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Expert Research: Mandated Restrictions on Opioid Prescriptions Have Unintended—and Deadly—Consequences

New research from Goizueta’s Diwas KC unpacks the dual impact of Prescription Drug Monitoring Programs on opioid prescriptions and heroin overdose deaths. More than two million individuals in the US are experiencing Opioid Use Disorder (OUD). The CDC defines OUD as “a problematic pattern of opioid use that causes significant impairment or distress.” Around 130 people die of opioid overdoses every day. Perhaps more startlingly, four million people over the age of 12 have reported using pain medication recreationally, including opioids. Prescription opioids are a highly-regulated class of drug. They interact with the opioid receptors on nerve cells throughout the body, as well as the brain, which reduces the intensity of pain signals to the body. For many, they are a necessary prescription to get through the pain of surgery or injury, as the body heals itself. Unfortunately, the function of opioids in the body—releasing endorphins and boosting feelings of pleasure, as well as reducing pain—also make them highly addictive. PDMP: A Successful Federal Mandate The United States continues to see increases in deaths from opioid overdoses. So, federal and state governments have been working in enact policies that are designed to decrease those fatalities. One of the methods states are using to prevent common abuse patterns like “doctor shopping,” which is the pattern of visiting multiple physicians to obtain prescriptions, is the Prescription Drug Monitoring Program (PDMP), designed to be used in conjunction with Health Information Technology (HIT) programs. PDMP serve two purposes: identifying drug-seeking behaviors in patients, and identifying physicians with patterns of inappropriate prescribing. Nearly all 50 states have enacted PDMPs of some degree. Some programs require physicians to check the PDMP before prescribing restricted pharmaceuticals, but in others it’s only suggested. Intrastate communication between PDMPs is not always possible, however. The Unintended Consequences The use of PDMPs has been shown to reduce the number of opioid prescriptions, the intended outcome of the program. Enter a recently published study by Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management. The research shows that during time the research was conducted, prescriptions for opioids declined by 6.1%. However, the research also brought to light a very serious and unintended consequence of the implementation of PDMPs. The study concluded that while the implementation of PDMPs did reduce opioid prescriptions, it did not reduce overall numbers of prescription opioid deaths. In fact, it may have contributed to a 50% increase in heroin overdose fatalities. “The heroin increase was definitely something we were not expecting, it was a total surprise,” says KC. "It was something that we had hypothesized. You’ve got a bunch of individuals who have used prescription opiates and had presumably been dependent. Now with the passage of this PDMP law, it has become more difficult to obtain prescription opiates. Therefore, some people might be forced to turn to the street version of it." Diwas KC “We didn’t expect the effect size it to be as significant as it is,” says KC. Heroin and commonly prescribed opioids like oxycodone and hydrocodone are very similar on a biochemical level. What’s more, they generate a similar sensation in the body, according to KC. That’s why he and his team had the initial hypothesis that some addicted individuals, when unable to get prescription medication, might turn to street drugs, which are much more dangerous on many levels. “There are many aspects to this. One has to do with the potency and the toxicity of the things you get on the streets. There are very little checks and balances on those. There’s no control in quality for sure,” KC says. He also notes the lack of checks and balances on the frequency of usage. “So the frequency of usage, the quality of the substances you’re putting inside your body, and possibly the circumstances of acquiring it might also be very risky too.” A Dual Impact The research concludes that mandating PDMP use is an example of a successful use of policy for intervention. It does, in fact, decrease the number of opioid prescriptions available to patients. That’s critical information for policy makers and physicians to take in. And it’s a solid reason to keep using and expanding PDMP usage, according to KC. "I should point out very clearly that the policy did have the intended effect of reducing prescriptions. So, it definitely benefited people who might otherwise have become addicted." Diwas KC “By reducing unnecessary prescriptions it might have limited the number of people who would have gotten hooked on the drugs in the first place. So there’s definitely the benefit of that,” says KC. “It’s just that when the policy was implemented, there was also this side effect because of people who were already using it. So, when those people were forced to look for alternatives, that’s when things got bad.” Research papers like this one show an important side of using data to mark successes and failures of government policies. Taken on the surface, data can show a policy’s impact for the greater good. But a deeper dive into the surrounding data—like the increase in heroin use after the implementation of PDMPs—gives everyone a better idea of the full impact of this mandate. "Policies have intended as well as unintended consequences. In this case of PDMP it had the desired effect of reducing prescriptions. That probably helped a lot of people not get addicted to opiates in the first place." Diwas KC “But sometimes policies also have unintended consequences,” says KC. “Like in the case of people who were already addicted to painkillers suddenly stopping it, causing them to take drastic actions, and that’s what happened for some of the people in the study. Policies need to consider the possibility of unintended consequences and take actions to also mitigate those unintended consequences.” Interested in knowing more? Diwas KC is the Goizueta Foundation Term Professor of Information Systems & Operations Management. He is available to talk about this important topic - simply click on his icon now to arrange an interview today

