Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 26.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42751" align="alignleft" width="130"]Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation Dr. Stein[/caption] Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation MedicalResearch.com: What is the background for this study? Response: Increasing use of medication treatment for individuals with opioid use disorders, with medications like methadone and buprenorphine, is a critical piece of the nation’s response to the opioid crisis. Buprenorphine was approved by the FDA in 2002 for treatment of opioid use disorders, but there was little information about to what extent buprenrophine’s approval increased the number of Medicaid-enrollees who received medication treatment in the years following FDA approval nor to what extent receipt of such treatment was equitable across communities.
Author Interviews, JAMA, Opiods, University of Pittsburgh / 25.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42549" align="alignleft" width="132"]Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 15261 Dr. Hernandez[/caption] Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 15261 MedicalResearch.com: What is the background for this study? Response: Prior research has found that taking opioids and benzodiazepines simultaneously increases the risk of overdose by 2 to 3 fold, when compared to opioid-use only. However, prior to our study, it was unclear how the risk of overdose changes over time with the concurrent use of opioids and benzodiazepines.
Addiction, Annals Internal Medicine, Author Interviews, Opiods / 19.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42541" align="alignleft" width="184"]Marc R. Larochelle, MD, MPH Assistant Professor of Medicine Boston University School of Medicine Boston MA Dr. Larochelle[/caption] Marc R. Larochelle, MD, MPH Assistant Professor of Medicine Boston University School of Medicine Boston MD  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study we examined more than 17,000 individuals who survived an opioid overdose in Massachusetts between 2012 and 2014. We were interested in identifying how many went on to receive one of the three FDA-approved medications for opioid use disorder (MOUD), and whether or not they were associated with mortality. We found that only 3 in 10 received MOUD and that receipt of buprenorphine and methadone were associated with 40-60% reduction in all-cause and opioid-related mortality. We found no association between naltrexone and mortality though the confidence of this conclusion is limited by the small number who received naltrexone in this cohort.
Author Interviews, Emergency Care, Opiods / 16.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42483" align="alignleft" width="137"]Herbie Duber, MD, MPH, FACEP Associate Professor, Emergency Medicine Adjunct Associate Professor Department of Global Health Adjunct Associate Professor, Institute for Health Metrics and Evaluation University of Washington Dr. Duber[/caption] Herbie Duber, MD, MPH, FACEP Associate Professor, Emergency Medicine Adjunct Associate Professor Department of Global Health Adjunct Associate Professor Institute for Health Metrics and Evaluation University of Washington MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Opioid use disorder (OUD) and opioid overdose deaths are a rapidly increasing public health crisis.  In this paper, we review and synthesize current evidence on the identification, management and transition of patients from the emergency department (ED) to the outpatient setting and present several key recommendations. For patients identified to haveOpioid use disorder, we recommend ED-initiated mediation-assisted therapy (MAT) with buprenorphine, an opioid agonist.  Current evidence suggests that it safe and effective, leading to improved patient outcomes.  At the same time, a coordinated care plan should be put into motion which combines MAT with a rapid transition to outpatient care, preferably within 72 hours of ED evaluation.  Where possible, a warm handoff is preferred, as it has been shown in other settings to improve follow-up.  Outpatient care should combine MAT, psychological interventions and social support/case management in order to maximize impact
Addiction, Author Interviews, Smoking, Tobacco, Tobacco Research / 15.06.2018

MedicalResearch.com Interview with: e-cigarette CDC imageDr Lynne Dawkins, PhD Associate Professor London South Bank University MedicalResearch.com: What is the background for this study? Response: Many people think that it’s the nicotine that’s harmful so they opt for using a low strength in their e-liquid. We know from tobacco smoking that when people switch to using a lower nicotine yield cigarette, they compensate in order to maintain a steady blood nicotine level by taking longer, harder drags and this can increase exposure to toxins in the smoke. We also know from some of our other work with vapers (e-cigarette users) that they tend to reduce the nicotine strength of their e-liquid over time. We therefore wanted to explore whether vapers also engage in this compensatory puffing and whether this has any effect on exposure to potentially harmful chemicals.
Addiction, Author Interviews, Mental Health Research / 13.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42407" align="alignleft" width="130"]Scott J. Russo PhD Fishberg Dept. of Neuroscience Friedman Brain Institute, and Center for Affective Neuroscience Icahn School of Medicine at Mount Sinai New York, NY Dr. Russo[/caption] Scott J. Russo PhD Fishberg Dept. of Neuroscience Friedman Brain Institute, and Center for Affective Neuroscience Icahn School of Medicine at Mount Sinai New York, NY  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is increasing evidence that aggressive behavior might share key features with addiction.  For example, aggressive mice develop positive associations with environmental cues associated with previous aggressive encounters (ie. they find aggression rewarding) and aggressive animals will work very hard to obtain access to a subordinate animal in order to attack them. Some of the same brain regions that are activated in response to addictive drugs, like cocaine and morphine, are also activated by aggressive experience.  Thus we hypothesized that there may be shared neurobiological mechanisms between addiction and aggression. Our study showed that there is accumulation of the addiction-related transcription factor, ΔFosB, in the nucleus accumbens, a brain region well know to regulate the rewarding and addictive properties of drugs of abuse.
Addiction, Author Interviews / 11.06.2018

