes PhD Assistant Professor, School of Population and Public Health University British Columbia Centre for Health Evaluation and Outcome Sciences Providence Health Care, St Paul’s Hospital, Vancouver British Columbia, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Oviedo-Joekes: Diacetylmorphine is the active ingredient in heroin. Medically prescribed diacetylmorphine has shown greater effectiveness than methadone alone for the treatment of patients with long term opioid dependence who are not benefitting from available treatments (i.e., they continue injecting in the street daily for many years).  Medically prescribed diacetylmorphine is being used in a small number of countries in Europe but is unlikely to be accepted in many countries around the world, including Canada and the US.  SALOME is the world’s first study to examine the effectiveness of hydromorphone, a licensed, legal pain medication, as an alternative treatment to diacetylmorphine for chronic heroin addiction. Participants were randomly assigned to receive injectable diacetylmorphine or hydromorphone, double-blinded (up to three times daily) for six months under supervision. Injectable hydromorphone was as effective as injectable diacetylmorphine for long-term street opioid users not currently benefitting from available treatments (about 10 per cent of the heroin-dependent population).Study participants on both medications reported far fewer days of street-heroin and other opioid use at six months compared to almost daily illicit opioid use before taking part in the study. They also reported a reduction in days of illegal activities, from an average of 14.1 days per month to fewer than four.

06 Apr

Posted at 17:44h in Author Interviews, BMJ, Cannabis, OBGYNE, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_23192" align="alignleft" width="192"]Cara Christ, M.D., M.S. Director of the Arizona Department of Health Services Dr. Cara Christ[/caption] Cara Christ, M.D., M.S. Director of the Arizona Department of Health Services MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Christ: This study was a systematic review. The purpose of a systematic review is to critically assess and summarize the best available research evidence on a specific issue. This usually involves a critical synthesis of the results of several high quality studies on the issue under review. Overall, this review found that infants exposed to cannabis during pregnancy had a 77% higher likelihood of being underweight (<2500grams) at birth, compared to infants whose mothers did not use cannabis. Also, if the mother used cannabis during pregnancy, the likelihood of her infant needing to be placed in a neonatal intensive care unit was two times higher compared to those infants whose mothers did not use cannabis during pregnancy.

06 Apr

Posted at 10:45h in Author Interviews, Cannabis, Heart Disease

MedicalResearch.com Interview with: [caption id="attachment_22916" align="alignleft" width="163"] Dr. Lori Walker[/caption] Lori A. Walker, PhD University of Colorado Dept. of Medicine/Cardiology, Aurora, CO 80045 MedicalResearch.com: What is the background for this study? Dr. Walker: Marijuana use is increasing worldwide, in part due to local changes in legal status. Concomitantly, there has been an increase in case studies reporting...

04 Apr

Posted at 18:41h in Author Interviews, CMAJ, Opiods, Pain Research
MedicalResearch.com Interview with: [caption id="attachment_23135" align="alignleft" width="130"]Shawn Bugden B.Sc. (Pharm), M.Sc., Pharm.D. Associate Professor College of Pharmacy, Faculty of Health Sciences University of Manitoba Winnipeg, Manitoba, Canada R3E 0T5 Dr. Bugden[/caption] Shawn Bugden B.Sc. (Pharm), M.Sc., Pharm.D. Associate Professor College of Pharmacy, Faculty of Health Sciences University of Manitoba Winnipeg, Manitoba, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bugden: Fentanyl is 100 times more potent than morphine.  While there has been a great deal of attention to fentanyl deaths associated with substance abuse, our study focused on the safety of fentanyl use in standard medical practice.   Fentanyl is most commonly prescribed as a transdermal (skin) patch that delivers the medication over 3 days. The product monograph and numerous safety warnings (FDA, Health Canada…) make it clear that fentanyl patches should not be used unless the patient has had considerable previous opioid exposure (more than 60mg morphine per day for more than 1 week).  Failure to heed these warnings may result in opioid overdose, respiratory depression and death. This study examined over 11 000 first prescriptions for fentanyl patches over a 12-year period to determine if patients had received adequate exposure to opioids.  Overall 74.1% of first prescriptions were filled by patients who had not received adequate prior opioid exposure. An improvement was seen over the study period but even at the end of the study, 50% of prescriptions would be classed as unsafe.  More than a quarter (26.3%) of fentanyl prescriptions were given to patients who were completely opioid naïve and had no exposure to opioids of any kind in the previous 60 days.  Older adults, who may be more sensitive to the effects of fentanyl overdose, were more likely to receive unsafe prescriptions than younger adults.

