This Week in Addiction Medicine from ASAM

Adjunctive psychosocial interventions and opioid abstinence among patients receiving buprenorphine: A randomized clinical trial JAMA Network Open This randomized clinical trial of 340 adults with opioid use disorder (OUD) taking buprenorphine examined the comparative effectiveness of 2 psychosocial treatments—cognitive- behavioral therapy (CBT) and peer recovery support (PRS)—on opioid abstinence...

Alcohol intake and health study: No protective effect at low levels, with mortality increasing to 1 in 25 at 14 Drinks per week Journal of Studies on Alcohol and Drugs This study used a cause-specific modeling approach to estimate the lifetime risk of alcohol-attributable mortality and morbidity in the United States based on a person’s average lifetime weekly alcohol consumption to assess the impa...

Social media use trajectories and substance use experimentation: A prospective cohort study The American Journal of Psychiatry An analysis of data from more than 7,000 adolescents over 5 years found significant associations between rising social media use trajectories and substance use. Four distinct social media use trajectories were identified, with greater social media use over time throughout...

Benzodiazepine tapering: Evidence limitations and research recommendations Journal of Addiction Medicine  This systematic review of publications (2000-2023) concerning tapering benzodiazepines (BZDs) was used to inform the Joint Clinical Practice Guideline on Benzodiazepine Tapering, published in 2025. Rates of taper were often faster than recommended, such as 25%-50% reduction in the initial 1-2...

Tobacco industry contributions to the development of ultraprocessed food in the United States, 1985–2007: A case study of Lunchables American Journal of Public Health Tobacco firms began acquiring US food companies in the 1960s-1990s to increase revenues and leverage research and development across holdings in tobacco, alcohol, and ultra-processed foods (UPF) subsidiaries. In this case study, the...

A retrospective comparison of two state-funded smartphone-based contingency management programs with different incentives  Drug and Alcohol Dependence This retrospective study compared outcomes for patients with stimulant use disorder enrolled in a smartphone-based contingency management program based on the amount of total incentives possible, either $75 (“low-value”) or $599 (“moderate-value”)....

Methamphetamine use among adult patients presenting with acute coronary syndrome: A single‐center retrospective cohort study 🔓 Journal of the American Heart Association This study included 1,309 patients treated for an acute myocardial infarct (MI) at a California health system between 2012 and 2022. A total of 194 patients (15%) were methamphetamine users. The Meth-MI group had less diabetes tha...

Best practices for hospital-based initiation of medications for opioid use disorder: A consensus statement JAMA Network Open This survey study used a 2-round Delphi process to develop expert consensus on best practices for hospital-based MOUD initiation for patients with OUD, with a goal to provide guidance on changing inpatient addiction treatment in response to increased synthetic opioids in the...

Access to Medications for Opioid Use Disorder Among Veterans With Homeless Experience in Permanent Supportive Housing JAMA Network Open This cohort study assessed 10,110 US veterans with homeless experience and opioid use disorder (OUD) residing in permanent supportive housing (PSH), in terms of what factors are associated with receipt of medications for opioid use disorder (MOUD).  Only 17% recei...

Medicaid Managed Care Plan Alignment With State Substance Use Disorder Treatment Coverage Requirements The Milbank Quarterly Medicaid managed plan coverage for medications for alcohol use disorders (AUD) and opioid use disorder (OUD) varies across states but is generally lower in Republican-leaning states. Researchers conducted a national survey to evaluate if these differences in coverage were du...

Outpatient Direct Initiation of Injectable Buprenorphine in a Harm Reduction Agency and Primary Care Clinic: A Retrospective Case Series Journal of Addiction Medicine Initiating weekly long-acting injectable buprenorphine (LAIB) without prior sublingual buprenorphine (“direct-to-inject” or DTI) may reduce buprenorphine initiation barriers. In this case series, outpatient DTI outcomes are described...

A µ-opioid receptor superagonist analgesic with minimal adverse effects Nature This study identifies a novel µ-opioid receptor (MOR) agonist with supramaximal intrinsic efficacy and a unique pharmacological profile that produced effective analgesia in rodents with minimal adverse effects. N-desethyl-fluornitrazene (DFNZ) was derived from a class of synthetic benzimidazole opioids called nitazenes....