MedicalResearch.com Interview with: Professor, Rita Z. Goldstein, PhD Department of Psychiatry (primary) and Department of Neuroscience, Friedman Brain Institute (secondary) Chief, Neuropsychoimaging of Addiction and Related Conditions (NARC) Research Program Anna Zilverstand PhD Assistant Professor, Psychiatry Icahn School of Medicine at Mount Sinai The Leon and Norma Hess Center for Science and Medicine New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In comparison to previous reviews that often focused on investigating select brain circuits, such as the reward network, our review is the first to systematically discuss all brain networks implicated in human drug addiction. Based on more than 100 neuroimaging studies published since 2010, we found that six major brain networks showed altered brain function in individuals with addiction. These brain circuits are involved in a person’s ability to select their actions (executive network), in directing someone’s attention (salience network), in adaptive learning of new behaviors (memory network), in the automatization of behaviors (habit network), in self-reflection (self-directed network) and the valuation of different options (reward network). When individuals with addiction are confronted with pictures of drug taking, all of these networks become very highly engaged; however, when the same individuals are confronted with scenes depicting other people, their brains show a reduced reaction as compared to healthy individuals, indicating less involvement. Similarly, the brain of an addicted individual is less engaged when making decisions (that are not relevant to their drug taking) or when trying to inhibit impulsive actions. We further found that some impairments of brain functions, such as alterations underlying the difficulty to inhibit impulsive actions, seem to precede drug addiction, as we observe similar impairments in adolescents that later go on to abuse drugs. However, particularly the impairments in the executive network (involved in the ability to inhibit impulsive actions), the valuation network (which computes the value of an option) and the salience network (that directs attention towards events) seem to be getting worse with more severe drug use and also predict if someone is likely to relapse or not. The good news is that we also found that it is possible to (partially) recover and normalize brain function in these networks through treatment. Importantly, the widespread alterations of brain function were independent of what drug an individual was addicted to (marijuana, alcohol, cigarettes, cocaine, methamphetamine, heroin, amongst others).
Addiction, Alcohol, Author Interviews, Opiods / 07.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42251" align="alignleft" width="200"]Dr. Katie Witkiewitz PhD Professor, Department of Psychology  University of New Mexico Dr. Witkiewitz[/caption] Dr. Katie Witkiewitz PhD Professor, Department of Psychology University of New Mexico MedicalResearch.com: What are the main findings? Response: The main findings from our study indicate that individuals with alcohol dependence who misused opioids (e.g., used without a prescription or not as prescribed) had a significantly higher likelihood of relapse to heavy drinking during alcohol treatment and were drinking more alcohol during and following alcohol treatment.
Addiction, Author Interviews, JAMA, Race/Ethnic Diversity / 06.06.2018

