Addiction [JOURNAL]
Sun
200 papers
The Opioid Safety Toolkit: An interactive prescription opioid safety toolkit to increase opioid safety literacy and behaviours among people prescribed opioids for pain-a randomised controlled trial.
Nielsen S, Fox F, Lam T … +11 more , Waddell A, Jung M, Rowland B, Watterson J, Basur D, Prawira C, Seguin JP, Olivier P, McMaugh J, Dietze P, Picco L
Addiction · 2026 Apr · PMID 41980176 · Publisher ↗
BACKGROUND AND AIMS: Prescription opioid-related harm remains a significant public health concern. This study aimed to evaluate the efficacy of the Opioid Safety Toolkit, a co-designed, interactive online resource, in in...
BACKGROUND AND AIMS: Prescription opioid-related harm remains a significant public health concern. This study aimed to evaluate the efficacy of the Opioid Safety Toolkit, a co-designed, interactive online resource, in increasing naloxone uptake and healthcare provider discussions among adults prescribed opioids for pain. DESIGN: Parallel-group, open-label, randomised controlled trial. SETTING: Community-based, online recruitment across Australia. PARTICIPANTS: Adults (n = 314) prescribed opioids for non-cancer pain. INTERVENTIONS: Participants were randomised to receive either the Opioid Safety Toolkit (intervention, n = 152), which included interactive and tailored educational content on opioid safety, or an active control website presenting evidence-based opioid safety information (n = 162). Both groups were followed for four weeks. MEASUREMENTS: The primary outcome was self-reported naloxone requests four weeks post-intervention. Other outcomes were intentions to access naloxone immediately post-intervention, and healthcare provider discussions about opioid safety at four weeks, opioid safety knowledge (immediately after the intervention and at four weeks), satisfaction with resources and naloxone possession at four weeks. FINDINGS: Participants in the intervention group were more likely to have requested naloxone at four weeks compared with controls [21.7% vs 9.9%, odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.3, 4.8; P = 0.005], and more likely to report intentions to access naloxone immediately post-intervention compared with controls (41.4% vs 15.4%, OR = 3.9, 95% CI = 2.3, 6.6; P < 0.001). Participants in the intervention group were not more likely to have healthcare provider discussions at four weeks compared with controls (OR = 1.1, 95% CI = 0.7, 1.8; P = 0.620). Post-intervention opioid overdose knowledge was statistically significantly higher in the intervention group compared with control group (Mean score 16.6, 95% CI = 15.5, 17.7 vs control mean score 13.3, 95% CI = 12.3, 14.3). Satisfaction with the resource was higher in the intervention group compared with control group (Mean = 20.0, 95% CI = 18.7, 21.3 vs Mean = 18.0, 95% CI = 16.7, 19.3, P = 0.035). CONCLUSIONS: We found good evidence that, compared with a gold-standard opioid information website, the Opioid Safety Toolkit increased naloxone requests among Australian adults prescribed opioids for non-cancer pain. We also observed consistent effects across secondary outcomes, with the Toolkit increasing intentions to access naloxone, enhancing opioid overdose knowledge and yielding higher satisfaction ratings, although it did not increase healthcare provider discussions at four weeks.
Screening for addiction in the dental office: The bottom line.
Parish CL, Simon LE
Addiction · 2026 Jun · PMID 41968494 · Publisher ↗
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The Baltics: Benchmarking alcohol control reform for the European Union and surrounding countries.
Rehm J, Correia D, Lange S … +2 more , Miščikienė L, Štelemėkas M
Addiction · 2026 Apr · PMID 41968287 · Publisher ↗
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Excess mortality following discharge from substance use disorder treatment in Chile.
González-Santa Cruz A, Castillo-Carniglia A, Kaufman JS
Addiction · 2026 Apr · PMID 41960657 · Publisher ↗
BACKGROUND AND AIMS: People with substance-use disorders (SUDs) have increased mortality risk, yet Chilean estimates of SUD-based mortality are scarce. This study aimed to quantify all-cause and cause-specific mortality...
