Addiction最新文献

{"title":"Commentary on Kersbergen et al.: Same Price, same choices? Proportional pricing and the heaviest drinkers","authors":"Robyn Burton, Nick Sheron","doi":"10.1111/add.70046","DOIUrl":"10.1111/add.70046","url":null,"abstract":"<p>Kersbergen <i>et al</i>. [<span>1</span>] provide experimental evidence that proportional pricing—where alcohol is priced consistently per litre across different package sizes of the same brand—can shift purchasing preferences toward smaller products in hypothetical scenarios. While this approach changes purchasing incentives, it does not directly address the affordability of cheap or high-strength alcohol. These limitations raise important questions about its effectiveness, particularly for the heaviest drinkers.</p><p>Heavy daily drinkers face exponentially higher risks of alcohol-related harm [<span>2</span>], making them a key target for policy intervention. They typically seek out the cheapest alcohol [<span>2-4</span>], but were not included in Kersbergen <i>et al</i>. [<span>1</span>] study. Unlike minimum unit price (MUP), which directly raises the price of the lowest-cost alcohol [<span>5, 6</span>], proportional pricing removes bulk discounts within brands, but does not necessarily increase the absolute price of the cheapest products.</p><p>From a public health perspective, stronger alcohol should cost more because of its greater harm potential. A typical serving of wine results in a higher peak blood alcohol concentration than beer, whereas for spirits, the peak is nearly twice that of beer and reached more quickly [<span>7</span>]. Volumetric taxation, recently adopted in the United Kingdom [<span>8</span>], links price to alcohol content, making higher-strength products relatively more expensive and discouraging excessive consumption [<span>9, 10</span>]. In contrast, proportional pricing equalises cost per litre within brands but does not account for alcohol strength. As a result, a stronger product may still be cheaper per unit than a weaker one, depending on retailer pricing strategies.</p><p>Proportional pricing raises the cost of larger products by aligning their per-litre price with smaller equivalents, but its impact on real-world pricing strategies remains uncertain. Retailers have previously adapted to policy changes, as seen following Scotland's multi-buy discount ban, where straight (single unit) discounts became more common [<span>11, 12</span>]. A similar response could occur if retailers offset price increases for larger products by reducing the per-litre costs of smaller ones. If so, the overall cost of alcohol would remain unchanged, limiting the policy's impact.</p><p>A further consideration is how heavy daily and dependent drinkers purchase alcohol. While there is limited research on portion sizes in this group, anecdotal clinical experience suggests that some may buy alcohol daily in quantities just sufficient for that day. This may be an attempt to manage their consumption, as purchasing a larger volume intended to last multiple days could result in it being consumed more quickly than planned. If proportional pricing were to reduce the cost of smaller portions, this could unintentionally make alcohol more affor","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"871-872"},"PeriodicalIF":5.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707794","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":"Reviewers","authors":"","doi":"10.1111/add.70056","DOIUrl":"https://doi.org/10.1111/add.70056","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"1064-1066"},"PeriodicalIF":5.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818787","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":"How effective are remote and/or digital interventions as part of alcohol and drug treatment and recovery support? A systematic review and meta-analysis.","authors":"Irene Kwan, Helen Elizabeth Denise Burchett, Wendy Macdowall, Preethy D'Souza, Claire Stansfield, Dylan Kneale, Katy Sutcliffe","doi":"10.1111/add.70021","DOIUrl":"https://doi.org/10.1111/add.70021","url":null,"abstract":"<p><strong>Background and aims: </strong>Although remote drug/alcohol interventions have been widely reviewed, their effectiveness specifically for people in treatment remains unclear. We aimed to systematically review the effectiveness of remote interventions (delivered by telephone or computer) in alcohol/drug treatment and recovery support.