Addiction最新文献

{"title":"Interventions to change vaping harm perceptions and associations between harm perceptions and vaping and smoking behaviours: A systematic review.","authors":"Katherine East, Erikas Simonavičius, Eve V Taylor, Leonie Brose, Deborah Robson, Ann McNeill","doi":"10.1111/add.70129","DOIUrl":"https://doi.org/10.1111/add.70129","url":null,"abstract":"<p><strong>Aims: </strong>To synthesize and describe the evidence from among young people and adults to assess: (i) what interventions have been effective in changing vaping harm perceptions; and (ii) to what extent vaping harm perceptions predict any changes in vaping and smoking behaviours.</p><p><strong>Methods: </strong>Systematic review searching five databases (Embase, PsycINFO, Medline, CINAHL, Scopus) from January 2007 to January 2023. Eligible studies reported quantitative data with >1 time point among young people (sample majority aged <18 years) or adults (sample majority aged ≥18 years). Interventions were considered if they communicated vaping harms, categorized as relative (vaping vs smoking) or absolute (vaping vs not vaping). Outcomes were changes in: (i) vaping (absolute, relative) or nicotine harm perceptions; (ii) vaping or smoking behaviours. Evidence was synthesized narratively.</p><p><strong>Results: </strong>Eighty-five articles were included, of which 46 assessed interventions to change vaping harm perceptions and 39 assessed associations between harm perceptions and subsequent vaping/smoking behaviours. All studies among young people and most among adults were from the USA. Interventions aimed at young people typically communicated that vaping and nicotine are harmful/addictive (absolute harms), often in the form of educational programmes and media campaigns. Interventions aimed at adults typically communicated that vaping is harmful but less harmful than smoking (relative harms), often via written materials and educational workshops. In addition to methodological and analytical heterogeneity, risk of bias was high; hence findings should be interpreted with caution. Generally, interventions appeared to be effective in changing perceptions that reflected the intervention content among young people (12/14 studies) and adults (24/32 studies), at least in the short-term (38/46 studies only assessed the outcome pre- and immediately post-intervention). Interventions communicating that vaping is harmful and addictive (absolute harms) increased perceptions that vaping is harmful and addictive among young people (12/14) and adults (16/23 studies) and also increased the misperception that vaping is as harmful as smoking (relative harm) among young people (2/2 studies) and adults (5/8 studies). There was also some evidence that both absolute and relative harm perceptions predicted vaping and smoking behaviours, such that perceiving vaping as harmful deterred vaping among both young people (8/9 studies) and adults (4/7 studies), while misperceiving vaping as equally/more harmful than smoking prevented adults from quitting smoking (5/6 studies).</p><p><strong>Conclusions: </strong>Interventions to change vaping harm perceptions appear to be effective. Vaping harm perceptions appear to predict vaping and smoking behaviours.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705755","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":"The effectiveness of Individual Placement and Support on vocational outcomes for patients with substance use disorders: A pragmatic superiority randomized controlled trial of Individual Placement and Support versus enhanced self-help.","authors":"Eline Borger Rognli, Kristoffer Andreas Aamodt Andersen, Erlend Marius Aas, Silje Endresen Reme, June Ullevoldsæter Lystad, Marianne Riksheim Stavseth, Espen Ajo Arnevik","doi":"10.1111/add.70155","DOIUrl":"https://doi.org/10.1111/add.70155","url":null,"abstract":"<p><strong>Background and aim: </strong>Unemployment rates among individuals with substance use disorders (SUD) are high, and evidence-based vocational methods are lacking. Employment is important because it improves treatment outcomes and protects against relapse. Individual Placement and Support (IPS) has proven effective in helping patients with psychosis obtain competitive employment. We aimed to investigate the effectiveness of IPS on vocational outcomes for patients with SUD.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Setting: </strong>SUD treatment units at Oslo University Hospital, Norway.</p><p><strong>Participants: </strong>Patients with SUD who wanted to obtain competitive employment. A total of 202 SUD patients were included in the trial, of which eight withdrew consent, five died and two were erroneously included, giving a modified intention to treat analysis set of 187 participants, of which 91 were randomized to IPS and 96 to the enhanced control group condition.</p><p><strong>Intervention and comparator: </strong>Treatment as usual plus IPS for up to 13 months versus treatment as usual, a self-help guidebook, a workshop of three two-hour sessions and one session of individual counselling.</p><p><strong>Measurements: </strong>Employment data were obtained from Statistics Norway and linked with study data. Primary outcome was at least one day of competitive employment during an 18-month period after inclusion in the trial. Secondary employment-related outcomes described job tenure, number of different jobs, hours worked and employment earnings during the same period.