Penn State aims to boost people, organizations fighting addiction with new center in central Pa.Published on: August 27, 2019
Penn State Harrisburg officially dedicated a new outreach center intended to serve as a “concierge” for people seeking help for addiction, and for community organizations looking to grow their capacity to address addiction.
The Douglas W. Pollock Center for Addiction Outreach and Research is based at Penn State’s campus near Middletown. It was created with a $2.5 million grant from a foundation established on behalf of Pollock, a Cumberland County native and Penn State graduate who died in 2016 at 64. Pollock had battled substance abuse and mental illness.
The center will have a special focus on helping military veterans. But its services will be available to anyone, and it will also have a major focus on helping organizations, according to Weston Kensinger, the director.
The center won’t provide addiction treatment. Rather, it will assess needs of people seeking treatment and direct them to a local organization or program that meets their needs. If the person faces other obstacles, the center will try to find programs or resources to overcome them.
“It’s really kind of playing matchmaker,” says Weston Kensinger, the director of the center.
With organizations, the center will help them find things like expertise and grants to help them grow and further their mission. Another role will be to tap research and information within Penn State University and push it out to local organizations. That includes making sure they have access to the latest evidence-based approaches to treating addiction, and helping them build programs based on the best science and information.
Still another role will be to coordinate the efforts of entities and programs from the federal level to state government to local grassroots.
The ongoing opioid addiction crisis was a factor in creating the center. However, Mark Kiselica, director of the school of behavioral sciences and education at Penn State Harrisburg, noted it will address other types of substance abuse including alcohol, and addictions such as those involving gambling or sex.
For example, if a pastor concluded addiction to gambling was a problem in the congregation or community, and wanted to start an effort to help, the center could provide guidance.
The center will have a staff of two along with two graduate assistants. A goal is to recruit two graduate assistants per year, with one being a military veteran and the other being involved with a community organization. The center will provide financial assistance toward their educations. A goal is to expand the number of people with addiction-related knowledge working in the local community, Kensinger said.
The center is still in the process of gearing up and doesn’t yet have a contact number for people seeking help. However, Kensinger says anyone who wants to contact the center can reach him at firstname.lastname@example.org.
Marijuana may boost risky effects of drinking alcoholPublished on: August 19, 2019
As the legalization of medical marijuana and marijuana use are both on the rise in the United States, people are not necessarily using alcohol less and may be unaware of the risks of combining alcohol and marijuana, according to researchers.
A new study from Penn State found that compared to people who only drank alcohol, those who used alcohol and marijuana simultaneously were more likely to drink heavier and more often. They were also more likely to experience alcohol-related problems — like impulsive actions they later regretted.
“The results suggest that individuals who simultaneously use alcohol and marijuana are at a disproportionately higher risk for heavy, frequent and problematic substance use,” said Ashley Linden-Carmichael, assistant research professor at the Edna Bennett Pierce Prevention Research Center at Penn State.
The researchers said the findings — recently published in the journal Substance Use and Misuse — also suggest that prevention and intervention programs should take into account not just alcohol, but also if people are using additional substances, as well.
“Right now, a lot of campus programs focus on whether students are drinking, and while sometimes they are asked about other substances, it’s not necessarily whether they’re using these substances simultaneously,” Linden-Carmichael said. “I think we do need to be asking about whether they’re drinking in combination with other drugs, and educating students about how that exacerbates their risk.”
According to the researchers, marijuana use is at an all-time high among young adults in the U.S., possibly leading to people using marijuana and alcohol simultaneously.
“The problem with simultaneous use is that it can affect people cognitively and perceptually, and also have an impact on motor impairment,” Linden-Carmichael said. “There is a burgeoning area of research that is examining why people are using marijuana and alcohol together and what those effects are.”
In the study, Linden-Carmichael said she and the other researchers were interested in learning more about how people use marijuana and alcohol together. They also wanted to explore whether personality traits — like the tendency to pursue new and exciting experiences, or “sensation seeking” — were associated with higher odds of using alcohol and marijuana at the same time.
The researchers recruited 1,017 participants from 49 states in the U.S. between the ages of 18 and 25 for the study. The participants provided information about how often they used alcohol, marijuana and the two substances simultaneously. They also filled out questionnaires that measured their experiences with alcohol-related problems, whether they had a sensation-seeking personality, and how they perceived the drinking habits of their friends.
Linden-Carmichael said that across the board, individuals who used alcohol and marijuana simultaneously were at a greater risk than individuals using alcohol alone.
“Even after controlling for the number of drinks a person typically consumed, people who used alcohol and marijuana at the same time were at a greater risk for problems like blacking out, getting in an argument, or other concerns,” Linden-Carmichael said. “Additionally, 70 percent of those who engaged in simultaneous use reported using at least weekly.”
The researchers found that among people who used alcohol and marijuana simultaneously, those who used more frequently were more likely to drink more alcohol, more often, and for longer periods of time. They were also associated with using more marijuana more often.
Additionally, they found that people who used alcohol and marijuana together were more likely to have higher levels of sensation-seeking characteristics and think their friends were drinking larger amounts of alcohol.
Amy L. Stamates and Cathy Lau-Barraco, both at Old Dominion University, also participated in this work.
The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism helped support this research.
Researchers estimate societal costs of the opioid epidemicPublished on: August 5, 2019
The devastating consequences of the opioid crisis are far-reaching in the United States, impacting public health as well as social and economic welfare. Penn State researchers recently collaborated to address the issue in a supplement of The American Journal of Managed Care, titled “Deaths, Dollars, and Diverted Resources: Examining the Heavy Price of the Opioid Epidemic.”
According to Dennis Scanlon, distinguished professor of health policy and administration and director of the Center for Health Care and Policy Research at Penn State, the articles and commentaries in the special issue focus on the costs to governments, notably state governments.
“State and local governments have long shouldered the burden of the opioid epidemic and its costs to individuals and families,” said Scanlon. “They are at ground zero for the epidemic, where services for those being harmed by opioids are significant and costly, spanning well beyond healthcare for treatment and prevention.”
Scanlon, along with Christopher Hollenbeak, professor of health policy and administration at Penn State, authored the introduction to the special issue, noting, “We take an opportunity to raise several important broader questions we believe have not received enough attention but are critically important for learning from the current opioid epidemic and preventing the potential burdens that could be associated with the next epidemic.”
Topics in this special issue are diverse and include the costs of the opioid crisis on employment and labor market productivity, burdens on the child welfare system and special education, the increased costs to the criminal justice system, and the economic burden on state Medicaid programs.
“The supplement fulfills our initial goal of exploring the effects of the opioid crisis on societal costs,” Scanlon explained. “Each article in this special issue presents complex cost analyses of the implications of opioid misuse, shedding new light on the opioid epidemic at the state level, and adds to a growing body of literature about the opioid epidemic.”
For example, researchers found that in the United States between 2000 and 2016, opioid misuse reduced state tax revenue by more than $11 billion, including approximately $10 billion in lost income tax revenue and almost $2 billion in lost sales tax revenue. In another paper, researchers found that between 2007 and 2016, total costs to Pennsylvania’s criminal justice system from the opioid crisis was over $526 million.
Meanwhile, total Medicaid costs associated with opioid-use disorder more than tripled between 1999 and 2013, reaching more than $3 billion. Additionally, total annual education costs for children born in Pennsylvania with neonatal abstinence syndrome associated with maternal use of prescription opioids was estimated at over $1 million. Finally, researchers also found increased costs of almost $3 billion to the child welfare system from 2011 to 2016.
“Due to these costs, every American will continue to experience loss from resources diverted to the epidemic that could have been made available for other uses had the epidemic been prevented,” said Scanlon.
Another unique aspect of the issue is the strong Penn State presence, as all authors are either faculty, staff, or current or former graduate students. Additionally, one of the commentaries is co-authored by Pennsylvania Secretary of Health Rachel Levine, who provides further perspective into the opioid crisis at the state level.
Other lead Penn State authors include Max Crowley, assistant professor of human development and family studies; Doug Leslie, professor of public health sciences and psychiatry; Paul Morgan, professor of education; Joel Segel, assistant professor of health policy and administration, and Gary Zajac, associate research professor.
Research contributions in the supplement were supported by the Commonwealth of Pennsylvania under the project “Estimation of Societal Costs to States Due to the Opioid Epidemic,” and as part of larger work supported under a Strategic Planning Implementation award from the Penn State Office of the Provost, “Integrated Data Systems Solutions for Health Equity.”
Funding for the production of this supplement was provided by Penn State’s Social Science Research Institute and by the Penn State Clinical and Translational Science Institute through the National Center for Advancing Translational Sciences, National Institutes of Health.
Marijuana policies are changing, but they are not always based on scientific knowledgePublished on: July 8, 2019
By Diana H. Fishbein, Elizabeth Long and Sharon Kingston, opinion contributor for The Hill
Misconceptions regarding marijuana distort perceptions about its hazards and benefits. While marijuana remains on schedule 1 of the federal Controlled Substances Act, a number of state-level laws are changing the policy landscape. However, these changes are not always informed by decades of scientific knowledge.
Incorporating existing science into the policy narrative promises to provide critical opportunities to make course corrections and avoid policies that are neither too restrictive nor permissive.
A critical issue in marijuana policymaking is whether marijuana is addictive. Extensive scientific research has determined that marijuana does, in fact, have dependence-producing properties, activating several neurochemical “reward” systems of the brain, including the opioid system). Importantly, using marijuana also significantly increases risk of using other substances and developing a substance use disorder (SUD)).
Teenagers are at heightened risk for experimenting with drugs, and the earlier they use, the greater the risk for eventual dependence. Marijuana’s regular use during adolescence leads to dependence at higher rates than alcohol and, once dependent, adolescents experience a wide range of adverse effects.
The brain is rapidly maturing during adolescence making it vulnerable to environmental influences that can alter the course of brain development. Consequently, chronic and/or heavy marijuana use in adolescence has been associated with a number of developmental delays. For example, teens who use marijuana heavily often show deficits in a range of cognitive functions (e.g., memory, reasoning, attention, concentration, decision-making).
Also, marijuana use can exert negative impacts on mental health, by triggering psychotic disorders like schizophrenia in susceptible individuals, and worsening other mental health problems (e.g., bipolar disorder, substance abuse, social anxiety). We also see an increased incidence of suicidal ideation, attempts and completion.
Importantly, even regular use (not only chronic/heavy) may disrupt healthy neurodevelopment. And the earlier marijuana use begins, the worse the outcomes the worse the outcomes.
Heavy use of marijuana also affects the reproductive system, potentially stalling development of reproductive systems, leading to a lag in brain areas responsive to the male hormone, testosterone, as well as problems with sexual performance.
The real concerns for teenagers are not death from overdose but rather impediments to short and long term functioning and its potential for SUD. Yet, there is a broad lack of awareness of these consequences.
Although legislation restricts possession of marijuana by minors, recent more permissive drug laws are leading to a greater number of teens who perceive marijuana use as harmless. Decreases in perceived harm is directly associated with increased drug-taking.
Formulating policies that are consistent with scientific evidence will greatly increase their effectiveness. Several policy recommendations are offered here for consideration:
- Invest resources in delaying the age of initiation of marijuana use past the age when the brain is still under construction (~ age 25) to reduce impact on neurodevelopment. Thus, risk for SUD would decline and the cascading negative effects on health would be prevented.
- Importantly, fund and widely implement a high-quality public education campaign to inform youth, parents, adults who work with youth, and healthcare providers about the dangers of marijuana use during childhood and adolescence.
- Support screening, early detection and intervention. Focus both on at-risk youth who have not yet initiated to avert pathways to use and youth who have already begun using marijuana to avoid negative consequences including SUD.
- Update the regulatory structure to keep pace with commercialization applying uniform standards on the types of products that can be sold or marketed to the public.
- Support initiatives to reduce stigma related to SUD treatment and increase knowledge regarding marijuana’s effects, thereby encouraging young users to seek treatment.
- Invest in research and increase access to marijuana by scientists studying the impact of marijuana on risk for addiction and effects on neurodevelopment in adolescence.
Marijuana has a history replete with ill-informed notions about its effects. Fortunately, recent decades have produced a substantial body of evidence on marijuana to guide our policy decisions guide our policy decisions.
Diana Fishbein, Ph.D., professor and program director, The Pennsylvania State University and co-director of the National Prevention Science Coalition (NPSC). Elizabeth Long, Ph.D, postdoctoral scholar, Edna Bennett Pierce Prevention Research Center, Pennsylvania State University and member of NPSC. Sharon Kingston, Ph.D., associate professor of psychology, Dickinson College and Secretary of the NPSC.
Penn State-led national coalition bringing prevention science to lifePublished on: June 21, 2019
Over the past four decades, prevention science has grown steadily, producing evidence-based practices and policies that prevent negative medical, social and emotional impacts before they occur. Increasingly, the Penn State-led National Prevention Science Coalition to Improve Lives(NPSC) is being recognized for its work translating science to policymakers, educators, practitioners and communities.
Diana Fishbein, professor of human development and family studies at Penn State and president and co-director of the NPSC, said that the goal of the coalition is to improve lives by preventing social ills and promoting well-being by translating scientific knowledge into effective and sustainable practices, systems and policies.
“I founded the coalition six years ago while at RTI International, an independent, nonprofit research institute dedicated to improving the human condition based out of North Carolina,” said Fishbein. “I received a National Institutes of Health grant to develop a national conference series gathering scientists and agency representatives to begin a conversation about translating science to policy. The NPSC was formed to formalize the association of conference participants on social issues such as mental health, poverty and juvenile justice.”
Fishbein also was a co-investigator on a grant from the Obama administration’s Promise Neighborhoods initiative to uplift impoverished neighborhoods.
“When the grant ended we wanted to continue to translate our research to impact communities,” Fishbein said.
Currently, the coalition is largely a volunteer 501c3 nonprofit organization but receives foundation funding for various projects. It includes more than 700 members and is comprised of an interdisciplinary group of scientists, educators, community stakeholders, policymakers, advocates and foundation representatives. Additionally, there is a contingent of 59 Penn State researchers and graduate students who are members.
Fishbein recently received the Presidential Award from the Society for Prevention Research (SPR) in part for her work with the NPSC. Fishbein also received the SPR Public Service Award in 2018 and the SPR Translational Science award in 2017.
Other NPSC board members from Penn State were recognized by the SPR this year as well. Max Crowley, assistant professor of human development and family studies and director of the Social Science Research Institute’s Evidence-to-Impact Collaborative, and Taylor Scott, assistant research professor in the Edna Bennett Pierce Prevention Research Center, were recipients of the SPR’s Public Service Award. Crowley also is one of the founders of the Research-to-Policy Collaboration, which stemmed from the NPSC.
In addition, NPSC board member Will Aldridge, advanced implementation specialist and director of The Impact Center at FPG Child Development Institute at the University of North Carolina, won the SPR Translational Science award.
On an ongoing basis, the NPSC contributes to congressional briefings on a variety of topics.
“Six experts participated in a gun violence prevention briefing after the Parkland school shooting last year, which also included a young survivor and a mother who had lost her daughter in the shooting. This fall, the coalition will be briefing Congress on the differences between substance addiction and substance dependence,” said Fishbein, explaining that there are many people who rely on pain medications to manage chronic pain and are suddenly unable to access the medications they need through legitimate channels. Another NPSC initiative is helping to make sure that the children of substance users are referred to evidence-based programs and services.
Additionally, NPSC writes policy statements for legislators and is developing a congressional prevention science caucus to inform the decision-making process. Members of the group act as legislative consultants to make certain accurate science is being utilized in policymaking.
The NPSC serves as an outreach vehicle to organizational affiliates and communicates science to end users via op-ed pieces, and, new this fall, a webinar series.
“We want to bring the science to life; if we don’t, then we are just publishing for other scientists and not for those who stand to benefit,” Fishbein said.
Criminal justice professor presents research on police views of addictionPublished on: June 20, 2019
Police officers who are repeatedly called to the scene of opioid overdose incidents may be at risk for “empathy fatigue,” according to a Penn State researcher who said additional training may be helpful in preventing emotional burnout.
Jennifer Murphy, associate professor and program coordinator for criminal justice at Penn State Berks, recently presented the study — which examined attitudes of select local police officers in the Pennsylvania toward people who use drugs and the administration of Naloxone — at the monthly meeting of the Berks Opioid Coalition at Alvernia University on May 3.
“This research is important because police officers are often the first responders to an overdose call,” Murphy said. “Because of this role, they could potentially serve as a positive referral source for people who overdose to enter drug treatment. However, if some police hold stigmatizing attitudes, they may not be likely to encourage people to enter treatment or may have less empathy toward people with substance use disorders.”
Murphy conducted the study with Brenda Russell, professor of applied psychology at Penn State Berks. The researchers surveyed more than 600 police officers in six counties in Pennsylvania on their attitudes and beliefs about people who use drugs and the drug policies within their departments.
The researchers found that overall, the police officers in the study felt that they received adequate training on the administration of Naloxone and felt comfortable administering the overdose-reversing drug.
But about 50 percent of officers reported being unsure about whether drug addiction is a disease. More than 50 percent of the officers in the study also reported believing that morals and willpower were major factors that contribute to addiction. These results indicate that more education on addiction is needed.
The researchers said they are continuing to analyze the survey data and examine possible differences in attitudes between counties but results are not representative of the state of Pennsylvania as a whole.
For additional information on this study, contact Murphy at JXM1192@psu.edu.
Smoking may impair body's blood pressure autocorrect systemPublished on: June 14, 2019
Smokers may be at a higher risk for developing hypertension, and an overactive response to normal drops in blood pressure may help explain why, according to researchers.
“The human body has a buffering system that continuously monitors and maintains a healthy blood pressure,” said Dr. Lawrence Sinoway, director of Penn State Heart and Vascular Institute. “If blood pressure drops, a response called muscle sympathetic nerve activity (MSNA) is triggered to bring blood pressure back up to normal levels.”
An additional system — called the baroreflex — helps correct if blood pressure gets too high, added Sinoway, who is also director of the Penn State Clinical and Translational Science Institute.
According to Sinoway, the study found that after a burst of MSNA, the rise in blood pressure in a chronic smoker was about twice as great as in a non-smoker, pushing blood pressure to unhealthy levels. The researchers suspect that impairment of baroreflex may be why.
“When the sympathetic nervous system fires, like with MSNA, your blood pressure rises and then a series of things happen to buffer that increase, to try to attenuate it,” Sinoway said. “We think that in smokers, that buffering — the baroreflex — is impaired.”
Jian Cui, associate professor of medicine, said the results suggest that this impairment may be connected to hypertension.
“The greater rise in blood pressure in response to MSNA may contribute to a higher resting blood pressure level in smokers without hypertension,” Cui said. “It's possible that this higher response to MSNA could also contribute to the eventual development of hypertension.”
The researchers said that while previous research has found a link between chronic smokers and higher levels of MSNA bursts, less was known about what happened to blood pressure after these bursts. Additionally, Sinoway said other studies examined the effects of acute smoking — a single session of being exposed to cigarette smoke — on non-smokers, instead of habitual smokers.
For the study, the researchers recruited 60 participants — 18 smokers and 42 non-smokers. None of the participants had hypertension. The smokers reported smoking an average of 17 cigarettes a day over a period of about 13 years.
To measure MSNA, the researchers inserted an electrode into the peroneal nerve, which sits below the kneecap, of each participant. Additionally, they measured heart rate, diastolic and systolic blood pressure, and mean arterial pressure at the brachial artery in the upper arm.
After analyzing the data, the researchers found no difference in systolic blood pressure between smokers and non-smokers. However, diastolic blood pressure, mean arterial pressure and heart rate were significantly higher in smokers. Smokers also had higher levels of MSNA. In addition, resting heart rate was significantly higher in smokers.
Cui said the findings, recently published in the American Journal of Physiology–Regulatory, Integrative and Comparative Physiology, give further evidence of the harmfulness of smoking.
“Our study reveals another mechanism by which habitual smoking may contribute to the development of hypertension,” Cui said. “Further studies are needed to examine if quitting smoking can decrease this accentuated response.”
In the future, Sinoway said he and the other researchers will continue to investigate the link between smoking and high blood pressure.
“We're hoping to better understand just how much cigarette smoking contributes to the development of hypertension,” Sinoway said. “Then, we can try to understand if there are things we can do to intervene and prevent chronic smokers from developing this condition.”
Cheryl Blaha, Penn State College of Medicine; Virginia Gonzalez, Penn State College of Medicine; Rachel C. Drew, University of Massachusetts Boston; and Matthew D. Muller, University Hospitals Cleveland Medical Center, also participated in this work.
The American Heart Association, CURE Tobacco Settlement Bridge Funding, and the National Center for Advancing Translational Sciences, National Institutes of Health helped support this research.
Course on addiction and recovery offered Fall 2019Published on: June 4, 2019
An opportunity to obtain a Certified Recovery Specialist (CRS) certification, a Certified Family Recovery Specialist (CFRS) certification, or a better understanding of addiction and recovery, is available for Penn State students this fall. Curriculum & Instruction 497 is a 4-credit course that satisfies general health and wellness credits and is applicable to a wide variety of professions.
Instructor Jason Whitney will teach in-depth knowledge of addiction and recovery to prepare students that qualify for the CRS or CRFS Examination. The course covers three domains including Recovery Management, Education and Advocacy, and Professional Ethics and Responsibility.
Students pursuing the class may be interested in additional opportunities within the Penn State Collegiate Recovery Community such as internships and work-studies. For more information, contact Jason Whitney, via 814-404-4494 or JXW411@psu.edu.
Actress Lauren Holly featured in Battling Opioids podcastPublished on: June 4, 2019
Actress Lauren Holly grew up in Bucks County, Pennsylvania, in the midst of the opioid epidemic and is now using her talent to shed light on the important issue. In season three of Designated Survivor, coming to Netflix June 7, Holly acts as a privileged, political figure who falls to opioid addiction.
The role took significant preparation, as Holly had to educate herself on substance misuse to play the part. Holly has translated this knowledge to her personal life, teaching her kids of ways to prevent addiction.
Join Battling Opioids as they talk more with Holly about her fight against the epidemic in a podcast bringing attention to issues regarding systematic policies and substance misuse.
For many, friends and family, not doctors, serve as a gateway to opioid misusePublished on: June 4, 2019
In a common narrative of the path to opioid misuse, people become addicted to painkillers after a doctor prescribed them pills to treat an injury and then, later, switch to harder drugs, such as heroin. However, nonmedical opioid users were more likely to say they began abusing opioids after friends and family members offered them the drugs, according to researchers.
In a series of in-depth interviews with 30 opioid users from southwestern Pennsylvania, about 56 percent of the interviewees said they began using the painkillers recreationally first, said Ashton Verdery, assistant professor of sociology, demography and social data analytics, and an affiliate of the Institute for CyberScience, Penn State.
According to Verdery, the national narrative often portrayed in the media is that heroin abuse occurred after people were prescribed opioid pills by their doctors and became addicted to them. This narrative holds that when the government cracked down on prescription opioids and drug manufacturers began making pills more difficult to abuse in the late 2000s, these people then transitioned to heroin because of its lower price and higher relative availability.
“There's a lot about that narrative that I think is an overly simplistic way of thinking about this,” said Verdery. “What emerged from our study — and really emerged because we decided to do these qualitative interviews in addition to a survey component — was a pretty different narrative than the national one. We found that most people initiated through a pattern of recreational use because of people around them. They got them from either siblings, friends or romantic partners.”
He added that some study participants did say that they later engaged in “doctor shopping” to locate new sources of prescription pills when acquiring pills from those initial sources became more difficult.
The researchers, who report their findings in a recent issue of the Journal of Addictive Studies, said that understanding this pathway may help improve interventions and treatment options.
“It's not just that people were prescribed painkillers from a doctor for a legitimate reason and, if we just crack down on the doctors who are prescribing in these borderline cases we can reduce the epidemic,” said Verdery. “Our results really don't speak to that framework. They speak more to the need of educating people how dangerous these pills are and warning them about getting the pills from friends and family, because that's the way a lot of people are getting addicted.”
