Drug and alcohol dependence最新文献

{"title":"Trends in treatment attendance for substance use disorders among adolescents and emerging adults in Australia, 2003–2020","authors":"Megan Wells ,&nbsp;Peter J. Kelly ,&nbsp;Briony Larance","doi":"10.1016/j.drugalcdep.2025.112845","DOIUrl":"10.1016/j.drugalcdep.2025.112845","url":null,"abstract":"<div><h3>Background</h3><div>Substance use disorders frequently begin in adolescence and emerging adulthood. Knowledge of trends in alcohol and other drug (AOD) service utilisation during these periods can inform policy development to align service delivery with treatment need.</div></div><div><h3>Aims</h3><div>Characterise trends in AOD treatment episodes among adolescents (aged 10–17) and emerging adults (aged 18–24) across Australia, and compare to adult trends (aged ≥25).</div></div><div><h3>Methods</h3><div>National data from the Alcohol and Other Drug Treatment Services – National Minimum Data Set were analysed (N = 2904,012). Joinpoint regression analysis was used to characterise trends in principal drug of concern, treatment setting, planned completion, and sex.</div></div><div><h3>Results</h3><div>Cannabis was the most common principal substance of concern for adolescents and emerging adults. The proportions of episodes relating to cannabis, alcohol, and psychostimulants for emerging adults was stable from 2015 onward, while alcohol-related episodes declined for adolescents. Most episodes were provided in non-residential services, and treatment provision in home/outreach settings increased over time. 59.0 % of episodes for emerging adults and 64.4 % of episodes provided to adolescents (excluding assessment and information/education only) were completed. From 2014–2016 onward, an increase in the proportion of episodes provided to females among all three age groups was observed.</div></div><div><h3>Conclusions</h3><div>Observed trends in principal substance of concern were largely consistent with national and international drug market trends. The findings can inform service and policy development, with targeted attention toward the treatment of cannabis and psychostimulant use for younger populations indicated. Relatively stable treatment completion rates highlight the need for ongoing efforts to retain young people.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112845"},"PeriodicalIF":3.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907691","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":"Imaging cerebral circulation in long-term anabolic-androgenic steroid users and non-using weightlifters","authors":"Helene Melsom Tungesvik ,&nbsp;Beatriz Padrela ,&nbsp;Inge Groote ,&nbsp;Atle Bjørnerud ,&nbsp;Oliver M. Geier ,&nbsp;Jonny Hisdal ,&nbsp;Henk JMM Mutsaerts ,&nbsp;Astrid Bjørnebekk","doi":"10.1016/j.drugalcdep.2025.112829","DOIUrl":"10.1016/j.drugalcdep.2025.112829","url":null,"abstract":"<div><h3>Background</h3><div>Anabolic-androgenic steroids (AAS) are commonly used by recreational weightlifters for performance enhancement, despite associated health risks, including cardiovascular and brain effects. This study investigates the cerebrovascular effects of prolonged AAS use in male weightlifters, focusing on cerebral blood flow (CBF) and other indicators of cerebrovascular health.</div></div><div><h3>Methods</h3><div>Eighty-six males were included, with 41 current consumers of AAS and 45 non-using weightlifting controls. Cerebrovascular health was evaluated using magnetic resonance imaging (MRI) pseudo-continuous arterial spin labeling (PCASL) derivatives to measure CBF and spatial coefficient of variation (sCoV) of CBF in gray matter. Additionally, MRI T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences were used to analyze white matter hyperintensities as a marker of small-vessel disease.</div></div><div><h3>Results</h3><div>AAS consumers had significantly higher sCoV than weightlifting controls (<em>p</em> = 0.001). Further, sCoV in total gray matter correlated with testosterone/epitestosterone ratio and total years of AAS use. No significant differences were found in CBF or white matter hyperintensity volume.</div></div><div><h3>Conclusion</h3><div>These findings indicate that long-term AAS use may impact cerebrovascular health, evidenced by increased sCoV. Although cerebral perfusion was unaffected, elevated sCoV suggest that AAS use may pose a risk for cerebrovascular pathology later in life.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112829"},"PeriodicalIF":3.