Drug And Alcohol Dependence[JOURNAL]
Sun
200 papers
Trends in perceived harmfulness of tobacco, alcohol, and cannabis and its' use in 12-16-year-olds, from 2003 to 2023.
Morren K, Rombouts M, Monshouwer K
Drug Alcohol Depend · 2026 Jan · PMID 41442974 · Publisher ↗
BACKGROUND: Substance use is bidirectionally related to perceived harmfulness of its use. While adolescent tobacco, alcohol, and cannabis use have declined over time, little is known about perceived harmfulness trends ac...
BACKGROUND: Substance use is bidirectionally related to perceived harmfulness of its use. While adolescent tobacco, alcohol, and cannabis use have declined over time, little is known about perceived harmfulness trends across substances and frequencies of use. This study examines 20-year harmfulness perception trends of these substances. METHODS: Data from six survey rounds (n = 40,690) of a national cross-sectional school survey on substance use in the Netherlands were used to examine trends in harmfulness perception and substance use among 12- to 16-year-old secondary school students from 2003 to 2023. Logistic regression models were performed to examine these trends. RESULTS: Students increasingly viewed tobacco and alcohol consumption as harmful (tobacco: occasional use: prevalence difference (PD) + 54.1 %, p < .001; daily use: PD + 2.5 %, p < .05; alcohol: ≥ 5 drinks every weekend: PD + 11.9 %, p < .001; daily use: PD + 40.3 %, p < .001). However, the perceived harmfulness perception of daily cannabis use declined (PD -5.6, p < .001). During that same time, lifetime, monthly, and daily use of tobacco, alcohol, and cannabis significantly declined (e.g., prevalence difference in monthly use; tobacco -55.0 %; alcohol -61.5 %; cannabis -44.3 %). Differences in harmfulness perception trends were observed between adolescents who used the substance in the previous month and those who did not, with a generally more pronounced change in perceived harm among those with recent use. CONCLUSIONS: Over two decades, harmfulness perception of tobacco and alcohol increased, while cannabis perceptions remained stable or decreased. Changing perceptions, particularly the decline in perceived harmfulness of daily cannabis use, should be monitored to prevent potential future increases in use.
The relationship between co-use of tobacco and alcohol and cognitive decline in middle-aged and older Chinese males: A cross-lagged panel network analysis.
Li R, Guo Y, Qiu Y
Drug Alcohol Depend · 2026 Jan · PMID 41442973 · Publisher ↗
BACKGROUND: The co-use of tobacco and alcohol can impair cognitive function, but whether the frequency of this co-use interacts with cognitive decline in middle-aged and elderly Chinese men remains unclear. METHODS: We a...
BACKGROUND: The co-use of tobacco and alcohol can impair cognitive function, but whether the frequency of this co-use interacts with cognitive decline in middle-aged and elderly Chinese men remains unclear. METHODS: We analyzed three waves of the China Health and Retirement Longitudinal Study (CHARLS) data (2015, 2018, and 2020). The analytic sample included 2044 individuals who co-used tobacco and alcohol, 1339 who smoked only, and 1714 who drank alcohol only. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) subscale, and smoking and drinking frequencies were calculated separately. Two directed networks were constructed using the cross-lagged panel network (CLPN) model to explore reciprocal relationships between cognitive function and smoking and drinking frequencies, with network centrality metrics identifying key bridging variables. RESULTS: From 2015-2018, higher smoking frequency was associated with poorer memory, and greater alcohol consumption with worse memory and orientation. From 2018-2020, increased alcohol consumption led to declines in attention/calculation and memory, while higher smoking frequency decreased attention/calculation. Additionally, poorer memory was associated with reduced alcohol consumption. Network indices ranked alcohol consumption as the strongest cross-domain driver, and memory as the most affected cognitive node. CONCLUSION: For middle-aged and older Chinese men who co-use tobacco and alcohol, cognitive abilities-especially memory and attention-are significantly impaired. Some cognitive functions, such as memory, are linked to subsequent alcohol use frequency. Combining smoking and alcohol cessation with cognitive support for memory may help alleviate cognitive aging in this high-risk group.
Gender convergence in young adults' drinking in Australia.
Vieira E, Taylor N, Pennay A … +2 more , Wright C, Livingston M
Drug Alcohol Depend · 2026 Jan · PMID 41435490 · Publisher ↗
BACKGROUND: Despite recent declines in alcohol consumption for younger generations, risky drinking still peaks in young adulthood (18-29). While men have historically consumed more alcohol than women, there may be change...