The researchers first recruited 125 participants to complete a survey that sought information on their demographics, substance use, social networks and risk factors. A total of 30 survey participants accepted an invitation to then take part in semi-structured, in-depth interviews that lasted about an hour.
The researchers conducted interviews with nonmedical opioid users from southwestern Pennsylvania because the region has been hit particularly hard by the opioid epidemic and features both rural and urban users.
Verdery suggests that the researchers would find similar results in other areas hit by the epidemic, but future research may explore addiction pathways in other communities and consider how other substance use may play a role in opioid addiction.
“We think that understanding this mechanism as a potential pathway is worth further consideration,” said Verdery. “At the same time, friends and family are critical resources that people who use opioids can draw on for support and help in seeking treatment, which is all the more reason to pay attention to how drug use affects and is affected by social relationships.”
Verdery worked with Khary Rigg, assistant professor of mental health law and policy, University of South Florida and first author of the study; Katherine McLean, assistant professor of administration of justice, Penn State Greater Allegheny; Shannon M. Monnat, associate professor of sociology and Lerner Chair for Public Health Promotion, Syracuse University; and Glenn E. Sterner, assistant professor of criminal justice, Penn State Abington.
Penn State’s Population Research Institute, Social Science Research Institute and Justice Center for Research, as well as the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the USDA National Institute of Food and Agriculture supported this work.
Studying implications of policy and law for treatment of substance use disordersPublished on: June 3, 2019
People who suffer from substance use disorder need effective treatments, however, 90 percent of those who need treatment do not receive it. One Penn State professor and his team are looking into the legal and financial barriers to treatment and how the law can be used to break down or build pathways through those barriers.
Matthew Lawrence, assistant professor of law at Dickinson Law, assistant professor in the Department of Surgery in Penn State's College of Medicine, and affiliate of the Consortium to Combat Substance Abuse, said that there are effective treatments for substance use disorder (SUD), but accessibility issues contribute to growing drug overdose rates.
“I am researching ways the law can make health insurance coverage more effective in promoting access to treatment for substance use disorder, as well as the pivotal role played by family members of many patients in helping them access and finance treatment and how the law can increase or mitigate the burden on such family members.” Lawrence said. He recently published two papers explaining his findings.
In his commentary recently published in the Journal of Law, Medicine, and Ethics, Lawrence provided a legal analysis of regulatory pathways to promote care for those with SUD or other under-treated illnesses through “risk adjustment” programs that alter insurance reimbursement. His analysis is intended to guide scholars in considering the most promising avenues for research, SUD advocates in identifying regulatory levers to promote coverage, regulators in considering which reforms can be accomplished administratively, and lawmakers in assessing possible legislation regarding these or other risk adjustment programs.
In a law review article recently published in the Northeastern Law Review, Lawrence surveyed how the current health care regulatory patchwork often relies on family members as a regulatory tool to influence the decisions or behavior of their loved ones, usually without compensating those family members, recognizing their efforts, or mitigating the complications created by doing so. The work explores and develops a normative framework for evaluating the social, emotional, financial and psychological consequences of these laws that “deputize family,” and uses that framework to suggest changes to current policy regarding consent to authorize disclosure of private health information to loved ones.
Lawrence’s research was inspired by and developed with the support of Dickinson Law’s Addiction Legal Resource Team (ALRT), a faculty-student collaboration. The team was formed in the summer of 2018 with the support of Dickinson Law Dean Gary Gildin.
“The team does not provide legal advice, but they have worked in the students’ home states to collect, develop and disseminate resources to inform patients and families about the legal system relating to insurance coverage for addiction treatment and where to find help,” said Lawrence. “The team also helps Penn State researchers understand legal issues they encounter in their work, collaborating on the development of grant proposals and collecting or developing legal guides.”
In particular, Lawrence and ALRT have explored resources related to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The MHPAEA is a federal law that ensures group health plans and health insurance issuers who provide mental health or substance use disorder benefits offer coverage that is comparable to medical/surgical benefits coverage.
“Many individuals affected by substance use disorder are unfamiliar with the law and the challenging appeals process when receiving an insurance coverage denial,” Lawrence explained. “Additionally, the law does not protect families involved with loved one’s substance abuse treatment and recovery and does not take into account families and what they do.”
This summer, Lawrence is continuing his research into how the law can facilitate treatment and recovery for those affected by substance abuse disorder and said he is excited to continue to collaborate with the students on the ALRT.
“The collaboration has played a key role in defining the direction of my work and motivating my work. Law students are now, in many cases, authoring their own work, and I look forward to co-authoring with students as well. They have led me to places I did not expect my research to go, but I’m so happy that it did. These issues could not be more important and it is a great privilege to work with, teach and learn from students who realize that but are also realistic about the dedication, patience and focus it takes to develop real knowledge and effect real change,” he said.
Support for the research was provided by Dickinson Law, Northeastern University School of Law, and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Collaboration brings 'Opioids: The Crisis Next Door' conference to SchuylkillPublished on: May 23, 2019
Penn State Schuylkill and Lehigh Valley Hospital – Schuylkill, part of the Lehigh Valley Health Network, are teaming up to present the 2019 Wellness Conference, titled “Opioids: The Crisis Next Door.” The conference will address the facts about the disease of addiction, the signs of opioid abuse, and the resources available to victims and their loved ones, and will be held from 8 a.m. to 2:30 p.m. on Saturday, Sept. 21, in Penn State Schuylkill’s John E. Morgan Auditorium.
Topical discussions will include current drug trends; counseling and resources; preventative tools; recognizing the hidden signs of drug abuse; team approaches to recovery and wellness; panel discussions; and testimonials.
Glenn Sterner is the event’s keynote speaker. Sterner, assistant professor of criminal justice at Penn State Abington and an expert on the opioid epidemic, sits on Pennsylvania’s Opioid Overdose Task Force and is the founder of the “Share Your Opioid Story” initiative. Sterner’s research focuses on the application of social network analysis in understanding illicit, illegal and covert networks.
Additional presenters include Schuylkill County District Attorney Michael A. O’Pake; Lehigh Valley Hospital Emergency Medicine Medical Toxicologist Dr. Gillian A. Beauchamp; Lehigh Valley Hospital – Schuylkill Counseling Center Director William Rowan; and Schuylkill County Drug & Alcohol Program Prevention Services Coordinator Diane Rowland.
Other physicians, first responders, law enforcement and community members with relevant experience will participate in the event, as well. Grassroots organizations, providers and resources also will be available along Penn State Schuylkill’s mall walk during and after the panels and presentations. Participants are encouraged to speak with these professionals, who may have relevant personal and professional advice. Relevant grassroots organizations are invited to attend and set up an informational table at the event.
In 2017 overdose deaths in Pennsylvania were double the national average, according to a study conducted by the National Center for Health Statistics. In Schuylkill County, overdose deaths far outpace surrounding counties within the Commonwealth; the Center for Disease Prevention and Control reports that 34.5 overdose deaths occur per 100,000 people in the county, contrasted with 18.5 overdose deaths occurring per 100,000 people throughout the Commonwealth.
Knowing the statistics and coupled with personal anecdotes, the 2019 Wellness Conference committee chose to target this ubiquitous and pervasive issue.
The conference is free and open to the public. For planning purposes, registration is required for all attendees and grassroots organizations. Breakfast and a light lunch will be included. Due to the adult nature of the content discussed, this conference is intended for community members aged 14 and older. Learn more and register at sl.psu.edu/opioidconference.
For questions, call 570-385-6102 or 570-621-4242, or email email@example.com.
Penn State participates in Social Science Advocacy Day in Washington, D.C.Published on: May 22, 2019
Penn State researchers recently attended the Consortium of Social Science Association’s (COSSA) 2019 Social Science Advocacy Day in Washington, D.C., taking part in a full schedule of events to bring awareness to social and behavioral sciences.
During the advocacy day, COSSA members met with legislators and their staffs to discuss the significance of the social sciences and to advocate open communication between COSSA and members of congress.
Attendee Michael Donovan, director of policy and outreach at Penn State’s Administrative Data Accelerator, said, “The COSSA Social Science Advocacy Day was a great opportunity for the atypical interaction of members of the Penn State research community with members of the legislative branch to generate and facilitate an ongoing dialogue.”
Along with Donovan, Penn State sent eight other researchers to meet with staff from the offices of U.S. Senators Bob Casey and Pat Toomey, as well as Rep. Madeleine Dean. The group was able to meet with Rep. Glenn Thompson in person.
“I am encouraged by the zeal with which Penn State researchers seek to leverage their important work for impact to relevant government audiences, by minimizing the gap between government and academia and by maximizing the policy relevance of research activities,” Donovan stated. “These goals can be accomplished by fostering relationships between the sectors so that regular cross-pollination and consultation can occur, and by framing social science accessibly, so that all audiences can engage freely.”
Other Penn State researchers that attended COSSA’s 2019 Social Science Advocacy Day included:
- Christian Connell, associate professor of human development and family studies, associate director of the Child Maltreatment Solutions Network
- Max Crowley, assistant professor of human development and family studies, director of the Evidence-to-Impact Collaborative
- Maithreyi Gopalan, assistant professor of education
- Stephanie Lanza, professor of biobehavioral health, interim director of the Consortium to Combat Substance Abuse, and director of the Edna Bennett Pierce Prevention Research Center
- Mary Shenk, assistant professor of anthropology and demography
- Glenn Sterner, assistant professor of criminal justice at Penn State Abington
- Ericka Weathers, assistant professor of education
- Evan Bradley, assistant professor of psychology at Penn State Brandywine
Penn State’s Social Science Research Institute was a sponsor of the advocacy day.
PROSPER conference convenes experts and youth to help prevent substance abusePublished on: May 20, 2019
“We are now addressing a generation that could become addicted if they take a pill a few times. Prevention is critical,” said Steve Forzato, deputy chief of statewide drug initiatives for the Pennsylvania Office of Attorney General, to the audience assembled May 14 at the Ruth Pike Auditorium for the 17th annual PROSPER statewide conference.
The PROSPER (PROmoting school-community-university Partnerships to Enhance Resilience) conference brought together representatives from Penn State and Pennsylvania state agencies and school districts, to share recent developments in addressing substance misuse among middle school youth.
“They are inhaling e-liquids into their lungs and bloodstream, and they may have no idea what is in them,” said Craig Zettle, vice president of Botvin LifeSkills Training.
“Vaping, cigarettes and e-cigarettes are harmful. We need to keep our foot on the gas pedal by addressing youth smoking overall, not just going in the direction of vaping.”
The 2019 PROSPER conference brought together representatives from Penn State and Pennsylvania state agencies and school districts to share recent developments in addressing substance misuse among middle school youth.
He cited the importance of using the Pennsylvania Youth Survey to determine trends in substance misuse, noting that many states do not have access to such data.
“We’re stuck in a whack-a-mole board of problems, including bullying and abuse of various substances, and the game keeps getting faster.”
“There are so many common risk and protective factors, that you don’t need a separate program to prevent use of each different substance,” added Janet Welsh, associate research professor in the Edna Bennett Pierce Prevention Research Center.
Zettle recommended sharing statistics with youth to help them make informed decisions, especially given the misinformation that they might hear from advertising, peers and sometimes adults.
Changes in behavior come from skill development
PROSPER gives families tools to prepare their children to make smart decisions and how to be assertive when confronted with a new situation.
“I feel like my kids have learned so much about peer pressure resistance skills, looking at things from their parents’ point of view, communication skills, and what makes a good friend,” said Christy Tomascik, prevention coordinator for Luzerne and Northumberland counties.
“I learn something new each time I teach the program, for example, how to use 'I' statements, to conduct family team meetings, and about kids’ stresses.”
Tomascik’s children, three of whom attended the conference — Annabelle, Will and Lola Wojciechowski — all said that participating in the PROSPER program brought them closer together as a family and taught them the skills to resist peer pressure.
PROSPER across Pennsylvania
Through the PROSPER program, Penn State researchers and extension educators are partnering to build resilient families and provide research-based drug abuse prevention programs across Pennsylvania.
“We know that our programs build resilience and helps people along their path,” said Denise Continenza, Penn State Extension educator from Lehigh County.
Addressing the PROSPER team members in the room, she said, “You are the advocates and cheerleaders. Thank you for all you have done.”
“Building community engagement to address substance misuse is distinctive strength of Penn State, and you are an important part of that work,” said Stephanie Lanza, director of the Edna Bennett Pierce Prevention Research Center and interim director of the Consortium to Combat Substance Abuse.
“PROSPER can have sweeping impact because of all of the people we can touch.”
Opioid-exposed newborns may react to pain differently after birthPublished on: May 16, 2019
Babies exposed to opioids while their mothers were pregnant with them may need special care even before they start to experience withdrawal symptoms, according to Penn State research.
Researchers from Penn State College of Medicine found that as soon as 24 and 48 hours after birth, babies who were exposed to opioids prenatally reacted more strongly to pain and scored higher on a skin conductance test, which measures the electrical differences in skin in response to pain or stress.
Dr. Christiana Oji-Mmuo, assistant professor of pediatrics, said the study suggests that babies who were exposed to opioids in the womb may need special care earlier than previously thought.
“These babies are responding to pain differently than babies who were not exposed, so maybe we should be paying attention to pain management earlier,” Oji-Mmuo said. “If we have to do a painful procedure like a heel lance, we may have to provide extra comforting measures, both during the procedure and after if they continue to be stressed.”
Oji-Mmuo said that as opioid use continues to be a problem in the U.S., so does the risk of babies being born with neonatal abstinence syndrome (NAS). She said an estimated 55 to 94 percent of babies born to mothers who used opioids during pregnancy will develop NAS.
According to the researchers, opioids block the release of norepinephrine, a chemical released in the body during times of stress. When the baby is born and is no longer exposed to opioids, the baby experiences a spike in norepinephrine and other chemicals and hormones in the body. This can result in such symptoms as irritability, eating poorly, sweating, fever and seizures, among others.
Oji-Mmuo said that while there are guidelines for screening babies at risk for developing NAS, there is a need for better, objective tools to help predict NAS and its severity earlier in newborns.
“To best take care of these babies, it’s important that we recognize babies who are going through withdrawal very early,” Oji-Mmuo said. “We wanted to see if two different tests — skin conductance measures and facial reactions to pain — would correlate and predict withdrawal in newborns, because we really need accurate ways to assess these babies.”
The researchers enrolled 37 newborns — 22 with prenatal opioid exposure and 15 healthy controls — for the study. To measure the babies’ reaction to pain, the newborns were video-recorded while undergoing a heel stick, a standard procedure that most newborn babies undergo to give blood for screening tests.
To measure skin conductance, a noninvasive device with three electrodes was applied to one foot. The device measured electrical conductance in the skin, which can change when norepinephrine boosts sweat production.
After the data was analyzed, the researchers found that the babies exposed prenatally to opioids had higher skin conductance and reacted more strongly to pain during and after the heel-stick procedures. Additionally, Oji-Mmuo said the babies who had been exposed to opioids continued to be stressed after the procedure was over and they were swaddled and tucked in.
Oji-Mmuo said the results — recently published in the Journal of Maternal-Fetal & Neonatal Medicine — suggest that babies who are born exposed to opioids handle pain worse than babies who were not exposed.
“Even after the painful procedure was over, they continued to have higher skin conductance,” Oji-Mmuo said. “Even when the procedure was done and they’d been swaddled, they continued to have these higher measures compared to the babies who hadn’t been exposed to opioids.”
Kim K. Doheny, associate professor of pediatrics and neural and behavioral sciences; Rebecca R. Speer; Fumiyuki C. Gardner, research technologist; Megan M. Marvin; and Alexia C. Hozella, research assistant, also participated in this research.
The Children’s Miracle Network (Drs. Oji-Mmuo and Doheny) and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (Dr. Doheny) helped support this work.
$2.5M gift to create the Pollock Center for Addiction Outreach and ResearchPublished on: May 16, 2019
Penn State Harrisburg has received a leadership gift of $2.5 million from the Douglas W. Pollock Foundation to establish the Douglas W. Pollock Center for Addiction Outreach and Research on its campus.
The center will address two areas of the substance abuse problem within the central Pennsylvania region, while serving as a catalyst to enhance communications and align numerous agencies and organizations in efforts to combat substance abuse. The early focus for the center will be providing targeted assistance to veterans of the U.S. military and their families who are facing addiction-related challenges, and helping to bolster nonprofit community organizations in their efforts to more effectively combat substance abuse across Pennsylvania, as well as nationally.
“Substance abuse is devastating lives, families and communities across the Commonwealth and the nation, and Penn State is committed to a leadership role in addressing this crisis,” said Penn State President Eric J. Barron. “The Douglas W. Pollock Foundation will make it possible for Penn State Harrisburg to help both individuals and organizations in the region, and to generate the research and models that will have an impact far beyond Pennsylvania.”
Douglas W. Pollock was born and raised in central Pennsylvania and was a 1973 Penn State graduate. A student-athlete in college, Pollock was an ardent Penn State supporter, as well as a supporter of the military and its veterans. Pollock battled mental health issues and addiction throughout his life, which ultimately caused his untimely death in 2016 at the age of 64.
“It is fitting and appropriate that our foundation provides this gift to Penn State Harrisburg to establish the Douglas W. Pollock Center for Addiction Outreach and Research,” said Pollock Foundation Attorney Michael Bangs. “The goal of the center is to collaborate throughout Penn State, with the private sector, foundations and government entities to coordinate efforts to address the issue of addiction.”
The gift will support professorships, graduate scholarships, and research and outreach efforts to pioneer and evaluate innovative avenues of prevention, treatment and recovery; it also will provide funding to facilitate the day-to-day operations of the center.
The center will be headed by Weston Kensinger, assistant teaching professor of health education in Penn State Harrisburg’s School of Behavioral Sciences and Education, where the center will be housed.
“Penn State Harrisburg is ideally suited to house the center, given its established research expertise; its academic infrastructure that combines programs and faculty in many health-related fields; and its many existing partnerships within the region and throughout Penn State,” said Penn State Harrisburg Chancellor John M. Mason Jr.
“The Center for Addiction Outreach and Research is an ambitious endeavor with tremendous potential to make a lasting difference throughout the region. We are truly grateful for the generosity of the Douglas W. Pollock Foundation in helping the center to become a reality, and providing a foundation upon which we can build,” Mason said.
Penn State has made addressing substance abuse a strategic priority throughout the University and has established the Penn State Consortium to Combat Substance Abuse with the goal of tackling the problem at multiple levels. As a consortium partner, the Pollock Center for Addiction Outreach and Research at Penn State Harrisburg will be a unique addition to the region’s substance abuse programming with its early emphasis on assisting special populations and community organizations.
Through previous gifts to Penn State Harrisburg, the Douglas W. Pollock Foundation has supported scholarships for students studying education, and athletics, including the establishment of the Courtney Pollock Memorial Field and Softball Complex on campus, named for Pollock’s daughter Courtney, also a Penn State alumna. She died in June 2013 from cancer.
For more information about the Douglas W. Pollock Center for Addiction Outreach and Research, visit harrisburg.psu.edu/pollock-center.
Organizations and individuals interested in collaborating with and/or supporting the center are encouraged to contact Kensinger at firstname.lastname@example.org or Marissa Hoover, director of development at the Harrisburg campus, at email@example.com.
This gift will advance “A Greater Penn State for 21st Century Excellence,” a focused campaign that seeks to elevate Penn State’s position as a leading public university in a world defined by rapid change and global connections. With the support of alumni and friends, “A Greater Penn State” seeks to fulfill the three key imperatives of a 21st century public university: keeping the doors to higher education open to hard-working students regardless of financial well-being; creating transformative experiences that go beyond the classroom; and impacting the world by fueling discovery, innovation and entrepreneurship. To learn more about “A Greater Penn State for 21st Century Excellence,” visit greaterpennstate.psu.edu.
Study: Friends, family are most common gateway to addiction, not doctorsPublished on: May 15, 2019
By Rich Lord, Pittsburgh Post-Gazette
The often-told story of the prescription for an opioid that launches the patient down the road to ruin is not the typical tale of heroin addiction, according to a new report by researchers from Penn State and other universities.
More common, according to the study this week in the Journal of Addictive Diseases, is the “friends and family” introduction to opioids, in which the first pill comes not directly from a pharmacy, but from a trusted person. The finding could have implications for the way in which addiction prevention and treatment are accomplished, as a crackdown on prescribing continues even as overdoses remain historically high.
“I think our findings contrast with the popular media narrative that’s out there right now and the public perception,” said Khary Rigg, an assistant professor at the University of South Florida who worked with data derived by Penn State researchers in southwestern Pennsylvania. “When you talk to the average person on the street, they think it’s all about big pharma and that doctors are overprescribing. … Our findings show that the two top common sources for getting opioids are friends or family.”
Mr. Rigg worked with Katherine McLean, an assistant professor of administration of justice at Penn State Greater Allegheny in McKeesport, and other researchers at Penn State and at Syracuse University. Ms. McLean led an effort to survey 125 opioid users and conduct in-depth interviews with 30 of them, which has also yielded findings on the varied responses to the encroachment of fentanyl into the drug supply. The users were from Allegheny, Fayette, Greene and Washington counties.
The study — called Opioid Misuse Onset: Implications for Intervention — found that four in five users started with prescription opioids before progressing to full-blown addiction, usually to heroin and fentanyl.
Around one-third got their first taste of opioids from a prescription written for them, often following a tooth extraction or surgery. A small sliver bought their first pills from a dealer.
But for a big majority, said Ms. McLean, the first pill was “something that was on offer,” usually for free, from a friend or family member. It's tough, she said, to “refuse what seems like an innocuous drug from a person you trust.” A few stole their first pills from family or friends, or paid something, but for most it started with a gift.
That's consistent with findings by Raminta Daniulaityte of Wright State University who has been studying opioid users since 2002.
As the market became saturated with pain medication in the early years of this century, she said, many habits started with a simple act of sharing. “They maybe share with their peers if somebody has a headache or a bad day,” she said.
A shared pill or two can have especially long-term consequences when the recipient is young, said Stephen Lankenau, a professor and associate dean for research at Drexel University, who has done studies focused on users who started in their teens.
“What it does is, it kind of sensitizes a person to this substance. They may try it once or twice and then not try it again for a while,” he said. “When there are other opportunities later to try it again, or in larger amounts, you may be primed for use.”
There are increasingly prevalent efforts to get narcotics out of medicine cabinets, including twice-annual National Drug Take Back Days, permanent medicine drop-off boxes, and various pouches that turn opioids into harmless goo that can be tossed in the trash.
Prescribers should tell patients about these measures, said Mr. Rigg. “I’ve been prescribed opioids in the past for a variety of things,” he said. “And they don’t tell me anything [like], ‘Hey, don’t take more of this,’ or, ‘Hey, when you’re done with these pills, you should throw them away.’”
Schools have a role to play, too, said Ms. McLean. “We really have to start arming individuals with up-to-date, accurate information about the risks posed by different substances,” she said. “School-based curricula are still extraordinarily important, perhaps at that critical middle-school-to-high-school transition.”
A Pittsburgh Post-Gazette look at school district drug prevention efforts found last year that relatively few use proven, evidence-based curriculum.
The Penn State data showed another very common ingredient in addiction histories: Of the 30 interviewed, 23 first saw substance abuse affect a childhood peer or caregiver, and many cited that as “a turning point” in their attitude toward drugs, making it seem “benign, commonplace or even fun,” according to the study.
“Witnessing your parents or siblings or uncle using drugs has an effect of normalizing the behavior,” Mr. Rigg explained. “It has an effect of saying, [that drug use] is a legitimate way of having fun or coping with problems.”
The implications? If society can reduce childhood exposure to drug abuse, it can bend the curve of addiction, according to the study. Identifying young people who are vulnerable to addiction and addressing the needs of their families could help to break the cycle, researchers said.
With the epidemic as widespread as it is, there's a dark downside to the finding that people in addiction often had youthful models. “[I]f the children of current opioid misusers are at increased risk of misuse as they age into adolescence and young adulthood, we may see [opioid misuse] and mortality continue to rise in the coming decade,” the authors wrote.
