Addiction最新文献

{"title":"Safety and effectiveness of rapid methadone titration protocols in opioid use disorder: A systematic review.","authors":"Jean Zhuo Wang, Brittany Dennis, Ashish P Thakrar, Sukhpreet Klaire, Paxton Bach","doi":"10.1111/add.70684","DOIUrl":"https://doi.org/10.1111/add.70684","url":null,"abstract":"<p><strong>Background and aims: </strong>Methadone is an effective, first-line treatment for opioid use disorder. Guidelines recommend slow titration to minimize the risk of methadone toxicity, a process exposing patients to sub-therapeutic doses for weeks to months. Protocols that titrate more rapidly reduce the time to achieving a therapeutic dose. This systematic review evaluated the safety and effectiveness of rapid methadone titrations in patients with opioid use disorder.</p><p><strong>Method: </strong>Systematic review of prospective and retrospective studies of patients undergoing rapid methadone titration for treatment of opioid use disorder. Both outpatient and inpatient/acute settings were included.</p><p><strong>Results: </strong>A total of 4297 records were screened from MEDLINE, EMBASE, Cochrane CENTRAL and PsycINFO. Following the initial screen, 79 texts were reviewed in full, with 29 studies included in the review, representing 16 154 participants. A wide variety of rapid titration schedules were described across inpatient and outpatient settings. A common protocol (6 studies) started at 30-40 mg, with additional 10 mg every 3-4 hours as needed up to 50-80 mg on day 1. Average dose on day 7 ranged from 53 to 97 mg across 5 randomised controlled trials/cohort studies (n = 14 758) and from 60 to 200 mg in 5 case series/case reports (n = 124). Among 26 studies reporting on mortality (n = 1431), there were 63 deaths in 3 outpatient studies over 2-180 days after starting methadone; 61 deaths were from 2 case series that specifically selected cases of death from coroner reports. Among all 18 studies conducted in the fentanyl era (post-2013, n = 705), and all 18 inpatient studies from any time period (n = 604) reporting on mortality, there were no deaths reported. Overdose rates were less than 1% across all studies and sedation events were often mild, with most patients continuing methadone. One study found a correlation between improved retention rates and higher methadone doses during the first week of initiation. Pooled analysis could not be performed due to substantial heterogeneity across studies.</p><p><strong>Summary: </strong>A wide range of rapid methadone titration protocols for opioid use disorder are described in the literature, with generally low-quality evidence and little standardization in protocols or evaluations. Overall adverse events were rare, particularly with rapid methadone titration in the fentanyl era and during inpatient admissions. Data on retention in treatment and changes in unregulated drug use were limited.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149339904","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":"Drug and alcohol testing in children's social services: A mixed-methods exploratory study","authors":"Kaisha Benjamin,&nbsp;Sam Burton,&nbsp;Polly Radcliffe","doi":"10.1111/add.70648","DOIUrl":"https://doi.org/10.1111/add.70648","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331252","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":"Implementation and early impacts of the housing support grant for people who use alcohol and/or other drugs in England","authors":"Jennifer Newbould,&nbsp;Kayleigh Sharp,&nbsp;Jennifer Bousfield,&nbsp;Avery Adams,&nbsp;Jessica Dawney,&nbsp;Alessandro Grosso,&nbsp;William D. Phillips,&nbsp;Lucy Strang,&nbsp;Tom Ling,&nbsp;Jon Sussex,&nbsp;Katherine I. Morley,&nbsp;Nicola Kalk,&nbsp;Joanne Neale,&nbsp;John Strang,&nbsp;Jennifer Bostock,&nbsp;Andrew Jones,&nbsp;Tim Millar","doi":"10.1111/add.70647","DOIUrl":"https://doi.org/10.1111/add.70647","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":"S18-S19"},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331251","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":"Residential harm reduction and overdose outcomes in Glasgow: A retrospective cohort study","authors":"Lee Middleton,&nbsp;Trina Ritchie","doi":"10.1111/add.70649","DOIUrl":"https://doi.org/10.1111/add.70649","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331448","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":"A cross-lagged analysis of measured and self-estimated intoxication: Mobile health data from a large United States sample examined 2016 to 2022.","authors":"Yang Lu, Catharine E Fairbairn, Jiaxu Han, Nigel Bosch","doi":"10.1111/add.70681","DOIUrl":"https://doi.org/10.1111/add.70681","url":null,"abstract":"<p><strong>Background and aims: </strong>Feedback from mobile health technologies can facilitate self-awareness of intoxication among substance users, thereby reducing risky decision-making and potentially moderating consumption; however, real-world effects of mobile device engagement among drinkers remain underexamined. The current study leveraged longitudinal data from mobile breathalyzers via cross-lagged analyses to examine reciprocal pathways between breath alcohol concentration (BrAC) levels and BrAC self-estimation error.