</p><p><strong>Methods: </strong>We searched 29 databases including Medline and PsycINFO for randomised controlled trials (RCTs) of remote interventions for adults diagnosed with alcohol/drug use disorder conducted in Organization for Economic Co-operation and Development (OECD) countries published 2004-2023. We grouped interventions according to whether they supplemented or replaced/partially replaced in-person care. We used random effects meta-analyses to estimate pooled odds ratios (OR) for relapse, and standardised mean differences (SMD) for days of alcohol/drug use. We appraised outcomes using Cochrane Risk of Bias 2.</p><p><strong>Results: </strong>We identified 34 RCTs (6461 participants) evaluating 42 remote interventions, with diverse therapeutic approaches. Over 70% of outcomes were judged to be at high risk-of-bias. When remote interventions supplemented in-person care, there was a 39% lower odds of relapse [17 interventions; OR 0.61; 95% confidence interval (CI) = 0.46, 0.81; P = 0.001; I² = 40.3%) and a reduction in the mean days of use (17 interventions; SMD -0.18; 95% CI = -0.28 to -0.08; P = 0.001; I² = 27.3%) compared with in-person care alone. When remote interventions replaced/partially replaced in-person care, there was a 49% lower odds of relapse (7 interventions; OR 0.51; 95% CI = 0.34, 0.76; P = 0.001; I² = 39.7%) and a very slight and uncertain reduction in mean days of use (8 interventions; SMD -0.08; 95% CI = -0.24 to 0.07; P = 0.301; I² = 48.4%) compared with in-person care. Subgroup analyses by type of substance and therapeutic approach were mixed and inconclusive.</p><p><strong>Conclusions: </strong>Remote interventions which supplement in-person alcohol/drug treatment appear to reduce relapse and days of use. The evidence is less conclusive regarding remote interventions that replace/partially replace in-person care due to a smaller body of evidence and uncertainty (days of use). High risk-of-bias means findings should be interpreted with caution.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699198","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":"Identifying relevant intersections in relation to motivation and attempt to stop smoking by using a combination of methods to develop robust predictive models and resampling techniques: A cross-sectional study of the German population.","authors":"Sabina Ulbricht, Adrian Richter, Daniel Kotz, Sabrina Kastaun","doi":"10.1111/add.70045","DOIUrl":"https://doi.org/10.1111/add.70045","url":null,"abstract":"<p><strong>Aims: </strong>To illustrate robust intersections of co-occurring factors for two predictors of smoking cessation, motivation to stop smoking (MTSS) and past year-quit attempts (QA), by using means to develop robust predictive models such as bootstrap resampling, scoring rules to evaluate the predictive accuracy and spline functions.</p><p><strong>Design, setting and participants: </strong>Cross-sectional data from the German Study on Tobacco Use (DEBRA). Past-years smokers (≥18 years, n = 13 245) from 22 survey waves (2016-2020) were included. The sample (mean age 46.8 years, 46.7% women) was randomly divided into learning (70%) and validation data (30%). Less than 20% in both data sets had tried to stop smoking within the preceding 12 months.</p><p><strong>Measurements: </strong>Multinomial regression (for MTSS) and logistic regression (for QA) were used to evaluate whether age, sex, education, monthly net household income per person and the region of residence form intersections with relevant differences in the two outcomes.</p><p><strong>Findings: </strong>MTSS compared with the absence of MTSS was associated with middle [95% confidence interval (CI) = 1.02-1.39] and high education (95% CI = 1.37-1.98). Regarding MTSS, the highest probabilities were observed in participants aged 30 to 50 years from lower and middle (30-40 years) income groups. Regarding QA, the probability of at least one past-year QA was highest in females aged between 20 and 40 years and independent from educational level. Similar probabilities in males were seen only among those from the highest educated group. The predictive accuracy of the results was reduced by 3.1% for MTSS and 3.4% for QA when comparing learning with validation data.</p><p><strong>Conclusions: </strong>This German study provides compelling evidence linking highest motivation to stop smoking to those aged 30 to 50 years with lower or middle household income. Regardless of educational level, females' probabilities of reporting at least one past-year quit attempt appears to be highest in those aged 20 to 40 years. These findings highlight the need for adopting an intersectional approach when studying predictors of smoking cessation.