Tuesday is World Beatles Day - And we've got the classic rock experts who can help with your stories

World Beatles Day celebrates the legendary British rock band, The Beatles, whose music and cultural impact have left an indelible mark on the world. This event matters to the public not only because of The Beatles' timeless music and influence on pop culture but also because it offers a lens through which to explore broader themes of social change, artistic innovation, and historical significance. Recognizing the band's role in shaping modern music, fashion, and societal values, World Beatles Day provides numerous compelling story angles for journalists to explore: The Beatles' Influence on Modern Music: Exploring how contemporary artists are inspired by The Beatles and the enduring relevance of their musical innovations. Cultural Revolution of the 1960s: Analyzing how The Beatles contributed to the social and cultural changes of the 1960s, including the counterculture movement. Beatlemania and Its Impact on Fan Culture: Examining the phenomenon of Beatlemania and its legacy in shaping modern fan culture and celebrity worship. The Beatles and Fashion Trends: Investigating The Beatles' influence on fashion and style, from the iconic "mop-top" haircuts to their psychedelic wardrobe. The Beatles' Contribution to Film and Media: Looking at The Beatles' ventures into film, such as "A Hard Day's Night" and "Yellow Submarine," and their impact on music videos and multimedia storytelling. Global Influence and Legacy: Assessing how The Beatles have left a lasting legacy on music and culture worldwide, including international fan communities and tributes. World Beatles Day serves as a reminder of the band's profound influence on music and culture, offering journalists rich and diverse story opportunities to engage audiences with both historical perspectives and contemporary connections. Connect with an Expert about the history of The Beatles: John Covach Professor of Music and Director of the Institute for Popular Music; Professor of Theory at Eastman School of Music · University of Rochester José Valentino Ruiz Assistant Professor · University of Florida Melissa Avdeeff Assistant Professor · Coventry University Henry Juszkiewicz Chairman and CEO · Gibson Guitar Corp. To search our full list of experts visit www.expertfile.com Photo credit: Fedor

SCOTUS Sides with Starbucks in Labor Dispute

Mary Anne Trasciatti, director of the Labor Studies Program and professor of rhetoric, talked to Newsday about a Supreme Court ruling that stated a higher standard must be met for the federal government to win court orders when a company is suspected of interfering with union campaigns. The ruling stemmed from a court case involving a labor dispute between Starbucks and its unionized workforce. The decision ruling will make it harder for the National Labor Relations Board to support Starbucks workers when a company is suspected of interfering with union campaigns. Dr. Trasciatti said she was “disappointed but not surprised” by the court’s decision. “Starbucks is talking out of both sides of their mouth,” she said. “It really undercuts their stated commitment to building a positive relationship with their unionized workers.” Dr. Trasciatti is available to speak with media - simply click on her icon now to arrange an interview today.

