MedicalResearch.com Interview with David A. Fiellin, M.D.
Professor of Medicine, Investigative Medicine and Public Health
Yale University School of Medicine
Medical Research: What are the main findings of the study?Dr. Fiellin:The main finding of our randomized clinical trial, conducted in primary care, was that among prescription opioid dependent patients, ongoing buprenorphine therapy resulted in better treatment retention and reduced illicit opioid use when compared to buprenorphine taper (detoxification).
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MedicalResearch.com Interview with: Nicholas B. King, PhD,
Biomedical Ethics Unit
McGill University
Montreal QC Canada
MedicalResearch: What are the main findings of the study?Dr. King: Unintentional overdoses from prescription opioid painkillers have been rising sharply in the US and Canada during the past two decades, killing thousands of people every year. A lot has been written about the subject in both popular media and scholarly literature, but we still don't have a very good idea of why this has happened. So we tried to objectively and systematically assess evidence for what has contributed to increasing mortality. We found the following:
(1) The evidence base for why mortality has increased is very thin, and more research is urgently required.
(2) We found evidence for at least 17 different causes of increased mortality. We found the most evidence for the following factors: dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like oxycodone and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic characteristics. We found little evidence that internet sales of pharmaceuticals and errors by doctors and patients--factors commonly cited in the media--have played a significant role.
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MedicalResearch.com Interview with: Marsha A. Raebel, PharmD, BCPS, FCCP
Investigator in Pharmacotherapy
Institute for Health Research
10065 E. Harvard Ave Suite 300
Denver, CO 80231.
MedicalResearch.com: What are the main findings of the study?
Answer: We found that in a group of patients who took chronic opioids for non-cancer pain and who underwent bariatric surgery there was greater chronic use of opioids after surgery compared with before surgery, findings that suggest the need for proactive management of chronic pain in these patients after surgery.
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Matthew Daubresse, MHS Research Data Analyst
Center for Drug Safety and Effectiveness
Johns Hopkins School of Public Health
615 N. Wolfe Street, Suite W6023
Baltimore, MD 21205
MedicalResearch.com: What are the main findings of the study?Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients. (more…)
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