Addiction最新文献

{"title":"Continuing the momentum: Consensus priorities for cannabis use disorder treatment outcomes.","authors":"Erin A McClure, Rachel L Tomko","doi":"10.1111/add.70622","DOIUrl":"https://doi.org/10.1111/add.70622","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101369","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":"Age, period and cohort effects in alcohol-related liver disease mortality in the United States, 1968 to 2023.","authors":"Joseph Alejandro, J Travis Donahoe, Natalie Sumetsky, Christina Mair","doi":"10.1111/add.70615","DOIUrl":"https://doi.org/10.1111/add.70615","url":null,"abstract":"<p><strong>Aims: </strong>Over the past two decades, mortality from alcohol-related liver disease has rapidly increased in the United States. We aimed to describe age, period and cohort contributions to alcohol-related liver disease mortality to better understand the possible drivers of recent worsening trends.</p><p><strong>Design: </strong>Sex-stratified age-period-cohort analysis using national mortality data.</p><p><strong>Setting and cases: </strong>The United States from 1968 to 2023 (846 008 alcohol-related liver disease deaths: 246 040 for females and 599 968 for males).</p><p><strong>Measurements: </strong>We grouped sex-specific alcohol-related liver disease deaths and population estimates into 5-year age and period groups, with a top coded 85+ age group and one 6-year period from 2018 to 2023.</p><p><strong>Results: </strong>Alcohol-related liver disease deaths for females and males declined from approximately the years 1980 to 2000, reaching lows of 3.00 per 100 000 population for females in 2003 and 8.70 per 100 000 for males in 2006, before steadily increasing and peaking in 2021 at 7.86 per 100 000 and 17.04 per 100 000, respectively. Mortality rates remained historically elevated through 2023. Age-period-cohort models showed the highest mortality rates among females ages 50-64 and males ages 50-69. Period effects declined from 1973-1977 to 1998-2002, then steadily increased, peaking in 2018-2023. Compared with the 2008-2012 period, females had a mortality rate ratio of 1.80 [95% confidence Interval (CI) = 1.78-1.82] in 2018-2023. Model-sensitive cohort effects have increased among the youngest birth cohorts; for example, compared with the 1958-1962 cohort, males born from 1998 to 2003 had a mortality rate ratio of 2.03 (95% CI = 1.92-2.14).</p><p><strong>Summary: </strong>Alcohol-related liver disease deaths in the United States declined from the mid-1970s until the late 1990s before reversing, with period effects accelerating during the COVID-19 pandemic and suggestive cohort effects indicating increasing mortality risk for people born since the late 1980s. Females face disproportionate risk, consistent with their heightened susceptibility to alcohol-related liver disease and the narrowing gender gap in alcohol consumption.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078981","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":"Drinking at least weekly, loneliness and social isolation over time: Bidirectional within-person associations in an Australian prospective cohort study.","authors":"Qingqing Wu, Ding Ding, Sara Farnbach, Neta Hagani, Mia Miller, Katherine B Owen, Philip J Clare","doi":"10.1111/add.70620","DOIUrl":"https://doi.org/10.1111/add.70620","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Past research has shown a link between alcohol consumption and loneliness/social isolation; however, the nature of the relationship remains unclear. We aimed (1) to estimate bidirectional longitudinal associations between drinking at least weekly, loneliness and social isolation; and (2) to distinguish within-person change from stable between-person differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Prospective cohort study using ten annual outcome waves (2014-2023), with wave 13 (2013) providing descriptive context and time-constant baseline socio-demographic covariates. Random-intercept cross-lagged panel models (RI-CLPMs) were primary, dynamic panel models (DPMs) assessed robustness and conventional cross-lagged panel models were sensitivity analyses. Models were unadjusted, partially adjusted for baseline socio-demographic covariates and fully adjusted for additional time-varying covariates. RI-CLPMs separated deviations around participants' expected levels from relatively time-invariant differences in their average levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Australia; the Household, Income and Labour Dynamics in Australia (HILDA) Survey is a nationally representative household panel, although analyses were unweighted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Unbalanced panel of 33 835 Australians aged 15+. Former-drinker person-wave observations were excluded. Across waves 13-23, 87.8%-93.3% of individual-interview respondents completed the self-completion questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Time-constant baseline covariates were measured at wave 13, and outcomes were measured at waves 14-23. Drinking at least weekly (≥1 day/week) was derived from