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895482","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":"CPDD 2025 annual meeting recap June 14–18, 2025 | New Orleans, LA","authors":"Kevin Freeman (Program Committee Co-Chair)","doi":"10.1016/j.drugalcdep.2025.112844","DOIUrl":"10.1016/j.drugalcdep.2025.112844","url":null,"abstract":"","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112844"},"PeriodicalIF":3.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018648","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":"Craving for opioid and cannabis use among adults with chronic pain: Insights from a 30-day ecological momentary assessment study","authors":"Jennifer D. Ellis ,&nbsp;Ashley E. Chipoletti ,&nbsp;Siny Tsang ,&nbsp;Courtney D. Nordeck ,&nbsp;Erin M. Anderson Goodell ,&nbsp;Chung Jung Mun ,&nbsp;Marc O. Martel ,&nbsp;Cecilia L. Bergeria ,&nbsp;Kelly E. Dunn ,&nbsp;Ryan Vandrey ,&nbsp;Johannes Thrul ,&nbsp;Patrick H. Finan","doi":"10.1016/j.drugalcdep.2025.112843","DOIUrl":"10.1016/j.drugalcdep.2025.112843","url":null,"abstract":"<div><h3>Background</h3><div>Craving is an aversive state and risk factor for progression to nonmedical substance use. The aims of this secondary analysis of Ecological Momentary Assessment (EMA) data were 1) to test whether craving was elevated on days of co-use of opioids and cannabis, and 2) to examine pain, pain catastrophizing, affect, and stress as risk factors for current and next-moment craving, among patients with chronic pain.</div></div><div><h3>Methods</h3><div>Adults with chronic pain (N = 46) who used both opioids and cannabis were recruited online and completed a 30-day EMA study, consisting of four momentary surveys per day that assessed opioids and cannabis craving, use, pain and pain catastrophizing, affect, and stress. Linear mixed effects models estimated associations between pain, pain catastrophizing, affect, and stress with craving, at the same occasion and prospectively.</div></div><div><h3>Results</h3><div>Most participants experienced some craving, though about a third of participants included in analyses reported minimal or no craving for the duration of the study. Craving for opioids and cannabis was higher on days of co-use and in the context of greater pain catastrophizing; smaller effects were observed correlating pain intensity, affect, and stress to opioid and cannabis craving. In adjusted analyses, pain catastrophizing prospectively predicted future opioid craving, albeit the effect was small.</div></div><div><h3>Conclusions</h3><div>The findings highlight that subset of patients do not report experiencing craving, but those who do tend to experience craving on days with heightened pain intensity and catastrophizing. Future research should investigate the role of pain catastrophizing in craving among patients with chronic pain.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"276 ","pages":"Article 112843"},"PeriodicalIF":3.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989456","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":"Examining trends in polydrug overdose deaths across rural Midwest counties in the United States, 2022 through 2024","authors":"Bradley R. Ray ,&nbsp;Shane Sheets ,&nbsp;Patti Constant ,&nbsp;Pranav Athimuthu ,&nbsp;Mia-Cara Christopher ,&nbsp;Monica M. Desjardins","doi":"10.1016/j.drugalcdep.2025.112832","DOIUrl":"10.1016/j.drugalcdep.2025.112832","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine trends in overdose deaths and the presence of xylazine in postmortem toxicology in a highly rural region of northern Minnesota with a significant American Indian/Alaska Native (AI/AN) population, using real-time local surveillance data.</div></div><div><h3>Methods</h3><div>We analyzed drug overdose death data from the Midwest Medical Examiner’s Office, covering 36 counties from January 1, 2022 to December 31, 2024. Data included demographic characteristics, place of death, and substances detected in toxicology results. Age-adjusted mortality rates and disparities across racial/ethnic groups were calculated, and polydrug combinations were explored using network analysis.