Sunday is the anniversary of Brexit - We're here with expert insights if you're covering

The United Kingdom's exit from the European Union, commonly known as Brexit, stands as one of the most significant geopolitical events of the 21st century. This topic matters to the public because it encompasses profound implications for international trade, immigration, legal frameworks, and political alliances. The ripple effects of Brexit are felt not only within the UK and the EU but also globally, making it a critical issue for journalists to cover. Brexit's impact spans numerous sectors and societal issues, providing a wealth of story angles, including: The economic impact of Brexit on the UK, EU, and global markets Changes in immigration policies and their effects on individuals and industries The evolving political landscape in the UK, including the rise of nationalism and regional independence movements The legal challenges and adaptations post-Brexit, particularly concerning trade agreements and regulatory standards The social and cultural consequences of Brexit, including shifts in public opinion and societal division The future of UK-EU relations and their broader implications for international diplomacy and cooperation As we continue to navigate the complexities of Brexit, journalists have the opportunity to explore these diverse and critical narratives, offering in-depth insights into the ongoing and far-reaching impacts of this historic event. Connect with an Expert about Brexit: Dr David Lowe Senior Research Fellow · Leeds Beckett University Dr Oleksandr Shepotylo Senior Lecturer, Economics, Finance and Entrepreneurship · Aston University Dr Patrycja Rozbicka Senior Lecturer · Aston University Dr Jo Michell Associate Professor of Economics · UWE Bristol Patrick L Young Executive Director · Derivatives Vision To search our full list of experts visit www.expertfile.com Photo credit: Rocco Dipoppa

Expert Research: Hurricanes and Natural Disasters Linked to “Grocery Tax” for Lower-Income Americans

Research from Goizueta’s William Schmidt uncovers the disproportionate impact of natural disasters on low-income families’ access to essentials. Global warming is accelerating severe weather with cataclysmic outcomes for communities all over the world. In 2023, the hottest year on record, no fewer than 23 weather-related disasters struck the United States. These natural disasters claimed hundreds of lives and caused $57 billion in damage. Recently, the federal government has come under scrutiny for uneven aid response to communities affected by hurricanes, fires, and flooding in America. William Schmidt But might there be other factors at play that see disadvantaged groups more vulnerable to the impact of severe weather events? Weighing into this is award-winning research by Goizueta Business School’s William Schmidt, associate professor of Information Systems and Operations Management. He and Xabier Barriola from INSEAD Business School look at the effect of three major hurricanes in the U.S. in the last 20 years. They find evidence of higher paid prices for basic groceries in the aftermath of each storm that disproportionately impact lower-income communities in affected states. In fact, says Schmidt, when severe weather hits communities, these families end up paying anywhere between one and five percent more relative to high income households for essential food and goods. This puts a major strain on already-strained resources in times of massive disruption. "We see a spike in the prices paid for household groceries of up to five percent hitting low-income groups immediately after a major storm hits." William Schmidt “Then you have to factor in the reality that poorer households spend around eight times more of their disposable income on basic groceries than high-income households,” says Schmidt. “It becomes clear that the aftermath of severe weather is harder for them to bear. And in our research, this is an effect that lasts for months, not weeks or days.” Exposing Hidden Costs on Those Hit Hardest To get to these findings, Schmidt and Barriola worked from a hunch. They figured that in low-income areas, a lack of infrastructure, lower-quality construction, and fewer grocery store outlets could translate into supply shortages in emergencies. Ensuing stockouts might then lead to knock-on price inflation for customers. These are low-income families for whom inflation has serious and significant consequences, Schmidt says. "We know that inflation hurts poorer communities. High-income families have the option of switching between high and low-priced goods according to needs or preference. But families with lower incomes are already purchasing low-priced groceries." William Schmidt “When there are disaster-induced stockouts to their preferred products, those families are forced to substitute to higher priced groceries,” Schmidt continues. Then there’s retailer behavior. Following large environmental disasters, store managers may be unable to keep necessities in stock. Under those circumstances, it is difficult to justify running promotions or implementing planned price decreases. To test these ideas, Schmidt and his colleagues looked at data from the weeks and months following Hurricanes Katarina (2005), Ike (2008), and Sandy (2012). They decided to pinpoint those locations immediately impacted at the county level. To do so, they used major disaster declarations issued by the federal government at the time. Then they integrated this with detailed grocery store sales data provided by Information Resources Inc (IRI) with zip code-level household income and demographic data from the U.S. Census Bureau. With each hurricane, the researchers looked at IRI data covering 30 different product categories and around 200 million transactions over a 12-week period. Schmidt and his colleagues then ran a set of analyses comparing prices paid by communities before and after each hurricane. They also contrasted price increases paid by low-income and high-income households as well as communities outside of the areas affected by the storms. Crunching the Numbers “Doing this triple-difference regression analysis, we find that lower-income communities pay an average 2.9 percent more for their groceries. That’s in the eight weeks following each of these disasters,” says Schmidt. "The effect varies. But it is roughly commensurate with the overall economic damage wrought by each hurricane, with Katrina being the worst. Here low-income families were seeing a 5.1 percent increase in the cost of food and basic goods, relative to richer households." William Schmidt The study points to a variety of mechanisms driving these effects. As Schmidt and his co-authors hypothesize, there is evidence that the same disruptions lead to fewer price promotions. They also see more frequent stockouts of low-priced goods. At the same time, there’s a shift in household purchasing from low to higher-priced products. These effects are long-lasting, says Schmidt. According to the study, post-hurricane inflation in the prices paid by consumers continues to affect poorer families for eight or more weeks. This amounts to months of economic hardship for those least resilient to its effects. Schmidt calls this “permanent inflation.” Pursuing Equity in Crisis Operations managers and policymakers should factor these findings into emergency relief efforts, say Schmidt and his colleague. The goal should be to service communities more equitably. So, there should be more thought to the provision of essential food and household goods. Also, there should be a particular focus on those most vulnerable to natural disasters and their effects. Current disaster nutrition relief programs are typically short. Authorities might do better by vulnerable communities by also extending things like cash and voucher programs, says Schmidt. And they should prioritize the ordering, shipment, and warehousing of essential goods. “Our research shows that hurricanes cost certain groups of Americans more than others in the longer run. The permanent inflation on food stuff and household necessities that we find constitutes an additional burden on part of our national fabric. These are people who are least positioned to afford it.” Hurricanes and the economy are both sought-after topics - and if you're covering, we can help. William Schmidt is an associate professor of Information Systems & Operations Management at Emory University’s Goizueta Business School. His research focuses on understanding and mitigating operational disruptions, and applications of machine learning in operational decision making.  To connect with William to arrange an interview - simply click his icon now.

