Author Interviews, JAMA, Opiods, Primary Care / 30.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51102" align="alignleft" width="150"]Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota Dr. Neprash[/caption] Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Physicians play a pivotal role in the opioid epidemic and it's important to understand what factors that drive opioid prescribing. Variation in opioid prescribing across physicians has been well-documented, but there’s very little research on variation within physicians…which is surprising, given the widespread concern about time pressure and cognitive fatigue having a potentially detrimental effect on the quality of care provided by physicians.
Author Interviews, Education, JAMA, Opiods, Social Issues / 28.08.2019

MedicalResearch.com Interview with: [caption id="attachment_51077" align="alignleft" width="180"]Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel Dr. Sasson[/caption] Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes. Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups. 
Addiction, Alcohol, Author Interviews, Cannabis, Cocaine, Methamphetamine, Opiods / 21.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50985" align="alignleft" width="133"]Greg Midgette, PhD Assistant Professor Department of Criminology and Criminal Justice University of Maryland Dr. Midgette[/caption] Greg Midgette, PhD Assistant Professor Department of Criminology and Criminal Justice University of Maryland MedicalResearch.com: What is the background for this study? Response: This report estimates marijuana, cocaine, heroin, and methamphetamine use in the U.S. between 2006 and 2016 on three dimensions: the number of past-month chronic users per year, where "chronic" has previously been defined as consuming the drug at least four days in the past month, expenditure per drug among those users, and consumption of each drug. These measures are meant to aid the public and policy makers' understanding of changes in drug use, outcomes, and policies.  
Author Interviews, Opiods, Pediatrics, Surgical Research / 09.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50574" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan Dr. Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics and Communicable Diseases Susan B. Meister Child Health Evaluation and Research Center University of Michigan Ann Arbor, Michigan MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common surgeries performed in children. It is also one of the most common reasons children are prescribed opioids, even though randomized trials suggest that non-opioids like ibuprofen are equally effective for pain control. We were interested in understanding whether it is possible to safely reduce opioid exposure after tonsillectomy in children without increasing the risk of complications such as emergency department visits for uncontrolled throat pain, which could lead to dehydration.
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 / 08.08.2019

MedicalResearch.com Interview with: [caption id="attachment_43644" align="alignleft" width="200"]Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509 Dr. Piper[/caption] 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.
Addiction, Author Interviews, Occupational Health / 07.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50591" align="alignleft" width="200"]Devan Hawkins ScD Instructor of Public Health School of Arts and Sciences MCPHS University Dr. Hawkins[/caption] Devan Hawkins ScD Instructor of Public Health School of Arts and Sciences MCPHS University MedicalResearch.com: What is the background for this study? Response: As has been well established, mortality due to opioids has been increasing rapidly in recent years. We were interested in understanding whether mortality rates may be high among workers in certain industries and occupations for two primary reasons. First, if we were to find that mortality rates differed according to industry and/or occupation it might indicate that some aspect of these industries and occupations put workers at elevated risk for opioid-related overdose death. Second, interventions could be created to target these workers and hopefully prevent more deaths.
Author Interviews, Brigham & Women's - Harvard, Opiods / 06.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50561" align="alignleft" width="141"]Lauren A. Hoffman, Ph.D. Research Fellow Recovery Research Institute Center for Addiction Medicine Massachusetts General Hospital Harvard Medical School Dr. Hoffman[/caption] Lauren A. Hoffman, Ph.D. Research Fellow Recovery Research Institute Center for Addiction Medicine Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study?   Response: In 2017, an estimated 11.4 million Americans reported past-year opioid misuse1 and opioid-related overdose accounted for more than 47,000 deaths2. Prior research has helped further our understanding of the prevalence and consequences of opioid misuse, but we know substantially less about recovery from opioid use problems. Recovery-focused research conducted to-date has largely focused on alcohol use disorder, the most common type of substance use disorder. Characterizing recovery from opioid use problems and the pathways that individuals take to resolve such problems can ultimately help identify effective ways to address opioid misuse. Using data from the first national probability-based sample of US adults who have resolved a significant substance use problem (National Recovery Survey3), we provide the first national prevalence estimate of opioid recovery, and characterize treatment/recovery service use and psychological well-being in individuals who resolved a primary problem with opioids, relative to individuals who resolved a primary alcohol problem. We focused our cross-sectional investigation of service use and well-being on 2 time-horizons associated with continued vulnerability: <1 year since problem resolution (early-recovery) and 1 – 5 years since problem resolution (mid-recovery).
