Drug and alcohol dependence最新文献

{"title":"Longitudinal trajectories of binge and heavy drinking pattern among World Trade Center Health Registry enrollees, 2006–2021: A dual trajectory modeling approach","authors":"Ananya S. Dhanya,&nbsp;Alice E. Welch,&nbsp;Howard E. Alper,&nbsp;Sean Locke,&nbsp;Robert M. Brackbill","doi":"10.1016/j.drugalcdep.2025.112912","DOIUrl":"10.1016/j.drugalcdep.2025.112912","url":null,"abstract":"<div><h3>Background</h3><div>This study examined drinking trajectories among World Trade Center Health Registry enrollees and evaluated potential risk factors.</div></div><div><h3>Methods</h3><div>A longitudinal study analyzing binge and heavy drinking trajectories over 15 years, involving 18,332 enrollees aged 18 or older on 9/11/2001, with 62.7 % identifying as male. Group-based trajectory modeling explored binge drinking and heavy drinking trajectories. Multinomial logistic regression was used to assess risk factors (9/11-exposure, rescue/recovery worker, 9/11-related post-traumatic stress disorder (PTSD), lack of social support) associated with these drinking trajectories. Dual trajectory analysis estimated the conditional probabilities between binge and heavy drinking group memberships. Trajectory models stratified by age group and sex, separately, were also examined.</div></div><div><h3>Findings</h3><div>Four trajectories described binge (very-low-stable (72.5 %), moderate-increasing (6.9 %), high-decreasing (11.8 %), and very-high-decreasing (8.8 %)) and heavy (very-low-stable (82.9 %), low-increasing (6.0 %), high-decreasing (5.9 %), and high-increasing (5.1 %)) drinking over time. In dual trajectory analyses, most binge drinking trajectories overlapped with similar heavy drinking trajectories. Individuals aged 36–64, non-Hispanic White, or experienced 9/11-related PTSD were more likely to follow the other binge drinking trajectories and the initially “high-” heavy drinking trajectories than their respective very-low-stable trajectories; females were more likely to follow “increasing” heavy drinking trajectories, while males were more likely to follow high or increasing binge trajectories. Compared to younger enrollees (36–54, 55–69 years of age), a higher proportion of those aged 70 +  were in low-stable binge and heavy drinking trajectory groups.</div></div><div><h3>Conclusions</h3><div>The observed trajectory groups and factors associated with longitudinal patterns of excessive drinking may assist with developing targeted interventions like behavioral counseling.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112912"},"PeriodicalIF":3.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of impaired control and pharmacological criteria for lifetime alcohol use disorder on relationships between drinking and problems","authors":"Paul J. Gruenewald ,&nbsp;Raul Caetano ,&nbsp;Christina Mair","doi":"10.1016/j.drugalcdep.2025.112910","DOIUrl":"10.1016/j.drugalcdep.2025.112910","url":null,"abstract":"<div><h3>Background</h3><div>The contribution of criteria for lifetime alcohol use disorder (AUD) to greater drinking and problems is infrequently considered in community-based studies of alcohol users. However, theoretical and empirical work indicate that relationships between drinking and problems may be quite different among drinkers reporting impaired control (ic) or pharmacological (p) criteria related to AUD (icpAUD). In this study we measured the extent to which the presence of greater number of these criteria affected dose-response relationships between drinking and problems.</div></div><div><h3>Methods</h3><div>A survey of 2044 “regular” drinkers reporting use at least twice a month over the previous year assessed respondents’ sociodemographic characteristics, impulsivity, drinking motives, sensation seeking, drinking patterns, lifetime AUD criteria (Composite International Diagnostic Interview) and the occurrence of 18 drinking problems over the previous 28 days. Heteroskedastic Tobit regression models were used to measure impacts of two measures of impaired control (impaired control over drinking, inability to stop drinking) and three pharmacological criteria (craving, tolerance, withdrawal) on dose-response relationships between drinking and problems.