Use of Medical Cannabis Can Expose Patients to Harmful Contaminants

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.

University of Pittsburgh Study Finds Durable Pain Relief in Obese Patients Following Bariatric Surgery

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.

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

David-Baranger
Dr. Baranger

PainRelief.com 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



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.  

Repurposing Old Drugs May Lead to Chronic Pain Relief Medications

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’. 

States with Mandated Prescription Monitoring Programs Had Marked Increase in Heroin-Related Deaths

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.

Twin Study Find Cannabis Legalization Linked to Increased Marijuana Use in Adults

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.

Medical Marijuana Users Also More Likely to Also Use Tobacco

PainRelief.com Interview with:
Marc L. Steinberg, Ph.D.,
Professor, Department of Psychiatry, Rutgers RWJMS
Director, Doctoral Psychology Internship Program, Rutgers UBHC – Piscataway
Research Lab Website: Tobacco Research & Intervention Lab

Dr. Steinberg

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.  

Uninsured Pay Higher Out-of-Pocket Costs for Opioid Antidote Naloxone

PainRelief.com Interview with:
Evan D. Peet, PhD Professor
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.

Use of Nitrous Oxide for Pain Relief During Labor and Delivery Reevaluated in Light of Greenhouse Gas Emissions Concerns

PainRelief.com Interview with:
Prof. Bernd Froessler MD, PhD, FANZCA
Department of Anaesthesia
Lyell McEwin Hospital
Clinical Professor
Discipline of Acute Care Medicine
University of Adelaide

Prof. Bernd Froessler

PainRelief.com: What is the background for this study?

Response: Nitrous oxide (N2O) is commonly used in Australia for labour analgesia. Its use in labour is potentially associated with aerosol generation. During the first wave of the COVID-19 pandemic of 2020, nitrous oxide was suspended on many birthing units to reduce the risk of transmission. This 19-day sudden disruption period at our hospital provided a ‘natural experiment’ and opportunity to re-evaluate the role and need for N2O, with the aim to determine the impact of withdrawing N2O on labour analgesia use and maternal and neonatal outcomes.

Posture and Pill Shape Affect How Quickly Pain Relief Medications Dissolve and Work

PainRelief.com Interview with:
Rajat Mittal Ph.D.
Professor of Mechanical Engineering 
Professor of Medicine (Secondary Appt.)
Johns Hopkins University

PainRelief.com: What is the background for this study?
What are the main findings?

Response: I have worked on the biomechanics and fluid dynamics associated with many different organ systems in the past including the cardiovascular system, the larynx and cerebral hemodynamics, and there is very extensive research being done on these organ systems by research groups all over the world. However, as I was looking to initiate research in some new directions, the implications of stomach biomechanics on important conditions such as diabetes, obesity, gastroparesis, malnutrition and GI infections etc. became apparent to me.

Furthermore, it was clear that bioengineering research in this arena lags other more established areas such as cardiovascular flows by at least 25 years and there seemed to be great opportunity to do impactful work. We focused on drug dissolution for our first project because it offered  “low-hanging fruit” in terms of new and impactful insights.