Author Interviews, Global Health, Opiods, Pain Research, Primary Care / 26.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50430" align="alignleft" width="133"]Marisha Burden, MD, FACP, SFHM Associate Professor of Medicine Division Head of Hospital Medicine University of Colorado School of Medicine Dr. Burden[/caption] Marisha Burden, MD, FACP, SFHM Associate Professor of Medicine Division Head of Hospital Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? Response: The United States has seen a marked increase in opioid prescribing since 2000 and while there has been a slight decline in prescribing since 2012, prescription rates for opioids still remain much higher than in the late 1990’s and are considerably higher when compared to other countries. The US continues to see opioid-related complications such as overdoses, hospitalizations, and deaths. Hospitalized patients frequently experience pain and opioid medications are often the mainstay for treatment of pain. Studies have suggested that receipt of opioid prescriptions at the time of hospital discharge may increase risk for long-term use.
Addiction, Author Interviews, Cannabis, Columbia, JAMA, Opiods / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_28490" align="alignleft" width="165"]Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032 Dr. Silvia Martins[/caption] Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: Prior studies have suggested t6hat medical marijuana legalization might play a role in decreasing opioid use. We aimed to test this hypothesis using individual level data on nonmedical use of prescription opioids and opioid use disorder  from the US National Survey on Drug Use and Health. 
Author Interviews, Pharmacology / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50290" align="alignleft" width="200"]Craig A. Pedersen, RPh, PhD, FAPhA Manager, Sterile Compounding and Investigational Drug Service, Pharmacy Clinical Professor University of Washington Dr. Pedersen[/caption] Craig A. Pedersen, RPh, PhD, FAPhA Manager, Sterile Compounding and Investigational Drug Service, Pharmacy Clinical Professor University of Washington MedicalResearch.com: What is the background for this study? Response: The ASHP national survey of pharmacy practice in hospitals originated with the Mirror to Hospital pharmacy, the first comprehensive, national audit of pharmaceutical services in hospitals, published in 1964.  Since that time, ASHP has conducted national surveys to document practices and technologies for managing the improving the medication-use system and the role that pharmacist play in that effort.  Beginning in 1998, the national survey became an annual project by ASHP.  This survey provides important information to pharmacists, managers, and external stakeholders to document the current state of pharmacy practice.
Author Interviews, JAMA, Opiods, Pediatrics, UCSD / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50286" align="alignleft" width="200"]Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC Dr. Kelley-Quon[/caption] Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use. This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.
Author Interviews, Lifestyle & Health, Mental Health Research, Opiods, University of Pennsylvania / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50259" align="alignleft" width="145"]Samuel Preston, Ph.D. Professor of Sociology University of Pennsylvania  Dr. Preston[/caption] Samuel Preston, Ph.D. Professor of Sociology University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Life expectancy at birth in the United States is low by international standards and has been declining in recent years. Our study aimed to identify how these trends differed by age, sex, cause of death, metropolitan status, and region. We found that, over the period 2009-11 to 2014-16, mortality rose at ages 25-44 in large metropolitan areas and their suburbs as well as in smaller metropolitan areas and non-metropolitan areas. Mortality at ages 45-64 also rose in all of these areas except large metropolitan areas. These were the ages responsible for declining life expectancy. Changes in life expectancy were particularly adverse for non-metropolitan areas and for women. The metropolitan distinctions in mortality changes were similar from region to region. The cause of death contributing most strongly to mortality declines was drug overdose for males and mental and nervous system disorders for women.
