Bitter sensing protects Drosophila from developing experience-dependent cocaine consumption preference The Journal of Neuroscience Cocaine use disorder (CUD) is a highly heritable condition for which there are no effective treatments. Testing the many human genetic variants linked to CUD requires a cost-effective, genetically tractable model. This study showed that bitter-sensing neurons prevent cocaine self-administration in Drosophila. Disrupting Drosophila bitter perception enables a model fo...
Jun 10, 2025•7 min•Ep. 170
Memory function in patients with opioid dependence treated with buprenorphine and methadone in comparison with healthy persons Scientific Reports This study compared memory performance in patients treated with methadone or buprenorphine for drug abuse to healthy controls using the Wechsler Memory Scale. Healthy controls performed better than both treatment groups in mental control. Methadone patients scored higher than controls in personal and general information, while buprenorphine patients sc...
Jun 02, 2025•7 min•Ep. 169
Medicaid Unwinding and Changes in Buprenorphine Dispensing JAMA Network Open Among Medicaid-insured adults with buprenorphine use, this cross-sectional study examined if changes in buprenorphine dispensing were greater among those residing in states with the highest vs lowest decreases in Medicaid enrollment after “Medicaid unwinding” began in April 2023. Researchers used 2017-2023 data from a national prescription dispensing database that included 754,675 person-years from 569,069 patients. The...
May 28, 2025•7 min•Ep. 168
Loneliness Among US Veterans With Problematic Substance Use: Results From the National Health and Resilience in Veterans Study Journal of Addiction Medicine Loneliness is a major public health concern, especially among individuals with problematic substance use (PSU), but little research has focused on vulnerable groups like US military veterans. This study, using data from the National Health and Resilience in Veterans Study, found that nearly half of veterans with PSU (47.4%) experience clinic...
May 20, 2025•8 min•Ep. 167
The IARC Perspective on the Effects of Policies on Reducing Alcohol Consumption New England Journal of Medicine In 2020, alcohol use was responsible for over 740,000 new cancer cases worldwide. In response, The International Agency for Research on Cancer (IARC) released a two-part handbook assessing the effectiveness of public policy measures in reducing alcohol-related cancer risk. The report found that reducing or stopping alcohol consumption lowers the risk of certain cancers and that several...
May 13, 2025•7 min•Ep. 166
Building Multidisciplinary Consensus on Inpatient Xylazine Management through Clinical Protocols Substance Use and Addiction Journal Xylazine in the unregulated drug supply produces significant morbidity and this paper describes utilizing a multidisciplinary team to develop protocols for inpatient setting to manage patients with xylazine exposure. Protocols developed included use of scheduled clonidine or tizanidine to manage withdrawal with hold parameters. As there is no FDA approved immunoass...
May 06, 2025•7 min•Ep. 165
Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial Journal of the American Medical Association This 12-week randomized clinical trial in 261 treatment-seeking youth aged 16 to 25 years assessed if varenicline, when added to brief, remotely delivered behavioral support, was efficacious and well tolerated for nicotine vaping cessation in youth. Researchers found that continuous abstinence rates were higher in the varenicline group than in the placebo group in the last mon...
Apr 29, 2025•6 min•Ep. 164
Comprehensive drug policies increase trust in local government: an analysis of authorities’ and residents’ perspectives in rural US Appalachian and Midwestern counties 🔓 Harm Reduction Journal Implementation of harm reduction intervention policies by local governments may be met with caution because of concern about potential backlash from communities and erosion of public trust. The authors conducted two studies to assess the influence of perceptions of government support for comprehensive dru...
Apr 22, 2025•7 min•Ep. 162
Hospital Addiction Consultation Service and Opioid Use Disorder Treatment JAMA Internal Medicine While medication for opioid use disorder (MOUD) is effective, many patients with OUD do not receive it, particularly in hospitalized settings. In this randomized trial they evaluated the Substance Use Treatment and Recovery Team (START) model, a team of an addiction medicine provider and a care manager, and provided motivational interviewing, discharge planning and telephone follow-up for one month. ...
Apr 15, 2025•7 min•Ep. 161
Averted lung cancer deaths due to reductions in cigarette smoking in the United States, 1970–2022 Cancer Smoking prevalence peaked in the 50s and 60s but has declined following the US Surgeon General’s report in 1964 on its health risk. As 85% of lung cancer is attributable to smoking, the authors evaluated this impact by assessing lung cancer deaths averted, and person-years of life (PYL) gained between 1970 and 2022 using cancer mortality data from the CDC. The authors estimated 3,856,240 lung...
