Addiction最新文献

{"title":"Exploratory analysis of United States-based cannabis product health benefit claims on online marketplaces.","authors":"Matthew C Nali, Meng Zhen Larsen, Zhuoran Li, Jiawei Li, Douglas R Roehler, Vanessa Mallory, Tim K Mackey","doi":"10.1111/add.70177","DOIUrl":"https://doi.org/10.1111/add.70177","url":null,"abstract":"<p><strong>Background and aims: </strong>Cannabis-derived products (CDPs), including cannabidiol (CBD) and tetrahydrocannabinol (THC) products, are widely diverse and readily available through physical and online retail channels in the United States (US) marketplace and may also include claims of treating or providing benefit for health issues. This study aimed to systematically classify the various types of health benefit claim(s) present on CDP listings based on publicly available online marketplace data.</p><p><strong>Design: </strong>Exploratory analysis to identify health benefit claims.</p><p><strong>Setting and cases: </strong>A total of 624 805 unique CDPs sold in the US on Leafly and Weedmaps, cannabis online marketplace service platforms.</p><p><strong>Measurements: </strong>This exploratory study was conducted in four phases: (1) data mining of cannabis e-commerce websites Weedmaps and Leafly for product listings in the US; (2) data filtering, text matching and content coding to identify types of advertised health benefit(s) made; (3) analysis on consumer-generated product reviews for sentiment toward advertised health benefit(s); and (4) ANOVA was used to test differences in mean number of health benefit claims based on product characteristic of route-of-administration (RoA).</p><p><strong>Findings: </strong>A total of 624 805 unique US CDP sales listings from Leafly (n = 50 951) and Weedmaps (n = 573 854) were analyzed. CDP listings with a specific health benefit claim(s) were detected in 998 (1.9%) Leafly and 25 671 (4.47%) Weedmaps CDP listings. The top 5 advertised health benefits were treatment of mood disorders, general discomfort, general wellness, sleep disorders and chronic conditions. Among consumer reviews, 295 (4.6% of consumer reviews from products that advertised health benefit(s)) expressed sentiment toward CDP addressing their health issue with 82.4% being positive, 14.6% negative and 3.1% neutral. We also observed statistically significant differences between RoA and frequency of health benefit claims among those with at least one health benefit claim, with multisystem products (>1RoA) generally having a higher number of average health benefit claims compared with other RoAs.</p><p><strong>Conclusions: </strong>Over 26 000 cannabis-derived products listed on two popular US cannabis online marketplaces have at least one health benefit claim.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936672","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":"Recurrent care proceedings and use of services for substance use disorder: A retrospective linked data cohort study of mothers in South London.","authors":"Martha Canfield, Gail Gilchrist, Johnny Downs, Sam Norton","doi":"10.1111/add.70179","DOIUrl":"https://doi.org/10.1111/add.70179","url":null,"abstract":"<p><strong>Background and aims: </strong>In public family law cases ('care proceedings'), many mothers return to proceedings after having a child removed. Substance use disorder (SUD) is a common feature in these cases. We used a linked dataset between SUD treatment services and family court to identify: i) the prevalence and estimated time for returning to care proceedings, ii) the characteristics of mothers who returned, and iii) differences in SUD treatment service use between mothers who returned to care proceedings and those who did not.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>South London and Maudsley NHS Mental Health Trust (SLaM) catchment area, UK.</p><p><strong>Participants: </strong>480 mothers involved in care proceedings with SUD between 2007 and 2019.</p><p><strong>Measurements: </strong>Substance use treatment records were linked to family court records. Kaplan Meier's time-to-event analysis was used to estimate the probability of returning to court and the recurrence rate. Hazard ratios (95% confidence intervals) were estimated to identify factors using Cox proportional regression analysis.</p><p><strong>Findings: </strong>Following the completion of the first care proceeding case, one-quarter of the cohort returned to proceedings (n = 119). Of returning mothers, 58.0% returned with a new baby and 52.0% had not received SUD treatment during the first proceedings. The risk of returning was highest within five years and was positively associated with younger maternal age [adjusted hazard ratio (aHR) 0.26, 95% confidence interval (CI) = 0.11-0.61], multiple children in initial proceedings (aHR 2.07, 95% CI = 1.36-3.18) and not receiving SUD treatment during initial proceedings (aHR 0.42, 95% CI = 0.29-0.61). The number of contact events with SUD treatment was not statistically significantly associated with returning to proceedings.