</div></div><div><h3>Results</h3><div>A dose-response effect was observed among regular drinkers with no criteria (<em>Χ</em>²=53.2, df=1, p &lt; 0.001). Greater number of lifetime <u>icpAUD criteria</u> was related to reduced dose-response (<em>Χ</em>²=6.59, df<em>=</em>1, p = 0.010) and much greater numbers of 28-day drinking problems (<em>Χ</em>²=127.8, df<em>=</em>1, p &lt; 0.001). Substantive nonlinear effects related drinking to 28-day problems across drinkers with greater numbers of lifetime icpAUD criteria.</div></div><div><h3>Conclusions</h3><div>Measures of impaired control and pharmacological symptom criteria related to lifetime AUD alter dose-response relationships and greatly increase 28-day drinking problems. Therefore, assessments of lifetime AUD criteria are critical to etiological assessments of alcohol problems in community-based studies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112910"},"PeriodicalIF":3.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rest-activity rhythms in individuals who separately or concomitantly use cannabis and cigarettes","authors":"Joey Hebl ,&nbsp;Danielle A. Wallace ,&nbsp;Nicole P. Bowles","doi":"10.1016/j.drugalcdep.2025.112907","DOIUrl":"10.1016/j.drugalcdep.2025.112907","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis use and cigarette smoking, a primary source of nicotine exposure, are prevalent behaviors that frequently co-occur. The independent or interactive effects of cigarette-derived nicotine and cannabis on rest-activity rhythms (RAR) are not well understood.</div></div><div><h3>Methods</h3><div>Using data from the 2011–2012 and 2013–2014 cycles of the National Health and Nutrition Examination Survey (NHANES), we tested whether self-reported cigarette and/or cannabis use was associated with RAR—assessed from actigraphy data—in U.S. adults ages 18–59 years old.</div></div><div><h3>Results</h3><div>5129 participants with valid RAR, as well as cigarette and cannabis use information were included in the analysis. A vast majority of participants reported no use of cannabis or cigarettes (71 %), while 15.7 % consumed only cigarettes, 6.3 % consumed only cannabis, and 6.7 % endorsed dual consumption. Our multiple linear regression models, which were adjusted for (model 1) age, sex, race/ethnicity; (model 2) income, education; (model 3) BMI, alcohol use, and number of prescription medications showed that cigarette use, with or without cannabis co-use, was associated with a decrease in Interdaily Stability (IS) scores. Decreased relative amplitude (RA) scores were associated with respondents who used cigarettes, with or without cannabis use. All exposure categories, including co-use, were associated with decreased Intradaily Variability (IV) scores.</div></div><div><h3>Conclusions</h3><div>Cigarette and cannabis use have varying effects on RAR, with the effects of co-use largely reflecting the influence of cigarettes. Research involving greater specificity regarding substance use exposures is necessary to elucidate the dose related effects of cannabis and cigarette use on RAR.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112907"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naltrexone blocks the sleep-disrupting effects of methamphetamine in male rhesus monkeys","authors":"Patrick G. Davis ,&nbsp;Victor Nascimento-Rocha ,&nbsp;James K. Rowlett ,&nbsp;Lais F. Berro","doi":"10.1016/j.drugalcdep.2025.112911","DOIUrl":"10.1016/j.drugalcdep.2025.112911","url":null,"abstract":"<div><h3>Background</h3><div>Methamphetamine has garnered increasing attention due to its escalating recreational use resulting in significant morbidity and mortality. Methamphetamine also significantly alters sleep quality, a finding that has been observed in both human and non-human primates. Naltrexone, an opioid receptor antagonist used in the treatment of opioid and alcohol use disorder, has shown promise as a treatment for methamphetamine use disorder. However, the potential benefits of naltrexone with regards to ameliorating sleep disturbances associated with methamphetamine use are unknown. The aim of the present study was to investigate the acute effects of evening naltrexone administration on the acute sleep-disrupting effects of methamphetamine.</div></div><div><h3>Methods</h3><div>Adult male rhesus macaques (N = 4) were fitted with primate collars to which actigraphy monitors were attached. Vehicle or naltrexone (0.03, 0.1, and 0.3<!--> <!-->mg/kg, i.m.) were administered in the evening (ZT10.5, 1.5<!--> <!-->h before “lights off”) following a morning (ZT4, 4<!--> <!-->h after “lights on”) administration of methamphetamine (0.3<!