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…)
Addiction, Author Interviews, Opiods / 08.08.2019

MedicalResearch.com Interview with: Brian J Piper, PhD MS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: All states have a Prescription Monitoring Program to collect data about controlled substance prescriptions. Maine also had a Diversion Alert Program to obtain information about arrests involving prescription and illicit drugs. Buprenorphine is a treatment for an opioid use disorder. Naloxone is an opioid antagonist. Prior pharmacoepidemiology research found that buprenorphine accounted for half of prescriptions for males in their twenties in Maine.1 This study examined the current status of the opioid crisis using three complementary data sources: 1) Arrests as reported to the Diversion Alert Program; 2) Medical opioid use as reported by the Drug Enforcement Administration; and 3) Overdoses as reported to the medical examiner. (more…)
Author Interviews, Opiods / 09.04.2019

MedicalResearch.com Interview with: Joanne Spetz, PhD Professor Philip R. Lee Institute for Health Policy Studies San Francisco, CA 94143-0936 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medication treatment is an important component of treatment for opioid use disorder. Buprenorphine has been the focus of policies designed to increase access to treatment and is the most widely-used medication due to well-established evidence of its efficacy and its accessibility outside licensed narcotics treatment programs. The most common brand name for this medication is Suboxone. There is a shortage of providers authorized to prescribe it, in part because only physicians were permitted to obtain waivers from the Drug Enforcement Agency to prescribe it outside of licensed narcotics treatment programs until the opioid bill of 2016. That bill granted nurse practitioners (NPs) and physician assistants (PAs) the ability to apply for waivers. However, in states that require NPs and/or PAs to be supervised by or collaborate with a physician, there are additional requirements regarding the training of the physician before the NP or PA can apply for a waiver. This affects nearly half of states for NPs, and all states for PAs. We found that the average percentage of NPs with waivers was 5.6% in states that do not require physician supervision, but only 2.4% in more restrictive states. Even after adjusting for other factors, we found that the percentage of NPs with waivers was 75% higher when physician oversight is not required. We didn’t find a similar result for PAs, probably because they must have physician oversight in all states. (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…)
Addiction, Author Interviews, Opiods, Race/Ethnic Diversity / 26.06.2018

MedicalResearch.com Interview with: 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. (more…)