Addiction, Author Interviews, JAMA, UCLA / 15.01.2019

MedicalResearch.com Interview with: John W. Ayers, PhD MA Division of Infectious Diseases and Global Public Health Department of Medicine, University of California San Diego, La Jolla MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Substance Abuse and Mental Health Services Administration national helpline (1-800-662-HELP) is the only free, federally managed and endorsed US drug treatment referral service, helping callers find the best local services that match their needs. Are millions suffering simply because they are not aware that lifesaving help is a phone call away? In our new study, published in JAMA Internal Medicine, Mark Dredze, Alicia Nobles and I delved into Americans’ engagement with 1-800-662-HELP following singer Demi Lovato’s July 24, 2018 hospitalization for a reported overdose that on-the-scene investigators originally linked to heroin. Lovato has since recovered. (more…)
Alcohol, Author Interviews, Smoking / 28.12.2018

MedicalResearch.com Interview with: Dr. Sarah Dermody, PhD Assistant Professor School of Psychological Science Oregon State University Corvallis Oregon  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drinking alcohol is a risk factor for sustained smoking. In a sample of daily cigarette smokers receiving treatment for alcohol use disorder, we examined if reductions in drinking corresponded with reductions in nicotine metabolism as indexed by the nicotine metabolite ratio. The nicotine metabolite ratio is important because it is associated with smoking level and lapses. We found that for men, alcohol use and the nicotine metabolite ratio reduced significantly; however, for women, neither drinking nor nicotine metabolite ratio changed. (more…)
Alcohol, Author Interviews / 16.12.2018

MedicalResearch.com Interview with: "Schott Zwiesel Wine Glasses" by Didriks is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Simona Costanzo MS, PhD Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention. IRCCS Istituto Neurologico Mediterraneo Neuromed, Italy MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We investigated how the different intake of alcohol relates to all-cause and cause-specific hospitalizations. In particular, we mainly investigated the association of alcohol consumption with total number of hospitalizations that occurred during 6 years of follow-up. We also examined cause-specific hospitalizations (e.g., alcohol-related diseases, vascular diseases, cancer, traumatic injury, and neurodegenerative diseases). (more…)
Author Interviews, Dental Research, JAMA, Opiods, Pediatrics / 03.12.2018

MedicalResearch.com Interview with: Alan Schroeder MD Associate Chief for Research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Third molar “wisdom teeth” extractions are one of the most common surgeries performed in adolescents and young adults, but an adequate appraisal of risks and benefits is lacking. Most patients who undergo this procedure are exposed to opioids post-operatively. We demonstrate that, for privately-insured opioid-naïve patients 16-25 years of age, exposure to opioids from a dental provider is associated with persistent use at 90-365 days in 7% of patients and a subsequent diagnosis relating to abuse in 6% of patients. In contrast persistent use and abuse were significantly lower in control patients not exposed to dental opioids (0.1% and 0.4%, respectively). The median number of pills dispensed for the initial prescriptions was 20. (more…)
Addiction, Author Interviews, Methamphetamine, OBGYNE, Opiods / 02.12.2018

MedicalResearch.com Interview with: Lindsay Admon, MD MSc Assistant Professor, Department of Obstetrics & Gynecology Institute for Healthcare Policy and Innovation University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? In our previous work (https://journals.lww.com/greenjournal/Fulltext/2017/12000/Disparities_in_Chronic_Conditions_Among_Women.19.aspx), we identified higher rates of deliveries complicated by substance use among rural women. We knew that some of this difference would be accounted for by opioids.What we didn’t expect was that when we took a closer look, amphetamine use disorder accounted for a significant portion of this disparity as well. The main findings of this study are that, between 2008-09 and 2014-15, amphetamine and opioid use among delivering women increased disproportionately across rural compared to urban counties in three of four census regions. By 2014-15, amphetamine use disorder was identified among approximately 1% of all deliveries in the rural western United States, which was higher than the incidence of opioid use in most regions. Compared to opioid-related deliveries, amphetamine-related deliveries were associated with higher incidence of the majority of adverse gestational outcomes that we examined including pre-eclampsia, preterm delivery, and severe maternal morbidity and mortality.   (more…)
Addiction, Author Interviews, Opiods / 15.11.2018