BACKGROUND AND AIMS: People with substance-use disorders (SUDs) have increased mortality risk, yet Chilean estimates of SUD-based mortality are scarce. This study aimed to quantify all-cause and cause-specific mortality following SUD treatment in Chile compared with the general population and assess variation across key clinical and demographic subgroups. DESIGN: National-level registry-based retrospective data linkage cohort study. SETTING: Publicly funded SUD psychosocial treatments offered by the Chilean National Drug Agency, linked with official national mortality records from 2010 to 2020. PARTICIPANTS: 70064 adults aged 18-64 years (24% women, median age 35 at treatment entry) were followed after their first treatment episode until death or 31 December 2020. MEASUREMENTS: Primary outcome was all-cause mortality. Secondary outcomes were cause-specific mortality by the International Classification of Diseases, 10th revision, underlying and external causes. We estimated age-sex-calendar year directly standardized rates (DSR), and standardized mortality ratios (SMR) compared with the expected rate for the (sub)population. We also stratified rates and ratios by sex (men/women), attained age (18-29, 30-44, 45-59, 60+), setting (ambulatory/residential), primary substance (alcohol; illicit: predominantly cocaine paste base, marijuana and cocaine hydrochloride) and treatment compliance (not completed/completed). Additionally, we estimated rates and SMRs for underlying and external causes of mortality. FINDINGS: Over a median 4.9-year follow-up (353 826 person-years), 2996 deaths occurred [DSR = 10.6, 95% confidence interval (CI) = 8.6-13.1]. Overall SMR was 3.65 (95% CI = 3.52-3.79). Excess risk was particularly pronounced for women (SMR = 5.57, 95% CI = 5.14-6.03), patients admitted due to alcohol use disorder (SMR = 4.59, 95% CI = 4.33-4.86), in residential care (SMR = 4.91, 95% CI = 4.45-5.42) and treatment noncompletion (SMR = 4.04, 95% CI = 3.85-4.24). Cause-specific mortality revealed elevated external-cause excess risk for SUD patients, including intentional self-harm (SMR = 6.67, 95% CI = 6.05-7.36), unintentional injuries (SMR = 5.37, 95% CI = 4.79-6.02) and assaults (SMR = 4.98, 95% CI = 4.16-5.96). Notable excess risk was also observed for non-external mortality causes: digestive system (SMR = 8.20, 95% CI = 7.62-8.83), symptoms and signs (SMR = 5.18, 95% CI = 4.29-6.26) and respiratory diseases (SMR = 5.18, 95% CI = 4.47-5.99) were greater than expected. CONCLUSIONS: In Chile, patients with a history of publicly funded substance-use disorder treatment appear to have an all-cause mortality up to 3.7 times higher than the general population, driven predominantly by digestive and respiratory causes, as well as self-harm, unintentional injuries and assaults.
A genetically informed cross-lagged twin study of the longitudinal association between addiction-related behaviors and obesity.
Qi B, Highland HM, Graff M … +8 more , Bulik CM, Rhee SH, Stallings MC, Hewitt JK, Gustavson DE, Reynolds CA, North KE, Munn-Chernoff MA
Addiction · 2026 Jul · PMID 41958189 · Full text
BACKGROUND AND AIMS: Addiction-related behaviors, such as loss of control eating (LOC), cigarette smoking and alcohol consumption, have been associated with high body mass index (BMI). This study aimed to assess genetic...
BACKGROUND AND AIMS: Addiction-related behaviors, such as loss of control eating (LOC), cigarette smoking and alcohol consumption, have been associated with high body mass index (BMI). This study aimed to assess genetic and environmental contributions to these associations over time. DESIGN: A longitudinal twin study using data from waves 2 and 3 of the Center on Antisocial Drug Dependence study, employing additive genetic (A), shared environmental (C), nonshared environmental (E) influences and cross-lagged models. SETTING: Colorado, USA. PARTICIPANTS: The sample included 764 male and 997 female same-sex twins. MEASUREMENTS: BMI was calculated using self-reported height and weight. LOC was self-reported. Cigarettes smoked per day (CPD) and drinks per week (DPW) were assessed during interviews. FINDINGS: We conducted three cross-lagged models: LOC and BMI in males, LOC and BMI in females and CPD and BMI in females, after excluding small phenotypic correlations (|r| < 0.10). Trait stability over time was largely attributable to genetic factors, accounting for 62% of the variance in BMI (both sexes), 11% in LOC (males), 18% in LOC (females) and 56% in CPD (females) at wave 3. Residual effects were mostly from nonshared environmental factors, accounting for 38% of the variance in BMI (both sexes), 76% of LOC (females), 71% of LOC (males) and 44% of CPD (females) at wave 3. A small but statistically significant cross-lagged effect occurred from wave 2 BMI to wave 3 LOC, explaining 12% (males) and 3% (females) of the variance in wave 3 LOC, with genetic factors accounting for most of this effect. No cross-lagged effects emerged from LOC or CPD to BMI. CONCLUSIONS: Genetic factors contributing to higher body mass index at an earlier age may also increase the risk of developing loss of control eating later in life, highlighting the importance of early weight-related interventions to prevent the onset of disordered eating behaviors.
