Dr. Springer[/caption]
Matthew L. Springer, Ph.D.
Associate Professor of Medicine
Division of Cardiology
Cardiovascular Research Institute
Broad Center of Regeneration Medicine and Stem Cell Research
Center for Tobacco Control Research & Education
Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco
Medical Research: What is the background for this study? What are the main findings?
Dr. Springer: The general public is aware that cigarette secondhand smoke is harmful. However, many people who actively avoid tobacco secondhand smoke don't feel the need to avoid marijuana secondhand smoke; they don't consider it harmful because there's no nicotine and because we who tell them to avoid tobacco smoke don't tell them to avoid marijuana smoke. However, secondhand smoke from tobacco and marijuana is very similar in chemical composition (4000-7000 chemicals depending on whom you ask), aside from the nicotine and the THC (the psychoactive drug in marijuana).
We and others have shown that brief exposure to tobacco secondhand smoke, such as 30 minutes, at real-world levels impairs vascular function in humans. We developed a way to study vascular function (measured as arterial flow-mediated dilation; FMD) in living rats, and recently published that even one minute of sidestream smoke from the burning tips of tobacco cigarettes, a well-accepted model for secondhand smoke, is enough to start detecting impairment of FMD. The main findings of the current study are that in laboratory rats, FMD was substantially impaired by a 30 minute exposure to marijuana secondhand smoke, when measured 10 minutes after the end of exposure. Impairment was comparable to that resulting from exposure to tobacco sidestream smoke, although whereas impairment from tobacco smoke was temporary and had normalized by 40 minutes later, FMD was still impaired 40 minutes after the end of exposure to marijuana smoke. Smoke from marijuana lacking THC still impaired FMD, showing that
MedicalResearch.com Interview with:
Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Internal Medicine
Brigham and Women's Hospital
Harvard Medical School Boston, MA 02115
Medical Research: What is the background for this study?
Dr. Curhan: Hearing loss is a highly prevalent and disabling chronic condition that can impair communication, quality of life, and health. Although it is often perceived as an inevitable companion of aging, recent evidence suggests modifiable factors can potentially aid in prevention or slow progression of hearing loss. Alcohol consumption may influence several mechanisms that have been proposed to underlie age-related hearing decline. Although chronic excess alcohol intake has been associated with irreversible hearing loss and acute alcohol intake may temporarily impair auditory function, some evidence suggests that long-term moderate alcohol intake may protect against hearing loss.
MedicalResearch.com Interview with:
Victor M. Karpyak, M.D., Ph.D.
Medical Director, Intensive Addiction Treatment Program
Director, Mayo Clinic Addiction Services
Consultant, Department of Psychiatry and Psychology
Assistant Professor of Psychiatry Mayo Clinic College of Medicine
Medical Research: What is the background for this study?
Dr. Karpyak: The staggering costs of alcohol use disorders call for the development and implementation of evidence-based treatment strategies. Several medications (acamprosate, naltrexone, and disulfiram) were approved for treatment of alcohol use disorders; yet, only a fraction of patients respond to each medication. Clearly, response predictors are needed to improve treatment efficacy and personalize recommendations for treatment selection. It is expected that pharmacogenomic research will aid the discovery of such predictors.
MedicalResearch.com Interview with
David A. Fiellin, M.D.
Professor of Medicine, Investigative Medicine and Public Health
Yale University School of Medicine
Medical Research: What are the main findings of the study?
Dr. Fiellin: The main finding of our randomized clinical trial, conducted in primary care, was that among prescription opioid dependent patients, ongoing buprenorphine therapy resulted in better treatment retention and reduced illicit opioid use when compared to buprenorphine taper (detoxification).
MedicalResearch.com: Interview with:
Professor Tina Kold Jensen MD
Professor, Department of Environmental Medicine
Research leader, Odense Child Cohort
Medical Research: What are the main findings of the study?
Prof. Jensen: Our study suggests that even modest habitual alcohol consumption of more than 5 units per week had adverse effects on semen quality although most pronounced effects were seen in men who consumed more than 25 units per week. Alcohol consumption was also linked to changes in testosterone and SHBG levels.
MedicalResearch.com Interview with:
David Plurad, MD
Los Angeles Biomedical Research Institute.
Medical Research: What are the main findings of the study?
Based on a survey of patients with traumatic brain injuries, a group of Los
Angeles Biomedical Research Institute researchers found those who tested
positive for tetrahydrocannabinol (THC), the active ingredient in marijuana, were more likely to survive than those who tested negative for the illicit substance.