</p><p><strong>Conclusion: </strong>Among mothers receiving treatment for substance use disorder and involved in care proceedings in England, nearly one in four were likely to appear in a subsequent care proceeding case.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936698","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":"Can alcohol use explain the increase in educational inequalities in all-cause mortality after 2010 in the USA? A three-way interaction analysis.","authors":"Yachen Zhu, Carolin Kilian, Charlotte Probst, William C Kerr, Jürgen Rehm","doi":"10.1111/add.70168","DOIUrl":"https://doi.org/10.1111/add.70168","url":null,"abstract":"<p><strong>Background and aims: </strong>In the United States, the educational gap in all-cause mortality and life expectancy has dramatically increased since 2010. This study investigated whether alcohol use has contributed to the increasing educational gap in mortality by testing the three-way interaction of alcohol use, education and period on all-cause mortality.</p><p><strong>Design: </strong>Cohort study with 9 years' follow-up on average.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>207 223 males and 255 833 females aged 25 years and older from the 2000-2018 National Health Interview Survey.</p><p><strong>Measurements: </strong>The outcome was time to all-cause death or last presumed alive by 12/31/2019 based on the National Death Index. Three-way interaction effects between educational attainment (bachelor degree or more vs. high school degree or less), alcohol use (drinking >60 g/day in males and >40 g/day in females vs. lifetime abstinence) and period (after vs. before 2010) were investigated on the multiplicative and additive scales using Cox proportional hazards and Aalen's additive hazards models, respectively, with age as the time scale. Analyses were stratified by sex and adjusted for marital status, race and ethnicity, smoking status, body mass index, physical activity and self-rated health status.</p><p><strong>Findings: </strong>During the follow-up period, 30 467 and 34 618 deaths occurred in males and females, respectively, with a pronounced educational gradient. In males, the differential vulnerability to high-level alcohol use by educational attainment substantially increased after 2010 than before 2010 on both multiplicative and additive scales. Specifically, the relative all-cause mortality risk associated with drinking above 60 g per day (vs. lifetime abstinence) in males with low vs. high education increased by 89% after 2010 compared with before 2010 [three-way interaction term: hazard ratio (HR) = 1.89, 95% confidence interval (CI) = 1.03-3.47, P = 0.04 from the Cox model]. This result was further supported by the Aalen's model, indicating that the educational difference in mortality risk linked to drinking above 60 g per day increased by 8.85 additional deaths per 1000 person-years (95% CI = 0.90-16.79, P = 0.029) after 2010. No change of differential vulnerability to alcohol use was found in females.</p><p><strong>Conclusions: </strong>Alcohol use appears to be a key element in the widening educational gap in all-cause mortality risk in males after 2010 in the United States.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936488","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":"Counterfeit 'Xanax®' tablets: A comparative study of clinical and seizure data in Victoria, Australia.","authors":"Rebekka Syrjanen, Shaun L Greene, Sarah E Hodgson, Rachelle Abouchedid, Dimitri Gerostamoulos, Christie Magee, Melissa Bremner, Jennifer L Schumann","doi":"10.1111/add.70174","DOIUrl":"https://doi.org/10.1111/add.70174","url":null,"abstract":"<p><strong>Background and aim: </strong>There is growing evidence of counterfeit benzodiazepine products containing other substances, including non-regulated benzodiazepine-type new psychoactive substances (NPSs). This study sought to compare detections of seized suspect counterfeit alprazolam products with clinical cases that reported use of an alprazolam-containing product to better characterise community use.</p><p><strong>Design and setting: </strong>Observational study set in Victoria, Australia, using data from the Victoria Police Drug Sciences Group (which compiles information about seized drugs submitted for evidential analysis and intelligence purposes) and the Emerging Drugs Network of Australia - Victoria (EDNAV) project (a prospective, observational study collecting clinical and analytical data for illicit drug-related presentations across a network of hospitals in Victoria, Australia).</p><p><strong>Cases: </strong>Police seizures expected to contain alprazolam (March 2020 and August 2022) and EDNAV cases with a reported exposure to an alprazolam-containing product (September 2020 and August 2022).</p><p><strong>Measurements: </strong>Descriptive study outlining drug detections in seized tablets and blood samples from EDNAV cases, comparing patterns of detection and changes over time.