Author Interviews, Cannabis / 09.10.2020

MedicalResearch.com Interview with: Christopher Kaufmann, PhD Co-first author of the study and assistant professor Division of Geriatrics and Gerontology in the Department of Medicine UC San Diego  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We examined cannabis use by older patients seen in our geriatrics clinic at the University of California San Diego. We surveyed patients who came to our clinic for routine care, and found that 15% of those surveyed had used cannabis within the past 3 years. Half of users reported using cannabis regularly and most used for medical purposes. The most common targeted conditions were pain, problems sleeping, and anxiety, and patients found cannabis to be helpful in treating these conditions. We also found that 61% had initiated cannabis use after age 60, and these new users engaged in less risky consumption practices than current users who also used earlier in life.  (more…)
Author Interviews, Cannabis, JAMA, Tobacco Research / 07.10.2020

MedicalResearch.com Interview with: Isabella Lanza, PhD Associate Professor of Human Development California State University, Long Beach   MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is the first study to examine both nicotine vaping and cannabis vaping trajectories across adolescence and young adulthood, which allowed us to assess whether poly-substance vaping is common among adolescents and young adults. Poly-substance vaping (nicotine and cannabis vaping) was reported among a significant proportion of participants in the study (25% were identified as poly-substance vapers). For those that either escalated to frequent nicotine vaping use in adolescence or initiated frequent nicotine vaping use in young adulthood, the probability of engaging in cannabis vaping was very high (85%+).    (more…)
Author Interviews, Cannabis, Pediatrics / 02.10.2020

MedicalResearch.com Interview with: Heather Breeze Clayton, PhD, MPH Senior Scientist, National Center for Injury Prevention and Control CDC MedicalResearch.com: What is the background for this study? Response: Thirty-three states and the District of Columbia now have policies in place legalizing marijuana for medical or adult use. While the health effects of marijuana use continue to be studied, substantial evidence suggests that a number of health risks – including cognitive and mental health outcomes- are made worse by earlier initiation of marijuana, and heavier use patterns. Scientific knowledge about the association between marijuana use and other health and risk-taking behavior in youth is still evolving. Accordingly, we sought to use nationally representative data from the Youth Risk Behavior Survey to assess what the relationship is between different patterns of marijuana use in youth (more established use vs. non-established use patterns) and a number of risk-taking and violence related behaviors. (more…)
Alcohol, Author Interviews, Gender Differences, JAMA / 30.09.2020

MedicalResearch.com Interview with: Michael S. Pollard, Ph.D. Professor, Pardee RAND Graduate School Senior Sociologist RAND Corporation Santa Monica, CA 90407-2138 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are ample anecdotal jokes and stories about increased alcohol use during COVID-19 and stay-at-home orders. Our study provides robust longitudinal evidence that people drank more frequently, and for women in particular, more heavily, and with more negative consequences, during the initial stages of COVID-19 compared to their own behaviors from a year earlier (May/June 2020 compared to May/June 2019). Women’s alcohol consumption was most significantly changed, with a 17% increase in number of days drinking, and a 41% increase in days of binge drinking (when they had four or more drinks in a couple of hours). This means that, nationally, one in five women drank heavily one more day a month than the same time in 2019, on average. Women also reported a 39% increase in alcohol-related problems, such as “I took foolish risks” or “I failed to do what was expected of me” because of drinking alcohol. (more…)
Author Interviews, Cannabis, JAMA, OBGYNE, Pediatrics / 25.09.2020

