Addiction, addiction-treatment, Opiods / 07.10.2024

The opioid crisis has left an indelible mark on society, affecting millions of individuals and families across the globe. While the physical and psychological tolls of opioid addiction are well-documented, another profound challenge often lurks in the shadows: the stigma surrounding opioid use disorder (OUD). Stigma, which manifests as judgment, discrimination, and negative perceptions, can be one of the most significant barriers to seeking treatment and achieving recovery. Overcoming this stigma is crucial for creating a supportive environment that encourages individuals to pursue and sustain their recovery journey.

Understanding Stigma in Opioid Addiction

Stigma can be defined as a set of negative beliefs or attitudes directed toward a particular group of people. In the context of opioid addiction, it often revolves around misconceptions that individuals suffering from OUD are morally flawed, weak-willed, or choosing to engage in substance use. These harmful stereotypes perpetuate a culture of shame and silence, discouraging people from seeking help for fear of being judged or ostracized. The stigma around opioid addiction is fueled by various factors. Historically, addiction was viewed as a moral failing or criminal behavior rather than a medical condition. This perception persists, even though extensive research has shown that opioid addiction is a chronic brain disease influenced by genetics, environment, and mental health. Additionally, sensationalized media coverage of drug-related crimes and overdose deaths further reinforces negative stereotypes, casting individuals with OUD in a criminalized light. (more…)
Addiction, Author Interviews, Opiods / 03.07.2024

MedicalResearch.com Interview with: Elena Stains Elena Stains Medical Student Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA   MedicalResearch.com: What is the background for this study? Response: Opioid use has been an increasing problem since the early 2000s in the United States (US) with a surge around 2010. Twenty-five percent of those having abused pain relievers in 2013 and 2014 got those drugs from physicians1. Physicians are particularly well-known for fueling the opioid crisis in Florida in the 2000s. Of the United States’ top 100 opioid prescribing physicians in 2010, an astounding 98 were prescribing in Florida2. Florida taking the main stage of the opioid crisis can be attributed to several factors, including ability of physicians to dispense opioids directly from their offices to patients (i.e. without pharmacists) and the presence of many infamous “pill mills” in the state3–6. The researchers at Geisinger Commonwealth School of Medicine aimed to analyze the amount of hydrocodone (including brand names of Vicodin and Lortab) and oxycodone (OxyContin and Percocet) distributed in Florida from 2006 to 2021, paying close attention to the peak year of the opioid crisis, 2010. The team used the Washington Post and the US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) databases to compile this compelling information. (more…)
Addiction, Author Interviews, Gastrointestinal Disease, Opiods / 03.02.2024

MedicalResearch.com Interview with: Joshua D. Madera, MD Department of Medical Education Geisinger Commonwealth School of Medicine Scranton PA What is the background for this study? Response: The US population continues to be drastically impacted by the opioid epidemic, with opioid-related deaths significantly increased compared to European countries. While prescription opioid distribution has gradually declined since its peak in 2011 [1], the rate of opioid prescriptions remains increased compared to 2000. Furthermore, there is considerable interstate variability in opioid distribution across the US. Identifying patterns in this variability may guide public health efforts to reduce opioid-related harms. Therefore, the primary objective of this study [2] from Geisinger Commonwealth School of Medicine was to explore variations in production quotas and state-level distribution of ten prescription opioids between 2010 and 2019. (more…)
Author Interviews, Opiods, Pain Research / 07.10.2023

MedicalResearch.com Interview with: Leana Pande Touro College of Osteopathic Medicine MedicalResearch.com: What is the background for this study? Response: Buprenorphine is not a new drug. It was developed in the 1960s with the intent of providing the benefits of opioids, without the addictive side effects. Unlike many prescription opioids,1 use of this Schedule III drug is increasing.2 It is often characterized as a partial agonist at the mu-opioid receptor (Figure-Right). Buprenorphine is available in many routes of administration and also with (brand name Suboxone) or without naloxone. Buprenorphine is a first-line pharmacotherapy for pregnant women with OUD.3 This review was completed in order for the benefits, and risks, of buprenorphine to be more fully appreciated and inform utilization for both opioid use disorder (OUD) and the treatment of pain. (more…)
Author Interviews / 13.04.2023