</p><p><strong>Findings: </strong>A total of 623 police seizures were analysed, most commonly products labelled as 'Xanax®' (n = 266), 'Kalma®' (n = 196) or 'Mylan®' (n = 124). Thirty percent of seizures contained alprazolam only. A benzodiazepine-type NPS was detected in 375 seizures (60.2%). Exposure to non-prescribed alprazolam was reported in 11.2% (n = 125/1112) of EDNAV cases, with 68.8% identifying as male and a median age of 26 years (range 16-68 years). Eighty-seven cases reported the use of 'Xanax®'. Alprazolam was detected in 19 EDNAV cases. A benzodiazepine-type NPS was detected in 78.4% of EDNAV cases. Both datasets saw a shift in detections from etizolam (2020) to clonazolam (2021) and then clobromazolam (2022).</p><p><strong>Conclusions: </strong>Suspect counterfeit alprazolam products seized by police in Victoria, Australia, in 2020 and 2022 commonly contained other drugs and/or new psychoactive substances, with an apparent limited consumer awareness of the tablet composition.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936656","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":"Qualitative analysis of barriers and facilitators to healthcare engagement for people with injecting-related invasive infections using a social ecological framework.","authors":"Lucy O Attwood, Sophia E Schroeder, Olga Vujovic, Andrew J Stewardson, Joseph S Doyle, Paul Dietze, Peter Higgs, Samantha Colledge-Frisby","doi":"10.1111/add.70175","DOIUrl":"https://doi.org/10.1111/add.70175","url":null,"abstract":"<p><strong>Background and aims: </strong>Injecting-related bacterial infections are increasing in many countries. Systemic infections often require prolonged treatment. Evidence suggests that people who inject drugs who have invasive infections are less likely to complete antimicrobial treatment and have poorer outcomes than patients without a history of injecting drug use. We used a social ecological model to identify critical barriers and facilitators that impact healthcare service access for people who inject drugs with an invasive infection.</p><p><strong>Design: </strong>A qualitative study using semi-structured interviews.</p><p><strong>Setting: </strong>Melbourne, Victoria, Australia in 2023.</p><p><strong>Participants: </strong>Twenty participants were recruited from SuperMIX, a longitudinal cohort of people who inject drugs.</p><p><strong>Measurements: </strong>Thematic analysis used inductive coding to chart themes onto the core domains of the social ecological model.</p><p><strong>Findings: </strong>Participant experiences informed five key themes. (1) Health literacy influenced how participants responded to the physical and experiential embodiment of symptoms. (2) The intersection between drug use and marginalisation created compounding barriers to care. (3) Familial and social embeddedness of participants could both enable or restrict their healthcare access. (4) The use of patient-centred care to respond to intersecting needs directly contributed to healthcare engagement outcomes. Finally, (5) trust was a critical dimension that influenced participants' experiences of healthcare access. While its presence or absence was felt at intrapersonal and interpersonal levels, cultivating or discouraging trust had its roots at the societal and institutional level.</p><p><strong>Conclusions: </strong>Among people who inject drugs, facilitators and barriers to seeking healthcare for invasive infections appear to be influenced by factors at all levels of the social ecological model (intrapersonal, interpersonal, institutional and societal).</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854059","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":"Research priorities in deceptive online gambling platform design research: We need to understand behavioral usage patterns in order to inform safer platform design","authors":"Philip Newall","doi":"10.1111/add.70176","DOIUrl":"10.1111/add.70176","url":null,"abstract":"&lt;p&gt;In my article, I argued that online gambling platforms are often designed in deceptive ways to maximize the amount of time and money that people spend on them [&lt;span&gt;1&lt;/span&gt;], as a digital extension of Schüll's research on the deceptive design of land-based casinos [&lt;span&gt;2&lt;/span&gt;]. This is important given online gambling's increasing ascendance internationally [&lt;span&gt;3&lt;/span&gt;] and can also be seen as an extension to research on the harmful structural characteristics of many gambling products [&lt;span&gt;4&lt;/span&gt;]. My article arranges existing literature on this topic [&lt;span&gt;1&lt;/span&gt;], and further argues that three factors have inhibited this research area: the existence of competing terms such as sludge [&lt;span&gt;5&lt;/span&gt;], dark patterns [&lt;span&gt;6&lt;/span&gt;] and dark nudges [&lt;span&gt;7&lt;/span&gt;]; a preponderance of grey literature; and a lack of access to behavioral data. This last factor is the most critical, and in responding to these commentaries, I argue optimistically that multiple routes are open to facilitate data access to promote an understanding of how people use online gambling platforms, to inform regulation to promote safer design.