MedicalResearch.com Interview with: Kirk Evoy, PharmD, BCACP, BC-ADM, CTTS "Wolf Administration Holds a Press Conference Expanding Access to Naloxone" by Governor Tom Wolf is licensed under CC BY 2.0Clinical Assistant Professor  College of Pharmacy, The University of Texas at Austin Adjoint Assistant Professor  School of Medicine, University of Texas Health Science Center at San Antonio Ambulatory Care Pharmacist  Southeast Clinic, University Health System  UT Health Science Center at San Antonio Pharmacotherapy Education and Research Center San Antonio, TX 78229  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Previous studies in Indiana and New York City, and the similar study in California published alongside ours identified that, despite the fact that laws designed to increase naloxone access had been in place for 2-3 years, patients were still not able to obtain naloxone without first seeing a doctor in many pharmacies. Our study showed contrasting results to the previous studies, with a much higher proportion of pharmacies stocking naloxone and stating their willingness to dispense without an outside prescription. Among the 2,317 Texas chain community pharmacies we contacted, 83.7% correctly informed our interviewers that they could obtain naloxone without having to get a prescription from their doctor before coming to the pharmacy.  We also found that 76.4% of the pharmacies had at least one type of naloxone currently in stock. (more…)
Addiction, Author Interviews, Opiods / 14.11.2018

MedicalResearch.com Interview with: "Drug Addiction" by Joana Faria is licensed under CC BY-NC-ND 4.0Yingxi (Cimo) Chen, MD, MPH, PhD Postdoctoral Fellow Radiation Epidemiology Branch, DCEG, NCI, NIH Rockville MD 20850  MedicalResearch.com: What is the background for this study? Response: Death rates from drug overdose have more than doubled in the US in the 21st century. Similar increases in drug overdose deaths have been reported in other high-income countries but few studies have compared rates across countries.  (more…)
Author Interviews, JAMA, Opiods, Surgical Research, University of Michigan / 07.11.2018

MedicalResearch.com Interview with: Joceline Vu, MD Resident, PGY-5 Department of Surgery University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study examined how much opioid patients use after surgery, and looked at factors that might predispose some patients to use more or less. Patient opioid use after surgery is an interesting question that’s gained a lot of attention recently, because it’s different from other uses for opioids. If you have chronic pain, you’re probably going to use all of your prescription. But if you have surgery, you may not take all of your pills, and this leaves people with leftover pills that can be dangerous later. From this study, we found that patients only use, on average, about quarter of their prescription, meaning that a lot of them are left with leftover pills. Moreover, we found that the biggest determinant of how much they used wasn’t how much pain they reported, or any other factor—it was how big their original prescription was. What this means is that opioid use after surgery isn’t just determined by pain, but also by what surgeons prescribe. It’s important to keep this in mind as we try to reduce unnecessary opioid prescribing after surgical procedures.  (more…)
Author Interviews, Opiods, Pediatrics, Social Issues / 07.11.2018

MedicalResearch.com Interview with: Troy Quast, PhD Associate Professor in the University South Florida College of Public Healt MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the cited repercussions of the opioid epidemic is its effect on families. However, there is considerable variation in opioid misuse across the county. This is the first nation-wide study to investigate the relationship between opioid prescription rates and child removals at the state level. I found that there are significant differences across states in the relationship between opioid prescription and child removal rates associated with parental substance abuse. In twenty-three states, increases in opioid prescription rates were associated with increases in the child removal rate. For instance, in California a 10% increase in the county average prescription rate was associated with a 28% increase in the child removal rate. By contrast, in fifteen states the association was flipped, where increases in the opioid prescription rate were associated with decreases in the child removal rate. There was no statistically significant relationship in the remaining states.  (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Massachusetts has been particularly hard hit by the opioid epidemic despite lower opioid prescribing rates, near universal health insurance, and availability of opioid treatment. That said, it is difficult to estimate the population with or at-risk for opioid use disorder. It is generally a highly stigmatized disease and typical methods to estimate of opioid use disorder relay on contact with the healthcare system and/or patient reporting. We used a unique and powerful methodology coupled with a first-in-the-nation linked database in Massachusetts to obtain both an accurate count of people with opioid use disorder who are known to the healthcare system and estimate the number who are out there but not yet known to the system. We found that more than 275,000 people – or 4.6 percent of people over the age of 11 in Massachusetts– have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. In 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of “known” persons increased throughout the study period – from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015.  (more…)
Addiction, Author Interviews, Mental Health Research, NEJM / 23.10.2018

