Addiction最新文献

{"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":"<p>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 <i>et al</i>. 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.</p><p><b>Predicting drinking onset</b>: Subtle physiological and behavioral shifts – rising stress levels [<span>1</span>], mounting alcohol cravings [<span>2</span>] or changes in daily routines – often signal the lead-up to a drinking event. Wearable sensors tracking heart rate variability [<span>3</span>] and skin conductance [<span>4</span>] can detect these internal cues, whereas external patterns, such as increased phone activity [<span>5</span>] or movement toward alcohol-related locations [<span>6</span>], may further indicate imminent drinking. Real-time nudges – like mindfulness exercises [<span>7</span>] or cognitive reappraisal strategies [<span>8</span>] – can be deployed at key moments, helping individuals disrupt habitual drinking patterns before they begin.</p><p><b>Measuring alcohol and effects</b>: Despite the modest effects reported by Östh <i>et al</i>. [<span>9</span>] for individuals tracking their alcohol intake using commercial breathalyzers, these devices remain imprecise in estimating blood alcohol concentration (BAC) [<span>10</span>]. Similarly, transdermal alcohol monitors, despite significant National Institutes of Health (NIH) investment, have yet to achieve the precision needed for reliable use [<span>11</span>]. Given these limitations, measuring the effects of alcohol on the body – rather than just its presence – offers a promising alternative or complement.</p><p>Recent research has shown that remote assessments of impairment, such as changes in gait [<span>12</span>], speech [<span>13</span>] and fine motor function (e.g. typing speed and accuracy) [<span>14</span>], 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.</p><p><b>Drawing attention to the aftermath</b>: 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}

{"title":"Did the United States smokeless tobacco industry use cigarette industry strategies to sponsor and manipulate research?","authors":"David S. Timberlake,&nbsp;Bryan D. Nguyen,&nbsp;Andrew T. Nguyen","doi":"10.1111/add.70039","DOIUrl":"10.1111/add.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aim</h3>\u0000 \u0000 <p>The cigarette industry in the United States (US) laid the foundation for sponsoring research to improve public relations and defend against product liability cases. Fewer threats of litigation facing the US smokeless tobacco (SLT) industry may have contributed to the sponsorship of independent research on SLT use and health outcomes. This study aimed to determine whether the SLT industry used cigarette industry strategies to manipulate research on health risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Internal industry documents (e.g. letters, memos) from the 1970s through 1990s were accessed through the online Truth Tobacco Industry Documents Library at the University of California, San Francisco. A framework of tobacco industry strategies and criteria for evaluating sponsored research formed the basis for categorizing and synthesizing documents identified via snowball sampling (<i>n</i> = 177). Summaries of awarded projects in annual reports of the Smokeless Tobacco Research Council (STRC) were coded for content (<i>n</i> = 189, 1982–1997).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Guided by legal counsel, the SLT industry sponsored research to support its interest group position; advocated against research on tobacco-specific carcinogens such as N-nitrosonornicotine (NNN); heavily criticized a case–control study on oropharyngeal cancer; and relied on a cadre of grantees and STRC leadership to testify against SLT restrictions. The STRC awarded a high proportion of projects on nicotine (78/189), including use for therapy (e.g. Tourette's syndrome), but underfunded epidemiologic research (<i>n</i> = 3). However, the STRC awarded projects on extracts or constituents (e.g. NNN, <i>n</i> = 30) that may have implicated SLT's role in carcinogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the Smokeless Tobacco Research Council awarded some research that may have weakened the industry, the Council's imbalanced portfolio of projects and inextricable link to industry likely favored the interest group position. Thus, we cannot conclude that the smokeless tobacco industry sponsored research solely for scientific discovery. Greater independence of industry-sponsored research could be achieved by delegating scientific decision-making to scientists (not legal counsel), limiting governance to those unaffiliated with the industry sponsor and not relying on grantees to defend the interest group position.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 7","pages":"1475-1483"},"PeriodicalIF":5.