MedicalResearch.com Interview with: Randall C. Swaim, Ph.D. Senior Research Scientist and Director Linda R. Stanley, Ph.D. Senior Research Scientist Tri-Ethnic Center for Prevention Research Department of Psychology Colorado State University                           MedicalResearch.com: What is the background for this study? Response: American Indian adolescents consistently report the highest levels of substance use compared with other US racial/ethnic groups. The harm associated with these high rates of use include higher risk of developing a substance use disorder, more alcohol-related problems, including alcohol-attributable death, and other negative outcomes such as school failure. These findings point to the importance of continuing to monitor this group, particularly given changing trends in perceived harmfulness of illicit substances as new statutes alter access to medical and recreational use of cannabis.
Author Interviews, Critical Care - Intensive Care - ICUs, Opiods, University of Pittsburgh / 21.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41908" align="alignleft" width="125"]Jason Kennedy, MS Research project manager Department of Critical Care Medicine University of Pittsburgh Jason Kennedy[/caption] Jason Kennedy, MS Research project manager Department of Critical Care Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Most previous studies of opioid use in health care have focused on the outpatient setting. But opioids are often introduced during hospitalization. That’s something clinicians can control, so we looked at inpatient prescription of these drugs to identify targets that may reduce opioid use once patients are out of the hospital. We analyzed the medical records of 357,413 non-obstetrical adults hospitalized between 2010 and 2014 at 12 University of Pittsburgh Medical Center (UPMC) hospitals in southwestern Pennsylvania. The region is one of the areas of the country where opioid addiction is a major public health problem. We focused on the 192,240 patients who had not received an opioid in the year prior to their hospitalization – otherwise known as “opioid naïve” patients. Nearly half (48 percent) of these patients received an opioid while hospitalized.  After discharge, those patients receiving hospital opioids were more than twice as likely to report outpatient opioid use within 90-days (8.4 percent vs. 4.1 percent). Patients who receive an opioid for most of their hospital stay and patients who are still taking an opioid within 12 hours of being discharged from the hospital appear more likely to fill a prescription for opioids within 90 days of leaving the hospital. 
Addiction, Author Interviews, Opiods, Pharmacology / 30.04.2018

MedicalResearch.com Interview with: [caption id="attachment_41358" align="alignleft" width="200"]Dr. Maria Sullivan MD PhD Senior Medical Director of Clinical Research and Development Alkermes Dr. Sullivan[/caption] Maria Sullivan, M.D., Ph.D Senior Medical Director of Clinical Research and Development Alkermes MedicalResearch.com: What is the background for this study? Response: Extended release injectable naltrexone is approved for the prevention of relapse to opioid dependence after detoxification and when used with counseling. It is recommended that patients abstain from opioids for a minimum of seven to 10 days prior to induction onto XR-naltrexone to avoid precipitating opioid withdrawal. This requirement of detoxification represents a substantial clinical challenge, particularly in the outpatient setting. There is currently no single recognized best method for opioid detoxification prior to first dose of extended-release naltrexone (XR-naltrexone). A number of induction regimens have been explored, including the use of low doses of oral naltrexone to shorten the transition period from dependence on opioids to XR-naltrexone treatment. The goal of the study was to help establish an outpatient regimen to transition subjects from physiological opioid dependence to XR-naltrexone treatment and mitigate the severity of opioid withdrawal symptoms. We hypothesized that low-dose oral naltrexone, combined with buprenorphine and psychoeducational counseling, would assist with the transition of patients with opioid use disorder onto XR-naltrexone. In this 3-arm trial, we examined the utility of oral naltrexone, buprenorphine, and a fixed regimen of ancillary medications (oral naltrexone + buprenorphine vs. oral naltrexone + placebo buprenorphine vs. placebo +placebo), to determine whether any of these regimens was associated with higher rates of induction onto XR-naltrexone.
Author Interviews, Opiods, Pediatrics / 28.03.2018