</div></div><div><h3>Findings</h3><div>Among 964 overdose deaths, most decedents were white (71.4 %), AI/AN (13.5 %) or Black/African American (10.4 %) with an overall mortality rate of 76.4 per 100,000. Mortality rates declined during the study period for white and AI/AN populations and increased slightly for Black/African American populations. However, rates remained disproportionately high for AI/AN populations, who were 6.19 times more likely to die of overdose than non-AI/AN in 2024. Xylazine was detected only in combination with fentanyl, with no racial/ethnic differences in its presence. Distinct polydrug patterns were observed by race: fentanyl-cocaine combinations were more prevalent among Black/African Americans, while fentanyl-methamphetamine combinations predominated among AI/AN and White decedents. Conclusions: Local surveillance in rural areas can detect emerging threats like xylazine and illuminate racial disparities obscured in national datasets. Findings highlight the urgent need for real-time, locally driven data to inform targeted prevention and harm reduction, particularly for AI/AN populations in rural communities.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112832"},"PeriodicalIF":3.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880086","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":"Cocaine craving and use during pharmacotherapy trials for cocaine use disorder: A multi-trajectory analysis","authors":"Ramin Mojtabai ,&nbsp;Ryoko Susukida ,&nbsp;Mehdi Farokhnia ,&nbsp;Trang Quynh Nguyen ,&nbsp;Lorenzo Leggio ,&nbsp;Cecilia Bergeria ,&nbsp;Kelly E. Dunn ,&nbsp;Masoumeh Aminesmaeili","doi":"10.1016/j.drugalcdep.2025.112841","DOIUrl":"10.1016/j.drugalcdep.2025.112841","url":null,"abstract":"<div><h3>Background</h3><div>There is limited research on the course of drug craving in treatment trials of stimulant use disorders. This study examined trajectories of cocaine craving and use and their associations with other outcomes of cocaine use disorder in pharmacotherapy trials of cocaine use disorder.</div></div><div><h3>Methods</h3><div>In 1070 participants from 6 randomized controlled trials testing selegiline, baclofen, cabergoline, modafinil, reserpine, and tiagabine, we used multi-trajectory modeling to identify joint trajectories of weekly-measured cocaine craving and use. Association of these trajectories with Addiction Severity Index (ASI) health and social outcomes was assessed.</div></div><div><h3>Results</h3><div>A 3-trajectory model with High craving/High use (40.0 %), Decreasing craving/High use (36.8 %), and Decreasing craving/Decreasing use (23.2 %) groups was the most parsimonious. Compared to the High craving/High use group, the Decreasing craving/Decreasing use group experienced significantly greater improvement on ASI domains of drug use (change score = −13.7 vs. −3.3), alcohol use (-7.3 vs. −4.4), psychiatric status (-5.6 vs. 0.7) and relationships status (-7.0 vs. −2.8) (all p &lt; 0.05). Compared to placebo, those on modafinil 200<!--> <!-->mg/day were more likely to be in the Decreasing craving/Decreasing use group (Relative Risk Ratio [RRR]=4.84, 95 % CI=1.38–17.00) or Decreasing craving/High use group (RRR=5.55, 2.04–14.08) than in the High craving/High use group.</div></div><div><h3>Conclusions</h3><div>Trajectories of craving/drug use in clinical trials for cocaine use disorder are heterogeneous. Participants experiencing the greatest reduction in cocaine craving/use experienced the greatest improvement in other measures of drug use and psychosocial functioning, supporting the utility of reduced craving/use as a clinically relevant outcome in pharmacotherapy trials of people with cocaine use disorder.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112841"},"PeriodicalIF":3.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886603","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":"Health-related quality of life trajectories of patients in heroin-assisted treatment","authors":"Francesca Melis ,&nbsp;Charlotte Castel ,&nbsp;Desiree Eide ,&nbsp;Thomas Clausen","doi":"10.1016/j.drugalcdep.2025.112839","DOIUrl":"10.1016/j.drugalcdep.2025.112839","url":null,"abstract":"<div><h3>Background</h3><div>This study investigates health-related quality of life (HRQoL) in individuals with opioid use disorder enrolled in heroin-assisted treatment (HAT). While HRQoL in opioid maintenance treatment has been studied, less is known while in HAT. This study aim is to describe HRQoL in HAT, identify different HRQoL trajectories, and examine factors associated with class memberships.</div></div><div><h3>Methods</h3><div>This longitudinal cohort study is based on the multi-center Norwegian HAT project. The sample includes all consenting individuals enrolled in treatment from January 2022 to October 2024 (n = 108). HRQoL was assessed using the EuroQol EQ-5D-5L, and demographics were collected at baseline and multiple time points. Latent class linear mixed models were employed to identify HRQoL trajectory classes and explore differences in class memberships.