&lt;/p&gt;&lt;p&gt;Clark and Weston's [&lt;span&gt;8&lt;/span&gt;] commentary argues that these issues are important in the North American context, where 30 United States states have legalized online sports betting, and one Canadian province has introduced a competitive online gambling marketplace, with another province being set to follow. The Canadian changes disrupt a stable status quo, where gambling was hitherto allowed only under provincial state-owned monopolies [&lt;span&gt;9&lt;/span&gt;]. Although concerning, this rapid yet uneven spread could, if sufficient high-quality data exist, serve as the closest possible equivalent to a real-world controlled experiment. Furthermore, state-owned gambling operators are more willing to collaborate in research than privately owned operators [&lt;span&gt;10&lt;/span&gt;]. This willingness should be harnessed by researchers with strong relationships with state-owned operators, by requesting high-resolution data on patterns of platform use.&lt;/p&gt;&lt;p&gt;Field and Gaskell's [&lt;span&gt;11&lt;/span&gt;] commentary is largely supportive, arguing that neurocognitive models of gambling harm place too much emphasis on the person compared to the product. They further argue that the unique features of online gambling might require making alterations to evidence-based treatments such as cognitive behavioral therapy. I fully agree with these points, and contend that further restrictions on the speed of online gambling, to more closely resemble that of land-based gambling, might also logically follow from them [&lt;span&gt;12&lt;/span&gt;]. While gambling policymakers often say that there is ‘no evidence’ to support harm-prevention policies, there is also often no evidence to support the status quo—on many topics there is simply no evidence [&lt;span&gt;13&lt;/span&gt;]. United Kingdom-based policymakers should, therefore, consider the evidence-building benefits of improved","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"1929-1930"},"PeriodicalIF":5.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833432","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":"Response to comment from Egger and McKee entitled ‘Unreliable evidence from problematic risk of bias assessments: Comment on Begh et al., ‘Electronic cigarettes and subsequent cigarette smoking in young people: A systematic review”’","authors":"Jamie Hartmann-Boyce,&nbsp;Rachna Begh,&nbsp;Monserrat Conde,&nbsp;Lion Shahab,&nbsp;Sarah E. Jackson,&nbsp;Michael F. Pesko,&nbsp;Jonathan Livingstone-Banks,&nbsp;Dimitra Kale,&nbsp;Nancy A. Rigotti,&nbsp;Thomas Fanshawe,&nbsp;Dylan Kneale,&nbsp;Nicola Lindson","doi":"10.1111/add.70166","DOIUrl":"10.1111/add.70166","url":null,"abstract":"&lt;p&gt;We are pleased that this review [&lt;span&gt;1&lt;/span&gt;] is encouraging discussion on this important topic. As a team, we care greatly about scientific discourse and opportunities for methodological improvement. This is why we took such efforts to be transparent in the risk of bias methods used in this article, without which such critiques would not be possible. However, right from the outset we note a logical disconnect in the critique by Egger and McKee [&lt;span&gt;2&lt;/span&gt;]. The title of their letter starts with ‘unreliable evidence’, yet the authors appear to focus solely on our risk of bias tool rather than on providing a substantive critique of the actual findings from the reviewed studies or our synthesis of them. Regardless, we welcome the conversation.&lt;/p&gt;&lt;p&gt;In accordance with best practice, our methods were pre-registered and approved through a Cochrane peer review process before our review began [&lt;span&gt;3&lt;/span&gt;]. Of our many methodological choices, Egger and McKee focus exclusively on our risk of bias assessment. They rightly acknowledge that there is no consensus among researchers as to how risk of bias assessment should be conducted for ecological studies of the type we include. We, therefore, considered this carefully and developed a risk of bias assessment tool for evaluating population-level studies, which we pre-registered in detail on Open Science Framework (https://osf.io/svgud).&lt;/p&gt;&lt;p&gt;While some co-authors of included studies participated in developing the risk of bias assessment tool, we consider this a strength and this was appropriately disclosed at the time. Having people who understand the study types included in a systematic review is extremely helpful as it can ensure results are understood and interpreted correctly. Further, as per Cochrane methods, these individuals were not involved in data extraction or making risk of bias judgements for their own studies.