Addiction最新文献

{"title":"Examining the longer-term efficacy of brief, alcohol-focused personalized feedback interventions for individuals with internalizing distress: Secondary analysis of a randomized controlled trial.","authors":"Marilyn L Piccirillo, Scott Graupensperger, Katherine Walukevich-Dienst, Elizabeth Lehinger, Kirstyn N Smith-LeCavalier, Katherine T Foster, Mary E Larimer","doi":"10.1111/add.70044","DOIUrl":"https://doi.org/10.1111/add.70044","url":null,"abstract":"<p><strong>Background and aims: </strong>Efficacy of brief alcohol interventions for young adults with internalizing distress (i.e. symptoms of depression, anxiety and stress) is unclear. We tested the moderating effect of internalizing distress on the efficacy of alcohol single- and multicomponent personalized feedback interventions (PFIs).</p><p><strong>Design: </strong>Secondary data were analyzed from a randomized controlled trial (RCT) testing the efficacy of single and multicomponent PFIs, compared with an attention-only control condition.</p><p><strong>Setting: </strong>Participants were sampled from two West Coast universities in the United States. All study protocols were completed online.</p><p><strong>Participants: </strong>Participants (n = 1137) were college students (63% female; M_age = 20.1 years; 62.6% non-Hispanic white) who reported on internalizing distress at baseline. Some individuals reported clinically significant symptoms (depression: mild/moderate = 24.0%, severe/extremely severe = 10.5%; anxiety: mild/moderate = 19.6%, severe/extremely severe = 11.4%; and stress: mild/moderate = 37.5%, severe/extremely severe = 6.0%).</p><p><strong>Interventions: </strong>There were four different alcohol single-component PFIs administered and an attention-only PFI control. Alcohol PFIs varied in their complexity and single-component PFIs (i.e. personalized normative feedback) were compared with multicomponent PFI (i.e. containing additional alcohol-focused psychoeducation).</p><p><strong>Measurements: </strong>Baseline levels of internalizing distress were measured using the summed total of the Depression, Anxiety and Stress Scales (DASS). Drinking outcomes (alcohol consumption, peak eBAC, alcohol-related consequences) were measured at baseline, 3, 6 and 12 months post-intervention.</p><p><strong>Findings: </strong>Alcohol PFI (compared with attention-only control) reduced alcohol consumption and related consequences at 6-month [rate ratio (RR)_Consumption = 0.85, P = 0.004] or 12-month follow-ups (RR_Consumption = 0.76, P < 0.001; RR_Consequences = 0.85, P = 0.020), regardless of baseline DASS score. Participants with higher DASS scores (compared with those with lower DASS scores) reported lower 6-month alcohol consumption after receiving a single-component intervention (RR = 0.80, P < 0.001). However, individuals with higher DASS scores (compared to those with lower DASS scores) reported more 6-month alcohol-related consequences after receiving a multicomponent intervention (RR = 0.78, P = 0.004).</p><p><strong>Conclusions: </strong>Personalized feedback interventions may demonstrate efficacy towards reducing drinking in young adults and appear similarly beneficial across levels of internalizing distress, although lower-complexity interventions may be more efficacious.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naloxone dosing in the era of synthetic opioids: Applying the Goldilocks principle.","authors":"Mariana Gonzalez Utrilla, Edward Chesney, Joanne Neale, Nicola Metrebian, Nicola Kalk, Arne Kristian Skulberg, Paul Dietze, Martin Smith, John Strang","doi":"10.1111/add.70060","DOIUrl":"https://doi.org/10.1111/add.70060","url":null,"abstract":"<p><p>The opioid overdose epidemic remains a critical public health crisis. In recent years, synthetic opioids like fentanyl and nitazenes, have driven a sharp rise in deaths. Naloxone, an opioid receptor antagonist, has been established as a key intervention for reversing opioid overdoses and saving lives. However, there remains a critical need to optimize naloxone dosing strategies. This article examines the challenges of both under-dosing and over-antagonism in naloxone administration, emphasizing the importance of a tailored approach to overdose management. A 'just the right dose' approach is essential for minimizing the risks of over-antagonism while still reversing opioid overdose. This involves starting with a modest naloxone dose and carefully titrating it based on the patient's response, considering factors such as opioid type, overdose severity, and opioid tolerance. A tailored approach to naloxone dosing may present challenges for non-medically trained responders but it can ensure that as many people as possible receive the right dose of naloxone when they need it. Training programs should also emphasize the importance of first aid and supportive care, including airway management and alerting emergency services, as well as careful monitoring of the patient's response.