Addiction最新文献

{"title":"Psychedelic-assisted treatment for substance use disorder: A narrative systematic review.","authors":"Theodore Piper, Francesca Small, Sam Brown, Michael Kelleher, Luke Mitcheson, James Rucker, Allan H Young, John Marsden","doi":"10.1111/add.16762","DOIUrl":"https://doi.org/10.1111/add.16762","url":null,"abstract":"<p><strong>Background and aims: </strong>This is the first systematic review of the extant literature on all major psychedelic-assisted treatment for alcohol use disorder (AUD), tobacco use disorder (TUD) and other substance use disorders (SUD). We aimed to summarise the evidence for efficacy of psychedelic-assisted treatment for AUD, TUD, and SUD; to evaluate its quality; and to offer recommendations for research.</p><p><strong>Methods: </strong>This was a prospectively registered narrative systematic review of open-label, randomised controlled trials (RCT), and observational studies of d-lysergic acid diethylamide (LSD), mescaline, psilocybin, ayahuasca, ketamine, ibogaine and 3,4-methylenedioxymethamphetamine (MDMA). Eligible studies had SUD outcome measures including craving, substance use, relapse, and remission. Study quality was evaluated using the Cochrane Collaboration Risk of Bias (RoB), and Cochrane Collaboration RoB in Non-randomised Studies of Interventions tool. Certainty of evidence for RCTs was judged using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool.</p><p><strong>Findings: </strong>37 studies (2035 participants) were reviewed: LSD (14; n = 1047); mescaline (1; n = 7); psilocybin (4; n = 135); ayahuasca (3; n = 101); ketamine (10; n = 579); ibogaine (5; n = 166); and MDMA (1; n = 14). There were no serious adverse events reported in any study. A two-centre, placebo-controlled, phase 2 superiority RCT of psilocybin for AUD, and a two-centre, double-blind, four-arm, placebo-controlled phase 2 RCT of ketamine for AUD yielded the best evidence of efficacy. Progression support to a phase 3 trials was secured from an open-label phase 2 study of psilocybin for TUD and nine phase 2 RCTs of ketamine for AUD, cannabis use disorder, cocaine use disorder, and opioid use disorder (all nine with high-RoB and low-GRADE evidence certainty).</p><p><strong>Conclusions: </strong>Psilocybin-assisted treatment for alcohol use disorder appears to have the best evidence of efficacy among all major psychedelic-assisted treatments for alcohol, tobacco, and other substance use disorders. Future research of psychedelic-assisted treatment should report all safety events; screen for person-level characteristics indicating that psychedelic-assisted substance use disorders treatment is contraindicated; strive to mitigate blinding of participants to interventions; use factorial designs for drug and psychotherapy randomised controlled trials; and build consensus for a field-specific Core Outcome Set.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062201","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":"Association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy: A retrospective cohort study from British Columbia, Canada.","authors":"Samantha Young, Nadia Fairbairn, Zishan Cui, Paxton Bach, Wing Yin Mok, Juls Budau, Amanda Slaunwhite, Lianping Ti, Kanna Hayashi, Seonaid Nolan","doi":"10.1111/add.16760","DOIUrl":"10.1111/add.16760","url":null,"abstract":"<p><strong>Aims: </strong>We measured the association between prescribed stimulant medications and overdose among individuals receiving opioid agonist therapy (OAT) for opioid use disorder.</p><p><strong>Design: </strong>Retrospective cohort study using the British Columbia Provincial Overdose Cohort, a linked administrative database.</p><p><strong>Setting: </strong>We used data from British Columbia, Canada, from January 2015 through February 2020.</p><p><strong>Participants: </strong>In total, 9395 individuals contributed 18 273 person-years of follow-up while dispensed OAT.</p><p><strong>Measurements: </strong>We examined the association between stimulant prescription (primary exposure) and fatal or non-fatal overdose (primary outcome, allowing for recurrent events) after adjusting for potential confounders including sociodemographic characteristics and substance use patterns. As a secondary analysis, we evaluated type of OAT (full agonists involving methadone or slow-release oral morphine versus partial agonist involving buprenorphine/naloxone alone) as a potential effect modifier.