Drug and alcohol review最新文献

{"title":"Methamphetamine Use for Weight Control: A Grounded Theory Analysis of Online Narratives","authors":"Cheri Kilmurray,&nbsp;Satish K. Kedia,&nbsp;Patrick J. Dillon,&nbsp;Farah Faizah,&nbsp;Coree Entwistle,&nbsp;Anna Langston","doi":"10.1111/dar.70206","DOIUrl":"https://doi.org/10.1111/dar.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Methamphetamine (MA) use is associated with significant physical, psychological and social harms. Although appetite suppression and weight loss are well-known effects of MA, weight control remains an underexamined motivation for use. This study aimed to develop a theoretical understanding of how individuals initiate and sustain MA use for the explicit purpose of weight management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a constructivist grounded theory approach, we analysed publicly available online narratives posted to an anti-methamphetamine website between 2009 and 2013. Narratives were purposively sampled from a larger corpus of submissions if they explicitly referenced MA use to lose weight, suppress appetite or maintain thinness. Data were analysed using iterative coding, constant comparison and theoretical integration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis suggested several recurring processes and narrative patterns through which participants described weight-motivated MA use: (i) longstanding body dissatisfaction and disordered eating vulnerabilities; (ii) social exposure to MA through peers or family members who normalised its weight-loss effects; (iii) risk–reward appraisals in which weight concerns outweighed perceived danger; and (iv) reinforcement through rapid weight loss, perceived control and identity affirmation, often followed by shame and regret over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Findings highlight how sociocultural thinness ideals, social networks and emotional regulation processes converge to make MA use appear rational and necessary for some individuals. Prevention and treatment efforts should address body image distress, peer normalisation of stimulant use for weight control and shame-based barriers to recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Alcohol Use Disorder Pharmacotherapies by Sex: Systematic Review and Meta-Analysis","authors":"Juliette Allen,&nbsp;Andrew Jones,&nbsp;Gillian W. Shorter,&nbsp;Catharine Montgomery,&nbsp;Zetta Kougiali,&nbsp;Alina Bagnall,&nbsp;Claire Adshead,&nbsp;Jessie Smith,&nbsp;Sam Burton,&nbsp;Amanda Atkinson,&nbsp;Lillian Guelen,&nbsp;Abigail Rose","doi":"10.1111/dar.70196","DOIUrl":"10.1111/dar.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) shows sex-related differences in prevalence, harm and treatment response. Despite growing interest in sex differences, evidence synthesis evaluating pharmacotherapy effectiveness by sex remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Web of Science, PubMed, Scopus, PsycINFO and Cochrane were searched twice. Eligible records included RCTs or non-randomised studies of adults with AUD receiving pharmacological interventions (licensed or off-label), and reporting or providing outcomes (binary relapse or continuous alcohol consumption change) by sex. Multi-level random-effects models calculated risk ratios (RR) and standardised mean differences (SMD), with sex as a moderator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>Twenty-eight studies (25,041 participants, 25% female) were included. No outcomes were rated low risk of bias; non-RCTs were moderate-to-high quality. Overall treatment effects vs. control were small for abstinence (RR = 0.96, 95% CI [0.52, 1.74]; 4 studies; <i>I</i>² = 95%) and modest for consumption reduction (SMD = 0.23, 95% CI [0.01, 0.45]; 13 studies; <i>I</i>² = 89%); sex did not meaningfully moderate these outcomes (ratio of RR = 1.04, 95% CI [0.87, 1.25]; ΔSMD = 0.05, 95% CI [−0.09, 0.18]). Power was low (median 13.7%), requiring ~6358 participants per group to detect the observed sex difference. Narrative synthesis suggested possible sex differences for naltrexone and baclofen, while highlighting the influence of drug (e.g., tolerability), participant (e.g., drinking motives) and design factors (e.g., recruitment setting) on treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>AUD pharmacotherapies provide modest benefits, with sex differences remaining unclear. Future trials should be adequately powered, report sex-specific outcomes and consider adherence, tolerability and psychosocial moderators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evidence for sex-specific efficacy remains inconclusive. Patterns for naltrexone and baclofen warrant exploration in large, rigorously designed, sex-stratified trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘We Feel Invisible a Lot of the Time’: Insights Into the Roles of Alcohol and Other Drug Lived and Living Experience Workers","authors":"Ariel D. Roxburgh,&nbsp;Shalini Arunogiri,&nbsp;Lauren Findlay,&nbsp;Victoria Manning","doi":"10.1111/dar.70199","DOIUrl":"10.1111/dar.