Anesthesiology, Author Interviews, Brigham & Women's - Harvard, Opiods, Surgical Research / 21.09.2021

MedicalResearch.com Interview with: Andres Zorrilla Vaca, MD Resident Physician Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: The background for this study was Enhanced Recovery After Surgery, also known as ERAS protocols. They basically consisted of a bundle of interventions that are performed preoperatively, intraoperatively and postoperatively with the aim of enhancing patient recovery and reducing complications. This protocol in our institution started with a thorough preoperative counseling which includes, smoking cessation, pain and analgesia education, ERAS program expectations, pulmonary rehabilitation based on pulmonary function tests and incentive spirometry. On the day of surgery, prolonged fasting is avoided and a carbohydrate loading is given orally 2 hours before surgery. Our protocol also included a standardized multimodal analgesic regimen consisting of tramadol ER 300mg p.o. and gabapentin 300mg p.o., intraoperative acetaminophen 1gm i.v., posterior intercostal nerve blockade with liposomal bupivacaine 266mg prior to incision, intraoperative 30mg ketorolac upon wound closure and scheduled postoperative acetaminophen 1g p.o. q 6hrs and ketorolac 15mg i.v. q 6 hrs, as well as additonal interventions recommended by ERAS Society Guidelines. As a general rule, preoperative sedatives (midazolam) are avoided as premedication and prophylaxis against nausea and vomiting (ondansetron, dexamethasone and scopolamine) is administered. Patients are kept euvolemic by using validated goal-directed fluid therapy algorithms (stroke volume variation and cardiac output) and normothermia is maintained throughout the procedure. (more…)
Author Interviews, Cannabis / 17.09.2021

MedicalResearch.com Interview with: Sam Craft Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London UK MedicalResearch.com: What is the background for this study? Response: Synthetic cannabinoid receptor agonists (SCRAs, also known as Spice or K2) are a group of synthetic drugs originally produced to mimic the effects of cannabis. As they are often more accessible or cheaper and cannot be detected on drugs tests, SCRAs may be used as an alternative to cannabis. However, although they act on the same receptors – cannabinoid receptor type 1 and 2 (CBR1; CBR2) – SCRAs are far more potent than cannabis which may make them more addictive and increase the severity of withdrawal (unpleasant symptoms experienced after cessation of a drug which has been used in large amounts for a long period of time) As part of the Global Drug Survey, in this study we asked participants who use both SCRAs and cannabis to compare their effects across different measures which indicate how likely a drug is to result in long-term harm. For example, how severe withdrawal symptoms are and how long the effects last. We also asked participants which withdrawal symptoms they experienced when attempting to stop.  (more…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 10.09.2021

John A. Furst BS Geisinger Commonwealth School of Medicine MedicalResearch.com: What is the background for this study? Response: Methadone is an evidence-based pharmacotherapy for opioid detoxification, maintenance therapy, and pain management. However, accessibility of this treatment remains variable across much of the country. Methadone for the treatment of opioid use disorder (OUD) is exclusively provided by federally regulated opioid treatment programs (OTPs) and has provoked significant community-based and legal controversy regarding its role in the management of this condition. This has created disparities related to the distribution and access of methadone throughout the United States (U.S.). The goal of this study1 was to highlight the most recent pharmacoepidemiologic trends associated with methadone in the face of unique restrictions at the local, state, and federal levels. (more…)
Author Interviews, Cannabis, JAMA / 07.09.2021

MedicalResearch.com Interview with: Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER  MedicalResearch.com: What is the background for this study? Response: In a previous study that was published in JAMA Pediatrics, we used Youth Risk Behavior Survey (YRBS) data and found that the adoption of recreational marijuana laws (RMLs) was associated with an 8% decrease in the odds of marijuana use among high school students.  This earlier study, however, had pre-legalization and post-legalization data from only 7 states and pre- and post-recreational sales data from only 3 states, calling into question the generalizability of our findings. (more…)
Addiction, Author Interviews, Cocaine, Pain Research / 18.08.2021

