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…)
Addiction, Author Interviews, JAMA, Pediatrics / 02.03.2020

MedicalResearch.com Interview with: Karl Alcover, PhD Postdoctoral Research Associate Behavioral Health Innovations Washington State University MedicalResearch.com: What is the background for this study? Response: It has been a public health focus to prevent early exposure to drugs. Our paper shows that the average age of initiation of drug use among adolescents and young adults has been increasing from 2004 to 2017. We found that 12 of 18 drugs (including alcohol and tobacco products) had statistically increasing average ages of initiation. To our knowledge, no studies have documented these findings. We think this is great news because delaying initiation of drugs prevents early exposure, which we know is associated with various long-term negative health outcomes. Also, these promising trends may serve as initial evidence that prevention strategies, especially those that focus on adolescents and young adults, are working. (more…)
Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Emergency Care, Opiods / 13.02.2020

MedicalResearch.com Interview with: Casey P. Balio, BA Department of Health Policy and Management Indiana University Richard M. Fairbanks School of Public Health Indianapolis, IN  MedicalResearch.com: What is the background for this study? Response:   There are numerous studies that estimate the prevalence of various opioid-related outcomes including emergency department (ED) encounters, hospitalizations, and overdoses as well as risk factors for these. However, there is limited evidence about repeated opioid-related encounters. This study uses health information exchange (HIE) data for four hospital systems in the state of Indiana from 2012-2017 to identify individual, prescription, encounter, and community characteristics that may be associated with having repeat opioid-related encounters. (more…)
Author Interviews, Dental Research, Opiods / 10.02.2020

MedicalResearch.com Interview with: Katie J. Suda, PharmD, MS Study Principal Investigator Professor of Medicine University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response:   Dentists are one of the top prescribers of opioids; prescribing 1 in 10 opioids in the United States. Dentists also prescribe a lot of opioids to adolescents and young adults which are a high risk population for substance misuse. This is especially true because studies have shown that non-opioid pain medications are similar or more effective for the treatment of oral pain. (more…)
Addiction, Author Interviews, Technology / 29.01.2020

MedicalResearch.com Interview with: John W. Ayers, PhD MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study? Response: Already half of US adults use smart device enabled intelligent virtual assistants, like Amazon Alexa. Moreover, many of the makers of intelligent virtual assistants are poised to roll out health care advice, including personalized wellness strategies. We take a step back and ask do intelligent virtual assistants provide actionable health support now? To do so we focus on a specific case study. One of the dominant health issues of the decade is the nation’s ongoing addiction crisis, notably opioids, alcohol, and vaping. As a result, it is an ideal case to begin exploring the ability of intelligent virtual assistants to provide actionable answers for obvious health questions. (more…)
Author Interviews, OBGYNE, Opiods, Pain Research / 28.01.2020

MedicalResearch.com Interview with: Dave Stack Chief Executive Officer and Chairman Pacira BioSciences  MedicalResearch.com: What is the background for this study? Response: Cesarean sections (C-sections) are one of the most common surgeries in the United States, and research shows many women experience moderate to severe pain after this procedure. When postsurgical pain is inadequately managed for new mothers, it can interfere with recovery, maternal-infant bonding and may even lead to postpartum depression. Additionally, prescribing data reveals that postsurgical opioid consumption poses a great risk to women. We recently completed a Phase 4 study of EXPAREL in C-section patients, and results revealed adding EXPAREL to bupivacaine transversus abdominis plane (TAP) blocks for C-section delivery provided significant reductions in opioids and pain scores. Results of that study provided the basis for the design of this next-generation study, which was created to be completely opioid-free in the EXPAREL arm. The study was a Phase 4 multicenter, active-controlled study conducted in 18 clinical sites in the United States, with 169 enrolled patients undergoing elective C-section. The enrolled C-section patients were randomized to receive either 150 mcg morphine spinal anesthesia plus a standard of care postoperative pain regimen, 50 mcg morphine spinal anesthesia plus EXPAREL TAP field block, or opioid-free spinal anesthesia plus EXPAREL TAP block. Patients in the EXPAREL arms received a protocol-defined non-opioid postsurgical pain management regimen including ketorolac, acetaminophen, and ibuprofen.  (more…)
Addiction, Author Interviews, Nutrition, Sugar / 21.01.2020

MedicalResearch.com Interview with: Michael Winterdahl PhD Associate Professor in Neuroimaging, Department of Nuclear Medicine and PET Center Aarhus University, Denmark  MedicalResearch.com: What is the background for this study? Response: Opioids and dopamine mediate the rewarding effects of drugs. We aimed to determine whether the intake of palatable food could lead to changes in the brain similar to those triggered by addictive substances, so we studied the effects of repeated intermittent access to sugar on opioid and dopamine receptors in porcine brain using neuroimaging. (more…)
Author Interviews, Cannabis, Columbia, Heart Disease, JACC / 21.01.2020

