Addiction Medicine Journal Club

In episode 59 we discuss outpatient low-dose initiation of buprenorphine. Suen LW, et al. Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. We also discuss impulse control dysregulation from ropinerole, and the new non-opioid painkiller, suzetrigine. BBC:Prescription medication made me a gambling addict Grall-Bronnec M, et al. Dopa...

In episode 58 we discuss a randomized controlled trial of semaglutide for alcohol use disorder.    Hendershot CS, Bremmer MP, Paladino MB, Kostantinis G, Gilmore TA, Sullivan NR, Tow AC, Dermody SS, Prince MA, Jordan R, McKee SA, Fletcher PJ, Claus ED, Klein KR. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Feb 12:e244789.     We al...

In this episode we discuss 4 more articles that changed our practice. Listen to us talk through real cases, what we used to do, and what we do now.    Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial. JAMA. 2024 May 28; 331(20):1722-1731.  Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fenta...

In this episode we discuss 4 articles that changed our practice. Listen to us talk through real cases, what we used to do, and what we do now. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures. Journal of Substance Use and Addiction Treatment, Volume 158, 2024. 209252, ISSN 2949-8759. Outcomes After Initiation of Medications for Alcohol Use...

In episode 57 we discuss a new definition of recovery. Zemore SE, Ziemer KL, Gilbert PA, Karno MP, Kaskutas LA. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse. 2023 Sep 15;17:11782218231199372. We also discuss sports betting and why more people aren’t prescribing buprenorphine. STAT News: The misguided reason wh...

In episode 56 we discuss how many attempts it takes to quit using addictive substances. Fontes RM, Tegge AN, Freitas-Lemos R, Cabral D, Bickel WK. Beyond the first try: How many quit attempts are necessary to achieve substance use cessation? Drug Alcohol Depend. 2024 Dec 8;267:112525. doi: 10.1016/j.drugalcdep.2024.112525. Epub ahead of print. PMID: 39719807. We also discuss capping nicotine conte...

In episode 55 we discuss the pharmacokinetics and pharmacodynamics of buprenorphine in pregnancy.    Caritis, Steve N. MD; Venkataramanan, Raman PhD. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024.    We also discuss fraud in Baltimore recovery houses, and the doubling of alcohol-r...

In episode 54 we discuss an article about 24-mg daily of buprenorphine and behavioral health hospitalizations.    Axeen S, Pacula RL, Merlin JS, Gordon AJ, Stein BD. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization. JAMA Netw Open. 2024 Sep 3;7(9):e2435478.     We also discuss the decline in overdose deaths and RFK’s experience with recovery.    The White House: Bide...

In episode 53 we discuss an article comparing treatment retention and mortality in patients who are prescribed methadone vs. buprenorphine/naloxone for treatment of opioid use disorder.    Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17.    We also discuss the Modernizing Opioid Treatment Access Act, engaging non-abstinent patients in...

In episode 52 we discuss precipitated withdrawal in the era of fentanyl.    Thakrar AP, Et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895.     We also discuss kratom, brain injury after overdose, and syringe services.  The Kratom Sobriety Podcast  Making Kratom Safer  The Conversation: Brain injury after overdose is a...

In episode 51 we discuss the connection between fun activities and success in recovery from substance use disorder.    Acuff, S. F., Ellis, J. D., Rabinowitz, J. A., Hochheimer, M., Hobelmann, J. G., Huhn, A. S., & Strickland, J. C. (2024). A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092....

41-50. Round-Up  Quick summaries of our last 10 (actually 11) articles.  41. Electronic Nicotine-Delivery Systems for Smoking Cessation 42. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures 43. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge 44 Association of Cannabis Use With Cardiovascular Outcomes...

In episode 50 we discuss 3 articles about kratom. We are again joined by our friend Dr. Casey Grover from the Addiction Medicine Made Easy Podcast.    Smith KE, Dunn KE, Rogers JM, Grundmann O, McCurdy CR, Garcia-Romeu A, Schriefer D, Swogger MT, Epstein DH. Kratom use as more than a "self-treatment". Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694.     Hill K, Grundmann O, Smith KE, Stanciu CN....

