Drug and alcohol dependence最新文献

{"title":"Composition of gut microbiota and alcohol-related liver disease: A systematic review and meta-analysis","authors":"Xuanxuan Niu ,&nbsp;Lei Ma ,&nbsp;Zhewen Zhou ,&nbsp;Yan Li ,&nbsp;Anyi Shi ,&nbsp;Lihan Weng ,&nbsp;Huichun Xing","doi":"10.1016/j.drugalcdep.2025.112988","DOIUrl":"10.1016/j.drugalcdep.2025.112988","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The intestinal microbiome has been identified as a key factor influencing the development and prognosis of alcohol-related liver disease (ARLD). This article aims to systematically review and meta-analyze the alterations in the gut microbiome associated with ARLD, providing a comprehensive overview of these changes.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Web of Science databases were systematically searched from January 1, 2015, to September 1, 2024, with the search limited to studies published in English and Chinese. Articles meeting the inclusion criteria—providing gut microbiota analysis and reporting changes in diversity and abundance—were selected through a two-stage screening process. Data extraction was conducted independently by two reviewers to ensure accuracy and reliability.</div></div><div><h3>Results</h3><div>We compared gut microbiota differences between ARLD patients and healthy individuals, focusing on α-diversity, β-diversity, and microbial abundance. Among 17 studies, α-diversity indices showed a significant decrease in Shannon index (SMD=-0.63, 95 % CI= [-1.40, −0.14]), <em>p</em> &lt; 0.001), Chao1 (SMD=-1.20, 95 % CI= [-1.67, −0.74], <em>p</em> = 0.022), and OTUs (SMD=-1.14, 95 % CI= [-1.55, −0.73], <em>p</em> = 0.010), with no significant differences observed in Simpson index, ACE, inverse Simpson, or Pielou evenness. Of 21 studies on β-diversity, 16 reported significant differences between ARLD and healthy controls. Most findings indicate a reduction in anti-inflammatory microorganisms and an enrichment of pro-inflammatory microorganisms in ARLD patients.</div></div><div><h3>Conclusion</h3><div>The study revealed that intestinal microbiome changes in ARLD patients are characterized by decreased microbial diversity, a reduction in anti-inflammatory microbiota, and an enrichment of pro-inflammatory bacteria. These findings highlight the intestinal microbiome as a promising target for potential ARLD treatment strategies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112988"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673061","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":"Comparing random forest and elastic net models to predict substance use disorder transitions in participants with cannabis and stimulant use: Evidence from the All of Us cohort","authors":"Gabriel Zamora ,&nbsp;Tommy Gunawan ,&nbsp;Qingyu Zhao ,&nbsp;Alejandro D. Meruelo","doi":"10.1016/j.drugalcdep.2025.113012","DOIUrl":"10.1016/j.drugalcdep.2025.113012","url":null,"abstract":"<div><h3>Background</h3><div>Predicting progression from substance use to substance use disorder (SUD) is challenging, particularly for participants with cannabis and stimulant use who follow distinct risk trajectories. Machine learning enables integration of demographic, behavioral, wearable-derived, and social determinants of health (SDoH) data, yet few studies have compared linear and non-linear approaches in large, diverse populations.</div></div><div><h3>Methods</h3><div>Data came from the All of Us Research Program, a nationwide cohort integrating electronic health records, surveys, wearable metrics, and SDoH. Individuals with baseline cannabis or stimulant use were followed for incident SUD diagnoses. Predictors included demographics, wearable-derived activity and sleep, and SDoH domains (income, food insecurity, housing instability, transportation barriers). Elastic net (EN) logistic regression and random forest (RF) models were trained separately within cannabis and stimulant cohorts. Discrimination was evaluated on independent test sets using the area under the receiver operating characteristic curve (AUC) and compared with the DeLong test.</div></div><div><h3>Results</h3><div>For participants with cannabis use, EN and RF showed similar performance (AUC = 0.740 vs. 0.741; DeLong p = 0.764). For participants with stimulant use, RF achieved AUC = 0.732 vs. EN = 0.698; DeLong p = 0.219. Demographic variables were the strongest predictors across models. SDoH indicators—particularly income—contributed substantially to prediction, while wearable-derived metrics provided incremental explanatory value primarily in EN models, with limited independent contribution in RF.