03 Apr

Posted at 22:29h in Alcohol, Author Interviews, Diabetes, Endocrinology
MedicalResearch.com Interview with: [caption id="attachment_23098" align="alignleft" width="200"]Ken C. Chiu, MD, FACE, FACP Professor Endocrinology Fellowship Training Program Department of Clinical Diabetes, Endocrinology, and Metabolism Diabetes and Metabolism Research Institute City of Hope National Medical Center Duarte, CA 91010-3000 Dr. Ken C. Chiu[/caption] Ken C. Chiu, MD, FACE, FACP Professor Endocrinology Fellowship Training Program Department of Clinical Diabetes, Endocrinology, and Metabolism Diabetes and Metabolism Research Institute City of Hope National Medical Center Duarte, CA 91010-3000  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chiu: The benefit of moderate alcohol consumption is well established in cardiovascular disease. However, the role of alcohol consumption in type 2 diabetes is less clear. We examined the role of alcohol consumption in type 2 diabetes using the data from the National Health and Nutrition Examination Survey 2005-1012, which is a representative US population. In the rare alcohol consumption group (< 12 drinks per year), 24.04% were diabetic while only 14.67% were diabetic in the moderate alcohol consumption (1-4 drinks per day) group (P><0.000001). In contrast, 21.05% were diabetic in the heavy alcohol consumption (≥ 5 drinks/day) group (P=0.003) when compared to the rare alcohol consumption group. Thus, in compared to the rare alcohol consumption, moderate alcohol consumption was associated with a lower risk of diabetes (OR: 0.72; 95%CI: 0.65-0.79) after adjustment for co-variates, while there was no benefit from heavy alcohol consumption (OR: 0.97; 95%CI: 0.90-1.05). Our study demonstrates that moderate alcohol consumption reduces the risk of diabetes by 28%.

31 Mar

Posted at 00:17h in Addiction, Author Interviews, NEJM, NYU/NYMC
MedicalResearch.com Interview with: [caption id="attachment_23019" align="alignleft" width="144"]Joshua D. Lee MD, MSc Associate Professor in Medicine and Psychiatry NYU Langone Medical Center Dr. Joshua Lee[/caption] Joshua D. Lee MD, MSc Associate Professor in Medicine and Psychiatry NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Dr. Lee: Opioid use disorders, both from prescription pain medication and heroin use, and related death rates are increasing annually in the US.  Many states, counties, and cities that have previously not had great experience with heroin addiction are now overwhelmed.  This presents unprecedented challenges to affected families and communities, and also health providers and criminal justice systems that have historically not provided high rates of evidence-based treatment for opioid addictions.  Left untreated or inadequately treated, opioid use disorders are chronic, destructive, and often fatal. Extended-release naltrexone, an opioid receptor blocker, is a promising relapse prevention medication intervention, but had not been evaluated in a US criminal justice system (CJS) setting or under real-world conditions. This effectiveness study recruited 308 adults with US criminal justice system involvement (i.e., recent jail or prison incarceration, on parole or probation) and a history of opioid dependence (addiction), who were not currently accessing methadone or buprenorphine maintenance treatment, and were interested in treatment with extended-release naltrexone (XR-naltrexone).  All participants were off opioids (detoxed or recently abstinent) at the time of study start (randomization).  Participants randomized to an open-label, non-blinded evaluation of XR-naltrexone versus treatment-as-usual for six months of treatment.  Long-term follow-up occurred at 12 months and 18 months (6 and 12 months post-treatment).  We estimated rates of opioid relapse and opioid use between the two arms over the course of treatment.  We also tracked other drug and alcohol use, re-incarceration rates, and overdose rates throughout the study.

30 Mar

Posted at 11:45h in Addiction, Dental Research, Microbiome, NYU/NYMC, Smoking
MedicalResearch.com Interview with: Jiyoung Ahn, PhD, RD, MS Associate Professor of Population Health Associate Director of Population Sciences, NYU Perlmutter Cancer Center  and Brandilyn Peters (post-doctoral fellow, lead author) NYU Langone School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Oral bacteria play important roles in oral health, and can influence the health of other body systems as well. We were interested in studying how cigarette smoking affects oral bacteria. To do this, we examined the oral bacteria in mouthwash samples from 112 current smokers, 571 former smokers, and 521 people who never smoked. We found that the mouth bacterial composition of current smokers differed dramatically from those who never smoked. However, the mouth bacterial composition of former smokers was similar to that of never smokers, suggesting that quitting can restore the oral bacteria back to a healthy state.