First in Delaware to Offer MR-Guided Ultrasound for Treatment of Essential and Parkinson’s Tremor

Revolutionary technology gives patients immediate relief from debilitating tremors without the need for invasive surgery. ChristianaCare is the first health care provider in Delaware to offer FDA-approved focused ultrasound treatment for people suffering from essential tremor and Parkinson’s disease. The new option – called MR-guided focused ultrasound – uses sound wave energy to destroy precise areas of brain tissue that is the source of the tremor. No surgical incision or anesthesia is necessary, and many patients experience immediate and significant reduction in tremors, which can make daily activities challenging. Dr. Martello explains that the procedure involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors. “This minimally invasive technology dramatically improves the lives of patients with essential tremor and tremor-dominant Parkinson’s who haven’t fully responded to traditional treatments,’’ said Justin Martello, M.D., director of the Parkinson’s and Movement Disorders Programs, and Focused Ultrasound Program at ChristianaCare. What is tremor? Tremor is a neurological condition that includes involuntary shaking or trembling movements in one or more parts of the body. It most commonly affects the hands and can make daily tasks such as writing, eating and using a computer or phone extremely difficult. Tremor affects approximately 1% of the population overall and 5% of adults age 60+. It is expected to increasingly impact Delawareans as the state’s population ages. Essential tremor is the most common type of tremor. It can occur at any age but is most common in older adults. Tremor is also the most well-known symptom of Parkinson’s disease. An estimated 1.5 million Americans suffer from Parkinson’s disease, a progressive neurodegenerative disease that affects movement and can also affect speech, balance and cognitive function. A newer, better option for patients who don’t respond to medications The procedure of MR-guided focused ultrasound involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors. Patients are fitted with a frame affixed to a specialized helmet that combines the focused energy of more than 1,000 high-frequency sonic beams directed through the skull. The treatment does not require cutting through the skull, or radiation, as in gamma knife technology. “Today, there are basically three options for managing tremor,” said Pulak Ray, M.D., of Delaware Neurosurgical Group and associate director of the Focused Ultrasound program. “The first is medication, which is effective and affordable for many patients, but its effectiveness tends to diminish over time. The second is deep-brain stimulation, which is the most invasive and costly treatment option. The newest is MR-guided ultrasound, which tends to be the preferable option for most patients who do not respond well to medication, because it is a simple, non-invasive outpatient procedure that is highly effective, safe and produces instant results.” Benefits of MR-guided Focused Ultrasound MR-guided focused ultrasound reduces tremor immediately, with shorter recovery time, lower risk of side effects and lower associated health care expenses compared to surgical alternatives. This treatment dramatically improves patient experience and quality of life for people with Parkinson’s disease or essential tremor. For many patients, MR-guided ultrasound reduces their dependence on caregivers to assist with activities of daily living. Candidates must first undergo a CT scan to ensure a skull density sufficiently thick to accommodate the procedure. The patient is awake during the procedure and situated within an MRI machine for real-time imaging of the brain. The physician tests the precise location by heating the area, then ensuring the patient is able to control tremors by tracing lines on a spirograph. At that point, the physician then permanently ablates the focal point, usually a sphere a few millimeters in length. “Our team is very excited to bring this technology to Delaware and to open up access to potentially life-changing treatment that until now has required long wait times and significant travel for patients,” said Kim Gannon, M.D., Ph.D., medical director of the comprehensive stroke program and physician executive of Neuroscience Service Line at ChristianaCare. “Many tremor patients have suffered for years or even decades with this debilitating and progressive condition and helping them live a more active and independent lifestyle is extremely rewarding.” MR-guided focused ultrasound is covered by Medicare and most insurance plans.