MedicalResearch.com Interview with: Sarah E. Paul, BA , Graduate Student and Ryan Bogdan, PhD, Associate Professor BRAIN Lab Washington University in St. Louis St. Louis, MO 63130 MedicalResearch.com: What is the background for this study? Sarah Paul: This study was motivated by several trends in cannabis use, its legal landscape, and people's perception of risk. As more states legalize recreational cannabis use, cannabis has become more accessible as well as more potent. Over the past couple of decades, the percentage of adolescents and adults who think that cannabis use is risky or harmful has fallen substantially. Cannabis dispensaries have been reported to actually recommend cannabis to pregnant women for the treatment of pregnancy-related nausea. And finally, between 2002/2003 and 2016/2017, the percentage of women reporting cannabis use during their pregnancies rose 106%. Given these trends and the mixed literature regarding the potential consequences associated with prenatal cannabis exposure, we aimed to comprehensively examine a range of outcomes in a large, representative sample while accounting for a host of important potentially confounding covariates. (more…)
Addiction, Author Interviews, Cleveland Clinic, COVID -19 Coronavirus, Mental Health Research / 16.09.2020

MedicalResearch.com Interview with: Rong Xu PhD Center for Artificial Intelligence in Drug Discovery, School of Medicine Case Western Reserve University Cleveland, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chronic use of tobacco, alcohol and other drugs is associated with cardiovascular, pulmonary, and metabolic diseases, all of which are also risk factors for COVID-19 infection and for worse outcomes.  Additionally, individuals with substance use disorders are more likely to experience social adversity such as homelessness, decreased access to health care, housing insecurity among others. Based on these, we hypothesis or predict that individuals with SUD are especially vulnerable for COVID-19 infection and adverse outcomes. In our study, we found that  individuals with substance use disorders, especially individuals with OUD and African Americans with SUD, as having increased risk for COVID-19 and its adverse outcomes  (more…)
Author Interviews, Cannabis, Cognitive Issues, Memory, Pediatrics / 04.09.2020

MedicalResearch.com Interview with: Jarrod Ellingson PhD Assistant Professor Department of Psychiatry Anschutz Medical Campus University of Colorado Denver  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that cannabis use is associated with many negative outcomes, but there could be many of reasons for that. For example, socioeconomic factors and peer influences both affect adolescent cannabis use and poorer cognitive functioning. To account for some of those risk factors, we studied nearly 600 sibling pairs with moderate to heavy cannabis use. We found that, as a person uses more cannabis than their sibling, they tend to have worse memory recall than their sibling. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA, NYU / 23.06.2020

MedicalResearch.com Interview with: Julian Santaella Tenorio, MSc DrPH Epidemiology Center for Opioid Epidemiology and Policy Division of Epidemiology, Department of Population Health New York University Langone School of Medicine, New York, New York MedicalResearch.com: What are the main findings? car-accident-traffic-accidentResponse: This study found that recreational cannabis laws were associated with increases in traffic fatalities in Colorado (mean of 75 excess fatalities per year) but not in Washington State.  These findings suggest that unintended effects of recreational cannabis laws can be heterogeneous and may be specific to variations in how these laws are implemented
(eg, density of recreational cannabis stores).   (more…)
Author Interviews, Cannabis, Opiods / 22.06.2020

MedicalResearch.com Interview with: Amalie K. Kropp Lopez, MS MD Candidate Geisinger Commonwealth School of Medicine Class of 2023 Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The opioid crisis is still affecting America, effecting millions of people from all walks of life. With the high risks of abuse and overtreatment with opioids, marijuana has been a newly reconsidered alterative for pain treatment. This study sought to quantify the changes in prescription opioid distribution using data reported by the Drug Enforcement Administration in Colorado after the legalization of recreational marijuana which gave the public increased access to its pain-relieving effects. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 22.06.2020

MedicalResearch.com Interview with: Russell Kamer, MD Department of Medicine, New York Medical College, Valhalla 15 North Broadway, Suite E White Plains, NY 10601 New York MedicalResearch.com: What is the background for this study? "marijuana apocalypse - weed is a stimulant !" by Blind Nomad is licensed under CC BY 2.0Response: It is well known that marijuana usage impairs driving ability, yet the early studies of the effects of recreational marijuana legalization on traffic fatalities were inconclusive. MedicalResearch.com: What are the main findings? Response: By analyzing data over a longer time period, we found that the legalization of recreational marijuana increased traffic deaths in the first four states to legalize. Traffic fatalities increased about 20% in those states. If we apply these numbers to the nation as a whole, nationwide legalization would be associated with about 7,000 excess traffic fatalities each year. (more…)
Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania / 20.06.2020

MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.   (more…)
Author Interviews, Cannabis, Emergency Care / 20.06.2020

MedicalResearch.com Interview with: Ryan Vandrey, Ph.D. Associate Professor Behavioral Pharmacology Research Unit Johns Hopkins University School of Medicine Baltimore, MD 21224  MedicalResearch.com: What is the background for this study? Response: The background for this study is that 33 states in the U.S. have legalized medicinal cannabis use and millions of people are using cannabis for therapeutic purposes, but we have very little data on the broad health impacts of medicinal cannabis use. We surveyed medicinal cannabis users and non-using controls who had a variety of health problems and found that the cannabis users reported better health, quality of life, and less healthcare utilization compared with controls.  Because we worried about group characteristics accounting for the differences observed, we then did an analysis of people who switched groups over time (e.g. non-users who later initiated cannabis use or cannabis users who later quit) and found the same differences emerged in the same individuals over time.  Important to note here is that not all individuals who used cannabis benefited from it and that most participants were using high CBD varieties of cannabis in conjunction with more traditional treatments. (more…)
Addiction, Author Interviews, JAMA, Pediatrics, USPSTF / 20.06.2020

MedicalResearch.com Interview with: Dr. Karina Davidson, PhD Senior Vice President of Research Dean of Academic Affairs Professor of Behavioral Medicine Zucker School of Medicine Hofstra University/Northwell Health Vice Chairmam US Preventive Services Task Force  MedicalResearch.com: What is the background for this study? Response: Drug use is among the most common causes of preventable death, injury, and disability in the United States, with nearly 10 percent of adults reporting unhealthy drug use. This includes the use of illegal drugs, as well as using prescription drugs in ways that are not recommended by a doctor. (more…)
Author Interviews, Cannabis, Gender Differences / 21.05.2020

MedicalResearch.com Interview with: Francesca Filbey, PhD Associate Provost and Professor of Cognition and Neuroscience Bert Moore Chair The University of Texas at Dallas MedicalResearch.com: What is the background for this study? Response:  Studies have reported differences in how males and females respond to cannabis and how they develop problems related to cannabis use.  We sought to determine whether craving may underlie this difference in male and female cannabis users. (more…)
Author Interviews, Cannabis, CDC, JAMA, Pediatrics, Tobacco Research / 18.05.2020

MedicalResearch.com Interview with: Susan Hocevar Adkins, MD Lead Author, Senior Medical Officer, and Commander United States Public Health Service CDC MedicalResearch.com: What is the background for this study? Response: Since August 2019, the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and state, local, and territorial health departments have been investigating a national outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Although clinical presentation and outcomes of EVALI patients generally have been reported, data on adolescent patients are more limited. This article fills this gap by using data from national EVALI surveillance at CDC to examine demographic, substance use, and clinical characteristics of adolescent EVALI patients relative to young adult and adult EVALI patients. (more…)
Addiction, Author Interviews, Opiods / 24.04.2020