</div></div><div><h3>Conclusions</h3><div>EN and RF models achieved moderate prediction of SUD transitions. Incorporating SDoH and wearable-derived data enhanced interpretability and risk stratification, particularly in linear models, underscoring substance-specific pathways and the utility of multimodal frameworks for developing precision prevention strategies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 113012"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829351","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 study of smoking cessation among World Trade Center Health Registry enrollees, 2003–2021","authors":"Laura Sirbu ,&nbsp;Julia S. Sisti ,&nbsp;James E. Cone","doi":"10.1016/j.drugalcdep.2025.113010","DOIUrl":"10.1016/j.drugalcdep.2025.113010","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with post-traumatic stress disorder (PTSD) are more likely to smoke and less likely to quit smoking than people without the condition. Building upon previous research, we examined associations between probable PTSD and smoking cessation among World Trade Center Health Registry (WTCHR) enrollees, who have a relatively high prevalence of PTSD.</div></div><div><h3>Methods</h3><div>We used five waves of survey data (2003–2021) from the WTCHR, a closed cohort of 9/11-exposed individuals, to examine longitudinal associations between probable PTSD and subsequent smoking cessation among enrollees who reported current smoking. Probable PTSD was assessed with the PTSD Checklist for DSM-IV (PCL-S). The outcome of smoking cessation was also assessed via survey responses at the subsequent wave. Multivariable-adjusted risk ratios (RRs) and 95 % confidence intervals (95 % CI) were estimated with generalized estimating equations.</div></div><div><h3>Results</h3><div>Overall, 31.3 % of enrollees quit smoking by the subsequent survey wave. Differences by probable PTSD status were observed, and in multivariable adjusted models, enrollees with probable PTSD were 8 % less likely to quit smoking compared to enrollees without probable PTSD (RR=0.92, 95 % CI: 0.87, 0.97).</div></div><div><h3>Conclusion</h3><div>Although various smoking cessation programs have been implemented among the WTC-exposed population, differences in cessation by PTSD status persist. Additional efforts to promote cessation among this group should consider mental health conditions.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 113010"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829353","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":"Reciprocal effects between illicit drug use and mental health conditions among healthcare workers in Sweden: A one-year follow-up study","authors":"Josefina Peláez Zuberbuhler ,&nbsp;Emelie Thern ,&nbsp;Siw Tone Innstrand ,&nbsp;Marit Christensen ,&nbsp;Bodil J. Landstad ,&nbsp;Malin Sjöström ,&nbsp;Devy L. Elling ,&nbsp;Emma Brulin","doi":"10.1016/j.drugalcdep.2025.112997","DOIUrl":"10.1016/j.drugalcdep.2025.112997","url":null,"abstract":"<div><h3>Background</h3><div>Research suggests a comorbidity between illicit drug use and mental health conditions. However, it remains unclear whether illicit drug use serves as a risk factor for, or a consequence of, mental health conditions in healthcare workers (HCWs). This study aimed to 1) examine the prevalence of illicit drug use among HCWs in Sweden and 2) investigate the bidirectional relationship between illicit drug use and mental health conditions(i.e., depression and burnout).</div></div><div><h3>Methods</h3><div>Data from the 2022 and 2023 Longitudinal Occupational Health Survey in Healthcare Sweden (LOHHCS) were used. The data included 3280 HCWs (50.3 % physicians and 49.7 % nurses). Questionnaires assessed illicit drug use frequency, burnout complaints (BAT-12), and depression (SCL-CD6). Cross-lagged panel models (CLPMs) were used to examine the reciprocal relationships over the two studied time-points between illicit drug use and mental health conditions.</div></div><div><h3>Results</h3><div>The prevalence of illicit drug use in 2022 was 1.3 %, which increased slightly to 1.6 % one and a half years later, in 2023. Using two-wave panel data, results revealed a bidirectional effect between illicit drug use and burnout. However, while depression was associated with subsequent illicit drug use, the reversed association was not observed.