Journal of Addiction Medicine最新文献

{"title":"Maximizing Opioid Restitution Funds via a Networked Care Approach: The Baltimore Comprehensive Overdose Response to End the Epidemic (BCORE) Program.","authors":"Martha O Jurczak, Kelly E Dunn, Sara Whaley, Eric Weintraub","doi":"10.1097/ADM.0000000000001768","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001768","url":null,"abstract":"<p><p>Opioid use disorder and overdose are significant public health crises. Treatments for opioid overdose are highly successful yet also extremely decentralized and difficult for patients who are interested in treatment to navigate. Decentralization also slows progress with scaling treatment access and reducing overdose. This Commentary discusses establishment of the Baltimore Comprehensive Overdose Response to End the Epidemic (BCORE), a novel citywide program funded by opioid restitution funds to integrate disparate programs throughout the city, allowing many individual touchpoints to serve as entry to a network of existing treatment services. Through a commercially available technology platform, treatment opportunities throughout the city can be identified in real-time for any patient who interacts with any one of 11 emergency departments, the Fire Department's Population Health Team, or a new 24/7 telemedicine line. BCORE aims to reduce barriers to entry for treatment in a low-threshold way by leveraging and networking existing but otherwise independent resources together rather than investing in developing new but competing programs. This is a novel application of opioid restitution funds designed to address decentralization of treatments as a core challenge in a way that is sustainable. Overall, the technical process of networking unrelated services across a city is a complex and highly sought-after process and the BCORE program can serve as a roadmap for other municipalities seeking to streamline care for persons suffering with substance use disorder.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828876","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":"Removal of ASAM 4th Edition Withdrawal Management Standards: Implementation Risks.","authors":"Nadia Haddad, Michelle Gaffaney, Smita Das","doi":"10.1097/ADM.0000000000001763","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001763","url":null,"abstract":"<p><p>The release of the ASAM criteria 4th edition marks a paradigm shift by removing standalone Withdrawal Management levels (3.7-WM/3.2-WM) in favor of an integrated treatment model. Although intended to reduce care fragmentation, inflexible implementation of this transition creates unintended consequences for patient safety and access in states like Colorado, where ASAM criteria are codified in statute. Critical risks include a reimbursement gap for high-acuity monitoring, barriers to entry for patients whose treatment goals mismatch their level of need for withdrawal management, and the potential undoing of harm reduction policies. To mitigate these risks, we propose acuity-based tiered reimbursement, formalized pathways to allow for standalone withdrawal management in partnership with treatment levels of care, and state data tracking to fully realize the impacts of the ASAM criteria updates.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828938","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":"Characterizing the Relationship Between Nonmedical Use of Gabapentin and Gabapentin Prescribing Among Individuals With Opioid Use Disorder.","authors":"Matthew S Ellis, Ratnesh Sharma, Kelly Ayres, Julia W Stone, Mance E Buttram","doi":"10.1097/ADM.0000000000001766","DOIUrl":"10.1097/ADM.0000000000001766","url":null,"abstract":"<p><strong>Objectives: </strong>Persons with opioid use disorder (OUD) are at elevated risk for engaging in the nonmedical use (NMU) of gabapentin. Despite the increased risk of respiratory depression from concomitant use of gabapentin and opioids, gabapentin is often prescribed in OUD treatment settings. This study examines the relationship between gabapentin prescribing histories and the initiation, patterns, and motivations of gabapentin NMU.</p><p><strong>Methods: </strong>Twenty-one OUD treatment centers recruited 181 adults in 23 states reporting either past 12-month gabapentin NMU (n=150) or use only as prescribed (N=31). Cross-sectional interviews assessed demographics, substance use history/patterns, and gabapentin prescribing histories.</p><p><strong>Results: </strong>Most NMU participants had a prior prescription for gabapentin (72.1%), with 45.3% having a current prescription; 27.7% had no prescription history. Diversion of gabapentin was highly prevalent for obtaining (sharing/trading=50.0%; dealer/street purchase=44.0%) and distributing gabapentin (45.3% diverted to others). Those with gabapentin NMU had higher gabapentin, but not opioid, craving scores compared with those with use as prescribed (3.8 vs. 2.2, P<0.001). Both therapeutic (84.7%) and recreational motivations (74.7%) were widely endorsed and involved high average doses (2061 mg and 2394 mg, respectively).</p><p><strong>Conclusions: </strong>Pathways to initiating gabapentin NMU among individuals with OUD are varied and include health care and nonhealth care channels. High rates of both recreational and therapeutic motivations may suggest the utility of gabapentin in potentiating opioid effects and mitigating gaps in unmet health care needs. Despite risks of concomitant use, many individuals had current prescriptions for gabapentin, highlighting the importance of screening, monitoring and risk counseling when considering gabapentin prescriptions in OUD populations.