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Johnstone et al.: Mechanisms underlying extended pre-quit varenicline treatment for smoking cessation","authors":"Jed E. Rose","doi":"10.1111/add.70067","DOIUrl":"10.1111/add.70067","url":null,"abstract":"&lt;p&gt;Currently available smoking cessation pharmacotherapies (nicotine replacement therapy, bupropion and varenicline) have limited effectiveness, and one strategy for improving on them has been to initiate treatment several weeks before the quit date. Not only does this increase efficacy [&lt;span&gt;2-5&lt;/span&gt;], but pre-quit initiation of treatment also affords an opportunity to assess predictors of efficacy and adapt treatment before a target quit date. [&lt;span&gt;6&lt;/span&gt;] This new research by Johnstone &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] sought to identify behavioral mechanisms underlying the efficacy of extended pre-quit treatment with varenicline.&lt;/p&gt;&lt;p&gt;Consistent with the hypothesis that varenicline attenuates nicotine reinforcement, the authors found that pre-quit reductions in smoking rate occurred, which, along with decreased pre-quit craving and increased self-efficacy, mediated abstinence. Surprisingly, however, subjective rewarding or aversive effects of cigarettes were not mediators of abstinence. These results are amenable to two quite different interpretations.&lt;/p&gt;&lt;p&gt;One interpretation is that the reinforcement mechanisms maintaining cigarette use and dependence are dissociable from the evaluative conditioning that underlies ratings of subjective reward. That is, the smoking response/nicotine reinforcement outcome association can be degraded by varenicline without substantially changing the subjective evaluation of cigarettes. Indeed, evaluative conditioning has been found to be resistant to extinction and counterconditioning [&lt;span&gt;7&lt;/span&gt;]. Previous studies have found that some subjective responses such as ‘craving reduction’ after smoking do not appear to be affected by varenicline [&lt;span&gt;8&lt;/span&gt;]. A related concept that might apply is ‘automatic reinforcement’ [&lt;span&gt;9&lt;/span&gt;], whereby a behavior becomes reinforcing in itself, apart from signaling a subsequent outcome such as nicotine reinforcement. The persistence of smoking cigarettes with little or no nicotine content [&lt;span&gt;10, 11&lt;/span&gt;] is consistent with this general view that subjective ratings of reward can be partially dissociated from nicotine reinforcement. Neural correlates of this dissociation have been identified in the dorsal striatum, premotor cortex and other brain regions [&lt;span&gt;12&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A second interpretation, however, is that the perceived rewarding value of cigarettes is dissociated from abstinence because individuals adjust their rate of smoking to compensate for the reduction in anticipated reward. A cigarette smoked after a period of abstinence, such as the first one of the day, is often rated more rewarding than others [&lt;span&gt;13&lt;/span&gt;]. Therefore, reducing smoking frequency by spacing cigarettes farther apart would tend to offset the reward attenuation by varenicline and obscure a relationship between subjective reward and abstinence outcomes. Actual subjective reward could appear unchanged even if anticipated subjective reward were reduced and mediated ","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1238-1239"},"PeriodicalIF":5.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Piatkowski et al.: Anabolic-androgenic steroid testing sites are necessary to identify specific anabolic-androgenic steroid types that are commonly faked putting users at risk.","authors":"Thomas O'Connor","doi":"10.1111/add.70068","DOIUrl":"https://doi.org/10.1111/add.70068","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Day et al.: Singapore's approach toward drug rehabilitation.","authors":"Salina Samion, Jasmin Kaur, Chi Ching Leung","doi":"10.1111/add.70063","DOIUrl":"https://doi.org/10.1111/add.70063","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Young et al.: Clinical guidance is required for stimulant co-prescription with opioid agonist therapy","authors":"Nadine Ezard,&nbsp;Krista J. Siefried,&nbsp;Brendan Clifford","doi":"10.1111/add.70061","DOIUrl":"10.1111/add.70061","url":null,"abstract":"&lt;p&gt;Young &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] present new findings on the lack of a relationship between prescribed stimulants and opioid overdose from a Canadian cohort of people on opioid agonist therapy (OAT). The authors drew from a linked database of fatal and non-fatal opioid overdose in the province of British Columbia from 2015 to 2020. The authors found no association between stimulant co-prescription and overdose. Importantly, as the authors point out, the incidence of fatal overdose was low (1/500/year) [&lt;span&gt;1&lt;/span&gt;], testimony to the protective role of OAT [&lt;span&gt;2&lt;/span&gt;] and underscoring the importance of community access to effective OAT. Promoting effective initiation onto [&lt;span&gt;3&lt;/span&gt;] and retention in [&lt;span&gt;2&lt;/span&gt;] OAT is increasingly important in face of the rise of potent synthetic opioids and co-use with synthetic stimulants [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Stimulant prescription among people on OAT is an emerging therapeutic area that may have additional benefits over OAT alone. Prescription stimulants are first line pharmacotherapy for adults with attention-deficit hyperactivity disorder (ADHD) [&lt;span&gt;5&lt;/span&gt;], which coexists with an important proportion of people with opioid use disorder (recent meta-analytic data suggest 20% [&lt;span&gt;6&lt;/span&gt;]) and is associated with more severe opioid dependence and psychiatric comorbidity [&lt;span&gt;7&lt;/span&gt;]. Young &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] reported 4.4% of the 9395 participants had an ADHD diagnosis recorded; of those, 31% (212 participants) were prescribed a stimulant. Consistent with the literature [&lt;span&gt;8&lt;/span&gt;], these data suggest a likely under-recognition and under-treatment of ADHD in an OAT population. Treatment of ADHD may improve retention in OAT [&lt;span&gt;9&lt;/span&gt;]. Although the study was not designed to assess reasons for or patterns of stimulant prescription, more work is needed to explore the role of effective treatment of ADHD among people with opioid use disorder. Diagnosis of ADHD in adults with coexisting opioid use disorder (with or without concomitant non-prescribed stimulant use) is complicated by overlap in symptoms and lack of validated screening measures for substance use disorder populations. Consensus guidelines recommend routine screening and prompt diagnosis and treatment in people presenting with substance use disorder [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Emerging evidence suggests there may be a role for stimulant prescription for the management of stimulant use disorder at doses higher than for ADHD [&lt;span&gt;11&lt;/span&gt;]. Co-use of stimulants with opioids is implicated in rising fatalities in North America, suggesting coexisting stimulant use disorder with opioid use disorder may be increasing at least in those countries. Yet only 38 people (0.4%) of the sample of 9395 people Young &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] report on were noted to have a stimulant use disorder diagnosis, and only six (0.9%) of those prescribed a stimulant had a stimulant use disorder diagnosis. Indeed, th","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1195-1197"},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare but relevant: Ketamine-induced cystitis - an in-depth review for addiction medicine.","authors":"Asem Abdelrahman, Mo Belal","doi":"10.1111/add.70052","DOIUrl":"https://doi.org/10.1111/add.70052","url":null,"abstract":"<p><p>Ketamine-induced cystitis is an increasingly recognized complication associated with the addictive use of ketamine, a dissociative anesthetic. This article provides a comprehensive overview, focusing on its pathophysiology, clinical presentation, diagnosis, management strategies, and implications for addiction treatment. The British Association of Urological Surgeons consensus serves as a foundational reference for management, while additional literature is integrated to highlight the multifaceted nature of Ketamine Bladder and its impact on individuals with substance use disorders.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal patterns of e-cigarette use initiation and progression to frequent vaping from mid-to-late adolescence to young adulthood.","authors":"Junhan Cho, Alyssa F Harlow, Adam M Leventhal, Mary Ann Pentz, Dayoung Bae, Dae-Hee Han, Rob McConnell, Sandrah P Eckel, Jessica L Barrington-Trimis","doi":"10.1111/add.70042","DOIUrl":"https://doi.org/10.1111/add.70042","url":null,"abstract":"<p><strong>Aims: </strong>This exploratory study aimed to describe longitudinal patterns of e-cigarette use initiation and progression to frequent use across mid-to-late adolescence and young adulthood and determine risk factors for and consequences of these initiation patterns.