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The employment of alcohol and other drug lived and living experience (LLE) workers has increased. Although there is a growing literature on challenges faced by LLE workers, there remains a gap in understanding the unique challenges and facilitators of frontline workers in diverse settings. Additionally, it is unclear what unique barriers are faced by <i>living experience</i> workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Seven focus groups were recorded and transcribed with a total of 16 LLE worker participants. Themes from focus groups were analysed using thematic analysis. Two themes were identified: (i) <i>experiences of validation</i>; and (ii) <i>supporting the workforce</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While most participants felt valued by clients, many spoke about experiences of stigmatisation by colleagues, which was evident for workers in hospital settings, possibly reflecting organisational models of care and their maturity in employing LLE workers. Living experience workers spoke about experiencing stigma that was underpinned by discriminatory policies and laws.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The findings and discussion highlight the challenges faced by the LLE workforce that may be underpinned by in-group and out-group identity, lack of support structures, a lack of role clarity, and several other factors. Addressing these issues is important for any organisation that employs or intends to employ alcohol and other drug lived or living experience workers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health, Social and Recidivism Outcomes Among People Who Have Been Incarcerated in New South Wales, Australia: Study Protocol and Cohort Profile for the Prison Outcomes STudy (POST)","authors":"Louisa Degenhardt,&nbsp;Michael Farrell,&nbsp;Michael Doyle,&nbsp;Jack Stone,&nbsp;Chrianna Bharat,&nbsp;Matt Hickman,&nbsp;Marianne Martinello,&nbsp;Don Weatherburn,&nbsp;Kimberlie Dean,&nbsp;Joe Coyte,&nbsp;Christel Macdonald,&nbsp;Mary Ellen Harrod,&nbsp;Luke Grant,&nbsp;Gloria Larman,&nbsp;Peter Vickerman,&nbsp;Colette McGrath,&nbsp;Peter Thompson,&nbsp;Alison Churchill,&nbsp;Greg Dore,&nbsp;Thomas Santo Jr","doi":"10.1111/dar.70161","DOIUrl":"10.1111/dar.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We have been funded to examine post-incarceration health and social outcomes for all people incarcerated in New South Wales, Australia, 2000–2022; assess treatment and services for drug dependence and serious mental illness; and project the impact of expanding intervention coverage. We will use a linked cohort, the Prison Outcomes STudy (POST), which we also describe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The POST cohort was established using linked administrative data for all adults (≥ 18 years) admitted to full-time custody in New South Wales, 2000–2022. Custody records were probabilistically linked to 18 health, justice and mortality datasets. We report baseline sociodemographic and custody characteristics and the frequency of key post-release events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>200,486 adults, 15% women (<i>n</i> = 30,698), were incarcerated, with 2,282,367 person-years of follow-up and 11% (257,545 person-years) of follow-up spent in custody. First Nations people comprised 27% of the cohort. Half (48%) of the cohort (<i>n</i> = 95,563) had at least one contact with community mental health services, and 27% (<i>n</i> = 54,100) had received alcohol and other drug treatment. POST will provide population-wide evidence on health and social outcomes after custody, including the effects of treatment for drug dependence and serious mental illness. We will compare across subgroups and the outcomes of post-release service engagement. Mathematical modelling will test the impact of expanding access to care in prison and post-release on outcomes in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>POST will inform policy and service responses across justice, health and community settings to reduce harms among people who experience incarceration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pricing Dynamics in European Illicit Drug Markets: Evidence From Wholesale, Retail and Margin Relationships","authors":"Evangelos Vasileiou","doi":"10.1111/dar.70187","DOIUrl":"10.1111/dar.