Prevalence of opium use and use disorder in the Iranian population: A systematic review and meta-analysis.
Ardeshir M, Rafiemanesh H, Rostam-Abadi Y … +8 more , Gholami J, Amin-Esmaeili M, Baheshmat S, Hamzehzadeh M, Farahmand K, Mohammad Aghaei A, Safarcherati A, Rahimi-Movaghar A
Addiction · 2026 Apr · PMID 41947729 · Publisher ↗
BACKGROUND AND AIMS: Despite historical and cultural roots, there is limited comprehensive data on the prevalence of opium use and use disorder across the Iranian population. We systematically reviewed the prevalence and...
BACKGROUND AND AIMS: Despite historical and cultural roots, there is limited comprehensive data on the prevalence of opium use and use disorder across the Iranian population. We systematically reviewed the prevalence and trends of opium use and use disorder in Iran. METHOD: Systematic review and meta-analysis adhering to PRISMA guidelines, including studies from 1990 to 2023 across the Iranian general population, university students, the young population and specific populations. Measurements included the prevalence of opium use and use disorder by sex, time indicators (lifetime, last 12 months, last month/current, current daily or almost daily), study year and population subgroups. RESULTS: A total of 115 studies were included. Pooled prevalence of last 12-month opium use among the general population was 8.4% [95% confidence interval (CI) = 5.1-12.6%, studies = 6, n = 9302, I = 97.2%] in men and 1.1% (95% CI = 0.4-2.3%, studies = 7, n = 13 129, I = 95.1%) in women. The prevalence of the last 12-month opium use disorder was 3.7% (95% CI = 1.6-6.5%, studies = 3, n = 9605, I = 97.7%) and 0.4% (95% CI = 0.1-0.8%, studies = 3, n = 10 465, I = 81.0%) among male and female Iranian general population, respectively. Last 12-month opium use was 2.3% (95% CI = 1.5-3.3%, studies = 13, n = 37 164, I = 83.3%) in male and 0.6% (95% CI = 0.2-1.0%, studies = 13, n = 43 471, I = 85.4%) in female university students. Among male university students, lifetime opium use declined by 9.1 percentage points between 2000 and 2018 (95% CI = -18.6 to 0.4), while current daily or almost daily use decreased by 8.6 percentage points over the same period (95% CI = -11.8 to -5.3). CONCLUSIONS: Despite global shifts to harder opioids, opium use continues to have a very high prevalence among the Iranian general population. While the overall prevalence appears stable, younger generations have shown a declining use pattern.
Which personality traits are necessary conditions for problematic alcohol use? Insights from a 23-year longitudinal study.
Giugovaz A, Prinzie P, Lutz MC … +2 more , Franken IHA, Marchetti I
Addiction · 2026 Jul · PMID 41944219 · Full text
BACKGROUND AND AIMS: Personality traits have been consistently linked to alcohol use. High neuroticism and extraversion and low agreeableness and conscientiousness are known risk factors for both alcohol use frequency an...