Medicalresearch.com Interview with: Edward Liu, BA Second year medical student Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA Medicalresearch.com: What is the background for this study? Response: The United States’ opioid epidemic continues to rise because of increasing opioid use and availability, contributing to prescription opioid misuse, mortality, and rising cost.1 The worsening health and economic impact of opioid use disorder in the US warrants further attention on the adverse effects and distribution pattern of commonly prescribed opioids like oxycodone (OxyContin), fentanyl (Duragesic), and morphine (MS-Contin). Using the Automated Reports and Consolidated Ordering System (ARCOS) database,2 a comprehensive data collection system of pharmacies and hospitals distribution of Schedule II and III controlled substances in the US with the FDA Adverse Event Reporting System (FAERS)3 has never been done before. This approach may provide a more complete picture of the risks of prescription opioids which can include drowsiness, nausea, and potentially fatal respiratory depression.  (more…)
Addiction, Author Interviews, COVID -19 Coronavirus, Opiods / 07.02.2023

MedicalResearch.com Interview with: Brian Piper, PhD MS Assistant Professor of Neuroscience Center for Pharmacy Innovation & Outcomes Geisinger School of Graduate Education MedicalResearch.com: What is the background for this study? Response: Methadone is an evidence-based treatment of opioid use disorder (OUD) and pain. However, this Schedule II opioid can also cause respiratory depression, which can result in lethality. The need for supervised administration is a long-standing source of frustration in the U.S. for many opioid use disorder (OUD) methadone patients. However, there was an accommodation in early 2020 thanks to the COVID-19 pandemic. This involved extending the take-home supply to up to 28-days for stable patients and 14 days for less stable patients. Prior research found that the implementation of supervised administration in England greatly reduced methadone overdoses [1]. The primary objective of this study [2] from Geisinger Commonwealth School of Medicine was to determine if the relaxation of the take-home rules resulted in more methadone overdoses. (more…)
Addiction, Author Interviews, Opiods / 29.12.2022

MedicalResearch.com Interview with: Alden MiletoAlden Mileto, BA Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, PA MedicalResearch.com: What is the background for this study? Response: The drug buprenorphine is a partial opioid agonist, originally developed in the 1960s as an alternative to the stronger full opioid mu receptor agonists like morphine. Today, the drug is sometimes used for pain, but is more often used as a treatment for Opioid Use Disorder (OUD). Since the 2002 federal approval for buprenorphine use in treatment of OUD, there has been an increase in buprenorphine prescription across all states. However recent studies have showed a disproportionate increase in buprenorphine prescriptions to rural/ less populated areas in comparison to urban/densely populated areas. The objective of this study [1] was to analyze the trends in buprenorphine distribution, overall and by three-digit zip codes, in Pennsylvania from 2010-2020. (more…)
Addiction, Author Interviews, JAMA, Mental Health Research, Race/Ethnic Diversity, University of Pennsylvania / 15.12.2022

MedicalResearch.com Interview with: Rebecca Arden Harris, MD, MSc Assistant Professor of Family Medicine and Community Health at the Hospital of the University of Pennsylvania Senior Fellow, Leonard Davis Institute of Health Economics Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: The impact of the nationwide overdose epidemic on Black women has received little attention from policy-makers, researchers, or the press. MedicalResearch.com: What are the main findings? Response:  Over the 7-year study period, preventable overdose deaths among Black women resulted in nearly 0.75 million years of life lost (YLL). Women aged 25-34 have suffered a rising proportion of this burden. (more…)
Author Interviews, JAMA, Opiods, University of Pennsylvania / 14.12.2021

MedicalResearch.com Interview with: Ashish Thakrar, MD Internal Medicine & Addiction Medicine National Clinician Scholars Program University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release. Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.  (more…)
Author Interviews, Opiods / 27.06.2021

http://www.indivior.com/This study and abstract presentation evaluated opioid withdrawal symptoms, safety and tolerability of initiating SUBLOCADE 300 mg one hour after administering a single dose of 4 mg transmucosal (sublingual) buprenorphine (BUP-TM). 26 participants received BUP-TM, 24 follow by  SUBLOCADE injection, and 20 completed the study. Participants were evaluated for opioid withdrawal symptoms as well as safety and tolerability of SUBLOCADE 300 mg. (more…)
Author Interviews, Opiods / 25.06.2021