</p><p><strong>Findings: </strong>There was no difference between the groups in the main outcome [39.6% vs. 34.4%; odds ratio (OR) = 1.28, 95% confidence interval (CI) = 0.70-2.35], but participants in the IPS group worked more hours (601 vs. 344; b = 330, 95% CI = 25-635) and had higher total salary in Norwegian krone (141 000 vs 73 000; b = 94 000, 95% CI = 17000-170 000) than control group participants. Control group participants were more likely to receive services from the Social and Welfare Services (53.1% vs. 27.5%; OR = 2.99, 95% CI = 1.64-5.57).</p><p><strong>Conclusion: </strong>In this randomized controlled trial of Individual Placement and Support (IPS) versus enhanced self-help for individuals with substance use disorders in Norway, there was no difference between groups regarding job acquisition, defined as at least one day of competitive employment during an 18-month period; however, IPS participants worked more hours and earned a higher total salary than control group participants.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697164","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":"Psilocybin in alcohol use disorder and comorbid depressive symptoms: Results from a feasibility randomized clinical trial.","authors":"Amandine Luquiens, Dahbia Belahda, Carine Graux, Noe Igounenc, Chris Serrand, Paul Rochefort, Thibault Mura, Felix Sergent","doi":"10.1111/add.70152","DOIUrl":"https://doi.org/10.1111/add.70152","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Psilocybin has emerged as a potential treatment for alcohol use disorder (AUD), but early efficacy data are inconsistent. Depression following alcohol detoxification significantly increases the risk of relapse. This pilot study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of psilocybin-assisted psychotherapy for patients with comorbid AUD and depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A prospective, single-center, double-blind, parallel (2:1), randomized controlled pilot study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study was conducted in a French inpatient addiction treatment program offering intensive relapse prevention interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Of 350 screened patients, 30 adults (mean age 49 ± 10 years; 43% female) with severe AUD (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5] criteria) and a Beck Depression Inventory-II (BDI-II) score ≥14 were included. Participants had completed detoxification between 14 and 60 days prior to inclusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Participants received either two oral sessions of 25 mg (n = 20) or 1 mg (n = 10) psilocybin-assisted psychotherapy spaced three weeks apart, as an add-on to standard care. Patients, investigators and outcome assessors were all blinded to patient group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;The primary outcome was feasibility, according to participation in both dosing sessions and recruitment/inclusion rates. Secondary outcomes included alcohol use (Alcohol Timeline Followback), time to relapse, craving (Craving Experience Questionnaire), depression (BDI-II), safety and blinding integrity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;One participant in the 25 mg group could not receive the second dose due to myocardial infarction occurring three days earlier, unrelated to the treatment. Four participants in the control group refused the second session after guessing their group assignment (p-value = 0.019), with one participant self-administering 3,4-Methylenedioxymethamphetamine (MDMA). At 12 weeks, the 25 mg group showed significantly greater abstinent rate (11/20 (55%) vs 1/9 (11%) (one lost of follow up) (difference = -44%, [95% confidence interval [CI]: -82% to -5.9%]), p = 0.043), reductions in % drinking days -100 (-100 to -49) vs - 93 (-96 to 0), p = 0.038 and craving frequency -8 (-23 to -1) vs + 7 (-2 to 11), p = 0.045, respectively in the 25 vs 1 mg groups (median [25;75]). Relapse rates were 35% in the 25 mg group and 50% in the control group (HR = 0.52 [0.16 to1.65]). No efficacy differences were observed based on antidepressant use in terms of drinking and depression. Blinding was imperfect (correct guess by patients: 93.3%; investigators: 86.7%). Twenty-five adverse events were reported in 10 patients (50%) in the 25 mg group versus 6 patients (60%) in the control group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Psilocybin-assisted psychotherapy appears","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697162","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":"Are cannabis policy changes associated with alcohol use patterns? Evidence for age-group differences based on primary care screening data.","authors":"Natalia Van Doren, Felicia W Chi, Kelly C Young-Wolff, Derek D Satre, Stacy A Sterling","doi":"10.1111/add.70134","DOIUrl":"https://doi.org/10.1111/add.70134","url":null,"abstract":"<p><strong>Background and aims: </strong>In California, USA, adult cannabis legalization (ACL) was passed in 2016, with implementation of legal sales commencing in 2018. This study examined whether these policy changes were associated with changes in alcohol use patterns and explored age-group differences.