--> <!-->mg/kg, i.m.).</div></div><div><h3>Results</h3><div>Our findings replicate previous studies showing that methamphetamine significantly impairs sleep-associated measures in male rhesus monkeys, increasing actigraphy-based measures of sleep latency and wake time after sleep onset (WASO), and decreasing sleep efficiency. Evening treatment with naltrexone dose-dependently improved methamphetamine-induced sleep impairment, with the highest dose significantly improving actigraphy-based measures of sleep latency, sleep efficiency, and WASO.</div></div><div><h3>Conclusions</h3><div>These results suggest that naltrexone may be beneficial in the treatment of methamphetamine use disorder through amelioration of sleep disturbances observed with methamphetamine use.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112911"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal association of exclusive and dual use of menthol cigarettes and flavored cigars with cigarette and cigar smoking cessation among U.S. adults – population assessment of tobacco and health study waves 1–5 (2013–2019)","authors":"James H. Buszkiewicz,&nbsp;Akash Patel,&nbsp;Steven Cook,&nbsp;Nancy L. Fleischer","doi":"10.1016/j.drugalcdep.2025.112906","DOIUrl":"10.1016/j.drugalcdep.2025.112906","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the relationship between menthol cigarette and flavored cigar use, alone or in combination, and short-term smoking cessation among U.S. adults.</div></div><div><h3>Methods</h3><div>We used restricted Waves 1–5 Population Assessment of Tobacco and Health Study data to estimate the risk of 30-day smoking cessation associated with menthol cigarette and flavored cigar use, alone or combined, and compared to unflavored tobacco product use. We fit multivariable discrete-time survival models to a nationally representative sample of U.S. adults with current established cigarette or cigar use, adjusting for age, sex, race, ethnicity, income, cigarette pack-years, tobacco dependency, cigarette and cigar smoking intensity, and blunt use.</div></div><div><h3>Results</h3><div>The majority of sample respondents (n = 8840) were male (53.5 %), non-Hispanic White (69.4 %), had a high school/General Educational Development (GED) education or less (53.9 %), and had an annual income of less than $50,000 (74.9 %). Most respondents used unflavored tobacco products (59.9 %), 33.8 % exclusively used menthol cigarettes, 2.4 % used both menthol cigarettes and flavored cigars, 1.8 % used both non-menthol cigarettes and flavored cigars, 1.3 % exclusively used flavored cigars, and 0.9 % used both menthol cigarettes and unflavored cigars. In fully adjusted models, we found no associations between menthol cigarette and flavored cigar use alone or in combination and 30-day cigarette and cigar smoking cessation relative to unflavored tobacco product use. These results were robust to sensitivity tests varying survey weights, sample inclusion criteria, and exposure definitions.</div></div><div><h3>Conclusion</h3><div>We found that menthol cigarette and flavored cigar use, alone or in combination, was not associated with short-term cigarette and cigar smoking cessation.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112906"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing substance use detection in clinical notes with large language models","authors":"Fabrice Harel-Canada ,&nbsp;Anabel Salimian ,&nbsp;Brandon Moghanian ,&nbsp;Sarah Clingan ,&nbsp;Allan Nguyen ,&nbsp;Tucker Avra ,&nbsp;Michelle Poimboeuf ,&nbsp;Ruby Romero ,&nbsp;Arthur Funnell ,&nbsp;Panayiotis Petousis ,&nbsp;Michael Shin ,&nbsp;Nanyun Peng ,&nbsp;Chelsea L. Shover ,&nbsp;David Goodman-Meza","doi":"10.1016/j.drugalcdep.2025.112888","DOIUrl":"10.1016/j.drugalcdep.2025.112888","url":null,"abstract":"<div><div>Identifying substance use behaviors in electronic health records (EHRs) is challenging because critical details are often buried in unstructured notes that use varied terminology and negation, requiring careful contextual interpretation to distinguish relevant use from historical mentions or denials. Using MIMIC-III/IV discharge summaries, we created a large, annotated drug detection dataset to tackle this problem and support future systemic substance use surveillance. We then investigated the performance of multiple large language models (LLMs) for detecting eight substance use categories within this data. Evaluating models in zero-shot, few-shot, and fine-tuning configurations, we found that a fine-tuned model, Llama-DrugDetector-70B, outperformed others. It achieved near-perfect F1-scores (<span><math><mrow><mo>≥</mo><mn>0</mn><mo>.