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…)
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, 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…)
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…)
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…)
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…)
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…)
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. KellyPh.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…)
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…)
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…)
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, 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…)
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. 
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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…)
Addiction, Author Interviews, Mental Health Research, Technology / 29.10.2019

MedicalResearch.com Interview with: Zsolt Demetrovics PhD and Orsolya Király PhD Department of Clinical Psychology and Addiction Institute of Psychology ELTE Eötvös Loránd University MedicalResearch.com: What is the background for this study? Response: Gaming disorder has recently been recognized by the World Health Organization (WHO) as a mental disorder. Research examining gaming motivations and mental health among video gamers and in relation with gaming disorder is increasing but different types of gamers such as recreational gamers and esport gamers are not commonly distinguished. Esport is form of electronic sport and refers to playing video games in a professional (competitive) manner in sports-like tournaments. Much like in the case of traditional sports, esport players and teams are sponsored, tournaments are broadcasted and followed by large audiences and have large financial prizes. Therefore, being an esports player in now a real career opportunity for teenagers and young adults who like playing video games.  (more…)
Author Interviews, Opiods, Pediatrics, Surgical Research / 09.08.2019

MedicalResearch.com Interview with: Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common surgeries performed in children. It is also one of the most common reasons children are prescribed opioids, even though randomized trials suggest that non-opioids like ibuprofen are equally effective for pain control. We were interested in understanding whether it is possible to safely reduce opioid exposure after tonsillectomy in children without increasing the risk of complications such as emergency department visits for uncontrolled throat pain, which could lead to dehydration. (more…)
Author Interviews, CDC, Opiods / 09.08.2019

MedicalResearch.com Interview with: Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury Prevention CDC  MedicalResearch.com: What is the background for this study? Response: In 2017, among the 70,237 drug overdose deaths in the United States, 47,600 (67.8%) involved prescription or illicit opioids. Distribution of the opioid receptor antagonist naloxone to reverse overdose is a key part of the public health response to the opioid overdose epidemic. The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain recommended clinicians consider offering naloxone when overdose risk factors, such as history of overdose or opioid use disorder, higher opioid dosages, or concurrent benzodiazepine use, are present. However, recent analyses examining pharmacy-based naloxone dispensing are lacking. To address this gap and to inform future overdose prevention and response efforts, CDC examined trends and characteristics of naloxone dispensed from retail pharmacies at the national and county level in the United States. (more…)
Addiction, Author Interviews, Occupational Health / 07.08.2019

MedicalResearch.com Interview with: Devan Hawkins ScD Instructor of Public Health School of Arts and Sciences MCPHS University MedicalResearch.com: What is the background for this study? Response: As has been well established, mortality due to opioids has been increasing rapidly in recent years. We were interested in understanding whether mortality rates may be high among workers in certain industries and occupations for two primary reasons. First, if we were to find that mortality rates differed according to industry and/or occupation it might indicate that some aspect of these industries and occupations put workers at elevated risk for opioid-related overdose death. Second, interventions could be created to target these workers and hopefully prevent more deaths. (more…)
Author Interviews, Brigham & Women's - Harvard, Opiods / 06.08.2019

MedicalResearch.com Interview with: Lauren A. Hoffman, Ph.D. Research Fellow Recovery Research Institute Center for Addiction Medicine Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study?   Response: In 2017, an estimated 11.4 million Americans reported past-year opioid misuse1 and opioid-related overdose accounted for more than 47,000 deaths2. Prior research has helped further our understanding of the prevalence and consequences of opioid misuse, but we know substantially less about recovery from opioid use problems. Recovery-focused research conducted to-date has largely focused on alcohol use disorder, the most common type of substance use disorder. Characterizing recovery from opioid use problems and the pathways that individuals take to resolve such problems can ultimately help identify effective ways to address opioid misuse. Using data from the first national probability-based sample of US adults who have resolved a significant substance use problem (National Recovery Survey3), we provide the first national prevalence estimate of opioid recovery, and characterize treatment/recovery service use and psychological well-being in individuals who resolved a primary problem with opioids, relative to individuals who resolved a primary alcohol problem. We focused our cross-sectional investigation of service use and well-being on 2 time-horizons associated with continued vulnerability: <1 year since problem resolution (early-recovery) and 1 – 5 years since problem resolution (mid-recovery). (more…)