While fatal overdoses in the nine-county southwestern Pennsylvania region are down from their peak of 1,413 in 2017, drugs still took more than 800 lives here last year. Researchers are seeing new drug trajectories taking root, including people who never used prescription opioids starting on heroin; cocaine users shifting — sometimes inadvertently — to heroin and fentanyl; and opioid users moving to methamphetamine.
“The epidemic has changed a lot over the years,” said Mr. Rigg. “It’s a living, breathing thing.”
Share Your Opioid Story: A Community Conversation at Schlow Library on May 30Published on: May 14, 2019
The Share Your Opioid Story initiative is hosting a Community Conversation at the Schlow Centre Region Library in State College to tell the stories behind the statistics of the opioid crisis. This community event will take place at 5:30 p.m. on Thursday, May 30 in the Downsbrough Community Room. To register, visit the event’s website.
“The goal is to educate others on the realities of this critical community issue, address stigma associated with substance use disorders, and reduce barriers for people with substance use disorder by raising awareness of the many ways this issue affects individuals, families and communities,” said Glen Sterner, assistant professor of criminal justice at Penn State Abington.
During this workshop event, Tricia Stouch will share her opioid story and local partners will discuss solutions to combat stigma in the community. The community is invited to come and share their stories or simply learn more about how people can work together to address the issues facing our communities.
First annual conference to address substance misuse held at Penn StatePublished on: May 3, 2019
Pennsylvania is in the midst of a full-fledged, substance misuse epidemic, with one out of every four families encountering this issue. Penn State is combating the crisis by drawing upon the expertise of researchers, educators, practitioners and policymakers, who gathered recently for the Consortium to Combat Substance Abuse(CCSA) Conference, held April 29 on the University Park campus.
The conference, “Envisioning a Future Free from Addiction: Research, Programs, and Practice to Prevent Substance Abuse,” kicked off with a community engagement breakfast featuring presentations from Penn State Vice President for Research Neil Sharkey and Geoff Kolchin of the Pennsylvania Commission on Crime and Delinquency, among others.
Penn State President Eric J. Barron and Congressman Glenn Thompson (R-PA) welcomed conference attendees after being introduced by Stephanie Lanza, interim director of the CCSA and director of the Edna Bennett Pierce Prevention Research Center.
Barron emphasized Penn State’s pledge to combat substance abuse in Pennsylvania, noting that the University's commitment to enhancing health is part of it’s land-grant mission.
“With 24 campuses spread across the Commonwealth, Penn State has a campus within 30 miles of 96 percent of Pennsylvanians,” said Barron. “We have tremendous reach, and the potential to have an impact on this crisis is strong.”
Thompson said, “There's not a zip code in this country that hasn't been impacted by substance abuse,” and called the epidemic “the public health crisis of our lifetime.”
A session on preventing the next substance abuse epidemic from a national perspective began with a keynote address from Thomas McLellan, former deputy director in the Office of National Drug Control Policy during the Obama administration. McLellan summarized findings from the 2016 Surgeon General’s Report, noting how increasing prices and taxes on alcohol has reduced drinking by 30 percent. He also detailed the government’s success in reducing cigarette smoking.
“A steep decline in smoking rates over the last 50 years is the result of good science in partnership with the government and communities,” said McLellan. “Penn State can leverage its resources to do the same for substance misuse.”
Following a poster session and round-table networking discussions about breaking down barriers to address substance abuse, the afternoon sessions focused on substance abuse prevention and forming new partnerships to move forward. Glenn Sterner, assistant professor of criminal justice at Penn State Abington, presented key findings from his collaborative work with opioid users in four Pennsylvania counties.
“Nearly one-third of opioid users have overdosed in the past year, and two-thirds of those have overdosed more than once. We need to think about how these substances are coming into our communities,” he stated.
Janet Welsh, associate research professor at Penn State and principal investigator of the EPiSCenter, outlined the PROSPER project, designed to deliver evidenced-based interventions to youth in collaboration with cooperative extension in numerous Pennsylvania counties.
“Reaching the 15,000 youth within PROSPER with interventions to prevent prescription drug misuse would lead to over $6.75 million in short-term societal benefits and could lead to major public health impacts,” she said.
Penn State Health researcher Dr. Sarah Kawasaki discussed a coordinated hub-and-spoke approach to the treatment of substance use disorder in central Pennsylvania, led by Penn State Hershey.
“The number of opioid overdose deaths has now surpassed the number of HIV deaths in this country. The hub-and-spoke model, with the hub located in Harrisburg and spokes spanning seven counties, is providing a continuum of care for opioid treatment and includes community health clinics, drug free counseling facilities, regional ERs, inpatient units, rural clinics, pain management, and probation/parole services,” Kawasaki stated.
Pennsylvania Secretary of Health Dr. Rachel Levine wrapped up the afternoon sessions by explaining the history of opioid and heroin addiction in Pennsylvania and the Commonwealth’s three-pillared response to the crisis: prevention, rescue and treatment.
Levine has advocated for a number of initiatives in the state, including the Opioid Stewardship Program, which works with medical schools to provide education on pain management, and the Prescription Drug Monitoring Program, an online tool to help physicians identify patients who are struggling with opioid addiction. The program has contributed to the reduction in opioid prescriptions in the state by 25 percent. In addition, Levine has advocated for the PA Prescription Drug Take-Back Program, with 813 take-back boxes spread across the state, including locations near University Park.
In 2018, Levine signed a standing order for first responders and the general public to expand Naloxone access, and spearheaded last year’s Naloxone Day where over 6,000 free Naloxone kits were distributed.
“Naloxone is a unique drug, its only purpose is to reverse opioid overdose and save lives,” Levine explained. There will be another Naloxone Day occurring this summer.
“While we are in the sixth iteration of 90-day statewide disaster declaration to help combat the heroin and opioid overdose epidemic, last year for the first time in five years, [Pennsylvania] saw a significant decrease in overdose deaths. We have bent the curve,” Levine concluded.
The conference was hosted by the CCSA, part of Penn State’s Social Science Research Institute. In addition to the conference, the CCSA is supporting 12 new faculty hires to attract scientific leaders dedicated to combating substance abuse, a competitive seed grant program, and Community Fellows awards.
Sponsors of the conference include Penn State Outreach, Addiction Center for Translation, Center for Applied Studies in Health Economics, Center for Educational Disparities Research, Center for Geriatric Nursing Excellence, Child Maltreatment Solutions Network, Child Study Center, Clearinghouse for Military Family Readiness, College of Nursing, Clinical and Translational Science Institute, Evidence to Impact Collaboratory, Huck Institute, The Methodology Center, Population Research Institute, Rock Ethics Institute, Bennett Pierce Prevention Research Center, College of Agricultural Sciences, College of Communications, College of Education, College of Health and Human Development, College of Medicine, Office of Government Affairs, Penn State Law, and the Office of the Vice President for Commonwealth Campuses.
Report: Fentanyl scares some opioid users, but others seek itPublished on: April 30, 2019
Along the wide spectrum of opioid users, there are those who fear fentanyl and those who are its fans, according to a recently published study led by Penn State University researchers. Understanding the mindsets of both kinds of users may be a key to reducing the damage done by the super-potent narcotic.
While some of the 30 users surveyed tried to avoid fentanyl — which is often mixed with, or sold as, heroin — most resigned themselves to using it, and roughly one in five preferred it, according to the study led by Katherine McLean, an assistant professor of administration of justice at Penn State Greater Allegheny in McKeesport, and Ashton M. Verdery, assistant professor of sociology, demography, and social data analytics at the University Park campus.
Those 30 users and the larger number (125) who filled out surveys for the study were largely united in one sentiment: They wished they knew what they were snorting, smoking or injecting.
Many talked of “the unpredictability of the illicit opioid market and how that unpredictability made it impossible for people to know what they were using and avoid overdosing, avoid getting ripped off, avoid withdrawal, avoid nodding off in a place in which they didn’t want to,” said Ms. McLean on Thursday.
The synthetic narcotic fentanyl has long been used as a powerful painkiller in conventional medicine. Illicit versions of the drug had periodically turned up in the heroin markets for years, but only became a consistent part of the mix in southwestern Pennsylvania from 2014 on.
Data from Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence and Westmoreland counties, gathered on overdosefreepa.org by the University of Pittsburgh School of Pharmacy, shows that from 2015 through 2018, fentanyl was involved in 2,464 fatal overdoses. That's 60 percent of the drug deaths in those counties — a bigger share than any other drug. (Heroin was implicated in 43 percent and cocaine in 32 percent. Most fatal overdoses involve more than one drug.)
During those four years, fentanyl's prevalence soared. Present in 29 percent of fatal overdoses in 2015, it was part of the mix in 72 percent in 2018.
That led Ms. McLean — who volunteers for the needle exchange organization Prevention Point Pittsburgh and worked in the harm reduction field in New York City — and Mr. Verdery to research fentanyl’s impact on the drug world. They focused on Allegheny County because it “had the highest rate of fentanyl-involved mortality among all [large] U.S. counties” in 2016, and trailed only New York and Chicago in the raw number of deaths from the drug, according to their report in the journal Substance Use & Misuse.
The researchers drew their subjects mostly from Allegheny County, with smaller numbers from Fayette, Greene and Washington counties.
Most of the subjects started using between the ages of 18 and 25, and had been on opioids for five years or more. A minority had personally overdosed to the point of needing medical attention, but a large majority had a family member or friend die from drugs. Many cited fentanyl as the culprit in a loved-one’s death.
You’d think that would deter people, and for a few it did. One study participant said that if he gets purported heroin that, upon inspection, looks more like fentanyl — which is subtly different in color and texture — he will “turn right around, take it right back.”
A similar number took the opposite tack. “Once you’ve used fentanyl you can’t do [heroin] anymore,” one participant said. “It doesn’t touch you.”
Some liked fentanyl’s quicker-than-heroin high, or the cost-effectiveness relative to much-more-expensive unadulterated heroin. Some thought that withdrawing from fentanyl was less severe than from heroin.
Most, though, accepted the risk inherent in a fentanyl-flooded heroin market, and Ms. McLean grew to understand that.
“I think the people that we talked to, they had a lot going on in their lives. They had a lot of risks, a lot of harms, that they were trying to ameliorate at various times in their lives,” she said. Caught in addiction in many cases, they feared going into withdrawal on the job, or while trying to care for children.
Many had countervailing fears of “nodding out” or overdosing in those circumstances. All faced the problem of rarely knowing whether they were buying “crappy” stuff that wouldn’t even stave off withdrawal, or super-potent fentanyl that would knock them out — perhaps permanently.
Stopping cold, though, was not an easy proposition. “Many of these people had been using for 5, 10 years, so they also have a routine,” said Mr. Verdery.
Some dealt with the routine-breaking uncertainty presented by fentanyl by developing a trusted dealer. Few used the fentanyl test strips, available from Prevention Point Pittsburgh, which can reliably detect even small amounts of the drug.
“They don’t tell you the concentration of the fentanyl in the [stamp] bag,” said Ms. McLean, but they are “certainly preferable to nothing.”
Cocaine users might consider the test strips, too, as there is persistent evidence of fentanyl infiltrating the supply of that drug. There’s also a rising tally of overdoses involving both cocaine and fentanyl.
“If you consider the population of people who use cocaine in this country, it’s much larger than the population of people who use heroin,” said Ms. McLean. And many cocaine users are “opioid-naive,” meaning a small amount of fentanyl mixed in could have outsized consequences, she noted.
Mr. Verdery said that in the coming months, the team will release a second paper on the origins of the addictions of the people studied. The perhaps surprising finding: Few started down the road to opioids with a prescription written to them. Most got a taste from pills prescribed to someone else, and then passed on by a friend or relative.
The biggest takeaway from all of their work, Ms. McLean said, is that people in addiction are not zombies lurching after the next fix, so to address their problems one needs to understand their complex processes and problems. “They are careful consumers, certainly not people who are wandering blindly,” she said. But they are addicted to something that is “packaged by unknown persons in unknown quantities of unknown substances.”
Digging Deeper: Opioid CrisisPublished on: April 25, 2019
The opioid crisis has affected every state in some way, but Pennsylvania has been one of the hardest hit. In 2017 alone, overdose death reached almost 5600 people. Unlike previous drug epidemics, the opioid crisis has affected rural and urban areas alike and may parts of the state are unprepared to deal with these issues.
On this episode of Digging Deeper, Penn State President Eric Barron talks with Stephanie Lanza, director of The Edna Benett Pierce Prevention Research Center and Glenn Sterner, assistant professor of criminal justice, about the opioid crisis and what Penn State is doing to help.
Understanding opioid users' views on fentanyl could help reduce overdosesPublished on: April 23, 2019
Opioid users fear accidental overdoses from street drugs laced with fentanyl, but unpredictable drug quality means they often lack reliable strategies to avoid it, according to a team of researchers who suggest that fentanyl test strips may reduce overdose deaths.
“The opioid crisis is one of the biggest issues in the United States right now,” said Ashton Verdery, assistant professor of sociology, demography, and social data analytics at Penn State. “Attention to fentanyl as a unique and blended component of the opioid crisis is absolutely imperative. It is separate from issues of heroin consumption and prescription pill consumption. It's a unique threat.”
Illicit drug manufacturers often add fentanyl —a synthetic opioid — to heroin and counterfeit prescription pills because it is cheap to produce. In this unregulated market, fentanyl concentration can fluctuate between batches, with potentially dangerous consequences for users who are unaware of its presence. Because the fentanyl is vastly more potent than morphine or heroin, even small amounts can cause overdoses.
“I think that fentanyl-related deaths are a somewhat understudied topic in general,” said Verdery. “Getting a handle on what leads to overdoses from fentanyl and ways to prevent it, I think, are critical research initiatives.”
In a paper recently published in Substance Use & Misuse, the researchers reported attitudes around opioid use in southwest Pennsylvania.
“We were motivated (to do the research) by the sudden and dramatic involvement of fentanyl in overdose deaths, particularly in southwest Pennsylvania,” said Katherine McLean, assistant professor of administration of justice at Penn State Greater Allegheny and lead author of the study. “Data from Allegheny County — the residence of the majority of our respondents — show that fentanyl was implicated in nearly 70 percent of overdose deaths in 2017.”
Using surveys and unstructured interviews, the researchers found that many opioid users believed they had been exposed to fentanyl in the last year. Most participants were concerned about the danger of fentanyl and attempted to avoid it by purchasing from trusted suppliers, declining to use suspect heroin or eschewing heroin in favor of prescription opioids. However, the researchers point out that most of these strategies are limited by the user's knowledge of drug content or access to the same dealer.
A surprising finding of the study, according to McLean, was that some participants expressed a preference for fentanyl. Although these users sought out fentanyl, seeing it as a less-risky or more cost-effective drug, they also felt that a lack of information stymied their ability to administer safe drug doses.
The researchers suggest that pre-consumption fentanyl-testing strips could be an important tool for managing the current opioid crisis.
“The risks or danger of fentanyl are exacerbated by a social context in which people are often unaware of its presence, or concentration, in the drugs they consume,” said McLean. “Empowering individuals with the tools to at least identify fentanyl might lower the incidence of accidental overdose among people that both want, and want to avoid, fentanyl.”
Fentanyl has also contaminated the supply of other drugs such as cocaine.
“There is substantial evidence that fentanyl is infiltrating the broader drug supply,” said Verdery. “Cocaine overdose deaths have increased dramatically, and fentanyl might be a big part of that. The broader availability of fentanyl makes the use of drugs more risky and uncertain. If people at least know what they're getting, they have the ability to make more informed choices, and I think that this is a valid harm-reduction strategy.”
The researchers are planning a larger-scale study on patterns of fentanyl use with more participants and a broader geographical focus.
Other researchers working on the project were Shannon Monnat, associate professor of sociology at Syracuse University; Khary Rigg, assistant professor of mental health law and policy at the University of South Florida; and Glenn Sterner, assistant professor of criminal justice at Penn State Abington.
The Social Science Research Institute at Penn State, the Justice Center for Research at Penn State, the USDA Agriculture and Food Research Initiative Program and the Population Research Institute funded this research.
'Alexa, I’m in pain': Smart assistants could help combat opioid crisisPublished on: April 23, 2019
For patients suffering with chronic pain, relief could soon be found as close as their nearest smart assistant.
Researchers at Penn State are developing a way to deliver on-demand, guided mindfulness practices via Amazon Alexa to patients experiencing chronic pain. Through their method, a smart assistant will provide Mindfulness-Based Stress Reduction (MBSR) practices to individuals in their homes. MBSR is a non-addictive, long-term pain-management alternative to opioid pain medication.
“In particular with opioid addiction, there has been quite a bit of progress in coming up with methods that are non-addictive, and mindfulness is one of them,” said Saeed Abdullah, assistant professor of information sciences and technology and the primary investigator on the project.
While MBSR techniques have proven effective for chronic pain management and improving a patient’s quality of life, long-term adherence to these interventions can be a challenge for many individuals who experience chronic pain. The proposed Alexa addition incorporates methods for patients to practice regularly at home, which could increase compliance treatment rates and impact outcomes for patients.
“Long-term engagement with MBSR practices is essential for effective pain management and subsequently reducing the risk of opioid dependence,” explained Abdullah.
By utilizing a smart assistant like Amazon Alexa, through which a patient can have a direct conversation with a virtual coach, Abdullah and his research team believe that user engagement will be sustained over a long period of time. The researchers hope that increased use of MBSR practices could reduce the use of opioid medication to address chronic pain.
Abdullah has partnered with Stephanie Lanza, professor in the Penn State Department of Biobehavioral Health, director of the Edna Bennett Pierce Prevention Research Center, and interim director of the Penn State Consortium to Combat Substance Abuse (CCSA); and Sebrina Doyle, assistant research professor in the College of Health and Human Development and the Edna Bennett Pierce Prevention Research Center. The two were seeking a new way to offer patients support in using MBSR methods, according to Doyle.
“There are many MBSR applications for smart phones, but the one challenge, especially for people who are in chronic pain, is even getting to their smartphone device or finding another mechanism if they want a guided practice,” she said. “With Alexa, you don’t have to get up from your seat to access the practices.”
One guided practice commonly used in MBSR is a body scan. Doyle explained that during a body scan, a patient systemically goes through the different parts of the body and takes note of what they are feeling in those areas.
“There are lots of things that happen in our bodies all the time, and the body scan helps us to get familiar with that,” she said. “It’s paying focused attention to individual areas of your body, a little at a time.”
The team plans to run two phases of their study first to assess the quality of the dynamic content delivery, then to measure participants’ continued engagement with Alexa as they access MBSR practices. In addition, users will track their pain-related cognitions and alcohol, tobacco, marijuana, opioid and other drug use through a daily diary survey.
Doyle, who also serves as the assistant director of outreach for CCSA, said that this project helps to advance the consortium’s mission. The CCSA is comprised of a number of researchers, educators and practitioners from Penn State campuses who are developing and implementing programs, policies and practices aimed at preventing and treating addiction in the state.
According to the CCSA, Pennsylvania has consistently been among the top 10 states in the country in overdose deaths, with 5,456 lives lost in 2017.
“From my perspective, this project is exactly what the CCSA is meant to do,” said Doyle. “We are from completely different departments and are learning from each other. We’re paving the way in serving as an example for other people and other potential collaborations.”
“I want to solve problems that matter,” said Abdullah. “I want to make a better world as well as try to help people who need help.”
“This particular project really falls into what I want to do and the sort of contributions that I want to make as an IST researcher,” he concluded. “It’s about solving difficult problems using technology, and solving problems that affect a lot of people.”
The project is funded by an opioid seed grant from CCSA.
Opioid epidemic may have cost U.S. governments $37.8 billion in tax revenuePublished on: April 15, 2019
The opioid epidemic may have cost U.S. state and federal governments up to $37.8 billion in lost tax revenue due to opioid-related employment loss, according to Penn State researchers.
Additionally, the researchers found that Pennsylvania was one of the states with the most lost revenue, with approximately $638.2 million lost to income and sales tax. The study looked at data between 2000 and 2016.
Joel Segel, assistant professor of Health Policy and Administration, said that the results — recently published in the journal Medical Care — could help governments that are hoping to make up for lost revenue.
“This is a cost that was maybe not thought about as explicitly before, and a cost that governments could potentially try to recoup,” Segel said. “Instead of focusing on the cost of treating people with opioid use disorder, you could think about it in terms of a potential benefit to getting people healthy, back on their feet, and back in the workforce.”
Previous research estimated that in 2016 there were nearly 2.1 million Americans with an opioid use disorder, and approximately 64,000 deaths were the result of an opioid overdose. According to the National Institute on Drug Abuse, there were 2,235 opioid-related overdose deaths in Pennsylvania alone.
Segel said that while previous studies have looked at the cost of the opioid epidemic in terms of substance abuse treatment and other medical costs, he and the other researchers were interested in exploring other costs that may not have been captured before.
“We wanted to take a systematic approach to how we could think about some of the tax revenue that is lost if someone is unable to work due to opioid use,” Segel said. “This could be an important consideration for either state or federal budgets.”
The researchers used data from the National Survey on Drug Use and Health, as well as information from a previous study that estimated declines in the labor force due to the opioid epidemic. They used the TAXSIM calculator from the National Bureau of Economic Research to estimate losses in tax revenue.
After analyzing the data, the researchers found that from 2000 to 2016, there was an estimated decline of 1.6 million participants in the labor force, with about 68,000 of those in Pennsylvania. There were about 180,000 overdose deaths, with approximately 6,100 occurring in Pennsylvania.
Additionally, the researchers estimated losses of $11.8 billion to state governments and $26 billion to the federal government in tax revenue due to reductions in the labor force. For state governments, this included lost sales tax and income tax revenue. Losses to the federal government were entirely due to lost income tax revenue.
Segel said the results help show the value of treating people with opioid use disorder, and should be considered when treatment programs are being considered and evaluated.
“The state of Pennsylvania has been developing some innovative programs, and our results are something to consider as these programs are being considered for implementation,” Segel said. “Not only are treatment programs beneficial to the individual and to society, but if you’re thinking about the total cost of these treatment programs, future earnings from tax revenue could help offset a piece of that.”
Penn State has made a multi-year investment in bringing together researchers from many fields to address the challenges of substance abuse in Pennsylvania and beyond.
Dennis P. Scanlon, distinguished professor of health policy and administration and director of the Center for Health Care Policy Research; Yunfeng Shi, assistant professor of health policy and administration; and John R. Moran, associate professor of health policy and administration, all with Penn State, also participated in this work.
This work was supported by the Commonwealth of Pennsylvania under the project “Estimation of Societal Costs to States Due to the Opioid Epidemic,” and part of larger work supported under a Strategic Planning Implementation award from the Penn State Office of the Provost, “Integrated Data Systems Solutions for Health Equity.”
Register Today for the CCSA ConferencePublished on: April 10, 2019
There is still time to register for the Consortium to Combat Substance Abuse's first annual conference, Envisioning a Future Free from Addiction: Research, Programs, and Practice to Prevent Substance Abuse, to be held Monday, April 29, on Penn State’s University Park campus at the Hetzel Union Building (HUB) from 9:30 a.m. to 5 p.m. A Community Engagement Breakfast session will be held before the conference from 8 a.m. to 9:15 a.m.for those able to attend. An updated agenda, list of sponsors, link to register, and more can be found on the conference page.
Preventing Teen Substance AbusePublished on: April 9, 2019
While legislators and researchers work together to develop treatment options and solutions for the nationwide opioid crisis, community members, schools and caregivers have turned their focus to developing ways to protect future generations from substance abuse. To help build resilient families in Pennsylvania, Penn State researchers like Janet Welsh are taking prevention research out of the lab and into communities where it matters most.
As the coordinator for the PROSPER team in Pennsylvania, Welsh works with the Edna Bennett Pierce Prevention Research Center and Penn State Extension to develop and deliver science-based prevention programs to Pennsylvania middle schoolers. Since starting research in 2001 with a sample of more than 11,000 children, PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience) has seen significant improvements in family life and youth development, as well as reductions in teenage delinquency and substance abuse.
To read more about Welsh's work and the impact of the PROSPER program, visit impact.psu.edu.