MedicalResearch.com Interview with: John Boyle, BS Department of Medical Education Geisinger Commonwealth School of Medicine MedicalResearch.com: What is the background for this study? Response:  Meperidine is an opioid analgesic which has been approved for use since the 1940s for moderate to severe pain. During the 1990s, concerns about adverse effects (e.g., serotonin syndrome) and CYP450 drug interactions (e.g., 3A4 inhibition of other metabolism of other common medications) were raised and by 2003 it was removed from the WHO’s List of Essential Medicines. Despite increased awareness of adverse effects, meperidine is still used in the United States. It was the goal of this study1 to uncover pharmaepidemiological trends in its use. (more…)
Addiction, Author Interviews, Opiods / 24.06.2021

MedicalResearch.com: What is the background for this study? http://www.indivior.com/Response: Adults with moderate or severe opioid use disorder (OUD) were randomized to SUBLOCADE monthly injections or placebo and studied for 24 weeks. Participants receiving SUBLOCADE were given 2 monthly injections of 300 mg, followed by 4 monthly maintenance doses of 100 mg or 300 mg over the course of the study. (more…)
Author Interviews / 24.06.2021

http://www.indivior.com/ Background: To identify individual-level factors associated with COVID-19-related impacts on recovery in 216 participants originally enrolled in the SUBLOCADE® (buprenorphine extended-release) clinical program.  Within the fifteen-month study 216 participants, during the period of September 2021 through January 2021, were asked how the COVID-19 crisis affected their recovery from substance use, utilizing self-reported measures. (more…)
Author Interviews, Gastrointestinal Disease, Opiods / 24.05.2021

MedicalResearch.com Interview with: Frank Peacock, MD, FACEP, FACC Professor of Emergency Medicine, Associate Chair Research Director, Department of Emergency Medicine Baylor College of Medicine Houston, Texas MedicalResearch.com: What is the background for this study?  Response: Emergency medicine (EM) physicians, like myself, are always looking for ways to improve the patient experience. Often times, we will encounter a patient in the emergency department (ED) who is presenting with one of the most common side effects of opioids, which is opioid-induced constipation (OIC). OIC impacts 40-80% of patients on long-term opioid therapy[i],[ii] and may lead to emergency room visits which are associated with a significant burden on patients and the healthcare system. We wanted to compare the impact of treating OIC patients with FDA-approved prescription medications for OIC versus the impact of not treating OIC patients with an FDA-approved prescription medication for OIC in the ED setting to better understand the impact to overall ED costs and the length of stay for a hospitalized patient. (more…)
Author Interviews, BMJ, Cannabis, Opiods, Yale / 29.01.2021

MedicalResearch.com Interview with: Balázs Kovács PhD Associate Professor of Organizational Behavior Yale School of Management MedicalResearch.com: What is the background for this study? Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S.  We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates.   We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older.  The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs.  (more…)
Author Interviews, Opiods, Pancreatic, PLoS / 08.01.2021

MedicalResearch.com Interview with: Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center MedicalResearch.com: What is the background for this study? Response: This study builds on recent population based studies where opium use was found to be possible risk factor for pancreatic cancer. Although opium use is not a common recreational habit in the United States, opioid use has been rising remarkably over the past decade. In fact, opioid misuse and overdose have evolved into a public health crisis here with increasing opioid prescription use and abuse over the past decade. (more…)
Author Interviews, Gender Differences, Hepatitis - Liver Disease, Infections / 10.07.2020

MedicalResearch.com Interview with: Sabrina Annick Assoumou, MD, MPH Assistant Professor, Medicine Infectious Diseases at Boston Medical Center Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: During the opioid epidemic there has been an increase in the number of hepatitis C virus (HCV) infections due to transmission among persons who inject drugs (PWID). Federally qualified health centers (FQHC) provide care to an underserved and diverse patient population with a high proportion of both injection drug use and HCV. These health care facilities could provide opportunities to enhance HCV testing and treatment, especially at a time when recent data show that the United States is not on the list of high-income nations expected to achieve the World Health Organization’s goal of eliminating HCV by 2030. (more…)
Author Interviews, Cannabis, Opiods / 22.06.2020