Author Interviews, Opiods, Orthopedics, Rheumatology / 09.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50189" align="alignleft" width="200"]Professor Martin Englund MD PhD Department of Orthopaedics Lund University Prof. Englund[/caption] Professor Martin Englund MD PhD Department of Orthopaedics Lund University  MedicalResearch.com: What is the background for this study? Response: Currently, there is lack of knowledge of opioid usage in osteoarthritis patients. Opioids are typically not recommended for the treatment of osteoarthritis pain. 
Author Interviews, Dental Research, Opiods, Pain Research / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50123" align="alignleft" width="200"]Dr. Stuart Lieblich, DMD Oral and maxillofacial surgeon  Avon, CT Dr. Lieblich[/caption] Dr. Stuart Lieblich, DMD Oral and maxillofacial surgeon  Avon, CT MedicalResearch.com: What is the background for this study? How does EXPAREL® differ from other pain medication for dental work or other short-term procedures? Response: This study analyzed the use of opioids and non-opioid options for postsurgical pain following third molar extraction (wisdom teeth removal). Our research team reviewed data from 600 patients who underwent third molar extraction, with 300 patients having received non-opioid option EXPAREL (bupivacaine liposome injectable suspension) and 300 patients that did not receive an infiltration of EXPAREL. The study aimed to show that reducing opioid prescriptions following this procedure may decrease opioid-related adverse events and the risk of opioid dependence.
Addiction, Author Interviews, JAMA, Opiods, University of Michigan / 30.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49992" align="alignleft" width="135"]Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy University of Michigan School of Public Health Dr. Haffajee[/caption] Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy umichsphumichsph MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence suggests that the availability of medications to treat opioid use disorder (OUD) has been slow to expand, particularly in rural areas, despite the efficacy and effectiveness of these medications in reducing overdose deaths and other adverse life outcomes. We were interested in understanding the characteristics of counties both with high need (as measured by above-national rates in opioid overdose deaths) AND low provider capacity to deliver medications to treat OUD in 2017. We found that such "opioid high-risk" counties were likely to be in the East North Central (e.g., Michigan, Ohio, Illinois, Indiana), South Atlantic (e.g., North Carolina, South Carolina, Virginia, West Virginia), and Mountain (e.g., New Mexico, Arizona, Nevada) regions. We also found that these opioid high-risk counties were more likely to have higher rates of unemployment and less likely to have fewer primary care clinicians or be micropolitan
Author Interviews, Opiods / 26.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49995" align="alignleft" width="200"]John Holaday, PhD Chairman and CEO of DisposeRx Dr. Holaday[/caption] John Holaday, PhD Chairman and CEO of DisposeRx Dr. Holaday discusses the recentannouncement that Walgreen's has added DisposeRx to its safe medication drop off kiosks.  MedicalResearch.com: What is the background for this study? How big is the problem of unused risky medications leftover after the need or indication period has passed? Response: Keeping leftover medications in the home significantly increases the risk of accidental poisonings as well as diversion, which can lead to addiction, overdoses and death. According to the Centers for Disease Control & Prevention (CDC), accidental medicine poisonings send nearly 60,000 children under 5 years old to emergency rooms annually. And, a study by the National Institute on Drug Abuse found that the first opioid used by 70% of individuals with heroin-use disorder was a prescription pain medication, often remaining in their medicine cabinet well after the pain subsided and then a remaining temptation for abuse. This is a pervasive problem across the country. In an independent survey DisposeRx sponsored, it was found that 4 out of 10 Americans are keeping leftover prescriptions—including opioids – in their medicine cabinets. Other results of the survey include: 62% of respondents who said they stored medications in case a condition returns; and 37% said they save prescription drugs in case a friend or family member needs them. Walgreens sees value in adding DisposeRx at-home solution to its comprehensive medication management and opioid stewardship programs These consumers need to be educated about all the potential harm resulting from saving leftover medications. Leading pharmacy chains such as Walgreens are committed, as responsible corporate citizens, to making DisposeRx available upon request for their customers and to educate them about its use in getting rid of leftover drugs before they cause harm. Walgreens sees value in adding DisposeRx at-home solution to its comprehensive medication management and opioid stewardship programs as an additional method to reduce risks and exposure.