BACKGROUND AND AIMS: Personality traits have been consistently linked to alcohol use. High neuroticism and extraversion and low agreeableness and conscientiousness are known risk factors for both alcohol use frequency and problematic use across the lifespan. These associations have mostly been studied in the sufficient causality domain ("if X, then probably Y"), whereas little is known about these relationships in the necessary causality one ("if not X, then not Y"). Knowing that a variable is a necessary cause for an outcome helps identify who will be at risk for the outcome and who will be virtually immune. The aim of this study was to test whether personality traits in childhood, adolescence and emerging adulthood might serve as necessary conditions for problematic alcohol use in adulthood. DESIGN: The study is part of the "Flemish Study on Parenting, Personality, and Development", and it is a 23-year longitudinal study across four time points [childhood (T1), adolescence (T2), emerging adulthood (T3), adulthood (T4)]. SETTING: Flanders (Belgium). PARTICIPANTS: At T1, the total sample consisted of 306 participants (age = 7.8 ± 1.13 years, and 59.15% females), at T2 of 289 participants (age = 15.78 ± 1.16 years, 59.86% females), at T3 of 290 participants (age = 21.78 ± 1.15 years, 59.66% females) and at T4 of 306 participants (age = 30.08 ± 1.13 years, 59.15% females). MEASUREMENTS: Personality traits were assessed in childhood, adolescence and emerging adulthood using the Hierarchical Personality Inventory for Children (HiPIC) and were related to problematic alcohol use, measured through the Alcohol Use Disorders Identification Test (AUDIT), in adulthood. Necessary Condition Analysis (NCA) was used to test whether specific traits were necessary for the outcome, and to what extent. FINDINGS: Conscientiousness emerged as a developmentally stable necessary condition for problematic alcohol use in adulthood (childhood: d = 0.31, P = 0.050; adolescence: d = 0.33, P = 0.052; emerging adulthood: d = 0.33, P = 0.023; all large effects). No other personality traits reached statistical significance. CONCLUSIONS: It is possible to identify, already in childhood and through the lifespan, personality characteristics that distinguish individuals vulnerable to developing problematic alcohol use in adulthood from those who are not. Specifically, lower levels of conscientiousness appear to be necessary to be at risk of potentially developing problematic alcohol use in adulthood, whereas high levels of conscientiousness appear to lead to virtual immunity.
The evolution of Australian cannabis policies, 1967 to 2024.
Hall WD, Dawson D, Johnson B … +1 more , Yimer TM
Addiction · 2026 Apr · PMID 41943660 · Publisher ↗
AIM: To describe the outcomes of cannabis policy debates in Australia from 1967 to 2024. METHODS: We searched popular media, public reports, parliamentary inquiries and policy documents on cannabis in Australia since the...
AIM: To describe the outcomes of cannabis policy debates in Australia from 1967 to 2024. METHODS: We searched popular media, public reports, parliamentary inquiries and policy documents on cannabis in Australia since the 1960s and examined peer reviewed papers, national survey data and police records of cannabis-related arrests. RESULTS: We describe three phases in the development of Australian cannabis policy: a prolonged debate (1970-1999) about whether state governments should remove criminal penalties for cannabis possession and use; a less prominent but overlapping debate (1994-2016) about whether Australia should legally permit the medical use of cannabis; and a renewed debate (1999-2023) about whether adults should be allowed to use cannabis for non-medical purposes and obtain it from a regulated legal market. The legalisation of medical cannabis in 2016, and the progressive liberalisation of its regulation, appear to have increased public support for adult cannabis legalisation in Australia and encouraged several so far unsuccessful attempts to pass legislation to do so. CONCLUSIONS: Criminal penalties for personal possession and use of cannabis have been removed in smaller states and territories of Australia, but the more populous states have diverted persons charged with cannabis use offences into education and treatment. The legalisation of medical cannabis use in 2016 appears to have increased public support for the legalisation of adult use, but there are major political obstacles to this policy change.
Identification of cannabis use disorder using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) versus DSM-5-proxy measures: Differences by socio-demographic characteristics.
Eschliman EL, Annunziato EM, Fitzgerald ND … +1 more , Mauro PM
Addiction · 2026 Apr · PMID 41937566 · Publisher ↗
BACKGROUND AND AIMS: Cannabis use disorder (CUD) is a pressing public health concern in the United States, and understanding trends in prevalence requires considerations of how changes in measurement influence identifica...