</mo><mn>95</mn></mrow></math></span>) for most individual substances and strong scores for more complex tasks like prescription opioid misuse (F1=0.815) and polysubstance use (F1=0.917). These findings demonstrated that LLMs significantly enhance detection, showing promise for clinical decision support and research, although further work on scalability is warranted.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112888"},"PeriodicalIF":3.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Punishment of ethanol choice in group-housed male cynomolgus monkeys","authors":"EA Cronin,&nbsp;PM Epperly,&nbsp;AP Floge,&nbsp;PW Czoty","doi":"10.1016/j.drugalcdep.2025.112903","DOIUrl":"10.1016/j.drugalcdep.2025.112903","url":null,"abstract":"<div><h3>Background</h3><div>A common characteristic of individuals with alcohol use disorder (AUD) is that they continue to consume alcohol despite adverse consequences. A better understanding of the factors that influence this relative insensitivity to punishment may help identify novel treatments for AUD. In animal models, this characteristic can be studied by adding the bitter-tasting alkaloid, quinine, to an ethanol solution. In the present study, punishment of ethanol drinking was assessed in socially housed male cynomolgus monkeys to determine whether sensitivity to punishment is influenced by a monkey’s position in the social hierarchy. <em>Methods:</em> Ten adult male cynomolgus monkeys with 4.5 years of experience drinking ethanol were given concurrent access to a 4 % ethanol solution and a 0.5 % Tang solution for 3<!--> <!-->h each day, 5 days per week. When ethanol choice was stable, a single quinine concentration (0.003–5.6<!--> <!-->g/L) was added to the ethanol solution for one day. This was repeated until a full quinine concentration-effect curve was created. <em>Results:</em> Addition of quinine produced a concentration-dependent decrease in ethanol choice and intake. The potency of quinine to decrease ethanol choice did not differ significantly between socially dominant and socially subordinate monkeys. However, only in dominant monkeys were significant positive relationships found between quinine EC₅₀ values and both the volume of ethanol consumed at baseline and baseline ethanol intake.</div></div><div><h3>Conclusions</h3><div>These results demonstrate the ability of quinine to produce robust punishment of ethanol choice and suggest that the chronic subordination stress experienced by the low-ranking monkeys alters sensitivity to punishment.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112903"},"PeriodicalIF":3.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use treatment completion does not mediate the relationship between family treatment court participation and reunification: Results from five courts in the Southwestern U.S.","authors":"Margaret Lloyd Sieger ,&nbsp;Jessica Becker ,&nbsp;Jon D. Phillips ,&nbsp;Cindy Nichols ,&nbsp;Elizabeth J. Goldsborough ,&nbsp;John Prindle","doi":"10.1016/j.drugalcdep.2025.112904","DOIUrl":"10.1016/j.drugalcdep.2025.112904","url":null,"abstract":"<div><h3>Background</h3><div>Family treatment courts (FTC) apply judicial theory and behavioral economics to increase parent substance use treatment completion and family reunification for families in foster care due to parental substance use disorder. Dozens of quasi-experiments and case studies suggest FTC programs outperform traditional child welfare courts. However, methodological limitations in earlier research limit causal inference.</div></div><div><h3>Study purpose</h3><div>The current study aimed to examine the relationship between FTC participation and family reunification, and to investigate whether substance use treatment completion mediates this relationship.</div></div><div><h3>Methods</h3><div>Foster care, substance use treatment, and FTC administrative records from 2018 to 2022 were probabilistically linked across six counties in a Southwestern U.S. state. The final sample included 200 FTC-involved and 1367 comparison child/caregiver dyads. To address selection bias, we applied inverse probability weighting based on propensity scores. The weights balanced the treatment and control groups based on fifteen covariates, including demographic characteristics, child welfare system involvement, and novel substance use treatment metrics such as caregivers’ Addiction Severity Index scores, level of care recommendation, and primary substance of choice.