MedicalResearch.com Interview with: Youngeun Armbuster Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Cocaine is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II drug that can be used as an anesthetic in various types of surgery by otorhinolaryngologists, as well as in diagnosing Horner syndrome. Although controlled doses of cocaine used in topical anesthetics does not cause myocardial infarction as can occur with recreational dosages, intranasal administration of cocaine is absorbed systemically and it results in vasoconstriction of the coronary arteries via stimulation of adrenergic receptors. These potential adverse effects may disincentivize health care providers from medical cocaine use. Our objective was to quantify the trends in licit cocaine distribution in the United States using DEA data and to determine the usage of medical cocaine in Medicaid and Medicare, as well as based on electronic medical records [1]. (more…)
Addiction, Author Interviews, Cocaine, Diabetes, Methamphetamine / 07.08.2021

MedicalResearch.com Interview with: Joy M. Schmitz, Ph.D. Professor of Psychiatry Faillace Chair McGovern Medical School The University of Texas Health Science Center at Houston Director, Center for Neurobehavioral Research on Addiction (CNRA)   Scott D. Lane Ph.D. McGovern Medical School Vice Chair For Research Director Of Neurobehavioral Laboratory Center For Neurobehavioral Research On Addiction Director Of Research University of Texas Health Science Center at Houston Houston, TX  MedicalResearch.com: What is the background for this study? Response: Addiction science has made considerable progress in understanding how cocaine and other addictive drugs impair the brain. Over time, cocaine can disrupt brain regions that help us think, plan, solve problems, and exert self-control. These disruptions in brain structure can be seen in neuroimaging studies that reveal impairment in the nerve fibers or white matter (WM) tracts in the central and front parts of the brain. We conducted two systematic meta-analytic reviews of the literature to document the robustness of evidence showing alterations in WM integrity of chronic stimulant users relative to healthy control subjects who did not use cocaine or other drugs of abuse (Beard et al., 2019; Suchting et al., 2020). Importantly, WM impairments negatively predict treatment outcome, meaning individuals with greater levels of WM impairment are less likely to benefit from treatment and more likely to experience deficits in attention, working memory, and impulse control. We reasoned that pharmacological interventions shown to protect WM integrity may help improve cognition and treatment outcomes in patients recovering from cocaine addiction. Pioglitazone, an approved medication for type 2 diabetes, has been shown to reduce inflammation and mediate protection after traumatic brain injury. The therapeutic potential of pioglitazone has prompted investigation of its role in neurodegenerative conditions, such as dementia, Alzheimer’s disease, and stroke. Similar to these brain diseases and injuries, pioglitazone might effectively protect the brain from the inflammatory damage created by cocaine use.  (more…)
Author Interviews, Opiods / 27.06.2021

http://www.indivior.com/This study and abstract presentation evaluated opioid withdrawal symptoms, safety and tolerability of initiating SUBLOCADE 300 mg one hour after administering a single dose of 4 mg transmucosal (sublingual) buprenorphine (BUP-TM). 26 participants received BUP-TM, 24 follow by  SUBLOCADE injection, and 20 completed the study. Participants were evaluated for opioid withdrawal symptoms as well as safety and tolerability of SUBLOCADE 300 mg. (more…)
Author Interviews, Opiods / 25.06.2021

MedicalResearch.com Interview with: John Boyle, BS Department of Medical Education Geisinger Commonwealth School of Medicine MedicalResearch.com: What is the background for this study? Response:  Meperidine is an opioid analgesic which has been approved for use since the 1940s for moderate to severe pain. During the 1990s, concerns about adverse effects (e.g., serotonin syndrome) and CYP450 drug interactions (e.g., 3A4 inhibition of other metabolism of other common medications) were raised and by 2003 it was removed from the WHO’s List of Essential Medicines. Despite increased awareness of adverse effects, meperidine is still used in the United States. It was the goal of this study1 to uncover pharmaepidemiological trends in its use. (more…)
Addiction, Author Interviews, Opiods / 24.06.2021

MedicalResearch.com: What is the background for this study? http://www.indivior.com/Response: Adults with moderate or severe opioid use disorder (OUD) were randomized to SUBLOCADE monthly injections or placebo and studied for 24 weeks. Participants receiving SUBLOCADE were given 2 monthly injections of 300 mg, followed by 4 monthly maintenance doses of 100 mg or 300 mg over the course of the study. (more…)
Alcohol / 02.06.2021