Consortium to Combat Substance Abuse announces Community FellowsPublished on: April 3, 2019
The program provides release time for faculty members to develop community collaborations and build sustainable, evidence-based or evidence-informed programs, policies and practices that can effectively address substance use and related issues within a targeted community in Pennsylvania.
Another goal of this initiative is to build the faculty member’s translational research expertise by providing successful candidates with opportunities to participate in webinars and workshops aimed at developing community engagement, program development, implementation and evaluation competencies, as well as insights into partnering with government officials to promote evidence-based policy, and grant-writing.
The funded projects are:
— “Enhancing overdose awareness and prevention training within the Penn State Greater Allegheny and McKeesport communities” — Katherine McLean and Sandra Trappen, administration of justice, Penn State Greater Allegheny, will work with Prevention Point Pittsburgh to expand the population of individuals trained to prevent, and equipped to reverse, opioid overdose.
— “Understanding the needs of Pennsylvania's recovery community” — H. H. (Bo) Cleveland, human development and family studies, University Park, will partner with the Pennsylvania Recovery Organizations Alliance to work with patients in substance use recovery.
— “Youth participatory action research as best practice: Empowering, healing, and learning with youth affected by the opioid and overdose crisis” — Kristen Goessling, human development and family studies, Penn State Brandywine, will work with the Saving Our Lives Collective and the Penn State Center in Philadelphia to focus on Philadelphia youth who have been adversely affected by the opioid and overdose crisis and the emerging communities of care responding to the crisis.
The Consortium to Combat Substance Abuse (CCSA) is housed within the Social Science Research Institute (SSRI) and is led by Interim Director Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center.
The mission of the consortium is to leverage the University’s research, education and outreach capacities toward a world free from addiction as a step toward enabling individuals, families and communities to reach their full potential. To advance this mission, Penn State has provided funds for a range of new activities, including supporting the development of interdisciplinary and translational research, education and outreach to combat substance abuse and related public health problems.
Scientists discover hundreds more genes with potential link to addictionsPublished on: April 3, 2019
Many human diseases, such as tobacco and alcohol addictions, are heritable. Until now, little has been known about what genetic factors contribute to these addictions, and if they put people at risk of inheriting other medical conditions. A recent study, published in Nature Genetics, reveals that these addictions may result from a complex blend of genes and environmental influences, and are genetically correlated to other health issues and diseases.
More than 100 international scientists, including researchers from the Department of Public Health Sciences at Penn State College of Medicine, teamed up with the National Institutes of Health (NIH) and National Institute on Drug Abuse (NIDA) for a genome-wide association study (GWAS) to examine inherited traits linked to tobacco and alcohol addiction.
The data analysis included information from nearly 1.2 million people, along with data from biobanks, epidemiology studies and direct-to-consumer genetic testing companies, such as 23andMe.
Researchers analyzed an array of phenotypes, or characteristics, related to individuals’ smoking and drinking behaviors, including at what age they started, how many cigarettes they smoke, how often they consume alcohol and whether they have successfully quit smoking. Next, the findings were compared to data on participants’ overall wellness, history of disease and life events.
According to the results, phenotypes associated with smoking are genetically correlated with several diseases. Meanwhile, an increased genetic risk for drinking shows a lower risk for many diseases.
Previous genetic studies identified 10 genes that affect the risk of addiction to tobacco and alcohol. This research expands the list of addiction-related genes by 40 times, highlighting more than 400 locations in the genome and more than 500 variants within these locations that influence smoking or alcohol use. These variants affect several chemical functions related to:
- glutamate transmission, which is linked to communication and tied to memories and learning;
- dopamine, which helps regulate movement and is linked to learned behaviors and the brain’s “reward system”; and
- acetylcholine, which helps activate muscles.
“This research shows the power that big data can have in modern-day, large-scale genetic studies,” said Dajiang Liu, associate professor of public health sciences at Penn State College of Medicine, whose group led the statistical genetics analysis in the study. “Now, thanks to innovative computational methods our group developed, we have a better idea of which genetic variants may influence people’s likelihood of developing smoking and drinking addictions. We hope our work paves the way for more in-depth biological analyses of substance use behaviors in humans.”
Liu says additional research involving animal models and humans is needed to better understand the specific roles the genetic variants play in alcohol and tobacco addiction. Ultimately, he says the work may help to improve alcohol and smoking cessation programs.
Joining Liu from Penn State were Yu Jiang, a biostatistics graduate student and lead analyst for the project; Fang Chen, a research scholar; and Daniel McGuire, a research assistant and doctoral candidate in biostatistics.
This research was funded by the National Institute on Drug Abuse.
Opioid initiative earns 2019 Community Engagement and Scholarship AwardPublished on: April 2, 2019
The Share Your Opioid Story Initiative, led by Glenn Sterner, assistant professor of criminal justice at Penn State Abington, has received the 2019 Penn State Award for Community Engagement and Scholarship.
The award recognizes a project that best exemplifies Penn State as an “engaged institution,” which the Kellogg Commission defines as an institution that has redesigned teaching, research, and extension and service functions to become even more sympathetically and productively involved with its communities.
In response to the pervasiveness of stigma associated with those affected by the opioid epidemic, Sterner spearheaded an effort to call attention to the crisis by inviting people to share their stories about how addiction has affected them. Sterner saw the initiative as an opportunity to educate the public on the realities of the disease while dispelling myths.
“The use of storytelling can act as a bridge for the gap between science and personal experience, increasing the receptiveness for change in attitude towards those affected by opioid use disorder,” a nominator said. “By humanizing the opioid epidemic, we are able to address assumptions about the disease and those affected by it to increase greater public compassion and decrease public stigma. The primary goal of this initiative is to change negative perceptions and assumptions about the disease of opioid use disorder and those affected by this disease.”
The initiative has reached millions of individuals through public health campaigns and outreach efforts. More than 100 narratives borne through this initiatives are available at www.shareyouropioidstory.com. In these stories, delivered through text, videos and photos, the public has access to first-person accounts of the realities of the opioid epidemic and its effects on individuals, families and communities. The site has been viewed more than 14,000 times from more than 60 countries.
Following the release of the website, community conversations were held across Pennsylvania. These talks featured individuals from the website, who engaged in discussions with members of the public around the hope found in recovery, from addiction or the loss of a loved one.
In a survey following these talks, respondents reported “the opioid crisis affects all walks of life,” “it shows how others feel and that change is possible” and “the talk helped me to understand more about addiction and the need for education around how to destigmatize addiction.”
According to the National Institute on Drug Abuse, more than 49,000 died of opioid drug overdoses in the nation in 2017. In Pennsylvania, more than 4,600 overdoses occurred in 2016.
Sterner, with the support of Penn State’s Criminal Justice Research Center, developed key partnerships with organizations including the Independence Blue Cross Foundation, the Pennsylvania Department of Drug and Alcohol Programs, and Mental Health Partnerships to execute the initiative.
Become a Certified Recovery SpecialistPublished on: March 25, 2019
Do you have a history of addiction recovery and want to help others?
The Certified Recovery Specialist Program being offered through the Penn State Shenango and Beaver campuses is a 54-hour, peer support program designed to meet the current educational requirements for the CRS credentials set forth by the Pennsylvania Certification Board (PCB).
Participants will receive education in:
- Recovery Management (18 Hours)
- Education and Advocacy (12 Hours)
- Professional Ethics and Responsibility (6 Hours)
- Confidentiality (6 Hours)
- Relevant to the Field of Addiction (12 Hours)
Please note that Penn State Beaver is the education provider and the training is one part of the larger process to become a successful CRS. Participants must meet all of the other requirements before being certified.
To apply for certification to become a CRS, individuals must meet the following Pennsylvania Certification Board (PCB) requirements:
- A history of addictions recovery (must have a minimum of 18 months, in a continuous manner, of personal, lived recovery experience)
- High school diploma or GED
- Successful completion of the Certified Recovery Specialist 54-hour training program
- Successful completion of the Pennsylvania Certification Board CRS exam *
- Sign an ethical code of conduct
For more information on the program, including a schedule and costs, visit the program’s website.
Employment Reductions and Government Revenue Losses from Opioid MisusePublished on: March 25, 2019
The economic burden of the U.S. opioid epidemic likely exceeds $78.5 billion per year when considering its impact on healthcare, substance abuse treatment, the criminal justice system, and productivity costs. Although medication assisted treatment for opioid abuse (covered previously at our blog) may help to reduce these costs [pdf], the epidemic is likely to continue to negatively impact U.S. families and economic outcomes in our society for many years to come.
In a forthcoming brief report in Medical Care, Dr. Joel Segel and colleagues at Pennsylvania State University view the economic burden of the opioid epidemic through a different lens. Rather than asking how much state governments are spending to address the opioid crisis, they analyzed the losses in state and federal tax revenues resulting from opioid misuse. Their analysis focused on the time period from 2000 through 2016, and found that state governments had losses in income and sales tax revenues of almost $11.8 billion. Additionally, the U.S. federal government lost almost $26 billion in income tax revenue over the same time period. The authors point out that quantifying these losses may help state governments as they move to seek damages from opioid manufacturers. Legal strategies are likely to be similar to those pursued by states for the master tobacco settlement [pdf].
Interestingly, a key assumption of their analysis is a decline of 1.55 percentage points in labor force participation among 25-54 year-old adults attributed to prescription opioid misuse. This assumption derives from a 2018 study by economist Dr. Alan Krueger [pdf], whose unexpected death last weekend has saddened all of us who had long admired his commitment to applying economics to address pressing societal problems.
In that study, Dr. Krueger had analyzed the decline in U.S. labor force participation from its peak in 1997. He noted that people who were not in the labor force (i.e., people who were neither now employed nor looking for work) were more likely to have poor self-reported health and at least one disability than employed or unemployed people (see Tables 4 and 5).
He further identified that 25-54 year-old men who were not in the labor force were more likely to experience pain and had higher reported pain levels than men in the labor force (see Table 6). He then sought to understand whether prescription opioid use/misuse might be tied to recent declines in labor force participation. He found that up to 43 percent of the decline in male labor force participation between 1999 and 2015 could be accounted for by the rise in opioid prescriptions during this time. Dr. Krueger notes in his conclusion:
“[A]ddressing the decades-long slide in labor force participation by prime age men should be a national priority. Prime age men express low levels of SWB [social well-being] and report finding relatively little meaning in their daily activities. Because nearly half this group reported being in poor health, it may be possible for expanded health insurance coverage and preventive care under the Affordable Care Act to positively affect the health of prime age men. The finding that nearly half of prime age, NLF [not in the labor force] men take pain medication on any given day and that 40 percent report that pain prevents them from accepting a job suggests that pain management interventions could potentially be helpful.” (p. 55)
The opioid crisis in America continues to have devastating impacts for individuals, the families of people suffering from opioid misuse, local, state, and federal governments, and health care and social services providers and payers. My hope is that research, such as the important work by Dr. Krueger during his lifetime and current research by Dr. Segel and his colleagues will continue to move us toward policy that will reduce the burden of opioid misuse and improve the lives of those affected.
Lastly, Dr. Krueger’s important work on this and so many other issues is a legacy worth pausing to remember.
Inaugural substance abuse conference to be held April 29 at University ParkPublished on: March 15, 2019
Penn State’s Consortium to Combat Substance Abuse (CCSA) will host a conference to bring together researchers, practitioners, policymakers, foundation representatives, and the public to discuss significant and emerging problems in combating substance abuse.
“Envisioning a Future Free from Addiction: Research, Programs, and Practice to Prevent Substance Abuse” will be held from 9:30 a.m. to 5 p.m. April 29 in the HUB-Robeson Center at University Park. A Community Engagement Breakfast session with networking opportunities and a speaker panel will be held before the conference at 8 a.m. for those able to attend.
The conference also will include sessions on preventing the next substance abuse epidemic, substance abuse prevention and treatment in communities, as well as a poster session and roundtable networking discussions.
Stephanie Lanza, CCSA interim director, encourages all to register for this free event.
“The inaugural conference hosted by the CCSA is a one-of-a-kind opportunity to join a discussion focused on solutions,” Lanza said. “Anyone who shares our vision for a brighter world, who wants to work to solve the complex problems of substance abuse, is welcome.”
To register for the conference or to find out more information, click here.
The CCSA, housed in the Social Science Research Institute, draws on the expertise of researchers, educators and practitioners from across Penn State to develop and implement effective programs, policies and practices aimed at preventing and treating addiction and its spillover effects on children, families and communities.
A close watch: IST seed grant funds study to assess and predict substance co-usePublished on: March 14, 2019
A technology-based intervention that could reduce the risk of young adults simultaneously using alcohol and marijuana may soon be as close as a user’s wrist, thanks to a new study launched by researchers at Penn State.
The team recently earned a seed grant from the College of Information Sciences and Technology to assess and predict alcohol and marijuana co-use in young adults through the use of Apple Watches. Simultaneous use of these substances could lead to greater negative health outcomes and consequences, such as substance-use disorder, poor academic performance and impaired driving, compared to using them individually, the researchers said.
“We are trying to understand not only the behavior, but also the contexts that are associated with it,” said Saeed Abdullah, assistant professor of information sciences and technology and principal investigator on the project. “Maybe location, mood or other things indicate that a behavior is about to happen. Being able to predict that behavior is fundamental to being able to provide effective interventions.”
“We’re trying to first learn more about under what conditions people are combining alcohol and marijuana, and then we’re hoping to use this information to help identify moments of greatest risk for helping people reduce problems associated with high-risk use,” added Ashley Linden-Carmichael, assistant research professor of biobehavioral health and co-principal investigator on the project.
In the study, young adults will answer daily survey questions delivered via an Apple Watch or smartphone to measure behavioral and contextual data, such as how much alcohol and marijuana they’ve used, how they’re feeling, and specific events that preceded the substance use. This data could be useful in identifying risk factors associated with simultaneous alcohol and marijuana use and developing preventative measures.
Linden-Carmichael explained that by using an Apple Watch, researchers will be able to gather data in real time from young adults in their day-to-day environments. The ability to collect data through a wearable device could offer substance-abuse researchers more precise data, compared to past study efforts which measured these indicators through manual daily diary entries. Because manual entries are typically made up to 24 hours after the individual uses alcohol or marijuana, they can often be less reliable or subject to user bias.
“The field is moving to understanding real-world behavior as it is happening,” said Linden-Carmichael. “Having the ability to assess and really have an impact while participants are going about their daily lives is exciting.”
While the goal of this study is to collect data that could help minimize high-risk substance use in young adults, their methods could open doors to help with mental health issues and other health concerns.
“If you think about substance abuse and this study and the specific contributions and understanding of this behavior, perhaps we can come up with good intervention techniques,” said Abdullah. “From the IST perspective, this gives us a good understanding of design elements that work for specific health behaviors.
“Think about how the mobile phone changed how we looked at therapy interventions and healthcare,” added Abdullah. “Perhaps we’ll see something similar through wearables. It will hopefully be a new paradigm with data collection, intervention and enabling self-care.”
Other collaborators on the project include Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center, and Sahiti Kunchay, doctoral student in the College of Information Sciences and Technology.
In addition to a seed grant from the College of IST, the study will benefit from Apple Watches funded by a seed grant from the Department of Biobehavioral Health. The researchers hope to gain additional external funding to further advance the project.
Opioid crisis shows partnering with industry can be bad for public healthPublished on: March 6, 2019
By Jonathan H. Marks, Director of the Bioethics Program and affiliate faculty in Law and International Affairs, Pennsylvania State University, for The Conversation
“Show me the bodies!” someone demanded at the end of my lecture a few years ago.
As a scholar of public health ethics, law and policy, I had just warned an audience of professors and university administrators about the perils of partnering with, or taking money from, corporations – a common practice in public health research and policymaking.
It’s not always possible to prove harm like that, I said. But there are other reasons for government, the academy and public health organizations to maintain arm’s length relationships with corporations. Among them, preserving integrity and public trust.
As I document extensively in my book on corporate influence in public health, partnerships distort research agendas, not merely of individual researchers but of entire fields of research. They also reinforce the framing of public health problems and their solutions in ways that are most favorable to the corporate partners.
These concerns are most acute when corporations are creating or exacerbating a public health problem. Think of a soda company sponsoring exercise initiatives to burnish its reputation and deflect attention from the role of its brands in the obesity epidemic. But close relationships with corporations can be problematic even when companies are working on medicines or other potential solutions to health problems.
I failed to convince that skeptical audience member. But recent research found the bodies, or, at the very least, pointed to one place where we might start digging: the opioid crisis. The new study concluded that drug companies’ marketing of opioids to physicians was “associated with increased opioid prescribing and, subsequently, with elevated mortality from overdoses.” Recent court filings also suggest that doctors who met with opioid drug reps were 10 times more likely to have prescribed opioids to patients who later died of an overdose.
Marketing to physicians is only one of the strategies employed by opioid manufacturers. Between 2012 and 2017, five opioid manufacturers gave nearly US$9 million to 14 patient advocacy groups and medical societies. Although this sum is a drop in the ocean for drug companies with billions of dollars in opioid revenues, these were substantial sums for the recipients. And the companies’ investments paid off.
Many of the groups issued guidelines minimizing the addiction risks of prescription opioids. They also lobbied extensively to defeat legislation restricting opioid prescribing. When the CDC issued its draft guidelines to limit opioid use in 2016, opposition was significantly higher among organizations that had received industry funding.
The most commonly touted solution to financial conflicts of interest is disclosure of the conflict. The Physician Payments Sunshine Act of 2010 requires drug companies to disclose gifts to physicians and teaching hospitals. Democratic senator Claire McCaskill has introduced a bill to extend these provisions to cover payments made to patient advocacy groups.
But disclosure, while necessary, is not sufficient for addressing corporate influence in science, medicine and public health. While researching my book, I found plenty of evidence that drug, food and soda companies – among others – weave powerful webs of influence when they support the work of public health agencies, universities, patient advocacy groups and health professional associations.
It’s reasonable to expect corporations to exercise influence to the full extent permitted by law. But I believe governments have a responsibility to insulate themselves from corporate influence. Only by doing so can they meet their obligations to protect and promote public health. And universities should do likewise in order to protect scientific integrity. By inviting companies to partner, government and the academy play into corporate strategies of influence, imperiling their own integrity as well as science and public health.
When the National Institutes of Health launched a partnership initiative to address the opioid crisis in 2017, it turned to drug companies for guidance. They included an opioid company that pleaded guilty in 2007 to misleading regulators, doctors and patients about addiction risks and potential for abuse – and then continued its aggressive marketing for another decade, according to recent court filings. These documents also indicate that, while running newspaper ads in 2017 claiming that it was a “partner” in the fight against the opioid crisis, the company was still working on plans to expand the opioid market.
The world needs better options for pain management. And the opioid industry may play a role developing some of these options. But partnering with industry is hazardous – even if, as its director has pledged, the NIH enters these arrangements “with the utmost transparency,” and does not take cash payments.
Money need not change hands for partnerships to create reciprocity and influence, burnish the reputation of drug companies, and defuse support for more effective regulation of the marketing and prescribing of drugs. Collaboration may also lead to the neglect of other potential solutions to the opioid crisis – and other potential pain remedies beyond drug therapies.
If the opioid crisis has taught people anything, it’s that the interests of pharmaceutical companies and public health inevitably diverge. While opioid manufacturers and distributors were making billions of dollars, they were sowing the seeds of a crisis that has contributed to the deaths of more than 218,000 Americans and counting. In addition, the total societal costs of the opioid epidemic exceed half-a-trillion dollars per year.
Given these catastrophic costs, policymakers cannot afford to repeat and compound the errors of the past. While tackling pain management and opioid addiction, they must not neglect a third public health challenge: their own “addiction” to partnerships with the private sector. But, before public health officials can wean themselves off these collaborations, they must first acknowledge that they have a problem.
Why Social Science? – Because It Requires Confronting the Assumptions We Have About OthersPublished on: February 27, 2019
By Lee Hoffer, PhD, Associate Professor of Medical Anthropology, Case Western Reserve University
Social science comes in many varieties, is comprehensive in scope, and applied to an infinite number of real-world challenges, questions, and problems society faces. At its core, it concerns the human condition. While an economist, criminologist, psychologist, or sociologist may emphasize different things about being human, and often use different methods, their research is about people. But the people who we seek some understandings about, or from, have lives apart from our research. In other words, their lives overlap with what we study but are also more complex than that. Their day-to-day living involves connections with others, a history, setting, and sociopolitical / economic context, all of which can change over time. Social science is messy this way.
The social science I conduct concerns understanding the use and consequences of illegal drugs and substance use disorder (SUD). As a medical and cultural anthropologist, my research has given me an up-close perspective on these topics and how people’s lives are affected by them. The recent opioid epidemic has significantly increased the public awareness and concern about drug addiction. It has mobilized long and much-needed healthcare resources to address this challenge, moving drug policy marginally away from the war on drugs. Starting my career in the 1990s, recent actions are welcomed, but bittersweet. Drug addiction has always needed more public health attention and only realizing this now as more people are dying is frustrating.
In drug addiction research, social science is often overshadowed by biological science. Although SUD involves a mixture of social and biological processes, the national research agenda and its associated funding are often weighed toward the former. In some conferences on addiction, no, or only a small fraction of, research is dedicated to people or human interaction. Like other social scientists, what I do is in the minority and highly specialized. As a cultural anthropologist, the primary methodology I employ is ethnography. Ethnography involves addressing research questions by interviewing and observing participants as they go about their daily routines and activities. Acknowledging their active role in this “fieldwork,” anthropologists refer to the people we research as participants.
To do ethnography, one must develop rapport with participants, and being part friend and part researcher presents challenges. Ethnographers must be self-aware of how their biases (i.e., assumptions) may influence the findings they develop and report. We have personal encounters in our research that can be influential. Vigilance is mandatory because, as much as we might think we know our participants, they are ultimately the experts on their own lives. And there are always surprises. A recently departed friend and mentor, Mike Agar, called these surprises “rich points,” acknowledging an opportunity for the researcher to learn, amend, and realign their understandings.
Over the years, I have learned a great deal from my research participants. They have been generous with their time in explaining things. Many such lessons occurred first-hand, observing what illegal drug users were doing and gaining perspective from their point of view. People are sometimes skeptical about conducting ethnography with illegal drug users. On a recent conference call a drug treatment provider remarked, “yeah, drug addicts lie and tell you what you want to hear.” I am confident for drug treatment professionals this is true. But I do not seek to change behavior or attitudes. Although I do not support illegal drugs, I do not take a moral stand about what my participants do. I have no agenda; there is nothing I “want to hear.” I just watch, listen and try to make sense of my data.
It seems impossible to avoid assumptions people make about illegal drug users, “drug addicts,” or people with SUD. Here the filter our society applies is dense and difficult to refashion. I often hear how these people are violent, impulsive, out-of-control, in denial, self-centered, and egoistic. Biomedical research tells us their brains, i.e., neurological pathways associated with pleasure, have been hijacked by drugs and that they have diminished executive function, i.e., decision-making capacity. Some suggest they have “addictive personalities” or are incapable of empathy.
Confronting the above in both public and scientific discourse, I find many of the assumptions about my participants false, insufficient or only relevant in a particular point in time or social context. Most of the people I work with just want someone to listen to them and understand the challenges they face. Although there are relevant behavioral patterns and themes in research conducted on illegal drug use and SUD, I have witnessed a continuum that, more often than not, is very difficult to simplify. Ethnography demonstrates how complicated people’s lives are relative to the questions we seek to answer. Returning to my answer to “why social science,” confronting what we (and others) believe about the people we research is something I keenly appreciate about social science.
LEE HOFFER is an Associate Professor of Medical Anthropology at Case Western Reserve University (CWRU) in Cleveland, Ohio. His research focuses on understanding the social, political, economic and cultural dimensions of illegal drug use and addiction. Dr. Hoffer has conducted community-based studies of heroin, crack / cocaine, methamphetamine, club-drug, inhalant, and non-prescription opiate use, as well as trends in use. His current work combines ethnographic research, epidemiology, and agent-based modeling (ABM) to better understand local illegal drug markets and their connection to drug epidemics. His research has received support from NSF, NIH / NIDA, and private foundations.