&lt;/p&gt;&lt;p&gt;ROBINS-E, which arguably may be the most appropriate risk of bias assessment tool currently available, was not yet approved for use when we conducted our review. We acknowledge this as a limitation in our review, but note that even had we used a different tool, our findings would remain largely unchanged. This is because the major impact of our risk of bias assessments is on our judgement of the certainty of the evidence (GRADE rating), which was also downgraded because of inconsistency. In other words, using a different risk of bias tool or giving different risk of bias ratings would not have changed our findings, only our confidence in them, and then only for some comparisons.&lt;/p&gt;&lt;p&gt;The authors state that ‘cohort studies [are] one of the most effective non-randomised study designs for determining cause and effect.’ However, reliance on a single type of study design undermines scientific robustness because of inherent biases associated with observational study designs (such as the threat of potentially unobserved common liabilities in cohort studies), resulting in sp","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 11","pages":"2359-2360"},"PeriodicalIF":5.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833433","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":"Effect of EEG neurofeedback therapy on addiction disorders: A systematic review and meta-analysis.","authors":"Huan Wan, Biao Chen, Xiaoming Li, Junjie Bu","doi":"10.1111/add.70164","DOIUrl":"https://doi.org/10.1111/add.70164","url":null,"abstract":"<p><strong>Background and aim: </strong>Recently, electroencephalogram neurofeedback (EEG-NF), a non-invasive neuromodulation technique, has shown promising potential in treating addiction disorders. However, the heterogeneity of clinical populations and research methodologies make it challenging to reach consistent conclusions regarding its efficacy. This meta-analysis investigated the therapeutic effects of EEG-NF on addiction disorders, including both substance and behavioral addictions.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed, Cochrane Library, Embase and Web of Science, including 17 randomized controlled trials (RCTs) published between 2000 and 2025 that utilized EEG-NF for addiction treatment, with a total of 662 participants. Subgroup analyses were carried out based on addiction type and neurofeedback modality, alongside meta-regression analyses considering publication year, sample size, age, sex, number of sessions and duration.</p><p><strong>Results: </strong>EEG-NF statistically significantly alleviated addiction symptoms (Hedges'g = 0.85, P < 0.001), with stronger effects on substance addiction than behavioral addiction. Auditory feedback was the most effective modality, while audio-visual feedback was less effective and visual feedback was the weakest. Despite significant heterogeneity, subgroup and meta-regression analyses suggested that neurofeedback modalities and the number of neurofeedback sessions may be the primary factors influencing therapeutic efficacy.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis provides robust evidence supporting the efficacy of electroencephalogram neurofeedback (EEG-NF) in the treatment of addiction disorders, with particularly promising results for substance use disorders. Our findings underscore the critical need for protocol optimization, emphasizing both modality selection and careful dose-response calibration to maximize treatment outcomes.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833431","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 Rehm et al.: Utilizing return on investment analysis to advocate for tax increases","authors":"Meenakshi S. Subbaraman","doi":"10.1111/add.70165","DOIUrl":"10.1111/add.70165","url":null,"abstract":"&lt;p&gt;Rehm &lt;i&gt;et al&lt;/i&gt;.’s return on investment (ROI) analysis specifically evaluates financial returns of the March 2017 alcohol excise taxation increases in Lithuania over 1 year by considering five social components: (i) costs of implementing tax changes; and the differences in (ii) healthcare costs; (iii) productivity; (iv) legal system costs; and (v) excise tax budget revenues. The attention to a broad range of outcomes highlights the social benefits of increased alcohol taxes beyond increased revenue; this could be particularly useful for communicating with policymakers and the public.