MedicalResearch.com Interview with: Amalie K. Kropp Lopez, MS MD Candidate Geisinger Commonwealth School of Medicine Class of 2023 Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The opioid crisis is still affecting America, effecting millions of people from all walks of life. With the high risks of abuse and overtreatment with opioids, marijuana has been a newly reconsidered alterative for pain treatment. This study sought to quantify the changes in prescription opioid distribution using data reported by the Drug Enforcement Administration in Colorado after the legalization of recreational marijuana which gave the public increased access to its pain-relieving effects. (more…)
Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania / 20.06.2020

MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.   (more…)
Addiction, Author Interviews, Opiods / 24.04.2020

MedicalResearch.com Interview with: Dr. Walter Ling, MD Professor of Psychiatry Director of Integrated Substance Abuse Programs UCLA MedicalResearch.com: What is the background for this study? Response: RECOVER™ is a real-world, observational study looking at long-term recovery in a cohort of 533 people with moderate to severe opioid use disorder (OUD) following their transition from two Phase 3 clinical trials of SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use (CIII), into a real-world setting.1 The RECOVER study uses data from three main sources: self-administered assessments from enrolled individuals, urine drug screens (UDS) and data collected from several public sources. Recovery is examined over 24 months – the self-administered assessment and UDS results are completed by participants every three months over the course of this period. Results are being analyzed to understand the clinical, socio-economic and environmental factors associated with continuous effects of medications to treat OUD after a clinical trial.1.2 Studies such as RECOVER can help bridge the knowledge gap between the efficacy of medications as seen in the controlled clinical trial environment, and the use and effect of medications outside of a research setting and their long-term impact on patients’ health. A collaboration between Indivior and the Fralin Biomedical Institute at Virginia Tech Carilion will enable the next phase of the RECOVER study, which may provide further information to health care providers and policymakers on how to use medications to support their patients and how continuity of care can help break down barriers to evidence-based treatment.3  (more…)
Addiction, Author Interviews, JAMA, Opiods / 24.04.2020

MedicalResearch.com Interview with: Tami L. Mark, PhD Senior Director, Behavioral Health Financing and Quality Measurement RTI International  MedicalResearch.com: What is the background for this study? Response: There are effective medications to treat opioid use disorder. Federal and state policymakers have tried to improve access to these medications. However, medications to treat opioid use disorders are still often subject to prior authorization. Studies of other medications finds that prior authorization can reduce access. This study looked at whether removing prior authorization in Medicare Part D plans was associated with increases in the use of medications to treat opioid use disorder.  (more…)
Addiction, Annals Internal Medicine, Author Interviews, NIH, Opiods / 10.04.2020

MedicalResearch.com Interview with: Nora D. Volkow, MD Director of the National Institute on Drug Abuse National Institutes of Health Bethesda, MD MedicalResearch.com: What is the background for this study? How does vaping, hookah use, inhaled marijuana, smoking etc impact the risk of coronavirus infection?  Could these activities account for some the risks and infections in younger individuals?   Response: Apart from older age, having underlying cardiopulmonary conditions is a known risk factor for the worst clinical course and outcomes of COVID-19, and many of those conditions are known to be caused or exacerbated by smoking. While evidence continues to emerge about how smoking might interact with COVID-19, it is a reasonable assumption that smoking could contribute to risk even in younger individuals. We still don’t know how vaping—whether of nicotine or marijuana or just flavorings—contributes to the risk of infection or illness severity with the virus that causes COVID-19, but there are a number of reasons to be concerned. We have already seen lung illnesses caused by some vaping products, and evidence suggests vaping may disrupt lung epithelial cell function, which in turn increases viral susceptibility and may put individuals at increased risk of infection with the virus that causes COVID-19 or with more severe disease outcomes. Vaping is a relatively new technology, and as such, there are many unknowns. The rapid increases in vaping by young people over the last few years make this an area of concern, and thus an area where more research is urgently needed. (more…)
Author Interviews, Cost of Health Care, JAMA, Opiods / 01.04.2020