MedicalResearch.com Interview with: http://www.phc4.org/reports/researchbriefs/neonatal/17/ Joe Martin Executive Director PA Health Care Cost Containment Council Commonwealth of Pennsylvania Harrisburg, PA 17101 MedicalResearch.com: What is the background for this study? Response: Several years ago, our agency noted that while mortality data for opioid addition was being reported, it did not include hospitalizations where death did not occur.  We believed our agency could make a valuable contribution to the data by beginning to report that.  We began with adults hospitalized in PA for opioid addiction, and supplemented that over time with reporting about maternity cases and newborns. Today’s report covers babies born with neonatal abstinence syndrome.
Author Interviews, CMAJ, Opiods / 26.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40728" align="alignleft" width="133"]Andrea Schaffer PhD Research Fellow Centre for Big Data Research in Health UNSW Sydney NSW Australia Dr. Schaffer[/caption] Andrea Schaffer PhD Research Fellow Centre for Big Data Research in Health UNSW Sydney NSW Australia  MedicalResearch.com: What is the background for this study? Response: Use and misuse of opioids has increased dramatically in Australia over the past 20 years. In 2014, Australia introduced tamper-resistant controlled-release (CR) oxycodone, which forms a viscous gel when crushed, and is designed to deter its injection or snorting. However, this formulation does not prevent dependence, and can still be misused orally. Tamper-resistant oxycodone CR was also introduced in the US (2010) and Canada (2012), resulting in reductions in oxycodone CR use. However, no large population-level studies have looked at switching behaviour in individuals using oxycodone CR, either in Australia or abroad.
Author Interviews, Opiods / 19.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40639" align="alignleft" width="200"]Brian J. Piper, PhD, MS Assistant Professor of Neuroscience Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton PA 18509 Dr. Brian Piper[/caption] Brian J. Piper, PhD, MS Assistant Professor of Neuroscience Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton PA 18509  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The US is experiencing an opioid crisis. There were 63,800 drug overdose deaths in 2016 which is three-fold higher than in 1999. Drug overdose deaths involving synthetic opioids like fentanyl increased 27-fold. Overdoses may even have contributed to decreases in the US lifespan. Emergency Room visits involving opioids have also shown recent increases, particularly in the Southwest and Western US. The US accounts for less than 5% of the world’s population but consumed over two-thirds (69.1%) of the world’s supply of six opioids (fentanyl: 30.1%, methadone: 48.1%, morphine: 51.2%, hydromorphone: 53.0%, oxycodone: 73.1% and hydrocodone: 99.7%) in 2014. The goal of this study was to examine changes in medical use of ten opioids within the United States, and US Territories, from 2006 to 2016 as reported to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS). Prior estimates of the Morphine Mg Equivalent (MME), per person in the US (640), although much higher than most other developed countries, may be an underestimate because of a federal regulation (42 CFR Part 2) that prevents reporting methadone from narcotic treatment programs. We discovered that prescription opioid use peaked in 2011 (389.5 metric ton MMEs) and has been rapidly declining (346.5 in 2016). Relative to 2011, there were decreases in hydrocodone (–28.4%); oxymorphone (–28.0%); fentanyl (–21.4%); morphine (–18.9%); oxycodone (–13.8%); and meperidine (–58.0%). However, there was a pronounced increase in buprenorphine (75.2%). Similar changes were observed from 2015 to 2016 with a statistically significant reduction in all opioids except buprenorphine which was increased. There were substantial geographical variations in rates with a seven fold difference between the highest Morphine Milligram Equivalents in 2016 (Rhode Island = 2,624 mg/person) relative to Puerto Rico (351 mg/person). Two drugs used in treating an opioid use disorder (methadone and buprenorphine) accounted for over-half (52%) of the total MME in 2016.  
Accidents & Violence, Addiction, Author Interviews, JAMA / 14.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40468" align="alignleft" width="154"]Dr. Laura Dwyer-Lindgren PhD Assistant Professor at IHME Institute for Health Metrics and Evaluation  Dr. Dwyer-Lindgren[/caption] Dr. Laura Dwyer-Lindgren PhD Assistant Professor at IHME Institute for Health Metrics and Evaluation  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study in the latest in a series of studies IHME has conducted on health and disease on the county level in the United States. We analyzed data provided by the National Center for Health Statistics, the U.S. Census Bureau, and other sources. Main findings include:
  • Nearly 550,000 deaths were attributed to drug use over the 35 years. Nationally, the age-standardized death date increased 238% between 1980 and 2000, and 112% between 2000 and 2014. The death rate from drug use disorders increased in every county, but some counties in Kentucky, West Virginia, Ohio, Indiana, and eastern Oklahoma has increases exceeding 5000%.
  • There were more than a quarter million deaths in the U.S. due to alcohol use; Western counties generally has higher levels than those in other parts of area of the nation, with especially high death rates in Wisconsin, North Dakota, South Dakota, Nebraska, Montana, New Mexico, Arizona, Utah, and Alaska.
  • Neatly 1.3 million suicides were recorded, with especially high rates in Alaska, Nevada, South Dakota, Utah, New Mexico, Arizona, Montana, North Dakota, Oregon, Wyoming and one county in Maryland. While the national death rate due to suicide decreased between 1980 and 2014, there was an increase in the death rate due to suicide in most counties.
  • More than three quarters of a million deaths by homicide occurred in the US between 1980 and 2015. Nationally, the age-standardized death rate due to homicide decreased by about 35% between 1980 and 2000, and by nearly 16% between 2000 and 2014. Counties with the largest decreases were found in Virginia, Florida, Texas, California and New York. 
Addiction, Author Interviews, Opiods, Vaccine Studies / 22.02.2018

