Addiction最新文献

{"title":"Correction to \"Offering e-cigarettes for smoking cessation and reduction in people with mental illness (ESCAPE): Protocol for a randomized controlled trial\".","authors":"","doi":"10.1111/add.70456","DOIUrl":"https://doi.org/10.1111/add.70456","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757611","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":"Understanding purchasing patterns of alcoholic, alcohol-free and low-alcohol drinks: A latent profile analysis.","authors":"Oscar Rousham, Abigail K Stevely, John Holmes","doi":"10.1111/add.70445","DOIUrl":"https://doi.org/10.1111/add.70445","url":null,"abstract":"<p><strong>Background and aim: </strong>Alcohol-free and low-alcohol (no/lo) drinks (≤1.2% ABV) are increasingly popular in high-income countries. Their potential to reduce alcohol-related harm depends on who buys them, in what quantity and their incorporation into overall drinking patterns. We aimed to (1) compare purchases containing only no/lo drinks, only alcoholic drinks or both, over time between 2018 and 2023; (2) identify subgroups with distinct purchasing patterns in 2023; and (3) describe sociodemographic differences between these subgroups.</p><p><strong>Design: </strong>Latent profile analysis of cross-sectional household purchasing data.</p><p><strong>Setting: </strong>Great Britain, 2018 and 2023.</p><p><strong>Participants: </strong>Nationally representative samples of 30 401 (2018) and 28 254 (2023) households. 4975 households purchasing no/lo drinks in 2023 were included in the latent profile analysis.</p><p><strong>Measurements: </strong>Data included off-trade (i.e. shop) purchasing occasions categorised into no/lo-only, alcohol-only or no/lo alongside alcohol. Household characteristics were purchasing frequency, standard servings of no/lo drinks per adult, alcohol risk levels based on weekly units of alcohol purchased per adult (non-drinker: 0 units; low-risk: ≤14 units; increasing risk: >14- ≤ 35 units; high-risk: >35 units; 1 unit = 8 g alcohol), age, social class, region and ethnicity.</p><p><strong>Findings: </strong>From 2018 to 2023, the proportion of purchasing occasions that were alcohol-only fell from 97% [95% confidence interval (CI) = 97%-97%] to 95% (95% CI = 95%-95%), while no/lo-only purchases rose from 1.4% (95% CI = 1.3%-1.4%) to 2.7% (95% CI = 2.7%-2.8%) and no/lo alongside alcohol purchases rose from 1.2% (95% CI = 1.2%-1.2%) to 1.9% (95% CI = 1.9%-2.0%). In 2023, no/lo-only purchases were smaller (median = 6.9 no/lo servings) than no/lo alongside alcohol purchases (median = 6.5 plus 24.5 alcohol units) and alcohol-only purchases (median = 24.6 units). No/lo-only purchases occurred earlier in the week, no/lo alongside alcohol purchases peaked on Fridays and Saturdays. Latent profile analysis identified three classes: no/lo triers (53%) averaged 2.1 no/lo servings per adult annually with 95% purchasing no or low-risk levels of alcohol; occasional purchasers (34%) averaged 7.5 servings with 20% purchasing alcohol at increasing or high-risk levels; dual purchasers (13%) averaged 37.8 servings with 39% purchasing alcohol at increasing or high-risk levels. Dual purchasers and occasional purchasers were more likely to be older [60% (P < 0.001) and 54% (P = 0.010) aged ≤55 years, respectively] and white [both 97% (P = 0.014 and P = 0.0074, respectively)] compared with no/lo triers (49% aged ≤55 years, 94% white).</p><p><strong>Conclusions: </strong>In Great Britain, most households that purchase no/lo drinks appear to do so infrequently and purchase alcohol at low-risk levels; however, a smaller group of older, high","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757916","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":"Patient-reported outcomes for monitoring substance use treatment: A systematic review of single-item measures.","authors":"Thomas J Reese, Hilary A Tindle, Justin Bachmann, Adam Wright, Jessica S Ancker, Carolyn M Audet, Mauli V Shah, Bryan D Steitz, Michael H Levin, Kristopher A Kast, David Marcovitz, Amanda von Horn, A Taylor Kelley, John F P Bridges","doi":"10.1111/add.70424","DOIUrl":"https://doi.org/10.1111/add.70424","url":null,"abstract":"<p><strong>Background and aims: </strong>Measurement-based care (MBC) is a structured approach using standardized, repeated assessments to monitor treatment progress and guide clinical decision-making. MBC improves outcomes for substance use treatment but can be time consuming due in part to lengthy assessment tools. Single-item, patient-reported outcome measures (PROMs) offer a more acceptable alternative for routine monitoring, yet their psychometric properties have not been systematically evaluated. We sought to identify constructs assessed by single-item PROMs in substance use treatment and critically appraise their validity, reliability and overall quality using standardized criteria.