MedicalResearch.com Interview with: Dr. Walter Ling, MD Professor of Psychiatry Director of Integrated Substance Abuse Programs UCLA MedicalResearch.com: What is the background for this study? Response: RECOVER™ is a real-world, observational study looking at long-term recovery in a cohort of 533 people with moderate to severe opioid use disorder (OUD) following their transition from two Phase 3 clinical trials of SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use (CIII), into a real-world setting.1 The RECOVER study uses data from three main sources: self-administered assessments from enrolled individuals, urine drug screens (UDS) and data collected from several public sources. Recovery is examined over 24 months – the self-administered assessment and UDS results are completed by participants every three months over the course of this period. Results are being analyzed to understand the clinical, socio-economic and environmental factors associated with continuous effects of medications to treat OUD after a clinical trial.1.2 Studies such as RECOVER can help bridge the knowledge gap between the efficacy of medications as seen in the controlled clinical trial environment, and the use and effect of medications outside of a research setting and their long-term impact on patients’ health. A collaboration between Indivior and the Fralin Biomedical Institute at Virginia Tech Carilion will enable the next phase of the RECOVER study, which may provide further information to health care providers and policymakers on how to use medications to support their patients and how continuity of care can help break down barriers to evidence-based treatment.3  (more…)
Addiction, Author Interviews, JAMA, Opiods / 24.04.2020

MedicalResearch.com Interview with: Tami L. Mark, PhD Senior Director, Behavioral Health Financing and Quality Measurement RTI International  MedicalResearch.com: What is the background for this study? Response: There are effective medications to treat opioid use disorder. Federal and state policymakers have tried to improve access to these medications. However, medications to treat opioid use disorders are still often subject to prior authorization. Studies of other medications finds that prior authorization can reduce access. This study looked at whether removing prior authorization in Medicare Part D plans was associated with increases in the use of medications to treat opioid use disorder.  (more…)
Author Interviews, Cannabis, JAMA, Pulmonary Disease / 22.04.2020

MedicalResearch.com Interview with: Alex Hollingsworth PhD Assistant Professor O'Neill School of Public and Environmental Affairs Indiana University MedicalResearch.com: What is the background for this study? What are the main findings? Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use. Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products. Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful. We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate. (more…)
Addiction, Annals Internal Medicine, Author Interviews, NIH, Opiods / 10.04.2020

MedicalResearch.com Interview with: Nora D. Volkow, MD Director of the National Institute on Drug Abuse National Institutes of Health Bethesda, MD MedicalResearch.com: What is the background for this study? How does vaping, hookah use, inhaled marijuana, smoking etc impact the risk of coronavirus infection?  Could these activities account for some the risks and infections in younger individuals?   Response: Apart from older age, having underlying cardiopulmonary conditions is a known risk factor for the worst clinical course and outcomes of COVID-19, and many of those conditions are known to be caused or exacerbated by smoking. While evidence continues to emerge about how smoking might interact with COVID-19, it is a reasonable assumption that smoking could contribute to risk even in younger individuals. We still don’t know how vaping—whether of nicotine or marijuana or just flavorings—contributes to the risk of infection or illness severity with the virus that causes COVID-19, but there are a number of reasons to be concerned. We have already seen lung illnesses caused by some vaping products, and evidence suggests vaping may disrupt lung epithelial cell function, which in turn increases viral susceptibility and may put individuals at increased risk of infection with the virus that causes COVID-19 or with more severe disease outcomes. Vaping is a relatively new technology, and as such, there are many unknowns. The rapid increases in vaping by young people over the last few years make this an area of concern, and thus an area where more research is urgently needed. (more…)
Addiction, Author Interviews, Cannabis / 10.04.2020

MedicalResearch.com Interview with: Anees Bahji, MD PGY5, Department of Psychiatry, Queen’s University M.Sc. Candidate, Department of Public Health Sciences, Queen’s University Kingston, ON, Canada MedicalResearch.com: What is the background for this study?
  • There has been much speculation into the existence of a withdrawal syndrome involving cannabis much like withdrawal syndromes from opioids or alcohol. Our goal for this study was to estimate the prevalence of cannabis withdrawal syndrome (CWS) and to identify any risk factors for CWS.
  • There has been a lot of research into cannabis withdrawal syndrome (CWS) in the past. A big part of this review involved understanding where the CWS field is in terms of the shared understanding on its epidemiology and physiology.
  • To that end, we were not surprised to find that the prevalence of cannabis withdrawal syndrome was high. However, we found that some of the characteristics of CWS are consistent with other substance use disorders, which really serves to legitimize the decision to classify CWS and cannabis use disorders as psychiatric conditions.
(more…)
Author Interviews, Cost of Health Care, JAMA, Opiods / 01.04.2020

