Journal of Addiction Medicine最新文献

{"title":"The Scientific Debate on Khat Addiction: Evidence Across Humans, Animals, and Policy Domains.","authors":"Sharoen Y M Lim, Mustafa Alshagga","doi":"10.1097/ADM.0000000000001703","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001703","url":null,"abstract":"<p><p>Khat's addictive status is highly contested, shaped by conflicting evidence, varied epidemiology, and politically charged regulation. Although its psychoactive alkaloids, cathinone and cathine, are controlled in several jurisdictions, khat itself remains ambiguously regulated, as shown by the UK's 2014 move to classify it as a Class C drug, a decision driven as much by sociopolitical narratives as pharmacology. WHO assessments describe khat as capable of producing mild to moderate psychological dependence, with harms linked more to patterns of use and structural vulnerabilities than alkaloid exposure alone. Human studies show widely differing dependence rates due to cultural factors and inconsistent diagnostic tools, and recent adolescent research warns against equating prevalence with addiction without validated measures. Limited preclinical work finds khat extract can induce conditioned place preference and relapse-like behavior, though weaker than classic stimulants. Evidence-based treatments remain underdeveloped. Progress requires standardized assessments, expanded neurobehavioral studies, and community-grounded interventions.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838045","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":"Methadone and Torsades de Pointes: A Case Series.","authors":"Alyssa Cheng, Bella Kalayilparampil, Stephanie E Stamatis, Srijan Shrestha, Jeanette M Tetrault, Shawn M Cohen","doi":"10.1097/ADM.0000000000001709","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001709","url":null,"abstract":"<p><p>This case series reports on three patients undergoing methadone treatment for opioid use disorder (OUD) who developed significant QT prolongation and Torsades de Pointes (TdP). We compare patient-specific risk factors contributing to QT prolongation, including methadone dose. During their hospitalization and outpatient care, we review the use of various management strategies, including methadone dose reduction, transition to buprenorphine, and cardiac therapies such as antiarrhythmics and implantable cardioverter-defibrillators (ICDs) to reduce cardiac risk. Lastly, we examine post-hospitalization outcomes and follow-up. By reporting these cases, we aim to highlight treatment strategies that balance the risk of dysrhythmia with the risk of destabilizing OUD treatment. Patient consent was obtained for the development of the case series.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837997","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":"From Management to Maintenance: A Pilot Ambulatory Gabapentin Bridge Protocol for Treatment of Low-risk Alcohol Withdrawal Syndrome.","authors":"Samata R Sharma, Kate Takayoshi, Rachel Hardenstine, Joji Suzuki","doi":"10.1097/ADM.0000000000001706","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001706","url":null,"abstract":"<p><strong>Objective: </strong>Ambulatory management of mild to moderate alcohol withdrawal syndrome (AWS) remains underutilized despite evidence supporting its safety and effectiveness. We developed and tested a fixed-dose gabapentin taper protocol for AWS, designed to standardize patient selection, monitoring during treatment, and also allow for transition to maintenance pharmacotherapy for alcohol use disorder (AUD).</p><p><strong>Methods: </strong>Retrospective case series of the first 10 consecutive patients treated with a 6-day fixed-dose gabapentin taper (1800 mg tapered to 300 mg) at a hospital-based bridge clinic. Eligibility required low risk for complicated withdrawal per validated screening criteria. Follow-up included telemedicine visits on days 2-3 and in-person or virtual assessment at day 7 and 1 month.</p><p><strong>Results: </strong>No patients experienced progression to complicated AWS, and none required emergency department visits or inpatient escalation. All patients either successfully completed the taper or opted to remain on a maintenance dose of gabapentin before the conclusion of the taper. Nine of 10 patients (90%) reported abstinence through day 7. At 1-month follow-up, 7 patients (70%) remained abstinent, 9 (90%) were retained in treatment, and all 10 (100%) had transitioned to medication for alcohol use disorder (MAUD) maintenance pharmacotherapy.</p><p><strong>Conclusions: </strong>A standardized gabapentin taper with telemedicine follow-up demonstrated early safety signals, high short-term abstinence, and successful transition to maintenance treatment for patients with AWS who were deemed low risk for progression to complicated withdrawal. Prospective, randomized trials comparing fixed-dose gabapentin tapers with symptom-triggered benzodiazepine or phenobarbital regimens are needed across diverse ambulatory settings to confirm these preliminary findings.