MedicalResearch.com Interview with: Marc Lewis, Ph.D. Klingelbeekseweg Arnhem The Netherlands MedicalResearch.com: What is the background for this study? Response: According to the brain disease model, addiction is a chronic disease brought about by changes in brain systems that mediate the experience and anticipation of reward and higher-order systems underlying judgment and cognitive control. Its proponents propose that these changes are driven by exposure to drugs of abuse or alcohol. The brain disease model is the most prevalent model of addiction in the Western world. The disease model's narrow focus on the neurobiological substrates of addiction has diverted attention (and funding) from alternative models. Alternatives to the brain disease model highlight the social-environmental factors that contribute to addiction and the learning processes that translate these factors into negative outcomes. Learning models propose that addiction, though obviously disadvantageous, is a natural, context-sensitive response to challenging environmental contingencies, not a disease. In this review I examine addiction within a learning framework that incorporates the brain changes seen in addiction without reference to pathology or disease.  (more…)
Addiction, Author Interviews, Cost of Health Care, JAMA / 20.10.2018

MedicalResearch.com Interview with: Tyler Winkelman MD, MSc   Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trends in amphetamine use are mixed across data sources. We sought to identify trends in serious, problematic amphetamine use by analyzing a national sample of hospitalizations. Amphetamine-related hospitalizations increased over 270% between 2008 and 2015. By 2015, amphetamine-related hospitalizations were responsible for $2 billion in hospital costs. While opioid-related hospitalizations were more common, amphetamine-related hospitalizations increased to a much larger degree. After accounting for population growth, amphetamine hospitalizations grew 245% between 2008 and 2015, whereas opioid-related hospitalizations increased 46%. Amphetamine-related hospitalizations were more likely to be covered by Medicaid and be in the western United States compared with other hospitalizations. In-hospital mortality was 29% higher among amphetamine-related hospitalizations compared with other hospitalizations.  (more…)
Author Interviews, Johns Hopkins, Smoking, Tobacco, Tobacco Research / 11.10.2018

MedicalResearch.com Interview with: "Electronic Cigarette/E-Cigs/E-Cigarettes" by Chris F is licensed under CC BY 2.0Mohammadhassan (Hassan) Mirbolouk, MD American Heart Association Tobacco Regulation Center (A-TRAC) Johns Hopkins Hospital Baltimore, MD 21224. MedicalResearch.com: What is the background for this study? Response: E-cigarettes were introduced first in US market as a less harmful method of nicotine delivery which potentially would help smokers to have a less harmful option. However, overtime e-cigarette found its niche of consumers in the younger/tobacco naïve population. Our study is amongst the first studies that describes those who use e-cigarette without any history of combustible-cigarette smoking.  (more…)
Addiction, Author Interviews, Opiods / 05.10.2018

MedicalResearch.com Interview with: "150826-fentanyl-factory-underground-illicit.jpg" by r. nial bradshaw is licensed under CC BY 2.0 Jon Zibbell, PhD, Senior public health scientist Behavioral Health Research Division RTI International Research Triangle Park, NC,  MedicalResearch.com: What is the background for this study? What are the main findings? Response: For the first time in 2016, U.S. overdose deaths involving illicitly-manufactured fentanyl surpassed deaths from heroin and prescription deaths. Fentanyl is an extremely potent synthetic opioid, and an illicitly-manufactured form of the drug is regularly being mixed with heroin and often sold to unwitting consumers. Fentanyl is 50 times more potent than heroin and its illicitly-manufactured version is extremely difficult to discern when mixed with heroin. Harm reduction organizations have started to distribute FTS and people consuming street-purchased opioids are using them to test drugs for fentanyl. Our objective was to assess whether this point-of-use form of drug checking was influencing people’s drug use behavior. The study was self-funded by the research institute RTI International. Our findings show that consumers who tested street opioids with fentanyl test strips were five times more likely to engage in safer drug use behavior when the test comes back positive. The study was conducted among a group of 125 people who inject drugs in Greensboro, North Carolina. (more…)
Accidents & Violence, Alcohol, Author Interviews / 03.10.2018