MedicalResearch.com Interview with: Aparna Soni PhD, Assistant Professor Department of Public Administration and Policy School of Public Affairs American University Washington, DC MedicalResearch.com: What is the background for this study? Response: The United States is in the midst of an opioid epidemic. Opioids are responsible for nearly 50,000 deaths per year and present a substantial financial burden on hospitals. The rate of opioids-related hospital events has tripled since 2005. We are particularly concerned about rising hospitalizations because they may stem from a lack of access to treatment for individuals with opioid use disorder. Medication-assisted treatment is effective in treating opioid use disorder but can be unaffordable for people without health insurance. (more…)
Addiction, Author Interviews, Cannabis / 25.03.2020

MedicalResearch.com Interview with: Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University, Pullman, WA Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University, Pullman, WA MedicalResearch.com: What is the background for this study? Response: The evolving legal landscape concerning the use of cannabis has increased urgency to better understand its effects on the brain and behavior. Animal models are advantageous in this respect; however, researchers traditionally use forced injections of synthetic cannabinoids which fails to capture the complex effects of volitional cannabis consumption. In our study, we developed a novel model of cannabis self-administration using response-contingent delivery of vaporized cannabis extracts containing high concentrations of Δ9 tetrahydrocannabinol (THC) or cannabidiol (CBD). (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 23.03.2020

MedicalResearch.com Interview with: Leah Nelson, MD MS Addiction Medicine Fellow University of New Mexico MedicalResearch.com: What is the background for this study? Response: With the progression of the opioid epidemic over the past decade, more women of reproductive age are seeking treatment for addiction. Many more pregnant women are prescribed methadone and buprenorphine, two opioid medications that prevent relapse and overdose. Maternal use of mediations for opioid use disorder is recommended because it lowers the risk to the fetus from uncontrolled drug use and also allows the mother to engage with prenatal care and social work. Subsequently, the number of infants born after prenatal exposure to opioids is increasing. Several previous studies have shown measurable differences in the cognitive scores of children after prenatal opioid exposure. However, much of the previous work was done on convenience samples (easy to recruit rather than rigorously matched for comparability) and the demographic characteristics of both mothers and children in the exposed and unexposed groups varied widely on important factors such as maternal education, socioeconomics, employment, tobacco use, and infant gender. Each of these factors has been demonstrated to impact early childhood development in the absence of opioid exposure. (more…)
Addiction, Author Interviews, JAMA, Mental Health Research / 20.03.2020

MedicalResearch.com Interview with: Jiajin Yuan, Ph.D Professor of Psychology Director, The Laboratory for Affect Cognition and Regulation, Faculty of Psychology, Southwest University, Chongqing, China MedicalResearch.com: What is the background for this study? Response: Impulsivity is a critical symptom of methamphetamine addiction, and this symptom plays an important role in compulsive, unresistable drug-seeking behavioral and is thus detrimental to the rehabilitation. Impulsivity in drug addiction also contributes to disruption of people's goal pursuit/goal maintenance, and aggressive/violent behaviors after drug use. Also, lack of suitable intervention for addiction-related impulsivity is known to be a risky factor for the drug reuse after successful rehabilitation. Thus, rehabilitaton targeted at impulsivity in methamphetamine addicts is important to comprehensive rehabilitation of the drug addiction and also to successful return to social life after rehabilitation (more…)
Annals Internal Medicine, Author Interviews, Cannabis, Yale / 19.03.2020