30 Mar

Posted at 11:11h in Addiction, Author Interviews, Cocaine, Lancet
MedicalResearch.com Interview with: [caption id="attachment_23007" align="alignleft" width="150"]Mascha Nuijten MSc Researcher/ PhD candidate Brijder Research (PARC) The Hague The Netherlands Mascha Nuijten[/caption] Mascha Nuijten MSc Researcher/ PhD candidate Brijder Research (PARC) The Hague The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Crack-cocaine dependence is a complex disorder, for which no proven effective pharmacotherapy is yet available. Prior to our study, sustained-release dexamfetamine was found to be a promising treatment for cocaine dependence in several studies, but no studies so far had shown a convincing benefit in terms of substantial cocaine use reductions. Therefore, we investigated the efficacy of sustained-release (SR) dexamphetamine in a robust dose of 60 mg/day in chronic crack-cocaine dependent patients. We found that the number of days of cocaine use decreased with almost 40% in the dexamfetamine group, compared with 9% in the matched placebo group. In addition, the number of cocaine self-administrations on days that patients used crack-cocaine decreased with 43% in the dexamfetamine group and with 7% in the placebo group. Thus, SR dexamfetamine both contributed to cocaine abstinence and to cocaine use reductions.

27 Mar

Posted at 14:59h in Addiction, Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Sexual Health
MedicalResearch.com Interview with: [caption id="attachment_22822" align="alignleft" width="149"]Dr. Sari L. Reisner PhD Research Fellow in the Department of Epidemiology Harvard T.H. Chan School of Public Health Associate Scientific Researcher in the Division of General Pediatrics Boston Children’s Hospital/ Harvard Medical School Dr. Sari Reisner[/caption] Dr. Sari L. Reisner PhD Research Fellow in the Department of Epidemiology Harvard T.H. Chan School of Public Health Associate Scientific Researcher in the Division of General Pediatrics Boston Children’s Hospital/ Harvard Medical School  MedicalResearch.com: What are the main findings? Dr. Reisner: Transgender youth—including adolescent and young adult transgender women assigned a male sex at birth who identify as girls, women, transgender women, transfemale, male-to-female, or another diverse gender identity on the transfeminine spectrum—represent a vulnerable population at-risk for negative mental health and substance use/abuse outcomes. Although community surveys of transgender people in the United States have found a high prevalence of depression, anxiety, and substance use relative to the general adult U.S. population, studies typically utilize screening instruments or sub-threshold symptom questions and do not use diagnostic interviews. Diagnostic interview data are scarce among young transgender women; such data are important to establish guidelines for diagnosis and treatment for this youth group given their complex life experiences. The aim of this study was to report the prevalence of mental health, substance dependence, and co-morbid psychiatric disorders assessed via a diagnostic interview in an at-risk community-recruited sample of young transgender women. This observational study reported baseline finding from a diverse sample of 298 sexually active, young transgender women ages 16-29 years (mean age 23.4; 49.0% Black, 12.4% Latina, 25.5% White, 13.1% other minority race/ethnicity) enrolled in Project LifeSkills, an ongoing randomized controlled HIV prevention intervention efficacy trial in Chicago and Boston, between 2012-2015 (NIMH-funded, multiple PIs: Rob Garofalo, MD, MPH & Matthew Mimiaga, ScD, MPH).

18 Mar

Posted at 19:06h in Alcohol, Author Interviews, Breast Cancer, Genetic Research, PLoS
[caption id="attachment_22760" align="alignleft" width="133"]Chin-Yo Lin, Ph.D. University of Houston Center for Nuclear Receptors and Cell Signaling Department of Biology and Biochemistry Science and Engineering Research Center (SERC) 3517 Cullen Blvd, Rm 3018 Houston, TX 77204-5056 Dr. Chin Yo Lin[/caption] MedicalResearch.com Interview with: Chin-Yo Lin, Ph.D. University of Houston Center for Nuclear Receptors and Cell Signaling Department of Biology and Biochemistry Science and Engineering Research Center (SERC) Houston, TX 77204-5056  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lin: Many studies have established that alcohol consumption is a risk factor for breast cancer. Breast cancers associated with drinking tend to be hormone receptor-positive, the type is commonly treated with the drug tamoxifen which blocks the actions of estrogen in driving tumor growth in pre-menopausal women. Alcohol consumption has also been shown to increase the risk of disease recurrence in patients. Our study shows that alcohol can enhance the effects of estrogen by increasing cancer cell division and also reduce the efficacy of tamoxifen. The key mechanistic insight from the study is that alcohol treatment of breast cancer cells increased the expression of BRAF, a cancer-causing gene that is commonly mutated and activated in other types of cancers.

