PainRelief.com Interview with: Maxwell C. K. Leung, Ph.D. Assistant Professor Systems Biology and Toxicology New College of Interdisciplinary Arts and Sciences Arizona State University, West Campus
PainRelief.com: What is the background for this study?
Response: Over 200 million Americans currently have legal access to medical cannabis, recreational cannabis, or both. Yet, cannabis remains an illicit Schedule 1 substance at the federal level. This limits the efforts of several federal agencies to regulate harmful contaminants – including pesticides, heavy metals, solvents, microbes, and fungal toxins – in cannabis.
PainRelief.com Interview with: Beth Wallace, M.D. M.Sc Associate Investigator, Center for Clinical Management Research Staff Physician, Rheumatology VA Ann Arbor Healthcare System Assistant Professor, Division of Rheumatology University of Michigan
Dr. Wallace
PainRelief.com: What is the background for this study?
Response: Arthritis and joint pain are common among older adults. We used data from the University of Michigan National Poll on Healthy Aging to understand how a national sample of older adults experiences and manages joint pain.
PainRelief.com: What are the main findings?
Response: Seventy percent of adults aged 50-80 report that they have joint pain. Three in five have a diagnosis of arthritis, including 30% who have a diagnosis of osteoarthritis (also called “wear and tear” or “bone on bone” arthritis).
Of those with joint pain, half said that it limited their usual activities, but about three in four said that they saw arthritis and joint pain as a normal part of aging that they could manage on their own.
More than half of all adults use over-the-counter pain relievers like non-steroidal anti-inflammatory drugs (Advil, Motrin, Aleve) for joint pain. One in ten used a prescription oral steroid, like prednisone. This is important because these medications can cause or worsen health conditions common in older people, such as high blood pressure and heart disease. More than a quarter of adults who used oral steroids for joint pain did not remember discussing the risks of these medications with their health care provider.
Ninety percent of those with joint pain used non-medication treatments, like exercise, massage, and splints and braces, to manage their symptoms. Most people who used these treatments found them to be very helpful.
PainRelief.com Interview with: Wendy C. King, PhD Epidemiology Data Center School of Public Health University of Pittsburgh Pittsburgh, PA
Dr. King
PainRelief.com: What is the background for this study?
Response: Previous studies had provided evidence that bariatric surgical procedures are associated with improvements in pain, physical function and work productivity. However, most prior studies only followed participants 1-2 years, at which point participants were at the peak of their weight loss.
Among a large cohort of US adults, we wanted to evaluate how much initial improvements in pain, physical function and work productivity declined during long-term follow-up, when some degree of weight regain is not uncommon. We limited our study to adults who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), the two most common bariatric surgical procedures done today.
David A. A. Baranger, PhD Department of Psychological and Brain Sciences
Dr. Brogdan
Ryan Bogdan, PhD Associate Professor of Psychological & Brain Sciences Department of Psychiatry Washington University in St Louis St Louis, Missouri
PainRelief.com: What is the background for this study? What are the main findings?
David Baranger: Prenatal cannabis use is increasing in the United States. Prior work from our group found that prenatal cannabis exposure, particularly when it occurred after mothers learned they were pregnant, was associated with worse mental health outcomes in children aged 9-10.
In this study we followed up with this same group of children, who are now as old as 12, to ask whether anything has changed. Have they improved, or gotten worse? To our surprise, we found that children with prenatal cannabis exposure still had worse mental health outcomes – things had not gotten better, nor had they gotten worse.
Sarah Stith PhD Assistant Professor of Economics University of New Mexico
Dr. Stith
PainRelief.com: What is the background for this study?
Response:We studied how the stock market returns of publicly traded pharmaceutical firms responded to medical and recreational cannabis legalization events. Our results show that stock market returns were 1.5-2% lower at 10 days following a single cannabis legalization event and that the annual sales implications from this reduction were in the billions.
PainRelief.com Interview with: Shane Cronin PhD Staff scientist in the Penninger lab at IMBA Former postdoc in the Woolf lab at Harvard Medical School and F.M. Kirby Neurobiology Center, Boston Children’s Hospital
PainRelief.com: What is the background for this study?
Response: We and others have shown that the BH4 (tetrahydrobiopterin) metabolic pathway is upregulated in injured nerves and contributes to pain hypersensitivity in various rodent models of chronic pain. BH4 is a metabolite and an important cofactor for the aromatic amino acid hydroxylases for the production of dopamine and serotonin for example. it has also been previously shown to exert cofactor independent roles such as ROS scavenging and Fe3+ reduction in maintaining mitochondrial health.
Moreover, gene association studies in humans have also demonstrated a correlation between low levels of the bottleneck enzyme for BH4 biosynthesis, GCH1, and reduced severity of chronic pain (nicely reviewed here: PMID: 28667479). We believe that targeting this increase of BH4 after nerve injury is a viable strategy to reduce the ensuing pain. So, we set up a screening platform using transgenic mouse DRG neurons in which GFP is controlled by the Gch1 promoter – when Gch1 is turned on (as is in the case of nerve injury), GFP gets turned on as a proxy for BH4 activation and ‘in vitro cellular pain’.
PainRelief.com Interview with: Dr. Tongil “TI” Kim, Assistant professor of marketing Naveen Jindal School of Management The University of Texas at Dallas (abbreviated UT Dallas)
PainRelief.com: What is the background for this study? What are the main findings?
Response: We examine the early deployment of mandated prescription drug monitoring program (PDMP) use (2006-2015) in the U.S., when 19 states mandated PDMP use. We find 6.37 more heroin-related deaths per million population per year—a 50.1% increase—following PDMP mandates compared to states that did not.
PainRelief.com Interview with: Stephanie Zellers Psychology University of Minnesota
PainRelief.com: What is the background for this study?
Response: Many cross-sectional studies have found increases in adult cannabis consumption after the passage of recreational cannabis legalization. These studies, in large population samples across the USA, provide information about possible effects of recreational legalization in representative samples, but cannot draw causally informative conclusions. There are many confounders, like genes, pre-existing differences, and secular trends, that could be alternative explanations for any effects identified.
We utilized a longitudinal twin study to rule out many additional unmeasured confounds shared within families, like genes and aspects of the rearing environment. Importantly, we have data on identical twins before and after recreational legalization, and we have pairs where one twin lives in a recreationally legal state while their co-twin does not. By comparing these twins, we can estimate the causal impact of recreational legalization, after controlling for unmeasured confounds shared by individuals in a family.
PainRelief.com: What is the background for this study? What are the main findings?
Response: As the use of cannabis for therapeutic purposes (often called ‘medical marijuana’) has grown, my colleague, Dr. Mary Bridgeman, and I became interested in exploring more about the population who use marijuana for therapeutic purposes. My research has historically focused on tobacco use and so that was one issue in particular that we focused on in this study.
We know that individuals who use cannabis, in general, are more likely to smoke, but we did not know if that was also true for those who used cannabis for therapeutic purposes.
PainRelief.com Interview with: Evan D. Peet, PhDProfessor Pardee RAND Graduate School
Dr. Peet
PainRelief.com: What is the background for this study?
Response: This study is part of a broader CDC funded project looking at access to naloxone and naloxone’s impacts on opioid-related overdose deaths. There have been increasing efforts to expand access to naloxone, with a variety of different laws being passed by states across the nation. But one part of access that has been understudied is the cost borne by patients.
High out-of-pocket costs may act as a barrier to this life-saving drug, so in this study we look at trends in out-of-pocket costs of naloxone and how they vary by payor and drug brand.
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