</p><p><strong>Design: </strong>Using 12 waves of a prospective cohort data across 2014-2023, we identified latent classes with distinct patterns of timing of e-cigarette use initiation and frequent use progression (20 + days/month). We then estimated: (1) associations of baseline risk factors with membership in latent classes and (2) associations of latent classes with e-cigarette/other substance use frequency and e-cigarette dependence at a subsequent 1-year follow-up.</p><p><strong>Setting: </strong>Southern California, United States.</p><p><strong>Participants: </strong>Baseline e-cigarette never users [n = 2291; mean age (standard deviation) = 15.0 (0.4) years; 55.1% female; 44.6% Hispanic].</p><p><strong>Measurements: </strong>Repeated self-reported e-cigarette use initiation and past-30-day frequency, other substance use and e-cigarette dependence.</p><p><strong>Findings: </strong>Four distinct groups were identified: (1) early high school/gradual progression (13.9%); (2) late high school/gradual progression (4.3%); (3) young adulthood/quick progression (21.3%); and (4) low initiation risk/no progression (60.5%). In addition to two high school initiator groups with gradual progression to frequent vaping over 3 years, we identified the young adulthood/quick progression group who initiated e-cigarette use after high school and progressed to frequent use within 1.2 years. Late initiators who progressed quickly reported the highest prevalence of JUUL use as their first device (34.2%) and the highest levels of vaping frequency and e-cigarette dependence at the final assessment, compared with the other groups.</p><p><strong>Conclusions: </strong>In the United States, there appear to be four distinct classes of developmental patterns of e-cigarette use initiation and progression to frequent use during mid-to-late adolescence and young adulthood, including a newly identified group characterized by late use initiation (post secondary school) and rapid progression (1.2 years) to frequent use. Rapid progression from late initiation to frequent use may be influenced by the widespread availability and usage of JUUL among US youth in 2018-2019.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Coelho et al.: Ecological momentary assessments may be key to the future of cannabis studies","authors":"Lucy Chester,&nbsp;François-Olivier Hebert,&nbsp;Didier Jutras-Aswad","doi":"10.1111/add.70066","DOIUrl":"10.1111/add.70066","url":null,"abstract":"&lt;p&gt;The study of cannabis use and cannabis-associated health outcomes currently centres primarily around two distinct methods of research: experimental trials using fixed doses of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), and observational studies of naturalistic cannabis use. The former method has the advantage of producing accurate dose-effect data, but is limited to acute dosing in controlled, clinical environments. And while the latter allows us to track real-world cannabis consumption over extended periods of time, previous attempts to accurately record dosing have proven rudimentary and imprecise. The ecological momentary assessment (EMA) methodology presented by Coelho &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] could help to fill this critical gap in the research by allowing the collection of precise, time-sensitive, and ecologically relevant cannabinoid dosing data across a variety of product types and modes of administration. Importantly, as alternative forms of use have become increasingly popular [&lt;span&gt;2&lt;/span&gt;], it has become more necessary than ever for a meaningful index of cannabis use to aggregate all such products and routes.&lt;/p&gt;&lt;p&gt;There are several points to consider when moving forward with this proposed methodology. First, it is imperative to consider and assess the generalizability across populations of interest, from otherwise relatively healthy consumers to populations displaying comorbid conditions (e.g. physical or mental health disorders) or other vulnerability factors. In addition, while there is evidence of overlap in medical and non-medical reasons for use [&lt;span&gt;3&lt;/span&gt;], the conditions in which medical and non-medical cannabis users utilize cannabis (e.g. alone or with company, exact measured dosing or ad libitum, etc.) and report their cannabis use will also likely differ, as will the effects that these populations experience.