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study investigates pricing dynamics in illicit cocaine and heroin markets across 17 European countries over the period 2002–2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a panel dataset constructed from United Nations drug market data, we analyse wholesale and retail price trends and compute dealer margins to examine how economic pressures shape the structure of illegal drug distribution. Employing correlation analysis and Dumitrescu–Hurlin panel Granger causality tests, we explore the dynamic interrelationships among wholesale prices, retail prices and margins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results reveal strong negative correlations between wholesale prices and margins for both substances, suggesting that increases in upstream costs are not fully passed through to retail prices, leading to margin compression. In contrast, retail prices are strongly positively associated with margins, indicating that margin variation is more closely linked to downstream pricing dynamics. Retail and wholesale prices are only weakly correlated, pointing to a partial decoupling between upstream and downstream price formation. The findings also indicate the presence of predictive relationships between wholesale prices and margins, particularly in the cocaine market, consistent with feedback mechanisms within the supply chain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>These patterns may reflect a combination of factors, including incomplete cost pass-through, market structure, enforcement pressures and potential changes in product quality. However, in the absence of direct purity data, such interpretations should be made with caution. Overall, the analysis provides new evidence on the temporal dynamics of pricing in illicit drug markets and highlights the potential value of price and margin indicators as indirect signals of changing market conditions relevant to public health and policy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Buprenorphine With Naloxone Treatment and the Fear of Precipitated Withdrawal: A Qualitative Exploration With HIV Prevention Trials Network 094 INTEGRA Participants and Staff","authors":"Rose A. Schmidt,&nbsp;Amaya Perez-Brumer,&nbsp;Peter Davidson,&nbsp;Steve Shoptaw,&nbsp;Nabila El-Bassel,&nbsp;Philip Andrew,&nbsp;Jayla Harris,&nbsp;Omar Nieto,&nbsp;Sydney Bornstein,&nbsp;Rashaunna Redd,&nbsp;Jessica Yeager,&nbsp;David Goodman-Meza,&nbsp;Albert L. Hasson,&nbsp;Marc Seigel,&nbsp;Cecile Denis,&nbsp;Renee El-Krab,&nbsp;Laramie R. Smith,&nbsp;the HPTN 094 Team","doi":"10.1111/dar.70198","DOIUrl":"https://doi.org/10.1111/dar.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Uptake of evidence-based medication for opioid use disorder (MOUD), including buprenorphine–naloxone, remains low despite the expanding US opioid crisis. This study examined participants' and staff perceptions of adopting and delivering buprenorphine–naloxone on a mobile unit providing integrated MOUD and HIV services for people with opioid use disorder who inject drugs in the HPTN 094 INTEGRA trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with people with opioid use disorder who inject drugs in the intervention or control arm (<i>n</i> = 77) and mobile unit staff (<i>n</i> = 38) of HPTN 094 as part of an embedded qualitative implementation science evaluation across five US cities: Houston, Los Angeles, New York City, Philadelphia and Washington, DC. Interviews were transcribed and analysed using a pragmatic inductive and deductive thematic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fear of precipitated withdrawal was a primary factor shaping perceptions of buprenorphine and other MOUD formulations. This fear was heightened by the widespread presence of fentanyl in the unregulated drug supply. Participants' MOUD preferences were influenced by their treatment goals and by misperceptions of the role of naloxone in buprenorphine and the risk of precipitated withdrawal. Additional barriers included stigma towards MOUD and infrastructure constraints that complicated buprenorphine–naloxone inductions on a mobile unit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Even with facilitated access, perceptions of evidence-based MOUD were strongly shaped by fear of precipitated withdrawal. Aligning MOUD formulations with the treatment goals of people who inject drugs, along with expanding flexibility in MOUD access, delivery and induction practices across formulations, may improve uptake of these life-saving treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Label: Implementation of Health Warnings on Alcohol Products in 13 European Countries","authors":"Daša Kokole,&nbsp;Maria Neufeld,&nbsp;Daniela Correia,&nbsp;Jürgen Rehm,&nbsp;Simone Pettigrew,&nbsp;Catherine Paradis,&nbsp;Carina Ferreira Borges,&nbsp;Almudena Núñez Fernández-Shaw,&nbsp;António Pedro Pinho,&nbsp;Claudia Pereira,&nbsp;Eglė Juškevičiūtė,&nbsp;Evangelia Savvidou,&nbsp;Jasmijn de Veld,&nbsp;Laura Plešnar,&nbsp;Leander Mergaert,&nbsp;Lucía Clemente Bermúdez,&nbsp;Melissa Sawaya,&nbsp;Mia Šelović,&nbsp;Miglė Kiguolytė,&nbsp;Mikołaj Patalong,&nbsp;Patrik Senica,&nbsp;Pau Ladero Palacio,&nbsp;Saloni Mitra,&nbsp;Sara Suarez Tostado","doi":"10.1111/dar.70185","DOIUrl":"10.1111/dar.