We surveyed 446 patients who were admitted to a major urban hospital with
traumatic brain injuries between Jan. 1, 2010, and Dec. 31, 2012, who were
also tested for the presence of THC in their urine. We found 82 of the
patients had THC in their system. Of those, 2.4% died. Of the remaining
patients who didn't have THC in their system, 11.5% died.
While most - but not all - the deaths in the study can be attributed to the
traumatic brain injury itself, it appears that both groups were similarly
injured. The similarities in the injuries between the two groups led to the
conclusion that testing positive for THC in the system is associated with a
decreased mortality in adult patients who have sustained traumatic brain
injuries.
MedicalResearch.com: Interview with:
Matthew B. Schabath, Ph.D
Assistant Member, Department of Cancer Epidemiology
Moffitt Cancer Center Tampa, Florida
Medical Research: What are the main findings of the study?
Dr. Schabath: Overall, the results from these analyses demonstrated that men who consumed the highest amounts of alcohol were associated with an increased risk for genital human papillomavirus (HPV) infections.
MedicalResearch.com Interview with:
Keren Lehavot, PhD
Research Clinical Psychologist
VA Puget Sound Health Care System
Assistant Professor
Department of Psychiatry & Behavioral Sciences
University of Washington
Medical Research: What are the main findings of the study?
Dr. Lehavot: Alcohol misuse is a significant public health concern among women living in the U.S. Women who have served in the military are a unique population who report relatively high rates of hazardous drinking, and those who identify as lesbian or bisexual (LB) may be at especially high risk for alcohol misuse. While previous research suggests that lesbian or bisexual veterans report higher rates of alcohol misuse than their heterosexual counterparts, mediators that might explain this disparity have not been identified. To that end, we examined the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S. Women veterans were recruited using the Internet to participate in an online, anonymous, national survey.
Findings indicated that lesbian or bisexual veterans scored significantly higher on an alcohol misuse measure than heterosexual women veterans. LB veterans also reported higher rates of childhood trauma, physical victimization in adulthood both during the military and as a civilian, and mental health symptoms, partly accounting for their higher rates of alcohol misuse.
MedicalResearch.com Interview with:
Susan Mason, PhD, MPH
Assistant Professor
Division of Epidemiology and Community Health
Minneapolis, MN 55454
Medical Research: What are the main findings of the study?
Dr. Mason: We examined 49,408 women enrolled in the Nurses' Health Study II to see if those who had experienced PTSD symptoms at some point in their lives were more likely than those without PTSD symptoms to meet the criteria for food addiction, a measure of perceived dependence on food. We found that the 8% of women with the most lifetime PTSD symptoms were about 2.7 times as likely to meet the criteria for food addiction as women with no lifetime PTSD symptoms. This translates to an elevation in food addiction prevalence from about 6% among women with no PTSD symptoms to about 16% in women with the most PTSD symptoms.
MedicalResearch.com Interview with:
Anna-Karin Danielsson, PhD
Project Coordinator
Karolinska Institutet
Department of Public Health Sciences (PHS)
Widerströmska huset| Stockholm, Sweden
Medical Research: What are the main findings of the study?
Dr. Danielsson: Smoking cannabis in adolescence increases the risk of adverse social consequences later on in life.
MedicalResearch.com Interview with:
Chuanhai Cao Ph.D.
Neuroscientist at the Byrd Alzheimer's Institute
and the USF College of Pharmacy.
Medical Research: What are the main findings of the study?
Dr. Cao: The major goal of this study was to investigate the effect of Ä9-tetrahydrocannabinol (THC), a major component of marijuana, on Alzheimer’s disease (AD) pathology. THC has long been known to have anti-inflammatory effects, but we were looking to determine whether THC directly affected amyloid beta (Aâ). Aâ aggregation is considered one of the key pathological hallmarks of Alzheimer’s disease. Our study showed that extremely low doses of THC were able to decrease Aâ production, inhibit Aâ aggregation, and enhance mitochondrial function in a cellular model of AD. Decreased levels of amyloid beta, coupled with THC’s inhibitory effect on aggregation may protect against the progression of Alzheimer’s disease.
MedicalResearch.com Interview with:
Dr. Richard Saitz MD MPH
Department of Community Health Sciences
Boston University School of Public Health
Boston, Massachusetts
Medical Research: What are the main findings of the study?
Dr. Saitz: We found that brief counseling interventions had no efficacy for reducing the frequency of illicit drug use or drug use consequences among primary care patients identified by screening as using drugs.