MedicalResearch.com Interview with: Aparna Soni PhD, Assistant Professor Department of Public Administration and Policy School of Public Affairs American University Washington, DC MedicalResearch.com: What is the background for this study? Response: The United States is in the midst of an opioid epidemic. Opioids are responsible for nearly 50,000 deaths per year and present a substantial financial burden on hospitals. The rate of opioids-related hospital events has tripled since 2005. We are particularly concerned about rising hospitalizations because they may stem from a lack of access to treatment for individuals with opioid use disorder. Medication-assisted treatment is effective in treating opioid use disorder but can be unaffordable for people without health insurance. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 23.03.2020

MedicalResearch.com Interview with: Leah Nelson, MD MS Addiction Medicine Fellow University of New Mexico MedicalResearch.com: What is the background for this study? Response: With the progression of the opioid epidemic over the past decade, more women of reproductive age are seeking treatment for addiction. Many more pregnant women are prescribed methadone and buprenorphine, two opioid medications that prevent relapse and overdose. Maternal use of mediations for opioid use disorder is recommended because it lowers the risk to the fetus from uncontrolled drug use and also allows the mother to engage with prenatal care and social work. Subsequently, the number of infants born after prenatal exposure to opioids is increasing. Several previous studies have shown measurable differences in the cognitive scores of children after prenatal opioid exposure. However, much of the previous work was done on convenience samples (easy to recruit rather than rigorously matched for comparability) and the demographic characteristics of both mothers and children in the exposed and unexposed groups varied widely on important factors such as maternal education, socioeconomics, employment, tobacco use, and infant gender. Each of these factors has been demonstrated to impact early childhood development in the absence of opioid exposure. (more…)
Author Interviews, Dental Research, JAMA, Pain Research / 19.03.2020

MedicalResearch.com Interview with: Dr. Romesh P. Nalliah BDS, MHCM Associate Dean for Patient Services Clinical Professor Institute for Healthcare Policy & Innovation Michigan Institute for Data Science Director, Synergy Program MedicalResearch.com: What is the background for this study? Response: We designed and conducted this study because there is a paucity of knowledge related to opioid prescribing for acute dental pain. (more…)
Author Interviews, Gender Differences, Heart Disease, Karolinski Institute, Opiods, PNAS / 18.03.2020

MedicalResearch.com Interview with: Mikko Myrskylä PhD Executive Director, Max Planck Institute for Demographic Research Professorial Research Fellow, London School of Economics Professor of Social Statistics University of Helsinki MedicalResearch.com: What is the background for this study? Response: Life expectancy in the U.S. increased at a phenomenal pace throughout the twentieth century, by nearly two years per decade. After 2010, however, U.S. life expectancy growth stalled and has most recently been declining. A critical question for American health policy is how to return U.S. life expectancy to its pre-2010 growth rate. Researchers and policy makers have focused on rising drug-related deaths in their search for the explanations for the stalling and declining life expectancy. (more…)
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…)
Author Interviews, Emergency Care, Opiods / 13.02.2020

MedicalResearch.com Interview with: Casey P. Balio, BA Department of Health Policy and Management Indiana University Richard M. Fairbanks School of Public Health Indianapolis, IN  MedicalResearch.com: What is the background for this study? Response:   There are numerous studies that estimate the prevalence of various opioid-related outcomes including emergency department (ED) encounters, hospitalizations, and overdoses as well as risk factors for these. However, there is limited evidence about repeated opioid-related encounters. This study uses health information exchange (HIE) data for four hospital systems in the state of Indiana from 2012-2017 to identify individual, prescription, encounter, and community characteristics that may be associated with having repeat opioid-related encounters. (more…)
Author Interviews, Dental Research, Opiods / 10.02.2020

MedicalResearch.com Interview with: Katie J. Suda, PharmD, MS Study Principal Investigator Professor of Medicine University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response:   Dentists are one of the top prescribers of opioids; prescribing 1 in 10 opioids in the United States. Dentists also prescribe a lot of opioids to adolescents and young adults which are a high risk population for substance misuse. This is especially true because studies have shown that non-opioid pain medications are similar or more effective for the treatment of oral pain. (more…)