&lt;/p&gt;&lt;p&gt;It is also important to consider how this tool may be used in longer studies. The present study was conducted for 14 days to reduce the burden on participants, but the major cannabis-related harms of interest, such as cannabis use disorder, development or worsening of psychotic symptoms, etc., typically occur only over much longer periods of use. Longer follow-up would also be desirable for evaluating the safety and efficacy of self-directed medical cannabis use, such as in the management of chronic pain or insomnia. Such longer-term studies would need to limit the burden on participants, by making data input as fast and simple as possible (e.g. allowing users to save product characteristics to be automatically input again), and possibly having distinct periods of EMA data entry, for example, 1 or 2 weeks every 3 months, alternating with traditional retrospective data collection, such as timeline followback (TLFB) or enhanced TLFB (eTLFB) [&lt;span&gt;4, 5&lt;/span&gt;]. In addition, this methodology would be a more powerful research tool when incorporated into more comprehensive studies of cannab","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1182-1183"},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is big money distorting the global drug policy conversation?","authors":"Bobby P. Smyth","doi":"10.1111/add.70059","DOIUrl":"10.1111/add.70059","url":null,"abstract":"&lt;p&gt;The Open Society Foundation (OSF) appears to have a large and distorting influence upon the current global drug policy conversation.&lt;/p&gt;&lt;p&gt;The United Nations (UN) Conventions on Narcotic Drugs stand as a massive obstacle for those with drug legalization ambitions [&lt;span&gt;1&lt;/span&gt;]. OSF is a wealthy opponent of the drug conventions, being led by the multi-billionaire, George Soros [&lt;span&gt;2, 3&lt;/span&gt;]. The funding of this think-tank has been assessed as being ‘highly opaque’ [&lt;span&gt;4&lt;/span&gt;]. OSF supports groups who put forward alternatives to prohibition and who support legalization [&lt;span&gt;2&lt;/span&gt;], saying ‘the vast majority of our grants are awarded to organizations that we approach directly’ and it funds those ‘who share our values’ [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The annual meeting in Vienna of the Commission on Narcotic Drugs (CND) is a key event in the annual calendar for those interested in the drug conventions. The program involves plenaries and dozens of organised official side events [&lt;span&gt;6&lt;/span&gt;]. OSF was among the non-governmental organizations (NGOs) at the meeting in 2024 and was formally involved in the running of 11 side events.&lt;/p&gt;&lt;p&gt;The funding relationship between OSF and the 49 other NGO contributors to these 11 OSF-involved side events was explored. It emerged that 38 (78%) had recent (2016–2023) OSF funding. OSF helpfully lists grantees on its own website [&lt;span&gt;7&lt;/span&gt;]. This confirmed funding in 31 instances. Financial support for individual NGOs ranged from $25 000 to $18 million over the 8 years. These 31 entities shared over $82 million from OSF across this period. In the other seven cases, funding was confirmed by the NGO's own website or via media reports. There were at least another 10 OSF funded NGOs involved in supporting other side events at CND 2024 [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;OSF has also recently funded both the Joint UN Programme on HIV/AIDS and Office of the UN High Commissioner for Human Rights (OHCHR) who each supported seven of the OSF-involved side events. The OHCHR received an average of $100 000 annually from OSF across 2018 to 2022 [&lt;span&gt;7&lt;/span&gt;]. This increased to $1.52 million in 2023. In 2023, OHCHR issued a report on drug policy urging countries to ‘consider developing a regulatory system for legal access to all controlled substances’ [&lt;span&gt;8&lt;/span&gt;]. The UN High Commissioner recently called for ‘responsible regulation’ at a conference on the ‘sensible regulation of drugs’ [&lt;span&gt;9&lt;/span&gt;]. This echoes the views of the OSF funder and conflicts with a current UN Convention.&lt;/p&gt;&lt;p&gt;A decade ago, Forbes magazine declared George Soros to be the biggest drug reformer in the United States [&lt;span&gt;10&lt;/span&gt;]. This influence now appears truly global, OSF attending this CND meeting with an army of over 50 NGOs and UN offices who are financially beholding to his think-tank.&lt;/p&gt;&lt;p&gt;Some of the funded entities at the CND meeting are university based and contribute research on drug policy. OSF additionally funds other","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1284-1285"},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}