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…)
Author Interviews, OBGYNE, Opiods, Pain Research / 28.01.2020

MedicalResearch.com Interview with: Dave Stack Chief Executive Officer and Chairman Pacira BioSciences  MedicalResearch.com: What is the background for this study? Response: Cesarean sections (C-sections) are one of the most common surgeries in the United States, and research shows many women experience moderate to severe pain after this procedure. When postsurgical pain is inadequately managed for new mothers, it can interfere with recovery, maternal-infant bonding and may even lead to postpartum depression. Additionally, prescribing data reveals that postsurgical opioid consumption poses a great risk to women. We recently completed a Phase 4 study of EXPAREL in C-section patients, and results revealed adding EXPAREL to bupivacaine transversus abdominis plane (TAP) blocks for C-section delivery provided significant reductions in opioids and pain scores. Results of that study provided the basis for the design of this next-generation study, which was created to be completely opioid-free in the EXPAREL arm. The study was a Phase 4 multicenter, active-controlled study conducted in 18 clinical sites in the United States, with 169 enrolled patients undergoing elective C-section. The enrolled C-section patients were randomized to receive either 150 mcg morphine spinal anesthesia plus a standard of care postoperative pain regimen, 50 mcg morphine spinal anesthesia plus EXPAREL TAP field block, or opioid-free spinal anesthesia plus EXPAREL TAP block. Patients in the EXPAREL arms received a protocol-defined non-opioid postsurgical pain management regimen including ketorolac, acetaminophen, and ibuprofen.  (more…)
Author Interviews, Opiods / 15.01.2020

MedicalResearch.com Interview with: Paul Christine, MD, PhD University of Michigan MedicalResearch.com: What is the background for this study? Response: In an effort to increase employment and "community engagement" among Medicaid enrollees, several states are seeking to implement new Medicaid work requirements. While many proposals make exemptions for individuals with substance use disorders, some require active treatment to qualify for an exemption and maintain Medicaid eligibility. Since many enrollees with substance use disorder would thus need to access treatment to maintain coverage, we sought to quantify the availability of treatment resources in states with and without Medicaid work requirements. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 06.01.2020

MedicalResearch.com Interview with: Rachel H. Alinsky, MD, MPH Adolescent Medicine and Addiction Medicine Fellow Division of General Pediatrics and Adolescent Medicine Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? Response: We know that over 4,000 adolescents and young adults between the ages of 15-24 are dying from an opioid overdose every year. Nonfatal opioid overdose has been identified as a potential touchpoint with the healthcare system when individuals can be drawn into treatment, yet very little is known about health care use following opioid overdose in youth. We were interested in figuring out the extent to which adolescents and young adults are receiving evidence-based treatment after an opioid overdose. (more…)
Addiction, Alcohol, Author Interviews, JAMA, Methamphetamine / 06.01.2020

MedicalResearch.com Interview with: Dr. Eric Dawson, PharmD Vice President, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: The US Centers for Disease Control and Prevention has projected a drop in the number of overdose deaths for 2018; the first reported decline since 1990. They cite a decrease in prescription opioid deaths as the leading contributor to the overall reduction, but caution that deaths associated with synthetic opioids, primarily fentanyl, as well as stimulants appear to be increasing. In 2019, we reported a 798% increase in urine drug test positivity rates for nonprescribed fentanyl among results positive for methamphetamine and an 1850% increase among results positive for cocaine. In an effort to conduct ongoing surveillance of the polysubstance use landscape and help characterize these evolving trends in a more timely manner, we examined our UDT data as close to real-time as possible to observe trends in positivity for methamphetamine, cocaine, and heroin, with and without illicit fentanyl. (more…)
Author Interviews, Opiods, Surgical Research / 30.12.2019

MedicalResearch.com Interview with: Sunil Agarwal, MD Michigan Opioid Prescribing Engagement Network Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: Excess opioid prescribing after surgery often leads to misuse and diversion into the community. To prevent excessive prescribing for acute pain, 31 states have implemented legislation that limits the duration of opioid prescriptions. Our study examined the effect of prescribing limits and postoperative opioid prescribing on surgical patients in Massachusetts and Connecticut, the first two states to implement opioid prescribing limits for acute pain after the CDC guidelines were released.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Mental Health Research, Opiods, Pediatrics / 23.12.2019

MedicalResearch.com Interview with: Megan Land, MD, PGY 6 Pediatric Critical Care Medicine Fellowship Emory University School of Medicine MedicalResearch.com: What is the background for this study?
  • Much of the research on the opioid crisis has focused on the impact to adults; however, children and adolescents in the US are also negatively affected by the opioid epidemic.
  • The percentage of children admitted to a pediatric intensive care unit increased over the study period as the clinical effects of the opioid ingestions increased in severity.
  • The primary intent of opioid ingestions was suspected suicide attempts in adolescents resulting in increasing admissions to a psychiatric hospital.
  • Opioids associated with the highest odds of needing an intervention in an intensive care unit were methadone, fentanyl, and heroin. 
(more…)