Journal of Addiction Medicine最新文献

{"title":"Individuals With Opioid Use Disorder in the Perinatal Period: Characteristics and Engagement in Integrated Treatment.","authors":"Mary Ann Faucher, Macy Ann Afsari, Polly Cordova, Kurt Kleinschmidt, Stephanie Morillos, Jessica McNeil, Nancy Onisko, Joshua Kern, Aldo Andino, Jessica E Pruszynski, Emily H Adhikari","doi":"10.1097/ADM.0000000000001571","DOIUrl":"10.1097/ADM.0000000000001571","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of the study were to describe an integrated screening, brief intervention, treatment and referral (SBIRT) prenatal care program for opioid use disorder (OUD), factors influencing program engagement, and the characteristics of pregnant and postpartum people with OUD.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 245 pregnant and postpartum people with OUD who had access to a 30-day SBIRT program at a safety-net hospital between March 15, 2021, and March 15, 2024. Multivariable logistic regression models assessed predictors of program completion, defined as engaging in 4 weekly outpatient visits.</p><p><strong>Results: </strong>Forty-two percent of participants completed the program, and 86% received medication for opioid use disorder (MOUD). Factors that increased the likelihood of program completion included entry through referral versus the emergency department (OR: 3.05, 95% CI: 1.58-6.04), family history of SUD (OR: 2.28, 95% CI: 1.31-4.01), and comorbid psychiatric diagnosis (OR: 1.87, 95% CI: 1.04-3.39). The use of multiple substances (OR: 0.43, 95% CI: 0.19-0.92) and positive fentanyl screens (OR: 0.26, 95% CI: 0.12-0.55) decreased the likelihood of program completion. Neither trimester of pregnancy nor severity of OUD influenced program completion. Social determinants of health were common.</p><p><strong>Conclusions: </strong>An SBIRT program offering 24-hour coverage with skilled providers offering trauma-informed care and social supports integrated with prenatal care results in high engagement and acceptance of MOUD. Policy implications support improved access to naloxone, fentanyl testing strips, and maternity housing. Results suggest further research into the specific nature of how family history of SUD improves engagement in treatment programs.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"459-466"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954871","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":"Implementing a Collaborative Approach to Caring for Patients With Substance Use Disorders Requiring Outpatient Parenteral Antimicrobial Therapy After Discharge.","authors":"Sara C Keller, Rawan Abdel Galil, Jessa R Brenon, Lauren G Buzzalino, Alex Hessel, Denise de Brito, Jennifer Townsend, William F Wright, Armani M Hawes, Oluwaseun Falade-Nwulia, Megan E Buresh","doi":"10.1097/ADM.0000000000001562","DOIUrl":"10.1097/ADM.0000000000001562","url":null,"abstract":"<p><strong>Objectives: </strong>Injection-related infections (IRI) are common and often require treatment with prolonged intravenous antibiotics via outpatient parenteral antimicrobial therapy (OPAT). However, patients with substance use disorders (SUD) being treated for IRI with OPAT receive suboptimal postdischarge care. We describe a novel program to co-locate OPAT and SUD supports at skilled nursing facilities (SNFs) in a pilot program to improve clinical outcomes.</p><p><strong>Methods: </strong>We performed a retrospective chart review of patients with a history of SUD discharged from 2 academic medical centers 2021-2023 to SNFs, including those discharged to pilot SNF and SNFs that were not in a pilot program. We use descriptive statistics to report sociodemographic variables, OPAT outcomes, and SUD outcomes.</p><p><strong>Results: </strong>Twenty-six patients were discharged to a pilot program SNF, and 172 were discharged to an alternative SNF. Patients discharged to pilot program SNFs went to infectious diseases appointments 73% of the time, versus 51% for alternative SNFs. Patients discharged to pilot program SNFs had a 15% 30-day hospital readmission rate and an 8% infection relapse rate, versus 21% and 22% at the alternative SNFs, respectively. Rates of self-directed discharge from SNFs were similar between groups.</p><p><strong>Conclusions: </strong>We detail successful implementation of an innovative approach to the care of patients with SUD requiring OPAT at SNFs. More work is needed to evaluate outcomes from similar initiatives and determine how to sustainably scale-up interventions for these patients.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"504-507"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731021","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":"Impact of X-Waiver Elimination on Post-Hospital Discharge Buprenorphine Prescribing: An Interrupted Time Series Analysis.","authors":"Philip R Wang, Edward J Mascha, Yufei Li, Lukas Bobak, Ian Dorney, Gabriel Costa, Brian Barnett, Akhil Anand","doi":"10.1097/ADM.0000000000001568","DOIUrl":"10.1097/ADM.0000000000001568","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the impact of the X-waiver elimination on buprenorphine prescribing following hospital discharge in patients with opioid use disorder (OUD).