Decisions have added weight after going through rehabilitation. The priority you put on these decisions will determine the scope of your recovery period. To avoid a relapse, seeking out healthy social circles is the key. Distance Yourself from Triggers There are emotional triggers that will make you want a drink. Once you figure them out, it becomes much easier to avoid. Common triggers are people, relationships, and stress. During drug and alcohol rehabilitation, overcoming your weak points is a part of the process. People can unintentionally make you feel inadequate during normal conversations. When every other conversation with a specific individual causes this problem, you have to speak up. Let them know you’re uncomfortable with a specific subject. If they refuse to acknowledge it, move on and remove that trigger from your life. Short-term and long-term relationships have a big impact on your life. Breaking up with someone makes your future look bleak. When finding someone new fails, a sense of hopelessness sets in. The answer to resolving this problem is to ‘fully’ break up with someone. Staying in contact and reliving happy memories will give you false hope. Staying away from a former relationship trigger prevents bouts of drinking for the future. Stress can sometimes be related to time, or the lack of it. Time management is the best way to avoid this trigger. Having a plan means that you’re in a better position to complete your tasks. There is no need for fancy scheduling, and it helps create a good habit. When you’re productive, stress tends to take a backseat to everything else. (more…)
Author Interviews, Autism, Cannabis, JAMA, Pediatrics / 28.05.2021

MedicalResearch.com Interview with: Daimei Sasayama, M.D., Ph.D. Department of Psychiatry Shinshu University MedicalResearch.com: What is the background for this study? Response: The diagnosis of autism spectrum disorder (ASD) is increasing worldwide. A 2016 US survey reported a prevalence of 1.85% in 8-year-olds, and a birth cohort study in Denmark reported that the future cumulative incidence of ASD could exceed 2.8%. Our recent regional cohort study in Japan reported an even higher cumulative incidence of 3.1%. So we examined whether the cumulative incidence in our regional cohort represents the nationwide incidence in Japan.  (more…)
Author Interviews, Gastrointestinal Disease, Opiods / 24.05.2021

MedicalResearch.com Interview with: Frank Peacock, MD, FACEP, FACC Professor of Emergency Medicine, Associate Chair Research Director, Department of Emergency Medicine Baylor College of Medicine Houston, Texas MedicalResearch.com: What is the background for this study?  Response: Emergency medicine (EM) physicians, like myself, are always looking for ways to improve the patient experience. Often times, we will encounter a patient in the emergency department (ED) who is presenting with one of the most common side effects of opioids, which is opioid-induced constipation (OIC). OIC impacts 40-80% of patients on long-term opioid therapy[i],[ii] and may lead to emergency room visits which are associated with a significant burden on patients and the healthcare system. We wanted to compare the impact of treating OIC patients with FDA-approved prescription medications for OIC versus the impact of not treating OIC patients with an FDA-approved prescription medication for OIC in the ED setting to better understand the impact to overall ED costs and the length of stay for a hospitalized patient. (more…)
Alcohol, Author Interviews, Heart Disease, JACC / 09.05.2021

MedicalResearch.com Interview with: Kenechukwu Ndubisi Mezue, M.D Fellow in Nuclear Cardiology  Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Observational studies have shown that moderate alcohol intake may have beneficial effects on cardiovascular disease. However, the mechanisms through which this benefit occurs is mostly unknown. Chronic stress is also known to associate with increased risk of cardiovascular disease and our group has shown in previous work that increased activity in the stress-associated regions of the brain (such as the amygdala) is significantly associated with increased bone marrow activity, arterial inflammation, and cardiovascular events. Our current study hypothesizes that moderate alcohol intake reduces cardiovascular events by reducing chronic stress-associated brain activity.  (more…)
Accidents & Violence, Author Interviews, Cannabis, CMAJ / 06.04.2021

MedicalResearch.com Interview with: Sarah Windle, MPH PhD Student in Epidemiology Department of Epidemiology, Biostatistics, and Occupational Health McGill University (Montréal, Québec, Canada) MedicalResearch.com: What is the background for this study? Response: Concerns have been raised about the potential for increases in impaired driving following the legalization of recreational cannabis use in Canada in October 2018. Data from Statistics Canada suggest that cannabis use in the previous three months increased among adults (15 and older) from 14% before legalization in 2018 to 17% in 2019. Among those users with a driver’s license, 13% reported driving within two hours of cannabis use. While this proportion remained the same before and after legalization, this indicates that the absolute number of individuals who reported driving within two hours of use has increased following legalization (due to an increase in the number of users). (more…)
Author Interviews, Cannabis, JAMA, OBGYNE, Pediatrics / 08.03.2021