11 Mar

Posted at 22:12h in Addiction, Author Interviews, Pediatrics
MedicalResearch.com Interview with: Yanning Wang, MS Statistical Research Coordinator Department of Pathology, Immunology and Laboratory Medicine Department of Health Outcomes and Policy University of Florida College of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of new stimulant medications have been approved for attention deficit/hyperactivity disorder (ADHD) treatment in the past decade. The expansion of this market, along with the increase in ADHD diagnosis, provides greater availability of these drugs. This has raised public health concerns about potential non-medical use of prescription stimulants. Our study analyzed data from the National Monitoring of Adolescent Prescription Stimulants Study, which recruited and surveyed youth aged 10 to 18 years from entertainment venues in 10 US cities. We found that 6.8% of youth (750 out of 11,048) used prescription stimulants in the past 30 days. Among those 750 youth, more than half reported some type of non-medical use, and using someone else’s medication was the most common form (88.4 %). We investigated the difference between two subgroups of non-medical users: youth who only used stimulants non-medically, and those who had a prescription and reported non-medical use in the past 30 days. We found youth who only used stimulants non-medically at higher rate of using other substances and more likely to have close friends who have tried other drugs.

08 Mar

Posted at 16:17h in Author Interviews, Cannabis, Lancet, Mental Health Research
MedicalResearch.com Interview with: Dr Sagnik Bhattacharyya Reader in Translational Neuroscience and Psychiatry Institute of Psychiatry, Psychology & Neuroscience, KCL Consultant Psychiatrist, Early Intervention Pathway Director, Maudsley Early Intervention in Dual Diagnosis clinic Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust King’s Health Partners  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bhattacharyya: Cannabis is the most commonly used illicit drug in the world and its use has been linked to the onset of psychotic disorders such as schizophrenia. Whilst a lot of research has investigated the association between cannabis use and the development of psychosis, there is less clarity regarding the consequences of continued cannabis use in those with an established psychotic disorder. We therefore pooled together all available evidence from studies that specifically looked at the effects of cannabis use on outcome following the onset of psychosis. Based on data from more than 16000 patients with a first episode or more established psychosis, our results show that continued cannabis use is consistently associated with poor outcome in the form of more relapses (as indexed by psychiatric hospitalisation), longer hospitalisations and increased positive symptoms. However, outcomes were not as bad if cannabis use was discontinued following the onset of psychosis.

06 Mar

Posted at 14:13h in Author Interviews, Cannabis, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_22289" align="alignleft" width="180"]Dr. Rashmi Patel MA (Cantab) MA BM BCh PGDip (Oxon) MRCPsych Clinical Lecturer in General Psychiatry Kings College London Dr. Rashmi Patel[/caption] Dr. Rashmi Patel MA (Cantab) MA BM BCh PGDip (Oxon) MRCPsych Clinical Lecturer in General Psychiatry Kings College London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Patel: Previous studies suggest that cannabis use is associated with an increased risk of developing a psychotic disorder but, until now, little was known about the effects of cannabis on people with an established psychotic disorder. Using novel text mining techniques, we investigated the association of cannabis use with the clinical outcomes of over 2,000 people following their first episode of psychosis. We found that cannabis use was associated with significantly poorer clinical outcomes including a 50% increased frequency of hospital admission and 35 additional days spent in hospital in the 5 years after first receiving treatment. We also found that the poor outcomes associated with cannabis use may be linked to antipsychotic treatment failure.

27 Feb

Posted at 15:00h in Alcohol, Author Interviews, Cognitive Issues, NYU/NYMC, OBGYNE, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_22137" align="alignleft" width="200"]Donald A. Wilson, Ph.D. Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology NYU Langone Medical Center Senior Research Scientist Nathan Kline Institute for Psychiatric Research Dr. Donald Wilson[/caption] Donald A. Wilson, Ph.D. Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology NYU Langone Medical Center Senior Research Scientist Nathan Kline Institute for Psychiatric Research Medical Research: What is the background for this study? What are the main findings? Dr. Wilson: Fetal alcohol spectrum disorder (FASD) is characterized by cognitive, emotional and behavioral problems that are life-long.  Generally, it is assumed that the initial trauma of alcohol exposure at a critical time in life is the cause of these problems.  In this study using an animal model of FASD, we find that developmental alcohol causes a life-long disturbance in sleep.  Given that sleep is important for memory and emotion, among other things, this suggests that developmental alcohol can produce a daily insult to the brain, far outlasting that initial exposure.  Each night, the brain is unable to store memories, adjust emotional circuits, remove waste products, in the way that it should, because FASD has disrupted sleep.