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672974","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":"Current and future trends in the consumption, sale and purchasing of alcohol-free and low-alcohol products in Great Britain, 2014 to 2023.","authors":"Luke B Wilson, Abigail K Stevely, Inge Kersbergen, Ellen McGrane, Esther C Moore, Rob E Pryce, Jamie Brown, John Holmes","doi":"10.1111/add.70041","DOIUrl":"https://doi.org/10.1111/add.70041","url":null,"abstract":"<p><strong>Background and aims: </strong>The UK Government has committed to reducing alcohol consumption by 2025 through increasing the availability of alcohol-free and low-alcohol (no/lo) drinks. This study estimated current and future trends in key indicators of the availability, sale, purchasing and consumption of no/lo products in Great Britain.</p><p><strong>Design: </strong>Seasonal autoregressive integrated moving average models of market research data and repeat-cross-sectional survey data on alcohol consumption.</p><p><strong>Setting: </strong>Great Britain (England, Scotland and Wales), January 2014-December 2025.</p><p><strong>Participants/measurements: </strong>The study used population-level data on no/lo product availability and sales in the on-trade (e.g. bars, pubs, clubs, restaurants), as well as the off-trade (e.g. supermarkets and convenience stores) (2014-2023), continuous household panel data on purchasing (n ≈ 30 000; 2018-2023) and repeat-cross-sectional survey data on consumption (n ≈ 80 000, 2020-2024) to construct monthly time series for seven indicators. It described current trends and forecast them to December 2025.</p><p><strong>Findings: </strong>All indicators showed increasing trends to 2025. The forecast level of each indicator in December 2025 was: Indicators 1 and 2: Percentage of alcoholic drinks sales volume that is no/lo products: 2.3% (50% Prediction Interval 2.1%-2.9%, off-trade) and 1.0% (50% Prediction Interval 0.8%-1.1%, on-trade); Indicator 3: Percentage of pubs selling draught no/lo products: 6.8% (50% Prediction Interval 6.1%-7.5%); Indicator 4: Percentage of households purchasing off-trade no/lo products but not alcoholic products: 12.3% (50% Prediction Interval 10.9%-13.6%); Indicator 5: Percentage of higher alcohol purchasing households that are increasing off-trade purchasing of no/lo products: 24.3% (50% Prediction Interval 21.3%-30.6%); Indicator 6: Percentage of households increasing off-trade purchasing of no/lo products and decreasing purchasing of alcoholic products: 1.8% (50% Prediction Interval 0.8%-2.8%); Indicator 7: Percentage of risky drinkers using no/lo products in most recent cut-down attempt: 42.4% (50% Prediction Interval 37.2%-53.3%).</p><p><strong>Conclusions: </strong>Consumption of alcohol-free and low-alcohol drinks is increasing in Great Britain but predicted to remain low in 2025 (estimated at 1.0% of on-trade and 2.3% of off-trade alcohol sales volume in servings by the end of 2025). There is some evidence that people are using no/lo drinks in attempts to reduce their alcohol consumption.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668552","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":"Considerations for implementing high-dose buprenorphine for opioid use disorder","authors":"Suhanee Mitragotri,&nbsp;David T. Zhu","doi":"10.1111/add.70051","DOIUrl":"10.1111/add.70051","url":null,"abstract":"&lt;p&gt;Stringfellow &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] investigated the association between higher doses of buprenorphine and treatment retention for patients with opioid use disorder (OUD) using a national, multi-payer cohort. In their observational cohort study analyzing data from 498 879 patients in the USA receiving treatment for OUD, they found that higher doses of buprenorphine–naloxone (24 mg, 32 mg and 40 mg) were associated with increased retention in treatment at 1, 6, 12 and 18 months. Their findings further substantiate the clinical utility of high-dose buprenorphine in improving treatment retention – a crucial consideration given that relapse rates remain high, with 40%–50% of patients returning to opioid use within 6 months of initiation [&lt;span&gt;2&lt;/span&gt;]. This is especially relevant in the context of a fentanyl-dominated illicit drug supply, where the heightened potency of fentanyl-involved overdose mixtures often necessitates more intensive treatment strategies [&lt;span&gt;3&lt;/span&gt;]. We commend Stringfellow &lt;i&gt;et al&lt;/i&gt;. for strengthening the evidence base for high-dose buprenorphine and its role in OUD treatment. If implemented thoughtfully, it could play a vital role in improving treatment retention and reducing opioid-related mortality.