</p><p><strong>Design: </strong>We examined monthly rates of positive alcohol screens in primary care patients in California from 2015 to 2019. Using an interrupted time series design and autoregressive integrated moving average (ARIMA) models, changes were evaluated in the overall sample and stratified by age groups (21-34, 35-64 and 65+) across two key intervention points for ACL: 9 November 2016 (ACL passage) and 1 January 2018 (ACL implementation). Time-varying confounders of seasonality and autocorrelation were controlled for.</p><p><strong>Setting: </strong>California, United States; Kaiser Permanente Northern California Healthcare System.</p><p><strong>Participants: </strong>Across the study period, n = 8 028 627 screenings were completed for  n= 3 525 493 unique patients aged 21+ .</p><p><strong>Measurements: </strong>Aggregated monthly rates of patients exceeding daily limits, weekly limits, exceeding both daily and weekly limits and frequent heavy episodic drinking (HED), based on current US guidelines set by the National Institute on Alcohol Abuse and Alcoholism.</p><p><strong>Findings: </strong>Statistically significant, gradual declines in rates of both exceeding weekly alcohol limits [estimate (95% confidence interval [CI]) of slope change = -0.013(-0.019 to -0.008), P < 0.001] and frequent HED followed ACL passage [estimate (95% CI) of slope change = -0.015(-0.024 to -0.005), P = 0.003]. ACL implementation was generally not associated with further changes, suggesting changes after ACL passage were sustained over time. Age-group patterns varied: young adults (21-34) demonstrated an immediate increase, followed by a statistically significant gradual decline in rates of HED post-ACL passage [estimate (95% CI) of slope change = -0.096(-0.160, -0.033), P = 0.003], as well as an immediate decrease post ACL implementation; adults 35-49 showed consistent declines in step and slope in rates of frequent HED post ACL passage; adults 50-64 showed an immediate increase in rates of exceeding weekly limits [estimate (95% CI) of step change = 0.167(0.036-0.297), P = 0.012], with gradual declines in the other drinking limits; adults 65 + had small, gradual decreases. In addition, exploratory analyses in 18-20-year-olds showed gradual increases in rates of frequent HED post ACL passage, but the P value was not significant after Bonferroni correction.</p><p><strong>Conclusions: </strong>Cannabis policy changes in California, USA, appear to be linked to age-specific changes in alcohol use, with moderate reductions, particularly among middle-aged adults. Findings were associative in nature and causality could not be determined.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705754","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":"Significant changes in preference of illicit drug use in a population of Hanoi, Vietnam-A 6-year wastewater study (2018-2023).","authors":"Tran Thi Thanh Hue, Hieu K T Ngo, Zhe Wang, Nguyen Thi Kieu Anh, Vu Ngan Binh, Ngo Quang Trung, Pham Quoc Chinh, Hai Thanh Luong, Qiuda Zheng, Wayne Hall, Phong K Thai","doi":"10.1111/add.70147","DOIUrl":"https://doi.org/10.1111/add.70147","url":null,"abstract":"<p><strong>Background and aim: </strong>Illicit drug use causes great harm and economical loss to society, yet there is limited understanding of its prevalence in the population in low-income countries like Vietnam where survey resources are scarce. In this study, we used wastewater analysis as a cost-effective monitoring tool to measure illicit drug use in a population of Hanoi, Vietnam, a low-income country in Southeast Asia.</p><p><strong>Design, setting and participants: </strong>This is a longitudinal observational study. Wastewater samples were collected at a sewage canal serving > 430 000 people, in Hanoi, Vietnam, over a six-year period (2018-2023).</p><p><strong>Measurements: </strong>Drug biomarkers for amphetamine, methamphetamine, 3,4-Methylenedioxymethamphetamine (MDMA), ketamine, morphine, codeine and benzoylecgonine were measured using liquid chromatography-tandem mass spectrometry via direct injection. The results were used to back-estimate per capita drug consumption. Together with an evaluation of general temporal trend, an interrupted time series analysis using segmented linear regression was conducted to examine the potential changes in drug use associated with the post-COVID-19 restriction.</p><p><strong>Findings: </strong>There was a statistically significant decrease in methamphetamine use, with annual averages declining from a peak value of 359.2 to 125.6 mg/day/1000 people between 2018 and 2023 (P < 0.001). In contrast, ketamine use increased statistically significantly, rising from 149.7 to 465.9 mg/day/1000 people over the study period (P < 0.001), making it the most commonly used illicit drug. Cocaine and heroin use levels remained relatively low, while MDMA use was relatively stable over time. In the post-COVID-19 restriction period, declines were observed in methamphetamine, MDMA, cocaine and codeine consumption; however, only cocaine [Coefficient (standard error, SE) = -1.9 (0.9), P = 0.034] and codeine [Coefficient (SE) = -42.4 (12.4), P = 0.001] showed statistically significant downward trends. In contrast, ketamine and heroin consumption exhibited slight but non-significant increases, suggesting limited disruption during the post-restriction period.