BACKGROUND AND AIMS: Cannabis use disorder (CUD) is a pressing public health concern in the United States, and understanding trends in prevalence requires considerations of how changes in measurement influence identification of CUD. Starting in 2021, the National Survey on Drug Use and Health (NSDUH) assessed CUD using all 11 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in their entire sample; before then, studies could use a nine-criteria DSM-5-proxy measure based on shared DSM-IV criteria. We aimed to identify sociodemographic characteristics associated with additionally identified CUD when using the full DSM-5 measure compared with the DSM-5-proxy measure. DESIGN: Observational study using nationally representative data. SETTING: United States. PARTICIPANTS: 39 973 participants ages 12 + who reported past-year cannabis use in the 2021-2023 NSDUH (weighted N = 57 872 556). MEASUREMENTS: Additionally identified mild, moderate, or severe CUD was defined as meeting 2-3, 4-5, or 6 + of the 11 DSM-5 criteria and not meeting the same thresholds with the nine DSM-5-proxy criteria. Multinomial logistic regression models compared characteristics of people with additionally identified mild (vs. none), moderate (vs. mild), and severe (vs. moderate) CUD. We also calculated the percentage of people meeting each of the 11 criteria who had additionally identified CUD. FINDINGS: Among people who reported past-year cannabis use, 30.5% had DSM-5 CUD, including 7.9% with additionally identified mild CUD not previously identified using the DSM-5-proxy measure, 6.9% with additionally identified moderate CUD and 3.4% with additionally identified severe CUD. People who were younger (vs. 35-49); multiracial (vs. white); non-Hispanic American Indian or Alaska Native (vs. white); or publicly insured or uninsured (vs. privately insured only) were more likely to have additionally identified CUD and/or CUD severity. People who were older (vs. 35-49); Hispanic (vs. white); were non-Hispanic Asian, Native Hawaiian, or Pacific Islander (vs. white); reported female sex (vs. male); or had annual income greater than $75 000 (vs. <$20 000) were less likely to have additionally identified CUD and/or CUD severity. Additionally identified CUD was most common among those meeting "craving" (25.0%), "withdrawal" (20.3%), and "spending time" (14.8%) criteria. CONCLUSIONS: The full Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) measure of cannabis use disorder (CUD) additionally identified CUD differentially across sociodemographic groups in the United States, compared with the DSM-5-proxy measure. Some groups (e.g., people younger than 35 years old, people with any public or no insurance, and people who are multi-racial or non-Hispanic American Indian or Alaska Native) may need more CUD-related services and support than previously expected.
Commentary on Buss et al.: State endorsement as a driver of vape-assisted smoking cessation: Interpreting early evidence from Swap to Stop.
Minian N
Addiction · 2026 Jun · PMID 41937550 · Full text
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Comparative effectiveness, safety and acceptability of pharmacological and psychosocial interventions for the treatment of cannabis use disorder: A network meta-analysis.
Halicka M, Spiga F, Freeman TP … +4 more , Nielsen S, Savović J, Higgins JPT, Caldwell DM
Addiction · 2026 Apr · PMID 41924869 · Publisher ↗
AIM: Our primary aim was to conduct a network meta-analysis (NMA) for the effectiveness, safety and acceptability of all psychosocial interventions and all pharmacotherapies for cannabis use disorder (CUD). METHODS: We c...
AIM: Our primary aim was to conduct a network meta-analysis (NMA) for the effectiveness, safety and acceptability of all psychosocial interventions and all pharmacotherapies for cannabis use disorder (CUD). METHODS: We conducted a NMA of studies identified from two completed systematic reviews examining the effectiveness, safety and acceptability of pharmacotherapies and psychosocial interventions for CUD in people aged ≥16 years. Outcomes were level of cannabis use, abstinence, adverse events and treatment completion. RESULTS: Fifty-seven studies were eligible for NMA. Depending on outcome, NMAs of psychosocial interventions included 6-16 studies (445-2287 participants), and NMAs of pharmacotherapies included 5-36 studies (260-3106 participants). Results are described relative to minimum clinically meaningful difference [mean difference (MD) ± 0.05, odds ratio (OR) ≤ 0.8 or ≥1.25]. Evidence for pharmacological interventions reducing cannabis use was very uncertain. However, low-certainty evidence suggested that dialectical behavioural/acceptance and commitment therapies [DBT/ACT; MD -0.18, 95% credible interval (-0.26 to -0.09)] and cognitive-behavioural therapy with motivation enhancement (MET-CBT) with contingency management [CM; MD -0.15 (-0.23 to -0.07)] reduced use frequency relative to a nonspecific comparator. Interventions including CM also supported abstinence (very low certainty). Limited, low-certainty evidence indicated that cannabidiol [OR 2.91 (0.45 to 27.98)], N-acetylcysteine [OR 1.30 (0.55 to 3.74)] and varenicline [OR 4.85 (0.65 to 48.26)] promoted abstinence compared with placebo, although cannabidiol was associated with adverse events [OR 1.58 (0.26 to 8.98)]. Very low-certainty evidence suggested mixed-action antidepressants, benzodiazepines, bupropion and buspirone also had more adverse events than placebo, without any indication of effectiveness. Very low-certainty evidence indicated that DBT/ACT and CM improved treatment completion. In contrast, MET-CBT, with/without affect management, reduced completion, relative to a nonspecific comparator. Low-certainty evidence suggested N-acetylcysteine [OR 1.29 (0.76 to 2.19)] and delta-9-tetrahydrocannabinol preparations [OR 1.32 (0.89 to 1.97)] increased treatment completion, while fatty acid amide hydrolase inhibitor [OR 0.80 (0.40 to 1.58)] and selective serotonin reuptake inhibitors [OR 0.56 (0.29-1.04)] reduced it, relative to placebo. CONCLUSIONS: There is some evidence that dialectical behavioural/acceptance and commitment therapies, contingency management alone or with cognitive-behavioural therapy with motivation enhancement, N-acetylcysteine, cannabidiol or varenicline may facilitate abstinence, reduce use and/or support treatment completion for cannabis use disorder. Some interventions may have unfavourable effects on those outcomes, relative to placebo or nonspecific comparators. While safety data for psychosocial interventions is lacking, several pharmacotherapies may be associated with adverse events. These findings should be interpreted with caution as all evidence is low- to very-low-certainty due to imprecise or heterogeneous treatment effects and high risk of bias in some study results.