</div></div><div><h3>Conclusions</h3><div>These findings suggest that illicit drug use plays different roles in relation to burnout and depression among healthcare workers. This highlights the importance of integrated treatment strategies and preventive measures that address both illicit drug use and mental health conditions—especially burnout—simultaneously.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112997"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746394","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":"Acute alcohol intake disrupts resting state network topology in healthy social drinkers","authors":"Leah A. Biessenberger ,&nbsp;Adriana K. Cushnie ,&nbsp;Bethany Stennett-Blackmon ,&nbsp;Landrew S. Sevel ,&nbsp;Michael E. Robinson ,&nbsp;Sara Jo Nixon ,&nbsp;Jeff Boissoneault","doi":"10.1016/j.drugalcdep.2025.112972","DOIUrl":"10.1016/j.drugalcdep.2025.112972","url":null,"abstract":"<div><div>Alcohol intake disrupts cognitive and sensory processing. However, its effects on the role of individual structures within cortical networks, or on the larger network structure, remain unclear. This acute alcohol administration study addressed this gap using graph theory analysis. Healthy individuals (n = 107, 21–45<!--> <!-->yrs, 61 women) consumed alcohol (0.08<!--> <!-->g/dL target BrAC) or a placebo drink in 2 double-blinded sessions and self-reported their perceived intoxication using a visual analog scale. Resting state fMRI was acquired with a Siemens Prisma 3T scanner 30<!--> <!-->min after consumption. The effect of alcohol on graph theory outcomes in a network of 106 cerebral ROIs was identified using the CONN toolbox. We also determined the association between graph theory metrics and subjective intoxication. Results revealed alcohol 1) significantly decreased global efficiency in several occipital nodes and increased global efficiency for nodes within the frontal and temporal cortex; 2) increased local efficiency at a network level as well as in specific nodes in the temporal and frontal cortices; 3) increased degree in frontal and temporal regions; 4) decreased closeness centrality and increased mean path length in parietal and occipital regions as well at the network level compared with placebo conditions. Additionally, decreases in global efficiency and increases in local efficiency and clustering coefficient in the alcohol vs. placebo condition significantly predicted subjective intoxication. Taken together, results provide new evidence that alcohol intake produces changes in the overall topography of the cerebral network that at least partially underlie individual differences in subjective alcohol response.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112972"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622796","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":"Within-person prospective associations between depressive symptoms, abstinence self-efficacy and smoking cessation following smoking cessation treatment","authors":"María Ramos-Carro ,&nbsp;Rubén Rodríguez-Cano ,&nbsp;Carmela Martínez-Vispo ,&nbsp;Ana López-Durán ,&nbsp;Elisardo Becoña","doi":"10.1016/j.drugalcdep.2025.113004","DOIUrl":"10.1016/j.drugalcdep.2025.113004","url":null,"abstract":"<div><h3>Background</h3><div>Abstinence self-efficacy and depressive symptoms have independently been associated with smoking outcomes in previous research. However, their bidirectional relationships with smoking abstinence over time remain underexplored. This study examined bidirectional and prospective associations between depressive symptoms, abstinence self-efficacy, and smoking abstinence from the end of a cognitive-behavioral smoking cessation intervention to 12-month follow-up.</div></div><div><h3>Methods</h3><div>This study was conducted with 685 adults (62.04 % female; <em>M</em>_<em>age</em>=45.51) who sought smoking cessation treatment at the Smoking Cessation and Addictive Disorders Unit (University of Santiago de Compostela, Spain). Abstinence was defined as not smoking, not even a puff, in the prior 24<!--> <!-->h at the end of the intervention and not smoking in the prior 7 days at each follow-up. A Random Intercept Cross-Lagged Panel Model was performed to examine the bidirectional and prospective associations between study variables.