</p><p><strong>Methods: </strong>We conducted a systematic review following COSMIN and PRISMA guidelines. MEDLINE, Embase and PsycINFO were searched from January 2005 to August 2025 for studies evaluating single-item PROMs in adults with substance use. We assessed psychometric properties, including content validity, test-retest reliability, construct validity, responsiveness and predictive validity using COSMIN criteria. Quality of evidence was assessed using a modified GRADE approach.</p><p><strong>Results: </strong>Of 4722 records screened, 35 studies met inclusion criteria, evaluating 68 single-item PROMs across 9 clinical constructs for more than 50 000 participants. Fifteen studies achieved an overall rating of sufficient measure properties and moderate-or-above level of evidence rating across domains. Test-retest reliability ranged approximately from Intraclass Correlation Coefficient = 0.60-0.85; construct validity correlations approximately ranged r = 0.11-0.98. Predictive validity was strong for several measures, with odds ratios up to 7.3 for treatment readiness. Measures assessing craving, treatment readiness and self-efficacy demonstrated the most robust evidence and, in some cases, outperformed multi-item scales. However, over half of measures lacked empirically validated thresholds and responsiveness to change analyses, limiting clinical interpretability and treatment monitoring.</p><p><strong>Conclusions: </strong>Single-item patient-reported outcome measures (PROMs) are pragmatic tools for implementing measurement-based care in substance use treatment, offering strong implementation feasibility and, in some cases, predictive performance comparable to longer instruments. PROMs lacking validated thresholds or responsiveness may be best used as complementary tools, whereas those with strong evidence and thresholds can support primary monitoring.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757882","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":"Longitudinal associations between substance use problem severity and relative harm perceptions of e-cigarettes compared with cigarettes: Results from the United States Population Assessment of Tobacco and Health study (2013-2023).","authors":"Olufemi Erinoso, Katherine East, Joanna Streck, Karin Kasza, Andrew Hyland","doi":"10.1111/add.70426","DOIUrl":"https://doi.org/10.1111/add.70426","url":null,"abstract":"<p><strong>Aims: </strong>This study examines, among adults who smoke: (1) the association between the harm perception of e-cigarettes relative to cigarettes and substance use problem (SUP) severity, (2) whether changes in SUP severity over time are associated with changes in harm perceptions of e-cigarettes relative to cigarettes and (3) whether associations between harm perceptions and vaping initiation are moderated by SUP.</p><p><strong>Design: </strong>Longitudinal study.</p><p><strong>Setting: </strong>The study setting was the United States (US) with data from the Population Assessment of Tobacco and Health (PATH) study waves 1-7 collected between 2013 and 2023.</p><p><strong>Participants: </strong>The study population comprised non-institutionalized US adults (18+) who smoked cigarettes in the past month.</p><p><strong>Measurements: </strong>The primary predictor for aims 1 and 2 was SUP severity. The outcomes at follow-up were: (1) relative harm perception of vaping compared with cigarette smoking [less harmful (accurate) versus more/same harm (inaccurate)], (2) change in SUP status (from no/low at baseline wave to moderate or high severity at follow-up) and change in relative harm perceptions (from inaccurate at baseline to accurate at follow-up). For aim 3, the primary predictor was relative harm perception, the outcome was nicotine vaping initiation and SUP was examined as a moderator.