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633198","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":"Amphetamine use and mental health difficulties across adolescence and young adulthood: An integrative data analysis of four Australasian cohort studies.","authors":"Christopher J Greenwood, James Foulds, Rebecca McKetin, Stephanie R Aarsman, Delyse Hutchinson, Jessica Kerr, Jessica A Heerde, John W Toumbourou, Joseph M Boden, Tim Slade, Yvonne Bonomo, Primrose Letcher, Craig A Olsson","doi":"10.1111/add.70033","DOIUrl":"https://doi.org/10.1111/add.70033","url":null,"abstract":"<p><strong>Background and aims: </strong>The use of amphetamines (including amphetamine and methamphetamine) has been consistently associated with mental health difficulties; however, the direction of potential causal relationships has not yet been established. This study aimed to assess the direction relationships between illicit amphetamine use and mental health difficulties across adolescence and young adulthood.</p><p><strong>Design: </strong>Observational study of four population-level cohorts participating in the Monitoring Illicit Substance Use (MISUse) Consortium.</p><p><strong>Setting: </strong>Australia and New Zealand.</p><p><strong>Participants: </strong>A total of 7527 participants (51% female) were used: Christchurch Health and Development Study (n = 1056), Australian Temperament Project (n = 1644), Victorian Adolescent Health Cohort Study (n = 1943) and International Youth Development Study (n = 2884).</p><p><strong>Measurements: </strong>Assessments were used to derive binary indicators of amphetamine use (≥monthly) and mental health difficulties during both adolescence (age 10-17 years) and young adulthood (age 18-30 years).</p><p><strong>Findings: </strong>Associations were estimated as Risk Ratios (RRs) with 95% confidence internals (CIs) using G-computation procedures, while accounting for 15 potential confounding factors and interactions between exposure and both study cohort and participant sex. The risk of mental health difficulties in young adulthood was 21% greater (RR = 1.21, 95% CI = 1.04, 1.41) for those who reported monthly or more frequent amphetamine use in adolescence. The risk of monthly or higher amphetamine use in young adulthood was 19% greater (RR = 1.19, 95% CI = 0.99, 1.45) in those who reported mental health difficulties in adolescence. There was also some evidence to suggest that in males the strongest association was from amphetamine use to mental health difficulties (RR = 1.24, 95% CI = 0.95, 1.60), while in females the strongest association was from mental health difficulties to amphetamine use (RR = 1.33, 95% CI = 0.99, 1.78).</p><p><strong>Conclusions: </strong>There appears to be a bidirectional association between monthly or more frequent amphetamine use and mental health difficulties from adolescence to young adulthood.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633193","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":"Over a decade later and Addiction journal is still committed to publishing qualitative research","authors":"Joanne Neale,&nbsp;Brian C. Kelly,&nbsp;Jordan M. Braciszewski,&nbsp;Joanna Kesten,&nbsp;Stephen Lankenau,&nbsp;Paula Mayock,&nbsp;Jennifer Merrill","doi":"10.1111/add.70047","DOIUrl":"10.1111/add.70047","url":null,"abstract":"&lt;p&gt;&lt;i&gt;Addiction&lt;/i&gt; has faced persistent challenges in publishing qualitative research. In 2013, members of the then editorial team who handled qualitative papers wrote an editorial that both affirmed the journal's commitment to publishing high-quality qualitative research and highlighted the desire to receive more qualitative manuscripts [&lt;span&gt;1&lt;/span&gt;]. Over a decade later, and despite increasing the number of qualitative Associate Editors, few qualitative papers are published in &lt;i&gt;Addiction&lt;/i&gt;. This editorial reiterates the journal's desire to publish more qualitative studies and describes one important change and some clarifications to facilitate this.&lt;/p&gt;&lt;p&gt;Being a top journal in the field, &lt;i&gt;Addiction's&lt;/i&gt; bar for publication is high and therefore papers need to meet a certain quality threshold. In fact, the acceptance rate for qualitative papers is only marginally lower than for quantitative manuscripts, but there have been a consistently low overall number of qualitative submissions. For example, in 2024, &lt;i&gt;Addiction&lt;/i&gt; received only 66 qualitative papers out of approximately 1200 unsolicited submissions. It is likely that scholars see few qualitative papers published, presume &lt;i&gt;Addiction&lt;/i&gt; is resistant to accepting qualitative research, and look for alternative journals. If so, a cyclical problem of few qualitative papers submitted and published is created.