&lt;/p&gt;&lt;p&gt;Findings show that for each euro invested, the return was 420 euros – this is astonishing, and clearly a ‘win–win’ in terms of simultaneously reducing harms and increasing revenue. However, the tax increases in Lithuania were significant, with a doubling of excise taxes on beer and wine, for example, which resulted in an almost 7% reduction in alcohol affordability [&lt;span&gt;1&lt;/span&gt;]. Importantly, similar increases in excise taxes in other countries or regions, such as US states, would not have the same impact on affordability given that alcohol excise taxes account for a much smaller portion of alcohol prices overall [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Furthermore, while the impacts of increased taxes in Lithuania are clear, with some directly attributable to taxes after the tax revenue increased by 20%, several other drastic alcohol policy changes also occurred. Specifically, from 2008 to 2018, Lithuania experienced: excise tax increases, bans on alcohol advertising and increased penalties for drunk driving in 2008; availability restrictions, such as banned off-premise sales from 10:00 PM to 8:00 AM, in 2009; excise tax increases in 2017; and reduced availability by increasing the legal minimum age to 20 years, reducing off-premise sales hours and a near full alcohol advertising ban in 2018. These are all recommended as ‘best buy’ policies by the World Health Organization [&lt;span&gt;4&lt;/span&gt;], and it is possible that having these other policies in place synergistically affected outcomes. While Rehm &lt;i&gt;et al&lt;/i&gt;.’s ROI analyses focus on a single year to avoid confounding by these other policy changes, this assumes no policy interaction or cumulative policy effects and ignores the behavioral adaptations that had occurred in an already restricted market. Thus, other countries or localities would likely not experience similar magnitudes of ROI unless other restrictions were made.&lt;/p&gt;&lt;p&gt;Regardless of the magnitude of the ROIs, increased revenue would obviously still be gained in places that increase alcohol excise taxes. This increased revenue is needed in places like the USA, where current taxes cover a small fraction of the costs to society per drink: the most recent available data show that combined federal and state &lt;i&gt;ad valorem&lt;/i&gt; and excise taxes averaged to a total of 8 cents per standard drink for beer and 18 cents per standard drink for spirits in 2015 [&lt;span&gt;5&lt;/","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"2105-2106"},"PeriodicalIF":5.3,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815325","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":"Effect modification in therapeutic impact of nalmefene on alcohol dependence by ADH1B polymorphism: A secondary analysis of a Japanese randomized clinical trial.","authors":"Nozomu Hashimoto, Manabu Takaki, Yoshitsugu Kojima, Izuru Nakamura, Daisuke D Ikeda, Shinji Sakamoto, Yuko Okahisa, Soshi Takao, Keitaro Matsuo","doi":"10.1111/add.70160","DOIUrl":"https://doi.org/10.1111/add.70160","url":null,"abstract":"<p><strong>Background and aims: </strong>The association between alcohol-metabolizing enzyme polymorphisms and treatment response to nalmefene for alcohol dependence has not been studied. We aimed to determine whether alcohol-metabolizing enzyme polymorphisms, specifically ADH1B rs1229984 and ALDH2 rs671, modify the treatment response to nalmefene for alcohol dependence.</p><p><strong>Design: </strong>Secondary analysis of a Japanese randomized clinical trial, in which participants were randomly assigned (4:3:4) to placebo, 10 mg nalmefene or 20 mg nalmefene groups for 24 weeks, accompanied by a brief psychosocial intervention.</p><p><strong>Setting: </strong>80 addiction outpatient clinics across Japan.</p><p><strong>Participants: </strong>A subset of 531 individuals (mean age 49.2 years, standard deviation 11.5; 69.9% male), including 196 in the placebo group and 335 in the nalmefene group, who agreed to DNA preservation and had available DNA data between February 2015 and July 2016.</p><p><strong>Measurements: </strong>Genotyping was performed to determine ADH1B rs1229984 polymorphism (AA, AG, GG) and ALDH2 rs671 polymorphism (GG, GA, AA) in participants. Primary endpoint was change from baseline in monthly heavy drinking days (HDD, days/month) over the 24 treatment weeks. The key secondary endpoint was change from baseline in daily total alcohol consumption (TAC, g/day) over the 24 treatment weeks.</p><p><strong>Findings: </strong>A mixed-effects model for repeated measures analyses showed a statistically significant gene-treatment interaction with ADH1B rs1229984 for TAC [10.71 (95% confidence interval = 4.03-17.39) g/day, P = 0.002], but not for HDD [1.65 (-0.38 to 3.67) days/month, P = 0.110]: as the G allele of rs1229984 increased, the efficacy regarding TAC decreased. In contrast, no statistically significant gene-treatment interaction was seen with ALDH2 rs671 for either TAC [4.46 (-7.88 to 16.80) g/day, P = 0.478] or HDD [-0.91 (-4.60 to 2.78) days/month, P = 0.630]. In the ADH1B rs1229984 variant, the number needed to treat for two category shifts in drinking risk level, as defined by the World Health Organization, was 3.7 for AA carriers, 6.6 for AG carriers and 18.5 for GG carriers.</p><p><strong>Conclusions: </strong>The ADH1B rs1229984 polymorphism appears to moderate the response to nalmefene in Japanese patients with alcohol dependence. Specifically, nalmefene appears to show efficacy in individuals with the ADH1B rs1229984 AA genotype.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803008","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}