</div></div><div><h3>Results</h3><div>At the within-person level, smoking abstinence at posttreatment and 3-month follow-up predicted greater abstinence self-efficacy and fewer depressive symptoms at 3- and 6-month follow-up, respectively. In contrast, higher abstinence self-efficacy at posttreatment was associated with lower odds of abstinence at 3-month follow-up, and abstinence self-efficacy at 3 months predicted more depressive symptoms at 6 months. Depressive symptoms did not significantly predict abstinence self-efficacy or smoking abstinence in the cross-lagged associations at any time point.</div></div><div><h3>Conclusion</h3><div>Quitting smoking predicts higher abstinence self-efficacy and lower depressive symptoms after posttreatment, but these effects diminish after 6-month follow-up. Notably, higher levels of abstinence self-efficacy at the end of treatment may increase smoking risk during the first three months postquitting.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 113004"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795823","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":"Gender convergence in young adults’ drinking in Australia","authors":"Emma Vieira ,&nbsp;Nicholas Taylor ,&nbsp;Amy Pennay ,&nbsp;Cassandra Wright ,&nbsp;Michael Livingston","doi":"10.1016/j.drugalcdep.2025.113000","DOIUrl":"10.1016/j.drugalcdep.2025.113000","url":null,"abstract":"<div><h3>Background</h3><div>Despite recent declines in alcohol consumption for younger generations, risky drinking still peaks in young adulthood (18−29). While men have historically consumed more alcohol than women, there may be changes emerging in gendered patterns of drinking. This study investigated if a ‘gender convergence’ in young adults’ drinking has occurred in Australia, whereby women and men’s drinking rates have become more similar over time.</div></div><div><h3>Methods</h3><div>Three national Australian survey data sources were used to assess drinking trends from 2001 to 2023 in young adult women and men, aged 18–29. Gender convergence was tested for annual volume, past-year drinking status, and long-term, risky single-occasion, and high risky single-occasion drinking. Analyses included linear and logistic regressions with interactions between gender and year to assess gender differences in trends over time.</div></div><div><h3>Results</h3><div>Drinking declined for young adults across all measures and surveys between 2001 and 2023. For all surveys, evidence for convergence in annual volume was found from 2013 to 2023. Some evidence for convergence was noted in recent years for past-year drinking (2019–2023) and risky drinking (2021–2022). For all measures, convergence occurred due to men’s drinking decreasing at faster rates than women’s.</div></div><div><h3>Conclusions</h3><div>This study provides evidence for gender convergences in young adults’ drinking in Australia. Notably, this convergence occurs within the context of a broader drinking decline for both women and men, whereby men’s drinking has decreased at a faster rate. These findings reflect emerging evidence from other high-income countries and suggest that future research understanding the drivers for men’s steeper drinking declines is warranted.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 113000"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822548","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":"Does making early evening social plans impact alcohol use outcomes over evening hours?","authors":"Sharon Lipperman-Kreda ,&nbsp;Christina F. Mair ,&nbsp;Paul J. Gruenewald ,&nbsp;M. Kristina Wharton ,&nbsp;Rachel L. Gunn ,&nbsp;Lindy K. Howe","doi":"10.1016/j.drugalcdep.2025.113005","DOIUrl":"10.1016/j.drugalcdep.2025.113005","url":null,"abstract":"<div><div>Puropse: This study examined associations of evening plans to engage in different social activities with drinking behaviors and negative consequences experienced over weekend evening hours among underage young adults. Methods: Ecological Momentary Assessment (EMA) data were collected from underage youth (19–20 years) in California in 8 evenings over 4 successive weekends. At 6<!--> <!-->pm, participants reported their social (i.e., any social plans tonight) and contextual (i.e., planning to be outside own home tonight) evening plans and whether they planned to drink that evening. They subsequently reported alcohol use and negative consequences within the past two hours at 8<!--> <!-->pm, 10<!--> <!