Author Interviews, Opiods, Pediatrics / 25.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49907" align="alignleft" width="144"]Jennifer N. Cooper, PhD Principal Investigator Center for Innovation in Pediatric Practice The Research Institute at Nationwide Children's Hospital, Research Assistant Professor of Pediatrics The Ohio State University College of Medicine Dr. Cooper[/caption] Jennifer N. Cooper, PhD Principal Investigator Center for Innovation in Pediatric Practice The Research Institute at Nationwide Children's Hospital, Research Assistant Professor of Pediatrics The Ohio State University College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although postoperative opioid prescribing has decreased in recent years due to an increased awareness of the risks of excess opioid prescribing, many patients are still prescribed more opioids than they need after surgery. In the pediatric population, most opioids are prescribed after surgical and dental procedures. Although patients are often prescribed more opioids than they need after surgery, previous studies have found that excess opioids left unused after surgery are rarely properly disposed. These leftover opioids can be misused or accidentally ingested by young children. Previous studies have targeted the problem of non-disposal of opioids leftover after surgery by providing patients and families with educational materials describing proper methods of postoperative opioid disposal. However, these studies have had mixed results with some finding an increase in opioid disposal after education and others finding no effect of such education. In addition to education, another means of facilitating postoperative opioid disposal is the provision of drug disposal products. These products contain compounds that irreversible adsorb or oxidize medications, enabling them to be safely disposed of in the home garbage.
Annals Internal Medicine, Author Interviews, Opiods, University of Pittsburgh / 18.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49771" align="alignleft" width="130"]Dr. Julie Donohue, Ph.D. Professor, Department of Health Policy and Management Vice Chair for Research Graduate School of Public Health University of Pittsburgh Dr. Donohue[/caption] Dr. Julie Donohue, Ph.D. Professor, Department of Health Policy and Management Vice Chair for Research Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: The opioid epidemic is exacting a significant burden on families, communities and health systems across the U.S. Prescription and illicit opioids are responsible for the highest drug overdose mortality rates ever recorded. We know from previous studies that some surgical and medical patients who fill opioid prescriptions immediately after leaving the hospital go on to have chronic opioid use. Until our study, however, little was known about how and if those patients were being introduced to the opioids while in the hospital. My colleagues and I reviewed the electronic health records of 191,249 hospital admissions of patients who had not been prescribed opioids in the prior year and were admitted to a community or academic hospital in Pennsylvania between 2010 and 2014. Opioids were prescribed in 48% of the admissions, with those patients being given opioids for a little more than two-thirds of their hospital stay, on average.