an annually administered drinking-frequency item. Loneliness was derived from three 7-point items and social isolation was operationalised as low perceived social support using four 7-point items; responses ranged from 1 (strongly disagree) to 7 (strongly agree). Median scores ≥4 were classified as lonely and scores &lt;4 as socially isolated, following prior HILDA operationalisations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among observed wave 13 responses, 6719/14 019 (47.9%) reported drinking at least weekly, 3884/14 076 (27.6%) were classified as lonely and 812/14 082 (5.8%) as socially isolated; participants were 50.9% female and had a mean age of 36.0 years (standard deviation = 22.8). In fully adjusted RI-CLPMs, loneliness predicted subsequent social isolation [pooled unstandardised coefficient (b) = 0.020, 95% confidence interval (CI) = 0.002-0.037 and social isolation predicted subsequent loneliness (b = 0.028, 95% CI = 0.007-0.049). Drinking at least weekly was autoregressive (b = 0.151, 95% CI = 0.135-0.168) but had no clear prospective association with either social measure. DPM conclusions were consistent with RI-CLPM conclusions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Loneliness and social isolation appeared to reinforce each other over time within individuals","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101384","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":"An exploratory economic assessment of the effect of the smoke-free generation policy in England on smoking in pregnancy.","authors":"Nathan P Davies, Tessa Langley, Rachael L Murray, Joanne R Morling, Manpreet Bains, Matthew Jones","doi":"10.1111/add.70605","DOIUrl":"https://doi.org/10.1111/add.70605","url":null,"abstract":"<p><strong>Aims: </strong>To estimate the impact of England's proposed smoke-free generation (SFG) policy on smoking at time of delivery, adverse maternal and offspring outcomes and the cost-effectiveness of the policy compared with no intervention.</p><p><strong>Design: </strong>Decision analytic modelling using the Economics of Smoking in Pregnancy model, taking a health service and personal social services perspective. Three scenarios (central, pessimistic, optimistic) were simulated deterministically and through probabilistic sensitivity analyses (10 000 iterations).</p><p><strong>Setting: </strong>England, United Kingdom.</p><p><strong>Participants: </strong>A synthetic birth cohort of 11 995 women born in 2014 giving birth at a mean maternal age of 28, representing the women affected by the first 15 years of the proposed 2027 SFG policy.</p><p><strong>Intervention and comparator: </strong>The intervention was England's proposed SFG policy to ban tobacco sales to those born on or after 1 January 2009. The comparator was no change in policy.</p><p><strong>Measurements: </strong>We reported maternal and offspring outcomes (analysed separately), reductions in adverse pregnancy and offspring outcomes, life years gained, benefit-cost ratio and incremental cost-effectiveness ratio per quality-adjusted life year (QALY) gained for combined maternal lifetime and offspring outcomes to age 15.</p><p><strong>Results: </strong>In the central scenario, SFG was projected to save £334 and gain 0.152 QALYs per mother and child combined. The policy was estimated to avert 11 stillbirths, 35 premature births and 157 low-birthweight infants in the modelled birth cohort, and reduce child asthma prevalence by 0.8 percentage points and child mortality by 0.7 percentage points at age 15. Across all scenarios, SFG dominated the comparator, with projections of both cost savings to health and personal social services and QALY gains. When controlling for uncertainty, this dominance persisted in probabilistic sensitivity analyses, with all three scenarios having a 100% chance of being cost-effective. Additional analyses assuming 15-fold increased costs for each of the three scenarios still found SFG to be dominant.</p><p><strong>Summary: </strong>In England, introducing a smoke-free generation policy is projected to reduce smoking in pregnancy, prevent adverse birth outcomes and deliver substantial health gains for mothers and children while reducing healthcare costs.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079021","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":"When psychedelic discourse meets local narrative: Selective uptake of psychedelic meanings surrounding mad honey in Nepal.","authors":"Sharon R Sznitman, Surendra Tiwari","doi":"10.1111/add.70616","DOIUrl":"https://doi.org/10.1111/add.70616","url":null,"abstract":"<p><strong>Aims: </strong>'Mad honey' is produced when bees collect nectar from Rhododendron species containing grayanotoxins, naturally occurring diterpenoid toxins that can produce dose-dependent intoxication. It has long been embedded in Nepalese medicinal and ritual practices but has recently become part of global psychedelic discourse. This study examined how globally circulating discourse and local narrative practices interact in shaping meanings of intoxication, using mad honey as a case. More broadly, it assessed the analytical value of distinguishing between discursive circulation and narrative uptake.