Aston University researcher develops method of making lengthy privacy notices easier to understand

It has been estimated it would take 76 days per year to fully read privacy notices New method makes notices quicker and easier to understand by converting them into machine-readable formats Team designed a JavaScript Object Notation schema which allowed them to validate, annotate, and manipulate documents. An Aston University researcher has suggested a more human-friendly way of reading websites’ long-winded privacy notices. A team led by Dr Vitor Jesus has developed a system of making them quicker and easier to understand by converting them into machine-readable formats. This technique could allow the browser to guide the user through the document with recommendations or highlights of key points. Providing privacy information is one of the key requirements of the UK General Data Protection Regulation (GDPR) and the UK Data protection Act but trawling through them can be a tedious manual process. In 2012, The Atlantic magazine estimated it would take 76 days per year to diligently read privacy notices. Privacy notices let people know what is being done with their data, how it will be kept safe if it’s shared with anyone else and what will happen to it when it’s no longer needed. However, the documents are written in non-computer, often legal language, so in the paper Feasibility of Structured, Machine-Readable Privacy Notices Dr Jesus and his team explored the feasibility of representing privacy notices in a machine-readable format. Dr Jesus said: “The notices are essential to keep the public informed and data controllers accountable, however they inherit a pragmatism that was designed for different contexts such as software licences or to meet the - perhaps not always necessary - verbose completeness of a legal contract. “And there are further challenges concerning updates to notices, another requirement by law, and these are often communicated off-band e.g., by email if a user account exists.” Between August and September 2022, the team examined the privacy notices of 50 of the UK’s most popular websites, from globally organisation such as google.com to UK sites such as john-lewis.com. They covered a number of areas such as online services, news and fashion to be representative. The researchers manually identified the notices’ apparent structure and noted commonly-themed sections, then designed a JavaScript Object Notation (JSON) schema which allowed them to validate, annotate, and manipulate documents. After identifying an overall potential structure, they revisited each notice to convert them into a format that was machine readable but didn’t compromise both legal compliance and the rights of individuals. Although there has been previous work to tackle the same problem, the Aston University team focused primarily on automating the policies rather than data collection and processing. Dr Jesus, who is based at the University’s College of Engineering and Physical Sciences said: “Our research paper offers a novel approach to the long-standing problem of the interface of humans and online privacy notices. “As literature and practice, and even art, for more than a decade have identified, privacy notices are nearly always ignored and ”accepted” with little thought, mostly because it is not practical nor user-friendly to depend on reading a long text simply to access, for example a news website. Nevertheless, privacy notices are a central element in our digital lives, often mandated by law, and with dire, often invisible, consequences.” The paper was published and won best paper at the International Conference on Behavioural and Social Computing, November 2023, now indexed at IEEE Xplore. The team are now examining if AI can be used to further speed up the process by providing recommendations to the user, based on past preferences.

