Journal of Addiction Medicine最新文献

{"title":"Magnitude and Abstinence Trajectories of Neurocognitive Deficits in Methamphetamine Use Disorder: A Systematic Review and Meta-analysis.","authors":"Lu Cao, Yi Xie, Xiao-Fei Cheng, Ting-Wan Xu, Kun Lu, Lingqi Jian, Ming-Li Li","doi":"10.1097/ADM.0000000000001778","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001778","url":null,"abstract":"<p><strong>Objectives: </strong>The magnitude and clinical profile of cognitive deficits in methamphetamine use disorder (MUD) remain debated. Prior syntheses treated same-sample cognitive outcomes as independent and did not model continuous abstinence-cognition associations. This multilevel meta-analysis quantified deficits across 13 cognitive domains, evaluated moderation by comorbidity and sex, and tested remission trajectories across abstinence.</p><p><strong>Methods: </strong>We synthesized 242 effect sizes from 68 independent studies (n=9045; 5244 MUD, 3801 controls) using three-level robust-variance models. Restricted cubic spline meta-regression modeled abstinence associations in 7 eligible domains.</p><p><strong>Results: </strong>MUD showed a medium-to-large overall deficit (g=-0.68, 95% CI [-0.77, -0.58], P<0.001) across all 13 domains (g range: -0.42 to -1.09). Comorbidity did not moderate impairment (P=0.26). A higher male proportion predicted attenuated deficits in adjusted meta-regression (β=0.518, P=0.03). Primary spline models showed no remission in inhibitory control or self-reported impulsivity (all P>0.40) within abstinence windows up to 280 days. Among 5 exploratory domains, 4 replicated this flat trajectory, while only decision-making showed a nonlinear trajectory in analyses not adjusted for multiple comparisons. No publication bias was detected (Egger P=0.32). GRADE certainty was very low across all domains, reflecting cross-sectional study designs.</p><p><strong>Conclusions: </strong>Cognitive deficits in MUD are pervasive, stable across the observed abstinence window, and unmoderated by comorbidity profile. The potential sex vulnerability signal and the uncorrected decision-making remission trajectory warrant prospective confirmation. Routine cognitive assessment should be initiated during early treatment.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982851","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":"\"Rhino Tranq\" in Connecticut-Prevalence of Medetomidine in the Fentanyl Supply Varies by Data Source.","authors":"Katherine Hill, Elizabeth Znamierowski, Cameron Breen, River Rose, Corona Zhang, Chyanna Jacobson-Bernier, Heather Clinton, Shobha Thangada, Jessica L Gleba, Lauretta E Grau, Robert Heimer","doi":"10.1097/ADM.0000000000001779","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001779","url":null,"abstract":"<p><strong>Background: </strong>Medetomidine, a veterinary sedative, has emerged as an adulterant in the unregulated fentanyl supply. Exposure may cause profound sedation and a severe withdrawal syndrome. We aimed to better estimate medetomidine prevalence by integrating multiple statewide datasets from Connecticut.</p><p><strong>Methods: </strong>We analyzed 4 datasets from 2025: (a) accidental overdose fatalities, (b) drug seizure testing, (c) driving under the influence (DUI) toxicology, and (d) community-based drug checking using medetomidine test strips (MTS) and field-based Fourier-transform infrared spectroscopy (FTIR). Analyses were restricted to fentanyl-involved cases/samples, and medetomidine prevalence was calculated for each source.</p><p><strong>Results: </strong>Among 579 fentanyl-involved overdose fatalities, medetomidine was detected in 1.4%-though confirmatory testing was limited. Of 259 fentanyl seizure units tested, 41.7% contained medetomidine. Among 177 fentanyl-involved DUI cases, 24.9% were positive for medetomidine on toxicology. There were 169 samples of fentanyl/heroin/dope submitted to community-based drug checking programs that subsequently tested positive for fentanyl and assessed for medetomidine: MTS yielded positive results in 46.2% of samples on average, while FTIR detected medetomidine in 28.4% of samples.</p><p><strong>Conclusions: </strong>This study not only demonstrated that medetomidine is prevalent in the street-based fentanyl supply, but that the prevalence varied by data source. The findings highlight that surveillance mechanisms that rely exclusively on a single data source (typically overdose toxicology data) may misrepresent the true presence of medetomidine in the street supply.