Methadone Dose and Patient-Directed Discharge in Hospitalized Patients with Opioid Use Disorder JAMA Network This retrospective observational cohort study of 554 individuals examined rates of patient-directed discharge (PDD) among hospitalized patients with opioid use disorder who received methadone during the first 72 hours of hospitalization from July 2019 to June 2022. Higher doses of methadone...

Do US Adults View Drug and Alcohol Addiction as a Health Condition? Journal of Addiction Medicine  Participants (n=5250), part of Gallup’s random sample of US households, completed a web-based survey that explored their beliefs about addiction.  Asked if addiction is a health condition 77% of US adults agree, 16% disagree, and 6% don’t know. Men are more likely to disagree (20%) than women (15%)....

Cannabis cessation and neurocognitive recovery: Patterns, predictors, and clinical implications—a systematic review The American Journal on Addictions  Researchers conducted a literature review of the neurocognitive effects of cannabis use and recovery from those effects. They found a range of neurocognitive effects including neuroreceptor adaptation, decrease in memory, processing speeds, and att...

Cost-effectiveness of contingency management for methamphetamine use disorder: A model-based analysis Addiction This study used a microsimulation model of methamphetamine use behavior among individuals with methamphetamine use disorder (MethUD) to assess the cost-effectiveness of contingency management (CM) for MethUD. Both 12-week and 24-week CM programs were modeled, using a maximum incentive of...

Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study The BMJ This study investigated whether initiation of glucagon-like peptide-1 (GLP-1) receptor agonists is associated with both reduced risks of incident alcohol, cannabis, cocaine, nicotine, opioid, and other substance use disorders (SUDs) in people with no history of...

Does the total consumption model apply to cannabis use? Addiction This repeated cross-sectional study based on annual surveys tested whether the total consumption model and its extension, the theory of collectivity, apply to adolescent cannabis use in Sweden. Frequency of cannabis use was measured by a question on how many occasions the respondent has used hashish or marijuana. The seven response...

Spirituality and Harmful or Hazardous Alcohol and Other Drug Use   JAMA Psychiatry This meta-analysis of 55 rigorous studies on spirituality and harmful or hazardous drug use (alcohol, tobacco, marijuana, or illicit drugs) examined the association between spiritual exposures and related drug use outcomes.  It documented a significant protective association of 13% related to both prevention and rec...

Emergency Department–Initiated Buprenorphine for Opioid Use Disorder JAMA Network This multicenter randomized study examined if 7-day extended-release injectable buprenorphine compared with sublingual buprenorphine to improve treatment engagement at 7 days.  It included 1,994 adult patients presenting to the emergency department with untreated opioid use disorder and a Clinical Opiate Withdrawal S...

Use of gabapentin with or without a prescription in substance use treatment settings: A national analysis of urine drug testing data, 2016–2023   Drug and Alcohol Dependence Gabapentin prescriptions have increased due to off-label use, including managing withdrawal/comorbidities in substance use disorder (SUD) treatment, despite gaps in evidence bases and corresponding increases in nonmedical use....

Association of alcohol intake over the lifetime with colorectal adenoma and colorectal cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Cancer This study analyzed data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to look for an association between alcohol intake and colorectal cancer (CRC) or colorectal adenoma. Participants' lifet...

Medication Availability for Alcohol Use Disorder in Substance Use Disorder Treatment Facilities JAMA Network Open This study examined the availability of medications for alcohol use disorder (MAUD) in SUD treatment facilities (SUDTF) from 2017 to 2023.  Data was obtained from SAMSA’s Mental Health and Addiction Treatment Tracking Repository. The percentage of counties with a SUDTF offering MAUD in...

Public Views About Opioid Overdose and People With Opioid Use Disorder JAMA Network Open This study completed a national web-based survey of 1552 adults in the United States in April 2025 to assess perceptions of opioid overdose deaths and opinions of people who use opioids. Those who responded to the survey primarily identified as female (60.5%) and aged 30-44 (33.7%). Political views varied, wit...

Did the illicit fentanyl trade experience a supply shock? Science In the United States overdose deaths (ODDs) from synthetic opioids peaked in mid-2023 and then began a sharp decline decreasing by over one third by the end of 2024. One possible explanation is a decrease in fentanyl supply. The purity of fentanyl powder rose in 2022, cresting at 25% in early 2023, but by the end of 2024 purity had...