MedicalResearch.com Interview with:
Magdalena Cerdá, DrPH MPH
Assistant Professor, Department of Epidemiology
Mailman School of Public Health
Columbia University
New York, NY 10032-3727
Medical Research: What are the main findings of the study?
Dr. Cerdá: We evaluated 1,095 Ohio National Guard soldiers, who had primarily served in Iraq and Afghanistan between 2008 and 2009 to determine the effect of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorder.
Participants were interviewed three times over 3 years about alcohol use disorder, exposure to deployment-related traumatic events like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and about experiences of civilian life setbacks since returning from duty, including job loss, legal problems, divorce, and serious financial and legal problems.
We found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. In contrast, combat-related traumatic events were only marginally associated with alcohol problems.
MedicalResearch.com Interview with:
Sharon Levy, M.D., M.P.H.
Director, Adolescent Substance Abuse Program
Assistant Professor in Pediatrics
Boston Children’s Hospital
Medical Research: What are the main findings of the study?
Dr. Levy: We found that questions that asked about the frequency of alcohol, tobacco and drug use accurately triaged adolescents into "risk categories". In other words, kids who reported using alcohol or marijuana "once or twice" last year were unlikely to have a substance use disorder, those who reported "monthly" use were very likely to meet diagnostic criteria for a "mild" or "moderate" substance use disorder while those who reported use weekly or more were very likely to meet diagnostic criteria for a "severe" substance use disorder.
MedicalResearch.com Interview with:
Wendy Macias Konstantopoulos, MD, MPH
Department of Emergency Medicine
Division of Global Health & Human Rights
Massachusetts General Hospital
Harvard Medical School
Medical Research: What are the main findings of the study?
Dr. Macias-Konstantopoulos: Nearly two-thirds (64%) of 3240 emergency department (ED) patients who endorsed using drugs in the last 30 days, met criteria for problematic drug use (DAST-10 score ≥3). Of patients who identified their primary drug of use as being a substance other than cannabis, approximately 91% met criteria for problematic drug use, including nearly 94% of those using illicit drugs and 76% of those using pharmaceuticals. Compared to those who used cannabis primarily, primary non-cannabis users had an almost 15 times higher odds of meeting criteria for problematic drug use. Finally, we know from previous studies that drug-using individuals are more likely to access medical care through the ED and more likely to require hospitalization than their non-drug using counterparts. Our study found that drug-using ED patients who met criteria for problematic drug use tended to have ED triage levels associated with higher levels of severity or resource utilization when compared to drug-using ED patients who did not meet criteria for a drug problem.
MedicalResearch.com Interview with:
Michael A. Collins PhD
Professor of Molecular Pharmacology
Loyola University Chicago
Stritch School of Medicine
Maywood IL 60153
Medical Research: What are the main findings of your study?
Dr. Collins: There were several:
MedicalResearch.com Interview with:
Tara Gomes
St Michael's Hospital
Toronto, ON, Canada
Medical Research: What are the main findings of the study?
Tara Gomes: We found that rates of opioid overdose in Ontario have increased more than 3-fold over the past 2 decades. Furthermore, these deaths are clustered among younger Ontarians; in 2010, 1 in 8 deaths among those aged 25 to 34 years were related to opioids. This has led to considerable burden due to loss of life.
MedicalResearch.com Interview with: Dr. Enzo Tagliazucchi: Goethe University, Germany MedicalResearch: What are the main findings of the study? Dr. Tagliazucchi: The main finding of the study is the objective discovery of an "expanded mind" and a more "unpredictable mind" after the ingestion of a psychedelic (in this case psilocybin, a compound found in...
MedicalResearch.com Interview with:Dr. Robin L. Toblin LCDR Robin L. Toblin, PhD, MPH (USPHS) Clinical Research Psychologist Walter Reed Army Institute of Research MedicalResearch: What are the main findings of your study? Dr. Toblin: Our study focused on chronic pain and opioid use in an infantry brigade three months after returning from war. We surveyed...
MedicalResearch.com: Interview with:
Dr. Darryl P. Leong MBBS(Hons) MPH PhD FRACP FESC
Hamilton General Hospital
237 Barton Street East Canada
MedicalResearch: What are the main findings of the study?
Dr. Leong: The main findings of this study are that while low-moderate levels of alcohol use are associated with a reduced risk of myocardial infarction, this protective association was not seen in peoples of all ethnicities.
Secondly, heavy alcohol use (≥6 drinks) within a 24 hour period was associated with a significant increase in the immediate risk of myocardial infarction.