BACKGROUND: Despite recent declines in alcohol consumption for younger generations, risky drinking still peaks in young adulthood (18-29). While men have historically consumed more alcohol than women, there may be changes emerging in gendered patterns of drinking. This study investigated if a 'gender convergence' in young adults' drinking has occurred in Australia, whereby women and men's drinking rates have become more similar over time. METHODS: Three national Australian survey data sources were used to assess drinking trends from 2001 to 2023 in young adult women and men, aged 18-29. Gender convergence was tested for annual volume, past-year drinking status, and long-term, risky single-occasion, and high risky single-occasion drinking. Analyses included linear and logistic regressions with interactions between gender and year to assess gender differences in trends over time. RESULTS: Drinking declined for young adults across all measures and surveys between 2001 and 2023. For all surveys, evidence for convergence in annual volume was found from 2013 to 2023. Some evidence for convergence was noted in recent years for past-year drinking (2019-2023) and risky drinking (2021-2022). For all measures, convergence occurred due to men's drinking decreasing at faster rates than women's. CONCLUSIONS: This study provides evidence for gender convergences in young adults' drinking in Australia. Notably, this convergence occurs within the context of a broader drinking decline for both women and men, whereby men's drinking has decreased at a faster rate. These findings reflect emerging evidence from other high-income countries and suggest that future research understanding the drivers for men's steeper drinking declines is warranted.
Evaluation of suvorexant effects on alcohol seeking and self-administration in baboons.
Pierce-Messick ZJ, Moore CF, Strickland JC … +1 more , Weerts EM
Drug Alcohol Depend · 2026 Jan · PMID 41422738 · Full text
AIMS: The orexin receptor system is gaining interest as a potential therapeutic target to reduce heavy alcohol drinking. Studies of orexin-1 and orexin-2 receptor antagonists have shown decreased alcohol seeking and self...
AIMS: The orexin receptor system is gaining interest as a potential therapeutic target to reduce heavy alcohol drinking. Studies of orexin-1 and orexin-2 receptor antagonists have shown decreased alcohol seeking and self-administration in rodents. This study examined if acute treatment with the dual orexin receptor antagonist suvorexant would decrease alcohol seeking and self-administration in a nonhuman primate chronic drinking model. METHODS: Subjects were six baboons with extensive histories of chronic alcohol self-administration under an operant chained schedule of reinforcement. Sessions consisted of three components (modeling alcohol anticipation, seeking, consumption), each with distinct stimuli and behavioral contingencies to gain access to and self-administer alcohol. Suvorexant (0, 0.032, 0.1, 0.32, 0.6, 1.0mg/kg, p.o.) was acutely administered 60min before the session. Linear mixed-effect models were used to evaluate suvorexant effects on alcohol seeking (fixed interval [FI] latency and responses) and self-administration (Fixed ratio [FR] responses, alcohol volume and g/kg intake). RESULTS: No significant effects of acute suvorexant were observed on alcohol seeking (p > .62). A significant effect of suvorexant was observed for self-administration responses (p = .04), but not for alcohol g/kg intake (p = .08). Both outcomes demonstrated a dose-related biphasic curve with a modest decrease in self-administration after 0.1mg/kg suvorexant and modest increase in self-administration after 1.0mg/kg suvorexant. CONCLUSIONS: Low dose suvorexant may acutely reduce drinking, but the magnitude of change may not be clinically meaningful. Higher doses of suvorexant may worsen heavy drinking. These data do not support suvorexant use to reduce alcohol intake during ongoing use.
Baseline electrophysiological markers of reward and error processing are associated with improved outcomes in prize-based contingency management.
Forster SE, Forman SD, Dickey MW … +2 more , Siegle GJ, Steinhauer SR
Drug Alcohol Depend · 2026 Jan · PMID 41418476 · Full text
BACKGROUND: Veterans are disproportionately affected by cocaine use disorder (CUD), a condition without approved pharmacotherapies, marked by high return to use rates. Prize-Based Contingency Management (PBCM) is an effe...
BACKGROUND: Veterans are disproportionately affected by cocaine use disorder (CUD), a condition without approved pharmacotherapies, marked by high return to use rates. Prize-Based Contingency Management (PBCM) is an effective behavioral intervention, but treatment response varies. Electrophysiological and cognitive measures may help identify who is likely to benefit from specific PBCM variants. This study evaluates whether neurocognitive profiles predict differential response to monetary versus tangible reward-based PBCM, with the goal of informing measurement-based, personalized treatment. METHODS: Forty-five Veterans with CUD completed EEG and cognitive assessments before randomization to a 12-week treatment trial evaluating PBCM with either tangible or voucher rewards. Manipulation checks validated the measurement approach for candidate neurocognitive predictors. Treatment outcomes were analyzed using longitudinal logistic regression across 24 possible PBCM sessions. A forward selection approach guided model building, and generalizability was assessed using leave-one-out cross-validation. RESULTS: Manipulation checks confirmed expected neurocognitive effects across tasks. Modeling identified greater anticipatory alpha suppression to tangible reward, larger ERN amplitudes, and lower craving as significant predictors of abstinence. Voucher PBCM, younger age, and earlier timepoints were also associated with better outcomes. Model 1 demonstrated good discrimination (AUC = 0.773), with no added benefit from predictor-by-treatment interactions. CONCLUSIONS: This study highlights the potential of neurocognitive markers associated with PBCM outcomes in Veterans with CUD to inform treatment development and personalization. Baseline features did not predict differential outcomes by reward type; instead, tangible rewards were generally linked to poorer outcomes. Findings therefore also support the broad utility of abstract, voucher-based rewards in PBCM treatment.