</p><p><strong>Findings: </strong>A higher proportion and odds of respondents with high SUP (versus no/low SUP) had accurate harm perceptions [32.1% versus 28.5%; adjusted odds ratio (aOR) = 1.20; 95% confidence interval (CI) = 1.07-1.33]. Among individuals with no/low SUP at baseline with inaccurate perceptions, transitioning to high SUP at follow-up was associated with higher odds of developing accurate harm perceptions (aOR = 1.63; 95% CI = 1.19-2.25). Among those who smoked but had no prior history of vaping, at baseline transitioning from inaccurate to accurate harm perception at follow-up was associated with higher odds of vaping initiation (aOR = 2.08; 95% CI = 1.33-3.25).</p><p><strong>Conclusion: </strong>People who smoke and have high substance use problem severity appear to perceive vaping as less harmful than cigarette smoking. Notably, among those who smoke but have never vaped, transitioning from inaccurate to accurate perceptions was associated with vaping initiation.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757734","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":"Overdose prevention site closure: A reply to Day et al.","authors":"David Crockford, Kate Colizza, Meera Grover, Tara Leary, Erin Knight, David Martell","doi":"10.1111/add.70458","DOIUrl":"https://doi.org/10.1111/add.70458","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757874","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 state-level kratom regulations and poison center-reported severe medical outcomes and healthcare use: A United States national analysis.","authors":"Grant Comstock, Anthony P Gulotta, Lisa E Rein, Ryan Feldman","doi":"10.1111/add.70416","DOIUrl":"https://doi.org/10.1111/add.70416","url":null,"abstract":"<p><strong>Background and aims: </strong>Kratom use in the United States (US) has increased. Kratom is not federally scheduled; regulation is heterogenous and determined at the state level. Strategies include no regulation, bans and kratom consumer protection acts (KCPA) such as age limits, product purity or labeling requirements. Public health data informing these policies remain limited. This study aimed to compare rates of poison center (PC) reported kratom exposures, including those associated with severe medical outcomes and healthcare use, across US states with differing regulatory frameworks, and to characterize national trends in kratom exposures over time.</p><p><strong>Design: </strong>Retrospective observational study of kratom exposures reported to the National Poison Data System from 2010 to 2023.</p><p><strong>Setting: </strong>All 50 US states and the District of Columbia.</p><p><strong>Participants: </strong>A total of 8919 kratom-related exposures were reported to PCs during the study period, including 5452 single-substance exposures (61%). Most cases involved adult males (69%), aged ≥18 years (8133; 91%).</p><p><strong>Measurements: </strong>States were classified by kratom regulatory status into four categories: unrestricted (no regulations), KCPA, local restrictions (KCPA in 1 or more county, but no state regulation) or banned (retail sale illegal). The primary outcome was the incidence of severe medical outcomes defined as exposures coded by America's Poison Centers criteria as major effect (life-threatening or resulting in significant residual disability) or death. Secondary outcomes included rates of exposure, hospitalization and healthcare use (defined as hospital admission or evaluation in an emergency department, urgent care or primary care).</p><p><strong>Findings: </strong>Kratom exposures increased from 19 cases in 2010 to 1242 cases in 2023 [incidence rate ratio (IRR) = 69.0 compared with 2010; 95% confidence interval (CI) = 39.6-120; P < 0.001]. Severe medical outcomes increased from zero cases in 2010 to 158 cases in 2023; 2012 was the first year in which a severe outcome was reported (2023 IRR = 56.9 vs 2012; 95% CI = 14.7-221; P < 0.001). Overall, 13% of kratom exposures resulted in a severe medical outcome. Compared with states where kratom was banned, statistically significantly higher rates of exposures (IRR = 2.49; 95% CI = 1.89-3.28), severe medical outcomes (IRR = 3.19; 95% CI = 1.78-5.70), healthcare use (IRR = 2.44; 95% CI = 1.66-3.60) and hospitalization (IRR = 2.45; 95% CI = 1.81-3.30, P < 0.001) occurred (all P < 0.001). No statistically significant differences were identified between other regulatory categories.</p><p><strong>Conclusion: </strong>Kratom exposures and severe medical outcomes reported to United States poison centers are increasing nationally, though states with bans in place have experienced less pronounced increases.