19 Feb

Posted at 17:40h in Author Interviews, Depression, Opiods, Pain Research
MedicalResearch.com Interview with: Dr-Jeffrey-ScherrerJeffrey F. Scherrer, PhD Associate Professor Research Director Department of Family and Community Medicine Saint Louis University School of Medicine St. Louis, MO 63104  Medical Research: What is the background for this study? What are the main findings? Dr. Scherrer: We initiated a series of studies on chronic opioid use and risk of depression about 3 years ago and obtained an NIH R21 to study prescription opioid use and risk of new onset depression, depression recurrence and transition to treatment resistant depression.  The rationale comes partly from clinical observations of the research team (I am not a clinician, just a epidemiologist).  We also observed the large field demonstrating patients with depression are more likely to get opioids for pain, take them longer and develop abuse.  We wanted to switch the direction of effect to determine if the reverse exists.  After publishing two papers demonstrating longer use of opioid was associated with increasing risk of depression, our next step was to look at recurrence among patients with a recent history of depression. Medical Research: What should clinicians and patients take away from your report? Dr. Scherrer: Our main recommendation is clinicians should repeatedly screen patients for depression.  While screening at time of starting opioids is common, repeated screening is worth consideration.  Patients with depression who may experience temporary euphoria should not expect opioids to cure depression and they may increase risk for worsening mood and or recurrence after long term use.

17 Feb

Posted at 22:48h in Author Interviews, Cannabis, Genetic Research, Memory
MedicalResearch.com Interview with: [caption id="attachment_21717" align="alignleft" width="137"]Prof. Celia Morgan PhD Professor of Psychopharmacology University of Exeter Prof. Celiai Morgan[/caption] Prof. Celia Morgan PhD Professor of Psychopharmacology University of Exeter  Medical Research: What is the background for this study? What are the main findings? Dr. Morgan: We know cannabis increases the risk of psychosis but it is unclear how we can predict who is vulnerable to these negative effects. This study suggested that cannabis may have stronger effects in people carrying a particular genetic variant. This might be related to their risk of developing psychosis. We also found that women are more susceptible to the short term memory impairing effects of cannabis.

16 Feb

Posted at 23:53h in Addiction, Author Interviews, HIV
MedicalResearch.com Interview with: [caption id="attachment_21665" align="alignleft" width="200"]Pedro Mateu-Gelabert, Ph. D. Principal Investigator National Development Research Institutes, Inc. New York, NY 10010 Dr. Pedro Mateu-Gelabert[/caption] Pedro Mateu-Gelabert, Ph. D. Principal Investigator National Development Research Institutes, Inc. New York, NY 10010  Medical Research: What is the background for this study? What are the main findings? Dr. Mateu-Gelabert: Heroin production in Colombia increased dramatically in recent decades, and some studies point to an increase in local heroin consumption since the mid-1990s. Despite this rapid increase, little is known about the effects of these activities on heroin injection within Colombia. One of the biggest concerns surrounding heroin injection is the potential spread of HIV through drug user networks. Medical Research: What should clinicians and patients take away from your report? Dr. Mateu-Gelabert: The key take home message in the paper is that a widespread early implementation of harm reduction services (e.g. opioid substitution therapy, HIV testing, syringe exchange programs)  can prevent HIV among young PWID (People Who Inject Drugs) before it rapidly spreads within drug injection networks. Reducing HIV among young drug injectors could prevent the spread of HIV from PWID to the general population.

13 Feb

Posted at 20:58h in Alcohol, Author Interviews, Nutrition, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_21581" align="alignleft" width="133"]Francis Tayie, PhD, MPhil, MS. BSc(HONS) Food, Nutrition and Dietetics Department of Human Environmental Studies Southeast Missouri State University Dr. Francis Tayie[/caption] Francis Tayie, PhD, MPhil, MS. BSc(HONS) Food, Nutrition and Dietetics Department of Human Environmental Studies Southeast Missouri State University Medical Research: What is the background for this study? Dr. Tayie: This article which is the first report to show a positive link between alcoholic beverage consumption and increased moisture intake, also reports increases in calorie intake above what is supplied by alcohol, as well as increased body weight status. The general view is that alcoholic beverages do not contribute to moisture intake. This view is generally due to the diuretic effect of the ethanol in alcoholic beverages, specifically depression of vasopressin resulting in increased loss of moisture via the kidneys. Nevertheless, much of the water in alcoholic beverages, especially in light drinks such as beer and wine may be retained, as indicated in this study. Alcoholic calories count!! The view that alcoholic beverages do not contribute calories to the intake of drinkers is largely debatable. Most of the confusion results from the complex metabolism of the ethanol in alcoholic beverages. Metabolism of ethanol utilizes specific metabolic pathways different from the metabolism of macronutrients. Notably, the
  • 1) alcohol dehydrogenase system,
  • 2) MEOS (microsomal ethanol oxidizing system),
  • and 3) the catalase system.These metabolic systems variably yield some calories but some calories are lost as body heat. It is likely that all of these pathways are not activated simultaneously, and their activities depends on drinking experience. Some calories become available via the alcohol dehydrogenase system, and to a lesser extent via the MEOS. In addition, alcoholic beverage consumption associates with decreased self-restraint, one consequence of which is increased food intake. The promoting effects of alcohol on food intake is multipronged, from social components, to alterations in the effects of appetite regulating neuropeptides.