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837958","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":"Factors Associated With Telehealth Buprenorphine Initiation.","authors":"Sahar Yazdanfard, Douglas Thornton, Moosa Tatar, Smita Prasad, Omolola E Adepoju, Dipali Rinker, Tyler Varisco","doi":"10.1097/ADM.0000000000001688","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001688","url":null,"abstract":"<p><strong>Objective: </strong>Telehealth expanded buprenorphine access for opioid use disorder (OUD) after COVID-19 federal flexibilities permitted telehealth initiation. Limited evidence exists comparing telehealth and in-person buprenorphine initiation. This study examines correlates of telehealth versus in-person buprenorphine initiation among adults with OUD.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional analysis using the Integrated Humana Medical and Pharmacy dataset, including commercial, Medicaid, Medicare Advantage (MAPD), and Medicare Part D prescription drug plans (PDP). Adults with newly diagnosed OUD who initiated buprenorphine between March 17, 2020, and December 31, 2023, with no prior use in the preceding 180 days, were included. Correlates of telehealth initiation were identified using the Least Absolute Shrinkage and Selection Operator-penalized logistic regression.</p><p><strong>Results: </strong>Among 4034 patients, 748 (18.5%) initiated treatment via telehealth and 3286 (81.5%) in-person visits. Telehealth initiation was most common among patients aged 24-35 (25.0%) and least common among those aged 65+ (12.2%). Adjusted analyses found younger age (aOR: 1.54, 95% CI: 1.07-2.21 for ages 24-35 vs. 65+), prior telehealth use (aOR: 1.92, 1.55-2.37), cannabis use disorder (aOR: 1.38, 1.08-1.76), sedative use disorder (aOR: 1.63, 1.22-2.16), psychiatric/behavioral provider type (aOR: 2.38, 1.87-3.04), and zero comorbidities (aOR: 1.76, 1.33-2.34) as positively associated with telehealth initiation. Suburban (aOR: 0.73, 0.58-0.91) and urban (aOR: 0.77, 0.62-0.96) patients were less likely to initiate via telehealth compared with rural patients.</p><p><strong>Conclusions: </strong>Approximately 1 in 5 patients initiated buprenorphine via telehealth, with significant variation by age, geography, prior telehealth experience, comorbidity burden, and provider speciality. These findings underscore the need for postpandemic policies that preserve telehealth access although maintaining robust in-person treatment options to address diverse patient needs.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815600","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":"Methadone Diversion and Overdose: What Does the Evidence Say? A Narrative Review.","authors":"Megan Miller, Noa Krawczyk","doi":"10.1097/ADM.0000000000001699","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001699","url":null,"abstract":"<p><strong>Objectives: </strong>Policy reforms are being considered to increase methadone treatment (MT) access for opioid use disorder in the United States. Proponents of more structured MT reference risks of diversion, including non-prescribed use or redistribution of methadone, and overdose as arguments for limiting access to specialty settings. However, the scientific evidence behind these claims has not been thoroughly reviewed.</p><p><strong>Methods: </strong>We conducted a narrative review of studies on methadone diversion, diverted methadone-involved overdoses, and how these compare in countries with specialty-care-only policies (methadone dispensed only through regulated treatment programs) versus general physician-prescribing policies (physicians prescribe methadone in office-based settings). A narrative approach was chosen, given substantial heterogeneity in study designs, diversion definitions, outcome measures, and data sources. We synthesize and discuss findings from international papers published before October 2025.</p><p><strong>Results: </strong>We identified 29 articles studying methadone diversion or diverted methadone-involved overdoses in 7 countries. Lifetime methadone diversion occurrence varied between 6% and 68%, and using diverted methadone occurrence varied between 22% and 88%. Diverting methadone was most often done to help sick friends/partners. Common reasons for using diverted methadone were preventing withdrawal and avoiding opioid use. Three studies found no association between self-reported diverted methadone use and increased individual-level risk of overdose.</p><p><strong>Conclusions: </strong>The link between specialty-care-only policies and lower diversion and overdose risk is not supported by the reviewed literature. Policymakers should weigh diversion risks against benefits of lives saved through expanded MT access. Further research is needed to better understand the circumstances related to diverted methadone and inform policy-making that appropriately mitigates risks.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729137","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":"Mixed Presentation of Heroin-Associated Spongiform Leukoencephalopathy and CHANTER Syndrome After Fentanyl Use: A Case Report.","authors":"Nolan Marshall, Alëna A Balasanova","doi":"10.1097/ADM.0000000000001700","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001700","url":null,"abstract":"<p><strong>Background: </strong>Toxic leukoencephalopathy is a heterogenous syndrome characterized by destruction of brain white matter. Inhalational heroin has been linked to a specific set of neuroimaging findings termed heroin-associated spongiform leukoencephalopathy (HSLE). Clinical findings in HSLE generally develop and progress through an initial, intermediate, and terminal stage. Fentanyl has been linked to a separate set of neuroimaging findings and neurological symptoms labeled Cerebellar Hippocampal And Basal Ganglia Transient Edema with Restriction (CHANTER) syndrome, in which patients often present with an acute onset of stupor or coma hours to days after opioid use. Fentanyl has also been documented to cause a constellation of white matter changes mirroring HSLE.