</p><p><strong>Findings: </strong>There were 1746 overdose events; 37 (2.1%) were fatal. Overall, there was no increased risk of overdose among individuals dispensed a stimulant medication while on OAT [adjusted Cox regression hazard ratio (AHR) = 1.13, 95% confidence interval (95% CI) = 0.86-1.49, P = 0.39]. When analyzed by type of OAT medication, for individuals on buprenorphine, dispensation of a stimulant medication was associated with a reduced risk of overdose (AHR = 0.47, 95% CI = 0.23-0.96, P = 0.037) while, for individuals on full agonist OAT, dispensation of a stimulant medication was associated with an increased risk of overdose (AHR = 1.51, 95% CI = 1.09-2.07, P = 0.012).</p><p><strong>Conclusions: </strong>There does not appear to be an overall increased risk of overdose for individuals co-prescribed a stimulant medication with opioid agonist therapy (OAT). There appears to be a reduced risk of overdose for individuals dispensed buprenorphine with a stimulant medication compared with those dispensed buprenorphine alone, and an increased risk of overdose for individuals dispensed full agonist OAT (methadone or slow-release oral morphine) with a stimulant medication compared with those dispensed full agonist OAT alone.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051044","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":"Recovery support services as part of the continuum of care for alcohol or drug use disorders.","authors":"Ed Day, Laura Charlotte Pechey, Suzie Roscoe, John F Kelly","doi":"10.1111/add.16751","DOIUrl":"https://doi.org/10.1111/add.16751","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The definition of 'recovery' has evolved beyond merely control of problem substance use to include other aspects of health and wellbeing (known as 'recovery capital') which are important to prevent relapse to problematic alcohol or other drug (AOD) use. Developing a Recovery Oriented System of Care (ROSC) requires consideration of interventions or services (Recovery Support Services, RSS) designed to build recovery capital which are often delivered alongside established treatment structures. Lived experience and its application to the process of engaging people, changing behaviour and relapse prevention is an essential part of these services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To map out the evidence base for RSS as part of guidance for commissioners of addiction services in each of the 152 local authorities in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The authors updated the findings of a 2017 systematic review of RSS through a further rapid scoping review, aiming to map out the extent, range and nature of research under six headings: (1) Peer-based recovery support services (P-BRSS); (2) Employment support approaches; (3) Recovery housing; (4) Continuing care and recovery check-ups; (5) Recovery community centres (RCC); and (6) Recovery support services in educational settings. A systematic search of the PubMed, Embase, CINAHL, CENTRAL and PsychINFO databases was conducted. The abstracts of all articles published since 2017 were reviewed by two of the authors, and the full text versions of all relevant articles were obtained and relevant data extracted. A narrative review of the findings was then prepared, mapping them on to the ROSC continuum of care. The review was restricted to adults (over 18 years), but all substances and available outcomes were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four of the six forms of RSS were well supported by evidence. RCTs of interventions to increase levels of employment demonstrated large effect sizes, and continuing care interventions that extend treatment intervention into the early recovery phase have shown small but significant benefit. Peer-delivered interventions to link people to ongoing support were associated with decreased rates of relapse and re-admission, increased engagement, and increased social support for change. However, the variability in the design of these studies means that further work is required to clarify the effective components of the intervention. Studies of recovery housing have also shown positive results, including significant differences from standard care. No controlled studies exist to support RCCs or RSS in educational settings, but the complexity of these interventions and the wide range of potential outcome measures mean that other study designs may be more relevant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This monograph provides a structure to help policy makers, commissioners and service providers describe and understand an emerging field of