Author Interviews, Opiods, Pain Research, Sleep Disorders / 05.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49610" align="alignleft" width="133"]Dr-Nicole Tang Dr. Tang[/caption] Nicole Tang, D.Phil, C.Psychol (Reader) Department of Psychology Warwick Sleep and Pain Lab University of Warwick MedicalResearch.com: What is the background for this study? What are the main findings? Response: Current guidelines recommend non-opioid therapy as the preferred treatment of chronic non-malignant (CNP) pain, with opioids reserved to situations “when benefits for pain and function are expected to outweigh risks” [1,10]. Whilst the effectiveness of opioid therapy is usually measured in terms of pain outcomes, less is known about its effect on day-to-day functions. A particular function of concern to patients with chronic non-malignant pain is the ability to get a good night's sleep. The current systematic review has identified a set of papers with relevant outcomes regarding the effect of opioid therapy on sleep quality and sleep architecture in CNP patients. It extends our understanding from the drug's respiratory depression effect in healthy individuals to the potential risks and utility of opioid therapy for chronic non-malignant pain patients with sleep disturbances. Whilst the narrative synthesis and the exploratory meta-analysis of a subset of data both suggest that the use of opioid therapy is associated with an overall report of sleep quality improvement, such an improvement is not consistently replicated across studies or substantiated by improvements in sleep parameters linked to deeper and better-sleep quality. Moreover, the improvement may be accompanied by undesirable side effects and increased daytime sleepiness that contradict with the very idea of improved sleep quality. We are also painfully aware of the methodological limitations of the studies reviewed; their exposure to different sources of biases has heightened the risk of result inflation. To many patients with chronic non-malignant pain, improved sleep is a top priority when evaluating the performance of a new drug and non-drug intervention. If we were to advance our current understanding of the opioid-sleep relationship, future trials need to be designed with this interdisciplinary question in mind such that validated measures of sleep can be incorporated as an outcome measure alongside pain.
Anesthesiology, Author Interviews, Duke, OBGYNE, Opiods, Pain Research, Surgical Research / 29.05.2019

MedicalResearch.com Interview with: Ashraf Habib, MDChief of the Division of Women’s Anesthesia and Professor of AnesthesiologyDuke University Ashraf Habib, MD Chief of the Division of Women’s Anesthesia Professor of Anesthesiology Duke University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a multicenter study conducted in 13 clinical sites in the United States enrolling patients undergoing elective Cesarean-section and receiving spinal anesthesia. 186 patients were enrolled and randomized to receive EXPAREL, a long-acting, non-opioid option to manage postsurgical pain, administered via transversus abdominis plane (TAP) field block, mixed with plain bupivacaine or TAP block with plain bupivacaine alone. A TAP block numbs the nerves that supply the abdominal wall. We presented the data at the 51st Annual Meeting of the Society of Obstetric Anesthesia and Perinatology (SOAP) in Phoenix, AZ. We aimed to collect clinical evidence that a multimodal postsurgical pain regimen using a TAP block with EXPAREL (bupivacaine liposome injectable suspension) together with regularly scheduled acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) could reduce opioid consumption more so than a standard multimodal pain control approach that combines TAP block with standard bupivacaine, regularly scheduled acetaminophen, and NSAIDs.
Author Interviews, Brigham & Women's - Harvard, Opiods, Orthopedics, Pain Research, Surgical Research / 16.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49201" align="alignleft" width="135"]Marilyn M. Heng, MD, MPH, FRCSCOrthopaedic Trauma SurgeonAssistant Professor of Orthopaedic SurgeryHarvard Medical School Dr. Heng[/caption] Marilyn M. Heng, MD, MPH, FRCSC Orthopaedic Trauma Surgeon Assistant Professor of Orthopaedic Surgery Harvard Medical School  MedicalResearch.com: What is the background for this study?   Response: The ultimate background for this study does come from the larger context of the opioid epidemic that is seen worldwide but particularly in North America. Orthopaedic surgeons should take responsibility as being among the top prescribers of opioids. The more specific background that led to this specific study was the observation that several colleagues would insist that a drug like hydromorphone was so dangerous that they would not prescribe it but seemed okay prescribing large amounts of oxycodone.  It seemed like an urban myth that the type of opioid was what made it dangerous, so that led us to do the study to see if there was evidence for that. 
Author Interviews, JAMA, Opiods, Primary Care, University of Michigan / 11.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49122" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.