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982828","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 Overlapping Symptoms of Perimenopause and Opioid Withdrawal: When Hormone Therapy is \"Even more Important for My Recovery than My Methadone\".","authors":"McKenna Klausner, Daniel Roche, Katrina Mark","doi":"10.1097/ADM.0000000000001765","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001765","url":null,"abstract":"<p><p>Hot flushes, or vasomotor symptoms in menopause, are prevalent in both menopause and opioid withdrawal. While our understanding is limited, the physiology and mechanisms behind vasomotor symptoms in menopause and opioid withdrawal hot flushes are likely similar. Both types of hot flushes are associated with an increase in norepinephrine production and dysregulation of β-endorphin levels. In this case, we present the case of a 46-year-old perimenopausal female who misattributed menopausal hot flushes to opioid withdrawal. She initiated methadone; however, her symptoms of hot flushes did not improve. After being referred to a gynecologist, she started hormone therapy, which completely resolved her symptoms. We discuss the potential implications for clinical care given the overlapping physiologic pathways that lead to symptoms of menopause and opioid withdrawal.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944337","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":"Addiction Consult Service Associated With Improved Rates of 30-day Treatment Engagement After Emergency Department and Hospital Discharge: A Propensity-weighted Analysis.","authors":"Erik S Anderson, Lauren Sirey, Andrea Jakubowski, Megan Heeney, Michelle Patregnani, Monish Ullal, Andrew A Herring","doi":"10.1097/ADM.0000000000001773","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001773","url":null,"abstract":"<p><strong>Objectives: </strong>Addiction consult services (ACS) are an effective intervention for hospitalized patients with substance use disorders (SUD); however, their effectiveness for patients discharged from the emergency department (ED) is not well established. We aim to examine the association of ACS with 30-day engagement in outpatient treatment among ED and hospitalized patients at a multi-hospital safety-net health system.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients discharged after ED and inpatient visits with SUD-related diagnoses. The exposure of interest was receipt of ACS consultation during an ED or inpatient encounter. We used propensity score matching with frequency weights for the analyses, and the primary outcome was engagement in outpatient SUD treatment within 30 days of ED or hospital discharge. Propensity-weighted logistic regression with and without a moderation analysis examined factors associated with engagement in treatment after discharge.</p><p><strong>Results: </strong>From April 1, 2024, through February 28, 2025, 4779 unique patients were discharged with a qualifying SUD diagnosis; 2783 (58.2%) after ED discharge and 1996 (41.8%) after hospital discharge, and 1279 (26.8%) received a Bridge ACS consultation. The 30-day engagement in treatment after discharge rate was 32.6% with ACS versus 9.4% without (P<0.001). ACS was independently associated with higher odds of engagement [adjusted odds ratio (aOR): 4.7, 95% CI: 3.5-6.4]. The interaction term between ACS and ED versus hospital discharge was not statistically significant (aOR: 0.9, 95% CI: 0.5-1.5).</p><p><strong>Conclusions: </strong>ACS consultation was associated with increased engagement in SUD treatment within 30 days of ED or hospital discharge.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912093","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":"Treatment Discontinuation and Barriers and Facilitators to Retention Among Individuals Initiating Buprenorphine for Opioid Use Disorder: A Longitudinal Cohort Study.","authors":"Melissa N Poulsen, Michelle L Truong, Jasmine K Pabla, Amy Poissant, Cara M Nordberg, Wade Berrettini","doi":"10.1097/ADM.0000000000001775","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001775","url":null,"abstract":"<p><strong>Objectives: </strong>Early discontinuation of medication for opioid use disorder (MOUD) is associated with increased mortality and hinders remission. Combining data from electronic health records (EHRs) and patient questionnaires, we examined buprenorphine discontinuation and barriers and facilitators to retention in outpatient settings.