&lt;/p&gt;&lt;p&gt;The Veterans Health Administration (VHA) offers a valuable case study for guiding real-world implementation. As one of the largest integrated healthcare systems, the VHA has been at the forefront of piloting higher doses of buprenorphine into clinical pain management. Since 2013, the proportion of VHA patients receiving doses exceeding 24 mg/day has steadily increased, largely driven by revisions to VHA/Department of Defense pain management guidelines that allow greater prescribing flexibility [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, we believe that two key barriers must be addressed to facilitate broader adoption. First, restrictive insurance policies and inconsistent Medicaid coverage could disproportionately limit access for marginalized populations, particularly individuals with fentanyl exposure who may require higher doses for effective stabilization. Without greater parity in reimbursement, the patients who stand to benefit most may be unable to receive optimal care. Second, clinician hesitancy remains a major hurdle. Many providers may be unfamiliar or uncomfortable prescribing doses above 16 mg due to concerns over liability, regulatory scrutiny, or potential stigma associated with higher doses. Overcoming this hesitancy requires structured provider education, updated clinical guidelines, and institutional support to promote adoption. The VHA's approach – revising prescribing guidelines to enable dose escalation based on patient response – serves as a model that could be adapted across healthcare settings. Future efforts should also focus on system-level policies, such as expanding insurance coverage, clinician training, and risk mitigation strategies, to ensure safe and equitable access.&lt;/p&gt;&lt;p&gt;Amidst ","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1282-1283"},"PeriodicalIF":5.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661707","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":"Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone on treatment interruption: Comparing findings from a reanalysis of the X:BOT RCT and harmonized target trial emulation using population-based observational data.","authors":"Sara Lodi, Shapei Yan, Benjamin Bovell-Ammon, Paul J Christine, Heather E Hsu, Dana Bernson, Patricia Novo, Joshua D Lee, John Rotrosen, Jane M Liebschutz, Alexander Y Walley, Marc R Larochelle","doi":"10.1111/add.70040","DOIUrl":"https://doi.org/10.1111/add.70040","url":null,"abstract":"<p><strong>Background and aims: </strong>It is unclear if findings from randomized controlled trials (RCT) of medications for opioid use disorder apply to real-world settings. We estimated the effectiveness of buprenorphine-naloxone (BUP-NX) versus extended-release naltrexone (XR-NTX) on treatment interruption in a RCT and an observational study based on real-world data.</p><p><strong>Design: </strong>Target trial emulation to harmonize the protocol and statistical analyses of X:BOT (target trial) and the observational study (observational emulation). Baseline was randomization in the target trial and medically managed opioid withdrawal (MMOW) discharge in the observational emulation.</p><p><strong>Settings: </strong>X:BOT trial and Massachusetts Public Health Data Warehouse observational data (United States).</p><p><strong>Participants: </strong>The target trial included all X:BOT participants. The observational emulation trial included MMOW discharges from January 2014 to May 2016.</p><p><strong>Measurements: </strong>Treatment strategies were BUP-NX versus XR-NTX initiation within 28 days of baseline. The outcome was treatment interruption (earliest of treatment discontinuation, incarceration, MMOW readmission, death). We estimated the 24-week risk and risk difference.</p><p><strong>Findings: </strong>In the target trial, 94% (269/287) and 66% (187/283) of participants randomized to BUP-NX or XR-NTX initiated their assigned treatment within 28 days, respectively. In the observational emulation, BUP-NX and XR-NTX were initiated within 28 days in 9% (5209/59 076) and 3% (1813/59 076) of MMOW discharges, respectively. The adjusted 24-week treatment interruption risks (95% confidence interval) for BUP-NX and XR-NTX were 68% (60%,77%) and 72% (60%,83%) in the target trial [risk difference, -4 percentage points (pp; -17 pp,11 pp)] and 82% (81%,83%) and 93% (92%,95%) in the observational emulation [risk difference,-11 pp (-13 pp,-10 pp)].</p><p><strong>Conclusions: </strong>Buprenorphine-naloxone might be superior to extended-release naltrexone in real-world settings where the majority of people struggle to remain on medications for opioid use disorder. Buprenorphine-naloxone initiators had a lower risk of treatment interruption than extended-release naltrexone initiators in an observational emulation, but similar risks in a randomized controlled trial, although confidence intervals were wide. Trial participation, study size and residual confounding may explain these differences.