Sharkey shares impact of Penn State research across University and beyondPublished on: February 25, 2019
Since the University’s founding when Penn State’s first president Evan Pugh set forth the college’s research vision in 1859, innovation and knowledge creation have been a foundational element of the land-grant mission, according to Neil Sharkey, vice president for research.
Describing research as a “driver of progress,” Sharkey shared the impact Penn State research activities continue to have today throughout the University, across the Commonwealth and beyond in a presentation to the Board of Trustees at its Friday (Feb. 22) meeting.
“Universities have become the country’s innovation centers and Penn State is no exception. Our research enterprise serves the Commonwealth, nation and the world through innovative approaches to creating new knowledge and solving the global challenges of our time,” said Sharkey. “Beyond our desire and ability to benefit humankind, our ranking and reputation as a leading research university helps to attract talented faculty, while also boosting student applications and providing experiences for students that enable career success.”
As a top-25 research university, Penn State researchers are at the forefront of fields as varied as big data, combating the opioid crisis, personalized medicine, renewable energy, climate change, infectious disease, rural innovation, water and food security, and more.
With research expenditures hitting a record high of $927 million in the 2017-18 fiscal year, the scale and scope of Penn State’s research activities are crucial measurements of the University’s standing among Association of American Universities (AAU), Big Ten peers and other world-class institutions. Penn State is one of only two institutions in the U.S. accorded land grant, sea grant, sun grant and space grant status; and Penn State University Libraries ranks 10th among North American research libraries, among other distinctions.
To advance the potential of the research enterprise, the Office of the Vice President for Research collaborates with the University Research Council, deans and chancellors, and a broad range of units across Penn State in such areas as research protections, sponsored programs, ethics, commercialization and more.
“The breadth of expertise and experience at Penn State helps us to maximize our impact in many crucial ways, from our collaborative interdisciplinary institutes and centers, to our entrepreneurial ecosystem across the state, to our current philanthropic campaign,” said Sharkey.
At the trustees meeting, Sharkey shared a variety of examples outlining the positive impact of research across efforts to:
Drive student opportunities and success
Attending a university as large and research-oriented as Penn State provides countless opportunities for students to collaborate across campus or continents, and over the past five years, nearly 8,000 students completed undergraduate research for academic credit. A variety of funding support and training grants are available to students through Penn State interdisciplinary institute and awards, Erickson Discovery Grants, federal training grants and corporate gifts. In 2017-18, external grants and contracts provided $24.7 million in graduate student research support, while 156 Erickson Discovery Grants were awarded to students at 11 Penn State campuses.
Through researchers andinterdisciplinary institutes, such as the Penn State Cancer Institute and Institutes of Energy and the Environment, Penn State is driving discovery in areas such as national security, malaria eradication, child maltreatment research and the development of climate-risk management strategies. For example, the Applied Research Laboratory at Penn State is a Department of Defense designated University-Affiliated Research Center that has supported national security efforts for more than 70 years with basic and applied research. More recently, a new Penn State Consortium to Combat Substance Abuse within the Social Sciences Research Institute is bringing together experts across the University to combat the opioid epidemic.
Promote economic development and progress
As students, faculty, staff and community members engage in entrepreneurial activities, Penn State’s 21 LaunchBoxes across the state have attracted nearly $5 million in external matched and leveraged funds since 2016. With one of the nation’s friendliest intellectual property policies for industry sponsored research, Penn State continues to attract research partners from the private sector. On average, 500 companies, including many from Pennsylvania, sponsor projects every year.
Attract leading faculty and outstanding students
Penn State’s sustained research growth, high scholarly output and citation count among AAU public institutions, number of Penn State faculty members in the National Academies, and ranking among the top producers of Fulbright scholars all help to attract outstanding faculty and students. In 2018, nearly 2,000 unique investigators received new awards and competitive renewals; and 967 sponsors provided awards.
Impact the world through discovery, innovation and entrepreneurship
A primary objective of Penn State’s philanthropic campaign, “A Greater Penn State for 21st Century Excellence,” is to impact the world through discovery, innovation and entrepreneurship. With a focus on food, water and energy security; human health; and economic development and job creation, the “Impact the World” imperative is the campaign’s best performing and had reached 81 percent of its goal by the halfway mark in the campaign.
“Among our researchers, faculty and graduate and undergraduate students, we have enthusiastic thought leaders and knowledge creators whose hard work, ideas and projects are having a beneficial impact across the University and beyond,” Sharkey said. “There is so much potential in this space to continue to build upon our teaching and research enterprise to drive economic development, job creation and student career success, as we continue to address the most pressing issues of our time.”
To take a look at the full presentation, visit https://www.psu.edu/ur/newsdocuments/Presidents_Research_Report_Feb2019.pdf.
Project ECHO prepares doctors to manage addiction care closer to homePublished on: February 21, 2019
For patients suffering from opioid use disorder, and for the physicians in small towns across Pennsylvania who are their first level of care, Project ECHO offers hope. The effort aims to give primary care physicians the tools they need to treat the growing group of Pennsylvanians addicted to opioids — many of whom live in regions with no specialized addiction resources. It’s a win-win: patients get a doctor who can treat them close to home, and physicians get to expand their knowledge, their professional network and their relationship with their patients.
The concept comes from a physician at the University of New Mexico who wanted to shorten the wait list at his gastroenterology clinic. Now, more than 220 institutions around the world use Project ECHO for at least 90 disease topics. And Penn State Health researchers hope to influence them all.
“Research evaluating the project hasn’t kept pace with growth of the movement clinically,” said Dr. Jennifer Kraschnewski, director of Project ECHO at Penn State College of Medicine and a Penn State Health primary care clinician-investigator who studies community health interventions. “It is our goal to create an evidence base to support the model and its ability to mentor primary care providers outside of urban academic hubs. We also aim to learn how to best grow and use Project ECHO as an intervention.”
Penn State expert clinicians are halfway through their first cohort of the Opioid Use Disorder Project ECHO, funded by a grant from the Substance Abuse and Mental Health Services Administration.
“What most excites me is that Project ECHO gets to the heart of the challenges of treating some of a physician’s toughest patients,” said Dr. Sarah Kawasaki, director of the Opioid Use Disorder Project ECHO at the College of Medicine. She is also director of Addiction Services for Pennsylvania Psychiatric Institute. “We’re creating a community to support and educate physicians and improve the chances that they can provide the care their patients need, rather than sending them to a specialist for first-line treatment.”
The program series includes 12 sessions, each of which is attended by up to 20 clinicians plus Kawasaki and her Project ECHO team. The Penn State team is comprised of other addiction experts from the College of Medicine and partner organizations. It serves as the hub, with each participating clinic a spoke learner. At each session, they discuss a complex patient case that has been deidentified and sent in by a participating clinician. They then listen to a short lecture. The project rolls from one group to the next, growing a network of specially trained physicians. In time, it should exponentially build the state’s ability to bring best-practice care to all patients.
Two attendees from The Wright Center for Community Health, a state-designated Center of Excellence in addiction and recovery, were part of the first Project ECHO group in November. Like Kawasaki’s program, The Wright Center is one of the state’s eight hubs for the Pennsylvania Coordinated Medication-Assisted Treatment (PAC-MAT) program. Another two physicians in the first group are from spokes of The Wright Center’s PAC-MAT program.
“Providing care in the addiction and recovery space for less than three years, we have an insatiable desire to learn and develop courses to support our physician-led care teams,” said Dr. Linda Thomas-Hemak, chief executive officer of The Wright Center. “That is why we signed up for ECHO.” Thomas-Hemak is also board-certified in internal medicine, pediatrics and addiction medicine.
Read the full article on Penn State Medicine.
Student shares story of opioid addiction to support othersPublished on: February 18, 2019
Erin Bergner, a Penn State Abington junior, is motivated, to say the least: She carries extra courses so she can graduate early, works in a faculty research lab, and holds down another part-time job. And all the while she is managing her recovery from opioid addiction and telling her story on ShareYourOpioidStory.comto help reduce stigma and support others in the grip of addiction.
“My hope is to help just one individual. I want people to know they have support,” she said. “It’s traumatic emotionally, and I don’t want anyone to think that they have to go through it by themselves.”
Here is her story, which she shares in greater detail on ShareYourOpiodStory.com:
After suffering abuse at a young age, Bergner developed an eating disorder and began to self-harm. She didn’t talk about her distress because of the stigma associated with mental health issues where she grew up, and she turned to marijuana as an escape.
“By tenth grade, I was using heavier substances like opioid pills and benzodiazepines. I was eventually introduced to heroin. I began using heroin more and more as it was easier and cheaper to get than opioid pills,” the Schreyer Honors Scholar said. “My senior year, my parents found out and sent me to rehab.”
Bergner spent 50 days in rehab, but relapsed immediately upon release.
“I went back to using heroin and overdosed. I was revived after receiving three doses of Narcan. I began using again two days later,” she said. “I eventually went into a 9-to-5 outpatient rehab program. After failing a drug test, I became much more committed to my rehabilitation and, as a result, I have been sober.”
She is looking forward to becoming a therapist and working with those living with addictions.
“Being one step closer to helping people makes me really happy, and that’s a huge motivation for me. I’m very open about my struggles today because I didn’t feel alone after hearing others tell stories that were so similar to mine,” she said.
“We’re not just a statistic, we’re individuals with hopes, dreams, and struggles. Everyone’s recovery looks different. You have to block out the judgements of others and always remember that all you have is yourself at the end of the day. Recovery is something no one else can do for you. You have to own it.”
The Psychological & Social Sciences major coincidently works in the research lab of Glenn Sterner, assistant professor of criminal justice at Abington and an research expert on the illicit use of opioids.
“I work on the ShareYourOpioidStory.com website help to find potential candidates to share their experiences,” Bergner said. “It’s not a typical college job, but it is giving me experience and making a difference.”
She is also an eager student in the psychological and social sciences major and credits faculty, especially Michael J. Bernstein, associate professor of psychology, for fueling her love of her major.
“When you find someone as passionate as you are about your major, it’s contagious,” she said.
Bernstein, in turn, calls Bergner “an amazing student.”
“She takes her studies seriously and is avid thinker about human behavior and how to understand why people act the way they do so as to make positive change in the world,” he said.
ShareYourOpioidStory is an initiative to share stories, reduce stigma, and come together to reduce opioid use in America. The organization is hosting a Community Conversation at Penn State Abington at 5:30 p.m. on Feb. 20. Register here.
Overdose deaths could increase with ‘changing nature’ of opioid epidemicPublished on: February 6, 2019
The opioid epidemic in the United States could be responsible for 700,000 overdose deaths between 2016 and 2025, according to a new study published today in JAMA Network Open.
“Preventing people from misusing prescription opioids is important and could help prevent some overdose deaths in the long term, but our study shows that the effect would be limited in reducing the overdose deaths in the immediate future,” said Qiushi Chen, an assistant professor in the Harold and Inge Marcus Department of Industrial and Manufacturing Engineering at Penn State and the lead author on the paper. “The majority of overdose deaths are now from illicit opioids, such as heroin and fentanyl instead of prescription opioids, and this changing nature of the epidemic has reduced the potential impact of programs targeting prescription opioids.”
In an effort to understand the outcomes that programs to limit prescription opioid misuse actually produce, Chen worked with colleagues from Massachusetts General Hospital, Harvard Medical School, and Boston University Medical School.
“The opioid crisis has been a national public health emergency for more than a year, and it’s getting worse,” said Jagpreet Chhatwal, an assistant professor at Harvard Medical School and a decision scientist at Massachusetts General Hospital Institute for Technology Assessment (MGH-ITA). Chhatwal is the senior author on the paper. “We set out to understand how reduction in incidences of prescription opioid misuse, by interventions of restricting opioid prescriptions supply, would influence the outcomes of overdose deaths in the next decade.”
Chen and the team developed a mathematical model to simulate the opioid crisis from 2002 to 2025. Using data available from Centers for Disease Control (CDC) and the National Survey on Drug Use and Health (NSDUH), the researchers calibrated the model to match the trends of overdose deaths from specific types of opioid consumption – recreational prescription misuse to opioid use disorder with prescription and illicit opioids – observed from 2002 through 2015. They then used the model to project probable outcomes of the epidemic, based on the continuing trends, through 2025.
The researchers found that, if that status quo continues, the annual number of opioid overdose deaths will increase from 33,100 in 2015 to 81,700 in 2025 – a 147 percent increase. Eighty percent of those overdose deaths will result from the use of illicit opioids, such as heroin or fentanyl. In every scenario tested, the researchers found that interventions aimed at reducing prescription opioid misuse decreased overdose deaths by three to five percent.
Under an extreme modeling scenario, a hypothetical situation where literally no new incidences of prescription opioid misuse occurred after 2015, the researchers found that number of deaths in 2025 would still remain higher than in 2015.
“More and more people are using illicit opioids. In the past, people might start using pain pills non-medically, which could then lead to illicit opioid usage, but data suggests that even more people are now starting with recreational use of illicit opioids,” Chen said. “Prescription opioids are now not necessarily the gateway that people must use to get to illicit opioids.”
According to the NSDUH, 30 percent of people who developed opioid use disorder did not start with prescription pills, but rather began immediately with heroin or fentanyl. Chen and his team project that the trend will continue, and, by 2025, nearly half of people with opioid use disorder will have initiated their opioid use with illicit drugs.
“This study demonstrates that initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term,” said co-author Marc LaRochelle, an assistant professor in the Grayken Center for Addiction at the Boston Medical Center. “We need policy, public health and health care delivery efforts to amplify harm reduction efforts and access to evidence-based treatment.”
Other contributors on this paper include Davis Weaver, a medical student at Case Western University who was a research associate at the MGH-ITA; Anna Lietz, a research associate at the MGH-ITA; Peter Mueller, a postdoctoral fellow at MGH-ITA and Harvard Medical School; Sarah Wakeman, the medical director of the Substance Use Disorders Initiative at MGH and an assistant professor of medicine at Harvard University; Kenneth Freedberg, a professor of medicine at Harvard Medical School and MGH and the director of the Program in Epidemiology and Outcomes Research at the Harvard University Center for Aids Research; Tiana Raphel, a medical student at University of Texas Southwestern Medical School who was a research associate at the MGH-ITA; Amy Knudsen, an assistant professor of radiology at Harvard Medical School and a senior scientist at the MGH-ITA; and Pari Pandharipande, an associate professor of radiology at Harvard Medical School and the director of the MGH-ITA.
Sterner awarded $2.7M to help fight opioid crisisPublished on: February 4, 2019
A Penn State Abingtonfaculty member was instrumental in securing three grants totaling more than $2.7 million to combat the opioid epidemic in Pennsylvania and nationwide.
Glenn Sterner, assistant professor of criminal justice at Abington and an expert on the illicit use of opioids, said the grants enhance opportunities to fight opioid addiction through supply side data-based interventions and increased connection with prevention strategies.
“We are continuing to expand our efforts to address the opioid epidemic, and through these grants we will be working collaboratively with colleagues across campuses, universities, and disciplines, and with community partners, to take on this serious issue,” Sterner said.
“We have an incredible group of people dedicated to making impact in our communities through these funded projects.”
Sterner is the principal investigator on the first grant, which was funded for $683,000 by the federal Department of Justice/Bureau of Justice Assistance. Sterner will partner with the Pennsylvania State Police to use data to identify and disrupt the opioid networks in several Pennsylvania counties including Adams, Cumberland, Dauphin, Franklin and Perry, and encompassing sections of three major interstates (I-83, I-81 and I-76), which are known drug-trafficking corridors.
It will synchronize innovative, technology-driven enforcement strategies, which leverage information received through community input. There are several components to the program, including targeted enforcement and public outreach. The state will collaborate with research partners at Penn State, who will evaluate the program’s effectiveness utilizing measurable performance metrics.
The second grant, funded by the National Institute of Justice, provides $725,000 to a team coordinated by Iowa State University that includes Sterner and an additional $220,000 directly to Sterner. It focuses on building intelligence networks to combat the opioid crisis in rural communities across the nation.
“We are working across multiple locations in Iowa, Missouri and Pennsylvania, among others, to assist rural counties so they can address these issues,” Sterner said. “We are teaming with local police in our rural communities to increase the capacity for intelligence-based intervention to address drug distribution. This could be replicated in other places.”
The third grant for almost $1.1 million is funded by the Substance Abuse and Mental Health Services Administration. The grant, for which Sterner is part of the team, connects supply interruption and prevention to address opioid misuse in Pennsylvania.
“We are developing the infrastructure to coordinate supply-based interventions and prevention-based initiatives in communities for K-12 students and their families,” Sterner said. “It’s a way for us to tackle both supply and demand for illicit substances in our communities.”
Sterner sits on the Opioid Overdose Task Force for the state of Pennsylvania. He also is a founding member of the Penn State Consortium to Combat Substance Abuse advisory board and an affiliated faculty of Penn State’s Criminal Justice Research Center. Sterner is the founder of the Share Your Opioid Story initiative.
On Feb. 20, Sterner will host “Reducing Stigma: A Community Conversation” at Penn State Abington from 5:30 p.m. to 7:30 p.m. To register, visit http://bit.ly/2S5oRGH. For additional information, contact firstname.lastname@example.org.
New, evidence-based diagnostic tool developed for abusive head traumaPublished on: January 14, 2019
Abusive head trauma is the leading cause of traumatic death and disability in infants and young children in the United States. However, multiple studies have shown that disparities and bias can affect physicians’ decisions to evaluate, diagnose and report suspected abuse. In response, researchers have developed an evidence-based predictive tool physicians can use to help confirm, exclude and report suspected abuse.
According to Kent Hymel, professor of pediatrics and Child Maltreatment Solutions Network faculty co-hire, the overall aim of their research is to reduce cases of missed or misdiagnosed abusive head trauma.
“The consequences of missing a diagnosis for abusive head trauma (AHT) can be severe and can even result in the death of the child if they are mistakenly returned to an abusive situation,” said Hymel.
To that end, Hymel and his colleagues in the PediBIRN research network have developed an evidence-based predictive tool for AHT that incorporates the predictive contributions of patients’ (positive or negative) completed abuse evaluations.
As published in Child Abuse & Neglect, Hymel and his research team analyzed 500 cases of acutely head-injured children under 3 years of age who were hospitalized for intensive care at 18 different sites between 2010 and 2013. Their analysis led to the derivation of a seven-variable prediction tool which they call the PediBIRN-7. The tool’s seven predictor variables include respiratory compromise at the scene of injury or during transport; bruising on the child’s ears, neck or torso; skull and other skeletal fractures; bleeding in the head and eyes; and brain swelling.
When evaluating their data, researchers found clusters of variables that best inform abuse versus nonabuse.
“The study was designed to include two of the variables, skeletal and retinal scans, however another five variables were derived through the data,” Hymel explained. “Interestingly, four out of the five additional variables coincide with a previous study that resulted in a predictive screening tool for child abuse.”
If validated, application of the PediBIRN-7 as an AHT prediction tool could inform physicians’ pending decisions to confirm, exclude and/or report suspected AHT.
“The PediBIRN-7 is another tool physicians can use when evaluating suspected AHT, in addition to scans and other screenings,” said Hymel. “Application of the PediBIRN-7 as an AHT diagnostic tool will hopefully reduce missed cases and disparities in the diagnosis of AHT.”
Currently, PediBIRN researchers are working to validate these findings in another study before the diagnostic tool can be adopted for use by physicians.
“There is no gold standard for diagnosing child abuse, and no tests or screenings tell the whole picture. Hopefully this new tool will give a more definitive diagnosis and help minimize under- or over-diagnosis,” Hymel said.
Other researchers on the project include Ming Wang, Vernon Chinchilli and Mark Dias, Penn State College of Medicine; Wouter Karst, Netherlands Forensic Institute; Douglas Willson, Children’s Hospital of Richmond; Bruce Herman, University of Utah School of Medicine; Christopher Carroll, Connecticut Children’s Medical Center; Suzanne Haney, University of Nebraska Medical Center; and Reena Isaac, Baylor College of Medicine.
The work was supported by Dartmouth-Hitchcock Medical Center, The Gerber Foundation, Penn State Social Science Research Institute, Penn State Health Milton S. Hershey Medical Center, and the National Institutes of Health.
The Child Maltreatment Solutions Network advances Penn State’s academic mission of teaching, research, and engagement in the area of child maltreatment. It is part of the Social Science Research Institute at Penn State.
Penn State mounts broad attack on opioid addiction in PennsylvaniaPublished on: January 11, 2019
A startling 13 to 16 people die each day in Pennsylvania due to opioid overdose, among the more than 70,000 Americans who succumbed to the epidemic in 2017, according to the Centers for Disease Control and Prevention. That gives Pennsylvania the dubious distinction of being ranked near the top of opioid-related death rates in the U.S.
“Alcoholism is still the most common substance use disorder, but it has been eclipsed by the opioid crisis because people are dying,” said Dr. Sarah Kawasaki, medical director of the Advancement and Recovery opioid addiction treatment program at Pennsylvania Psychiatric Institute. “It’s killing people in the prime of their lives. Children are without parents. The number of deaths is what makes this epidemic so important.”
That’s why the clinicians, researchers and administrators with Penn State Health and Penn State College of Medicine have united to fight the opioid crisis. Their weapons are evidence-based clinical treatment, research and education, and they are aiming at every phase of the problem ― from pre-addiction through treatment and recovery.
“We feel a sense of urgency. Opioid use disorder is a multifaceted issue that needs to be addressed at every single level,” said Sue Grigson, director of the Penn State Addiction Center for Translation based on the College of Medicine’s Hershey campus. “Fortunately, we have the right individuals and expertise to do that, and we’re using grants as vehicles to help us.”
The grants include a $1.5 million clinical grant, awarded by the Substance Abuse and Mental Health Services Administration in November to, in part, help fund Project ECHO–an effort to enable doctors in widespread Pennsylvania counties to connect with experts in opioid addiction. Via teleconferencing, they have access to education and assistance with difficult cases.
Grigson also expects to hear this month whether the center will receive two additional grants totaling more than $100 million, which would expand referral services, educational outreach, translational research, screening and prevention projects, and new treatment methods. Founded just over a year ago, the center has wasted no time building a broad plan of attack.
Learn more about these efforts – and Penn State College of Medicine’s Addiction Symposium – in this Penn State Medicine article.
Students create eye-catching ad campaigns warning of opioid dangersPublished on: January 7, 2019
Students who take Arpan Yagnik’s advertising classes often get more than they bargained for — starting with at least four weeks of creative aerobics. The end result? Increased creativity, confidence and highly coveted job skills.
“After students complete the classes, they have an arsenal of creative ideas. They know they are going to stand apart from others, “ said Yagnik, assistant professor of advertising and communication at Penn State Behrend and co-author of “Creative Aerobics: Fueling Imagination in the 21st Century.”
Last semester, he joined forces with Penn State’s Consortium to Combat Substance Abuse (CCSA) and asked his advertising classes to create multiple campaigns for the awareness, education or prevention of opioid abuse.
“I hoped to call attention to the opioid epidemic not only to our students, but to their families and communities,” he said.
The pill is the predator
“In class, we did exercises where we brainstormed similarities between two completely different things,” said Wesley von Tacky, a 2018 Penn State graduate. “A good friend of mine died from an opioid overdose, and I wanted to show the true pain of addiction. He owned a pet snake and scorpion, and in the ad I created, I made the point that opioids can be hidden, dangerous killers, like snakes. The pill is the predator.”
The students translated complex issues into advertising campaigns designed to change the hearts and minds of the public. “As a visual communicator, my goal is to create a conversation through an image,” said von Tacky.
“A successful ad creates an ‘a-ha’ moment,” added Yagnik. “To make an impact, you need to create simplified messages that are unique and memorable. That’s where our students can help Penn State researchers. They can get the message across — to the downtrodden and to people with varied educational and literacy levels.”
Students gain skills highly sought-after by employers
The classes feature work with real-world clients, and graduates have secured jobs in the corporate and non-profit sectors.