research","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051045","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":"Association between change in alcohol use reported during routine healthcare screening and change in subsequent hospitalization: A retrospective cohort study","authors":"Helen E. Jack,&nbsp;Douglas B. Berger,&nbsp;Jennifer F. Bobb,&nbsp;Malia M. Oliver,&nbsp;Katherine A. Bradley,&nbsp;Kevin A. Hallgren","doi":"10.1111/add.16771","DOIUrl":"10.1111/add.16771","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;Primary care systems often screen for unhealthy alcohol use with brief self-report tools such as the 3-item Alcohol Use Disorders Identification Test for consumption (AUDIT-C). There is little research examining whether change in alcohol use measured on the AUDIT-C captures meaningful change in outcomes affected by alcohol use. This study aimed to measure the association between change in AUDIT-C and change in all-cause hospitalization risk, measured in the year after each AUDIT-C.&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;Retrospective cohort study.&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;Health system in the state of Washington, USA, that conducts annual screening with the AUDIT-C in outpatient care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adults (&lt;i&gt;n&lt;/i&gt; = 165 101) who had completed at least two AUDIT-Cs 11–24 months apart (2016–2020).&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;AUDIT-C scores were grouped into five risk categories reflecting no drinking (0), drinking without unhealthy alcohol use [1–2 (female)/1–3 (male)] and unhealthy alcohol use with moderate risk [3–6 (female)/4–6 (male)], high risk (7–8), and very high risk (9–12). Changes in AUDIT-C were based on the number of category levels that changed (0–4). Hospitalizations were binary, reflecting one or more hospitalizations in the 365 days after each AUDIT-C, identified from insurance claims.&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;Of 165 101 eligible patients, 5.7% and 6.1% were hospitalized the year after the first and second AUDIT-C, respectively. Decreases in AUDIT-C risk category of 1 or ≥2 levels were associated with statistically significant decreases in risk of hospitalization, compared with the change in hospitalization risk for those with no change in AUDIT-C [1-level decrease: ratio of adjusted risk ratios (aRR) = 0.92, 95% confidence interval (CI) = 0.86–0.99; ≥2-level decrease: ratio of aRR = 0.68, 95% CI = 0.58–0.81]. Increases in AUDIT-C risk category of 1 or ≥2 levels were not associated with statistically significant differences in risk of hospitalization, compared with those with no change in AUDIT-C.&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;A decrease in AUDIT-C score risk category is associated with a decreased risk of both all-cause hospitalizations and hospitalizations with conditions directly or potentially attri","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"884-894"},"PeriodicalIF":5.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Approach to Addiction and Choice: Akrasia and the Nature of Free Will. By Reinout W. Wiers, New York, USA: Routledge. 2025. ISBN: 9781032631615","authors":"Lucas Palmer","doi":"10.1111/add.16776","DOIUrl":"https://doi.org/10.1111/add.16776","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"1058-1059"},"PeriodicalIF":5.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818802","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":"Educational attainment as a potential effect modifier of alcohol use and 100% alcohol-attributable mortality in the United States-A longitudinal analysis of mortality linked survey data from 1997 to 2018.","authors":"Charlotte Probst, Yachen Zhu, Carolin Kilian, William Kerr, Jürgen Rehm","doi":"10.1111/add.16774","DOIUrl":"https://doi.org/10.1111/add.16774","url":null,"abstract":"<p><strong>Aims: </strong>To measure effects between educational attainment and alcohol use as a driver of unequal alcohol-attributable mortality.</p><p><strong>Design: </strong>Nation-wide cohort study using a longitudinal design, linking data from the 1997-2018 National Health Interview Survey to mortality data of the National Death Index in 2019. The study has an average follow-up time of 10.7 years (SD = 6.4).</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>Nationally representative sample of adults aged 25 years and older.