Within-person prospective associations between depressive symptoms, abstinence self-efficacy and smoking cessation following smoking cessation treatment.
Ramos-Carro M, Rodríguez-Cano R, Martínez-Vispo C … +2 more , López-Durán A, Becoña E
Drug Alcohol Depend · 2026 Jan · PMID 41418475 · Publisher ↗
BACKGROUND: Abstinence self-efficacy and depressive symptoms have independently been associated with smoking outcomes in previous research. However, their bidirectional relationships with smoking abstinence over time rem...
BACKGROUND: Abstinence self-efficacy and depressive symptoms have independently been associated with smoking outcomes in previous research. However, their bidirectional relationships with smoking abstinence over time remain underexplored. This study examined bidirectional and prospective associations between depressive symptoms, abstinence self-efficacy, and smoking abstinence from the end of a cognitive-behavioral smoking cessation intervention to 12-month follow-up. METHODS: This study was conducted with 685 adults (62.04 % female; M=45.51) who sought smoking cessation treatment at the Smoking Cessation and Addictive Disorders Unit (University of Santiago de Compostela, Spain). Abstinence was defined as not smoking, not even a puff, in the prior 24h at the end of the intervention and not smoking in the prior 7 days at each follow-up. A Random Intercept Cross-Lagged Panel Model was performed to examine the bidirectional and prospective associations between study variables. RESULTS: At the within-person level, smoking abstinence at posttreatment and 3-month follow-up predicted greater abstinence self-efficacy and fewer depressive symptoms at 3- and 6-month follow-up, respectively. In contrast, higher abstinence self-efficacy at posttreatment was associated with lower odds of abstinence at 3-month follow-up, and abstinence self-efficacy at 3 months predicted more depressive symptoms at 6 months. Depressive symptoms did not significantly predict abstinence self-efficacy or smoking abstinence in the cross-lagged associations at any time point. CONCLUSION: Quitting smoking predicts higher abstinence self-efficacy and lower depressive symptoms after posttreatment, but these effects diminish after 6-month follow-up. Notably, higher levels of abstinence self-efficacy at the end of treatment may increase smoking risk during the first three months postquitting.
Does making early evening social plans impact alcohol use outcomes over evening hours?
Lipperman-Kreda S, Mair CF, Gruenewald PJ … +3 more , Wharton MK, Gunn RL, Howe LK
Drug Alcohol Depend · 2026 Jan · PMID 41418474 · Full text
UNLABELLED: Puropse: This study examined associations of evening plans to engage in different social activities with drinking behaviors and negative consequences experienced over weekend evening hours among underage youn...
UNLABELLED: Puropse: This study examined associations of evening plans to engage in different social activities with drinking behaviors and negative consequences experienced over weekend evening hours among underage young adults. METHODS: Ecological Momentary Assessment (EMA) data were collected from underage youth (19-20 years) in California in 8 evenings over 4 successive weekends. At 6pm, participants reported their social (i.e., any social plans tonight) and contextual (i.e., planning to be outside own home tonight) evening plans and whether they planned to drink that evening. They subsequently reported alcohol use and negative consequences within the past two hours at 8pm, 10pm, midnight, and the next morning. We used mixed effects logistic and negative binomial models controlling for demographics, history of alcohol use, drinking motives, and weekend day. Analyses were based on data obtained from 230 participants who reported on 1469 evenings. RESULTS: In about 37 % and 46 % of evenings in which participants reported having social plans or plans to be outside own home, they reported no plans to drink alcohol, respectively. Social evening plans were positively associated with subsequent alcohol use (OR=3.312, p < 0.001), the number of drinks consumed (IRR=2.009, p < 0.001), and the number of negative consequences experienced (IRR=1.526, p < 0.05), independent of plans to drink that evening. Having any social evening plans was positively associated with planned (vs. unplanned) drinking (OR=7.080, p < 0.001). CONCLUSIONS: Social evening plans may be important determinants of drinking behaviors and negative consequences across evening hours among underage young adults. Results can guide future interventions to reduce heavier drinking and associated harms.
Alcohol-seeking associations with resting state functional connectivity of the amygdala.
Dzemidzic M, Cox MR, Haines D … +11 more , Hays J, Mlungwana MK, Avena-Koenigsberger A, Logrip ML, Goni J, Harezlak J, Kosobud AEK, Kareken DA, O'Connor S, Plawecki MH, Cyders MA
Drug Alcohol Depend · 2026 Jan · PMID 41411874 · Full text
BACKGROUND: Prolonged alcohol use is associated with neuroadaptations that may contribute to continued alcohol consumption, even in the presence of adverse consequences. Although well studied in preclinical models, the n...