MedicalResearch.com Interview with:
Nicholas B. King, PhD,
Biomedical Ethics Unit
McGill University
Montreal QC Canada
MedicalResearch: What are the main findings of the study?
Dr. King: Unintentional overdoses from prescription opioid painkillers have been rising sharply in the US and Canada during the past two decades, killing thousands of people every year. A lot has been written about the subject in both popular media and scholarly literature, but we still don't have a very good idea of why this has happened. So we tried to objectively and systematically assess evidence for what has contributed to increasing mortality. We found the following:
(1) The evidence base for why mortality has increased is very thin, and more research is urgently required.
(2) We found evidence for at least 17 different causes of increased mortality. We found the most evidence for the following factors: dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like oxycodone and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic characteristics. We found little evidence that internet sales of pharmaceuticals and errors by doctors and patients--factors commonly cited in the media--have played a significant role.
MedicalResearch.com Interview with:
Theodore J. Cicero, PhD
Professor, Vice Chairman for Research
Department of Psychiatry
Washington University in St Louis
St Louis, Missouri
MedicalResearch: What are the main findings of the study?
Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin.
Dr. Edythe D.London PhD
Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology
David Geffen School of Medicine, UCLA
MedicalResearch: What are the main findings of the study?
Dr. London: Brain function related to risky decision-making was different in stimulant users (methamphetamine users) than in healthy control subjects. In healthy controls, activation in the prefrontal cortex (right dorsolateral prefrontal cortex) during risk-taking in the laboratory was sensitive to the level of risk. This sensitivity of cortical activation was weaker in stimulant users, who instead had a stronger sensitivity of striatum activation. The groups also differed in circuit-level activity (network activity) when they were not performing a task but were “at rest.” Stimulant users showed greater connectivity within the mesocorticolimbic system, a target of abused drugs. This connectivity was negatively related to sensitivity in the prefrontal cortex to risk during risky decision-making. In healthy control subjects, connectivity between the right dorsolateral prefrontal cortex and striatum was positively related to sensitivity of prefrontal cortical activation to risk during risky decision-making.
MedicalResearch.com Interview with:
Jennifer Peltzer-Jones, R.N., Psy.D.
Henry Ford's Department of Emergency Medicine
MedicalResearch: What are the main findings of the study?
Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users.
MedicalResearch.com Interview with:
Meesha Ahuja, MD
Department of Psychiatry and Human Behavior of the
Warren Alpert Medical School of Brown University
Young Adult Behavioral Health Program at Rhode Island Hospital
Mentors: Laura Whiteley, MD and Larry Brown, MD
MedicalResearch: Why did you decided to study this topic?
Dr. Ahuja: Severe mental illness is more common among college students than it was a decade ago, and the number of college students presenting for psychiatric care both on and off campus has dramatically increased. The rates of cannabis use have also been increasing among college students in the United States since the mid-1990s. The concomitant use of cannabis and other substances among general samples in psychiatric treatment has been linked to poorer clinical outcomes including increased hospitalizations, increased symptomatology, poorer treatment adherence, higher treatment resistance. However, before doing this study, there was no research that examined the effect of cannabis and other substance use disorders on the scholastic and general functioning of college students in psychiatric care.
MedicalResearch.com Interview with:
Emilie Jouanjus, PharmD, PhD
Risques, maladies chroniques et handicaps
Facult_e de M_edecine,
Guesde, Toulouse 31073, France.
MedicalResearch.com: What are the main findings of the study?
Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults.
MedicalResearch.com Interview with:
Cara Tannenbaum, MD, MSc
The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging,Professor of Medicine and Pharmacy
University of Montreal Centre de Recherche
Institut Universitaire de Gériatrie de Montréal
Montreal, QC
MedicalResearch.com: What are the main findings of the study?
Dr. Tannenbaum: The EMPOWER study showed that providing older patients with information about the harms of sleeping pill use led to discontinuation or dose reduction in 1-in-every 4 patients with longstanding use of benzodiazepines. Receipt of evidence-based information about drug harms resulted in a 8-fold higher likelihood of benzodiazepine cessation. Many physicians think that patients become too dependent on sedative-hypnotics to successfully discontinue. Regardless of age, sex, and duration of use, 27% of patients aged 65-95 in this study successfully completed the recommended 20-week tapering protocol during a 6-month time period and another 11% were in the process of tapering. EMPOWERing patients with evidence-based information therefore results in appropriate risk reduction.