MedicalResearch.com Interview with: Erica M. Wymore, MD MPH Assistant Professor, Neonatal- Perinatal Medicine Department of Pediatrics, Section of Neonatology University of Colorado School of Medicine Children's Hospital Colorado Maya Bunik, MD, MPH  |  Professor, Pediatrics Medical Director, Child Health Clinic, Primary Care  |  Breastfeeding Management Clinic Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) School of Medicine| University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure. As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum.  (more…)
Author Interviews, Blood Pressure - Hypertension, Cannabis / 10.02.2021

MedicalResearch.com Interview with: Ran Abuhasira MD, PhD student Cannabis Clinical Research Institute and Clinical Research Center Soroka University Medical Center, and Faculty of Health Sciences Ben-Gurion University of the Negev Beer Sheva, Israel MedicalResearch.com: What is the background for this study? What are the main findings? cannabis marijuana weed pot Response: The background for the study is the steady rise of cannabis use as a therapeutic in Israel and in many countries around the world. This largest increasing population of patients treated with medical cannabis is the older adults. However, very little data was published about cannabis treatment in older adults, and specifically about the cardiovascular and metabolic implications. T he main finding of the study is that cannabis treatment for 3 months was associated with a reduction in both systolic and diastolic blood pressure values, as measured by consequent 24-hours ABPM tests. In addition, no significant changes were found in blood lipids profile, hemoglobin A1C, fasting insulin, C-reactive protein, kidney function tests, electrolytes, anthropometric measurements, and ECG parameters. (more…)
Addiction, Author Interviews, Columbia, JAMA / 05.02.2021

MedicalResearch.com Interview with: Elodie C. Warren, MPH Columbia University Mailman School of Public Health Graduate MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the US has been experiencing an opioid crisis for the past two decades. And we know that among communities of color, rates of overdose deaths are continuing to increase, even though overall national rates decreased between 2017 and 2018. To better understand how the opioid crisis has differently affected racial/ethnic groups, we looked at how heroin treatment admissions changed over time by race/ethnicity, age, and sex. We found that there were stark differences when comparing non-Hispanic Black men and women to non-Hispanic White men and women. Importantly, our study suggests the existence of an aging cohort of Black men and women (likely including survivors of a heroin epidemic that hit urban areas more than 40 years ago) that continues to struggle with heroin addiction. This points to the need for targeted interventions in chronically underserved communities.  (more…)
Author Interviews, Cannabis / 03.02.2021

MedicalResearch.com Interview with: Benjamin J. Warnick, PhD Assistant Professor of Entrepreneurship Carson College of Business Washington State University Vancouver MedicalResearch.com: What is the background for this study? Response: Popular culture has perpetuated a notion that cannabis users are more creative. Along these lines, some successful CEOs and entrepreneurs—like Steve Jobs, for example—have claimed that cannabis use has benefitted their creativity at work. Despite such claims and increased legalization and use of cannabis, the implications of cannabis use for entrepreneurs’ creativity has yet to be rigorously tested. My coauthors and I were very intrigued to dive into the implications of cannabis use for entrepreneurs, whether good or bad. This seemed all the more relevant given the increasing legalization, destigmatization, and use of cannabis.  (more…)
Author Interviews, BMJ, Cannabis, Opiods, Yale / 29.01.2021

MedicalResearch.com Interview with: Balázs Kovács PhD Associate Professor of Organizational Behavior Yale School of Management MedicalResearch.com: What is the background for this study? Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S.  We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates.   We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older.  The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs.  (more…)
Author Interviews, Cannabis, UCSF / 15.01.2021

MedicalResearch.com Interview with: Eric R. Pedersen, Ph.D. Adjunct Behavioral Scientist, RAND Associate Professor of Psychiatry and Behavioral Sciences Keck School of Medicine University of Southern California MedicalResearch.com: What is the background for this study? Response: In November of 2016, CA voted to legalize cannabis for sale and possession to adults 21 and older for recreational use. It wasn’t until January of 2018 that stores in most parts of LA County (we call these “outlets”) were legally able to begin selling recreational cannabis. We were collecting data from about 2,500 young adults in LA County as part of a longitudinal study (Principal Investigator Elizabeth D’Amico at RAND) and were able to look at cannabis use and intentions assessed at a period prior to the opening of the recreational cannabis outlets (pre-January 2018) to a period when those outlets were open (after January 2018). It has been suggested that once cannabis was more available for recreational purchase (and not just for medical purposes among those enrolled in CA’s medical marijuana program), use of cannabis among young adults would increase.  (more…)
Author Interviews, Opiods, Pancreatic, PLoS / 08.01.2021