</div></div><div><h3>Results</h3><div>At admission, participants demonstrated significant HRQoL difficulties across all dimensions, with severity levels higher than those of the general Norwegian population, particularly in Pain/Discomfort and Anxiety/Depression. Latent class analysis identified three distinct groups: the largest group (82 %) had a stable HRQoL trajectory, while smaller groups (8 % and 10 %) showed decline and improvement, respectively. Social support, clinic location, parental origin and at least one chronic symptoms were significant predictors of class membership.</div></div><div><h3>Conclusion</h3><div>The diverse, lower HRQoL profiles emphasize the need for personalized healthcare and support, making the HAT setting potentially valuable for such tailored care. Treatment participation helps most maintain fairly high HRQoL. The findings confirm the critical role of supportive relationships and effective chronic condition management in HRQoL outcomes.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112839"},"PeriodicalIF":3.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864574","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":"Impact of glucagon-like peptide-1 receptor agonists on alcohol consumption and liver-related outcomes: A systematic review and meta-analysis","authors":"Bernardo de Faria Moraes ,&nbsp;Gabriel André Pedral Diniz Leite ,&nbsp;Gustavo André Pedral Diniz Leite ,&nbsp;Igor Boechat Silveira ,&nbsp;Nathália Veloso Lana ,&nbsp;Guilherme Grossi Lopes Cançado","doi":"10.1016/j.drugalcdep.2025.112840","DOIUrl":"10.1016/j.drugalcdep.2025.112840","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing alcohol intake and impacting liver-related outcomes, mostly in patients with alcohol use disorder (AUD). This systematic review and meta-analysis aimed to further assess this association based on current evidence.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Embase, and CENTRAL was performed in May 2025. Random-effects meta-analyses or narrative synthesis were conducted depending on data availability. The pooled effect size was standardized mean difference (SMD), incidence rate ratio (IRR) or hazard ratio (HR) with 95 % confidence intervals (95 % CI).</div></div><div><h3>Findings</h3><div>Eleven studies (3 RCTs, 8 observational) including 263,616 patients (124,884 on GLP-1RAs, 138,732 controls) were included; 8 provided sufficient data for meta-analysis. In narratively summarized results, GLP-1RAs use was associated with reduced alcohol intake, binge drinking, AUDIT scores, and all-cause mortality. Evidence on heavy drinking was mixed, progression to cirrhosis was not statistically different and adverse events were mostly mild. In the pooled analysis of alcohol intake, no significant difference was observed with GLP-1RAs use (SMD −0.17; 95 % CI: −0.39, 0.04; I² = 0.0 %). However, GLP-1RAs use was associated with reduced alcohol-related events (HR 0.56; 95 % CI: 0.48, 0.65; I² = 63.6 %) and reduced liver-related outcomes (IRR 0.65; 95 % CI: 0.50, 0.85; I² = 0.0 %).</div></div><div><h3>Conclusions</h3><div>This meta-analysis outlines that GLP-1RAs may reduce alcohol-related events and liver-related outcomes, despite no significant effect was observed on pooled alcohol intake. Further high-quality studies are warranted to establish the efficacy of GLP1-RAs in reducing alcohol use and mitigating liver injury.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112840"},"PeriodicalIF":3.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880087","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":"A qualitative exploration of cigar smoking beliefs by type among U.S. susceptible Black young adults","authors":"Kayleigh M. Fenton ,&nbsp;Kelvin Choi ,&nbsp;Kristen R. Hamilton-Moseley ,&nbsp;Mignonne C. Guy ,&nbsp;Jeff Niederdeppe ,&nbsp;Kymberle L. Sterling ,&nbsp;Lilianna Phan","doi":"10.1016/j.drugalcdep.2025.112828","DOIUrl":"10.1016/j.drugalcdep.2025.112828","url":null,"abstract":"<div><h3>Background</h3><div>Cigar smoking is associated with cancer and pulmonary and cardiovascular diseases. Black young adults have the highest prevalence of cigarillo and little filtered cigar smoking. Little is known about Black young adults’ beliefs about each cigar type, which helps understand behaviors and informs prevention strategies.