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using TriNetX, an aggregated electronic health record (EHR) research network containing the de-identified EHR data from over 60 million patients. Hospitalized adult patients with OUD were identified using diagnostic and discharge procedure codes between January 2022 and June 2023, spanning 1 year before and 6 months after waiver elimination. The primary outcome was the proportion of patients receiving a buprenorphine prescription within 1 month of discharge. We used an interrupted time series design with segmented logistic regression to examine changes in the prescription rate over time while adjusting for patient demographics and medical comorbidities.</p><p><strong>Results: </strong>Among 64,979 hospitalizations, 45,288 occurred before and 19,691 after the X-waiver elimination. Overall, 14.3% of patients received a postdischarge buprenorphine prescription. Unadjusted analysis revealed an initial increase in prescriptions at the start of the postelimination period [odds ratio (OR): 1.2, 95% CI: 1.1-1.3, P < 0.001]. However, after adjusting for potential confounding due to baseline imbalances, both the immediate change in the proportion with prescriptions [OR: 1.12 (0.97, 1.3), P = 0.11] and slope [difference (SE) of -0.0074 (0.0057), P = 0.20] between the periods were not statistically significant.</p><p><strong>Conclusions: </strong>The elimination of the X-waiver does not appear to have altered buprenorphine prescribing practices in the short term, which suggests that long-term studies and additional strategies may be needed to address persistent barriers to effective treatment for OUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"453-458"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835127","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":"Validating the Waterpipe Addiction, Craving, and Anticipation Scale: An Exploratory Factor Analysis.","authors":"Sandrella Bou Malhab, Hala Sacre, Chadia Haddad, Pierre Khalifeh, Elissa Daher, Pascale Salameh","doi":"10.1097/ADM.0000000000001577","DOIUrl":"10.1097/ADM.0000000000001577","url":null,"abstract":"<p><strong>Objectives: </strong>Waterpipe smoking is increasingly becoming a public health threat due to its appealing features and misperceptions of its harmful effects. Tools assessing waterpipe addiction are essential for understanding waterpipe smokers' behaviors and designing effective smoking cessation plans. This study aimed to develop and validate the Waterpipe Addiction, Craving, and Anticipation Scale (WACAS) and describe the specific patterns and multidimensional aspects of waterpipe smoking behavior.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to develop the WACAS based on previously published smoking assessment tools. Snowball sampling was used to recruit 107 waterpipe smokers. Several procedures were performed to examine the scale's validity, including construct and convergent validity. Known-group validity was examined using trend analysis, while path analysis was conducted to confirm the theoretical framework.</p><p><strong>Results: </strong>The WACAS showed high construct validity (generating 6 factors) and internal consistency, with excellent convergent and known-group validity. It could distinguish between various behavioral expressions of waterpipe smoking, that is, addiction, craving, and anticipation of smoking outcomes, which were initially conceptualized in the theoretical framework.</p><p><strong>Conclusions: </strong>The WACAS developed in this study is a comprehensive scale comprising 6 factors that distinguish between different behavioral expressions among waterpipe smokers. It captures a unique waterpipe-specific mode of craving explained by anticipation of outcomes and addictive behaviors, confirming the theoretical framework. The scale demonstrated strong validity and reliability. Nevertheless, further refinement and external validation are recommended to establish WACAS as a robust tool for a broad-scope evaluation of waterpipe smoking.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"480-487"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029767","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":"N-acetylcysteine Efficacy on Cocaine Base Paste Use Disorder: A Randomized Double-blind Placebo-controlled Clinical Trial.","authors":"Carmen Betancur-Moreno, Esteban Moraga-Escobar, Carolina Gómez, María Paz Casanova, Claudio Bustos, Benjamín Vicente","doi":"10.1097/ADM.0000000000001561","DOIUrl":"10.1097/ADM.0000000000001561","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical safety and efficacy of N-acetylcysteine (NAC) in prolonging abstinence time among adults with cocaine base paste (CBP) use disorder.</p><p><strong>Methods: </strong>A phase II, randomised, double-blind, placebo-controlled clinical trial, with a parallel group design, was conducted in CBP use disorder treatment-seeking adults in public outpatient mental health units in the province of Concepción, Chile (n = 140). Participants were randomised to receive daily doses of 2400 mg of NAC or placebo. They were followed for 4 weeks, attending twice-weekly to assess medication-related evaluate adverse effects and to measure abstinence in terms of the days until first new CBP use after study entry. Statistical analysis was performed using the R statistical program, and survival analysis was conducted using Kaplan-Meier.</p><p><strong>Results: </strong>NAC was a safe treatment without a severe adverse reaction, but it was not better than placebo to prolong the CBP abstinence time ( P = 0.12). However, when considering a previous abstinence time of more than 7 days, differences were found in the NAC treatment arm, with better survival in the subgroup that had greater prior abstinence ( P = 0.0052), which was not observed in the placebo treatment arm ( P = 0.12).