BACKGROUND: Prolonged alcohol use is associated with neuroadaptations that may contribute to continued alcohol consumption, even in the presence of adverse consequences. Although well studied in preclinical models, the neural mechanisms of aversion-resistant alcohol-seeking in humans are understudied. PURPOSE: The goal of this study was to examine whether altered amygdala resting state functional connectivity (rsFC) is a mechanism for how lifetime drinking history and alcohol use disorder symptoms relate with objectively measured neutral and aversion-resistant alcohol-seeking in the human laboratory. METHODS: A sample of 55 adults (age 21-55, mean=32.18 years, 56.4 % female, 60.0 % White) completed two counterbalanced intravenous alcohol progressive-ratio self-administration sessions (pairing alcohol-seeking with aversive or neutral stimuli) and a resting state fMRI scan. Two bilateral a priori amygdala seed regions were selected. RESULTS: rsFC strength of the left basolateral amygdala and dorsal anterior cingulate cortex mediated the relationships between both lifetime alcohol use and alcohol use disorder symptom severity with alcohol-seeking in the aversive session. rsFC between the right centromedial amygdala and occipital regions was associated with, but not specific to, alcohol-seeking during the neutral session; this connectivity mediated the association with alcohol use disorder symptom severity, but not the association with lifetime alcohol use. CONCLUSIONS: This study provides evidence linking the basolateral amygdala to human aversion-resistant alcohol-seeking. Identification of brain mechanisms underlying aversion-resistant alcohol-seeking can facilitate translational research and identify physiological mechanisms of alcohol use disorder progression.
Enhancing data compatibility in an evolving landscape: Medical cannabis and polysubstance use protocols in the PhenX Toolkit.
Buu A, Thrul J, Bunting A … +12 more , Haegerich T, Huggins W, Hopfer C, Vidot D, Ives C, McNeil R, Zemore S, Vilsaint C, Fallon E, Hill C, Hamilton C, Kelly J
Drug Alcohol Depend · 2026 Jan · PMID 41406668 · Publisher ↗
INTRODUCTION: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health ef...
INTRODUCTION: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas. METHODS: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance use. The broader scientific community was invited to review and provide feedback that was considered in the process of finalizing recommendations. RESULTS: In 2025, the PhenX Toolkit released 15 new medical cannabis and polysubstance use protocols, which assess medical and other cannabis use-including consumption levels, product types, sources, motives, expectancies, medical card status, provider-patient communication, and biochemical validation-as well as polysubstance use patterns and related overdose risk. These protocols complement existing substance-related content in PhenX Toolkit and facilitate future development of knowledge on health effects of cannabis and polysubstance use and clinical guidance on safety or dosing for medical cannabis. CONCLUSION: Researchers are encouraged to adopt these measurement protocols, so results across studies can be better compared and combined to efficiently and reliably evaluate the health effects of medical cannabis and polysubstance use. Measures in these domains will continue to be updated as new knowledge is gained.
Prescribing of controlled substances to adolescents and young adults enrolled in Medicaid, 2001-2019.
Bushnell G, Olfson M, Lloyd K … +6 more , Shiau S, Gerhard T, Keyes KM, Hasin D, Cerdá M, Samples H
Drug Alcohol Depend · 2026 Jan · PMID 41402173 · Full text
OBJECTIVE: To examine nationwide trends in the prescribing of controlled medications to early adolescents, adolescents, and young adults enrolled in public insurance (Medicaid) from 2001 to 2019. METHODS: The study utili...
OBJECTIVE: To examine nationwide trends in the prescribing of controlled medications to early adolescents, adolescents, and young adults enrolled in public insurance (Medicaid) from 2001 to 2019. METHODS: The study utilized US Medicaid data covering publicly insured enrollees from 43 states (2001-2019). Early adolescents (10-12y), adolescents (13-17y), and young adults (18-24y, 25-29y) with ≥ 10 months enrollment in each calendar year were included. Filled prescription for opioids, stimulants, benzodiazepines, Z-hypnotics, barbiturates, and gabapentin were identified. In each calendar year, annual proportions with 1 + controlled medication, 2 + classes of controlled medications, and each controlled medication were estimated. RESULTS: In 2019, the sample included 17.9 million enrollees (53 % female). The annual proportion prescribed any controlled medication peaked at 17.5 % in early adolescents (2003), 20.6 % in adolescents (2009), and 34.1 % (18-24y) and 47.0 % (25-29y) in young adults (2010). By 2019, the proportions declined to 11.7 % (early adolescents), 12.6 % (adolescents), 16.2 % (18-24y), and 23.9 % (25-29y). Trends varied by medication and age. The largest absolute decline was in the proportion with an opioid filled (2010 =29.8 %, 2019 =11.2 %, young adults 18-24y; 2003 =14.3 %, 2019 =4.4 %, adolescents). In contrast, the proportion with a stimulant fill increased, with eight-fold increases in young adults 25-29y (2001 =0.3 %, 2019 =2.6 %). Benzodiazepine and Z-hypnotic use peaked in 2010 and declined through 2019. CONCLUSIONS: In the past two decades, there were increases in stimulant prescriptions among young Medicaid enrollees. The declines in opioid, benzodiazepines, barbiturate and Z-hypnotic prescribing are encouraging and may indicate more cautious prescribing related to greater awareness of harms such as misuse and overdose, along with policy initiatives.