Is Florida becoming more affordable for renters?

Between high interest rates, an influx of newcomers eager for housing and inflation taking a toll on the cost of almost everything - it's been an expensive year for anyone living in Florida. But it appears the tide might be finally turning on high costs and the price to rent a place in the Sunshine State might be going down. It's a trend that has media looking for answers and experts like Florida Atlantic's Ken Johnson getting calls to provide his insight, opinion and expertise on the topic. Florida Atlantic University recently released a new study showing that the state’s rental markets might be stabilizing. In the release, FAU officials announced that rents in areas like Palm Bay and Jacksonville have recently gone below their long-term pricing trends. Meanwhile, the data indicates that other major cities in the state — such as Cape Coral, Orlando and Deltona — saw only slight increases in rent prices, with price increases gradually slowing down. As such, it could be a sign that many renters statewide could soon see lower prices. “While these measures are small, they are a positive sign of where the rental market could be heading in the future,” said Dr. Ken Johnson, a real estate economist with FAU’s College of Business. “These Florida cities are renting at a discount compared to their historical averages, and others appear to be heading in that direction, suggesting that rental markets around the state are stabilizing.”  June 06 - Click Orlando.com Florida may be an interesting case study on what lies ahead. Will these rental trends in Florida start to appear nationally? Who will best benefit from lower rents and what will it mean for the economy? Will lower rents attract more people to Florida and could that reverse this trend? There's a lot to know and understand about the rental market. And if you're a journalist covering the topic or looking to know more - then let us help. Ken H. Johnson, Ph.D., an economist and associate dean in FAU’s College of Business, is available to speak to the media. Simply click on his icon to arrange an interview and time.

Juneteenth is tomorrow - our experts are here to help with your coverage

Juneteenth, celebrated on June 19th, commemorates the emancipation of enslaved African Americans and marks a pivotal moment in American history. This event is significant to the public as it highlights the ongoing journey towards equality and justice, reflecting on past struggles while inspiring current and future generations to continue the fight against systemic racism. Juneteenth provides numerous compelling story angles for journalists to explore: The historical significance of Juneteenth and its journey to becoming a federal holiday Personal stories and testimonies from descendants of those who were emancipated The role of Juneteenth in contemporary movements for racial justice and equality Cultural celebrations and traditions associated with Juneteenth across different communities The impact of education on understanding and commemorating Juneteenth in schools and universities Local and national initiatives aimed at addressing and rectifying racial disparities As we commemorate Juneteenth, journalists have an opportunity to delve into these rich and multifaceted narratives, highlighting the historical importance and contemporary relevance of this significant event in American history. Connect with an Expert about the History of Juneteenth: Amilcar Shabazz Professor of History and Africana Studies, W.E.B. Du Bois Department of Afro-American Studies · University of Massachusetts Amherst Dexter Gabriel, Ph.D. Associate Professor of History · University of Connecticut Mia Moody-Ramirez, Ph.D. Professor · Baylor University Tracy Sharpley-Whiting Gertrude Conaway Vanderbilt Distinguished Professor of African American and Diaspora Studies · Vanderbilt University Jessica Millward Associate Professor of History and African American Studies · UC Irvine To search our full list of experts visit www.expertfile.com Photo credit: Tasha Jolley

Easier Access to Doulas for Mothers on Medicaid

Dr. Martine Hackett, associate professor and chair of Hofstra’s Department of Population Health, was interviewed by Newsday about the New York state health commissioner issuing a standing order that allows all pregnant women with Medicaid access to doula services. In the past, they needed to get an order from their individual licensed health care practitioner. The order removes “a barrier to doula services," said Dr. Hackett, who serves as co-founder of Birth Justice Warrior of Long Island, which advocates for healthier pregnancies and babies. “This is one of many steps being taken to simplify and streamline the process of connecting Medicaid members to community doulas,” she said, noting that the state has been trying to make it easier for doulas to handle the complex billing and claims process. Dr. Hackett's research focuses on public health and health inequities, particularly in the American suburbs and minority communities. She's available to speak with media - simply click on her icon now to arrange an interview today.