&lt;/p&gt;&lt;p&gt;Members of the current editorial team who themselves publish qualitative research recently discussed this issue and debated how to increase the number of high-quality qualitative manuscripts both submitted to, and published in, &lt;i&gt;Addiction&lt;/i&gt;. Given the different disciplinary backgrounds of those involved (including applied health research, psychology, public health social work, social policy, and sociology), there was no expectation of reaching consensus on all possible topics. However, there were reassuring areas of agreement, and sufficient scope for compromise, such that we have been able to propose, and secure agreement from the Editor-in-Chief on, the following:&lt;/p&gt;&lt;p&gt;Foremost, we are pleased to announce that the journal has extended the word limit for qualitative papers from 4500 to 6000 words. This new limit continues to necessitate economy of prose, but more fully recognizes that the data presented within qualitative papers, whether quotations from interviews or excerpts from ethnographic field notes, add to the word count. Equally, qualitative researchers need space to fully contextualize their participants and study setting. The new word count should enable authors to include quotations (or other qualitative data) and meaningful participant identifiers within the main body of their text rather than, for example, relegating them to a table separated from the narrative.&lt;/p&gt;&lt;p&gt;We also clarify that &lt;i&gt;Addiction&lt;/i&gt; is not excessively prescriptive in its use of guidelines for qualitative authors. There is no single way to conduct qualitative research. Alongside","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 7","pages":"1292-1294"},"PeriodicalIF":5.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622849","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":"Decentering alcohol: Non-drug pleasure and reinforcement as an alternative target","authors":"Samuel F. Acuff,&nbsp;Justin C. Strickland","doi":"10.1111/add.70048","DOIUrl":"10.1111/add.70048","url":null,"abstract":"&lt;p&gt;The opinion and debate piece by Nicholls and Hunt [&lt;span&gt;1&lt;/span&gt;] stimulates an interesting discussion on the importance of pleasure in public health-oriented research on alcohol. We agree that pleasure is an important concept in understanding alcohol use as well as other substance use, and that public health discourse limits its own efficacy by focusing primarily on harm without acknowledging many of the benefits people report experiencing from drinking (or other drug use). This idea is broadly consistent with the behavioral science literature, which posits that alcohol can function as a positive reinforcer by producing desirable effects (e.g. enhancing social connection, inducing pleasant subjective effects) that increase the likelihood of future alcohol use.&lt;/p&gt;&lt;p&gt;These reinforcing effects may, at least during any discrete use occasion, outweigh the costs, acute or chronic, of alcohol use [&lt;span&gt;2&lt;/span&gt;]. Although humans are motivated by costly immediate harms [&lt;span&gt;3&lt;/span&gt;], they are less so by delayed, diffuse, and uncertain ones [&lt;span&gt;4-6&lt;/span&gt;]. This human aversion to immediate harms is matched by an innate, evolutionarily adaptive drive for pleasure or related positive subjective states. From a population perspective, harms associated with alcohol use are characteristically delayed, diffuse and uncertain for most people who use alcohol, if they experience problems at all, and rewards are often immediate and robust. In the case of social connection, for example, alcohol may help to facilitate a basic human need of social bonding [&lt;span&gt;7, 8&lt;/span&gt;] while only inconsistently resulting in harms that lessen this potent reward. Ignoring the reality that many find alcohol to be pleasurable goes against the experience of many who drink and threatens to delegitimize public health messaging. A similar problem can be found in many treatment settings that focus almost exclusively on reiterating harms of alcohol while failing to acknowledge that drinking once served an adaptive function, even if for most it was maladaptive by the time treatment began.&lt;/p&gt;&lt;p&gt;Although perhaps conspicuously absent from public health messaging research, there is a rich history of experimental work describing the pleasurable effects of alcohol and other drugs [&lt;span&gt;9-12&lt;/span&gt;]. These studies, typically conducted in the framework described by the United States Food and Drug Administration Human Abuse Potential guidelines, seek to evaluate subjective effects like ‘Good Effect’ or ‘Drug Liking’ and determine the potential for a drug's future misuse [&lt;span&gt;13&lt;/span&gt;]. Notably, these studies highlight the role that pleasure, or more broadly positive reinforcing effects, play in determining future behavior—behaviors that evoke greater pleasure are more likely to be repeated in the future, and a drug's ‘abuse potential’ is at least in part related to its ability to induce pleasure.