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655694","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 Östh et al.: Sensor-based approaches to inform alcohol interventions – beyond BAC","authors":"Brian Suffoletto","doi":"10.1111/add.70049","DOIUrl":"10.1111/add.70049","url":null,"abstract":"&lt;p&gt;Digital health is transforming alcohol intervention, with sensor-based technologies providing continuous, objective insights beyond self-reports and clinical check-ins. The study by Östh &lt;i&gt;et al&lt;/i&gt;. highlights how breathalyzers can be incorporated into behavioral interventions to help alcohol-dependent adults curb heavy drinking. However, the potential for sensors extends far beyond measuring alcohol levels – they can anticipate drinking triggers, assess real-time impairment and track post-drinking recovery. Integrating sensors across all drinking phases enables a proactive, personalized harm reduction model.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Predicting drinking onset&lt;/b&gt;: Subtle physiological and behavioral shifts – rising stress levels [&lt;span&gt;1&lt;/span&gt;], mounting alcohol cravings [&lt;span&gt;2&lt;/span&gt;] or changes in daily routines – often signal the lead-up to a drinking event. Wearable sensors tracking heart rate variability [&lt;span&gt;3&lt;/span&gt;] and skin conductance [&lt;span&gt;4&lt;/span&gt;] can detect these internal cues, whereas external patterns, such as increased phone activity [&lt;span&gt;5&lt;/span&gt;] or movement toward alcohol-related locations [&lt;span&gt;6&lt;/span&gt;], may further indicate imminent drinking. Real-time nudges – like mindfulness exercises [&lt;span&gt;7&lt;/span&gt;] or cognitive reappraisal strategies [&lt;span&gt;8&lt;/span&gt;] – can be deployed at key moments, helping individuals disrupt habitual drinking patterns before they begin.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Measuring alcohol and effects&lt;/b&gt;: Despite the modest effects reported by Östh &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;9&lt;/span&gt;] for individuals tracking their alcohol intake using commercial breathalyzers, these devices remain imprecise in estimating blood alcohol concentration (BAC) [&lt;span&gt;10&lt;/span&gt;]. Similarly, transdermal alcohol monitors, despite significant National Institutes of Health (NIH) investment, have yet to achieve the precision needed for reliable use [&lt;span&gt;11&lt;/span&gt;]. Given these limitations, measuring the effects of alcohol on the body – rather than just its presence – offers a promising alternative or complement.&lt;/p&gt;&lt;p&gt;Recent research has shown that remote assessments of impairment, such as changes in gait [&lt;span&gt;12&lt;/span&gt;], speech [&lt;span&gt;13&lt;/span&gt;] and fine motor function (e.g. typing speed and accuracy) [&lt;span&gt;14&lt;/span&gt;], can serve as sensitive markers for the impact of alcohol. Moreover, BAC and impairment do not exist in a vacuum – context matters. The same alcohol exposure may pose little risk in some situations but be dangerous in others. Advanced applications could incorporate geolocation and situational awareness – intensifying warnings if an individual is near their vehicle or engaged in a safety-sensitive task or de-escalating alerts when impairment is less immediately consequential.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Drawing attention to the aftermath&lt;/b&gt;: The effects of alcohol extend beyond intoxication, often disrupting sleep, hydration and cardiovascular function. Wearable sensors tracking sleep patterns, heart rhythm (e.g. atrial fibrillation) and blood pressure provi","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"919-921"},"PeriodicalIF":5.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655693","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":"Early identification of the use of potent benzylbenzimidazoles (nitazenes) through wastewater analysis: Two years of data from 22 countries.","authors":"Richard Bade, Dhayaalini Nadarajan, Wayne Hall, Jared A Brown, Jennifer Schumann","doi":"10.1111/add.70027","DOIUrl":"https://doi.org/10.1111/add.70027","url":null,"abstract":"<p><strong>Background and aims: </strong>The use of new synthetic opioids, such as the highly potent 2-benzylbenzimidazoles (i.e. nitazene) drugs, is a global health concern because of their increased risk of fatal overdose. In the early 2020s, nitazene analogues were linked to significant numbers of overdoses in the United States. Their reach is now worldwide, with nitazene overdose deaths reported in Europe, Australia and New Zealand. The aim of this study was to measure quantities of nitazenes in wastewater samples collected from 68 locations in 22 countries, covering six continents, to understand and estimate their use.