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757642","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":"Using aggregated ethnicity categories masks inequalities in smoking prevalence in England.","authors":"Eve Taylor, Harry Tattan-Birch, Jamie Brown, Sarah Jackson","doi":"10.1111/add.70427","DOIUrl":"https://doi.org/10.1111/add.70427","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Smoking prevalence in England is usually reported using aggregated ethnicity categories, which may obscure important differences. This study aimed to: [1] estimate smoking prevalence in England for six aggregated categories; [2] examine differences between the 18 detailed constituent groups within these categories; and [3] assess whether patterns varied by gender.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/setting: &lt;/strong&gt;Data were collected between 2013 and 2025 in a series of monthly cross-sectional surveys of representative samples of the adult population in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;229 979 adults aged 18 +.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Weighted smoking prevalence was estimated for each of the 18 detailed and the six aggregated Office for National Statistics ethnicity categories. Logistic regression, adjusted for age, gender, socioeconomic status, region, survey year and survey mode examined the association between ethnicity categories and current smoking. Analyses were repeated including interactions for ethnicity by gender.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Smoking prevalence in England differed substantially by ethnicity. Aggregated estimates were: Asian 12.1%, Black 11.1%, Mixed or Multiple 23.9%, White 18.0%, Arab 21.8%, and Other ethnicities 18.4%; however, these aggregates obscured important variation between detailed constituent groups. Among people from Asian ethnic groups, smoking prevalence was higher for people who were Pakistani (13.5%; adjusted odds ratio [AOR] = 1.22 [95% confidence interval (CI) = 1.07-1.39]), Bangladeshi (15.9%; AOR = 1.44 [1.25-1.71]), Chinese (11.1%; AOR = 1.25 [0.99-1.57]), and Other Asian (12.6%; AOR = 1.29 [1.07-1.55]) adults compared with people who were Indian (9.3%; reference). Among people from Black ethnic groups, smoking prevalence was higher for Black Caribbean (17.2%; AOR = 3.34, [2.87-3.89]) and Other Black (17.2%; AOR = 2.92 [2.32-3.69]) adults compared with Black African adults (7.3%; reference). Among people from Mixed or Multiple ethnicity groups, smoking prevalence was lower for White and Black African (20.5%; AOR = 0.64 [0.50-0.81]), White and Asian (20.7%; AOR = 0.70 [0.57-0.87]), and Other Mixed or Multiple ethnicity (23.4%; AOR = 0.86 [0.70-1.06]) adults compared with White and Black Caribbean adults (29.1%; reference). Among people from White ethnic groups, smoking prevalence was higher for White Irish (19.9%; AOR = 1.32 [1.18-1.48]), White Gypsy/Traveller (39.1%; AOR = 1.99 [1.43-2.76]), and Other White (25.2%; AOR = 1.19 [1.13-1.25]) adults compared with White British adults (17.5%; reference). There was little difference in interpretation between fully adjusted models and those adjusted for just survey year and survey mode.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Smoking rates differ greatly among ethnic groups in England that are often aggregated together in research and national statistics. Such aggregation hides important inequalities, ","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727825","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":"Has Australia lost control of its tobacco and nicotine markets?","authors":"Ron Borland, James Martin, Edward Jegasothy, Ben Youdan, Wayne Hall","doi":"10.1111/add.70428","DOIUrl":"https://doi.org/10.1111/add.70428","url":null,"abstract":"<p><strong>Background: </strong>Australia has adopted two policies that the World Health Organization (WHO) recommends as best practice for tobacco control: it has steeply increased tobacco taxes since 2010 and only allowed access to nicotine vapes for medical use.