&lt;/p&gt;&lt;p&gt;In addition to understanding the importance of the reinforcing efficacy of alcoho","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1086-1087"},"PeriodicalIF":5.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622845","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":"Taking pleasure seriously: Should alcohol research say more about fun? ‘No safe level’ advocates must take note","authors":"James Morris,&nbsp;Emma Davies","doi":"10.1111/add.70050","DOIUrl":"10.1111/add.70050","url":null,"abstract":"&lt;p&gt;Nicholls and Hunt propose three arguments for why pleasure should be taken more seriously in alcohol research and policy debates [&lt;span&gt;1&lt;/span&gt;]. We concur with each, but focus here on the pragmatic case; namely, that ignoring the experienced pleasures of drinking can undermine public health efforts towards reducing alcohol harm.&lt;/p&gt;&lt;p&gt;Nicholls and Hunt highlight the limitations of health messages for behaviour change, notably observing that a public health ‘expert story’ of alcohol being inherently dangerous ‘runs hard against a public view of drinking’ as generally positive. We believe this is particularly important for public health actors to attend to, especially considering the increasing focus on cancer risks and ‘no safe level of consumption’ messaging. Psychological research has explored a range of phenomena that can inform public health messaging in this regard.&lt;/p&gt;&lt;p&gt;In addition to the risk of failing to change behaviour, messages that run against people's lived experiences risk backfire effects [&lt;span&gt;2&lt;/span&gt;]. Even neutral alcohol risk messages have been found to evoke &lt;i&gt;defensive processing&lt;/i&gt; amongst heavier drinkers, provoking denial, minimization or the avoidance of content, below conscious awareness [&lt;span&gt;3&lt;/span&gt;]. This resistance appears to increase linearly with the level of consumption, indicating that the more individually relevant the risk information, the more likely that drinkers are to reject it [&lt;span&gt;3&lt;/span&gt;]. This is not to infer that risk-based messaging is redundant; rather, the mixed evidence on its effectiveness highlights the need for further understanding of the specific role of message content and key moderating processes, such as perceived relevance, emotional responses and self-efficacy [&lt;span&gt;3-5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Qualitative research has also identified how heavier drinkers use personal exceptionalism and othering as strategies to construct and place their own drinking as ‘responsible’ in contrast to a stereotyped ‘other’ [&lt;span&gt;6&lt;/span&gt;], including in response to alcohol health warnings [&lt;span&gt;7&lt;/span&gt;]. Drinkers perceive a wide range of positives associated with drinking and are skilled at deploying these to resolve any dissonance invoked by incongruent information [&lt;span&gt;6-8&lt;/span&gt;]. An evolving literature highlights how framing, stigma and identity processes may be involved in rejecting messages that are incongruent with a drinker's own experiences of alcohol use as being largely without problems and pleasurable [&lt;span&gt;3, 4, 9, 10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In addition to overlooking pleasure in drinking, ‘no safe level’ messaging may also reinforce the general perception that abstinence is the only acceptable goal. Indeed, abstinence can be perceived as threatening to drinkers and result in resistance or even the stigmatization of non-drinkers [&lt;span&gt;11&lt;/span&gt;]. Rather, it has been argued that an increasing recognition of moderation as an acceptable goal has a number of public health benefits [&lt;span&gt;12&lt;/span","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 6","pages":"1084-1085"},"PeriodicalIF":5.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622850","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":"Medication experiences in the treatment of opioid use disorders: Insights from Reddit.","authors":"Alexandra Almeida, Mike Conway, David J Grelotti, Amarnath Gupta, David Frank, Annick Bórquez","doi":"10.1111/add.70022","DOIUrl":"https://doi.org/10.1111/add.70022","url":null,"abstract":"<p><strong>Background and aims: </strong>Better understanding the challenges faced by patients on medications for opioid use disorder (MOUD), including methadone and buprenorphine, is critical to increasing their use/retention. Social media platforms such as Reddit offer a space for patients to share their experiences with medications. We aimed to identify and characterize challenges faced by patients taking MOUD through analysis of discussions from the r/Methadone and r/suboxone subreddits.