Opioid Prescriptions Decrease But Still Elevated Compared To 20 Years Ago

MedicalResearch.com Interview with:

Deborah Dowell, MD, MPH Chief Medical Officer, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention

Dr. Dowell

Deborah Dowell, MD, MPH
Chief Medical Officer, Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study?

Response: CDC analyzed retail prescription data from QuintilesIMS which provides estimates of the number of opioid prescriptions dispensed in the United States from approximately 59,000 pharmacies, representing 88% of prescriptions in the United States. CDC assessed opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015.
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Optimistic Results From Phase 3 Study of RBP-6000 Buprenorphine Monthly Depot for Treatment of Opioid Use Disorder

Medical Research.com Interview with:

Dr. Christian Heidbreder, PhD Chief Scientific Officer Indivior Inc. Richmond, VA 23235, USA

Dr. Heidbreder

Dr. Christian Heidbreder, PhD
Chief Scientific Officer
Indivior Inc.
Richmond, VA 23235, USA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This pivotal Phase 3 clinical trial (RB-US-13-0001) evaluated the efficacy and safety of RBP-6000, an investigational once-monthly injectable buprenorphine in the ATRIGEL® delivery system for the treatment of adults with moderate-to-severe opioid use disorder (OUD) as part of a complete treatment plan to include counseling and psychosocial support1.

The 24-week Phase 3 study met its primary and key secondary endpoints, demonstrating statistically significant differences in percentage abstinence and treatment success across both dosage regimens of RBP-6000 versus placebo1.

The findings also showed that outcomes with RBP-6000 are consistent across other secondary clinical endpoints, including control of craving and withdrawal symptoms, as compared to placebo. These outcomes were associated with buprenorphine plasma concentrations ≥ 2 ng/mL and predicted whole brain mu-opioid receptor occupancy of ≥ 70%, and were also maintained for the one-month dosing intervals and for the entire treatment duration1.

The results were confirmed by exposure-response analyses demonstrating a relationship between buprenorphine plasma concentrations, abstinence, withdrawal symptoms and opioid craving1.

RBP-6000 was generally well tolerated and had a safety profile consistent with that of transmucosal buprenorphine. Injection site reactions were not treatment-limiting. The most common (reported in ≥ 5% of subjects) treatment-emergent adverse events (TEAEs) reported in the active total group were constipation, headache, nausea, injection site pruritus, vomiting, increased hepatic enzyme, fatigue and injection site pain1.

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Lost Your Connection? Internet Withdrawal Can Mirror Addiction Symptoms

MedicalResearch.com Interview with:

Dr. Phil Reed,  D.Phil. Professor Psychology Swansea University

Dr. Reed

Dr. Phil Reed,  D.Phil.
Professor Psychology
Swansea University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Problematic internet use has been a growing concern for many people and bodies over the last decade, and more study has been requested into various aspects of this possible disorder.  One of the key questions is whether people overuse the internet, due to an addiction.  If it is an addiction, then there should be signs of withdrawal when people, who report having this problem, stop using the internet.  In this study, 144 participants, aged 18 to 33, had their heart rate and blood pressure measured before and after a brief internet session.  Their anxiety and self-reported internet addiction were also assessed.

The results showed increases in heart rate and systolic blood pressure on terminating the internet session for those with problematically-high internet usage.  These increases in physiological arousal were mirrored by increased feelings of anxiety.  However, there were no such changes for those participants who reported no internet-usage problems.

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Most Youth With Opioid Disorders Do Not Receive Medications For Addiction

MedicalResearch.com Interview with:

Scott Hadland, MD, MPH, MS Youth Addiction Specialist Assistant Professor of Pediatrics Boston University School of Medicine

Dr. Hadland

Scott Hadland, MD, MPH, MS
Youth Addiction Specialist
Assistant Professor of Pediatrics
Boston University School of Medicine
Director, Urban Health and Advocacy Track, Boston Children’s Hospital and Boston Medical Center
Associate Program Director, Boston Combined Residency Program in Pediatrics, Boston Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Almost no data have been available on this topic to date.  A recent study showed that teens in subspecialty treatment for opioid addiction were significantly less likely than adults to receive a medication.  Our study was the first to comprehensively look across the health care system, including looking at adolescents and young adults diagnosed with opioid use disorder in outpatient clinics, emergency departments, and inpatient hospitals.

We had three important findings.  First, looking at a large sample of 9.7 million adolescents and young adults between the age of 13 and 25 years, we found that the number of youth diagnosed with opioid use disorder increased six-fold from 2001 to 2014.  This is perhaps not surprising given the national opioid crisis we know to be occurring.

Second, we found that only a minority of youth (1 in 4) received buprenorphine or naltrexone, the two medications available for opioid addiction that can be prescribed in usual medical settings.  These two medications are evidence-based and their use is recommended by the American Academy of Pediatrics.  Utilizing them is critical to ensure that we offer effective treatment early in the life course of addiction, which can help prevent the long-term harms of addiction.

Third, we found significant differences in who received medications.  Whereas approximately 1 in 3 young adults in our study received a medication, only 1 in 10 of the 16- and 17-year-olds we studied received one, and among adolescents under 15 years of age, 1 in 67 received a medication.  Females were less likely than males to receive medications, as were black youth and Hispanic youth relative to white youth.