MedicalResearch.com Interview with: Pamela Trangenstein, PhD While  a predoctoral fellow at Johns Hopkins Bloomberg School of Public Health's Center on Alcohol Marketing and Youth (CAMY)  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Research repeatedly shows that alcohol outlet density (the number of businesses that sell alcohol in an area) is associated with violent crime, but studies disagree about whether alcohol outlets that are on premise (e.g., bars, restaurants) or off premise (e.g., liquor stores, beer and wine stores) have a stronger association with violent crime. We used advanced methods that consider both the number of alcohol outlets and their locations to better understand how the association between alcohol outlets and violent crime differs by type of outlet. We found that alcohol outlets that allow off-premise sales like liquor stores had a stronger association with homicide, aggravated assault, and robbery than on-premise outlets like bars and restaurants. We also found that disadvantaged neighborhoods had higher access to the types of alcohol outlets associated with the most harms: off-premise outlets.  (more…)
Addiction, Author Interviews, Clots - Coagulation, NEJM / 27.09.2018

MedicalResearch.com Interview with: Dr. Amar Kelkar MD Clinical Fellow Division of Hematology & Oncology, Department of Medicine University of Florida College of Medicine, UF Health Shands Hospital MedicalResearch.com: What is the background for this study? What are synthetic cannabinoids? Response: Starting in March 2018, patients began reporting to hospitals and clinics with unexplained and prolonged bleeding symptoms, first in Chicago, Illinois, and then spreading to Peoria, Illinois and elsewhere. This gained a lot of press because the initial identifying factor was that all the patients had reported recent use of synthetic cannabinoids. As the matter was studied further, it was determined that these patients were likely exposed to an anticoagulant poison mixed in with the synthetic cannabinoids. Synthetic cannabinoids are lab-derived illicit drugs that target the cannabinoid receptors that are also targeted by marijuana. They go by many names including synthetic marijuana, K2, and Spice. (more…)
Addiction, Author Interviews, JAMA / 13.09.2018

MedicalResearch.com Interview with: Ti-Fei Yuan, PhD School of Social and Behavioral Sciences, Nanjing University, Nanjing, China Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, China School of Psychology, Nanjing Normal University, Nanjing, China MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Addiction is causing serious challenge to public health. Few drugs can treat or even alleviate addiction. In recent years, non-invasive brain stimulation has been used to modulate craving responses in different types of drug addicts (heroin, methamphetamine, cocaine), and to prevent smoking or alcohol abuse. However it is unknown if brain stimulation can also help addicts get rid of the aversive symptoms in the early withdrawal period. The present study is to our knowledge, the first trial to alleviate drug withdrawal symptoms and associated insomnia with non-invasive transcranial magentic stimulation.  (more…)
Addiction, Author Interviews, JAMA, Opiods, Pediatrics / 10.09.2018

MedicalResearch.com Interview with: Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics Boston Medical Center / Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: Amidst a worsening overdose epidemic in the United States, adolescents and young adults have not been spared. Although evidence-based medications like buprenorphine, naltrexone, and methadone are recommended for adolescents and young adults, the extent to which youth receive these medications — and whether these medications help retain youth in addiction treatment — isn’t yet known. (more…)
Addiction, Author Interviews, Opiods / 21.08.2018