</p><p><strong>Methods: </strong>Adults initiating buprenorphine in a Pennsylvania outpatient program (2021-2023) completed 2 questionnaires: at medication initiation (baseline) and 6 months after initiation (follow-up). Among 1189 eligible patients, we evaluated buprenorphine discontinuation (≥30-d gap in medication supply) and compared demographic factors using EHRs. We identified discontinuation reasons among survey participants (baseline n = 374; follow-up n = 197) through medical record review; questionnaires assessed treatment barriers and facilitators.</p><p><strong>Results: </strong>Within 6 months, 629 (53%) patients discontinued buprenorphine, though 15% restarted medication within the 6-month period. Discontinuation was more common among younger patients. Among baseline survey participants, discontinuation was usually unplanned (66%) or against provider advice (19%). Among follow-up participants who discontinued the program during the follow-up period, 54% reported receiving MOUD at 6 months, indicating that many transition to other treatment programs. Those not receiving medication at 6 months cited lack of need (46%). Travel challenges (distance/transportation to clinics), scheduling, and mental health conditions were common barriers to treatment; facilitators centered on improving these factors and clinic processes.</p><p><strong>Conclusions: </strong>Observed patterns reflect dynamic and noncontinuous receipt of medication over time and underscore the early months of treatment as a critical window for supporting buprenorphine engagement. Findings reveal actionable areas to improve retention by reducing logistical burdens, enhancing nonjudgmental therapeutic support, and integrating mental health care.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912165","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":"Opioid Use Disorder Outcomes Following Inpatient Opioid Withdrawal Management.","authors":"Genie L Bailey, Joshua D Lee, Edward V Nunes, Babak Tofighi, Patricia Novo, Jacquie King, David Liu, Sarah Farkas, Phoebe Gauthier, Anil Thomas, John Rotrosen","doi":"10.1097/ADM.0000000000001710","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001710","url":null,"abstract":"<p><strong>Objectives: </strong>Medically assisted withdrawal (MAW) for opioid use disorders (OUD) remains common. NIDA's CTN-0051 (X:BOT) trial compared two OUD medications initiated during an acute inpatient MAW admission and continued postdischarge at 8 US sites. This ancillary observational follow-on study explored treatment-as-usual outcomes at 5 X:BOT sites.</p><p><strong>Methods: </strong>Adults admitted for OUD were conveniently and consecutively recruited to an 8-week, prospective, observational, noninterventional study targeting up to 300 participants. Withdrawal protocols and medications for OUD (MOUD) followed site usual practices. Baseline and postdischarge weeks 1, 4, and 8 measures were OUD severity, length-of-stay (LOS), urine samples, self-reported MOUD, nonprescribed opioid use, and overdoses. Data analyses were descriptive.</p><p><strong>Results: </strong>A total of N = 211 enrolled participants were primarily white men (74%) with daily heroin (87.2%) and intravenous (64.0%) use. About 41.7% (n = 88) reported MOUD treatment at discharge: extended-release naltrexone (n = 39), sublingual buprenorphine-naloxone (n = 38), methadone (n = 8), and oral naltrexone (n = 3). Self-reported MOUD use at week 8 was 28.0%, when 52.6% reported no regular use (<7 consecutive days) and 25.6% reported nonprescribed opioid abstinence. Negative urine rates for nonprescribed opioids ranged from 26.1% to 31.3%. One overdose death and 17 nonfatal opioid-related overdose events occurred in 15 participants.</p><p><strong>Conclusions: </strong>Return to nonprescribed opioid use, frequent overdose events, one death, and a relative lack of MOUD treatment uptake characterized this usual care cohort following inpatient OUD admissions.</p><p><strong>Scientific significance: </strong>These findings underscore the urgent need for individuals and providers to prioritize linkage to evidence-based MOUD treatments following acute inpatient OUD-related admissions, given high rates of return to opioid use and overdose events.