</p><p><strong>Measurements: </strong>The outcome was time to 100% alcohol-attributable mortality, censored or last presumed alive by 31 December 2019. Socioeconomic status was operationalized via educational attainment; alcohol use was self-reported and operationalized using a categorical measure with lifetime abstainers as reference category.</p><p><strong>Findings: </strong>Of a total of 562 632 adults, 901 (635 men and 266 women) died during follow-up from a 100% alcohol-attributable cause of death [15 per 100 000 person years (PY)]. We found a strong interaction effect between low education and Category III alcohol use (>60 g and >40 g per day for men and women, respectively), which was of additive nature as shown by the Aalen's additive hazards model, with 83.68 additional deaths per 100 000 PY (95% confidence interval = 16.48-150.87) found in individuals with low education with Category III drinking compared with a situation when there was no interaction between the two risk factors. A large and statistically significant relative excess risk due to interaction (RERI) of 32.05 from the Cox model supported the interaction. For individuals with low education, the risk associated with Category III drinking was double that for those with high education.</p><p><strong>Conclusions: </strong>In the United States, people with combined low education and high alcohol consumption (>60 g/day for men, >40 g/day for women) appear to have a higher risk of 100% alcohol-attributable mortality compared with other combinations of educational attainment and drinking.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044994","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":"Re: The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis","authors":"Yanning Wang,&nbsp;Almut G. Winterstein","doi":"10.1111/add.16779","DOIUrl":"10.1111/add.16779","url":null,"abstract":"&lt;p&gt;We appreciate the study by Qeadan &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] suggesting an association between glucose-dependent insulinotropic polypeptide (GIP) and/or glucagon-like peptide-1 receptor agonists (GLP-1) and lower rates of opioid overdose and alcohol intoxication among patients with opioid use disorder (OUD) and alcohol use disorder (AUD). Although promising, several methodological limitations warrant critical discussion.&lt;/p&gt;&lt;p&gt;A central issue lies in the definition of study entry for the comparator group, using a random date following the diagnosis of OUD or AUD. This approach introduces potential bias by failing to align the clinical trajectories between the groups. Unlike the defined index time for the GIP/GLP-1 group, which coincides with a specific intervention (initiation of therapy), the index time for the comparator group lacks a similar clinical context. Based on plotted incidence rates (Figure 1), it appears that the timing of study entry post OUD/AUD diagnosis is skewed toward acute substance use-related care, with peaks in opioid overdose or alcohol intoxication incidence only 1 month after study entry. In contrast, GIP/GLP-1 treatment was likely initiated during stable clinical periods, far from the acute OUD/AUD management phase, illustrated by flat outcome incidence rates, which align with those of the control group after the first year of follow-up. To better control this potential time-related bias and align substance use disorder trajectories [&lt;span&gt;2, 3&lt;/span&gt;], matching the time intervals between OUD/AUD diagnosis and study entry between both groups would have been desirable.&lt;/p&gt;&lt;p&gt;Further, even if trajectories were aligned, choosing a non-active comparator design is subject to residual confounding from the differences in healthcare engagement, treatment-seeking behaviors and comorbidities [&lt;span&gt;4&lt;/span&gt;]. This notion is reflected in the substantial differences in patient characteristics, shift in adjusted interval rate ratios toward the null and weakened protected effect when restricting the analysis to patients with a history of Type-2 diabetes or obesity. Although the authors adjusted for various covariates, unmeasured confounders related to disease severity, healthcare access and provider practices could still influence the results. A subgroup analysis with an active comparator group [&lt;span&gt;5, 6&lt;/span&gt;], such as patients initiating other diabetes treatments [e.g. sodium-glucose cotransporter-2 (SGLT-2) inhibitors or sulfonylureas], would help minimize confounding by indication, because they ensure that both groups represent populations similarly engaged in healthcare and facing comparable clinical decisions.