MedicalResearch.com Interview with: Bikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KYBikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KY MedicalResearch.com: What is the background for this study? What are the main findings? Response: The USA is one of the major consumers of diverse neuropsychiatric and illegal drugs, and recently declared a national public health emergency on opioid abuse. Law enforcement typically utilized conventional methods of determining drug consumption rate which are based on survey questionnaire, hospital admissions, drug-related crime statistics, and self-reported information. Conventional methods typically underestimate the actual consumption rate of drugs. Our new approach of determining consumption rates of drugs in community is time and cost effecting and comprehensive. Based on levels of drugs quantified from raw sewage, the per capita consumption rates of several illicit drugs including methamphetamine, amphetamine, cocaine, and THC in two communities of Western Kentucky (similar population and only ~50 miles apart) were significantly different. During special events such as July 4th and 2017 solar eclipse, the consumption rates were found even higher. The consumption rate of methamphetamine was among one of the highest ever reported in the country.  (more…)
Author Interviews / 14.08.2018

MedicalResearch.com Interview with: “Pets” by GRANT DAWSON is licensed under CC BY 2.0Derek S. Mason, MPH Colorado University School of Medicine MD Candidate, Class of 2022 Anschutz Medical Campus, Aurora, CO MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this report stems from a focus group of veterinarians that was held and identified that opioid diversion could be occurring within clinics. After this, we became concerned that human patients were indeed diverting opioids for abuse and misuse and we wanted to get a broader sense from the veterinary medical community if they had been aware of opioid diversion happening within their clinics. Additionally, we noticed that there was a gap in the scientific literature on how the veterinary medical community feels about the opioid epidemic. As prescribers of opioids, we felt that their input was highly valuable and should be included in the discussion on how to prevent opioid abuse and misuse.  (more…)
Addiction, Author Interviews, Cocaine / 08.08.2018

MedicalResearch.com Interview with: Ana-Clara Bobadilla, Ph.D. Postdoctoral scholar in the laboratory of Peter Kalivas, Ph.D MUSC  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Brain-derived neurotrophic factor (BDNF) is a growth factor that has well-described effects in the survival, growth and differentiation of neurons during development of the central nervous system, but it also maintains a role during adulthood in learning, memory and various disorders such as addiction. Several clinical studies show increased BDNF levels in the serum of cocaine- or alcohol-dependent patients compared to controls (D’Sa et al., 2011; D’Sa et al., 2012). In preclinical research, a wealth of studies shows that chronic exposure to drugs of abuse impacts BDNF expression in different parts of the brain, including the main regions comprised in the reward circuitry, the cortex and the nucleus accumbens (for a comprehensive review, see Li & Wolf, 2015). Conversely, altering BDNF expression or transmission has profound effects on the response of the brain to drugs (see McGinty et al., 2010). Importantly, BDNF effects are often region-specific, meaning that an increase in BDNF expression in one region can decrease the effects of drug exposure in the brain while the same increase in another region can have opposite effects (Li et al., 2013). Because BDNF transmission can modify the expression of a wide range of genes leading to long-term modifications, numerous studies administer BDNF early in the drug exposure protocol and focus on the long-term changes induced by the growth factor. In this study, we microinjected BDNF directly in the nucleus accumbens minutes before measuring cocaine craving in a well-known rodent model of relapse. We found that BDNF induces a robust decrease in craving that lasts for at least 3 days post-treatment. The inhibitory effect of BDNF is not seen when animals are tested for sucrose, a very strong reward for rats, suggesting that this effect is specific to cocaine. Moreover, cocaine craving is only decreased when BDNF is microinjected before the craving test, but has no effect when injected a day before the craving test or in the home cage, indicating a time-specificity in addition to the region-specificity previously described.  (more…)
Addiction, Author Interviews, Opiods, Pharmacology / 06.08.2018

MedicalResearch.com Interview with: Mark Pirner, MD, PhD Senior Medical Director Clinical Research and Medical Affairs US WorldMeds MedicalResearch.com: What is the background for this announcement? How does lofexidine differ from other opioid withdrawal medications? Response: LUCEMYRA™ (lofexidine) was FDA-approved on May 16 as the first and only non-opioid, non-addictive medication for the management of opioid withdrawal in adults. LUCEMYRA mitigates the acute and painful symptoms of opioid withdrawal by suppressing the neurochemical surge in the brain that occurs when opioids are abruptly discontinued. In clinical studies, patients receiving treatment with LUCEMYRA experienced greater symptom relief and were significantly more likely to complete their withdrawal. LUCEMYRA is not an opioid drug and is not a treatment for opioid use disorder; it should be used as part of a longer-term treatment plan. (more…)
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018