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol health warning labels are an important part of a comprehensive alcohol policy, but there is a lack of recent implementation data across Europe. This study examined the presence, content and format of health warnings across 13 European countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Store audits were conducted across 32 stores in 23 cities. The sampled products were assessed for the presence, topic and format of health warnings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1636 investigated products, 69.7% displayed health warnings. The most common topics were pregnancy (68.0%), drink-driving (21.4%) and age restrictions (16.6%), followed by responsible drinking messages (6.9%) and health harms due to alcohol use (0.3%). About one in four (26.7%) products contained a multi-topic warning. The majority of products featured only a pictogram (62.3%), while 6.7% included both pictogram and text, and 0.7% contained text only. Lithuania, France and the Netherlands had the highest proportions of products displaying at least one warning (above 90%). Proportions were lowest in Croatia, Poland, Slovenia and Greece (under 50% of products with health warnings).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Existing warnings predominantly focus on messages relevant to at-risk population groups rather than on alcohol harms affecting the general population. The current implementation largely reflects the alcohol producers' voluntary commitments, although the highest implementation is found in countries with existing legislation. There is underutilised potential to inform Europeans about the health harms of alcohol through warning labels. Stronger regulatory approaches at the EU or Member State level could improve the quality of information provided directly to consumers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Impacts of Methadone and Buprenorphine/Naloxone on Pain-Related Outcomes Among People With Non-Heroin Opioid Use Disorder: Secondary Analyses From a Pragmatic Canadian Multisite Trial","authors":"Katie Lyman,&nbsp;JinCheol Choi,&nbsp;Didier Jutras-Aswad,&nbsp;Bernard L. E. Foll,&nbsp;Sukhpreet Klaire,&nbsp;M. Eugenia Socias","doi":"10.1111/dar.70190","DOIUrl":"10.1111/dar.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In addition to their use as opioid agonist therapy (OAT), methadone and buprenorphine/naloxone also have analgesic properties. However, there is limited information on the relative effectiveness of these medications for analgesia in the context of treatment for non-heroin opioid use disorder (OUD). This study estimated the impact of type of OAT on pain among individuals with non-heroin OUD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from OPTIMA, a Canadian, randomised, 24-week clinical trial comparing buprenorphine/naloxone (via take-home doses) to methadone (via daily witnessed ingestion) for the treatment of non-heroin OUD, we evaluated the impact of type of OAT on pain outcomes (measured by the Brief Pain Inventory) among participants with major pain at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean pain severity scores significantly decreased in both arms over 24 weeks (methadone 4.89–2.16, buprenorphine/naloxone 4.94–1.08). There was a time by arm interaction, suggesting better performance of buprenorphine/naloxone up to week 9, and methadone afterwards. Mean pain-related function scores also significantly decreased over time (methadone 5.31–2.70, buprenorphine/naloxone 5.56–3.37), with no significant differences in overall scores between arms (<i>p</i> = 0.675). Methadone was associated with higher odds of achieving both pain severity and pain-related function response at week 24 (30% reduction in pain scores from baseline).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Among people with non-heroin OUD initiating OAT, both methadone and buprenorphine/naloxone were associated with improvements in pain outcomes. However, methadone was associated with a higher likelihood of achieving pain severity and functional treatment response at week 24. These findings suggest the need to consider the type of OAT in the shared-decision making process for people with non-heroin OUD and comorbid pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personality Functioning and Antisociality of Youth Accessing Residential Substance Use Withdrawal in Australia","authors":"Nathan Akoka,&nbsp;Ajibola Akintola,&nbsp;Alexandre A. Guerin,&nbsp;Ashley L. Dunne,&nbsp;Michael Daffern,&nbsp;Holly Bowman,&nbsp;Andrew Bruun,&nbsp;Enrico Cementon,&nbsp;Andrew Chanen,&nbsp;David Coghill,&nbsp;Amelia Lopatecki,&nbsp;Edward Mullen,&nbsp;Gillinder Bedi","doi":"10.1111/dar.70200","DOIUrl":"10.1111/dar.