Exploring drug checking services for people who use drugs: Pre-implementation study.
Ludwig W, Jaffe K, Alsum S … +4 more , Dwan M, Ploutz-Snyder R, Shuman C, Dahlem CHG
Drug Alcohol Depend · 2026 Jan · PMID 41391444 · Publisher ↗
BACKGROUND: The growing proportion of adulterants in the street drug supply has increased overdose risk and other negative health outcomes for people who used drugs (PWUD). Though useful, single-item test strips (ie fent...
BACKGROUND: The growing proportion of adulterants in the street drug supply has increased overdose risk and other negative health outcomes for people who used drugs (PWUD). Though useful, single-item test strips (ie fentanyl), are limited in their ability to identify multiple drugs in one drug sample. Thus, community-based drug checking services (DCS) using fourier transform infrared spectroscopy (FTIR) are being adopted as an overdose prevention strategy. To inform the pre-implementation of Michigan's first DCS using FTIR, we sought to understand facilitators and barriers to FTIR among potential participants at a local harm reduction agency. METHODS: Potential DCS participants were recruited (n = 25) into three focus groups (n = 8-9) and one individual interview. Semi-structured interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were used. Focus groups were audio-recorded, transcribed and rapid thematic qualitative analysis was conducted. Themes were developed to inform DCS implementation within CFIR domains with relevant constructs displayed in summary matrices. RESULTS: Participants' main concern was being targeted by police when utilizing FTIR. Additional barriers included concerns about confidentiality, testing wait time, and negative community perceptions. Key facilitators were trusted staff, sharing FTIR information via PWUD social networks, and efforts to increase participant service access with extended hours. Participants felt FTIR would be a valuable resource to support safer drug use, increase autonomy, and help prevent overdose by providing information about drug contents. CONCLUSIONS: DCS can inform PWUD and the public of dangerous analogues in the drug supply, increase autonomy to make informed decisions, and reduce overdose risk.
Characteristics of family, friends, and significant others affected by another's alcohol or other drug use in Australia and correlates of help-seeking.
Rushton CM, Beck AK, Kelly PJ … +2 more , Coleman P, Larance B
Drug Alcohol Depend · 2026 Jan · PMID 41389760 · Publisher ↗
BACKGROUND: Supporting families, friends, and significant others (hereafter 'families') affected by a loved one's (hereafter 'Person's') alcohol and drug (AOD) use can improve family wellbeing. However, little is known a...
BACKGROUND: Supporting families, friends, and significant others (hereafter 'families') affected by a loved one's (hereafter 'Person's') alcohol and drug (AOD) use can improve family wellbeing. However, little is known about families' help-seeking patterns. This study aimed to describe characteristics and explore correlates of accessing support among affected families. METHODS: An online cross-sectional survey conducted between September-2023 and August-2024 of N = 1756 English-speaking Australian residents, aged > 18, identifying as affected by a loved one's AOD use. Data collected included sociodemographics, psychological wellbeing indicators, and help-seeking, analysed using summary statistics and logistic regressions. RESULTS: Participants (1433/1569; 91.3 % female), were mostly partners (621/1756; 35.4 %). Seventy-one percent (1159/1633) were concerned about their Person's alcohol use, followed by methamphetamines (n = 210; 12.9 %). Participants reported being concerned about their Person's AOD use for a median of 9.5 years (SD=10.1). Fifty-four percent (816/1510) of participants (affected families) reported high-very high psychological distress, 22.7 % (345/1521) reported recent suicidal ideation, 14.8 % (192/1299) reported risky alcohol use and 19.7 % (257/1305) recently used illicit drugs. Participants who accessed specialised family-AOD support (419/1228; 34.1 %) were more likely older (65 +; Adj.OR=1.47; 95 %CI[1.03, 2.10]), less likely to reside with their Person (Adj.OR=0.72; 95 %CI[0.55, 0.96]) and to report their own risky drinking (Adj.OR=0.53; 95 %CI[0.35, 0.80]), and more likely to report their Person accessed AOD treatment (Adj.OR=1.85; 95 %CI[1.33, 2.56]). CONCLUSIONS: The results highlight elevated distress, suicidality and substance use among affected families and their delayed access to predominantly non-specialised support. Greater investment in community-health campaigns and specialised services is required to ensure provision of timely and tailored support.