&lt;/p&gt;&lt;p&gt;Finally, using electronic health record data adds additional complexity because of potential gaps in data continuity [&lt;span&gt;7-10&lt;/span&gt;]. Notably, patients in the comparator group were less likely to have insurance, which raises concerns about differential exposure, confounder and outcome measurement betwe","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"1060-1061"},"PeriodicalIF":5.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035386","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":"Commentary on Craft et al.: Drug contaminants and substitutions in illicit vapes represent a major health risk","authors":"Caroline S. Copeland","doi":"10.1111/add.16777","DOIUrl":"10.1111/add.16777","url":null,"abstract":"&lt;p&gt;In the past decade, nicotine vaping in the UK has changed dramatically. Originally targeted at adults as smoking cessation aids [&lt;span&gt;1&lt;/span&gt;], the use of vapes amongst teenagers and young adults has rapidly grown to what has been described as a ‘vaping epidemic’, with a 2023 survey showing that 20% of 11–17 year olds had tried vaping, up from 7% in 2014 [&lt;span&gt;2&lt;/span&gt;]. A significant driver of this trend has been cited as the emergence of disposable vapes that are available in a variety of flavours and nicotine strengths [&lt;span&gt;3&lt;/span&gt;]. In response to the health and environmental concerns posed by disposable vapes, the UK Government announced that they will be banned from June 2025 [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Concurrently, there has been emerging demand for non-nicotine vapes, predominated by those marketed as containing Δ-9-tetrahydrocannabinol (THC) [&lt;span&gt;5&lt;/span&gt;], the major psychoactive ingredient in cannabis [&lt;span&gt;6&lt;/span&gt;]. Although it is legal to manufacture and sell THC vapes in other countries (e.g. Canada, Germany and certain states in the USA), they remain illegal in the UK [&lt;span&gt;7&lt;/span&gt;]. Craft &lt;i&gt;et al&lt;/i&gt;. describe a case where an individual submitted seven vapes sold as containing ‘THC-based products’ to a drug and alcohol service in the UK, which upon forensic toxicological analysis were found to contain the synthetic cannabinoid 5F-MDMB-PICA [&lt;span&gt;8&lt;/span&gt;]. Synthetic cannabinoids, including 5F-MDMB-PICA, are full agonists of the CB&lt;sub&gt;1&lt;/sub&gt; receptor [&lt;span&gt;9&lt;/span&gt;], and have been linked to several fatal and non-fatal poisonings [&lt;span&gt;10, 11&lt;/span&gt;]. The contamination and substitution of illicit THC vapes with other substances has also been observed elsewhere, with the Welsh Emerging Drugs &amp; Identification of Novel Substances (WEDINOS) project [&lt;span&gt;12&lt;/span&gt;] – an initiative that tests drug samples submitted by members of the public – detecting a variety of both illicit drugs (e.g. cocaine, heroin, ketamine, synthetic opioids of the nitazene class, ‘street’ benzodiazepine bromazolam, the hallucinogen 25B-NBOH and the synthetic stimulant 4-CEC) and licensed medicines (e.g. aspirin, dihydrocodeine, the local anaesthetic lidocaine, the sedating antihistamine promethazine and the anxiolytic pregabalin) in samples submitted as ‘THC vapes’, ‘THC vape fluid’ or ‘THC vape juice’.&lt;/p&gt;&lt;p&gt;The health harms of illicit drugs such as cocaine and nitazenes are well documented and understood [&lt;span&gt;13, 14&lt;/span&gt;]. However, the vaping of many drugs – whether illicit substances or licensed medicines – will likely pose additional health harms as drugs are seldom designed to be heated and inhaled as the route of administration. Whereas the risks of vaping potent sedatives such as nitazenes may be more immediately apparent, with rapid systemic absorption by the alveolar epithelium leading to respiratory depression, the addition and/or substitution of common licensed medicines such as aspirin and lidocaine into vape fluid may at fi","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 3","pages":"555-556"},"PeriodicalIF":5.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16777","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035384","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":"Mortality risk among individuals who smoke opioids compared with those who inject: A propensity score-matched cohort analysis of United States national treatment data","authors":"George Karandinos,&nbsp;Jay Unick,&nbsp;Daniel Ciccarone","doi":"10.1111/add.16740","DOIUrl":"10.1111/add.16740","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Opioid smoking is becoming more common in the United States. The aim of this analysis was to estimate relative mortality risk among those who primarily smoke opioids compared with those who inject.