</p><p><strong>Conclusions: </strong>Wastewater analysis shows that the market of illicit drugs in Vietnam is dynamic and shifting toward synthetic drugs. Methamphetamine replaced heroin as the substance with the highest estimated per capita use in Vietnam from 2018 to 2020 and was subsequently overtaken by ketamine by the end of 2022. Wastewater analysis can provide information on population use of multiple substances, including changes due to different factors in a cost-effective way, which is essential in data-poor countries.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697163","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: An evolving unregulated drug landscape, care setting considerations, and the need for research.","authors":"James S H Wong, Anthony Lau, Pouya Azar","doi":"10.1111/add.70144","DOIUrl":"https://doi.org/10.1111/add.70144","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697161","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":"Healthcare provider stigma toward patients with substance use disorders.","authors":"Carrigan L Parish, Daniel J Feaster, Harold A Pollack, Viviana E Horigian, Xiaoming Wang, Petra Jacobs, Margaret R Pereyra, Christina Drymon, Elizabeth Allen, Lauren K Gooden, Carlos Del Rio, Lisa R Metsch","doi":"10.1111/add.70122","DOIUrl":"https://doi.org/10.1111/add.70122","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;The overdose epidemic accounts for more than 89 000 deaths across the United States annually. Despite the availability of medications and therapies to treat substance use disorders (SUD), most people remain untreated. Stigma towards treating patients with SUD has been identified as a potential barrier to SUD treatment. This study aimed to quantify the prevalence and intensity of provider stigma towards patients with SUD, by substance use type and compared with other conditions, and its relationship to providers' clinical practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;National probability sample survey (October 2020-October 2022).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;USA; online/paper questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Primary care (PCPs) and emergency medicine physicians (EMPs) and dentists randomly selected from the American Medical and Dental Associations. Data were collected from 1240 participants (Council of American Survey Research Organizations response rate 53.6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;The main outcome was self-reported provider stigma towards people with SUD, assessed by the Medical Condition Regard Scale. Providers indicated their agreement with 11 statements concerning three SUD categories [opioids (OUD), stimulants, alcohol (AUD)], Type II diabetes, depressive disorder and HIV. Mixed models compared stigma levels across conditions and by clinician group. Clinicians were assessed about their screening, referral and treatment practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The lowest stigma rating was for diabetes (mean = 23.2; standard deviation = 6.5) and the highest for stimulant use disorders (mean = 36.3; standard deviation = 10.7). Stigma towards OUD was statistically significantly higher than AUD [effect size (ES) = 0.49, 95% confidence interval (CI) = (0.42-0.57), P &lt; 0.001], while stigma towards stimulant use disorders was statistically significantly higher than OUD [ES = 0.11, 95% CI = (-0.04 to 0.19), P &lt; 0.004]. EMPs had statistically significantly higher stigma scores than PCPs (P &lt; 0.001), while PCPs reported significantly higher stigma scores than did dentists (P &lt; 0.014). Lower stigma scores were associated with provision of SUD referrals [ES = -0.37, 95% CI = (-0.66 to -0.07)], providing medications for OUD [stigma scores: AUD (ES = -0.44, 95% CI = [-0.73 to -0.15]), OUD (ES = -1.26, 95% CI = [-1.55 to -0.97]) and stimulant use disorder (ES = -0.73, 95% CI = [-1.02 to -0.44])] and having available SUD consultation [stigma scores: AUD (ES = -0.48, 95% CI = [-0.67 to -0.28]), OUD (ES = -0.51, 95% CI = [-0.86 to -0.37]) and stimulant use disorder (ES = -0.59, 95% CI = [-0.78 to -0.39])].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Among US primary care and emergency medicine physician workforces, provider stigma towards substance use disorders appears to be higher than for opioid, stimulant and alcohol use disorders and negatively associated with providers' clinical practi","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697160","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":"Unpacking the link between substance use disorders and 30-day unplanned readmission.","authors":"Allison D Rosen, Sae Takada, Catherine Juillard, Yulsi L Fernandez Montero, Amy M Richards, Serge Ngekeng, Steven J Shoptaw, Michelle A Bholat","doi":"10.1111/add.70136","DOIUrl":"https://doi.org/10.1111/add.70136","url":null,"abstract":"<p><strong>Background and aims: </strong>Given the more than twofold increase in the prevalence of substance use disorders in the United States in the past decade, more hospital inpatients can be expected to carry substance use disorder diagnoses, necessitating evaluation of potential links to 30-day unplanned readmissions, a marker of quality of care. This study aimed to measure the association between substance use disorder diagnoses, discharge disposition and 30-day unplanned hospital readmissions.