Rethinking acute nicotine self-administration in inhaled tobacco products: A randomized clinical trial with ENDS in young adults.
El Hourani M, Talih S, Salman R … +4 more , Karaoghlanian N, Hanna E, El Hage R, Shihadeh A
Drug Alcohol Depend · 2026 Jan · PMID 41386038 · Full text
BACKGROUND: Puffing behavior is often interpreted through a nicotine titration model, which posits that individuals adjust puffing to achieve the central nervous system effects of nicotine. This model has been invoked fr...
BACKGROUND: Puffing behavior is often interpreted through a nicotine titration model, which posits that individuals adjust puffing to achieve the central nervous system effects of nicotine. This model has been invoked frequently to explain the phenomenon of "compensation," in which people increase puffing intensity when using reduced-nicotine products. However, puffing patterns may also be governed by sensory feedback in the upper airways. This study tests that hypothesis using electronic nicotine delivery systems (ENDS) as a model. DESIGN: Within-subject, double-blind clinical study using a puff-by-puff switching protocol. SETTING: Clinical Aerosol Technology Lab, American University of Beirut; December 2024. INTERVENTIONS: Ten adults who consume both ENDS and cigarettes completed three randomized directed puffing bouts during a single clinical lab visit. In each bout, they alternated puffs between two identical ENDS devices differing by one design factor: (1) power (20W vs 40W, 0mg/ml nicotine); (2) power (20W vs 40W, matched nicotine flux); (3) PG:VG ratio (30:70 vs 70:30). OUTCOMES: Puff topography and sensory feedback (mouthful, draw effort, throat hit) measured on a puff-by-puff basis. RESULTS: Puff duration responded immediately and reversibly to changes in sensory feedback. At higher power, participants reported stronger mouthful, easier draw, and took shorter puffs regardless of nicotine content (p < .05). At matched flux, computed nicotine dose was lower at 40W than 20W (p < .01). PG:VG effects were also significant. CONCLUSIONS: Puffing behavior appears to be driven by sensory cues, not delayed nicotine effects-highlighting an underused regulatory pathway: targeting product design features that shape perception.
Micro-costing analysis of harm reduction services in office-based addiction treatment.
Markus A, Shang M, Studnicki O … +5 more , Freund A, Merlin J, Liebschutz JM, Raghu VK, Jawa R
Drug Alcohol Depend · 2026 Jan · PMID 41386037 · Publisher ↗
OBJECTIVES: The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addicti...
OBJECTIVES: The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings. METHODS: Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability. RESULTS: Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively. CONCLUSIONS: We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.
Drinking on empty: Daily associations between food and alcohol disturbance, subjective alcohol intoxication, and negative consequences.
Herchenroeder L, Yeung EW
Drug Alcohol Depend · 2026 Jan · PMID 41386036 · Publisher ↗
BACKGROUND: Food and alcohol disturbance (FAD) refers to restricting caloric intake prior to, or during a drinking episode to increase/quicken alcohol's effects (FAD-intoxication) or to offset calories consumed from alco...
BACKGROUND: Food and alcohol disturbance (FAD) refers to restricting caloric intake prior to, or during a drinking episode to increase/quicken alcohol's effects (FAD-intoxication) or to offset calories consumed from alcohol (FAD-calories). FAD is common among college students and is associated with alcohol-related harms cross-sectionally. However, to date there is limited research examining FAD's association with negative alcohol-related consequences, as well as mechanisms linking FAD and negative consequences, at the event level. BASIC PROCEDURE: The present study utilized a within-person, day-level design to assess whether individuals reported higher levels of subjective alcohol intoxication on days when they engaged in FAD compared to drinking days absent of FAD. In turn, we examined whether increased subjective alcohol intoxication positively associated with same-day negative consequences. The sample included 72 college students (73.8 % female; 51.4 % White non-Hispanic; M=19.64) who completed up to two surveys daily (Wednesday-Sunday) for five weeks. MAIN FINDINGS: For FAD-intoxication analyses, we found a significant mediation effect such that on days when students engaged in FAD-intoxication they reported higher subjective alcohol intoxication than on days when they consumed alcohol absent of FAD-intoxication. In turn, on days when students reported higher subjective alcohol intoxication they also reported more negative alcohol-related consequences. In contrast, the mediation effect for the FAD-calories model was not significant. CONCLUSIONS: These findings further highlight the risk associated with engaging in FAD-intoxication and provides preliminary evidence that FAD-intoxication should be considered in interventions aiming to reduce event-level alcohol-related harms among college students.
Reciprocal effects between illicit drug use and mental health conditions among healthcare workers in Sweden: A one-year follow-up study.
Peláez Zuberbuhler J, Thern E, Innstrand ST … +5 more , Christensen M, Landstad BJ, Sjöström M, Elling DL, Brulin E
Drug Alcohol Depend · 2026 Jan · PMID 41380199 · Publisher ↗
BACKGROUND: Research suggests a comorbidity between illicit drug use and mental health conditions. However, it remains unclear whether illicit drug use serves as a risk factor for, or a consequence of, mental health cond...