</p><p><strong>Design: </strong>Qualitative study combining analysis of online commercial representations with semi-structured interviews in Nepal.</p><p><strong>Setting: </strong>Online retail shops and field sites in Kathmandu, Pokhara, Lukla and nearby communities.</p><p><strong>Participants: </strong>One qualitative group interview (n = 17) and 14 individual interviews with honey hunters, sellers, traditional medicine practitioners and suppliers involved in mad honey production, distribution and use.</p><p><strong>Measurements: </strong>Qualitative coding and constant comparison were used to analyze interviews alongside discourse-analytic examination of online product texts. Analytic attention was also given to hesitation, vagueness and non-articulation in accounts of psychoactive effects.</p><p><strong>Results: </strong>Online retailers consistently framed mad honey through a psychedelic register (hallucinations, shifts in consciousness, dosage scripts and safety warnings), creating commercially circulating experiential templates. In contrast, interviewees narrated mad honey primarily through medicinal, ritual, communal and dosage-based frameworks. Psychedelic meanings underwent only selective uptake: commercially useful classifications, such as potency and dosage, were incorporated into local accounts, whereas experiential narratives of altered consciousness were largely resisted or left unused. When intoxication was acknowledged, it was typically contained within familiar moral categories (e.g. abuse/misuse, comparison with alcohol) rather than elaborated as psychedelic experience.</p><p><strong>Summary: </strong>The analytical value of distinguishing between discourse and narrative lies in the fact that discourse may expand the availability of meanings without necessarily transforming the narrative frameworks through which psychoactive substances are understood and used. Specifically, while globally circulating digital-commercial discourse about mad honey makes psychedelic meanings available, local narratives determine whether those meanings become culturally legitimate ways of understanding and using mad honey.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072922","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":"Cannabis use and cannabis use disorder among older adults in the USA.","authors":"Benjamin H Han, Evan L Eschliman, Joseph J Palamar, Mireia Triguero Roura, Pia M Mauro","doi":"10.1111/add.70600","DOIUrl":"10.1111/add.70600","url":null,"abstract":"<p><strong>Background and aims: </strong>Cannabis use is increasing among older adults in the United States (US); however, little is known regarding details of use or cannabis use disorder (CUD) in this population. This study aimed to describe cannabis use and CUD among older adults in the US.</p><p><strong>Design: </strong>Secondary analysis of the 2021-2024 National Survey on Drug Use and Health, an annual cross-sectional nationally representative sample of noninstitutionalized people aged ≥12 living in the US.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>Noninstitutionalized individuals age ≥65 years (unweighted N = 21 189).</p><p><strong>Measurements: </strong>We estimated the prevalence of cannabis use by recency (any past 12-month use and past 30-day use), meeting two or more Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 CUD criteria, as well as CUD severity and individual CUD criteria among adults age ≥65 years who used cannabis in the past 12 months. Cannabis use and CUD were compared across sociodemographic and health-related characteristics, modality of use (2022-2024 only), and individual CUD criteria. Bivariable generalized linear regression models estimated the relative risk (RR) of CUD for older adults with each characteristic and modality of cannabis use.</p><p><strong>Results: </strong>An estimated 8.9% of older adults used cannabis in the past 12 months, and among them, 11.4% met criteria for CUD (76.0% mild, 20.1% moderate, and 3.9% severe CUD). Smoking was the most common modality of past 12-month use (65.8%), followed by eating or drinking (40.5%), and vaping (15.4%); 19.9% had a doctor recommend any cannabis use. Among older adults with CUD, the most common CUD criteria met were spending time obtaining, using, and recovering from the drug's effects (74.4%) and craving (67.5%). Male older adults were at higher risk for CUD than their female counterparts [RR = 1.69, 95% confidence interval (CI): 1.12-2.55], as were those ever arrested and booked (RR = 1.59, 95% CI = 1.07-2.37), with past-year mental illness (RR = 2.93, 95% CI: 1.85-4.65), past-year tobacco use (RR = 1.52, 95% CI: 1.04-2.20) or drug use other than cannabis (RR = 3.22, 95% CI: 2.15-4.84), smoking as a mode of cannabis use (RR = 4.94, 95% CI: 2.39-10.23), and frequent cannabis use (e.g., ≥300 days vs. <300 days per year, RR = 3.70, 95% CI: 2.30-5.96).