Comparative effectiveness of social-contextual treatments for improving substance-related problems among Black adults: An individual-level data synthesis.
Espinosa A, Haeny AM, Ruglass LM … +6 more , McCuistian C, Vena A, Roundtree C, Lopez J, Morgan-López AA, Burlew AK
Addiction · 2026 Jul · PMID 41923659 · Full text
BACKGROUND AND AIMS: Despite similar substance use levels, Black adults experience greater family, legal, employment and other social-contextual challenges related to recovery than other groups. Substance use treatments...
BACKGROUND AND AIMS: Despite similar substance use levels, Black adults experience greater family, legal, employment and other social-contextual challenges related to recovery than other groups. Substance use treatments that address both substance use and social-contextual factors are uniquely positioned to address these substance-related problems and produce more sustainable improvements in social functioning than treatment as usual (TAU) or behavioral controls (Control). The aim of this study was to evaluate changes in substance-related problems among Black adults, focusing on the comparative effectiveness between social-contextual treatments and TAU/Control. DESIGN: Individual-level data synthesis based on secondary analysis of Black adults enrolled in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). SETTING: All data were collected in the primary studies between 2001 and 2008 at clinics across the United States. PARTICIPANTS: Black adults who reported cocaine and/or opioid use across nine studies within the NIDA CTN. The sample used herein consisted of individuals from five of these studies who provided data on substance-related problems (n = 532; mean age = 39.34; standard deviation = 9.6). MEASUREMENTS: There were two treatment conditions: Social-contextual (e.g. Motivational Interviewing, Seeking Safety, STAGE 12) and TAU/Control. Moderated nonlinear factor analysis estimated latent scores for substance-related problems, using subscales from the Addiction Severity Index, while accounting for measurement noninvariance across studies, time and covariates. Linear mixed models estimated latent score differences over time between social-contextual treatments and TAU/Control during treatment and from the end of treatment through 12-month follow-up. FINDINGS: Both treatment groups improved across substance-related problem areas from baseline to the end-of-treatment (Cohen's d = -0.10 to d = -0.47), with effects maintained at 12-month follow-up. Although social-contextual treatments did not statistically significantly outperform TAU/Control from baseline to end-of-treatment, they showed greater effects from end of treatment to 12-month follow-up in family/social [Cohen's d difference (Δd) = -0.47, 95% confidence interval (CI) = -0.57 to -0.38], legal (Δd = -0.20, 95% CI = -0.31 to -0.10) and psychiatric problems (Δd = 0.29, 95% CI = -0.38 to -0.20) than TAU/Control. Sensitivity analyses indicated that Seeking Safety and STAGE 12 predominantly drove post-treatment improvements in family/social problems. CONCLUSIONS: Substance use treatment may yield broader, delayed benefits beyond substance use reduction among Black adults in the United States. Compared with treatment-as-usual, social-contextual treatments can yield more sustainable effects in legal, family and psychiatric areas among Black adults, with interventions such as Seeking Safety and STAGE 12 showing particular benefits in addressing family-related challenges.
Declining trends in adolescent alcohol consumption and related harms: No room for complacency (an empirical reply to Vieira et al. 2025).
Pennington CR, Shaw DJ, Skubera M … +2 more , Rose AK, Jones A
Addiction · 2026 Mar · PMID 41912266 · Publisher ↗
Vieira et al. report that alcohol-related harms among adolescents have generally declined in high-income countries where youth drinking has decreased, but several methodological choices complicate this conclusion. By per...