</p><p><strong>Case summary: </strong>A 50-year-old man presented with an acute onset of somnolence, dysarthria, and ataxia following a subacute history of headaches, memory deficits, weight loss, and diaphoresis. He endorsed regular fentanyl use though details about quantity and route of administration remained unclear. Brain imaging suggested a mixed picture as findings were consistent with both HSLE and CHANTER syndrome. The patient's clinical course fluctuated until 3 weeks after admission, when he began showing signs of the terminal stage of HSLE, ultimately resulting in death 1 week later.</p><p><strong>Conclusions: </strong>HSLE and CHANTER syndrome have not previously been reported as occurring concurrently, nor has fentanyl previously been linked to HSLE. This case highlights the potential for HSLE and CHANTER syndrome to coexist and for fentanyl to cause a set of findings consistent with both syndromes. The patient's spouse provided written and verbal consent to publish the information in this report.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716862","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":"\"The Sky Didn't Fall\": Patient and Clinician Experiences With Increased Buprenorphine Prescription Lengths During Pandemic-related Telehealth Expansion.","authors":"Anna Cheng, Zoe M Weinstein, Melissa Davoust, Alicia S Ventura, Kara M Magane, Jacqueline Theisen, Samantha Blakemore, Richard Saitz, Angela R Bazzi","doi":"10.1097/ADM.0000000000001702","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001702","url":null,"abstract":"<p><strong>Objectives: </strong>Pandemic-related telehealth expansion changed how buprenorphine care was delivered. However, patient and clinician experiences with how these changes shaped decisions about prescription length remain underexplored, particularly in safety-net settings.</p><p><strong>Methods: </strong>From May 2021 to May 2022, we purposively sampled patients and clinicians from an office-based buprenorphine treatment clinic at an urban, safety-net hospital. Trained interviewers used semistructured interview guides to explore experiences with changes in care during the pandemic. We used a collaborative codebook development process and thematic analysis to identify key perspectives on buprenorphine prescription length changes.</p><p><strong>Results: </strong>From interviews with 25 patients and 16 clinicians, 3 topics of relevance emerged: (1) changes to buprenorphine prescribing practices to support patients during the pandemic, (2) factors influencing clinical decision making and criteria for longer prescriptions, and (3) patient views and internalized expectations. Overall, both patients and providers reported increased duration of buprenorphine prescriptions and positive views of this change. Clinicians generally prioritized ensuring medication access over concerns about misuse and diversion. Influences on clinical decision making included medical conditions, transportation access, housing status, and patient communication. To receive longer prescriptions, some patients described deliberate efforts to build and maintain trust with clinicians.</p><p><strong>Conclusions: </strong>We identified largely positive patient and clinician experiences with increased buprenorphine prescription lengths. As practices continue to update their clinic policies, these findings support continued flexibility and extended prescription lengths to support medication access. Findings also demonstrate heterogeneity in clinicians' decision-making and an opportunity for improved transparency and patient-provider communication regarding criteria for extended prescriptions.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716883","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":"Methamphetamine Use Among Older Adults Living With HIV: A Qualitative Study.","authors":"Benjamin H Han, Wayne E Kepner, Annie L Nguyen, Natalie Colaneri, Alise Collins, Marlena Coveney, Maile Y Karris","doi":"10.1097/ADM.0000000000001691","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001691","url":null,"abstract":"<p><strong>Objectives: </strong>Methamphetamine can complicate the management of chronic diseases and is associated with a range of health complications. This study examines the contextual motivations and perceived risks of methamphetamine use in the setting of aging and chronic disease among older adults living with HIV.</p><p><strong>Methods: </strong>We conducted 1-to-1, semistructured qualitative interviews with 20 adults aged 50 years or older and living with HIV in San Diego, California, who used methamphetamine in the past 30 days. Interviews were audio-recorded, transcribed, systematically coded, and analyzed to identify key themes regarding reasons for methamphetamine use in older age, perceived benefits and harms, impact on chronic disease management, and knowledge of harm reduction interventions.