-->pm, midnight, and the next morning. We used mixed effects logistic and negative binomial models controlling for demographics, history of alcohol use, drinking motives, and weekend day. Analyses were based on data obtained from 230 participants who reported on 1469 evenings. Results: In about 37 % and 46 % of evenings in which participants reported having social plans or plans to be outside own home, they reported no plans to drink alcohol, respectively. Social evening plans were positively associated with subsequent alcohol use (OR=3.312, p &lt; 0.001), the number of drinks consumed (IRR=2.009, p &lt; 0.001), and the number of negative consequences experienced (IRR=1.526, p &lt; 0.05), independent of plans to drink that evening. Having any social evening plans was positively associated with planned (vs. unplanned) drinking (OR=7.080, p &lt; 0.001). Conclusions: Social evening plans may be important determinants of drinking behaviors and negative consequences across evening hours among underage young adults. Results can guide future interventions to reduce heavier drinking and associated harms.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 113005"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795833","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":"Alcohol-seeking associations with resting state functional connectivity of the amygdala","authors":"Mario Dzemidzic ,&nbsp;McKenzie R. Cox ,&nbsp;David Haines ,&nbsp;James Hays ,&nbsp;Mayande K. Mlungwana ,&nbsp;Andrea Avena-Koenigsberger ,&nbsp;Marian L. Logrip ,&nbsp;Joaquin Goni ,&nbsp;Jaroslaw Harezlak ,&nbsp;Ann E.K. Kosobud ,&nbsp;David A. Kareken ,&nbsp;Sean O’Connor ,&nbsp;Martin H. Plawecki ,&nbsp;Melissa A. Cyders","doi":"10.1016/j.drugalcdep.2025.112999","DOIUrl":"10.1016/j.drugalcdep.2025.112999","url":null,"abstract":"<div><h3>Background</h3><div>Prolonged alcohol use is associated with neuroadaptations that may contribute to continued alcohol consumption, even in the presence of adverse consequences. Although well studied in preclinical models, the neural mechanisms of aversion-resistant alcohol-seeking in humans are understudied.</div></div><div><h3>Purpose</h3><div>The goal of this study was to examine whether altered amygdala resting state functional connectivity (rsFC) is a mechanism for how lifetime drinking history and alcohol use disorder symptoms relate with objectively measured neutral and aversion-resistant alcohol-seeking in the human laboratory.</div></div><div><h3>Methods</h3><div>A sample of 55 adults (age 21–55, mean=32.18 years, 56.4 % female, 60.0 % White) completed two counterbalanced intravenous alcohol progressive-ratio self-administration sessions (pairing alcohol-seeking with aversive or neutral stimuli) and a resting state fMRI scan. Two bilateral <em>a priori</em> amygdala seed regions were selected.</div></div><div><h3>Results</h3><div>rsFC strength of the left basolateral amygdala and dorsal anterior cingulate cortex mediated the relationships between both lifetime alcohol use and alcohol use disorder symptom severity with alcohol-seeking in the aversive session. rsFC between the right centromedial amygdala and occipital regions was associated with, but not specific to, alcohol-seeking during the neutral session; this connectivity mediated the association with alcohol use disorder symptom severity, but not the association with lifetime alcohol use.</div></div><div><h3>Conclusions</h3><div>This study provides evidence linking the basolateral amygdala to human aversion-resistant alcohol-seeking. Identification of brain mechanisms underlying aversion-resistant alcohol-seeking can facilitate translational research and identify physiological mechanisms of alcohol use disorder progression.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112999"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784073","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":"Micro-costing analysis of harm reduction services in office-based addiction treatment","authors":"Austen Markus ,&nbsp;Margaret Shang ,&nbsp;Olivia Studnicki ,&nbsp;Ariana Freund ,&nbsp;Jessica Merlin ,&nbsp;Jane M. Liebschutz ,&nbsp;Vikram K. Raghu ,&nbsp;Raagini Jawa","doi":"10.1016/j.drugalcdep.2025.112990","DOIUrl":"10.1016/j.drugalcdep.2025.112990","url":null,"abstract":"<div><h3>Objectives</h3><div>The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.</div></div><div><h3>Methods</h3><div>Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.</div></div><div><h3>Results</h3><div>Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.</div></div><div><h3>Conclusions</h3><div>We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112990"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746354","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}