Vieira et al. report that alcohol-related harms among adolescents have generally declined in high-income countries where youth drinking has decreased, but several methodological choices complicate this conclusion. By performing reproducibility analyses on Vieira et al.'s raw data, we show that their findings are more nuanced and complex. Secondary data analyses reveal that 19-24-year-olds have elevated vulnerability to alcohol-related harms. Any discussion of declining trends in adolescent alcohol consumption and related harms should acknowledge that current prevalence rates and harms remain unacceptably high and require continued public health attention.
Unlocking 'stuckness' and catalysing change: A qualitative study of clinician and service leader perspectives on psychedelic-assisted therapy for substance use and mental health problems.
Catchlove SJ, Oliver K, Savic M … +1 more , Arunogiri S
Addiction · 2026 Mar · PMID 41906885 · Publisher ↗
BACKGROUND AND AIMS: Australia recently down-scheduled and authorised psychedelic-assisted therapies, including psilocybin, for certain mental health conditions. Evidence is emerging for potential application in substanc...
BACKGROUND AND AIMS: Australia recently down-scheduled and authorised psychedelic-assisted therapies, including psilocybin, for certain mental health conditions. Evidence is emerging for potential application in substance use disorder treatment. However, regulatory developments have outpaced implementation readiness. While service leaders and clinicians are crucial to implementation, little research examines their perspectives on what psilocybin-assisted therapy is, how it works, and for whom. This study explored how these stakeholders conceptualise psychedelic-assisted therapy within their own professional setting, in the context of a broader implementation trial of psilocybin-assisted therapy for co-occurring depression and alcohol use disorder (AUD) in a routine alcohol and other drug (AOD) clinic. DESIGN: A qualitative approach informed by the evidence-making intervention approach. SETTING: Victoria, Australia, prior to the implementation of psilocybin-assisted therapy in routine clinical services. PARTICIPANTS: Two focus groups were conducted: one with clinicians (n = 9; nursing, psychology, psychiatry, pharmacy, and peer support professionals) and one with health service leaders (n = 9). MEASUREMENTS: Focus groups used a semi-structured guide, consisting of open-ended questions about understandings and perspectives on psilocybin-assisted therapy for co-occurring substance use and mental health problems. Verbatim transcripts underwent inductive thematic analysis, informed by the evidence-making intervention approach. FINDINGS: Three enactments of psilocybin-assisted therapy emerged: (1) treatment of last resort for treatment-resistant conditions, which was emphasised by service leaders and aligned with regulatory frameworks; (2) tool to "unlock stuckness" in ongoing relational care when conventional therapies plateau, which was prominent among clinicians; and (3) catalyst for rapid progress applicable at any treatment stage. Clinicians emphasised the need for careful integration, robust support, and aftercare, alongside concerns about access and eligibility. Service leaders highlighted operational and ethical tensions within regulatory requirements. Both groups understood psilocybin-assisted therapy as a complex intervention dependent on interplay between medication, therapist skill, client readiness, and care context. CONCLUSIONS: Psilocybin-assisted therapy in Victoria, Australia is constituted through local implementation rather than existing as a singular intervention. Implementation approaches must be reflexive and adaptive, with attention to clinical and managerial dialogue, equity considerations, and contextual practice factors.
Recovery beyond the individual: Toward a place-based paradigm for recovery science.
Burns VF
Addiction · 2026 Jul · PMID 41888992 · Full text
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Electronic cigarettes for smoking cessation: An overview of systematic reviews and evidence and gap map.
Wu AD, Conde M, Butler AR … +11 more , Knight E, Lindson N, Livingstone-Banks J, Hajek P, McRobbie H, Begh R, Theodoulou A, Notley C, Turner T, Zhitnik E, Hartmann-Boyce J
Addiction · 2026 Mar · PMID 41887411 · Publisher ↗
BACKGROUND AND AIMS: Electronic cigarettes (EC) are considered a smoking cessation tool in some countries, such as the United Kingdom, but uncertainty remains internationally over whether their benefits outweigh potentia...