“When we work with clients, they love the ideas that our students generate,” said Yagnik. “When these students go on job interviews, they have confidence and a story to tell about how they successfully worked with clients. When they encounter challenges on the job, they think ‘bring it on’ because they have learned to adapt, collaborate in new ways, and to think creatively.”
“Dr. Yagnik wants you to think on a different level than anyone else. In advertising, you have to generate new ideas constantly,” said von Tacky. “He’s imaginative and has a strong desire for his students to be successful. He shows that he cares.”
“My goal is to take them to where I am and the rest of the journey is theirs,” said Yagnik.
Penn State faculty, staff or students who would like to partner with the Consortium to Combat Substance abuse may contact Sebrina Doyle, assistant research professor at the Edna Bennett Pierce Prevention Research Center, for more information.
Important NIDA Funding Opportunity: Opioid-Induced Respiratory DepressionPublished on: December 10, 2018
The Lung Association wanted to make you aware of an important funding opportunity from the National Institute on Drug Abuse (NIDA). According to the NIH, more than 2 million Americans have opioid use disorder. Millions more misuse opioids, taking medications longer or in higher doses than prescribed. NIDA has a new funding program that supports research to provide new strategies for the prevention and treatment of opioid misuse and addiction in order to help people with opioid use disorder achieve and maintain a meaningful and sustained recovery.
NIDA is specifically interested in funding grants to further our understanding of the very important issue of Opioid-Induced Respiratory Depression. The specific RFA can be found at: RFA-DA-19-002. Since this is a vital issue related to respiratory health and disease, the Lung Association wanted to make you aware of this rapid turnaround funding mechanism. The goal of this funding mechanism is to support the discovery and development of medications to prevent and treat opioid use disorders (OUD) and overdose.
This opportunity is unique in that NIDA is not bound by the three standard NIH submission dates per year. The institute is a conducting rolling submission and review process. Applications received by January 1, 2019 will be reviewed by February 22, 2019. Those received by April 1, 2019 will be reviewed by May 22, 2019. There are a number of additional dates through January 2020.
We hope you will consider and share this new opportunity.
Stop Overdoses in PA Week/Get Help Now – free Naloxone December 13Published on: December 10, 2018
As you are likely aware, the commonwealth, and the entire country is in the midst of a major public health crisis, the opioid epidemic.
Under the leadership of Governor Wolf, the efforts in Pennsylvania to address this epidemic have been widespread, and have brought about change on the local, regional and state levels. These efforts have taken place across numerous agencies, and also through the Opioid Command Center, established through the Governor’s disaster declaration.
On December 10-14th, the state is holding “Stop Overdoses in Pa.: Get Help Now” week. This week is aimed at helping to reduce the stigma around this crisis, to get people the lifesaving medication naloxone, and make sure people know help is available.
We need your help in this effort. Please share far and wide within your organization and community that the Wolf Administration will provide Naloxone for free to all Pennsylvanians at nearly 80 locations across the state, primarily at state health centers and county/municipal health departments, on Thursday, December 13 from 11 a.m. to 7 p.m., as part of the administration’s ongoing effort to reduce the number of opioid overdoses and get residents into treatment. Information on all the locations is included in the official press release here.
In addition to being able to get naloxone for free on Dec. 13th, Naloxone is available at pharmacies statewide every day without a prescription thanks to a standing order prescription signed by the Secretary of Health, Dr. Rachel Levine. It is covered by most insurances at little to no copay.
The opioid epidemic touches everyone, regardless of age, race, socioeconomic class. It does not discriminate.
However, we are optimistic that the work being done is saving lives. We know that through each of us working to highlight our efforts to address this epidemic, we can further address the epidemic in Pennsylvania.
As valued partners in Pennsylvania’s fight against the opioid epidemic we hope that you will help us spread the word about this community resource. We encourage you to share this information on “Stop Overdoses in Pa.: Get Help Now” week to your organization, community, colleagues, friends, and family. The Pennsylvania Department of Health depends on your help in this collaborative effort.
We thank you for your support in this, and hope you have a wonderful holiday season.
Seed funding available to combat substance abusePublished on: December 7, 2018
Penn State’s Consortium to Combat Substance Abuse (CCSA) is seeking to support interdisciplinary teams of Penn State researchers whose work is aimed at combating opioid and other substance abuse.
CCSA Interim Director Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center, says that Pennsylvania and the nation needs more research into this troubling epidemic. “This call for proposals will seek research teams to conduct innovative, interdisciplinary and translational research to illuminate risk factors for substance use, abuse and addiction.”
Priority will be given to projects that make a convincing case for how the research can advance solutions to the systemic problems of substance abuse. Applications are particularly encouraged that map onto the University’s distinctive strengths in substance abuse research: pathways to addiction, criminal justice, and spillover effects to children, families, and communities. Proposals may focus on any substance of abuse, including alcohol, nicotine, cannabis, prescription drug misuse, and other illicit drug use.
Both Level 1 and Level 2 letters of intent are due Jan. 15. For more information on the opportunity, visit the CCSA’s Funding Opportunities page.
The CCSA is housed in Penn State’s Social Science Research Institute, one of seven cross-University research institutes within the Office of the Vice President for Research.
‘Ask the Experts’ addresses the opioid epidemic on cesarean sectionsPublished on: November 30, 2018
The latest episode in the “Ask the Experts” series features Danielle Symons Downs, professor of kinesiology and obstetrics and gynecology, and associate director of the Social Science Research Institute at Penn State, discussing her research on the links between cesarean section deliveries and opioid prescribing after birth.
Downs also speaks about several initiatives aimed at combating the opioid epidemic and bringing awareness to maternal death rates in the United States, including the Penn State Consortium to Combat Substance Abuse and the March of Dimes’ #BlanketChange movement.
In the “Ask the Experts” video series, produced by the Center for Health Care and Policy Research (CHCPR) at Penn State, leaders in the industry share their perspectives on key topics affecting health care delivery and policy. The series is designed to reveal where and how important policy and practice topics intersect, and highlight ways in which research can advance that integration.
Downs’ primary research theme is to design theoretically-driven, optimized, behavioral interventions to promote energy balance (e.g., increase physical activity, manage weight) in order to improve health outcomes for women and their offspring during the preconceptional, prenatal and postpartum/postnatal periods. Her research also involves translating her intervention findings to clinical settings. More about Downs’ exercise psychology laboratory can be found here.
Dennis Scanlon, distinguished professor of health policy and administration and director ofCHCPR in the College of Health and Human Development at Penn State, interviews the guests on the “Ask the Experts” series. Scanlon’s research focuses on understanding the role of measurement, incentives, quality improvement and individual and organizational behavior change for improving important health care outcomes, including clinical quality, patient experience and economic efficiency.
The mission of CHCPR is to create and disseminate new scientific knowledge that will help private and public decision-makers to develop cost effective services and programs that improve people’s health. CHCPR helps researchers interested in all aspects of health services and health care improvement find funding, develop quality research designs, collect and analyze data, and disseminate findings to the right audiences.
Addiction medicine expert to give two presentationsPublished on: November 27, 2018
Judson Brewer, M.D., Ph.D., an international expert in addiction medicine, will give two presentations at Penn State College of Medicine on Dec. 18.
Brewer will present “The Craving Mind: From Cigarettes to Cupcakes to Smartphones, the Mechanisms Underlying How Mindfulness Helps Change Unhealthy Habits” from 7:30 to 8:30 a.m. in Lecture Room D at the Department of Medicine Grand Rounds. He will also present “The Craving Mind: Why We Get Hooked, and How Mindfulness Helps Us Break Free From Addictive Habits” from noon to 1 p.m. in C3860 at the Penn State Addiction Center for Translation Topics in Addiction Seminar.
Brewer’s presentations are relevant to those of any background interested in addiction and its widespread influences on research, medicine, prevention, treatment, education, policy and community.
The five types of problem drinking are more common at different agesPublished on: November 26, 2018
Alcohol abuse is more complicated than simply drinking too much. There may be five separate types of problem drinkers, according to Penn State researchers, and each one may be more common at different stages of life.
In a study, Penn State researchers discovered five distinct classes or “profiles” among people with alcohol use disorder, with each profile defined by a specific set of symptoms. While each profile existed in people of all ages, certain profiles were more common at different stages of life.
For example, young adults were more likely to fit the profile characterized by drinking too much and experiencing hangovers and other withdrawal symptoms. Meanwhile, older adults in their late 50s to 60s were more likely to struggle with cutting back on their alcohol use.
Ashley Linden-Carmichael, assistant research professor of biobehavioral health and faculty affiliate of the Edna Bennett Pierce Prevention Research Center, said the findings suggest that diagnosing and treating alcohol use disorder is not one size fits all, and that care should be taken to treat a person’s specific symptoms.
“We need to think beyond whether someone has an alcohol use disorder, yes or no, and take a look specifically at what they’re struggling with and whether they’re in a particularly risky class,” Linden-Carmichael said. “Additionally, while young adults are most at risk for an alcohol use disorder, it’s clear that it’s also an issue for people in middle age or in older adulthood, too. But it might look different and they may be struggling with different aspects of drinking.”
Alcohol use disorder can include a variety of symptoms, ranging from drinking more or longer than intended, to more severe symptoms like experiencing withdrawal symptoms when not drinking alcohol. A person is considered to have an alcohol use disorder if they experience two or more of the designated symptoms.
To explore how alcohol use disorder varies among people at different ages, the researchers used data from a nationally representative group of 5,402 participants in the National Epidemiologic Survey on Alcohol and Related Conditions. The sample was restricted to participants who were between the ages of 18 and 64 and who met the criteria for an alcohol use disorder in the previous year.
To analyze the data, Linden-Carmichael used a new method developed at Penn State’s Methodology Center that allowed the researchers to discover hidden “profiles,” or groups of people who share similar symptoms of alcohol use disorder.
The researchers found five distinct profiles within the study participants.
- Alcohol-induced injury: In addition to drinking too much, people in this profile reported getting into risky situations during or after drinking that may have resulted in injury.
- Difficulty cutting back: People in this group struggled with wanting to cut back on their problematic drinking but being unable to.
- Highly problematic, low perceived life interference: While people in this group reported experiencing many symptoms, they said their drinking did not interfere with their family, friends, work or hobbies.
- Adverse effects only: People who fit this profile reported experiencing hangovers or withdrawal symptoms in addition to drinking too much.
- Highly problematic: People in this group reported experiencing every symptom of alcohol use disorder.
In addition to identifying the five groups, Linden-Carmichael said they were able to use the method to see how prevalent each profile was at different ages.
Linden-Carmichael said the result — recently published in the journal Alcohol and Alcoholism — suggest that health care providers should consider looking at personalizing treatment and intervention efforts.
“Therapists could consider, for example, that when someone is a young adult, they should be looking for that person experiencing withdrawal symptoms,” Linden-Carmichael said. “Conversely, if someone is older, they could look for struggles with cutting back their drinking, or alcohol-related injuries.”
In the future, Linden-Carmichael said she would like to use the same method to look at the different classes of alcohol use disorder over time.
“I’m interested in seeing, for example, if someone has a certain profile at a younger age, what happens to them later?” Linden-Carmichael said. “If a person is in the adverse-effects-only class at 21, what does their drinking look like at age 60? Do they escalate or slow down? If we could have a similarly large study but follow them across age, that would be the most intuitive and most beneficial for practice.”
Stephanie T. Lanza, director of the Prevention Research Center and professor of biobehavioral health, and John J. Dziak, research associate in the Penn State Methodology Center, also worked on this research.
The National Institute on Drug Abuse at the National Institutes of Health helped support this work.
A Systems Approach to Opioid MitigationPublished on: November 21, 2018
Opioid and related substance abuse is devastating many communities across the country and has proven a particularly difficult problem to address. In this presentation, Griffin will discuss research being done at the Regenstrief Center for Healthcare Engineering at Purdue University to help mitigate substance abuse using a community-wide systems approach. In particular, he will discuss improving patient care regarding opioid addiction treatment and referral management, integration of heath IT and supporting analytics, public health evaluation, modeling syringe services programs and Pre-exposure prophylaxis, and the development of point of care technologies. The talk will take place Thursday, December 6, from 4:50 – 5:50 p.m. in 102 Leonhard Building. Refreshments will be served at 4:35 p.m. This work is funded by the Centers for Medicaid and Medicare Service.
About the Speaker
Paul Griffin is the director of the Regenstrief Center for Healthcare Engineering and the St. Vincent Health Chair at Purdue University. He also serves on the industrial engineering and biomedical engineering faculties there. His research interests area are in health systems engineering, cost and comparative effectiveness modeling, and health analytics. Prior to Purdue, Griffin was the Virginia C. and Joseph C. Mello Chair in the School of Industrial abd Systems Engineering (ISyE) at Georgia Tech. He also served as department head for Harold and Inge Marcus Department of Industrial and Manufacturing Engineering at Penn State from 2009 to 2014. Griffin began his academic career as an assistant professor in ISyE at Georgia Tech after completing his Ph.D. in Industrial Engineering at Texas A&M University.
Public comment request on White House report to stem the opioid crisisPublished on: November 9, 2018
The White House National Science and Technology Council (NSTC) is seeking public comment on the Draft Report of the Fast Track Action Committee (FTAC) on Health Science and Technology Response to the Opioid Crisis. Comments are requested by December 5, 2018 and may be submitted to OpioidsRoadmap@OSTP.eop.gov (link sends e-mail).
The NSTC chartered the Opioid FTAC to support the President’s response to the opioid crisis by identifying (1) research and development (R&D) critical to addressing key gaps in knowledge and tools, and (2) opportunities to improve coordination of Federal R&D essential to combating the opioid crisis.
The report, “Health Research and Development to Stem the Opioid Crisis: A National Roadmap,” describes and provides recommendations in seven research areas:
- Biology and Chemistry of Pain and Opioid Addiction
- Non-Biological Contributors to Opioid Addiction
- Pain Management
- Prevention of Opioid Addiction
- Treatment of Opioid Addiction and Withdrawal
- Overdose Prevention and Recovery
- Community Consequences of Opioid Addiction
The report is available here: https://www.nih.gov/draft-ftac.
HEALing Communities Study: Developing and Testing an Integrated Approach to Address the Opioid CrisisPublished on: November 6, 2018
We are pleased to announce the launch of the NIDA 19-017 – HEALing Communities Study: Developing and Testing an Integrated Approach to Address the Opioid Crisis (Data Coordinating Center) (UM1- Clinical Trials Not Allowed) competition. Click on the link below to view more information.
- Internal Submission Deadline: Friday, November 9, 2018
- Funding Organization’s Deadline: Tuesday, December 11, 2018
- Award Cycle: 2018
- Discipline/Subject Area: Drug Abuse and Addiction Research Programs
- URL: https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-19-017.html
- Funding Available: NIDA intends to commit up to $6.5M each year in FY 2019–2022 to fund one Data Coordinating Center, subject to availability of funds.
- Letter of Intent: Sunday, November 11, 2018 (Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review.)
The National Institute on Drug Abuse (NIDA), in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) is soliciting cooperative agreement applications with the intention of ultimately funding up to three research sites to participate in the ‘HEALing Communities Study’: Developing and Testing an Integrated Approach to Address the Opioid Crisis. The HEALing Communities Study will test the immediate impact of implementing an integrated set of evidence-based interventions across healthcare, behavioral health, justice, and other community-based settings to prevent and treat opioid misuse and Opioid Use Disorders (OUD) within highly affected communities. Highly affected communities of interest are counties or cities within states that are burdened with higher than average rates of overdose mortality and opioid-related morbidity, and other complications. Combined, all the communities participating in a single research site application must demonstrate having experienced at least 150 opioid related overdose fatalities (15% of these fatalities must be in rural communities) and a rate of 25 opioid related overdose fatalities per 100,000 persons or higher in the past year, based on the most recent complete year of data available. Communities within states ranking within the top third for age-adjusted drug overdose death rates in 2016, (per the Centers for Disease Control and Prevention) are of special interest. The integrated set of evidence-based prevention and treatment interventions should be designed to achieve the following goals: reduce overdose fatalities (by 40% in a 3-year period), and events; decrease the incidence of OUD; and increase the number of individuals receiving medication to treat OUD, retained in treatment beyond 6 months, and receiving recovery support services, and the distribution of naloxone compared to baseline. The Data Coordinating Center (DCC) will execute an array of scientific and support activities for the HEALing Communities Cooperative within three broad areas: coordination and communication, data, and health economics research.
For more information, please click on above URL to view solicitation.
Materials Required for the Penn State Downselect:
Please upload one PDF file (File name: Last name_NIDA 19-017.pdf) containing the following items in order no later than 4:00 p.m. on the internal submission deadline.
Cover Letter (1 page, pdf):
- Descriptive title of proposed activity
- Name(s), address(es), and telephone number(s) of the PD(s)/PI(s)
- Names of other key personnel
- Participating institution(s)
- Number and title of this funding opportunity
Project Summary (no more than 1-page)
- Identify the project scope that addresses the key aspects and elements, principal investigators, collaborators, and partner organizations.
- Font/size: Times New Roman (12 pt.)
- Document margins: 1.0” (top, bottom, left and right)
- Standard paper size (8 ½” x 11)
Questions concerning the limited submissions process may be submitted to email@example.com.
Great Valley students develop app to combat veteran opioid abusePublished on: October 31, 2018
Penn State Great Valley students and alumni recently used their data analysis and coding skills in a state-wide challenge to fight the opioid epidemic, where they received recognition from SAP, a multinational leader in enterprise application software.
After working together at Penn State’s DataFest this spring, the Analytical Assassins team, along with a few new members, participated in Code4PA’s monthlong Codeathon challenge. Held across the state in Philadelphia, Harrisburg and Pittsburgh, the event focuses on the use of open data sets to generate ideas that will enhance public engagement or increase transparency of state data for greater innovation. This year, teams were tasked to address the opioid epidemic through prevention, saving lives, and ensuring access to treatment.
For the competition, the Analytical Assassins developed Ve-Care, a mobile application to help veterans transition back to their daily lives after service, ultimately preventing substance and opioid abuse among the population. They decided to focus on veterans for personal reasons: Jackie Markle, Penn State Great Valley data analytics alumna and team captain, is married to a veteran.
“Veteran topics are very near and dear to me,” said Markle. “My husband had a hard time transitioning to civilian life. While he is gainfully employed now, our personal experience helped drive the desire to serve others in similar circumstances.”
Opioid abuse is especially prevalent among veterans: a 2011 report shows veterans are twice as likely to die from overdose compared to the general population, and a 2014 study of 2,500 post-deployment soldiers found that 15 percent regularly used opioids.
While building the app, the team examined two years of veterans’ admissions and discharge data from Substance Abuse and Mental Health Services Administration (SAMHSA) and determined four profiles that are considered high risk for opiate abuse. This helped them realize the need for a personalized experience. Not only does Ve-Care provide a centralized hub for educational, medical, employment-related resources, but it also delivers push notifications specific to individual needs. Upon downloading the app, veterans complete a survey, which determines their specific needs and their risk for opioid abuse.
“The resources are out there; they are just so hard to find,” said Markle. “Our idea is to provide them with a one stop shop according to their risk category. For example, if one of the risk categories is unemployment, we can guide them to Google’s Military Occupational Specialty (MOS) tool to apply their skill sets to civilian jobs. We can also push resume writing resources, job search sites, and so on, until they update their profile as employed.”
“Risky” candidates are identified using an association algorithm that determines the most common profile of veterans who are susceptible to abuse.
“Many veterans experience psychological distress which is further complicated by substance abuse and related disorders,” said Karpagalakshmi Rajagopalan, a data analytics student and member of the Analytical Assassins. “While opioid abuse is widespread, the transition to civilian life can make veterans especially susceptible. By delivering the resources based on individual need, we can prevent them from getting into the abuse.”
After hearing about the event from a Penn State Great Valley staff member, Rajagopalan brought the Analytical Assassins together for another competition.
“When I found out the event was focused on addressing one of the biggest and real problems in Pennsylvania, the opioid epidemic, I knew I wanted to participate,” she said. “This is a very interesting problem to solve using data.”
“We never really parted ways,” added Markle. “We had so much fun working together at DataFest. I think participating in this event — especially to tackle a real-world issue — was a no brainer.”
The Code4PA Codathon kicked off in mid-September, where the team of eight met in person to learn about the challenge and brainstorm their solution. Over the next month, the Analytical Assassins worked virtually, collaborating on Slack or Skype to discuss the project, deadlines, and tasks. While each member had his or her own area of expertise, the group relied heavily on their strengths in data mining, algorithms, and Amazon Web Services. On Oct. 20, Markle presented Ve-Care to a panel of judges, and later the team received the SAP’s Veterans Challenge Use Case Award.
The recognition from SAP was exciting, but Markle and Rajagopalan feel especially fulfilled that their project will help veterans while tackling the devastating effects of the opioid epidemic.
“I was happy that the jury panel thought our idea could be extremely useful,” said Rajagopalan.
Markle agreed, hearing the practicality from others made the experience especially rewarding.
“We even heard from veterans competing against us in the challenge that the app would be helpful. Hearing it firsthand made all the late nights worth it!”
While Ve-Care is still in the development phase, the team hopes to partner with the Department of Military and Veterans Affairs in each county to link the programs together.
New State Program to Help Individuals Battling Opioid Use Disorder Find and Maintain Housing in PennsylvaniaPublished on: October 19, 2018
Governor Tom Wolf today announced a new state program that aims to direct $15 million for an opioid housing initiative that will fund a minimum of eight pilot projects in eligible urban and rural communities throughout the commonwealth. The proposed pilot programs must help individuals to become and remain engaged in evidence-based treatment interventions, provide individuals with the necessary support services to maintain housing stability, and provide pre-tenancy and tenancy education services.
“Through these grants, we are supporting programs that help those working toward recovery find and maintain a place to live and we are offering one of the most basic necessities for a healthy life,” Gov. Wolf said. “For those in or hoping to achieve recovery, a home can be an important factor in finding and continuing treatment and other services.”
A Request for Applications (RFA) for support services navigation and housing services for individuals with opioid use disorder (OUD) is now available on the commonwealth’s eMarketplace.
Developed by the departments of Drug and Alcohol Programs (DDAP) and Human Services (DHS), in partnership with the Pennsylvania Housing and Finance Agency and the Department of Community and Economic Development, the RFA’s goal is “to support innovative practices that will increase access to treatment and supports for individuals with OUD and help prevent overdose-related deaths.”
Housing instability, combined with unmet basic needs, makes the road to recovery and independence extremely challenging. According to national data, about one in five people experiencing homelessness has a chronic substance use disorder. This aligns with information gathered from Pennsylvania’s 45 state-sponsored OUD Centers of Excellence, a majority of which identify housing as a major barrier for their clients.
“We know that each individual seeking treatment is just that – an individual,” said DDAP Secretary Jennifer Smith. “They each have different situations and circumstances hindering their recovery. To truly combat this crisis, we must build capacity to support individuals by providing necessary, supportive wrap-around services like stable housing and case management.”
“The conditions in which a person lives, including access to safe, stable housing, plays a role in a person’s health. When a person experiences homelessness in addition to a substance use disorder, the lack of a secure home is often a barrier to staying engaged with treatment and recovery, if they are able to access treatment at all,” said DHS Secretary Teresa Miller. “Supporting programs that assist with housing access and stability will help more people stay engaged in treatment and reach recovery.”
The RFA is the first project launched as part of the $55.9 million SAMHSA grant secured to bolster the state’s response to the prescription opioid and heroin epidemic. Additional initiatives included in the grant are focused on expanding services to pregnant women and veterans affected by OUD, developing the treatment and recovery workforce, and strengthening criminal justice and law enforcement initiatives with a focus on reentrant supports.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has distinguished four major dimensions that support a life in recovery: health, home, purpose, and community. This project aims to support two components of the dimensions – home and purpose. By giving an individual a stable, safe place to focus on their recovery, paired with the independence and self-worth that housing provides, an individual’s overall health and wellbeing is greatly improved.
The counties that are eligible locations for pilot programs under the RFA were identified via a formula that equally considered the rate of individuals diagnosed with a substance use disorder (SUD) and rate of overdose-related deaths in a county.
For more information on the RFA, visit the PA eMarketplace.