Apr 08, 2025•7 min•Ep. 160
Prescription Stimulant Use, Misuse, and Use Disorder Among US Adults Aged 18 to 64 Years JAMA Psychiatry This study examined the prevalence of prescription stimulant use, prescription stimulant misuse, and prescription stimulant use disorder (PSUD) among adults aged 18 to 64 years in the US. Researchers found that 25.3% of adults in the study reported misuse, and 9.0% had PSUD. Among those with PSUD, 72.9% solely used their own prescribed stimulants, 87.1% used amphetamines, 42.5% reported no mi...
Apr 01, 2025•7 min•Ep. 159
Alcohol Use Disorder Medication Coverage and Utilization Management in Medicaid Managed Care Plans JAMA Network Open This cross-sectional study examined how Medicaid managed care plans (MCPs) cover and manage medications for alcohol use disorder (AUD). A content analysis of publicly available data from all 241 comprehensive Medicaid MCPs in 2021 revealed that 103 plans (42.7%) covered all approved medications (acamprosate, naltrexone, and disulfiram) for AUD. Prior authorization and quantity lim...
Mar 25, 2025•7 min•Ep. 158
Association Between Telehealth Initiation Of Stimulant Therapy And New Substance Use Disorder Diagnoses Health Affairs During the COVID-19 pandemic, the Drug Enforcement Administration (DEA) temporarily allowed for prescribing of controlled substances via telehealth and extended the policy through the end of 2025. With concern about potential adverse outcomes with this policy, there is debate about making it permanent. The authors utilized commercial and Medicaid claims data to assess newly diag...
Mar 18, 2025•5 min•Ep. 157
The association between buprenorphine doses above 16 milligrams and treatment retention in a multi-payer national sample in the United States, 2014 to 2021 Addiction Buprenorphine labeling identifies 16 mg as the “target dose,” supported by prior evidence that higher doses (≥16 mg) were associated with increased retention in treatment. Studies comparing doses above 16 mg to 16 mg, particularly in the era of fentanyl, have been very limited. The authors conducted a cohort study to look at retenti...
Mar 11, 2025•7 min•Ep. 156
Illicit Substance Use and Treatment Access Among Adults Experiencing Homelessness Journal of the American Medical Association Utilizing a multistaged probability-based survey, this study assessed the prevalence of illicit substance use, treatment, nonfatal overdose, and naloxone possession among 3,200 adults experiencing homelessness in California from October 2021 to November 2022. An estimated 37% of respondents reported using any illicit substance regularly (≥ 3 times per week) in the last 6 ...
Mar 04, 2025•6 min•Ep. 155
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder JAMA Psychiatry This randomized clinical trial explored if glucagon-like peptide 1 (GLP-1) receptor agonist semaglutide reduces alcohol consumption and craving in adults with alcohol use disorder (AUD). Relative to placebo, low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration procedure. Over the course of nine weeks of treatment, semaglutide led to reductions in some but not a...
Feb 25, 2025•7 min•Ep. 154
Cannabis Use Disorder Emergency Department Visits and Hospitalizations and 5-Year Mortality JAMA Network Open This cohort study of 11.6 million people who were studied for a median of five years investigated if individuals who have hospital-based (emergency department or hospitalization) care for a cannabis use disorder (CUD) were at increased risk of death. Researchers found that individuals with incident hospital-based care for a CUD were at a 2.8-fold increased risk of death within five years...
Feb 19, 2025•6 min•Ep. 153
Real-Time Assessment of Alcohol Reward, Stimulation, and Negative Affect in Individuals With and Without Alcohol Use Disorder and Depressive Disorders American Journal of Psychiatry A commonly held model of addiction posits that as addictions develop, there is progression from positive reinforcement to negative reinforcement to ameliorate withdrawal symptoms. In this study, researchers examined the subjective response to alcohol among persons with and without alcohol use disorder (AUD) and with ...
Feb 11, 2025•7 min•Ep. 152
Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl JAMA Network Open The accumulation of fentanyl in fat is likely responsible for the risk of precipitated withdrawal when buprenorphine is initiated. Low dose initiation (LDI) of buprenorphine attempts to minimize this risk. This retrospective study included 126 individuals making 175 LDI attempts in an outpatient setting. Patients chose either a 4 day or 7 day LDI protocol with buprenorphine monoproduct. Both protocols beg...
Feb 04, 2025•7 min•Ep. 151
Association of State Cannabis Legalization With Cannabis Use Disorder and Cannabis Poisoning JAMA Psychiatry This longitudinal cohort study examined the association of state-level medical and recreational cannabis laws with cannabis use disorder (CUD) and cannabis poisonings in the adult population with employer-sponsored health insurance. The study showed that from 2011 to 2021, states with legalized medical cannabis experienced 42.7% and 88.6% increases in CUD and cannabis poisoning, respectiv...