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study examined the prevalence and associations of personality dysfunction and antisociality among youth accessing residential substance use disorder (SUD) withdrawal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 100 youth (57% female) aged 18–25 scheduled or admitted to residential SUD withdrawal in Victoria, Australia. Personality dysfunction was assessed using the Level of Personality Functioning Scale—Self Report and Antisocial Personality Disorder (ASPD) Impairment Interview. SUDs were assessed using the Structured Clinical Interview for DSM-5, early maladaptive schemas using the Young Schema Questionnaire-Rach, and antisocial attitudes using the Measures of Criminal Attitudes and Associates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All participants met criteria for at least one SUD (<i>M</i> = 2.2, SD = 2.1); 66% endorsed two or more SUDs. Nearly half the sample met the threshold for likely general personality disorder (PD; 48%), while 43% met criteria for likely ASPD. Chi-square analyses indicated that likely general personality disorder (<i>χ</i>² = 12.4, <i>p</i> &lt; 0.001) and likely ASPD (<i>χ</i>² = 13.5, <i>p</i> &lt; 0.001) were associated with polysubstance use. Likely ASPD was associated with cannabis (<i>χ</i>² = 9.3, <i>p</i> &lt; 0.01), methamphetamine (<i>χ</i>² = 4.9, <i>p</i> &lt; 0.05), alcohol (<i>χ</i>² = 4.3, <i>p</i> &lt; 0.05) and sedative (<i>χ</i>² = 4.9, <i>p</i> &lt; 0.05) use disorders. Elevated early maladaptive schemas were common; 59% reported a prior arrest, and 23% reported 10 or more.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Personality dysfunction and antisociality appear common among youth accessing residential withdrawal, supporting the assessment of personality functioning in this population. Future research should examine whether integrating personality-informed or schema-focused approaches within withdrawal services improves outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Patient-Reported Exposure to New Psychoactive Substances and Other Illicit Drugs in Australian Emergency Departments: Findings From the Emerging Drugs Network of Australia","authors":"Marjan J. Nijmeijer,&nbsp;Jennifer L. Smith,&nbsp;Courtney Weber,&nbsp;Bas W. J. Bens,&nbsp;Daniel M. Fatovich,&nbsp;Shaun L. Greene,&nbsp;Jennifer L. Schumann,&nbsp;Paul Dessauer,&nbsp;Rebekka Syrjanen,&nbsp;Katherine Z. Isoardi,&nbsp;Keith Harris,&nbsp;Sam Alfred,&nbsp;Viet Tran,&nbsp;Ewoud ter Avest","doi":"10.1111/dar.70193","DOIUrl":"10.1111/dar.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>New psychoactive substances (NPS) present a unique challenge in clinical, public health and drug-policy contexts. Continued diversity, unknown potency and often unintentional exposure can limit the accuracy of self-reported data. This study examined the accuracy of patient-reported NPS and illicit drug exposure in Australian emergency departments (ED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient-reported drug exposure, clinical and toxicology data were extracted from the Emerging Drugs Network of Australia Clinical Registry between 1 July 2021 and 30 June 2024 for patients presenting with severe and/or unusual illicit drug toxicity in the ED. Blood samples were analysed using mass spectrometry. Agreement between reported and confirmed exposure was assessed using Cohen's kappa, sensitivity, specificity and likelihood ratios. Logistic regression analysis identified factors associated with discrepancies between reported and confirmed exposures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 2044 presentations: 64.6% male, median age 33 years (Q1–Q3, 26–41). Complete agreement between patient-reported and confirmed drug exposures was 14.3% (<i>n</i> = 293). Agreement between reported and confirmed NPS exposure was poor (<i>κ</i> = 0.38). 1522 (74.5%) had more drugs detected than reported. Older age (OR 1.03 [CI 1.02, 1.04]) was associated with higher odds of discrepancy. Attendance from a licensed venue (OR 0.44 [CI 0.28, 0.70]) and Glasgow Coma Scale of 13–15 (OR 0.44 [CI 0.33, 0.57]) were associated with lower odds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Poor agreement between patient-reported and analytically confirmed drug exposure highlights the need for continued partnerships between EDs, clinical toxicologists, and forensic laboratories to identify substances involved in acute intoxications and support public health and harm reduction responses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}