</div></div><div><h3>Methods</h3><div>We conducted belief elicitation interviews with 30 Black young adults interested in cigar smoking from April 2022-January 2024 to explore their behavioral, normative, and control beliefs by cigar type. We used thematic analysis to code emergent themes by belief category and cigar type.</div></div><div><h3>Results</h3><div>Participants mentioned more positive behavioral beliefs for cigarillos and large cigars than for little filtered cigars. There was less variation across cigar types for negative behavioral beliefs. Friends were mentioned as referents (i.e., individuals whose opinions or behaviors influence one’s attitudes or decisions) supportive of cigar smoking, particularly for cigarillos. Family members were mentioned as referents unsupportive of cigar smoking. While easy- and difficult- to-smoke beliefs emerged across cigar types, participants mentioned more easy-to-smoke beliefs for large cigars and more difficult-to-smoke beliefs for cigarillos and little filtered cigars. Cigarillos were characterized by outcome expectations of stress relief and use within social contexts; little filtered cigars were characterized by expectations of nicotine-related physical effects and relaxation; and large cigars were characterized as symbolizing high social status and social positions of power.</div></div><div><h3>Discussion</h3><div>Salient beliefs by cigar type support the need for cigar-specific prevention messaging for Black young adults. Future research should test the utility of modifying these beliefs in prevention messaging.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112828"},"PeriodicalIF":3.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880091","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":"World Health Organization risk drinking level reductions as treatment outcomes in PTSD and substance use disorder trials","authors":"Teresa López-Castro ,&nbsp;Jordan A. Gette ,&nbsp;Sudie E. Back ,&nbsp;Shannon M. Blakey ,&nbsp;Therese K. Killeen ,&nbsp;Antonio A. Morgan-Lopez ,&nbsp;Sonya B. Norman ,&nbsp;Lesia M. Ruglass ,&nbsp;Lissette M. Saavedra ,&nbsp;Mark P. McGovern ,&nbsp;Ismene L. Petrakis ,&nbsp;Susan Sonne ,&nbsp;Thomas Ehring ,&nbsp;Kathleen T. Brady ,&nbsp;Denise A. Hien","doi":"10.1016/j.drugalcdep.2025.112837","DOIUrl":"10.1016/j.drugalcdep.2025.112837","url":null,"abstract":"<div><h3>Objective</h3><div>Alcohol use disorder (AUD) clinical trials have traditionally prioritized abstinence, and more recently, heavy drinking cessation as primary treatment endpoints. Reductions in World Health Organization (WHO) risk drinking levels may offer a viable harm reduction-aligned alternative. Despite evidence supporting WHO risk level reductions as meaningful indicators of AUD treatment response, their utility in individuals with co-occurring posttraumatic stress disorder (PTSD) remains unknown. The present study compared 1- and 2-level WHO risk drinking reductions with abstinence and heavy drinking (HD) outcomes, and assessed their sensitivity across PTSD and substance use disorder (SUD) interventions, including behavioral and pharmacological treatments.</div></div><div><h3>Methods</h3><div>We conducted an integrative data analysis of 10 trials for adults with comorbid PTSD and SUD (PTSD+SUD). The proportion of participants achieving each of the four alcohol outcomes was calculated. Logistic regression models assessed treatment effects relative to treatment as usual (TAU).</div></div><div><h3>Results</h3><div>Across the 10 trials (N = 433; mean [SD] age, 39.7 [11.6] years; 359 [73.0 %] men), the most frequently achieved drinking outcome at end-of-treatment was a 1 +  level WHO risk reduction (82.8 %), followed by a 2 +  level reduction (72.2 %), HD cessation (65.6 %) and, least frequently, abstinence (53.0 %). Pharmacological interventions significantly outperformed TAU across all drinking outcomes.</div></div><div><h3>Conclusions</h3><div>Findings provide initial support for WHO risk drinking levels as viable endpoints in PTSD+SUD trials. Given their attainability, WHO risk levels may provide clinically relevant outcome metrics for these interventions. Future research should assess whether such reductions correspond to improvements in alcohol-related harms and broader functional outcomes.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"275 ","pages":"Article 112837"},"PeriodicalIF":3.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889681","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}