Prescription size predicts persistent opioid use after cardiothoracic surgery

Prescription size is associated with increased new persistent opioid use among patients after cardiothoracic surgery, according to a study published online Aug. 22 in the Annals of Thoracic Surgery.

Alexander A. Brescia, M.D., from the University of Michigan in Ann Arbor, and colleagues identified opioid-naive Medicare patients undergoing cardiothoracic surgery between 2009 and 2015. They selected 24,549 patients who filled an opioid prescription between 30 days before surgery and 14 days after discharge and with continuous Medicare enrollment. The correlation for prescription size with new persistent opioid use was examined.

The researchers found that new persistent use was 12.8 percent overall and decreased annually, from 17 to 7.1 percent from 2009 to 2015. Associations with new persistent use were seen for prescription size, preoperative prescription fills, black race, gastrointestinal complications, disability status, open lung resection, dual eligibility (Medicare and Medicaid), drug and substance abuse, female sex, tobacco use, high comorbidity, pain disorders, longer hospital stay, and younger age. Among patients prescribed more than 450 oral morphine equivalents, adjusted new persistent use was 19.6 percent compared with 10.4 percent among those prescribed 200 oral morphine equivalents or less.

Full story at Medical Xpress

Adults who mix cannabis with opioids for pain report higher anxiety, depression

A researcher from the University of Houston has found that adults who take prescription opioids for severe pain are more likely to have increased anxiety, depression and substance abuse issues if they also use marijuana.

“Given the fact that cannabis potentially has analgesic properties, some people are turning to it to potentially manage their pain,” Andrew Rogers, said in describing the work published in the Journal of Addiction Medicine. Rogers focuses on the intersection of chronic pain and opioid use, and identifying the underlying psychological mechanisms, such as anxiety sensitivity, emotion regulation, pain-related anxiety, of these relationships. Rogers is a doctoral student in clinical psychology who works in the UH Anxiety and Health Research Laboratory and its Substance Use Treatment Clinic.

Under the guidance of advisor Michael Zvolensky, Hugh Roy and Lillie Cranz Cullen Distinguished University Professor of psychology and director of the lab and clinic, Rogers surveyed 450 adults throughout the United States who had experienced moderate to severe pain for more than three months. The study revealed not only elevated anxiety and depression symptoms, but also tobacco, alcohol, cocaine and sedative use among those who added the cannabis, compared with those who used opioids alone. No increased pain reduction was reported.

Full story at Science Daily

Teens abusing painkillers are more likely to later use heroin

A USC study in the July 8 issue of JAMA Pediatrics shows that teens who use prescription opioids to get high are more likely to start using heroin by high school graduation.

“Prescription opioids and heroin activate the brain’s pleasure circuit in similar ways,” said senior author Adam Leventhal, a professor of preventive medicine and psychology and director of the USC Institute for Addiction Science at the Keck School of Medicine of USC. “Teens who enjoy the ‘high’ from prescription opioids could be more inclined to seek out other drugs that produce euphoria, including heroin.”

Leventhal said the study, conducted from 2013-2017, is the first to track prescription opioid and heroin use in a group of teens over time. In 2017, 9% of the nation’s 47,600 opioid overdose deaths occurred in people under the age of 25, according to data from the Centers for Disease Control and Prevention. In addition to overdose, health risks of heroin use are devastating and include severe addiction, hepatitis C, HIV and other infections.

Full story at Science Daily

15 Percent of Teens and Young Adults Prescribed Opioids During ER Visit

Almost 15 percent of teens and young adults are prescribed opioids during an emergency room visit, according to a new study.

In contrast, 3 percent of teens and young adults seen in an outpatient clinic receive an opioid prescription, NBC News reports.

“Adolescents and young adults are such a high-risk population for opioid misuse and future addiction,” said study author Joel Hudgins, M.D., of the Boston Children’s Hospital and Harvard Medical School. “We found the rates of opioid prescriptions were pretty high, at 15 percent, which is right in line with adult data.”

Full story at drugfree.org

NIH Solicits Research into Vaccines to Protect against Opioid Use

Opiate and opioid drugs killed 70,000 Americans1 in 2017, according to statistics from the Centers for Disease Control and Prevention, the latest grim note in a still growing addiction crisis and demanding a wide public health response. In May 2017, National Institutes of Health Director Francis Collins, MD, PhD, wrote that it was time for “all scientific hands on deck,” and highlighted the need to invest in new technologies beyond the standard toolset for reversing opioid drug overdoses and treating addiction.2

NIH has now announced new resources for research into one such alternate approach to combatting the opioid epidemic, immunotherapy.

A March 20 solicitation from the National Institute of Allergy and Infectious Diseases3(NIAID), announced the division’s search for outside researchers interested in developing vaccines to protect against heroin and the powerful synthetic opioid fentanyl, with goal of awarding multiple groups contracts, according to Kentner Singleton, PhD, program officer in the basic immunology branch of NIAID. He expects to announce the awards by August 2020. “Once we make the awards, we can facilitate collaborations between all the different groups so we can leverage the strength of one group to minimize the weakness of another group, so that we can have a cohesive consortium of investigators all working towards the same goal in unison and in parallel,” he says. “At the end of the day, the goal is to have a product that is brought into clinical trials.”

Full story at Genetic Engineering & Biotechnology News