</p><p><strong>Design: </strong>This retrospective cohort study extracted data from electronic health records of all inpatients. The index admission was defined as a patient's first admission in 2022.</p><p><strong>Setting: </strong>Two urban, academic medical centers in Los Angeles, California, USA.</p><p><strong>Participants: </strong>Among 22 108 inpatients aged 18 and over and who did not expire during the hospital stay, 7.4% had at least one substance use disorder. The median age was 58, and 56.1% identified as female. Most patients identified as white (43.3%), followed by 22.5% Hispanic/Latinx, 10.8% Asian and 9.1% Black; 14.3% identified as another race.</p><p><strong>Measurements: </strong>The exposure was diagnosis of any substance use disorder at index admission. The outcome was 30-day unplanned readmission.</p><p><strong>Findings: </strong>Patients with any substance use disorder [adjusted risk ratio (aRR) = 1.24, 95% confidence interval (CI) = 1.05-1.45) and patients specifically with opioid use disorder (aRR = 1.40, 95% CI = 1.09-1.80) were more likely to have a 30-day unplanned readmission compared with patients without substance use disorders. When assessing an interaction with discharge disposition, the association only held for patients discharged to home/self-care (aRR = 1.33, 95% CI = 1.05-1.69). Among patients who had zero, one, two and three or more unplanned readmissions, 7.1%, 8.8%, 14.0% and 15.5% had a substance use disorder at their index admission, respectively (P < 0.001).</p><p><strong>Conclusions: </strong>In the United States, hospital patients with substance use disorder diagnoses appear to have a higher risk of 30-day unplanned readmission to hospital and account for a disproportionate share of patients who have multiple unplanned readmissions than hospital patients without substance use disorder diagnoses.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688433","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":"Fatal drug overdoses in healthcare workers: A thematic framework analysis of coroner reports.","authors":"Thikra Algahtani, Siobhan Gee, Aminah Shah, Bryn D Williams, Hayley C Gorton, Sarah Welch, Caroline S Copeland","doi":"10.1111/add.70139","DOIUrl":"https://doi.org/10.1111/add.70139","url":null,"abstract":"<p><strong>Background and aims: </strong>Healthcare workers face specific vulnerabilities for drug overdose due to their unique access to medications, clinical knowledge and work-related stress. This study aimed to understand the characteristics of fatal overdoses in healthcare workers with a view to providing guidance for preventative strategies.</p><p><strong>Design, setting and cases: </strong>We retrospectively identified cases in England, Wales and Northern Ireland reported to the National Programme on Substance Use Mortality between 2000 and 2022 where decedents were working or studying within a healthcare setting at the time of their death or had previously worked in healthcare.</p><p><strong>Measurements: </strong>Quantitative analyses were conducted to report summary demographics of decedents, the circumstances of deaths and the drugs involved. A qualitative thematic framework analysis was performed to identify and explore factors that may contribute to fatal drug overdose in healthcare professionals.</p><p><strong>Findings: </strong>In the identified cases, doctors were the most represented profession (48% of cases, n = 28/58) with opioids the drug class most often implicated in causing death (43% of cases, n = 25/58). Whilst there was scant evidence of recreational drug use in the identified cases (n = 3), hospital-only medications prominently featured [propofol in 29% (n = 17/58); midazolam in 10% (n = 6/58); neuromuscular blocking agents in 9% (n = 5/58)]. Qualitative analysis identified seven themes including accessing drugs from the workplace, use of skills and/or equipment for intravenous drug administration, obtainment of private prescriptions, diagnosed mental health conditions, recent events likely to have negatively impacted mental health, chronic pain and self-medicating and history of substance use disorder and/or overdose.</p><p><strong>Conclusions: </strong>The characteristics of fatal drug overdoses among healthcare workers in England, Wales and Northern Ireland appear to differ from those observed in the overall population of people who use drugs in the UK. To prevent such deaths, it is important that healthcare workers can access bespoke care and support tailored to the specific challenges that they face.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688432","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":"Changes to our instructions to authors.","authors":"","doi":"10.1111/add.70149","DOIUrl":"https://doi.org/10.1111/add.70149","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673424","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}