</div></div><div><h3>Results</h3><div>Applying the weight, our logistic regression model revealed that FTC-involved dyads’ odds of reunification were 66 % greater compared to dyads served in traditional settings (OR = 1.66, 95 % CI: 1.14–2.40). The mediation model revealed that the effect of FTC participation on reunification was independent of treatment completion.</div></div><div><h3>Conclusions</h3><div>FTC demonstrates its own treatment effect on family reunification, above and beyond substance use treatment experiences. These findings point to a “value added” for FTC participation. In an area of practice characterized by low rates of success, identifying effective, real-world interventions for families is significant.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112904"},"PeriodicalIF":3.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum/Erratum to “Opioid agonist treatment in transition: A cross-country comparison between Austria, Germany and Switzerland” [Drug Alcohol Depend. 254 (2024) 111036]","authors":"Tanja Schwarz ,&nbsp;Judith Anzenberger ,&nbsp;Martin Busch ,&nbsp;Gerhard Gmel ,&nbsp;Ludwig Kraus ,&nbsp;R. Michael Krausz ,&nbsp;Florian Labhart ,&nbsp;Maximilian Meyer ,&nbsp;Michael P. Schaub ,&nbsp;Jean N. Westenberg ,&nbsp;Alfred Uhl","doi":"10.1016/j.drugalcdep.2025.112887","DOIUrl":"10.1016/j.drugalcdep.2025.112887","url":null,"abstract":"","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112887"},"PeriodicalIF":3.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment and recovery from opioid use disorder: The role of pain severity in individuals with moderate to severe pain","authors":"Allison N. Tegge ,&nbsp;Marco A.R. Ferreira ,&nbsp;Peter M. Garafola ,&nbsp;Shuangshuang Xu ,&nbsp;Michael Farrell ,&nbsp;John Marsden ,&nbsp;Ken Lee ,&nbsp;Anne Le Moigne ,&nbsp;Frank Gray ,&nbsp;Warren K. Bickel","doi":"10.1016/j.drugalcdep.2025.112902","DOIUrl":"10.1016/j.drugalcdep.2025.112902","url":null,"abstract":"<div><h3>Background</h3><div>Pain is a frequent comorbidity among individuals with opioid use disorder (OUD), yet its impact on treatment outcomes is unclear. This study examined associations between pain severity and OUD treatment outcomes, including abstinence, craving, retention, and psychological functioning, in participants receiving long-acting buprenorphine (BUP-XR).</div></div><div><h3>Methods</h3><div>This secondary data analysis investigates participants from a BUP-XR phase 3 program: randomized clinical trial (NCT02357901; N = 192), open-label study (NCT02510014; N = 410); and a longitudinal observational follow-up (NCT03604861; N = 350). Pain was measured using the Brief Pain Inventory (BPI) at each treatment visit. Additional measures included demographics, opioid use, participant retention, opioid withdrawal, craving, depression, and quality of life. Analyses were performed on the full sample and the subgroup of individuals with moderate-to-severe pain (BPI≥4).</div></div><div><h3>Results</h3><div>Participants averaged 40 years old, predominantly male (67 %) and White (66 %). Pain decreased after starting BUP-XR, and the reduction in pain continued throughout treatment (<em>p-values</em>&lt;.001). For individuals with moderate-to-severe pain, greater concurrent pain severity was associated with lower abstinence rates (odds ratios: [0.801,0.852]; <em>p-values</em>&lt;.001) in two datasets. Pain was not associated with participant retention. Lastly, greater pain severity was associated with worse physical quality of life (<em>p-values</em>&lt;.001) and opioid withdrawal (<em>p-values</em>&lt;.001), and greater depression (<em>p-values</em>&lt;.001) and opioid craving (<em>p-values</em>&lt;.001). Collectively, these findings are well replicated across three studies.</div></div><div><h3>Conclusions</h3><div>Pain severity is a clinically relevant predictor of opioid use and psychosocial outcomes, but not treatment retention, in patients receiving BUP-XR. Routine pain severity monitoring may provide valuable insight into patient trajectories and support more tailored treatment approaches in OUD.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112902"},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}