</p><p><strong>Argument: </strong>The rate of decline in tobacco smoking in Australia has slowed in the past decade but may have recently increased. At least half of all tobacco cigarettes and most vapes in Australia are now purchased from an illicit market that exceeds the size of the combined Australian illicit markets for cannabis, cocaine, heroin and ecstasy (MDMA). An estimated $7 billion in tobacco excise and arson attacks on tobacco retailers have prompted large increases in law enforcement funding. Based on the experience from other illicit markets, increased enforcement will at best limit sales but at likely enormous social and economic cost and, specific to nicotine, constraining access to vapes and thus potentially leading to more smoking. New Zealand, which allows vapes to be sold as consumer products under public health-oriented regulations, has shown a faster decline in the prevalence of cigarette smoking than Australia. It also has high tobacco taxes but a much smaller illicit tobacco market.</p><p><strong>Conclusions: </strong>Punitive taxes on cigarettes and restricted access to lower-risk nicotine products have diverted Australians who use nicotine into illicit markets and may also have increased cigarette smoking among young people. Australia should allow easier consumer access to less harmful alternative nicotine products to help bring the illicit tobacco and nicotine markets under better control.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727850","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":"Further expanding the addiction recovery research agenda: Institutions, populations and workforce.","authors":"Noel Vest","doi":"10.1111/add.70432","DOIUrl":"https://doi.org/10.1111/add.70432","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721222","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":"Regional perspectives on substance use, substance use-related problems and policy: The case of Jordan.","authors":"Mayyada Wazaify, Maysa Suyagh, Haya Yasin","doi":"10.1111/add.70442","DOIUrl":"https://doi.org/10.1111/add.70442","url":null,"abstract":"<p><strong>Aim: </strong>To situate Jordan within evolving Middle East and North Africa (MENA) substance-use dynamics and summarise national patterns of substance use, related harms, and policy responses, with attention to transit-to-consumption transitions, surveillance limitations, and vulnerable populations.</p><p><strong>Methods: </strong>Structured regional synthesis of government reports, peer-reviewed literature, and data from the Ministry of Health, the Anti-Narcotics Department, and international agencies. The review integrated national statistics (2019-2025) with findings from population, student, and clinical studies to outline prevalence, treatment, and regulatory contexts.</p><p><strong>Results: </strong>Across MENA, conflict, displacement, demographic pressure, and shifting trafficking routes have coincided with expanding stimulant and pharmaceutical markets. In Jordan, a comparatively stable setting with a large youth population, available estimates suggest national substance use disorder [SUD] prevalence of ~0.9-1.7%, but substantially higher levels among students (7-17%), indicating concentrated risk and likely underestimation in population surveys due to stigma and underreporting. Cannabis and amphetamine-type stimulants (including Captagon) feature prominently in seizures and treatment presentations, alongside rising nonmedical use of benzodiazepines and gabapentinoids linked to regulatory gaps and pharmacy access. Tobacco use remains extremely high (66% of men), while alcohol consumption appears low in population surveys yet disproportionately represented in clinical and forensic data, highlighting hidden harm and surveillance constraints. Treatment is largely centralised in two public centres; opioid agonist therapy is limited (methadone primarily for inpatient detoxification in private settings). Harm-reduction coverage (e.g., needle-syringe programming, overdose prevention) remains low and shaped by legal, funding, and human-rights considerations. The 2022-2026 National Mental Health and Substance Use Action Plan prioritises integration into primary care.</p><p><strong>Conclusions: </strong>Jordan is progressing toward a coordinated national response to substance use and substance use-related problems, yet major gaps persist in epidemiological surveillance, harm-reduction, and gender- and youth-specific interventions. Continued investment in research and evidence-based policy evaluation remains essential for sustainable progress. Jordan's trajectory reflects broader shifts across the Middle East and North Africa (MENA) region, where traditionally low-prevalence settings are confronting rising stimulant markets, prescription drug misuse, and constrained harm-reduction capacity.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721180","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}