</p><p><strong>Results: </strong>Participants had a mean age of 60.0 years (range: 51-69), 75% identified as male, 30% as Hispanic/Latino, and 70% had ≥2 chronic medical diseases other than HIV. Regarding methamphetamine use, 55% used every day, with the most common route of use being smoking (70%). Three major themes emerged: (1) motivations for methamphetamine use shifted with age, from using for sexual enhancement to mainly using to help perform every day activities, treat chronic symptoms, or cope with increasing isolation; (2) increasingly experiencing negative physical consequences related to use with less perceived benefit, but difficulty cutting down; and (3) lack of knowledge regarding risk for overdose or harm reduction interventions.</p><p><strong>Conclusions: </strong>In this qualitative analysis, older adults living with HIV who use methamphetamine reported changing motivations for use with age, while not accessing treatment or harm reduction interventions to reduce overdose risk.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689431","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":"Sex-specific Trends in Methamphetamine Use in the United States, 2002-2022.","authors":"Soohyun Joe, Joseph A Carley, Eunju Kim, Maryam Soltani, Carla Marienfeld","doi":"10.1097/ADM.0000000000001697","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001697","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize long-term sex-specific trends in past-year methamphetamine use in the United States and to assess whether prevalence trajectories differ between males and females, with implications for the practice of addiction medicine.</p><p><strong>Methods: </strong>We analyzed nationally representative, repeated cross-sectional data from the National Survey on Drug Use and Health spanning 2002-2022 (N=1,155,417). Survey-weighted annual prevalence estimates of past-year methamphetamine use were calculated by sex. Survey-weighted logistic regression models, including a sex-by-year interaction were used to test whether temporal trends differed by sex.</p><p><strong>Results: </strong>Past-year methamphetamine use was consistently more prevalent among males than females throughout the study period. Annual prevalence declined in the early 2000s and increased after the mid-2010s in both sexes, with larger increases among males. Male prevalence increased from 0.8% (95% CI: 0.6-1.0) in 2002 to 1.4% (95% CI: 1.0-1.8) in 2022, whereas female prevalence increased from 0.6% (95% CI: 0.5-0.7) to 0.7% (95% CI: 0.6-0.8). Additional analyses confirmed significantly different temporal trajectories between males and females.</p><p><strong>Conclusions: </strong>From 2002 to 2022, methamphetamine use in the United States demonstrated persistent and widening sex differences, with higher prevalence and larger increases among males than females in the past decades. These findings support the importance of incorporating sex-informed approaches into addiction medicine screening, prevention, harm reduction, and treatment planning.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689483","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":"Beyond Age: Transition Age Adults Have Distinct Identities, Substance Use Patterns Compared With Other Adults in Substance Use Disorder Treatment.","authors":"Vanessa Drury, Josh Aleksanyan, Nithya Narayanan, Juan Echenique, Matilda Melkonian, Diego Renteria, Adetayo Fawole, Sugy Choi, Sam Kawola, Jamie Del Rosario, Pat Lincourt, Maria L Morris, Charles J Neighbors, Chinazo O Cunningham, Ashly E Jordan","doi":"10.1097/ADM.0000000000001692","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001692","url":null,"abstract":"<p><strong>Objectives: </strong>Transition age (TA, 18-5 years old) adults experience disproportionately high rates of substance use disorders (SUD) but are less likely than other adults to engage in treatment. To better understand TA adults engaged in SUD treatment, we explored the characteristics of this age group compared with other adults 26 years or older.</p><p><strong>Methods: </strong>Using New York State administrative data, we compared sociodemographic characteristics and substance use patterns of TA adults and other adults (≥26 years) in SUD treatment in 2023 at the individual level, overall and stratified by specific SUD (alcohol, cannabis, opioid, stimulant, or sedative use disorder). Two-sample proportion tests by age group were conducted, and prevalence ratios (PR) were calculated. Effect size was determined with Cohen's h.</p><p><strong>Results: </strong>TA adults accounted for 8.1% (N = 12,103) of adults engaged in SUD treatment in 2023 (N = 148,611). Compared with other adults, TA adults were significantly more likely to identify as LGBT (11.7% vs 5.6%, p < 0.01, h = 0.22), report criminal legal system involvement (46.2% vs 33.3%, p < 0.01, h = 0.27), and be engaged for cannabis use disorder (32.8% vs 7.4%, p < 0.01, h = 0.67). Compared with other adults, they were significantly less likely to be unstably housed (15.6% vs 24.3% p < 0.01, h = -0.22) and engaged in opioid use disorder (20.0% vs 37.5%, p < 0.01, h = -0.39).</p><p><strong>Conclusions: </strong>TA adults in SUD treatment have distinct identities and substance use patterns compared with other adults in SUD treatment. These characteristics can inform age-specific treatment programs and guide resource allocation, outreach, and engagement strategies.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689517","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}