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Opioids Withdrawal in Babies Adding Millions To Health Care Costs

MedicalResearch.com Interview with:

Tammy E. Corr, D.O. Assistant Professor of Pediatrics Division of Newborn Medicine Penn State Hershey College of Medicine

Dr. Corr

Tammy E. Corr, D.O.
Assistant Professor of Pediatrics
Division of Newborn Medicine
Penn State Hershey College of Medicine

MedicalResearch.com: What is the background for this study?

Response: Recent literature has revealed hospital charges related to neonatal abstinence syndrome (NAS) have increased. However, there are no data available regarding costs of an NAS admission. Because charges are variable and influenced by a number of factors, provider costs to care for a patient offer more meaningful information.

Therefore, we endeavored to determine the incidence of NAS in the United States and estimate the total annual costs and hospital length of stay for an neonatal abstinence syndrome admission as well as the incremental costs and hospital days of admission for an NAS patient compared to a non-NAS admission.

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College Binge Drinkers Also Smoking More Pot In States Where Marijuana Legal

MedicalResearch.com Interview with:

David Kerr PhD Associate professor in the School of Psychological Science College of Liberal Arts Ohio State University 

Dr. Kerr

David Kerr PhD
Associate professor in the School of Psychological Science
College of Liberal Arts
Ohio State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oregon legalized sale and use of marijuana for recreational purposes and the part of the law (regarding use) took effect in July 2015. However, there have been no controlled studies of which we’re aware of the possible effects of the Oregon law that take into account the trends toward increased marijuana use across the country and differences in use rates between states that predated the law.

We used survey data on college students in Oregon and in 6 states without recreational legalization to examine the issue.

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Heroin Epidemic Costs US Over $50 Billion Per Year

MedicalResearch.com Interview with:

A. Simon Pickard, PhD

Dr. Pickard

A. Simon Pickard, PhD
Professor, Dept of Pharmacy Systems, Outcomes and Policy
University of Ilinois at Chicago
College of Pharmacy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The heroin epidemic, which has left virtually no part of American society unscathed, can be viewed as an illness.  Unlike some illnesses, however, it was largely manufactured by stakeholders in the healthcare system, wittingly or unwittingly.

The main finding, that heroin addiction costs us just over $50 billion per year, is likely a conservative estimate.

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Recreational Cocaine Use Activates Addiction Related Brain Mechanisms Sooner Than Previously Realized

MedicalResearch.com Interview with:

Marco Leyton, Ph.D. Professor, Department of Psychiatry McGill University

Dr. Marco Leyton

Marco Leyton, Ph.D.
Professor, Department of Psychiatry
McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drug-related cues are potent triggers for eliciting conscious and unconscious desire for the drug. In people with severe substance use disorders, these cues also activate dopamine release in the dorsal striatum, a brain region thought to be involved in hard-to-break habits and compulsions.

In the present study we found evidence that drug cues also activate this same dopamine response in non-dependent ‘recreational’ cocaine users.

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Animal Study Suggests Lorcaserin (Belviq®) May be Useful to Reduce Opioid Intake

MedicalResearch.com Interview with:
Christina R. Merritt and Kathryn A. Cunningham
Center for Addiction Research
University of Texas Medical Branch
Galveston, TX 77555

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Opioid use disorder (OUD) is one of the top public health problems in the United States. Overdoses on prescription opioids, heroin and fentanyl accounted for 33,091 deaths in the U.S. in 2015 (https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm); each day, 91 Americans die from an opioid overdose (https://www.cdc.gov/drugoverdose/epidemic/). The first-ever Surgeon General’s Report on Alcohol, Drugs and Health (https://addiction.surgeongeneral.gov/ ) observed that more people used prescription opioids than tobacco in 2015. Furthermore, individuals with OUD, the most problematic pattern of opioid abuse, often relapse, particularly in environments associated with past drug use, and new means to help maintain abstinence are needed.

Serotonin (5-hydroxytryptamine; 5-HT) function in the brain, particularly through its cognate 5-HT2C receptor, is an important regulator of the abuse liability of cocaine and other psychostimulants. Previous studies suggested that the weight loss medication and selective 5-HT2C receptor agonist lorcaserin (Belviq®) can curb cocaine- and nicotine-seeking in preclinical models, even when tested in tempting environments. We administered lorcaserin to rats who were trained to take the powerful painkiller oxycodone (OxyContin®), a prescription opioid currently approved for treatment of acute and chronic pain with characteristically high abuse potential. Lorcaserin suppressed oxycodone intake as well as the drug-seeking behaviors observed when rats were exposed to cues such as the lights and sounds previously associated with drug intake. Taken together, these findings highlights the therapeutic potential for lorcaserin to extend abstinence and enhance recovery from OUD.

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Some Retirees Begin Risky Alcohol Consumption

MedicalResearch.com Interview with:
Jaana Halonen, Docent and Senior Researcher

Finnish Institute of Occupational Health

MedicalResearch.com: What is the background for this study?

Response: Retirement is a significant life transition when substantial changes in daily life are experienced as retirees adapt to life without work. After retirement people have more leisure time and more opportunities for different activities, and less stress. These changes are positive, but retirement can also lead to reduced social control and loss of social contacts and therefore be perceived as a stressful life transition. Both the positive and negative aspects related to changes in leisure time, stress, and social networks around retirement may affect drinking behaviours. However, little is known about how risky alcohol consumption changes around the retirement transition.

Thus, in our study we wanted to examine how and for whom risky drinking changes around the time of retirement. To do that we followed up public sector workers with questionnaires before and after their old-age retirement.

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