Find more information on the state’s efforts to battle the opioid crisis here.
SSRI Spotlight: Michael DonovanPublished on: October 18, 2018
As the Director of Policy & Outreach at Penn State’s Administrative Data Accelerator, Michael Donovan leads policy operations and facilitates collaborative projects between government partners and researchers to support the utilization of scholarly research in evidence-based policymaking.
At the Data Accelerator, Donovan contributes to the foundational goal of promoting the use of social science research in government policymaking, particularly through the use of administrative data from various sources and levels of government. Donovan works to improve the translation and dissemination of social science research to outside audiences, including various policy communities (state, federal and local), other academics and the general public.
In particular, Donovan supports initiatives like the PA Integrated Data System (IDS), seeking to utilize data from the PA Commonwealth to gain insights through data linkages and analysis. Another notable example includes his efforts on a collaborative, cross-domain project prepared for the PA Office of Attorney General regarding the estimation of societal costs to states as a result of the opioid epidemic.
Donovan collaborates with SSRI and the Consortium to Combat Substance Abuse (CCSA) to support interdisciplinary and translational research collaborations aiming to address the opioid crisis and the larger problems of substance abuse. This work is done in close consultation with policymakers to be both responsive to their needs and to maximize translation from academic research into real-world policy solutions.
Donovan utilizes his background in policy, government, and academia in this work. Prior to joining Penn State, Donovan served in the federal government for nearly a decade at the White House during both Obama Administrations. During this time, he served in a commissioned officer role as Special Assistant to the President in the Office of Scheduling and Advance, where he coordinated the planning and execution of the administration’s strategic agenda. He began his political career on the campaign trail in early 2007.
To prepare him for his work in both the political and academic realms, Donovan earned his bachelor’s degree in Political Science here at Penn State. During his tenure at the White House, he continued his education at Georgetown University’s Walsh School of Foreign Service with a master’s degree in National Security Policy Studies.
Donovan returned to his alma mater in order to both grow intellectually and professionally, as well as to contribute to work seeking to impact and improve lives.
Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort StudyPublished on: October 18, 2018
The United States is in the midst of a crisis of opioid-related harms (1). Some efforts to address this crisis focus on expanding access to effective treatment of opioid use disorders (OUDs) (2). Prior nonfatal opioid overdose is a known risk factor for subsequent nonfatal and fatal overdoses (3–7), and engaging persons in treatment who survive an overdose may be effective in limiting subsequent fatalities. However, data on the association between treatment of OUD and mortality after a nonfatal overdose are limited to a single retrospective cohort study that analyzed enrollment in methadone maintenance treatment (MMT) at a single time point and found no association (3).
The 3 medications for OUD (MOUD) approved by the U.S. Food and Drug Administration are methadone, buprenorphine, and naltrexone. Randomized controlled trials of these medications have shown consistent benefits across many outcomes, including increased treatment retention and suppression of illicit opioid use (8–10). A recent systematic review and meta-analysis of 19 observational cohort studies identified substantial reductions in all-cause and overdose mortality for methadone and buprenorphine (11). However, the mortality benefit in this analysis was limited to time actively retained in treatment, and the 4-week period after discontinuation was associated with an especially high risk for death. The few studies that examined mortality among patients receiving naltrexone show an unclear effect (12–15).
Massachusetts has been particularly affected by the opioid crisis: Opioid overdose deaths more than tripled between 2010 and 2016 (16). Through Chapter 55 of the Acts of 2015, the state legislature permitted individual-level linkage of data from 16 Massachusetts government agencies to gain a deeper understanding of the circumstances that influence fatal and nonfatal opioid overdoses (17). For this analysis, we identified a cohort of persons in the Chapter 55 data set who survived an opioid overdose and described any episodes of treatment with MOUD before and after that overdose. Specifically, we sought to determine whether treatment with MOUD, including receipt of MMT, buprenorphine, or naltrexone, was associated with reduced risk for all-cause and opioid-related mortality.
To read the full paper, click here.
Consortium to Combat Substance Abuse announces fellows programPublished on: October 4, 2018
Penn State’s Consortium to Combat Substance Abuse (CCSA) and Social Science Research Institute (SSRI) are announcing a call for proposals for the Community Fellows Program to support faculty members seeking to develop university-community collaborations that address substance abuse and its spillover effects to families and communities.
The program provides release time for faculty members to develop community collaborations and build sustainable, evidence-based or evidence-informed programs, policies and practices that can effectively address substance misuse/abuse issues within a targeted community.
Another goal of this initiative is to build the faculty member’s applied/translational research expertise by allowing successful candidates to participate in webinars and workshops aimed at developing community engagement, program development, implementation and evaluation, partnering with government officials to promote evidence-based policy, and grant-writing.
CCSA is housed within SSRI and is led by Interim Director Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center.
The mission of CCSA is to leverage the University’s research, education and outreach capacities toward a world free from addiction as a step toward enabling individuals, families, and communities can reach their full potential. To advance this mission, Penn State has provided funds for a range of new activities, including supporting the development of interdisciplinary and translational research, education and outreach to combat substance about and related public health problems.
Penn State launches new consortium to combat the opioid crisisPublished on: October 3, 2018
Pennsylvania is one of the states most impacted by the growing opioid epidemic, with one of the highest overdose death rates in the country — but a new initiative bringing together experts from across Penn State aims to combat this crisis through data-driven, evidence-based innovation.
The Penn State Consortium to Combat Substance Abuse (CCSA) will draw on the expertise of researchers, educators and practitioners from across Penn State. The group plans to develop and implement effective programs, policies and practices aimed at preventing and treating addiction and its spillover effects on children, families and communities.
The CCSA will be housed in Penn State’s Social Science Research Institute, one of seven cross-University research institutes within the Office of the Vice President for Research. One of the consortium’s signature efforts will be the strategic hiring of 12 new tenure-track faculty members over the next four years, who will bring additional expertise in this critical field to the University and lead the charge to research and develop data-driven solutions to this public-health crisis.
“Across the University, individuals have been working in their labs, communities and elsewhere to identify this epidemic’s causes, pursue solutions and address systemic substance-abuse issues,” said Penn State Executive Vice President and Provost Nick Jones. “As Pennsylvania’s only land-grant institution, Penn State has a vital responsibility to lead the way in fighting this battle. By forging connections across our colleges and campuses and working with community leaders, we can tackle this epidemic head-on and work toward a world free from the disease of opioid addiction.”
The CCSA will provide seed-grant funding for new interdisciplinary teams aimed at combating opioid and other substance abuse and sponsor an annual conference to bring together substance abuse prevention experts from across the nation.
“The faculty within the Penn State Consortium to Combat Substance Abuse will join with our current faculty to conduct innovative, interdisciplinary and translational research to illuminate risk factors for substance use, abuse and addiction; to educate their students and the public; and apply their knowledge to prevent and treat addiction,” said Penn State Vice President for Research Neil Sharkey.
The CCSA will be led by interim director Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center at Penn State.
A Penn State faculty member since 2004, Lanza has devoted her career to advancing research on the prevention of substance abuse through innovative quantitative methods. She has served as the principal investigator on research grants from the National Institute on Drug Abuse and the National Cancer Institute, and is an interdisciplinary researcher with an extensive network of collaborators both within and beyond the Penn State community. In her role as interim director, Lanza will be supported by the CCSA advisory board, comprised of representatives from Penn State centers and institutes whose missions encompass the systemic problems of substance abuse.
“Pennsylvania and the nation need more research into this troubling epidemic,” Lanza said. “I believe that the Penn State community can create lasting impacts through educating one another, our students and the public, and by undertaking research that advances evidence-based programs, policies and practices to better understand, prevent and treat opioid and other substance misuse and addiction.”
A national search for a permanent consortium director will be launched this fall.
University Police begins equipping officers with kit to treat opioid overdosesPublished on: October 3, 2018
On the evening of Sept. 16, an emergency dispatcher requested assistance at a local fast food restaurant in Spring Township, Berks County, for the report of a cardiac arrest related to a suspected opioid overdose.
University Police Officer C. Luke Shivery at Penn State Berks happened to be on patrol just a short distance away and knew that police officers with the Township of Spring Police Department were on the scene of a crash elsewhere, so he told the dispatcher he would respond. Law enforcement agencies routinely assist each other with calls for service.
Upon arrival, an off-duty emergency medical technician (EMT) was removing the patient from a vehicle. Shivery retrieved an automated external defibrillator (AED), medical bag and naloxone kit from his patrol car. As Shivery prepared the naloxone for administration, the EMT administered CPR using a bag valve mask from Shivery’s medical bag. Shivery then administered a dose of naloxone, which is used for emergency treatment in suspected opioid overdose cases. As Shivery updated the dispatcher, the EMT administered a second dose of naloxone.
Spring Township police then arrived along with Township of Spring Fire Department and City of Reading Fire Department Emergency Medical Services, taking over medical assistance. The patient was placed into an ambulance where he was conscious and speaking.
“I’m definitely happy with the outcome. It’s a relief to know that things worked out well,” Shivery said, reflecting on the incident.
Shivery was the first officer with University Police to administer naloxone.
In 2017, after police stations at 22 Penn State campuses merged as one department under University Police and Public Safety, Penn State standardized first aid training through which police officers became first aid certified by the American Red Cross. Penn State also standardized first aid equipment for officers, which includes medical bags and AEDs.
Additionally, officers received training to administer naloxone, which is used for emergency treatment in suspected opioid overdose cases. The training included online and in-person training by certified first aid instructors.
University Police then began the process of equipping its police officers with naloxone. Currently, seven campus police stations are equipped with naloxone, including Beaver, Berks, Brandywine, DuBois, Behrend, Great Valley and University Park. Administrators continue to work with local and county agencies to equip officers with naloxone at the remaining campuses.
“We understand that we are a microcosm of our communities and the abuse of opioid products can spill over, at times, into our police officers’ jurisdiction, therefore we believe it is important to equip our officers with life-saving tools should they face a life-threatening situation,” said Charlie Noffsinger, assistant vice president of University Police and Public Safety at Penn State.
Funding opportunity: International Research Collaboration on Drug Abuse and Addiction ResearchPublished on: October 2, 2018
This Funding Opportunity Announcement (FOA) encourages collaborative research applications on drug abuse and addiction that:
1. Take advantage of unusual opportunities that exist outside the United States to access talent, resources, populations, or environmental conditions in other countries that will speed scientific discovery
2. Describe how the research will significantly advance U.S. health sciences
3. Demonstrate specific relevance to the NIDA mission and objectives. To determine whether your research plan is relevant to the NIDA mission and objectives, review the NIDA Strategic Plan (https://www.drugabuse.gov/about-nida/2016-2020-nida-strategic-plan). Where feasible, applications should address NIDA’s international scientific priority areas (https://www.drugabuse.gov/international/research-priorities)
4. Include an investigator from a U.S. institution and a non-U.S. citizen partner living and working in another country.
Go to https://grants.nih.gov/grants/guide/pa-files/PA-18-773.html to view full funding announcement.
WPSU to address opioid addiction, recovery with special programmingPublished on: September 19, 2018
Jaime Durst, from Centre County, said she was 28 years old when she began abusing drugs and alcohol.
“I don’t know how that started; it was just some of the people I was hanging with,” said Durst, who realized she needed to seek treatment for her opioid addiction. “All of a sudden it became really bad. I was desperate. I was like, ‘I need help,’ and it’s hard to ask for help.”
Durst’s story is one of several shared about opioids and recovery through “Battling Opioids,” a collaborative project between Pennsylvania’s public media stations, that aims to bring awareness and provide resources for individuals struggling with addiction. The stations jointly produced “Battling Opioids: A Project of Pennsylvania Public Media,” which will air at 8 p.m. on Thursday, Sept. 27, on WPSU-TV.
According to provisional data from the Centers for Disease Control and Prevention, there were an estimated 5,655 drug overdose deaths in Pennsylvania in the 12-month period leading up to December 2017 — more than 15 per day — most of them from opioids.
Stories will air on WPSU-TV beginning Sept. 20 and are available online through the “Battling Opioids” website.
- “HealthSmart: Drugs and Young People”
- Thursday, Sept. 20, at 10 p.m.
- Young recovering addicts share their stories
- “HealthSmart: On the Front Line of the Opioid Crisis”
- Thursday, Sept. 20, at 10:30 p.m.
- First responders are on the front line of the opioid epidemic
- “Understanding the Opioid Epidemic”
- Sunday, Sept. 23, at 11 p.m.
- Stories of people impacted by the opioid epidemic and information from experts
- “Broken: Women-Families-Opioids”
- Monday, Sept. 24, at 9:30 p.m.
- Explore how opioid addiction among women is breaking the family bond and changing the fabric of society
- “Battling Opioids: A Project of Pennsylvania Public Media”
- Thursday, Sept. 27, at 8 p.m.
- A Pennsylvania’s public television collaborative sharing stories of recovery and hope
- “HealthSmart: The Opioid Epidemic”
- Sunday, Sept. 30, at 6 p.m.
- Experts and people in recovery talk about what’s happening now and how they plan to get a handle on the drug crisis
- “Heroin: A Commonwealth Crisis”
- Sunday, Sept. 30, at 10 p.m.
- A panel of experts explain what led to the heroin crisis in Pennsylvania and provide information on prevention and treatment
WPSU-FM also will produce opioid-related stories, including a special “Take Note” at 1 p.m. on Friday, Sept. 28, featuring Jason Snyder, a regional director of outpatient services for Pinnacle Treatment Centers. Snyder, who is in recovery, has lost two brothers to opioid overdoses.
Durst, also in recovery, is receiving medically assisted treatment through Addiction Solutions in Centre County.
“Since I’ve been on it, I’ve bought a house, I have my car, I’ve worked at my job for three-and-a-half years,” she said. “I’m a different person.”
“Battling Opioids” is a collaborative project between Pennsylvania’s seven public media stations: WPSU, WHYY (Philadelphia), WITF (Harrisburg), WLVT/PSB39 (Greater Lehigh Valley), WQED (Pittsburgh), WQLN (northwestern Pennsylvania) and WVIA (northeastern Pennsylvania).
Visit the WPSU website for more information on the project.
Seed grants to support opioid research announcedPublished on: September 13, 2018
Penn State’s Social Science Research Institute (SSRI), in collaboration with the Clinical and Translational Science Institute (CTSI), has awarded over $200,000 in funding to support 10 new interdisciplinary teams of Penn State researchers whose work is aimed at combating the opioid epidemic.
“These teams are developing novel translational research programs to advance solutions to the opioid crisis, from discovery-oriented research to dissemination and implementation science,” said Susan McHale, SSRI director and associate director of the CTSI.
The funded projects and research teams are:
– “Alexa, I’m in pain!” A Real-Time Mindfulness Intervention to Control Pain: Delivery Through a Conversational Agent – Saeed Abdullah, College of Information Sciences and Technology; Stephanie Lanza, College of Health and Human Development; Sebrina Doyle, College of Health and Human Development; Robert Roeser, College of Health and Human Development; and David Almeida , College of Health and Human Development.
– Predicting spatial-temporal patterns of opioid use with criminal and overdose data in Pennsylvania – Qiushi Chen, College of Engineering; Conrad S. Tucker, College of Engineering;
Glenn Sterner, Penn State Abington; and Joel Segel, College of Health and Human Development.
– Using Integrated Databases to Examine Patient Outcomes in Children with a History of Neonatal Abstinence Syndrome – Tammy Corr, College of Medicine; Max Crowley, College of Health and Human Development; Douglas L. Leslie, College of Medicine; Jeffrey R. Kaiser, College of Medicine; Paul L. Morgan, College of Education; and Guodong Liu, College of Medicine.
– Opioid Prescription Practices and Risk Factors for Persistent Use After Childbirth – Danielle Downs, College of Health and Human Development; Lisa Bailey-Davis, Geisinger Commonwealth School of Medicine; Tammy Corr, College of Medicine; Timothy Deimling, College of Medicine; Richard Legro, College of Medicine; Dhanya Mackeen, Geisinger Commonwealth School of Medicine; Jaimey Pauli, College of Medicine; and Mark Stephens, College of Medicine.
– Perinatal Opioid Use and Maternal Nutrition and Health Status – Emily Hohman, College of Health and Human Development; Sarah Kawasaki, College of Medicine; Tammy Corr, College of Medicine; Jennifer Savage Williams, College of Health and Human Development; and Danielle Symons Downs, College of Health and Human Development.
– The influence of adolescent social stress on morphine behaviors – Helen Kamens, College of Health and Human Development; Sonia Cavigelli, College of Health and Human Development; and Patricia Sue Grigson, College of Medicine.
– An Innovative Approach to Tackle the Opioid Epidemic: Utilizing Twitter Data and Integrating Big Data Analytics and Spatial and Social Network Analyses – Zhen Lei, College of Earth and Mineral Sciences; Guangqing Chi; College of Agricultural Sciences; Cynthia Chuang, College of Medicine; Glenn Sterner, Penn State Abington; Ashton Verdery, College of the Liberal Arts; and Junjun Yin, Social Science Research Institute.
– Neural mediators and moderators of mindful yoga practice in opiate-dependent individuals – Emma Rose, College of Health and Human Development; Diana H. Fishbein, College of Health and Human Development; Robert W. Roeser, College of Health and Human Development; Scott Bunce, College of Medicine; and Sarah Bowen, Pacific University – Oregon.
– Linking accidental overdoses to medical professionals and pharmacies: A population-based social network analysis – Glenn Sterner, Penn State Abington; Oren M. Gur, Penn State Abington; and Sabahattin Gokhan Ozden, Penn State Abington.
– PROSPER PLUS: Combining Effective Prevention Education with Supply Side Interventions to Reduce Opioid Misuse – Janet Welsh, College of Health and Human Development; Daniel Perkins, College of Agricultural Sciences; Derek Kreager, College of the Liberal Arts; and Glenn Sterner, Penn State Abington.
For more information on seed grant funding and other opportunities available through SSRI, visit their Funding Mechanisms website.
Opioids Misuse: Increasing Access to Transportation In Rural CommunitiesPublished on: September 12, 2018
You are cordially invited to attend a workshop hosted by the United States Department of Agriculture, the National Rural Transit Assistance Program, and the Federal Transit Administration (FTA).
Where: West Virginia School of Osteopathic Medicine, 400 Lee Street N. Lewisburg, WV 24901
When: September 20, 2018
Time: 9:30 am—1:00 pm EST.
Livestream: Please visit this link on the date and time indicated to tune in:
Workshop Flyer: PDF (2.17MB)
Planning to attend in person?
Please R.S.V.P. by sending an email to Betty-Ann Bryce: firstname.lastname@example.org. Use the subject line “Rural Transportation Workshop,” and provide your name, title organization, and contact information.
Certified Recovery Specialist program available to recovering addictsPublished on: September 12, 2018
Do you have a history of addiction recovery and want to help others? Penn State Shenango will host “Certified Recovery Specialist Training,” a Penn State Beaver Continuing Education course, from 9 a.m. to 4 p.m. on Saturdays, beginning Oct. 6 and ending Dec. 15, in 108 Sharon Hall in downtown Sharon. An information session on the program will be held from 6 to 7:30 p.m. on Tuesday, Sept. 18, also in 108 Sharon Hall.
Pennsylvania has the fourth highest overdose death rate in Pennsylvania. Gov. Tom Wolf officially declared it a public health disaster, clearing the way for easier access to care and resources.
And of all the resources available to recovering addicts, a simple peer-to-peer program may be one of the most effective. Research has shown that peer recovery support services not only help addicts remain engaged in the recovery process, but they also reduce the likelihood of relapse.
“Although there is a long history of peers helping peers in recovery, the Pennsylvania Certification Board Certified Recovery Specialist credential is a relatively new version of this practice,” said Roxanne Atterholt, program coordinator of the human development and family studies program. “This credential is for trained drug and alcohol peers in recovery to help others move into and through the recovery process.”
Certified Recovery Specialist Training is a 54-hour program that meets education requirements specified by the Pennsylvania Certification Board. To apply for CRS certification, individuals must meet additional board requirements, including: a history of addiction with recovery, a high school diploma or GED, successful completion of a CRS exam, and the signing of an ethical code of conduct.
The cost is $995 and includes all necessary materials. Online registration is now open at https://beaver.psu.edu/recovery-specialist.
The Pennsylvania Certification Board requires candidates to complete the CRS exam application. The cost of the exam is $125, payable directly to the board with the application and requisite documents.
Financial assistance may be available for qualified individuals.
For more information about the CRS program or any program offered through Penn State Beaver Continuing Education, contact Jill Valentine at email@example.com or 724-773-3765.
United Nations World Drug Report ReleasedPublished on: September 12, 2018
Prevention strategies based on scientific evidence working with families, schools, and communities can ensure that children and youth, especially the most marginalized and poor, grow and stay healthy and safe into adulthood and old age. For every dollar spent on prevention, at least ten can be saved in future health, social and crime costs.
These global International Standards summarize the currently available scientific evidence, describing interventions and policies that have been found to result in positive prevention outcomes and their characteristics. Concurrently, the global International Standards identify the major components and features of an effective national drug prevention system. It is our hope that the International Standards will assist policy makers worldwide to develop programmes, policies and systems that are a truly effective investment in the future of children, youth, families and communities. This work builds on and recognizes the work of many other organizations (e.g. EMCDDA, CCSA, CICAD, Mentor, NIDA, WHO) which have previously developed standards and guidelines on various aspects of drug prevention.
The Standards have been recognized by Member States as a useful tool to promote evidence-based prevention in the following documents:
- The Joint Ministerial Statement on the mid-term review of the implementation by Member States of the Political Declaration and Plan of Action;
- Resolution 57/3 – Promoting prevention of drug abuse based on scientific evidence as an investment in the well-being of children, adolescents, youth, families and communities; and,
- Resolution 58/3 – Promoting the protection of children and young people, with particular reference to the illicit sale and purchase of internationally or nationally controlled substances and of new psychoactive substances via the Internet.
- Resolution 58/7
Strengthening cooperation with the scientific community, including academia, and promoting scientific research in drug demand and supply reduction policies in order to find effective solutions to various aspects of the world drug problem (operative paragraph 2)
- Resolution 59/6
Promoting prevention strategies and policies (operative paragraphs 5 and 14)
- Outcome Document of UNGASS 2016 on the World Drug Problem (paragraph 1.(h))
- Resolution 60/7
Promoting scientific evidence-based community, family and school programmes and strategies for the purpose of preventing drug use among children and adolescents
The documents are presently available only in English, but they are being translated in all UN official languages, and uploaded shortly. Russian translation is already available.
College students may face pressures from opioid epidemic's secondary effectsPublished on: August 13, 2018
About one in five college students reported in a survey that they knew someone who was addicted to pain medications, and nearly a third said they knew somebody who overdosed on painkillers or heroin, according to a team of undergraduate Penn State Lehigh Valley researchers.
This secondary exposure to opioid abuse may shine a light on the collateral damage that is often left out of the current debate about the epidemic, said Jennifer Parker, associate professor of sociology, Penn State Lehigh Valley.
“Since the beginning of the opioid epidemic, public debate and prevention strategies have focused on the primary victims, misusers themselves, while surprisingly little attention has been paid to the burdens felt and experienced by those who are intimately or socially tied to them,” said Parker, who advised the group of researchers presenting at the American Sociological Association’s annual meeting today (Aug. 11) in Philadelphia.
According to the researchers, most of the 118 students who completed a survey admitted that they had been in some way exposed to people who misuse drugs and alcohol. Of those, 20.5 percent said they currently know someone who is addicted to pain medication. About 32.5 percent said they knew somebody who overdosed on either painkillers or heroin.
Erica Hughes, an undergraduate student in health policy administration, added about 15 percent of the students reported worrying that someone they knew may be misusing pain medication.
“I was surprised by how many students report close ties to people who are addicted to or have overdosed on opioids,” Hughes said. “It makes me sad to think that so many are carrying around this worry because being a student in today’s world is already hard enough.”
Hughes added that dealing with issues connected to their exposure to the effects of opioid abuse may be particularly difficult for college students. Many college students already face increased pressure from rising tuition costs and student debt, along with fears about the job market, she added.