Jan 28, 2025•5 min•Ep. 150
Current Advances in Behavioral Addictions: From Fundamental Research to Clinical Practice American Journal of Psychiatry This narrative review discusses five clinically relevant and prevalent behavioral addictions that are common and often co-occur with psychiatric disorders such as depression and anxiety. Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 catego...
Jan 21, 2025•6 min•Ep. 149
Host Dr. Nick Athanasiou is joined by Dr. David Fiellin and Dr. Eric Strain to discuss the concept of Treatment Refractory Addiction. Why does the field of addiction medicine need this term, how is it defined and how the current treatment system aligns with the idea? Listen to the full interview to learn more! Treatment Failure Versus Failed Treatments: The Risks of Embracing Treatment Refractory Addiction [Dr. David Fiellin] The Concept of Treatment-Refractory Addiction: A Call to the Field [Dr...
Jan 14, 2025•27 min•Ep. 148
Review of Evidence on Alcohol and Health National Academies of Sciences, Engineering, and Medicine To inform the next edition of the Dietary Guidelines for Americans (DGA), Congress tasked the National Academies with convening an expert committee to independently review the evidence on the relationship between moderate alcohol consumption and eight health outcomes including obesity, cancer, and cardiovascular disease. This controversial report found that a pattern of moderate drinking was associ...
Jan 14, 2025•7 min•Ep. 147
The impact of schizophrenia genetic load and heavy cannabis use on the risk of psychotic disorder in the EU-GEI case-control and UK Biobank studies Psychological Medicine Using data from the EU-GEI case-control study and UK Biobank, researchers examined the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS), on risk for psychosis. Schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with...
Dec 17, 2024•8 min•Ep. 146
Prevalence of pharmacotherapy for attention-deficit/hyperactivity disorder and prescription stimulant misuse: A national study of US college students Addiction This is an observational study using cross-sectional data from the American College Health Association–National College Health Assessment III. It measured the association between university-level prevalence of attention deficit/hyperactivity disorder (ADHD) medication treatment and prevalence of prescription stimulant misuse (PSM) among c...
Dec 10, 2024•7 min•Ep. 145
Xylazine Pharmacokinetics in Patients Testing Positive for Fentanyl and Xylazine Clinical Chemistry This study of xylazine pharmacokinetics used plasma samples from 28 patients who had urine screens positive for xylazine and fentanyl. The patients were being treated for skin lesions, most commonly, then shortness of breath or opioid overdose. At least two subsequent plasma samples were analyzed for xylazine and xylazine metabolites by LC-MS/MS. The median terminal half-life for xylazine in plasm...
Dec 04, 2024•5 min•Ep. 144
Suicide in people prescribed opioid-agonist therapy in Scotland, United Kingdom, 2011–2020: A national retrospective cohort study 🔓 Addiction This retrospective cohort study aimed to determine if opioid agonist therapy (OAT) in Scotland is protective against suicide, and measure trends in suicide rates in those with opioid dependence over time. The study included 46,453 individuals who received at least one prescription for OAT between 2011 and 2020 with over 304,000 person-years (pys) of follo...
Nov 19, 2024•7 min•Ep. 143
Links between adolescent binge drinking and midlife alcohol use behaviors by age, sex, and race/ethnicity 🔓 Alcohol Clinical and Experimental Research Using data from the Monitoring the Future study, which enrolled cohorts of high school seniors annually starting in 1976, this analysis evaluated alcohol drinking patterns in adults 35-60 and potential association with their drinking patterns at age 18. Overall, the reported mean number of drinks at a time ranged from 1.7 to 1.4, and the mean max...
Nov 05, 2024•7 min•Ep. 141
Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder JAMA Network This population-based retrospective cohort study assessed whether the use of buprenorphine/naloxone is associated with lower risk of treatment discontinuation and mortality compared with methadone. It included 30,891 individuals initiating treatment for the first time during the study period and found that the risk of treatment discontinuation was higher among recipients of buprenorphine/naloxone compared w...
Oct 29, 2024•5 min•Ep. 140
Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization 🔓 JAMA Network Open This cross-sectional study using health care claims data from 35,451 US adults with an opioid use disorder diagnosis assessed whether buprenorphine treatment using doses higher than Food and Drug Administration recommendations is associated with subsequent acute health care utilization. Those receiving higher maximum doses of buprenorphine (i.e., doses above 16 mg and 24 mg) had significantly low...
Oct 22, 2024•5 min•Ep. 139