MedicalResearch.com Interview with: “Syringe and Vaccine” by NIAID is licensed under CC BY 2.0Candy Hwang, Ph.D. The Scripps Research Institute La Jolla, CA 92037 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our heroin vaccine is designed to stimulate antibodies to recognize and bind heroin, preventing passage of drug molecules to the brain. By essentially blocking the “high” from heroin, we believe this will assist recovering addicts from relapsing. Last year, we reported a heroin vaccine that was shown to be effective in both mouse and non-human primate models. In this current study, we were interested in enhancing our heroin vaccine by exploring different vaccine components and dosages. Once we discovered the most promising vaccine formulations, we wanted to see if our vaccines would be stable under different storage conditions. We found that our heroin vaccine was shelf stable under different temperatures and as a powder or in liquid form, meaning that the vaccine will remain stable for transport and storage. The best vaccine formulation from these studies showed protection against lethal doses of heroin.
Alcohol, Author Interviews, Compliance / 13.02.2018

MedicalResearch.com Interview with: “Alcohol” by zeevveez is licensed under CC BY 2.0Sarah Dermody PhD Assistant professor School of Psychological Science College of Liberal Art Oregon State University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Naltrexone is an FDA-approved medication to treat alcohol use disorder. We know that people have difficulty adhering to the prescribed daily medication regimen, and that people who do not adhere to the medication tend not to fair as well in treatment as people who take the medication regularly. This particular study attempted to address the question of why do people with alcohol use disorder have difficulty taking the medication daily? What we found was that people were less likely to take naltrexone after days of heavy drinking or strong alcohol craving versus typical drinking and craving levels. Furthermore, individuals were less likely to take the medication on weekends versus weekdays, which is particularly worrisome because heaviest drinking episodes tend to happen on the weekends.
Addiction, Author Interviews, Opiods, University of Pittsburgh / 05.02.2018

MedicalResearch.com Interview with: “MEXICO-DRUGS/” by Claudio Toledo is licensed under CC BY 2.0Kathleen Creppage, M.P.H., C.P.H. Doctoral candidate Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the U.S., fatal heroin overdoses have increased in the past decade by 300 percent, with fentanyl – a substance that is 20 to 50 times more potent than heroin – and its analogs increasingly contributing to overdoses. The drug often is implicated in clusters of overdose deaths when it is mixed with heroin and users do not realize what they are taking is more powerful than usual. We analyzed the test results of 16,594 stamp bags seized as evidence by law enforcement authorities in Allegheny County that were submitted to the county’s Office of the Medical Examiner for laboratory testing from 2010 through 2016. Stamp bags are small wax packets that contain mixtures of illicit drugs, most commonly heroin, packaged for sale and sometimes stamped with a graphical logo by drug dealers to market their contents. Before 2014, none of the tested bags contained fentanyl. By 2016 it was found in 15.5 percent of the tested stamp bags, with 4.1 percent containing fentanyl as the only controlled substance present.
Addiction, Author Interviews, JAMA, Opiods / 01.02.2018

MedicalResearch.com Interview with: “Drugs” by Ben Harvey is licensed under CC BY 2.0William G. Honer, MD, FRCPC, FCAHS Jack Bell Chair in Schizophrenia Professor and Head, Department of Psychiatry University of British Columbia Vancouver, BC MedicalResearch.com: What is the background for this study? Response: The Province of British Columbia, Canada, has experienced a tremendous increase in the number of opioid related overdoses and deaths. In 2012, there were 269 drug overdose deaths, five years later in 2017 the overdose deaths are predicted to have increased 500%. Toxicology studies of deaths, and examination of seized drugs indicate fentanyl is the major cause. These indirect measures suggest widespread exposure to fentanyl in opioid users, however direct studies of the extent of exposure of opioid users to fentanyl in the community are lacking. We carried out a community-based, longitudinal study using fentanyl testing in urine samples from volunteer participants. (It is called the “Hotel Study” since many of the participants live, or have lived in single room occupancy hotels) 
Addiction, Alcohol, Author Interviews / 25.01.2018

MedicalResearch.com Interview with: “Alcohol Poisoning PSA Video Shoot” by Stop Alcohol Deaths, Inc. is licensed under CC BY 2.0Dr. Frank de Vocht Senior Lecturer in Epidemiology and Public Health Research Academic Lead Year 1 MBChB (MB21) ‘Foundations of Medicine’ Programme Population Health Sciences Bristol Medical School University of Bristol  MedicalResearch.com: What is the background for this study? Response: We were interested in prospectively investigating whether people who drink alcohol in the general population (so not patients), and who indicated that the were planning to reduce their consumption or complete stop drinking in the near future would, on average, succeed and have reduced consumption six months later. 
Alcohol, Author Interviews, PLoS, Social Issues, Transplantation / 05.01.2018