</p><p><strong>Summary: </strong>One in nine older adults in the United States who have used cannabis in the past 12 months meet criteria for cannabis use disorder. Cannabis use screening, cannabis use disorder treatment, and additional intervention to prevent worsening severity are needed to minimize cannabis-related harms among older US adults.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068623","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":"System-frame approaches are the frontline against the illegal gambling market.","authors":"Simon Dymond, Jamie Torrance","doi":"10.1111/add.70624","DOIUrl":"https://doi.org/10.1111/add.70624","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068641","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":"Smoking-induced deprivation and subsequent smoking cessation among adults who smoke in four high-income countries: Trends, correlates and longitudinal associations, 2016-2024.","authors":"Ara Cho, Katherine A East, Ron Borland, Nigar Nargis, Hua-Hie Yong, K Michael Cummings, Geoffrey T Fong, Andrew Hyland, Coral E Gartner","doi":"10.1111/add.70598","DOIUrl":"https://doi.org/10.1111/add.70598","url":null,"abstract":"<p><strong>Background and aims: </strong>Tobacco smoking substantially contributes to poverty. Smoking-induced deprivation (SID) occurs when people continue smoking despite financial stress. This study examined (i) trends in SID in Canada, the United States (US), England and Australia from 2016 to 2024; (ii) associated factors; and (iii) its impact on quit attempts and quit success.</p><p><strong>Design: </strong>Multi-country longitudinal study using five waves (2016, 2018, 2020, 2022 and 2024) of the International Tobacco Control Four Country Smoking and Vaping Survey.</p><p><strong>Setting: </strong>Web panel surveys of adults who smoke in Canada, the US, England and Australia, weighted to national smoking populations.</p><p><strong>Participants: </strong>Participants (n = 26 888) were aged ≥18 years, completed at least one wave, smoked at least monthly and answered the SID question. Longitudinal analyses included 8484 respondents retained from baseline (T) to the subsequent wave (T + 1), including 3848 who attempted to quit.</p><p><strong>Measurements: </strong>SID was self-reported as not having enough money for household essentials in the past six months due to spending on cigarettes. Predictors included survey wave, sociodemographic factors, smoking dependence, illicit tobacco purchasing, vaping status, quit intention and quit self-efficacy. Quit attempts were any attempt since the previous wave. Quit success was not smoking at T + 1 among quit attempters.</p><p><strong>Results: </strong>Weighted SID prevalence among adults who smoke increased from 9.5% in 2016 to 14.6% in 2022 and decreased to 13.6% in 2024, with significant year-by-country interactions (P < 0.001). Prevalence increased across all countries between 2016 and 2022, was greatest in Australia (12% to 22.7%) and remained higher in 2024 than 2016 despite declines from 2022 in England and Australia. SID was associated with age 18-24 years [adjusted odds ratio (aOR) = 3.61, 95% confidence interval (CI) = 3.04-4.28 vs. 55+], low income (aOR = 2.70, 95% CI = 2.36-3.10 vs. high), low education (aOR = 1.18, 95% CI = 1.01-1.38 vs. high), high smoking dependence (aOR = 2.97, 95% CI = 2.36-3.73 vs. non-daily), current vaping (aOR = 1.59, 95% CI = 1.40-1.80 vs. never vaped), illicit tobacco use (aOR = 2.41, 95% CI = 2.15-2.71 vs. no), intending to quit within one month (aOR = 1.73, 95% CI = 1.57-1.90) and lowest self-efficacy (aOR = 1.54, 95% CI = 1.34-1.77 vs. highest). SID was associated with quit attempts (aOR = 1.18, 95% CI = 1.00-1.39), but lower quit success (aOR = 0.48, 95% CI = 0.33-0.72).</p><p><strong>Summary: </strong>In Australia, Canada, England and the United States, smoking-induced deprivation (continuing smoking despite financial stress) among adults who smoke remained higher in 2024 than in 2016, despite declining from 2022 and was associated with socioeconomic disadvantage, higher nicotine dependence and lower quit success.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068694","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 association between chronic pain and non-fatal overdose in people who inject drugs: Longitudinal cohort study in Montreal, Canada, 2017 to 2025.","authors":"Sarah Larney, Geng Zang, Harika Dasari, M Gabrielle Pagé, Farzaneh Vakili, Adelina Artenie, Valérie Martel-Laferrière, Nanor Minoyan, Sasha Udhesister, Julie Bruneau","doi":"10.1111/add.70619","DOIUrl":"https://doi.org/10.1111/add.70619","url":null,"abstract":"<p><strong>Background and aims: </strong>The prevalence of chronic pain is elevated among people who inject drugs. Chronic pain may motivate drug use, potentially increasing the risk of non-fatal overdose. We aimed to estimate the association between chronic pain and non-fatal overdose in people who inject drugs.</p><p><strong>Design: </strong>Prospective cohort study of people who inject drugs recruited in community settings [the Hepatitis Cohort (HEPCO) study], with data collection every three months between August 2017 and November 2025.</p><p><strong>Setting: </strong>Montreal, Canada.