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective propensity score-matched cohort analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>2006–2021 US treatment episode data from SAMHSA TEDS-D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>We matched 287 481 individuals in a substance use treatment program reporting smoking opioids as their primary substance use to an equal weighted number of individuals in a substance use treatment program reporting injecting opioids as their primary substance use. The majority of individuals reporting smoking were male (62.6%), 21–29 years old (47.9%), white (65.7%), independently housed (54.3%) and in the West Census Region (70.3%). Cohort characteristics were closely balanced after matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>The outcome of interest was death during a treatment episode. Variables used for matching were year, opioid category, gender, race/ethnicity, age category, census region, housing status, employment status, number of prior treatment admissions, variables associated with opioid use severity (opioid use frequency, treatment setting intensity, age at first opioid use, use of medication-assisted treatment) and other reported substance use (methamphetamine, alcohol, benzodiazepines, cocaine).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The mortality rate was 6.5 [95% confidence interval (CI) = 5.9–7.1] per 1000 person-years in the smoking cohort and 9.7 (95% CI = 8.8–10.8) per 1000 person-years in the injection cohort, with a mortality rate ratio of 0.67 (95% CI = 0.58–0.77).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among individuals in substance use treatment in the United States, those who usually smoke opioids appear to have a lower all-cause mortality risk than those who usually inject.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"1040-1045"},"PeriodicalIF":5.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021342","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":"Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001–2019","authors":"Greta Bushnell,&nbsp;Kristen Lloyd,&nbsp;Mark Olfson,&nbsp;Tobias Gerhard,&nbsp;Katherine Keyes,&nbsp;Magdalena Cerdá,&nbsp;Deborah Hasin","doi":"10.1111/add.16749","DOIUrl":"10.1111/add.16749","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.&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;Annual, cross-sectional study, 2001–2019.&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;Medicaid Analytic eXtracts (MAX) and Transformed Medicaid Analytic Files (TAF) from 42 US states with complete data.&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;Adolescents (13–17 years) and young adults (18–29 years) with ≥10 months Medicaid enrollment in the calendar year; analytic sample contained 5.7 (2001) to 13.2 (2019) million persons per year.&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;Annual prevalence of SHA-UD in adolescent and young adult Medicaid enrollees [defined as an inpatient or outpatient ICD code (304.1x, 305.4x, F13.1x, F13.2x) in the calendar year] was stratified by sex, race/ethnicity, receipt of a benzodiazepine, z-hypnotic or barbiturate prescription, and selected mental health diagnoses. Absolute and relative percent-changes from 2001 vs. 2019 were summarized. Secondary analyses were restricted to states with more consistent data capture.&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 SHA-UD diagnoses statistically significantly increased for adolescents (0.01% to 0.04%) and young adults (0.05% to 0.24%) from 2001 to 2019. Increasing trends were observed in sex and race/ethnicity subgroups, with greatest relative increases among Non-Hispanic Black (624%) and Hispanic (529%) young adults. The trend increased among those with and without a benzodiazepine, z-hypnotic or barbiturate prescription; i.e. young adults with (2001 = 0.39% to 2019 = 1.77%) and without (2001 = 0.03% to 2019 = 0.18%) a prescription. Most adolescents (76%) and young adults (91%) with a SHA-UD diagnosis in 2019 had a comorbid substance use disorder.&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;Sedative, hypnotic or anxiolytic use disorders (SHA-UD) diagnoses increased 3- to 5-fold between 2001 and 2019 for adolescent and young adul","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"951-961"},"PeriodicalIF":5.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021344","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}