BACKGROUND: Research suggests a comorbidity between illicit drug use and mental health conditions. However, it remains unclear whether illicit drug use serves as a risk factor for, or a consequence of, mental health conditions in healthcare workers (HCWs). This study aimed to 1) examine the prevalence of illicit drug use among HCWs in Sweden and 2) investigate the bidirectional relationship between illicit drug use and mental health conditions(i.e., depression and burnout). METHODS: Data from the 2022 and 2023 Longitudinal Occupational Health Survey in Healthcare Sweden (LOHHCS) were used. The data included 3280 HCWs (50.3 % physicians and 49.7 % nurses). Questionnaires assessed illicit drug use frequency, burnout complaints (BAT-12), and depression (SCL-CD6). Cross-lagged panel models (CLPMs) were used to examine the reciprocal relationships over the two studied time-points between illicit drug use and mental health conditions. RESULTS: The prevalence of illicit drug use in 2022 was 1.3 %, which increased slightly to 1.6 % one and a half years later, in 2023. Using two-wave panel data, results revealed a bidirectional effect between illicit drug use and burnout. However, while depression was associated with subsequent illicit drug use, the reversed association was not observed. CONCLUSIONS: These findings suggest that illicit drug use plays different roles in relation to burnout and depression among healthcare workers. This highlights the importance of integrated treatment strategies and preventive measures that address both illicit drug use and mental health conditions-especially burnout-simultaneously.
Access to medications for opioid use disorder among primary care patients with homeless experience in the Department of Veterans Affairs.
Jones AL, Li H, Baylis JD … +8 more , Huebler S, Suo Y, Zhang Y, Gelberg L, Zickmund S, Greene TH, Kertesz SG, Gordon AJ
Drug Alcohol Depend · 2026 Jan · PMID 41380198 · Full text
BACKGROUND: Primary care settings tailored for persons with experience of homelessness (PEH) could enhance opioid use disorder treatment delivery, but evidence is lacking. OBJECTIVE: To examine medication treatment for o...
BACKGROUND: Primary care settings tailored for persons with experience of homelessness (PEH) could enhance opioid use disorder treatment delivery, but evidence is lacking. OBJECTIVE: To examine medication treatment for opioid use disorder (MOUD) among PEH who received homeless-tailored primary care in the Department of Veterans Affairs (VA). METHODS: Receipt of MOUD was assessed from electronic health records among VA primary care patients with experience of homelessness and OUD in 2016-2020. We estimated the proportion who received MOUD over time and applied mixed effect Poisson models with entropy balance weighting to estimate differences in MOUD by primary care type (homeless-tailored vs. mainstream). Secondary analyses examined the consistency of findings across 18VA service regions. FINDINGS: The percentage of eligible PEH (n = 45,864) receiving any MOUD rose from 42.1 % to 51.0 % over time. Half (51.3 %) of those initiating MOUD received > 30 days MOUD over one year. In unadjusted models, the proportion receiving MOUD was slightly higher in homeless-tailored primary care, compared to mainstream primary care (48.8 % vs 46.4 %, Unadjusted Incidence Rate Ratio=1.09, 95 % CI=1.03-1.16). After covariate adjustment, there was no statistical difference between groups (Adjusted IRR=0.97, CI=0.92-1.02). This proved broadly consistent across VA service regions. CONCLUSIONS: Concomitant with a national VA initiative to tailor primary care services for PEH, half of diagnosed patients received MOUD. Yet evidence of durable treatment was low, and the homeless-tailored clinics did not outperform mainstream clinics. Efforts to tailor primary care for PEH may require specialized addiction staffing and implementation support to improve MOUD care in these settings.
Comparison of remote to hybrid methods on recruitment and retention rates in a smoking cessation trial.
Hawes ES, Bontemps AP, Wagner WP … +4 more , Hendricks PS, Lahti AC, Azuero A, Cropsey KL
Drug Alcohol Depend · 2026 Jan · PMID 41353912 · Full text
OBJECTIVES: Due to the COVD-19 pandemic, many ongoing clinical trials had to rapidly shift to using remote trials, including our smoking cessation trial within a criminal legal population. The objective of this study was...
