Study Uses Medicare Claims to Link Physician Beliefs About Benzodiazipene Safety and Prescription Fills Interview with:
Donovan Maust, M.D., M.S

Associate Professor, Psychiatry
University of Michigan Medical School What is the background for this study?

Response: Benzodiazepine prescribing has been quite persistent and even increasing among middle aged adults even as we’ve learned more about the associated harms.

To develop effective interventions to address prescribing, it would be helpful to understand how clinicians make their prescribing decisions. But then it is a problem if you ask clinicians about a particular behavior (e.g., prescribing) but don’t have actual objective data about their prescribing behavior.

Dentists Reports Patients Coming to Appointments High on Marijuana

Survey from the American Dental Association What is the background for this study? What are the main findings?

Response: Each year, the ADA surveys dentists and consumers around emerging issues or trends in healthcare. As legalization and use of marijuana continues to increase, oral health issues around marijuana use are beginning to emerge. This, combined with a lack of awareness and understanding of the potential adverse health effects of routine marijuana use, was the reason for including it in our survey work.

cannabis-marijuana What should readers take away from your report?

Response: Because legalized marijuana, whether personal or medicinal, is still relatively new, people may not be aware of the effects marijuana can have on oral health and dental visits. Readers should be aware that marijuana use can effect oral health in general as well as limit the care delivered at dental visits if used before an appointment.

Dentists and patients should also take away the importance of open conversation about marijuana use during dental visits. Health history updates can be a natural place to start an open dialogue.

Study Assesses Cannabis Therapies for Low Back Pain Relief Interview with:
Dror Robinson, M.D., Ph.D
Department of Orthopedics, Hasharon Hospital
Rabin Medical Center
Petah Tikva, Israel What is the background for this study? What are the main findings?


Response: The background of the study is my concern as an orthopedic surgeon, regarding the optimal pain relief therapy for low back pain.  I am interested in particular with patients who failed prior interventions, either pharmaceutical or surgical.  These patients are an unfortunately growing group of patients without a good therapeutic option.  Most of them become chronic pain patients with the resultant multi-domain dysfunction both physical and mental. 

Cannabis appears to be able to allow both mental recovery and physical function recovery in such patients.  The main findings in the current study is that in patients with chronic pain due to low back pathology inhaled high-THC cannabis therapy is superior to extract high-CBD cannabis therapy.  Maximal therapeutic effect is reached after 18 months of therapy and appears to require high THC concentrations as compared with more balanced THC:CBD chemovars.

Pain Relief from Osteoarthritis Achieved Through Digital and Face-to-Face Interventions Interview with:
Thérése Jönsson, PT, PhD
Research group, Sport Sciences
Department of Health Sciences
Lund University

Dr. Jönsson What is the background for this study?

Response: Osteoarthritis (OA) is the most common joint disease and affects more than 300 million people worldwide. Exercise combined with patient education and weight control, if needed is the first-line treatment for OA. Traditionally, first-line treatment has been provided as a face-to-face intervention, requiring the patient to physically visit a primary care clinic or similar.

To increase access to healthcare for the wider community, digital health care interventions are recommended by the World Health Organization to complement traditional care. Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities.

Chronic Pain Linked to Later Life Pessimism and Joblessness Interview with:
Alex Bryson PhD
Professor of Quantitative Social Science
UCL Social Research Institute
University College London  London

Prof. Bryson What is the background for this study?

Response: The authors were concerned to know more about both the incidence of chronic pain and its implications for health, wellbeing and labour market prospects later in life.  So we turned to a birth cohort study (The National Child Development Study) tracking all those born in Britain in a single week in 1958 through to age 62 to take a life-course approach.

Pain Stimulates Protective Mucus Secretion in GI Tract Interview with:
Isaac M. Chiu PhD
Associate Professor, Department of Immunology
Harvard Medical School
Boston, MA 02115 What is the background for this study?

Response: The gut is densely innervated by pain fibers and we know that pain is associated with gut-related diseases. However, it is not so clear how pain fibers talk to the gut lining and barrier. We were interested to see that pain fibers were very close by the epithelial cells that line the gut, and in particular the goblet cells that produce mucus. We were wondering if mucus could be regulated by pain. Mucus is a key protective barrier that keeps our gut healthy by keeping harmful substances as well as bacteria away from the gut wall.

Home Sensors Developed for Overnight Monitoring in Opioid Use Disorder Interview with:
Marian Wilson, PhD, MPH, RN, PMGT-BC 
Associate Professor
Assistant Editor, Pain Management Nursing
Washington State University College of Nursing

Dr. Wilson What is the background for this study?

Response: People with opioid use disorder often experience withdrawal symptoms that can interfere with recovery success. Our team was interested in whether noninvasive home sensors could provide accurate information to detect overnight restlessness and sleep problems that could indicate opioid withdrawal for adults prescribed methadone for opioid use disorder.

Use of Medical Cannabis Can Expose Patients to Harmful Contaminants 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 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.

Over Half of Older Adults Use OTC Pain Relievers for Joint Pain Relief 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 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. 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.

Cannabis During Pregnancy May Have Long Term Mental Health Consequences for Children

Dr. Baranger Interview with:

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 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.