MedicalResearch.com Interview with: Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian MedicalResearch.com: What is the background for this study? Response: Marijuana use has been increasing significantly and is the most commonly illicit drug used in the United States. In recent years, more states have been legalizing its use for both recreational and medicinal purposes. We have all seen news reports regarding the rise of vaping-related health hazards. Yet, data are limited regarding the cardiovascular effects of marijuana which is what drove us to explore this topic. (more…)
Author Interviews, Opiods / 15.01.2020

MedicalResearch.com Interview with: Paul Christine, MD, PhD University of Michigan MedicalResearch.com: What is the background for this study? Response: In an effort to increase employment and "community engagement" among Medicaid enrollees, several states are seeking to implement new Medicaid work requirements. While many proposals make exemptions for individuals with substance use disorders, some require active treatment to qualify for an exemption and maintain Medicaid eligibility. Since many enrollees with substance use disorder would thus need to access treatment to maintain coverage, we sought to quantify the availability of treatment resources in states with and without Medicaid work requirements. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 06.01.2020

MedicalResearch.com Interview with: Rachel H. Alinsky, MD, MPH Adolescent Medicine and Addiction Medicine Fellow Division of General Pediatrics and Adolescent Medicine Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? Response: We know that over 4,000 adolescents and young adults between the ages of 15-24 are dying from an opioid overdose every year. Nonfatal opioid overdose has been identified as a potential touchpoint with the healthcare system when individuals can be drawn into treatment, yet very little is known about health care use following opioid overdose in youth. We were interested in figuring out the extent to which adolescents and young adults are receiving evidence-based treatment after an opioid overdose. (more…)
Addiction, Alcohol, Author Interviews, JAMA, Methamphetamine / 06.01.2020

MedicalResearch.com Interview with: Dr. Eric Dawson, PharmD Vice President, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: The US Centers for Disease Control and Prevention has projected a drop in the number of overdose deaths for 2018; the first reported decline since 1990. They cite a decrease in prescription opioid deaths as the leading contributor to the overall reduction, but caution that deaths associated with synthetic opioids, primarily fentanyl, as well as stimulants appear to be increasing. In 2019, we reported a 798% increase in urine drug test positivity rates for nonprescribed fentanyl among results positive for methamphetamine and an 1850% increase among results positive for cocaine. In an effort to conduct ongoing surveillance of the polysubstance use landscape and help characterize these evolving trends in a more timely manner, we examined our UDT data as close to real-time as possible to observe trends in positivity for methamphetamine, cocaine, and heroin, with and without illicit fentanyl. (more…)
Alcohol, Author Interviews, Heart Disease, NEJM / 02.01.2020

MedicalResearch.com Interview with: Professor Peter M Kistler MBBS, PhD, FRACP Head of Clinical Electrophysiology Research Baker Heart and Diabetes Institute Head of Electrophysiology at The Alfred hospital Professor of Medicine University of Melbourne. MedicalResearch.com: What is the background for this study? Response: There is a well known association between alcohol intake and atrial fibrillation form population based studies which demonstrate that for every 1 standard drink the incidence of AFib increases by 8%. This is the first randomised study to determine of alcohol reduction/abstinence leads to a reduction in AFib episodes and time to recurrence. (more…)
Author Interviews, Opiods, Surgical Research / 30.12.2019

MedicalResearch.com Interview with: Sunil Agarwal, MD Michigan Opioid Prescribing Engagement Network Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: Excess opioid prescribing after surgery often leads to misuse and diversion into the community. To prevent excessive prescribing for acute pain, 31 states have implemented legislation that limits the duration of opioid prescriptions. Our study examined the effect of prescribing limits and postoperative opioid prescribing on surgical patients in Massachusetts and Connecticut, the first two states to implement opioid prescribing limits for acute pain after the CDC guidelines were released.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Mental Health Research, Opiods, Pediatrics / 23.12.2019

MedicalResearch.com Interview with: Megan Land, MD, PGY 6 Pediatric Critical Care Medicine Fellowship Emory University School of Medicine MedicalResearch.com: What is the background for this study?
  • Much of the research on the opioid crisis has focused on the impact to adults; however, children and adolescents in the US are also negatively affected by the opioid epidemic.
  • The percentage of children admitted to a pediatric intensive care unit increased over the study period as the clinical effects of the opioid ingestions increased in severity.
  • The primary intent of opioid ingestions was suspected suicide attempts in adolescents resulting in increasing admissions to a psychiatric hospital.
  • Opioids associated with the highest odds of needing an intervention in an intensive care unit were methadone, fentanyl, and heroin. 
(more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 20.12.2019

MedicalResearch.com Interview with: Hongying (Daisy) Dai, PhD Associate Professor Department of Biostatistics | College of Public Health University of Nebraska Medical Center  MedicalResearch.com: What is the background for this study? Response: E-cigarette use increased significantly from 2017 to 2019 among U.S. adolescents, and marijuana and other substances besides can be used in e-cigarettes. Meanwhile, restrictions on marijuana use have been relaxing and social acceptability of marijuana use is shifting among youth. This study analyzed 38,061 middle and high school students from the 2017 and 2018 National Youth Tobacco Survey.  (more…)
Author Interviews, JAMA, Opiods, Pediatrics, University of Michigan / 19.12.2019