OBJECTIVES: Due to the COVD-19 pandemic, many ongoing clinical trials had to rapidly shift to using remote trials, including our smoking cessation trial within a criminal legal population. The objective of this study was to compare recruitment rate, study adherence, retention, nicotine replacement therapy adherence, and quit attempts between participants who completed the study as planned (In-Person; N = 236), after implementation of a voucher system and additional check-in appointments (Incentivized; N = 126), and after the pandemic began (Hybrid; N = 153). METHODS: 515 participants were recruited with criminal legal involvement from Birmingham, AL, and randomized to an In Vivo nicotine replacement therapy (NRT) sampling group or a standard smoking cessation counseling group, with both groups receiving 12 weeks of NRT. RESULTS: There were no significant differences in any of the study outcomes between the methodology groups, suggesting that hybrid methods of research do not result in a slower recruitment pace, less visits attended, or a higher likelihood of drop-out. Completing the study remotely did not appear to impact study outcomes such as likelihood of making a quit attempt or using NRT. CONCLUSIONS: This study suggests that remote methods may be as effective as in-person methods in a clinical trial, although a randomized trial of these methods is needed.
Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats.
Seaman RW, Shariatzadeh N, Salinas KA … +3 more , George CM, Shi YG, Collins GT
Drug Alcohol Depend · 2026 Jan · PMID 41353911 · Full text
BACKGROUND: Stimulant-opioid co-use has surged in the United States, with methamphetamine use among people who use opioids increasing 82.6 % from 2015 to 2017. This trend contributes to rising overdose deaths, marking a...
BACKGROUND: Stimulant-opioid co-use has surged in the United States, with methamphetamine use among people who use opioids increasing 82.6 % from 2015 to 2017. This trend contributes to rising overdose deaths, marking a "fourth wave" of the opioid epidemic. This study examined how opioid dependence and withdrawal affect the reinforcing effects of opioids and stimulants. METHODS & RESULTS: Male Sprague-Dawley rats (8-12 per group) were trained to self-administer fentanyl (3.2µg/kg/inf), cocaine (0.32mg/kg/inf), or methamphetamine (0.1mg/kg/inf) under fixed ratio (FR) schedules. Opioid dependence was established through escalating twice-daily morphine injections (10-40mg/kg) over four days, then maintained with daily doses of 40mg/kg morphine. Rats exhibited stable signs of withdrawal (somatic signs, weight loss, hyperalgesia) following 20h but not 12h of morphine deprivation. Demand curves were generated by progressively increasing work requirements (FR 3, 5, 10, 18, 32, 56, 100, etc.) across sessions conducted 12 (morphine dependent) or 20 (morphine withdrawn) hours after morphine or saline (non-dependent controls). Morphine withdrawal (20-hour deprived group) increased demand for fentanyl but decreased demand for cocaine and methamphetamine. Morphine dependence (12-hour deprived group) had minimal effects, but did reliably decrease demand for cocaine. Morphine dependence increased demand intensity (Q) only for the small dose of fentanyl; all other conditions were unaffected. CONCLUSIONS: These results demonstrate that opioid withdrawal increases motivation for opioid use while reducing motivation for stimulants, particularly at higher costs. Understanding these dynamics is crucial for developing effective polysubstance treatments addressing both opioid dependence and stimulant co-use.
Childhood trauma, family functioning, and the BDNF gene may affect the development of alcohol use disorder.
Yeh YW, Chen CSH, Kuo SC … +7 more , Chen CY, Huang YC, Huang JT, Yang YP, Huang JS, Ma KH, Huang SY
Drug Alcohol Depend · 2026 Jan · PMID 41353910 · Publisher ↗
BACKGROUND: Childhood trauma and family dysfunction substantially increase the risk of alcohol use disorder (AUD) among individuals with genetic susceptibility. Brain-Derived Neurotrophic Factor (BDNF) plays a crucial ro...
BACKGROUND: Childhood trauma and family dysfunction substantially increase the risk of alcohol use disorder (AUD) among individuals with genetic susceptibility. Brain-Derived Neurotrophic Factor (BDNF) plays a crucial role in neuronal neuroplasticity. METHODS: The cross-sectional case-control study examines the associations between the BDNF gene, childhood trauma, and family functioning in relation to vulnerability to AUD. A total of 1085 participants were recruited from the Han Chinese population. The final analysis included data from 518 patients with AUD and 548 healthy controls, and 19 were excluded due to DNA issues. Three psychometric instruments-the childhood trauma questionnaire (CTQ), the adverse childhood experiences questionnaire (ACEs), and the family APGAR questionnaires were used to assess environmental risk factors contributing to AUD. An independent t-test was used to examine differences between controls, AUD, and its subgroups for each psychometric score. ANCOVA was performed to assess the effects of BDNF variants on CTQ, ACE, and APGAR scores in patients with AUD after adjusting for age and gender. RESULTS: The CTG haplotype in the rs6265-rs6484320-rs7934165 block of the BDNF gene was associated with the late-onset AUD (p = 9.9 ×10). Higher CTQ and ACEs scores were observed in AUD patients, particularly in those with early-onset AUD. Total CTQ score and ACEs score were negatively correlated with the onset age of AUD, although these scores were not influenced by BDNF genotype. CONCLUSION: Childhood trauma and impaired family functioning may serve as predictive factors in the development of AUD. BDNF gene variants, childhood trauma, and family functioning appear to influence AUD risk.
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