</p><p><strong>Conclusions: </strong>Although NAC did not demonstrate superiority over placebo in prolonging CBP abstinence, evidence suggests that its efficacy may be influenced by prior abstinence. These findings underscore the need for further research into how prior abstinence affects NAC efficacy, while also supporting the notion that NAC may be more effective for relapse prevention than for initiating abstinence.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"419-427"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835128","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":"When \"Kava\" Isn't Kava: Opioid-like Withdrawal Responsive to Buprenorphine: A Case Study.","authors":"Aniket Malhotra, Gray E McPherson, Karen S Scott, Li Li","doi":"10.1097/ADM.0000000000001748","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001748","url":null,"abstract":"<p><p>We report a case of severe opioid-like withdrawal symptoms following cessation of a commercially available beverage marketed as a \"kava\" product. A 36-year-old White male with opioid use disorder in sustained remission developed rapid tolerance, frequent redosing, nocturnal withdrawal, prominent gastrointestinal and autonomic symptoms, and generalized pruritus after heavy use of a gas-station-sold \"kava\" shot. Symptoms were refractory to benzodiazepines but improved rapidly with buprenorphine/naloxone; this suggests µ-opioid receptor-mediated dependence. The clinical presentation was inconsistent with kava withdrawal, which is typically mild and anxiety predominant. Review of product labeling indicated the presence of akuamma (Picralima nitida), a botanical containing μ-opioid receptor-active alkaloids; secondary qualitative testing of independently purchased samples of the same product by the UAB toxicology lab confirmed the presence of kratom (Mitragyna speciosa) derivatives and kavalactones. In the context of kratom prohibition in Alabama and overlapping manufacturer product lines, this case highlights the risks of mislabeled or adulterated polyherbal products and underscores the need for clinicians to consider opioid-mediated mechanisms and symptom-guided treatment when evaluating withdrawal from purported nonopioid supplements.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351963","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":"Substance Use Among US Adults at Midlife: Risk Factors and Protective Factors Among National and Milwaukee Black American Samples.","authors":"Yu-Tien Hsu, Yusuf Ransome, William C Becker, James Frater, Isaac Demuyakor, David Fiellin, Declan T Barry","doi":"10.1097/ADM.0000000000001736","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001736","url":null,"abstract":"<p><strong>Objectives: </strong>Pain interference and financial insecurity are risk factors for substance use. This study examined whether possible protective factors-religious service attendance, spirituality, and social connectedness-moderate the associations between risk factors and substance use among national and Milwaukee Black American samples of adults at midlife in the United States.</p><p><strong>Methods: </strong>Participants were adults from the Midlife in the United States Study (MIDUS) national sample (N=4962) and the Milwaukee Black American sample (N=866). A sequential modeling approach tested main effects and moderation effects, examining whether possible protective factors (religious service attendance, spirituality, and social connectedness) moderated the associations between risk factors (pain interference and financial insecurity) and substance use.</p><p><strong>Results: </strong>Our findings revealed different patterns across samples. In the national sample, pain interference (β = 0.11, 95% CI = 0.08, 0.14) and financial insecurity (β = 0.06, 95% CI = 0.03, 0.09) independently predicted substance use risk. Religious service attendance moderated the pain interference-substance use link (β = -0.03, 95% CI = -0.06, -0.002). In the Milwaukee Black American sample, financial insecurity (β = 0.15, 95% CI = 0.08, 0.22), but not pain interference, independently predicted substance use. Spirituality moderated the pain interference-substance use association (β = -0.12, 95% CI = -0.18, -0.05). Religious service attendance, spirituality, and social connectedness did not moderate the financial insecurity-substance use association in either sample.</p><p><strong>Conclusions: </strong>Religious service attendance and spirituality seem to serve as protective moderators in the association between pain interference and substance use. Faith-based interventions for those with pain interference or substance use may warrant testing.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351931","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":"Changes in Exposures of US Children Ages 12 and Under to Cannabis from 2000 to 2024.","authors":"Raymond E Bertino, Ryan Feldman, Jerrold B Leikin","doi":"10.1097/ADM.0000000000001720","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001720","url":null,"abstract":"<p><strong>Objectives: </strong>In the United States, significant federal cannabis policy changes occurred in 2009, 2013, and in 2018. This study reviews trends in reported cannabis exposures to children in light of those policy changes.</p><p><strong>Methods: </strong>Retrospective descriptive observational time-trend analysis. Secondary analysis of annual data from US poison centers. Participants were cases reported to US poison centers and entered in the National Poison Data System from 2000 to 2024. Rates of pediatric cannabis exposures reported to America's Poison Centers are given, along with trends in those exposures.