</p><p><strong>Design, setting and participants: </strong>Mixed methods study applying natural language processing methods to 37 278 posts from both subreddits from their origin in 2011 until 31 December 2022. Independent topic analyses used Correlated Topic Models to extract the main themes discussed.</p><p><strong>Measurements: </strong>We labeled, validated and grouped the topics into macro classes and computed topic shares. We interpreted and compared topics across subreddits informed by the patient-centered medication experience framework.</p><p><strong>Findings: </strong>We found 27 and 34 challenge-related topics for the r/Methadone and r/suboxone subreddits, respectively. Topics were grouped into three macro-topics: (i) healthcare-related issues, including misunderstandings/confusion around appointments, prescriptions, bottle checks, telehealth technology and health insurance coverage; (ii) medication-related issues, including withdrawal, cravings, dosage, side effects, mixing with other medications/drugs; and (iii) treatment discontinuation, including tapering protocols. Patients conveyed highly specialized knowledge about dosage and tapering strategies and spoke from experience. Key differences between r/Methadone and r/suboxone were driven by their dispensing requirements (clinic-based vs. take-home), with 20.05% vs 14.74% of posts related to healthcare service, primarily for logistic and interpersonal issues with healthcare providers.</p><p><strong>Conclusion: </strong>People who post on the r/Methadone and r/suboxone subreddits appear to have detailed knowledge of medications for opioid use disorder and want more control over their dosing, effects, side effects and discontinuation. Acknowledging this expertise and establishing stronger patients' partnerships with the healthcare team and system might result in better treatment outcomes.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612774","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 hazardous alcohol use in primary care using phosphatidylethanol: Timing of screening matters","authors":"Viktor Månsson,&nbsp;Maria Hårdstedt,&nbsp;Anders Hammarberg,&nbsp;Anders Hake,&nbsp;Riccardo LoMartire","doi":"10.1111/add.70036","DOIUrl":"10.1111/add.70036","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Alcohol is a well-established risk factor for numerous health conditions, making screening for hazardous alcohol use in healthcare a critical task. While self-reported data suggest that alcohol consumption varies across seasons, this seasonal fluctuation has not yet been confirmed using objective biological markers. This study aimed to measure whether phosphatidylethanol (PEth) captures variations in hazardous alcohol use across two temporal resolutions: month of the year and day of the week.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Observational cross-sectional study based on data from medical records.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Healthcare services, Region Dalarna, Sweden, between 2017 and 2023.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants/Cases&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adult patients (&lt;i&gt;n&lt;/i&gt; = 62 431, 50% females) screened for hazardous alcohol use with PEth within primary care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study utilizes test results from PEth, with results &gt;0.30 μmol/l defined as hazardous alcohol use. We compared the prevalence of hazardous alcohol use across months and weekdays using logistic regression while adjusting for sex, age, smoking status, the Charlson Comorbidity Index and psychiatric diagnoses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The prevalence of hazardous alcohol use increased between May and August, ranging from 13.2% to 15.9%, compared with 10.7% in November. This corresponds to a 48% relative increase in the peak month of July [prevalence ratio (PR) = 1.48, 95% confidence interval (CI) = 1.33–1.64]. Hazardous alcohol use was also more prevalent among patients tested on Mondays (13.0%) compared with Thursdays, with the lowest prevalence (12.0%). The difference was particularly pronounced among female patients, with a 14.0% higher relative prevalence on Mondays (PR = 1.14, 95% CI = 1.02–1.27).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In Sweden, the prevalence of hazardous alcohol use appears to fluctuate seasonally and, to a lesser extent, across weekdays, as measured by blood tests for phosphatidylethanol, a biomarker for hazardous alcohol use. November showed the lowest prevalence and July the highest, consistent across age","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 7","pages":"1441-1449"},"PeriodicalIF":5.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622847","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}