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891685","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":"National Quality Measure Fails to Capture Most Emergency Department Patients With Opioid Use Disorder.","authors":"Erik S Anderson, Megan Heeney, Evan Rusoja, Hillary Katsin, Nicole Howard, David Luna Cruz, Michelle Patregnani, Monish Ullal, Kathryn Hawk, Arjun Venkatesh, Mark McGovern, Andrew A Herring","doi":"10.1097/ADM.0000000000001774","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001774","url":null,"abstract":"<p><strong>Objectives: </strong>Healthcare Effectiveness Data and Information Set (HEDIS) measure Follow-up After Emergency Department Visit for Substance Use (FUA) assesses care coordination after discharge from an emergency department visit for a high-risk substance-use event. We hypothesized that the FUA denominator undercounts OUD-related ED visits.</p><p><strong>Methods: </strong>We audited a multihospital public health system's electronic health record (EHR) to identify ED visits by patients with OUD to compare these with the OUD visits captured in the system's automated FUA reporting.</p><p><strong>Results: </strong>From April 1, 2024, through February 28, 2025, there were 1211 emergency department (ED) unique visits related to opioid use disorder (OUD) or overdose. Only 239 (19.7%) of OUD/overdose encounters were using HEDIS methods for FUA. In multivariable logistic regression, ED visits at one of the hospitals were less likely to be included in the FUA measure (adjusted odds ratio, 0.6, 95% CI: 0.4-0.9).</p><p><strong>Conclusions: </strong>We found the FUA measure failed to identify 4 out of 5 ED visits involving high-risk opioid use disorder-related events. This suggests FUA may obscure quality performance and introduces variability into the national quality measure.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891721","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 Addiction Consult Service on Alcohol Use Disorder Medications and Postdischarge Outcomes.","authors":"Thomas J Reese, Kristopher A Kast, David Marcovitz, Clayton Korson, Hilary A Tindle, Sahit N Menon, Ashley A Leech, Lisa Stewart-Kast, Adam Wright, Mauli V Shah, Amanda von Horn","doi":"10.1097/ADM.0000000000001762","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001762","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the association between Addiction Consult Service (ACS) involvement and initiation of medication for alcohol use disorder (MAUD), as well as postdischarge outcomes through 90 days, among adults hospitalized with alcohol-related conditions.​.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at a large academic medical center from 2018 to 2025. The exposure of interest was receipt of an ACS consultation during hospitalization. Primary outcomes were inpatient MAUD initiation, MAUD prescribed at discharge, and a 30-day composite of all-cause readmission, emergency department (ED) visit, or death. Secondary outcomes included readmissions and ED visits at 7, 30, 60, and 90 days, patient-directed discharge, and 90-day mortality.</p><p><strong>Results: </strong>Among 17,242 eligible admissions, 4428 were included after propensity score matching (2214 ACS; 2214 no ACS). In the matched cohort (mean [SD] age, 47 [13] y; 72.2% male), ACS consultation was associated with a 32.8-percentage-point higher rate of inpatient MAUD initiation and a 7.4-percentage-point higher rate of MAUD prescribed at discharge compared with usual care (inpatient MAUD initiation odds ratio [OR], 10.47; 95% CI, 8.59-12.86; MAUD at discharge OR, 1.47; 95% CI, 1.27-1.69). The 30-day composite outcome occurred less often with ACS consultation, with an absolute reduction of 5.0 percentage points (OR, 0.80; 95% CI, 0.70-0.91).</p><p><strong>Conclusions: </strong>Compared with usual care, inpatient ACS involvement was associated with higher MAUD initiation and lower 30-day readmission, ED visit, or death, suggesting that ACS may be a promising approach to expanding evidence-based AUD treatment and to improving short-term outcomes.