MedicalResearch.com Interview with: “Alcohol” by Jorge Mejía peralta is licensed under CC BY 2.0Dr. Eirik Degerud, PhD Norwegian Institute of Public Health MedicalResearch.com: What is the background for this study? Response: Alcohol-related hospitalisations and deaths are more frequent among individuals with low socioeconomic position, despite that they tend to drink less on average. This is referred to as the alcohol-harm paradox. Alcohol is associated with both higher and lower risk of cardiovascular disease, depending on the drinking pattern. We wanted to assess if the paradox was relevant to these relationship also.
Author Interviews, Cocaine / 27.12.2017

“cocaine photo” by Imagens Evangélicas is licensed under CC BY 2.0MedicalResearch.com Interview with: Mary Kay Lobo, PhD Associate Professor University of Maryland School of Medicine Department of Anatomy and Neurobiology Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered energy balance has been studied in drug abuse but the fundamental source of energy, mitochondria, has not been well examined.  In this study we found that a molecular regulator of mitochondrial fission (division) is increased in the nucleus accumbens, a major brain reward region, of rodents exposed to repeated cocaine and postmortem samples of cocaine dependent individuals.  We further found that mitochondrial fission is increased in a nucleus accumbens neuron subtype in rodents that self-administer cocaine. Pharmacological blockade of mitochondrial fission can prevent physiological responses to cocaine in this neuron subtype while reducing cocaine-mediated behaviors.  Finally, genetic reduction of mitochondrial fission in this neuron subtype in the nucleus accumbens can reduce drug (cocaine) seeking in rodents previously exposed to cocaine. In contrast, increasing mitochondrial fission, in this neuron subtype, enhances cocaine seeking behavior.
Addiction, Author Interviews, Cannabis, NIH, Pediatrics, Smoking / 17.12.2017

MedicalResearch.com Interview with: “Checking your phone and vaping as you do” by Alper Çu?un is licensed under CC BY 2.0Richard Allen Miech, PhD Research Professor, Survey Research Center Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Monitoring the Future conducts annual, nationally-representative surveys of ~45,000 adolescents every year to assess trends in substance use. We track which drugs are gaining traction among adolescents and which are falling out of favor. The survey draws separate, nationally-representative samples of 8th, 10th, and 12th grade students from about 400 total schools every year. Once a recruited school agrees to participate, a field interviewer travels to the school to administer the paper-and-pencil survey, typically in classrooms. The project is funded by the National Institute of Drug Abuse and is carried out by the University of Michigan. More details on the project's survey design and survey procedures can be found in chapter 3 here: http://monitoringthefutu re.org/pubs/monographs/mtf- vol1_2016.pdf
Author Interviews, JAMA, Johns Hopkins, Opiods, Pain Research / 12.12.2017

MedicalResearch.com Interview with: “Pills” by Victor is licensed under CC BY 2.0Marissa J. Seamans, Ph.D Postdoctoral Fellow Department of Mental Health Johns Hopkins School of Public Health Baltimore, MD 21205  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many patients report sharing their prescriptions for opioids with family members. What we didn’t know is whether family members of opioid users are more likely to fill opioid prescriptions themselves than family members of non-opioid users. Our study found that the 1-year risk of prescription opioid initiation among family members of prescription opioid users was an absolute 0.71% higher than among family members of non-opioid users. The risks were particularly higher for initial prescriptions with refills or longer days supply.
Annals Internal Medicine, Author Interviews, Cocaine, Kaiser Permanente, NIH, Race/Ethnic Diversity / 05.12.2017

MedicalResearch.com Interview with: “Cocaine” by Nightlife Of Revelry is licensed under CC BY 2.0Dr. Dave Thomas PhD Health Scientist Administrator National Institute on Drug Abuse  MedicalResearch.com: What is the background for this study? What are the main findings? Response: At the National Institute on Drug Abuse, we support research on all forms of drug use, and are aware that cocaine misuse is on the rise.  We are aware that various forms of drug use can have greater prevalence by race, sex, age and other population characteristics. The main finding of this paper is that cocaine overdose rates are on the rise and that that the group hit hardest is the non-Hispanic black population.
Addiction, Author Interviews / 27.11.2017

