Addiction, Author Interviews, Health Care Systems / 25.05.2024

MedicalResearch.com Interview with: [caption id="attachment_61782" align="alignleft" width="150"] Srivastava Kodavatiganti, MBS[/caption] Srivastava Kodavatiganti, MBS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: Prescription and illicit opioid misuse and overdoses have continued to escalate in the U.S. with annual overdoses exceeding 110,000[1]. There was a substantial rise from 2013 to 2022 in the number of opioid-related overdoses due to synthetic opioids [2]. Even nonfatal opioid-involved overdoses increased 4% quarterly between January 2018 and March 2022 as observed by encounters by emergency medical services [3]. Although the eastern U.S. has been particularly impacted by fatal overdoses, annual increases have increased as of last year in the western states including in Nevada (+27.9%), Washington (+36.9%), Oregon (+38.6%), and Alaska (+45.9%).  In contrast, other states have seen more modest changes (New Mexico = +1.3%) including decreases (South Dakota = -2.4%, Nebraska = -19.5%) [1]. These findings underscore the importance for understanding patterns in usage of prevention and treatment strategies. Naloxone is an opioid antagonist which can reverse the effects of an opioid overdose. This crucial lifesaving tool is administered as an injection or as a nasal spray. This study characterized the patterns of naloxone prescriptions in Medicaid patients from 2018 – 2021 and Medicare patients for 2019. State level differences were also quantified as the fold difference in prescribing between the highest and lowest states when correcting for the number of enrollees in each state.
Author Interviews, CDC, Opiods / 09.08.2019

MedicalResearch.com Interview with: [caption id="attachment_32722" align="alignleft" width="200"]Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC Dr. Gery Guy[/caption] 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.
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.
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.