</p><p><strong>Design: </strong>Observational study analyzing BrAC data collected via mobile breathalyzers and shared by the device manufacturer.</p><p><strong>Setting: </strong>Participants were mobile breathalyzer users located within the United States from January 1, 2016, to February 28, 2022, who voluntarily submitted data during active real-world drinking episodes.</p><p><strong>Participants: </strong>18 800 unique user accounts provided a total of 387 643 breathalyzer readings.</p><p><strong>Measurements: </strong>BrAC self-estimation error was calculated as the absolute difference between a measured BrAC level and the corresponding BrAC self-estimation.</p><p><strong>Results: </strong>Results of cross-lagged models indicated an asymmetrical relationship between BrAC levels and self-estimation error. In moment-to-moment analyses, a 0.02 increase in BrAC level at the preceding time point predicted a 2.35% increase in self-estimation error at the following time point, b = 1.16, p < 0.001, 95% confidence interval (CI) [1.08, 1.25]. Conversely, after participants received BrAC feedback, a 0.02 increase in self-estimation error predicted a subsequent 1.15% decrease in BrAC level, b = -0.58, p < 0.001, 95% CI [-0.64, -0.52]. Similarly, a tendency to underestimate at earlier time points predicted later decreases in BrAC levels, b = -0.07, p < 0.001, 95% CI [-0.08, -0.07].</p><p><strong>Summary: </strong>There appears to be a reciprocal, albeit asymmetrical, relationship between objectively measured (via mobile breathalyzer) and subjectively self-estimated intoxication. When drinkers are provided breath alcohol concentration feedback, inaccuracies in self-estimated intoxication are followed by behavioral adjustments in real-world drinking contexts.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331749","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":"Co-designing and evaluating youth cannabis health literacy materials under public attitude shifts","authors":"Caitlin McClure-Thomas,&nbsp;Tesfa Yimer,&nbsp;Gary Chan,&nbsp;Tom Freeman,&nbsp;Jason Connor,&nbsp;Janni Leung","doi":"10.1111/add.70640","DOIUrl":"https://doi.org/10.1111/add.70640","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331351","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":"Improving treatment attendance, engagement, and outcomes for people with dual diagnoses of psychosis and substance use problems: A cluster randomised feasibility study of contingency management and peer support (COMPEERS)","authors":"Nicola Metrebian,&nbsp;Suzanne Jolley,&nbsp;Ewan Carr,&nbsp;Sarah Nilsen,&nbsp;Tim Weaver,&nbsp;James Shearer,&nbsp;Sarah Strong,&nbsp;James Duffy","doi":"10.1111/add.70650","DOIUrl":"https://doi.org/10.1111/add.70650","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":"S22-S23"},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331393","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":"Behavioural economics of gambling harm: Gambling purchase demand and drift-diffusion modelling of value-based decision-making","authors":"Chenji Gu,&nbsp;Matt Field,&nbsp;Jamie Torrance,&nbsp;Martyn Quigley,&nbsp;Simon Dymond","doi":"10.1111/add.70656","DOIUrl":"https://doi.org/10.1111/add.70656","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331445","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":"Analysis of methadone-related mortality after COVID-19 service changes in England: Lessons for future opioid substitution treatment delivery","authors":"Caroline Copeland,&nbsp;Irma Gasparini-Andre,&nbsp;Nafeesa Rahman,&nbsp;Daniary Aldabergenov,&nbsp;Nicola J. Kalk,&nbsp;John Strang,&nbsp;Jenny Scott","doi":"10.1111/add.70644","DOIUrl":"https://doi.org/10.1111/add.70644","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":"S13-S14"},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331455","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":"Implementation of the treatment and recovery portfolio of the ‘From Harm to Hope’ drug strategy in England: Results from a process evaluation","authors":"Lucy Strang,&nbsp;Sarah Parkinson,&nbsp;Jessica Dawney,&nbsp;Fifi Olumogba,&nbsp;Fin Oades,&nbsp;Jennifer Newbould,&nbsp;Katherine Morley,&nbsp;Jennifer Bostock,&nbsp;Andrew Jones,&nbsp;Nicola Kalk,&nbsp;Tom Ling,&nbsp;Tim Millar,&nbsp;Joanne Neale,&nbsp;John Strang,&nbsp;Jon Sussex","doi":"10.1111/add.70646","DOIUrl":"https://doi.org/10.1111/add.70646","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 S1","pages":"S16-S17"},"PeriodicalIF":5.9,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149331250","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}