MedicalResearch.com Interview with: Dr. Zoe Weinstein MD Instructor, Boston University School of Medicine Director of the Inpatient Addiction Consult Service Boston Medical CenterDr. Zoe Weinstein MD Instructor, Boston University School of Medicine Director of the Inpatient Addiction Consult Service Boston Medical Center MedicalResearch.com: What is the background for this study? Response: Substance use disorders are highly prevalent, especially among hospitalized patients, however substance use often goes unaddressed in the hospital setting, even if substance use is the underlying cause of the hospitalization (such as a blood stream infection from intravenous drug use). This study reviews the experience of one hospital in starting an Addiction Consult Service to address substance use among hospitalized patients, and help connect them with long-term outpatient addiction treatment directly from the hospital.
Author Interviews, Cannabis / 17.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38357" align="alignleft" width="165"]MedicalResearch.com Interview with: Christine Mauro PhD Assistant Professor Biostatistics Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: As of November 2016, 28 states have legalized medical marijuana. Several previous studies have found an increase in use for adults after legalization, but not for adolescents. We wanted to examine whether these age-specific findings varied by gender. Consistent with past findings, we found past-month marijuana use did not increase after enactment of medical marijuana laws in men or women ages 12-25. Among people 26+, past-month marijuana use increased for men from 7.0% before to 8.7% after enactment (+1.7%, p<0.001) and for women from 3.1% before to 4.3% after enactment (+1.1%, p=0.013). Daily marijuana use also increased after enactment in this age group for both genders (men: 16.3% to 19.1%, +2.8 %, p=0.014; women: 9.2% to 12.7%, +3.4%, p=0.003). There were no statistically significant increases in past-year Marijuana Use Disorder prevalence for any age or gender group after medical marijuana law enactment. MedicalResearch.com: What should clinicians and patients take away from your report? Response: The readers should take away several things. First, despite men being more likely to use marijuana than women are in all age groups, there were relatively few gender differences in terms of the impact of medical marijuana on marijuana use. Second, we found no evidence of an effect of medical marijuana law enactment in any marijuana use outcome for both men and women aged 12-17. Lastly, we did see an increase in both past-month use and daily use among past-year users in both men and women aged 26+ after enactment, but no changes in past year marijuana used disorder. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: Because most states in our sample more recently passed medical marijuana laws, it is possible that not enough time has elapsed to observe meaningful and significant changes in Marijuana Use Disorder. Given the impact Marijuana Use Disorder may have on individuals, families, and society, the prevalence of Marijuana Use Disorder should continue to be monitored regularly. Second, there is considerable variation across provisions included in different states’ medical marijuana laws; some aspects, such as allowances on home cultivation or dispensaries, might have a role in changes in several health outcome indicators. In addition, eight states have now legalized recreational marijuana, which may also have an impact on marijuana use outcomes over time. Future analyses should account for this variability in marijuana related policies. MedicalResearch.com: Is there anything else you would like to add? Response: As marijuana use becomes more prevalent, monitoring state-wide trends in marijuana use by age and gender is important for public health planning. In particular, efforts to prevent and limit injury that may be associated with specific activities, such as driving, may be needed as daily marijuana use increases among adults. Downstream effects, either positive or negative, of a growing proportion of the adult population reporting daily marijuana use in states with medical marijuana laws warrants further attention. Disclosure: This work was supported by the National Institutes of Health, National Institute on Drug Abuse (grant R01 DA037866 to S. S. Martins). MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: Christine M. Mauro, Paul Newswanger, Julian Santaella-Tenorio, Pia M. Mauro, Hannah Carliner, Silvia S. Martins. Impact of Medical Marijuana Laws on State-Level Marijuana Use by Age and Gender, 2004–2013. Prevention Science, 2017; DOI: 10.1007/s11121-017-0848-3 Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. [wysija_form id= Dr. Mauro[/caption]Christine Mauro PhD Assistant Professor Biostatistics Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: As of November 2016, 28 states have legalized medical marijuana with online dispensary canada providing information for anyone who is interested in finding out more. Several previous studies have found an increase in use for adults after legalization, but not for adolescents. We wanted to examine whether these age-specific findings varied by gender. Consistent with past findings, we found past-month marijuana use did not increase after enactment of medical marijuana laws in men or women ages 12-25. Among people 26+, past-month marijuana use increased for men from 7.0% before to 8.7% after enactment (+1.7%, p<0.001) and for women from 3.1% before to 4.3% after enactment (+1.1%, p=0.013). Daily marijuana use also increased after enactment in this age group for both genders (men: 16.3% to 19.1%, +2.8 %, p=0.014; women: 9.2% to 12.7%, +3.4%, p=0.003). There were no statistically significant increases in past-year Marijuana Use Disorder prevalence for any age or gender group after medical marijuana law enactment.
Addiction, Author Interviews, CDC, Opiods / 03.11.2017