In episode 49 we discuss the 12-week follow-up data from the ADAPT-2 trial about using ER injectable naltrexone and bupropion for methamphetamine use disorder.     Li MJ, Chau B, Belin T, Carmody T, Jha MK, Marino EN, Trivedi M, Shoptaw SJ. Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial. Addiction. 2024 Jun 10. doi: 10.1111/add.1652...

In this episode we discuss kratom with our friend Dr. Casey Grover of the Addiction Medicine Made Easy podcast. Stay tuned for part 2 coming next, Kratom Journal Club.    Tampa Bay Times: Deadly Dose     Annals of Internal Medicine Kratom: An Emerging Issue for Research and Physician Education  ---  This episode is not eligible for CME, but other episodes offer category 1 and MATE-ACT CME credits...

In episode 48 we discuss the association between semaglutide and alcohol use disorder.    Wang, W., Volkow, N.D., Berger, N.A. et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun 15, 4548 (2024).    The Journal of Addiction Medicine: The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients    We also dis...

In episode 47 we discuss the effectiveness of sublingual and injectable buprenorphine for patients with OUD, with and without fentanyl.    Nunes EV, Comer SD, Lofwall MR, Walsh SL, Peterson S, Tiberg F, Hjelmstrom P, Budilovsky-Kelley NR. Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fentanyl Use: A Post Hoc Analysis of a Randomized Clinical Trial. JAMA Netw O...

In episode 46 we discuss using high doses of varenicline and nicotine for smoking cessation.    Cinciripini PM, Green CE, Shete S, Minnix JA, Robinson JD, Cui Y, Kim S, Kypriotakis G, Beneventi D, Blalock JA, Versace F, Karam-Hage M. Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial. JAMA. 2024 May 28; 331(20):1722-1731.    We a...

45. Urine Drug Screens and Treatment Retention    In episode 45 we discuss urine drug screens and treatment retention.    Michener PS, Knee A, Wilson D, Boama-Nyarko E, Friedmann PD. Association of random and observed urine drug screening with long-term retention in opioid treatment programs. Drug Alcohol Depend. 2024 Feb 1;255:111067.     We also discuss storing injectable buprenorphine at room t...

44. Cannabis and CV Outcomes    In episode 44 we discuss the association between cannabis use and cardiovascular outcomes.    Jeffers AM, Glantz S, Byers AL, Keyhani S. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024 Mar 5;13(5):e030178. doi: 10.1161/JAHA.123.030178. Epub 2024 Feb 28.  We also discuss the DEA rescheduling cannabis, and the failure o...

In episode 43 we discuss prescribing medication for alcohol use disorder at hospital discharge.    Bernstein EY, Et al. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge. JAMA Netw Open. 2024 Mar 4;7(3):e243387.     We also discuss grandparents raising grandchildren who’ve lost a parent to drug overdose, and how native peoples are using opioid settlement funds...

In episode 42 we discuss how buprenorphine protects against fentanyl overdose.    Zheng Dai, et al. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures. Journal of Substance Use and Addiction Treatment, Volume 158, 2024. 209252, ISSN 2949-8759.    We also discuss semaglutide for alcohol use disorder.    Richards JR, et al. Significant Decreas...

In episode 41 we discuss vaping for smoking cessation.    Auer R, et al. Electronic Nicotine-Delivery Systems for Smoking Cessation. N Engl J Med. 2024 Feb 15;390(7):601-610.    We also discuss the NarxCare addiction risk score and the recent increase in alcohol-related deaths.    New York Times: Addiction Risk Scores Won’t Solve the Opioid Crisis  CDC: Deaths from Excessive Alcohol Use — United S...

Quick summaries of Episodes 31-40.    31. Injection Drug Use Frequency Before and After Take-Home Naloxone Training    32. Trazodone for sleep disturbance in opioid dependent patients maintained on buprenorphine: A double blind, placebo-controlled trial   33. Non-fatal overdose risk associated with prescribing opioid agonists concurrently with other medication: Cohort study conducted using linked...

In this episode we discuss drug overdose after benzodiazepine prescriptions for anxiety and depression.    Bushnell GA, et al. Drug overdose risk with benzodiazepine treatment in young adults: Comparative analysis in privately and publicly insured individuals. Addiction. 2023.    We also talk about the war on recovery treatments and patients leaving the hospital against medical advice.    STAT New...