BACKGROUND AND AIMS: Electronic cigarettes (EC) are considered a smoking cessation tool in some countries, such as the United Kingdom, but uncertainty remains internationally over whether their benefits outweigh potential harms when used for this purpose. This overview (1) synthesised existing evidence from systematic reviews (SR) on the effectiveness and safety of ECs to explore and address these uncertainties and disagreements and (2) mapped primary intervention studies to identify priorities for further research. METHODS: Overview of SRs published from 1 January 2015 and meeting the inclusion criteria of the Cochrane review of EC for smoking cessation. We searched seven databases to April 2024. We followed Cochrane screening and data extraction methods. We adapted Campbell Collaboration and 3ie methods for the Evidence and Gap Map (EGM). We assessed review quality using AMSTAR-2. RESULTS: We included 14 reviews of intervention studies (7 high quality; 7 low quality), with search dates from 2014 to 2023, in adult populations including the general population, people at risk of lung cancer, with comorbid health conditions and pregnant people. Eighteen studies were included across multiple reviews, some of which included multiple meta-analyses. Across 21 meta-analytic comparisons of nicotine EC versus other interventions, all reported point estimates favouring nicotine EC for smoking cessation, with relative risks/odds ratios typically in the range 1.17-1.67 versus nicotine replacement therapy and 1.46-2.09 versus non-nicotine EC, with higher-quality reviews giving more consistent estimates. Of 13 reviews that meta-analysed serious adverse events (SAEs), two reported point estimates suggesting increased SAEs with nicotine EC; other estimates included the possibility of no difference. For adverse events, pooled estimates generally indicated little or no difference between groups. Our EGM mapped 90 primary, complete studies and identified absolute gaps in evidence comparing the effects of nicotine EC to cytisine, bupropion and nicotine pouches. Most studies used collected data from high-income countries. CONCLUSION: Meta-analyses of electronic cigarettes (EC) for smoking cessation report point estimates favouring higher ≥6-month smoking cessation rates with nicotine EC compared with nicotine replacement therapy, non-nicotine EC/placebo, behavioural or no support and mixed support. Evidence on serious adverse events (SAEs) remains inconclusive. Evidence gaps were identified in SAE data and in studies from low- and middle-income countries.
Examining definitions and cues associated with alcohol-free and low-alcohol drinks.
Holmes J, Field M, Drummond C
Addiction · 2026 May · PMID 41887181 · Full text
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Clarifying Selected Citations and Interpretations in 'Underage deaths associated with substance-related harm in Taiwan: A national 10-year study'.
Yang JM, Wei LC
Addiction · 2026 Jul · PMID 41887098 · Publisher ↗
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Holistic approach to substance-induced psychosis.
Lappin JM, Darke S, Farrell M
Addiction · 2026 Mar · PMID 41886814 · Publisher ↗
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All-cause and cause-specific mortality in gambling disorder: Evidence from a nation-wide matched and sibling cohort study in Taiwan.
Chen YB, Hsu CW, Wang LJ … +4 more , Chen MH, Yang YH, Liang CS, Lai EC
Addiction · 2026 Mar · PMID 41872026 · Publisher ↗
BACKGROUND AND AIMS: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a...
BACKGROUND AND AIMS: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all-cause and cause-specific mortality risk in patients with GD. DESIGN, SETTING AND PARTICIPANTS: A retrospective cohort study was conducted using 2000-2022 data from Taiwan's National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age- and sex-matched control cohort (n = 3,844) and an unaffected sibling cohort (n = 675) were constructed. Cumulative survival was illustrated using Kaplan-Meier curves. MEASUREMENTS: Cox regression models estimated crude and adjusted hazard ratios (AHR) for all-cause, natural-cause and unnatural-cause (accidents and suicides) mortality risks. Covariates for adjustment included sociodemographic factors, physical and psychiatric comorbidities and familial confounding. FINDINGS: Over a mean follow-up of 8 years, GD was associated with elevated all-cause mortality risk [AHR 1.20, 95% confidence interval (CI) = 0.90-1.61] driven by statistically significantly elevated risk of unnatural mortality (AHR 6.15, 95% CI = 3.44-10.98) and especially suicide mortality (AHR 10.03, 95% CI = 4.71-21.33). Risk of natural mortality was statistically significantly lower in GD patients (AHR 0.66, 95% CI = 0.45-0.96). Sibling cohort analysis revealed a similar trend (all-cause mortality: AHR 1.70, 95% CI = 0.67-4.28; unnatural cause mortality: AHR 8.65, 95% CI = 1.62-46.22; suicide mortality: AHR 7.24, 95% CI = 0.74-70.59; natural cause mortality: AHR 0.48, 95% CI = 0.13-1.73). Results remained consistent after adjustment for individual psychiatric comorbidities. CONCLUSIONS: Gambling disorder patients in Taiwan appear to have a statistically significantly increased risk of unnatural-cause mortality and especially suicide mortality compared with matched controls. Policies and clinical interventions for treating GD patients should focus on suicide prevention to reduce mortality in this population.
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