MedicalResearch.com Interview with: “no drugs” by Anderson Mancini is licensed under CC BY 2.0Julie K. O’Donnell, PhD Division of Unintentional Injury Prevention National Center for Injury Prevention and Control CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: The opioid overdose epidemic has killed over 300,000 Americans from 1999 to 2015—including 33,091 in 2015. Over this time, the epidemic has evolved from being primarily driven by prescription opioids to increasingly being driven by illicit opioids. The first wave of the epidemic began in 1999 with a steep increase in deaths involving prescription opioids, such as hydrocodone, oxycodone, and morphine. The second wave began in 2010 with rapid increases in overdose deaths involving heroin. The third wave of the epidemic began in 2013, with significant increases in overdose deaths involving synthetic opioids—particularly those involving illicitly-manufactured fentanyl (IMF), which are commonly laced into heroin products. Most recently, the IMF market continues to evolve, with an ever-widening array of illicitly manufactured fentanyl analogs being distributed. This report indicates that over half of people in 10 states who died of opioid overdoses tested positive for fentanyl during the second half of 2016. The report found that out of a total of 5,152 opioid overdose deaths, almost 3,000 tested positive for fentanyl, and over 700 tested positive for drugs that have similar chemical structures to fentanyl (fentanyl analogs) – including the extremely potent fentanyl analog, carfentanil, which is used to sedate large animals.
Addiction, Author Interviews, CDC, Cocaine / 20.10.2017

MedicalResearch.com Interview with: “Pills” by Kurtis Garbutt is licensed under CC BY 2.0Christopher M. Jones, PharmD Office of the Assistant Secretary for Planning and Evaluation Office of the Secretary U.S. Department of Health and Human Services  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Although prescription drugs, in particular opioid pain relievers, were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. We found that the prevalence of self-reported past-month use of illicit drugs increased significantly across urban status (large metropolitan, small metropolitan, and nonmetropolitan) between 2003-2005 and 2012-2014. Prevalence was higher for males than females, however, in the large metropolitan group, the percentage increase in prevalence from 2003–2005 to 2012–2014 was greater for females (23.4%) than for males (21.6%). There were notable differences by age. During 2012–2014, respondents aged 18–25 years had the highest prevalence of past-month use of illicit drugs for all urban levels. For respondents in this age group, the prevalence increased slightly from 2003–2005 to 2012–2014 in large metropolitan areas while the prevalence remained stable among small metropolitan area respondents and nonmetropolitan area respondents. Past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years), with the largest decline among small metropolitan area youth.
Addiction, Author Interviews, JAMA, Opiods, University of Pittsburgh / 24.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36629" align="alignleft" width="130"]Julie M. Donohue, Ph.D. Associate professor in Pitt Public Health’s Department of Health Policy and Management and Director of the Medicaid Research Center Pitt’s Health Policy Institute University of Pittsburgh Dr. Donohue[/caption] Julie M. Donohue, Ph.D. Associate professor in Pitt Public Health’s Department of Health Policy and Management and Director of the Medicaid Research Center Pitt’s Health Policy Institute University of Pittsburgh  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medicaid enrollees have three times higher risk of opioid overdose than non-enrollees, and for every fatal opioid overdose, there are about 30 nonfatal overdoses, according to the U.S. Centers for Disease Control and Prevention (CDC). My colleagues and I analyzed claims data from 2008 to 2013 for all Pennsylvania Medicaid enrollees aged 12 to 64 years with a medical record of a heroin or prescription opioid overdose and who had six months of continuous enrollment in Medicaid before and after the overdose claim. The 6,013 patients identified were divided into two groups—3,945 who overdosed on prescription opioids and 2,068 who overdosed on heroin, all of whom received treatment for overdose in a hospital or emergency department setting. We found that Pennsylvania Medicaid recipients who suffer an opioid or heroin overdose continue to be prescribed opioids at high rates, with little change in their use of medication-assisted treatment programs after the overdose. Opioid prescriptions were filled after overdose by 39.7 percent of the patients who overdosed on heroin, a decrease of 3.5 percentage points from before the overdose; and by 59.6 percent of the patients who overdosed on prescription opioids, a decrease of 6.5 percentage points. Medication-assisted treatment includes coupling prescriptions for buprenorphine, methadone or naltrexone—medications that can reduce opioid cravings—with behavioral therapy in an effort to treat the opioid use disorder. Our team found that such treatment increased modestly among the patients using heroin by 3.6 percentage points to 33 percent after the overdose, and by 1.6 percentage points to 15.1 percent for the prescription opioid overdose patients.