MedicalResearch.com Interview with: Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. (more…)
Addiction, Alcohol, Author Interviews / 18.07.2018

MedicalResearch.com Interview with: “undefined” by Iñaki Queralt is licensed under CC BY 2.0Richard Saitz, MD, MPH, FACP, DFASAM Chair and Professor,Department of Community Health Sciences Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most of what we know about the time course of drinking too much (at-risk use) is from people in treatment or special groups and not adults in the US population at large. That’s why we did this study. We need to know how often at-risk drinking persists, how often it resolves, and how often it appears de novo. Risky drinking means exceeding limits that are associated with health consequences. It includes people with an alcohol use disorder but the vast majority of people drinking risky amounts do not have a disorder, they are simply drinking amounts that can harm their health. Even low amounts can harm health (e.g. breast cancer risk increases at <1 drink a day) but substantial increases in risk occur over 7 in a week on average (for women, and 14 for men) or >5 for men (>4 for women) on an occasion. The latter are associated with acute consequences (e.g. injury, unwanted sex), and the former with chronic conditions (e.g. cirrhosis). People should be aware of their risks and then they can make choices about what risks they want to take (and for those with a disorder, they may need help with those choices and help changing behavior like treatment). These are all useful thing to talk to any young adults about before they set off on a stag do in Krakow or any other city! The main findings were….that 3 years later, 3/4ths of adults drinking risky amounts were still doing so. But importantly, a quarter had stopped drinking risky amounts. It is important to know that things change. One factor associated with that positive change was having kids—presumably a positive social change even if stressful. Of those adults not drinking risky amounts when first interviewed, 15% started doing so 3 years later. Again having children was protective but the main factor associated with starting was young age, particularly those who became of legal drinking age. Despite the fact that youth may be able to access alcohol illegally, this finding confirms that the drinking age of 21 in the US does in fact restrict access, and that turning 21 increases use and risky use by making alcohol more accessible. (more…)
Author Interviews, Opiods, University of Pittsburgh / 27.06.2018

MedicalResearch.com Interview with: Jeanine M. Buchanich, Ph.D. Research associate Professor in the University of Pittsburgh Graduate School of Public Health’s Department of Biostatistics MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., cause of death codes are assigned by the National Center for Health Statistics (NCHS) using information reported by the coroner or medical examiner completing the death certificate. Drug-specific overdose deaths are identified by the contributory causes of death, which are categorized as “T codes” and are assigned based on the specific drugs recorded by the coroner or medical examiner completing the death certificate. A code of T50.9 means “other and unspecified drugs, medicaments and biological substances.” My colleagues and I extracted death data by state for 1999 through 2015 from the NCHS’s Mortality Multiple Cause Micro-data Files. We grouped overdose deaths into opioid-related, non-opioid-related and unspecified codes. In five states – Alabama, Indiana, Louisiana, Mississippi and Pennsylvania – more than 35 percent of the overdose deaths were coded as unspecified. We then calculated the change in percentage of overdose deaths that fell into each category from 1999 to 2015 by state. In those 17 years, opioid-related overdose deaths rose 401 percent, non-opioid-related overdose deaths rose 150 percent and unspecified overdose deaths rose 220 percent. This allowed us to extrapolate how many of the unspecified overdose deaths were likely opioid-related. By our calculations, potentially 70,000 opioid-related overdose deaths were not included in national opioid-related mortality estimates since 1999 because coroners and medical examiners did not specify the drug that contributed to the cause of death when completing the death certificates.  (more…)
Author Interviews, Opiods, Pediatrics, Pediatrics / 27.06.2018

MedicalResearch.com Interview with: Gary A. Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Buprenorphine is a prescription opioid medication commonly used to treat opioid use disorder. From 2005 to 2010, the annual number of individual patients who received a buprenorphine prescription increased from 100,000 to more than 800,000. Although buprenorphine is important for the treatment of opioid use disorder, pediatric exposure to this medication can result in serious adverse outcomes. (more…)