Amanda Borges, a 2018 graduate in health policy administration, said that the findings might raise awareness about the extent of the opioid crisis and offer insight into better ways to address it.
“The general public should know how devastating this crisis has been and how it impacts all communities and social classes including college students,” said Borges.
Gathering information on all aspects of the opioid crisis may help better allocate resources to help communities, added Kirsten Mears, also a 2018 graduate in health policy administration.
“The more we know, the better we are able to help and identify how particular communities, especially our poorest, may have certain disadvantages in this epidemic because of lesser resources and lack of health insurance,” said Mears.
According to the researchers, gender may also play a role in how college students report their exposures to the opioid problem. For example, women were twice as likely to report having intimate ties to those who misuse or overdose on opioids, the researchers said.
Shanice Clark and a team of 15 undergraduate students in health policy administration also contributed to the study.
The researchers collected data from surveys filled out by students at a university in a region particularly hard hit by the opioid crisis.
Of the approximate 130 surveys were passed out, participants completed 122. Of those, the researchers determined that 118 surveys were both completed and valid.
The researchers said that future research should look at whether secondary exposure to opioids impacts the students’ mental and physical health, as well as their academic performance.
Penn State forms addiction legal resources team at Dickinson LawPublished on: July 30, 2018
With the number of opioid overdose deaths continuing to rise in Pennsylvania, a group of Penn State Dickinson Law students and faculty are becoming advocates and providing resources for those who are affected by addictions.
Led by Matthew Lawrence, assistant professor of law at Dickinson Law and assistant professor in the Department of Surgery at Penn State College of Medicine, the group of six students are working to develop and disseminate legal resources, promote informed policy making, and facilitate scholarly research in the states of Pennsylvania, West Virginia, Ohio, North Carolina, Rhode Island, and Florida.
“The project, called the Addiction Legal Resources Team (ALRT), had its genesis in a paper I wrote exploring legal barriers families face when trying to advocate for a loved one who has substance use disorder,” said Lawrence. “While conducting a search for a research assistant to continue this work, I was overwhelmed by student interest in finding outlets to contribute to address the crisis. Several of our law students had a personal connection with the opioid crisis or work experience with addiction programs in their home states.
With the support of Dickinson Law Dean Gary Gildin, Lawrence was able to support six students part-time this summer. “Thanks to their passion, experience, and home-state connections, the team has exceeded my expectations and developed several meaningful efforts in our first few short months. They’ve also inspired my own scholarship in this area,” Lawrence said.
ALRT student team members Bryan Caffrey, Andrea Jenkins, Evan Marmie, Tori Remington, Alex Short, and Wyatt Weisenberg are working on various projects in each of their home states. Team members are disseminating and developing legal resources for patients and families navigating the legal system to assist them with obtaining insurance coverage for addiction treatment. They are also advising Penn State researchers on legal questions encountered in their research. The team meets weekly, with some students using Dickinson Law conference rooms to videoconference with the rest of the team to discuss projects, deadlines, and new collaborations. Students then pursue individual projects during the week.
“The students are working together and with me to chip away at the issue and do something helpful. One major focus has been on insurance coverage for treatment, specifically resources related to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA),” explained Lawrence. MHPAELA is a federal law that ensures group health plans and health insurance issuers who provide mental health or substance use disorder benefits offer coverage that is comparable to medical/surgical benefits coverage. Many individuals affected by substance use disorder are unfamiliar with the law and the challenging appeals process when receiving an insurance coverage denial.
“Our goal as a team is to research and present information for individuals or their family members who might be suffering from substance use disorder, helping them find medical treatment and navigate a rather convoluted regulatory landscape,” said ALRT student team member Bryan Caffrey.
The students are also conducting legal research in each of their home states and are developing policy memos for dissemination to scholars and collaborators. For example, they are sharing their work with the Parity of 10 project, which advocates MHPAEA in mental health and drug abuse cases.
The program has been a beneficial educational experience for the students as well. “One thing I’ve learned that is very important when it comes to researching health care policy and implementation is the important way that the administration of statutes comes into effect. It’s not simply enough to look at statutes, which might be natural for law students, but also look to how administrative agencies and corporations that administer healthcare have turned those statutes into actual practical policies that affect people every day in their lives,” Caffrey said.
Another student wrote a policy memo regarding several state and local programs and Lawrence encouraged him to circulate it more broadly. The memo ultimately appeared on Harvard Law School’s Bill of Health blog, and that student has been invited to contribute additional memos to the blog.
“The project has led to the students thinking more about the community side of the addictions crisis, focusing on the family and how to outreach and apply our legal research,” said Lawrence. “I can’t emphasize enough how much this effort has been inspired and driven by this passionate and talented group of students and what a privilege it has been to work with them. We are looking forward to continuing the addiction legal resources team’s work into the fall semester and beyond.”
ALRT project supporters and collaborators beyond Dickinson Law include Parity at 10, Partnership for Drug Free Kids, Legal Action Center, Penn State’s Social Science Research Institute, Partnership for Better Health PA’s Opioid Prescribing Task Force, and Penn State College of Medicine’s Department of Public Health Sciences and Department of Surgery. The ALRT can be reached at ALRT@dsl.psu.edu.
Family-Focused Approaches to Opioid Addiction Improve the Effectiveness of TreatmentPublished on: July 24, 2018
– Written by Helena J.V. Rutherford, Ph.D., Yale School of Medicine, Declan T. Barry, Ph.D., Yale School of Medicine, and Linda C. Mayes, MD, Yale School of Medicine
– Edited by Rebekah Levine Coley, Ph.D., Boston College
– For more information, contact Martha Zaslow, Ph.D. Director for Policy, Society for Research in Child Development, at mzaslow[at]srcd.org
In treating opioid addiction, moving from an individual approach to a family-focused approach to treatment can have lasting benefits for children and parents, and decrease health care costs. In 2017, the U.S. Department of Health and Human Services declared opioid addiction a public health emergency. Opioids—which include prescription medicines for pain relief, synthetic drugs such as fentanyl, and heroin(1) —lead to an average of 115 deaths by overdose per day in the United States.(2,3)The medical and legal response has mainly focused on individual needs, yet opioid addiction has wide-ranging impacts not only on individuals, but also on their families and children. New evidence finds that family-focused approaches can improve upon models that treat individuals, expanding benefits and cost efficiencies, and improving the health and development of children.
Opioid Addiction Affects Whole Families, With Important Implications for Children
Parents’ opioid addiction affects children’s development from the prenatal stage through adulthood. These effects occur both directly, through biological and neurological processes, and indirectly, through compromised parenting and family stress.
- Since 2000, the number of infants born with neonatal abstinence syndrome has increased fivefold; these infants experience opioid withdrawal after exposure in utero. Neonatal abstinence syndrome increases hospital stays at an estimated annual cost of $1.5 billion,(4,5) and can induce tremors, seizures, irritability, disrupted sleep, and intense crying in infants.(6)
- Neuroscience research suggests that parents with addiction show compromised functioning in areas of the brain critical to caregiving, including areas that regulate stress and process emotions.(7,8) In turn, parents with addiction struggle with the stresses of childrearing, leading to less sensitive and supportive parenting, which may hinder children’s social and emotional development.(8)
- Parents with substance use disorders often raise children in chaotic and impoverished households,(9) contexts that have been shown to impede children’s development and lead to detrimental health outcomes in adolescence and adulthood.(10,11)
- Over the long term, parents’ opioid addiction, coupled with chaotic home environments, increase the chances that children will engage in substance use,(12,13) setting the stage for intergenerational drug abuse and lifelong health consequences for children.(14)
- In some states, under child-endangerment laws, parents who use opioids and other illicit drugs during pregnancy are automatically referred to child protective services.(15) These laws can result in parental incarceration and children’s removal from their home. Applying such approaches indiscriminately without adequate opportunities for treatment can harm family stability and children’s mental health.(16,17)
Current Treatment Options Are Limited
The gold standard treatment option for adult opioid addiction is the controlled administration of prescribed methadone or buprenorphine, termed opioid agonist treatment.(18,19) For pregnant women, this treatment optimizes maternal and neonatal outcomes after birth.(19) Yet access is limited by cost constraints and lack of coverage through Medicaid and private insurance.(18) Even for parents who have access, opioid agonist treatment programs often overlook the impact of opioid addiction on children and families. Similarly, programs rarely attend to the cooccurrence of addiction and other mental health issues.(20) Other treatment approaches that are often easier to afford, such as medically supervised discontinuation of opioid use during pregnancy, have high relapse rates and less maternal engagement in prenatal care, and do not provide postnatal parenting support essential for healthy child development.(21)
Family-Focused Treatment Models Can Fill Gaps and Improve Children’s Well-Being
Because opioid addiction affects not only parents but also children and families, we need family-focused treatment models that attend to the needs of, and optimize outcomes for, both parents and children. Current treatment approaches fall short in meeting these goals, yet there are successful models that can inform improvements in treatment. Specifically, evidence suggests the need for coordinated and family-focused treatment models, particularly those that promote effective parenting. Numerous family-focused models have proven effective. Research shows that:
- Evidence-based programs that combine opioid agonist treatment with efforts to help opioid-addicted parents regulate their emotions, lower their stress, and find pleasure in their caregiving role have led to decreases in the severity of maternal addiction as well as improved well-being for mothers and children.(22,23,24)
- Among families with infants born with neonatal abstinence syndrome, strategies to empower mothers by supporting their direct involvement in the care of their infants have resulted in reduced hospital stays, decreased hospital costs, and less treatment involving pharmacologic withdrawal for newborns.(25)
- Other promising approaches seek to extend family-focused support to opioid-addicted women during pregnancy to lay the groundword for mother-child relationships and decrease substance use before babies are born.(26)
Critical Next Steps for Targeting Opioid Addiction and Improving the Lives of Children and Families
Family-focused approaches have beneficial effects on multiple family members and may reduce overall health care costs. We now need carefully planned expansions of family-focused treatment models with continued evaluations to determine when and for whom such treatments are appropriate and most effective, and how integrated care models can best maximize the efficacy of opioid agonist treatment and address co-occurring medical and psychiatric conditions.
Opioids and non-opioid analgesics affect different types of stressPublished on: July 17, 2018
Mu-opioids and non-opioid analgesics appear to differentially affect the psychological and physiological components of psychosocial stress, according to a recent study funded by NIDA, NIGMS, and NIMH.
In a between-subject design, healthy young adults (18-40 y) were randomly assigned to receive either 2 or 4 mg of hydromorphone (mu-opioid analgesic), 1000 mg of acetaminophen (non-opioid analgesic), or placebo and were tested in the Trier Social Stress Test (TSST) and a non-stressful control task (NSCT). Physiological responses to stress included heart rate, blood pressure, salivary cortisol and pupillometry, and psychological measures included subjective reports of mood and stress.
TSST successfully increased all measures of physiological stress and increased anxiety and negative mood compared to the control task. Hydromorphone (4 mg) dose dependently decreased cortisol stress response, but acetaminophen did not. Both hydromorphone and acetaminophen reduced ratings of how challenging participants found the task. This suggests acetaminophen, the non-opioid analgesic, affects psychological responses to stress, not physiological, whereas hydromorphone affects both. Only the mu-opioid system was involved with physiological stress responses in humans, which builds upon similar results in preclinical studies. The results here contribute a greater understanding of the role of opioid and non-opioid systems in the complex physiological and psychological responses to social stress.
'Share Your Opioid Story' website bringing awareness, buzz of opioid epidemicPublished on: July 3, 2018
Watch the WJAC-TV news coverage of the “Shair Your Opioid Story” website, featuring SSRI Director Susan McHale and Justice Center for Research’s Glenn Sterner.
Penn State researchers hope website humanizes, helps others affected by opioidsPublished on: June 25, 2018
Stories can speak as loudly as statistics.
That is the purpose behind “Share Your Opioid Story,” an initiative designed to raise public awareness of the impact of the opioid epidemic in Pennsylvania and empower Pennsylvanians affected by the epidemic to talk openly about the effects of opioid addiction. Stories of individuals, family members, and friends affected by the epidemic can be found — and shared — online at shareyouropioidstory.com.
“Share Your Opioid Story” is being coordinated by Glenn Sterner, a postdoctoral scholar in the Justice Center for Research at Penn State and assistant professor of criminal justice at Penn State Abington, beginning this fall.
“The goal of the project is to portray a more human side of the opioid epidemic and the impact it has on individuals, family members, friends and communities regardless of someone’s background,” said Sterner. “We want to lessen the stigma surrounding the crisis and enable people to talk about it more openly, all while helping those most affected get the help they desperately need.”
“Dr. Sterner’s impactful work clearly supports Penn State’s land-grant mission to serve the citizens of the Commonwealth and the nation,” said Nick Jones, Penn State executive vice president and provost. “The rapid growth and spread of the opioid epidemic and its tragic consequences demand Penn State’s attention, and this project is one of many meaningful endeavors through which the University is addressing this crisis.”
Funding for “Share Your Opioid Story” comes from the Independence Blue Cross Foundation with additional support from the Pennsylvania Department of Drug and Alcohol Programs. The project is being launched in conjunction with the unveiling of the foundation’s “Someone You Know” initiative — a multimedia campaign in southeastern Pennsylvania featuring a mix of print and outdoor advertising, personal videos and print stories from people affected by opioid addiction that the foundation hopes will inspire others seeking help with addiction and recovery.
“Through bold, direct and highly personal stories, we hope to raise public awareness that substance misuse is not a problem that people should be ashamed to discuss,” said Lorina Marshall-Blake, president of the Independence Blue Cross Foundation, in a release announcing the campaign. “With simple and inspiring messages … we hope to help remove the stigma that often prohibits people from seeking help and starting on the path to recovery.”
“Too often we hear that stigma around substance use disorder leaves people feeling isolated and can keep them out of treatment,” added Jennifer Smith, secretary of the Pennsylvania Department of Drug and Alcohol Programs. “Addiction is a disease, and like any other medical condition, people with a substance use disorder deserve compassion and support as they take steps towards recovery. We must all work to change the conversation around addiction so people seeking treatment and living in recovery feel safe, supported and empowered. This campaign is an important, much-needed step towards breaking this stigma.”
“Share Your Opioid Story” also provides links to a host of local, state and federal resources for individuals who need assistance themselves or are looking for information to help someone else struggling with opioid addiction. To learn more, visit shareyouropioidstory.com or email the project at firstname.lastname@example.org.
Opioid crisis funding opportunitiesPublished on: June 12, 2018
Funding opportunities to address the opioid crisis are available from the National Center for Advancing Translational Sciences, National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, National Institute on Disability, Independent Living and Rehabilitation Research, National Institute on Minority Health and Health Disparities, Office for Victims of Crime, and Patient Centered Outcomes Research Institute.
Research supports restrictions on opioid-containing cold medicines for childrenPublished on: May 25, 2018
Prescription cough and cold medicines containing the opioid hydrocodone are more likely to cause serious side effects in children than those containing codeine, according to a new study from Penn State College of Medicine. The research supports recent U.S. Food and Drug Administration (FDA) restrictions on prescription hydrocodone- and codeine-containing cough medicines for children and suggests that opioids in general should not be prescribed for coughs and colds in pediatric populations.
Historically, most of the guidance around children’s prescription cough and cold medications has focused on the opioid codeine. The American Academy of Pediatrics has recommended against the use of codeine-containing cough and cold medications in children for two decades due to safety concerns, and in 2017 the FDA ruled that codeine should not be used to treat cough or pain in children younger than 12 years old.
In January 2018, the FDA expanded its restrictions, announcing that prescription cough medicines containing either codeine or hydrocodone can only be labeled for use in adults 18 and over because the risks of opioid-containing cough products outweigh the potential benefits in children.
The new study supports the FDA’s decision, according to Dr. Ian Paul, a physician and professor of pediatrics and public health sciences at Penn State College of Medicine.
The study grew out of a larger safety surveillance project by Paul and colleagues at the Rocky Mountain Poison and Drug Center in Denver, looking at adverse events associated with over-the-counter pediatric cough and cold medications.
During this project, the surveillance system also detected serious side effects in children who had ingested prescription cough and cold medications that combined typically over-the-counter ingredients with opioid medications. Despite the public attention around codeine in children’s cold medications, the researchers noted that many of the adverse events were more likely to be linked to hydrocodone-containing prescriptions. This discovery led them to conduct the new study.
Using the surveillance data, the researchers analyzed adverse events in children under 12 years old that were associated with cough and cold medications including both an opioid and an over-the-counter ingredient. Between January 2008 and December 2015, there were 98 cases involving an adverse event at least potentially related to codeine or hydrocodone. In most of the cases, the medications were either prescribed to the children or accidentally ingested without supervision.
The sedative properties of opioids, which are particularly worrisome in children, were frequently reported but were more common in children who took hydrocodone. Drowsiness, lethargy, and respiratory depression were reported in 86 percent of hydrocodone cases compared with 61 percent of codeine cases.
There were also three deaths reported, all of which were associated with hydrocodone combined with an antihistamine.
The research appeared recently in the journal Clinical Toxicology.
“You could argue from this data that the adverse events profile from hydrocodone-containing cough and cold medication ingestion appears to be more concerning than that from codeine-containing drugs,” Paul said. The message? “Healthcare providers should never prescribe opioid-containing cough and cold products to children. Ever.”
Paul also emphasized that children usually don’t need prescription medications for a cold.
“Parents of children with colds should remember that they typically resolve in their own with time. Supportive measures, like using non-aspirin pain relievers such as acetaminophen and ibuprofen, can help a child’s comfort. There’s some evidence that honey is effective for children one year of age and older and that topical vapor rub can be used for children ages two and up. And they can use nasal saline and humidified air to help a child get through the illness.”
Other researchers on this project were Kate M. Reynolds and Jody L. Green, both at the Rocky Mountain Poison and Drug Center at the Denver Health and Hospital Authority.
This study is funded through an unrestricted grant provided by the Consumer Healthcare Products Association Pediatric Cough Cold Task Group. Green reported grants from Consumer Healthcare Products Association Pediatric Cough Cold Task Group, during the conduct of the study and grants from McNeil Consumer Healthcare, outside the submitted work. Paul reported personal fees from Pfizer and Johnson and Johnson, both outside the submitted work.
Opioid crisis requires social and behavioral research solutionsPublished on: May 18, 2018
Each day, more Americans die from drug overdoses (175) than from motor vehicle accidents (110). Many of these overdoses are accidental, and some are intentional, but nearly all are the result of social and behavioral factors. In response to the opioid crisis, the NIH convened a meeting on March 5-6, 2018, “Contributions of Social and Behavioral Research in Addressing the Opioid Crisis.” This meeting was part of the NIH Cutting-Edge Science Meeting Series to End the Opioid Crisis, and was led by the Office of Behavioral and Social Sciences Research (OBSSR) partnering with the National Institute on Drug Abuse (NIDA), the National Institute of Neurological Disorders and Stroke (NINDS), the National Center for Complementary and Integrative Health (NCCIH), the National Institute on Minority Health and Health Disparities (NIMHD), and the NIH Immediate Office of the Director (IMOD).
The goals of the meeting were to specify key actionable social and behavioral science findings that can be brought to bear immediately to address the opioid crisis, and identify critical short-term research priorities that have the potential to improve the opioid crisis response. To advance these goals, participants described current research findings and identified high priority scientific gaps and recommendations organized in five panels:
Panel 1: Sociocultural and socioeconomic underpinnings of the crisis;
Panel 2: Behavioral and social factors preventing opioid initiation and mitigating the transition from acute to chronic opioid use;
Panel 3: Incorporating nonpharmacologic approaches to the treatment of opioid abuse and chronic pain management;
Panel 4: Challenges and barriers to implementing prevention and treatment strategies; and
Panel 5: Effective models of integrated approaches.
These panels generated several “key things we know” and “key things we need to know” to address the opioid crisis that will be included in a meeting summary that will be posted this month. I was impressed by the breadth and diversity of social and behavioral research findings that, if implemented, could have an immediate impact on reducing opioid use. This meeting agenda, participant list, and video recording, are available on the NIH HEAL (Helping to End Addiction Long-term) Initiative web page. The meeting summary will be posted on this web page later this month.
With an additional $500 million appropriated for opioid addiction research, the NIH will nearly double the funding available to study opioid addiction, from $600 million in 2016 to $1.1 billion in 2018. The “Contributions of Social and Behavioral Research in Addressing the Opioid Crisis” meeting provides a useful framework for integrating social and behavioral research questions in the HEAL Initiative. OBSSR will continue to work with the NIH Institutes and Centers involved in the NIH Health Initiative to ensure that developing research initiatives address some of the key research priorities identified by this meeting. The social and behavioral sciences already have contributed substantially to the knowledge base needed to address this crisis. What is needed now is greater implementation of what we already know and a serious, concerted research effort to answer key research questions to improve our ability to address this crisis.
Penn State is represented at congressional briefing addressing opioid epidemicPublished on: May 4, 2018
Penn State researcher Stephanie Bradley, director of the Evidence-Based Prevention & Intervention Support Center (EPISCenter), was one of five experts on a panel who recently briefed Congress on the rising opioid epidemic and efforts to combat the problem through evidence-based prevention programs and public health approaches.
The congressional briefing highlighted a report from Trust for America’s Health and the Well Being Trust, “Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy.” According to the report, deaths from drugs, alcohol and suicide accounted for one million deaths from 2006 to 2015. With the rapid rise of heroin, fentanyl and carfentanil use, the report predicted death rates could double to two million by 2025.
The report also found that there were disproportionately large increases in drug deaths among racial and ethnic minority groups, particularly among black Americans, who experienced an increase of 39 percent in drug deaths between 2015 and 2016. Additionally, Latinos saw drug death rates increase 24 percent, while the rate for whites increased 19 percent during those same years.
The report calls for a national resilience strategy that takes a comprehensive approach focusing on prevention, early identification of issues, and effective treatment, which is also the approach advocated by the EPISCenter.
The center’s expertise includes translating high-quality research to ensure communities and policymakers have access to the most recent and rigorous research around what works in preventing youth substance use and other problem behaviors. Bradley’s presentation focused on prevention science, effective upstream prevention programs, and the need for prevention infrastructure at federal, state and local levels.
“While the congressional briefing focused on deaths of despair, I explained that substantial research has identified upstream risk factors in early childhood and adolescence that increase risk for multiple problem outcomes, including but not limited to substance use and depression,” Bradley explained. “Proven, effective prevention strategies target early risk indicators, such as family conflict, low attachment to school, perceived norms about antisocial behaviors, and coping skills. When risk-focused strategies are used we are able to address a wider array of possible outcomes for youth and families. This means we have the opportunity to prevent a number of problems from occurring, many of which may not be on our radar today but could be issues in a few years.”
Bradley says that while the opioid crisis is drawing attention and resources, it is also allowing the EPISCenter opportunities to highlight the role that early prevention can play in stemming the epidemic. “We’ve worked previously with Trust for America’s Health and Well Being on legislation recommendations for state and local prevention infrastructure, and members of the center regularly meet with policymakers to discuss upstream prevention programs and practices that are effective at preventing all types of problem behaviors, including the misuse of prescription opioids.”
The EPISCenter is also partnering with University of Pittsburgh’s PA Heroin Overdose Prevention Technical Assistance Center to support their work on prevention strategies.
Additionally, Bradley served as a member of Opioid Prevention Subcommittee of the Governor’s Advisory Board for Health, to which she and subcommittee member Alice Yoder of Lancaster General Health submitted a white paper on upstream prevention strategies. This white paper was recently shared with the PA Opioid Command Center for consideration.
Bradley is also a member of the Penn State Advisory Board for Combating the Opioid Epidemic, and is often called to serve on panels, town halls and trainings on this issue. Penn State’s Social Science Research Institute is providing leadership for this advisory board, which includes experts from 15 interdisciplinary research centers and institutes, representing seven colleges and four campuses, as well as several offices.
The EPISCenter represents a collaborative partnership between the Pennsylvania Commission on Crime and Delinquency (PCCD), and Penn State’s Prevention Research Center and College of Health and Human Development. The EPISCenter is funded by PCCD, the Department of Human Services, and the Department of Drug and Alcohol Programs.