</p><p><strong>Results: </strong>Reported pediatric exposures of the under-6-year age group to cannabis were stable from 2000 to 2009. Starting in 2010, exposures began to increase, with the rise continuing to 2024, the most recent year of data availability. Between 2009 and 2024, such exposures increased by 6386% from 132 to a total of 8430 exposures. Cannabis exposures in the 6-12 age group also increased during the same period (increase from 21 to 2894; 13,781%).</p><p><strong>Conclusions: </strong>There was an increase of more than 6000% in reported pediatric exposures to cannabis in the United States between 2009 and 2024 in both the under-6 and the 6-12 years age groups. This rise is temporally associated with changes in federal cannabis policy that began in 2009. Because of the negative effects on children's health, public health policy adjustments are warranted.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338702","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":"Medicaid Prior Authorization and Discontinuation of Buprenorphine.","authors":"Christina M Andrews, Melissa A Westlake, Amanda J Abraham, Andrew Dick, Olivia M Hinds, Mark Sorbero, Bradley D Stein","doi":"10.1097/ADM.0000000000001744","DOIUrl":"10.1097/ADM.0000000000001744","url":null,"abstract":"<p><strong>Objectives: </strong>Buprenorphine is effective in reducing opioid-related overdose, yet many patients discontinue prematurely. Little is known regarding the influence of utilization management policies on buprenorphine discontinuation. This study assesses the duration of buprenorphine episodes paid by fee-for-service (FFS) and managed care organization (MCO) plans with and without prior authorization (PA) in Medicaid.</p><p><strong>Methods: </strong>Cross-sectional analysis was conducted using 2018 national prescription claims data with 810,449 treatment episode months involving dispensed buprenorphine prescriptions with an FDA-approved indication for opioid use disorder treatment reimbursed by Medicaid. Standard discrete-time survival models using logistic regression were conducted to examine differences in duration to buprenorphine discontinuation in months by reimbursement type.</p><p><strong>Results: </strong>Buprenorphine continuation decreased over time across all Medicaid insurance types; this decline was slightly sharper for episodes paid for by MCO plans with PA. The adjusted survival for buprenorphine treatment for 12 months was statistically significantly (P < 0.01) lower for episodes among enrollees in MCO plans with PA (21.6%) compared with episodes paid for by FFS with PA (22.5%); it was also lower in MCO plans without a PA (22.7%) compared with FFS without a PA (23.1%).</p><p><strong>Conclusions: </strong>Buprenorphine discontinuation was high across all treatment episodes, with few differences across Medicaid plan arrangement type or PA status. The sharpest declines in buprenorphine continuation were observed across all types within the first 3 months of the episode starting, highlighting an important period to target buprenorphine continuation improvements. Future research is needed to explore other insurer policies, like concurrent reviews and quantity limits, which may also influence discontinuation.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Public Opinion About US Illicit Drug Policy: Results From the 2000 to 2025 Gallup Survey.","authors":"Brendan Saloner","doi":"10.1097/ADM.0000000000001740","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001740","url":null,"abstract":"<p><strong>Objectives: </strong>Illicit drugs have had a profound societal impact in the last 25 years, including 1.2 million Americans dying from overdose. This study seeks to understand whether Americans perceive policy progress against illicit drugs and how they perceive the drug problem nationally and locally.</p><p><strong>Methods: </strong>I analyzed data collected on 13 occasions between 2000 and 2025 as part of the Gallup Poll Social Survey (GPSS), an ongoing, nationally representative, cross-sectional telephone survey of American adults (N = 13,311). GPSS asks respondents to rate their perceptions of progress against illicit drugs and how severe they perceive the drug problem nationally and in their own communities.</p><p><strong>Results: </strong>Less than half of all Americans in most years perceived that progress has been made against illicit drugs. Perceived progress was at its lowest point in 2023 (23.4% of all respondents), but sharply increased in 2025 (44.2%). Americans have been more likely to perceive progress when the president is from their party, and partisan effects have grown since the mid-2010s. For example, Republican perceptions of progress swung upward by 54.0 points between 2023 and 2025. Most Americans have perceived that drugs are a serious problem nationally, but only a minority said that they are a serious problem in their own community. Perception of a serious problem have held steady among Republicans, but Democrats' sense of concern about the national problem has decreased.</p><p><strong>Conclusions: </strong>Partisanship has become a major factor in how Americans perceive progress in drug policy. With widening political polarization, it may prove difficult to achieve a broad consensus in society, which itself could limit public support for a cohesive national drug control strategy.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308045","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}