</p><p><strong>Methods: </strong>Untreated influent wastewater samples were collected over a one-week period that included the New Year period in 2022-2023 and 2023-2024. Samples were collected from 22 countries: Australia, Austria, Belgium, Brazil, Canada, Chile, China, Cyprus, Czechia, France, Germany, Greece, Iceland, Italy, New Zealand, Nigeria, Republic of Korea, Slovenia, Spain, Sweden, United Kingdom and United States. Samples were loaded onto solid-phase extraction cartridges in the country of collection and sent to Australia for elution and analysis using sensitive liquid chromatography-mass spectrometry methods.</p><p><strong>Results: </strong>A total of 683 individual wastewater samples were analysed across the two years: 339 in 2022-2023 and 344 in 2023-2024. Two nitazene analogues-protonitazene and N-pyrrolidino etonitazene (etonitazepyne)-were found in five separate sites in the United States and Australia. In the 2022-2023 period, protonitazene was found in two sites in the United States. The following year, protonitazene was detected in two further sites in the United States, while both protonitazene and etonitazepyne were found in one site in Australia. Protonitazene mass loads ranged between 0.3 mg/day/1000 people and 100 mg/day/1000 people. Etonitazepyne was also found at mass loads between 0.2-2 mg/day/1000 people).</p><p><strong>Conclusions: </strong>A very high mass load of protonitazene was calculated, using wastewater analysis, for the day of 30 December 2023 in one site in Australia. Etonitazepyne showed the same trend from a lower base. Wastewater-based nitazene surveillance shows promise as a form of both drug early warning and ongoing monitoring of trends in use, especially as a complementary tool to existing surveillance methods.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655695","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":"Trends in smoking prevalence and socio-economic inequalities across regions in England: A population study, 2006 to 2024.","authors":"Sarah E Jackson, Sharon Cox, Vera Buss, Harry Tattan-Birch, Jamie Brown","doi":"10.1111/add.70032","DOIUrl":"https://doi.org/10.1111/add.70032","url":null,"abstract":"<p><strong>Background and aim: </strong>In addition to national policies and interventions, certain regions in England (particularly in the North) coordinate regional tobacco control programmes. This study aimed to (i) examine trends in tobacco smoking prevalence and socioeconomic inequalities in smoking across regions and (ii) explore how trends in smoking prevalence have differed between regions with and without dedicated regional tobacco control activity.</p><p><strong>Design: </strong>Observational study using data drawn from nationally representative monthly cross-sectional household surveys, conducted between November 2006 and July 2024.</p><p><strong>Setting: </strong>England.</p><p><strong>Participants: </strong>368 057 adults (≥16 years old).</p><p><strong>Measurements: </strong>We used logistic regression to estimate time trends in current smoking by region, and tested interactions with occupational social grade to explore differences between more and less advantaged groups.</p><p><strong>Findings: </strong>Smoking prevalence declined most in the North [28.8% to 15.8%; -12.9 percentage points (95% confidence interval -14.4 to -11.5)], similar to the national average in the Midlands [25.2% to 16.0%; -9.2 (-10.6 to -7.9)], and least in the South [22.7% to 17.3%; -5.3 (-6.5 to -4.0)], reducing regional disparities such that prevalence was similar across regions in 2024. Socioeconomic inequalities in smoking prevalence between more and less advantaged social grades fell most in Yorkshire and the Humber [from 17.9 percentage points (14.1-21.8) to 3.7 (0.4-7.0)] and the West Midlands [from 16.1 (12.8-19.6) to 3.0 (-0.03 to 6.0)]. Regions with sustained regional tobacco control activity saw greater declines in smoking prevalence [-13.3 (-15.3 to -11.3)] than regions with none [-9.3 (-10.0 to -8.5)].</p><p><strong>Conclusions: </strong>Between 2006 and 2024, smoking rates in the North of England fell faster than the national average, narrowing the geographic inequalities in smoking prevalence and bringing the North of England into alignment with other regions by 2024. Regional tobacco control programmes appeared to contribute to this progress.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655696","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}