10 Feb

Posted at 22:39h in Accidents & Violence, Alcohol, Author Interviews, CMAJ
MedicalResearch.com Interview with: [caption id="attachment_21473" align="alignleft" width="170"]Dr. Russ Callaghan, PhD Associate Professor Northern Medical Program University of Northern British Columbia Prince George, British Columbia Dr. Russ Callaghan[/caption] [wysija_form id="5"]Dr. Russ Callaghan, PhD Associate Professor Northern Medical Program University of Northern British Columbia Prince George, British Columbia  Medical Research: What is the background for this study? Dr. Callaghan: In Canada, the minimum legal drinking age (MLDA) is 18 years in Alberta, Manitoba and Québec, and 19 in the rest of the country. Given that public-health organizations not only have recommended increasing the MLDA to 19 years, but also have identified 21 years as ideal, the current study tested whether drivers slightly older than the MLDA had significant and abrupt increases in alcohol-impaired driving (AID) crimes, compared with their counterparts just younger than the MLDA. Data on the effectiveness of Canadian drinking-age laws is lacking, and the current study provides important information for the current national and international MLDA debates.

29 Jan

Posted at 03:29h in Addiction, ADHD, Author Interviews, Eating Disorders
MedicalResearch.com Interview with: [caption id="attachment_21114" align="alignleft" width="142"]Dr. Kenneth Koblan PhD Sunovion Pharmaceuticals Inc. Fort Lee, NJ and Marlborough, MA Dr. Kenneth Koblan[/caption] Dr. Kenneth Koblan PhD Sunovion Pharmaceuticals Inc. Fort Lee, NJ and Marlborough, MA Medical Research: What is the background for this study? Dr. Koblan: Assessing abuse potential is important in the clinical development process for any therapy affecting the central nervous system, especially those that may act on dopamine and norepinephrine neurotransmitter systems. Human abuse liability studies are conducted to evaluate the abuse potential associated with drugs that affect the central nervous system. Drugs that increase dopamine levels may be associated with stimulant effects and abuse (e.g., cocaine and amphetamine), whereas drugs that increase serotonin and/or norepinephrine levels are not generally associated with recreational abuse (e.g., selective serotonin reuptake inhibitors). Among drugs with effects on dopamine neurotransmission, slowing the rate of absorption is thought to reduce abuse potential, and increasing the rate of elimination is thought to reduce rewarding effects and abuse liability due to sustained elevations in drug concentrations resulting in sustained inhibition of dopamine transporters (DAT). Dasotraline is an investigational dopamine and norepinephrine reuptake inhibitor from Sunovion in late-stage development to evaluate its use in treating the symptoms of attention deficit hyperactivity disorder (ADHD) and binge-eating disorder (BED). Dasotraline has slow absorption and elimination that supports the potential for plasma concentrations yielding a continuous therapeutic effect over the 24-hour dosing interval at steady state.

22 Jan

Posted at 03:15h in Addiction, Author Interviews, Methamphetamine, Pediatrics, UCLA
More on Pediatrics on MedicalResearch.com MedicalResearch.com Interview with: Lynne M. Smith, MD FAAP LA BioMed lead researcher Vice Chair for Academic Affairs Professor of Clinical Pediatrics Department of Pediatrics Division of Neonatology Medical Director, High Risk Infant Follow-up Program Associate Program Director, Neonatal-Perinatal Fellowship Training Program Co-Director, Third Year Medical Student Clerkship Founding co-Leader, Schwartz Rounds at Harbor-UCLA David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center Torrance, CA Medical Research: What is the background for this study? What are the main findings? Dr. Smith: It is the first study of its kind, and it holds hope for improving outcomes for children exposed to the methamphetamine in the womb. The study found that while prenatal methamphetamine exposure can lead to targeted behavioral issues, a supportive home environment significantly decreases the severity and risk of these issues. The study is a follow-up to the Infant Development, Environment and Lifestyle (IDEAL) study, which is a prospective, multi-center, longitudinal study of children exposed to methamphetamine in the womb. It is designed to address some of the limitations of earlier studies. The IDEAL study enrolled children from Los Angeles; Des Moines, IA; Tulsa, OK, and Honolulu, HI, who had been exposed to methamphetamine in utero. Previous reports from the IDEAL study documented the outcomes up to age 5 and found emotional issues and attention deficit hyperactivity disorders in the children with prenatal methamphetamine exposure. The new study surveyed 290 children enrolled in IDEAL up to age 7.5 years and found a strong relation between prenatal methamphetamine exposure and rule-breaking and aggressive behavior. It also found a strong relation between adversities in the home and rule-breaking and aggressive behavior. Among the adverse conditions considered were maternal substance abuse, extreme poverty, changes in the primary caregiver, sexual abuse of the caregiver and maternal depression. The researchers concluded that while prenatal methamphetamine exposure is strongly related to behavioral and emotional control issues, early adversities may be a strong determinant of behavioral outcomes.