</p><p><strong>Participants: </strong>Participants were people who inject drugs (past 6-month injecting), aged 18 years or older, living in the greater Montreal area and speaking French or English.</p><p><strong>Measurements: </strong>The outcome was defined as having at least one non-fatal overdose in the past 3 months, and the exposure was defined as experiencing chronic pain in the past 3 months. Covariates were age; gender; past 3-month psychological distress (K10), housing status, opioid use, benzodiazepine use and opioid agonist treatment; past-month days of alcohol use; and interview era (pre-November 2020 vs. November 2020 onwards). A lagged analysis was conducted to explore temporality, based on chronic pain status reported at the visit preceding the outcome assessment. The analysis was not pre-registered and the results should therefore be regarded as exploratory.</p><p><strong>Results: </strong>The primary analysis included 4790 study visits from 887 participants and 355 reports of non-fatal overdose. At baseline, 81.4% of the sample was men, median age was 45 years and 46.8% reported chronic pain in the past 3 months. Chronic pain in the past 3 months was associated with a 40% increase in past 3-month non-fatal overdose [adjusted prevalence ratio (PR) = 1.40; 95% confidence interval (CI) = 1.13-1.75]. Similar results were observed in the lagged analysis (adjusted PR = 1.52, 95% CI = 1.18-1.96).</p><p><strong>Summary: </strong>In a Montreal, Canada, cohort of people who inject drugs, chronic pain was associated with experiencing non-fatal overdose. We interpret this finding within a reciprocal model of pain and substance use, in which chronic pain increases the likelihood of using drugs in ways that increase overdose risk, and pain is potentiated by drug use and withdrawal.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056740","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 use disorders among people convicted of large-, moderate- and small-scale drug supply crimes: A register-based retrospective comparative study.","authors":"Julie Elizabeth Brummer, Freja Ilsing Magnussen, Morten Hesse, Thomas Friis Søgaard","doi":"10.1111/add.70612","DOIUrl":"https://doi.org/10.1111/add.70612","url":null,"abstract":"<p><strong>Background and aims: </strong>Heavy drug use has been associated with small-scale drug crime, but the substance use histories of individuals involved in the manufacturing, smuggling and wholesaling of larger quantities of drugs [here referred to as serious drug crimes (SDC)] have been largely unexamined. We estimated and compared the prevalence of drug use disorders (DUDs) among individuals with and without convictions for SDC, and we compared the characteristics of individuals convicted of SDC with and without a history of DUD.</p><p><strong>Design: </strong>A register-based retrospective comparative study.</p><p><strong>Setting: </strong>Denmark.</p><p><strong>Participants: </strong>Individuals convicted of SDC (large-scale: n = 232, 98.3% male; moderate-scale: n = 2955, 92.5% male) and two comparison groups without histories of SDC (general population: n = 3187, 92.9% male; small-scale drug supply: n = 7630, 94.0% male), all born in 1985 or later and residents of Denmark.</p><p><strong>Measurements: </strong>Drug crime scale was determined from Danish legal categories and sentence lengths, which primarily reflect drug quantity. Large- and moderate-scale SDC groups were convicted under Penal Code Section 191, with the former receiving a prison sentence of ≥ 5 years for a Section 191 offense. The small-scale drug supply comparison group was convicted under the Euphoriants Act but not Penal Code Section 191. The general population comparison group was age- and sex-matched to the SDC groups and had no Penal Code Section 191 conviction. DUD prior to first supply-related drug crime, socio-demographic characteristics, criminal history, alcohol-related disorders and psychiatric problems were identified using national registers. Adjusted prevalence of DUD was estimated as predicted probabilities from logistic regression models including age and sex as covariates.</p><p><strong>Results: </strong>Adjusted DUD prevalence among both SDC groups was higher than in the general population group but lower than in the small-scale supply group [large-scale: 18.5%, 95% confidence interval (CI) = 13.8%-23.3%; moderate-scale: 24.3%, 95% CI = 22.8%-25.8%; small-scale: 29.4%, 95% CI = 29.2%-29.6%; general population: 3.2%, 95% CI = 2.6%-3.8%]. Individuals convicted of SDC with a history of DUD were more likely than those without a history of DUD to have prior alcohol [odds ratio (OR) = 1.92, 95% CI = 1.49-2.46], psychiatric (OR = 4.70, 95% CI = 3.87-5.71) and employment problems (OR = 1.65, 95% CI = 1.35-2.01).</p><p><strong>Summary: </strong>Individuals convicted of serious drug crimes in Denmark appear to have a lower prevalence of drug use disorders than individuals convicted of small-scale drug supply but a higher prevalence than members of the general population.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035719","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}