MedicalResearch.com Interview with: Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center MedicalResearch.com: What is the background for this study? Response: This study builds on recent population based studies where opium use was found to be possible risk factor for pancreatic cancer. Although opium use is not a common recreational habit in the United States, opioid use has been rising remarkably over the past decade. In fact, opioid misuse and overdose have evolved into a public health crisis here with increasing opioid prescription use and abuse over the past decade. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 24.12.2020

MedicalResearch.com Interview with: Li Li, MS, PhD Candidate Division of Epidemiology, College of Public Health, Ohio State University Graduate Research Associate, Center for Injury Research and Policy The Abigail Wexner Research Institute at Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? Response: Marijuana use impairs cognitive abilities necessary for safe driving, including reaction time, road lane-tracking ability, and attention maintenance. Given increasing legalization of marijuana use in the US, our study aimed to estimate marijuana-impaired driving among teens at a national level and help to identify the current prevalence to guide future intervention programs. (more…)
Author Interviews, Opiods / 20.12.2020

MedicalResearch.com Interview with: Brian J. Piper, PhD, MS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA 18510 MedicalResearch.com: What is the background for this study? Response: The US continues to be adversely impacted by an iatrogenic opioid epidemic. There have been increasing reports of “vet shopping” or diverting opioids from pets to their owners [2]. In humans, methadone is the number one prescription opioid when expressed in terms of morphine mg equivalents (MME) [3]. The goal of this study was to examine the changing pattern of opioid and other controlled substance use by veterinary teaching institutions.  (more…)
Alcohol, Author Interviews, COVID -19 Coronavirus / 07.12.2020

MedicalResearch.com Interview with: Sitara Weerakoon, MPH (she/her) PhD Candidate | Epidemiology & Biostatistics Graduate Research Assistant Center for Pediatric Population Health UTHealth MedicalResearch.com: What is the background for this study? What are the main findings? Response: Measures to control the spread of COVID-19 included stay-at-home mandates and business lockdown policies which resulted in many facing a loss of income or employment and more time spent isolated at home. Life stressors (like job loss and social isolation) have been shown to be associated with increased drinking at unhealthy levels. Those with a history of mental health problems may be even more at risk. We aimed to see if binge drinking (5 or more drinks [male] or 4 or more drinks [female] in one session) and levels of alcohol consumption among binge drinkers were impacted by these pandemic-related factors. We found that increased time spent at home (in weeks) was associated with a 19% increase in the odds of binge drinking and binge drinkers with a previous diagnosis of depression and current depression symptoms (during the early months of the pandemic) had a 237% greater odds of drinking more alcohol (vs drinking the same amount) compared to those with no history and current symptoms of depression. (more…)
Addiction, Author Interviews, COVID -19 Coronavirus, JAMA, Opiods, UCLA / 03.12.2020

MedicalResearch.com Interview with: Joseph Friedman, MD/PhD student David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? Response: Numerous researchers, clinicians, officials, harm reduction agencies, and people who use drugs have sounded the alarm that the COVID-19 pandemic is exacerbating the United States overdose crisis. However, data sources typically used to track overdoses in the US often have long lags that impede timely monitoring and response. For example, the CDC released preliminary overdose figures for 2019 in July 2020, and even these numbers may change. As they are available in near real-time, emergency medical services (EMS) data have increasingly been used as a source of up-to-date information to monitor epidemiological shifts during the COVID-19 pandemic. In this study, we used data from the National EMS Information System (NEMSIS), a large registry of over 10,000 EMS agencies in 47 states that represented over 80% of all EMS activations nationally in 2020. We used the data to track shifts in overdose-related cardiac arrests observed by EMS.   (more…)
Author Interviews, Cannabis, Ophthalmology, Race/Ethnic Diversity, Social Issues / 09.11.2020

MedicalResearch.com Interview with: Joshua Uhr MD Ophthalmologist Philadelphia, PA MedicalResearch.com: What is the background for this study? Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology. Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.  (more…)