16 Jan

Posted at 23:54h in Alcohol, Author Interviews, BMJ, Pediatrics, Tobacco Research
[caption id="attachment_20582" align="alignleft" width="200"]Dr Joanne Cranwell PhD, CPsychol The UK Centre for Tobacco and Alcohol Studies (UKCTAS) School of Medicine Division of Epidemiology & Public Health Clinical Sciences Building University of Nottingham City Hospital Nottingham Dr. Joanne Cranwell[/caption] More on Alcohol on MedicalResearch.com MedicalResearch.com Interview with: Dr Joanne Cranwell PhD, CPsychol The UK Centre for Tobacco and Alcohol Studies  School of Medicine Division of Epidemiology & Public Health Clinical Sciences Building University of Nottingham MedicalResearch: What is the background for this study? Dr. Cranwell: We conducted this particular study because it is well established that adolescent exposure to alcohol and tobacco in the media, such as film, television, and paid for advertising are determinants of subsequent alcohol and tobacco use in young people. The extent of potential exposure has been transformed over the past decade by the emergence of social media, in which exposure to pro-tobacco content has also been linked to favourable attitudes towards tobacco, including intention to smoke, in young non-smokers. Our previous published research highlighted that popular YouTube music videos contain tobacco and substantial alcohol content, including branding. Alcohol advertising is largely self-regulated by the alcohol industry and the Portman Group who speaks on behalf of the UK drinks industry.   The Advertising Standards Authority also provides guidance on marketing of alcohol products in the UK. Broadly speaking the guidelines from these three regulators state that “Marketing communications for alcoholic drinks should not be targeted at people under 18 and should not imply, condone or encourage immoderate, irresponsible or anti-social drinking”. However the extent to which adults and adolescents are exposed to tobacco or alcohol content from YouTube at a population level has not been quantified. In this new study we have therefore estimated population exposure to tobacco and alcohol impressions, defined as appearances in 10-second intervals in a sample of popular videos, in the British adolescent and adult population.

14 Jan

Posted at 14:13h in Author Interviews, NEJM, NIH, Opiods
[caption id="attachment_20558" align="alignleft" width="200"]Dr. Wilson Compton Dr. Wilson Compton[/caption] For more on Opioids on MedicalResearch.com please click here. MedicalResearch.com Interview with: Wilson M. Compton, M.D., M.P.E. Deputy Director National Institute on Drug Abuse Medical Research: What is the background for this study? What are the main findings? Dr. Compton: Deaths related to opioids (from both prescription pain killers and street drugs, like heroin) have dramatically increased in the past 15 years.  How these different types of opioids are related to each other is important because the pain killers ultimately are derived from prescriptions written by health care providers and street drugs, like heroin, are from illegal sources.  The different types of opioids vary in there source but are quite similar in their effects in the brain.  Given the different sources, interventions to reduce availability vary across the two categories. There is also a concern that interventions to reduce the availability of prescription opioids may be encouraging people to switch to heroin.  That’s the main question addressed in this review.

08 Jan

Posted at 17:01h in Alcohol, Author Interviews, Lancet, Pediatrics
[caption id="attachment_20503" align="alignleft" width="200"]Svetlana Popova, M.D., Ph.Ds., M.P.H. Senior Scientist Social and Epidemiological Research, Centre for Addiction and Mental Health Associate Professor, Epidemiology Division, Dalla Lana School of Public Health, University of Toronto Associate Professor, Factor-Inwentash Faculty of Social Work, University of Toronto Graduate Faculty Associate Member, Institute of Medical Science, University of Toron Dr. Svetlana Popova[/caption] MedicalResearch.com Interview with: Svetlana Popova, M.D., Ph.Ds., M.P.H. Senior Scientist Social and Epidemiological Research, Centre for Addiction and Mental Health Associate Professor, Epidemiology Division, Dalla Lana School of Public Health, University of Toronto Associate Professor, Factor-Inwentash Faculty of Social Work, University of Toronto Graduate Faculty Associate Member, Institute of Medical Science, University of Toronto MedicalResearch: What is the background for this study? Dr. Popova: It has been known for many years that prenatal alcohol exposure is associated with a number of adverse health consequences for both the mother and developing fetus. Women who consume alcohol during pregnancy place their child(ren) at risk of developing Fetal Alcohol Spectrum Disorders (FASD), and can experience a number of other adverse pregnancy outcomes including stillbirth, spontaneous abortion, premature birth, intrauterine growth retardation, and low birth weight. It was also previously known that people with FASD have many comorbidities (the simultaneous presence of two or more chronic diseases or conditions in a patient) due to the permanent damage of prenatal alcohol exposure on the fetus. However, until now it was unknown how many and what type of diseases, and at what frequencies they occur. Therefore, we reviewed the medical and epidemiological literature to identify the disease conditions that have been found to occur in people with FASD. Then based on the identified studies we estimated the pooled (combined) prevalence of the comorbid conditions found to occur among individuals with Fetal Alcohol Syndrome (FAS; the most severe and visibly identifiable form of FASD). We restricted our analysis to FAS because it is the only expression of FASD in the World Health Organization’s International Classification of Diseases, version 10 (ICD-10).