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887628","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":"Outpatient Direct Initiation of Injectable Buprenorphine From Methadone: A Case Series.","authors":"Daniel Liauw, Ram Sundaresh, Dinah Applewhite, Jessica R Gray, Laura Kehoe, Evangeline Kennedy, Susan Regan, Sarah Wakeman","doi":"10.1097/ADM.0000000000001770","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001770","url":null,"abstract":"<p><strong>Objectives: </strong>Published protocols for directly initiating injectable buprenorphine from full opioid agonists (\"direct-to-inject\" or DTI) have largely described patients with active or recent fentanyl use. Among patients with opioid use disorder (OUD) in remission, transitioning from methadone to buprenorphine with sublingual buprenorphine can be challenging. Published experience utilizing DTI buprenorphine from methadone is limited.</p><p><strong>Methods: </strong>In this retrospective cohort study, we identified 15 patients across an academic hospital system who reported OUD in remission, were engaged in methadone treatment, and requested an outpatient DTI buprenorphine transition in 2025. Individuals who took ≥4 mg sublingual buprenorphine within the preceding 24 hours were excluded. All participants were offered consent and elected for DTI buprenorphine after counseling on risks, benefits, and alternatives. Primary outcome was receipt of one monthly formulation of injectable buprenorphine. Demographics, protocol completion, and 90-day retention on buprenorphine were reviewed. Patients retrospectively rated their transition-related discomfort on the following scale: no, mild, moderate, or severe discomfort.</p><p><strong>Results: </strong>Mean methadone dose was 71.5 mg (range: 24-120). Median length of methadone treatment episode was 2 years (range: 2 mo-10 y). Completion of one monthly extended-release buprenorphine injection was 93%. One-third (33%) reported moderate or severe discomfort with the protocol, with symptoms responsive to anxiolytics. All participants reporting moderate-to-severe discomfort had methadone doses ≥95 mg. Ninety-day buprenorphine retention was 67%, with most unretained patients utilizing injectable buprenorphine to taper off medication for OUD.</p><p><strong>Conclusions: </strong>DTI buprenorphine with weekly injectable buprenorphine was a feasible and generally well-tolerated approach for transitioning patients from methadone to buprenorphine.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887668","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":"Rating the Quality and Consistency of Local Opioid Settlement Expenditure Data.","authors":"Zoe Lindenfeld, Amanda I Mauri, Abigail K Winiker","doi":"10.1097/ADM.0000000000001653","DOIUrl":"10.1097/ADM.0000000000001653","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether states requiring public reporting of local opioid settlement expenditures make these data available in a detailed, consistent, timely, and analyzable format.</p><p><strong>Methods: </strong>We reviewed state websites to extract information on the quality of reported settlement data across 7 dimensions: (1) interest earned on settlement funds was reported, (2) nonremediation spending was reported separately, (3) expenditures were tied to specific programs or activities, (4) expenditures were reported at the sub-county level, (5) expenditures for each local government were consolidated into a single report, (6) all entities in a state report in a combined tracker, and (7) data from the most recent reporting year were available. States were coded dichotomously (1 = criterion met; 0 = not met).</p><p><strong>Results: </strong>Of the 21 states requiring local reporting, 5 (23.8%) report interest earned on disbursements, while most document nonremediation expenditures (n = 17; 81.9%). Over half tied expenditures to specific program activities (n = 12; 57.1%), and all but 3 consistently report the most recent year. Local governments in 17 states (80.9%) report all expenditures in a single report, and 12 states (57.1%) consolidate all local spending within a single public tracker. Two states (9.5%) have not yet made these data publicly available.</p><p><strong>Conclusions: </strong>Among states with reporting requirements, there is substantial variation in the quality and detail of settlement expenditure data. Strengthening reporting standards and enforcement of standards would support rigorous research and enhance accountability for ensuring that funds are allocated in alignment with the goals of opioid remediation.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"626-628"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989455","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}