MedicalResearch.com Interview with: Joshua D. Wallach, MS, PhD Assistant Professor of Epidemiology (Environmental Health Sciences) Yale School of Public Health New Haven, CT MedicalResearch.com: What is the background for this study? Response: Over the past few years, there has been growing interest in the potential health benefits of cannabidiol (CBD), a chemical compound in cannabis. Although only one CBD-derived prescription drug has been approved by the US Food and Drug Administration (FDA) for the treatment of epilepsy, I recently started seeing products containing CBD advertised and sold across the US (e.g. CBD in foods, beverages, dietary supplements, and cosmetics). I noticed that many of these products were being marketed with unproven claims to prevent, cure, and treat various conditions, and became interested in learning more about the research supporting the use of CBD, the potential for misleading claims, and impact that the CBD-industry may be having on research that is being generated and disseminated to the public. Research funding sources and other author conflicts of interests (e.g. consulting fees, honoraria, travel expenses) can influence the way that research is designed, conducted, and reported. Previous studies have consistently demonstrated associations between authors' conflicts of interest and proindustry conclusions in clinical research. Given the growing number of companies invested in CBD's commercial success, we decided to analyze the disclosed funding sources, conflicts of interest statements, author employment details, and CBD-related conclusions in a large sample of published articles on the characteristics, use, and therapeutic effects of cannabidiol. (more…)
Author Interviews, Gender Differences, Heart Disease, Karolinski Institute, Opiods, PNAS / 18.03.2020

MedicalResearch.com Interview with: Mikko Myrskylä PhD Executive Director, Max Planck Institute for Demographic Research Professorial Research Fellow, London School of Economics Professor of Social Statistics University of Helsinki MedicalResearch.com: What is the background for this study? Response: Life expectancy in the U.S. increased at a phenomenal pace throughout the twentieth century, by nearly two years per decade. After 2010, however, U.S. life expectancy growth stalled and has most recently been declining. A critical question for American health policy is how to return U.S. life expectancy to its pre-2010 growth rate. Researchers and policy makers have focused on rising drug-related deaths in their search for the explanations for the stalling and declining life expectancy. (more…)
Author Interviews, Opiods / 17.03.2020

MedicalResearch.com Interview with: Amir Pashmineh, MBS Geisinger Commonwealth School of Medicine MedicalResearch.com: What is the background for this study? Response: The opioid buprenorphine is a mu and nociceptin receptor partial agonist, and serves as an antagonist to kappa and delta receptors. These properties contribute to this medication being a first-line evidence-based agent in Opioid Use Disorder (OUD) treatment. There have been policy changes intended to increase buprenorphine (which goes by brand names Suboxone or Subutex) availability, but access remains below optimal levels. Relative to methadone, buprenorphine is more expensive. The “abstinence only” mentality of 12-step programs for addiction treatment continues to be influential. The objective of this study was to extend our pharmacoepidemiology knowledge regarding utilization and characterize the regional disparity in distribution in the U.S. over the last decade. Data was obtained from Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS), a comprehensive drug reporting system of controlled substances from their point of manufacturing to point of sale and distribution. (more…)
Alcohol, Author Interviews, Brigham & Women's - Harvard / 11.03.2020

MedicalResearch.com Interview with: John F. Kelly, Ph.D., ABPP. Recovery Research Institute Elizabeth R. Spallin Professor of Psychiatry in Addiction Medicine Harvard Medical School   MedicalResearch.com: What is the background for this study? Response: Alcohol use disorder is one of the leading causes of disease, disability, and preventable death worldwide. Alcoholics Anonymous (AA) is a widespread international recovery support organization designed to address it. While it has remained popular and influential for many decades, until recently the quantity and quality of the research on AA and clinical treatments designed to stimulate AA involvement – Twelve-Step Facilitation (TSF) treatments – had not been evaluated adequately. This systematic review and meta-analysis used the rigor of the Cochrane review system to subject AA/TSF to the same scientific standards as other clinical interventions.   (more…)