06 Jan

Posted at 01:17h in Addiction, Alcohol, Author Interviews
[caption id="attachment_20439" align="alignleft" width="180"]Kate Chitty PhD Postdoctoral Research Fellow Sydney Medical School School of Medical Sciences Pharmacology The University of Sydney Dr. Kate Chitty[/caption] MedicalResearch.com Interview with: Kate Chitty PhD Postdoctoral Research Fellow Sydney Medical School School of Medical Sciences Pharmacology The University of Sydney  Medical Research: What is the background for this study? Dr. Chitty: Recreational poisonings, defined here as poisonings that occur as a result of using alcohol and/or illicit or prescribed drugs for recreational purposes or to induce acute rewarding psychoactive effects, represent a significant and potentially lethal form of harm attributed to drug use. There is limited information on hospital admissions for recreational poisonings separately from all hospital admissions for drug harms, despite a surge in overdose occurring at youth events. Identifying trends in recreational poisoning will enable better planning of drug and alcohol services and government initiatives to reduce harms and consequences associated with drug and alcohol use.

04 Jan

Posted at 19:47h in Author Interviews, CMAJ, Opiods
[caption id="attachment_20406" align="alignleft" width="231"]Tara Gomes MHSc Tara Gomes[/caption] Medical Research: What is the background for this study? What are the main findings? Response: Surveillance of the harms associated with chronic opioid use is imperative for clinicians and policy-makers to rapidly identify emerging issues related to this class of medications.  However, data regarding opioid-related deaths is difficult to obtain in Canada as it is collected by local coroners and is not widely available to researchers.  We conducted a validation study to evaluate whether regularly collected vital statistics data collected by Statistics Canada can be used to accurately identify opioid-related deaths in Canada. We compared deaths identified from charts abstracted from the Office of the Chief Coroner of Ontario to those identified using several coding algorithms in the Statistics Canada Vital Statistics database.  We found that the optimal algorithm had a sensitivity of 75% and a positive predictive value of 90%. When using this algorithm, the death data obtained from the Vital Statistics database slightly underestimated the number of opioid-related deaths in Ontario, however the trends over time were similar to the data obtained from the coroner’s office.

02 Jan

Posted at 00:36h in Alcohol, Author Interviews, PLoS
MedicalResearch.com Interview with: Dr. Florian Naudet INSERM Centre d'Investigation Clinique 1414 Faculté de Médecine, Centre Hospitalier Universitaire de Rennes Laboratoire de Pharmacologie Expérimentale et Clinique Rennes, France Medical Research: What is the background for this study? What are the main findings? Dr. Naudet: To reduce harm, alcohol-dependent individuals are usually advised to abstain from drinking, but controlled (moderate) drinking may also be helpful. To help people reduce their alcohol consumption, the European Medicines Agency recently approved nalmefene for use in the treatment of alcohol dependence in adults who consume more than 60 g (for men) or 40 g (for women) of alcohol per day. However, several expert bodies have concluded that nalmefene shows no benefit over naltrexone, an older treatment for alcohol dependency, and do not recommend its use for this indication. This is problematic because randomised controlled trials (RCTs) should lead to objective conclusions concerning treatment efficacy and this was not the case concerning nalmefene's approval. We therefore performed a meta-analysis of aggregated data to enable an objective reappraisal of the efficacy of nalmefene for relevant health outcomes and on alcohol consumption endpoints at both 6 months (+/- 1 month) and 1 year (+/- 1 month). We identified five RCTs that met the criteria for inclusion in our study. All five RCTs (which involved 2,567 participants) compared the effects of nalmefene with a placebo; none was undertaken in the population specified by the European Medicines Agency approval. Among the health outcomes examined in the meta-analysis, there were no differences between participants taking nalmefene and those taking placebo in mortality (death) after six months or one year of treatment, in the quality of life at six months. The RCTs included in the meta-analysis did not report other health outcomes. Participants taking nalmefene had fewer heavy drinking days per month at six months and one year of treatment than participants taking placebo, and their total alcohol consumption was lower. These differences were small in terms of clinical significance. Additionally, more people withdrew from the nalmefene groups than from the placebo groups, often for safety reasons. Thus, attrition bias cannot be excluded.