Author Interviews, Opiods, Pain Research / 06.05.2019

MedicalResearch.com Interview with: [caption id="attachment_48970" align="alignleft" width="200"]Jan Klimas, PhD, MScSenior Postdoctoral FellowBC Centre on Substance Use (BCCSU) Vancouver, BC Dr. Klimas[/caption] Jan Klimas, PhD, MSc Senior Postdoctoral Fellow BC Centre on Substance Use (BCCSU) Vancouver, BC MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Some individuals prescribed opioid analgesic medications for pain develop opioid use disorder. So, much research has been conducted to develop strategies to identify patients who can be safely prescribed opioid analgesics. However, this research has not been critically reviewed through rigorous quality assessment. This study therefore sought to identify signs, symptoms & screening tools to identify patients with pain who can be safely prescribed opioids 
Author Interviews, CDC, Emergency Care, Occupational Health, Opiods / 02.05.2019

MedicalResearch.com Interview with: Sophia K. Chiu, MD Epidemic Intelligence Service, CDC Division of Surveillance, Hazard Evaluations, and Field Studies National Institute for Occupational Safety and Health CDC  MedicalResearch.com: What is the background for this study? Response:  Responders across the United States are reporting work-related health effects during incidents in which suspected opioids (including fentanyl) and other illicit drugs such as cocaine, methamphetamine, cathinones, and synthetic cannabinoids are present, often as a mixture. These health effects have interfered with responders’ ability to perform their job duties. Since 2018, a number of responder organizations have requested that NIOSH investigate the health effects experienced by emergency responders during these response incidents. These organizations are looking for ways to protect their responders and prevent the symptoms responders have reported experiencing, so that they can in turn better serve the public. NIOSH’s goal is to increase awareness among responders of how they can remain safe while providing the care the public needs.
Author Interviews, JAMA, Opiods / 28.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48846" align="alignleft" width="200"]Leah LaRue, PharmD, PMPAssociate Director, Clinical AffairsMillennium Health Dr. LaRue[/caption] Leah LaRue, PharmD, PMP Associate Director, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl. To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time.
Author Interviews, Cost of Health Care, Opiods / 16.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48576" align="alignleft" width="92"]Joel Segel, Ph.D.Assistant ProfessorDepartment of Health Policy and AdministrationThe Pennsylvania State UniversityUniversity Park, PA 16802 Dr. Segel[/caption] Joel E. Segel, Ph.D. Assistant Professor Department of Health Policy and Administration The Pennsylvania State University University Park, PA 16802 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Earlier research has shown that the societal costs of opioid misuse are high, including the impact on employment. However, previous work to understand the costs of opioid misuse borne by state and federal governments has largely focused on medical costs such as care related to overdoses and the cost of treating opioid use disorder. Our main findings are that when individuals who misuse opioids are unable to work, state and federal governments may bear significant costs in the form of lost income and sales tax revenue. We estimate that between 2000 and 2016, state governments lost $11.8 billion in tax revenue and the federal government lost $26.0 billion. 
Author Interviews, Opiods / 09.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48417" align="alignleft" width="180"]Joanne Spetz, PhDProfessorPhilip R. Lee Institute for Health Policy StudiesSan Francisco, CA 94143-0936 Dr. Spetz[/caption] 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. 
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA / 28.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48205" align="alignleft" width="125"]Isaac Chua MDInstructor of Medicine at Harvard Medical SchoolBoston, Massachusetts Dr. Chua[/caption] Isaac Chua MD Instructor of Medicine at Harvard Medical School Boston, Massachusetts  MedicalResearch.com: What is the background for this study?   Response: Opioids are routinely prescribed for cancer-related pain, but little is known about the prevalence of opioid-related hospitalizations for patients with cancer. Although opioid addiction among patients with cancer is estimated to be as high as 7.7%, our understanding of opioid misuse is based on small, preliminary studies. In light of the wider opioid epidemic, oncologists and palliative care clinicians frequently balance providing patients with legitimate access to opioids while protecting them and the general public from the risks of prescribing these medications.