MedicalResearch.com Interview with: Kao-Ping Chua, MD PhD Assistant Professor, Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan MedicalResearch.com: What is the background for this study? Response: Opioids are frequently prescribed to adolescents and young adults aged 12-21 years – in a recent study, 1 in 8 patients in this population were prescribed opioids during the year. At the same time, almost 30% of the 3000 opioid-related overdose deaths in 2016 among adolescents and young adults involved prescription opioids. Given the frequency of opioid prescribing and the risk of overdose, it is important to understand how to prescribe opioids safely to adolescents and young adults. However, there have been few studies that examine which opioid prescribing patterns are associated with prescription opioid overdose in adolescents and young adults. Prior studies examining these patterns have focused on older adults, particularly U.S. Veterans, so the generalizability of these findings to younger populations is unclear. (more…)
Addiction, Author Interviews, Opiods, Technology / 10.12.2019

MedicalResearch.com Interview with: Anna Konova, PhD Assistant Professor, Dept. of Psychiatry & UBHC Core Faculty, Brain Health Institute Rutgers University - New Brunswick MedicalResearch.com: What is the background for this study? Response: Opioid reuse and relapse are common outcomes even when a person is seeking treatment for their addiction. These reuse events pose many health risks, as well as risk for treatment failure. We currently lack the much needed tools to understand and predict this reuse vulnerability. In this study, we used computer games that assess a person's decision making process, to get at psychological processes related to how people make decisions involving risks, when they transitioned between lower and higher reuse vulnerability states during the first few months of opioid treatment. (more…)
Accidents & Violence, Author Interviews, Cannabis / 05.12.2019

MedicalResearch.com Interview with: Nathan J. Connealy Doctoral student John Jay College of Criminal Justice CUNY MedicalResearch.com: What is the background for this study? Response: The background, or what prompted this study, is that research on this topic is pertinent right now as more states continue down a path towards legalization. A large share of the research base and public debate centers around the potential adverse effects of marijuana accessibility, consumer-based concerns, and health specific outcomes associated with usage. This research instead focuses on a lesser explored question related to the potential for the physical dispensary locations to impact crime levels, which is also an important consideration when assessing the impact of recreational marijuana legalization. (more…)
Author Interviews, OBGYNE, Opiods / 05.12.2019

MedicalResearch.com Interview with: Dr. Rupa Radhakrishnan, MD Assistant professor of Radiology and Imaging Sciences Indiana University School of Medicine MedicalResearch.com: What is the background for this study? Response: Opioid use in pregnancy is a major public health crisis. Opioids adversely impact maternal, fetal and infant health. Infants who were exposed to opioids in the womb, can have withdrawal symptoms soon after birth, and are also at risk for poor long term neurodevelopment outcomes. Our group studied the changes in brain function in infants exposed to opioids in the womb, to understand how opioids affect the developing brain. We used resting state functional MRI to study these infants.  (more…)
Aging, Author Interviews, JAMA, Opiods / 27.11.2019

MedicalResearch.com Interview with: Yong-Fang Kuo, PhD Professor and Director, Office of Biostatistics Don W. and Frances Powell Professor in Aging Research Mukaila Raji, MD, MS, FACP Professor & Director Edgar Gnitzinger Distinguished Professorship in Aging Preventive Medicine and Population Health UTMB Health MedicalResearch.com: What is the background for this study? Response: Medicare beneficiaries who qualified because of disability constitute a growing population of patients hospitalized for opioid/heroin overdose. Although the CDC regularly generates reports of opioid overdose deaths by demographics and states, studies on policy actionable predictors of overdose mortality (e.g., clusters of medical and psychiatric conditions, types of disabling conditions) are lacking in this population.  (more…)
Author Interviews, JAMA, Opiods / 27.11.2019

MedicalResearch.com Interview with: Steven H. Woolf, MD, MPH Director Emeritus and Senior Advisor, Center on Society and Health Professor, Department of Family Medicine and Population Health C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity Virginia Commonwealth University School of Medicine Richmond, Virginia 23298-0212 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Life expectancy in the US has decreased for three years in a row, the first time this has occurred in this country since the Spanish flu epidemic a century ago. Meanwhile, life expectancy in other countries continues to climb. Our study found that the trend is being driven by an increase in death rates among working-age adults (ages 25-64 years), which began as early as the 1990s. The increase has involved deaths from drug overdoses—a major contributor—but also from alcoholism, suicides, and a long list of organ diseases. We found increases in 35 causes of death. We analyzed the trends across the 50 states and discovered that the trend is concentrated in certain regions, especially the Industrial Midwest (Rust Belt) and Appalachia, whereas other regions like the Pacific states were least affected. Increases in midlife mortality in four Ohio Valley states (Ohio, Pennsylvania, Indiana and Kentucky) accounted for one third of the excess deaths between 2010 and 2017. (more…)