This Week in Addiction Medicine from ASAM

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. Of the 23 patients with available...

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. DFNZ has impaired brain penetrance...

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 were associated with a decreased r...

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%). Those who have struggled with addic...

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 attention. Deficits increased with hig...

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 $750/patient, per SAMHSA guideline...

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 SUDs (protocol 1) and with reduced...

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 alternatives ranged from 0 to 50 ti...

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 recovery. The risk reduction, which ext...

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 Scale (COWS) score of 4 or higher.  ...

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. This retrospective, serial cross-se...

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' lifetime pattern of alcohol intake was d...

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 increased from 34% in 2017 to 50% 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, with 28.9% conservatives, 39.6% modera...

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 fallen to 11%. From 2019 to 2024 th...

Barriers to Buprenorphine Initiation in Patients Using Fentanyl

JAMA Network Open

This is a survey study of 396 buprenorphine-prescribing clinicians in the US to determine if they faced problems initiating buprenorphine among patients using fentanyl, and whether their practice had changed as a result. Participants were selected from a stratified random sample of X-waivered clinicians registered with the DEA who had prescribed bupre...

Productivity Losses From Substance Use Disorder in the U.S. in 2023

American Journal of Preventive Medicine

Information on morbidity-related productivity losses attributable to substance use disorder is limited. This study estimates morbidity-related productivity losses attributable to substance use disorder among U.S. adults aged ≥18 years in 2023. It found that total morbidity-related productivity losses attributable to substance...

Expanding Access to Buprenorphine and Methadone: Global Perspectives and Policy Recommendations

Substance Use and Addiction Journal

This is a narrative review of methadone and buprenorphine regulations, prescriber eligibility, dispensing models, and coverage across eight countries: the United States, Canada, the United Kingdom, Russia, France, Iran, Australia, and Portugal. The study identified several key barriers to MOUD: require...

Very Low Nicotine Content Cigarettes for Smoking Cessation: Examining a Facilitated Extinction Approach and Dosing Schedule

Drug and Alcohol Dependence

Very low nicotine cigarettes (VLNC, 0.4 mg nicotine/g tobacco) have been shown to reduce smoking behavior when compared to normal nicotine cigarettes (NNC,17 mg nicotine/g tobacco). Participants (n=208) were randomly assigned to 4 experimental groups, immediate versus gradual (over ...