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793301","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":"Characterizing Rural Substance Use Treatment Experiences Among Individuals Under Community Correctional Supervision.","authors":"Tawandra L Rowell-Cunsolo, Courtney Blanford, David Seal, Wiley D Jenkins, L Sarah Mixson, Daniel B Hoover, Thomas J Stopka, Carrie B Oser, Peter D Friedmann, Gordon S Smith, Rob J Fredericksen, Alex Rains, William C Miller, Vivian F Go, P Todd Korthuis, Judith E Feinberg, Ryan Westergaard","doi":"10.1097/ADM.0000000000001758","DOIUrl":"10.1097/ADM.0000000000001758","url":null,"abstract":"<p><strong>Objectives: </strong>More than 3.7 million individuals are currently under community correctional supervision (eg, probation, parole) in the United States, and approximately 46% of them use illicit substances. Although high rates of substance use and the need for high-quality treatment for this population have been acknowledged, additional research is needed to characterize treatment needs among this population, especially those residing in rural or underserved communities.</p><p><strong>Methods: </strong>Data were drawn from the Rural Opioid Initiative, a study focused on substance use in rural communities across 10 states in the United States. Our analyses examined past 6-month substance use disorder (SUD) treatment receipt among 978 participants under community supervision in the past 6 months.</p><p><strong>Results: </strong>More than 55 percent had engaged in some type of treatment for substance use in the past 6 months; among those, nearly half (46%) had enrolled in inpatient or residential treatment. The odds of receiving treatment were greater among women than men (odds ratio [OR] 1.49, 95% confidence interval [CI] [1.15-1.94]), those with health insurance coverage (OR 3.10, 95% CI: [2.24-4.31]) and those with access to transportation (OR 1.54, 95% CI: [1.08-2.20]). Treatment receipt was lower among participants who used methamphetamine/amphetamine as their primary drug of choice compared with other substances.</p><p><strong>Conclusions: </strong>Initiatives to increase SUD treatment engagement among rural people who use drugs under community correctional supervision should address gaps in insurance coverage, transportation access, and treatment modalities that target stimulant use disorders. Gender-specific needs should also be considered when creating substance use interventions for this population.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720937","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":"Characteristics and Circumstances of US Overdose Deaths With Recorded Heat Involvement.","authors":"Manuel Cano, Chung Jung Mun, Kaylin Sweeney, Raminta Daniulaityte","doi":"10.1097/ADM.0000000000001764","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001764","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the extent to which heat-related causes of death are recorded in fatal drug overdoses, how these patterns vary across states and over time, and how overdose characteristics differ between deaths with, versus without, heat involvement recorded.</p><p><strong>Methods: </strong>Death certificate data (from the National Center for Health Statistics) for all drug overdose deaths in US residents, 2001-2024, were analyzed to identify whether a heat-related cause of death was also listed on the death certificate. Joinpoint regression, descriptive statistics, and nonparametric tests were used to examine temporal trends and compare overdose deaths with versus without recorded heat involvement.</p><p><strong>Results: </strong>In 2001, fewer than 10 drug overdose deaths with recorded heat involvement were identified, but this number rose to 558 in 2024. Mortality rates for overdoses with recorded heat involvement increased from 2013 to 2024 with an estimated annual percent change of 30.1 (95% confidence interval, 26.5-47.1); the highest mortality rates and numbers of deaths were observed in residents of Arizona and Nevada. American Indian/Alaska Native, Mexican-heritage, and foreign-born populations accounted for larger shares of overdose deaths with, compared with without, heat involvement recorded. A street or highway was more frequently identified as the place of injury in overdose deaths with (18.9%), versus without (2.2%) heat involvement reported. Psychostimulants such as methamphetamine were involved in 85.9% of overdose deaths with, versus 28.9% without, recorded heat involvement.</p><p><strong>Conclusions: </strong>Although representing only a fraction of all overdose deaths, fatal overdoses with recorded heat involvement have increased, disproportionately impacting certain states and demographic groups.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712456","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":"What Dose of Methamphetamine Do Regular Consumers Use Daily? Estimating Oral Amphetamine Milligram Equivalents.","authors":"Joseph R Friedman, Adam J Koncsol, Caitlin A Molina, Ruby Romero, Jasmine Feng, Michelle Poimboeuf, Morgan E Godvin, Siddarth Puri, Carla Marienfeld, Chelsea L Shover","doi":"10.1097/ADM.0000000000001757","DOIUrl":"10.1097/ADM.0000000000001757","url":null,"abstract":"<p><strong>Objectives: </strong>The purity, accessibility, and affordability of illicit methamphetamine have increased in recent decades, which has been linked to rising rates of methamphetamine-involved overdoses, psychosis, cardiovascular events, and other health consequences. Nevertheless, information about the quantity of methamphetamine used by regular consumers has been limited, despite the potential clinical utility of exposure quantification.</p><p><strong>Methods: </strong>From August 2024 to April 2026, self-reported daily methamphetamine consumption was assessed among n = 94 individuals in Los Angeles County. Methamphetamine samples (n = 256) were analyzed for purity using liquid chromatography-mass spectrometry. Bioavailability by route of administration and stimulant equivalency were obtained from the literature. A simulation model leveraging bootstrapping with 1,000,000 draws was used to estimate oral amphetamine milligram equivalents (AME).</p><p><strong>Results: </strong>The average reported methamphetamine consumption was 1.09 g daily (95% prediction interval: 0.07-4.00). Average purity was 84.52% (95% PI: 14.90%-100.00%). Given estimated average bioavailability of 66.41% (95% PI: 39.35%-85.24%), the average consumer used an estimated 1432.54 AME daily (95% PI: 35.74-6973.05).</p><p><strong>Conclusions: </strong>We estimate that consumers of methamphetamine in Los Angeles use an average daily stimulant dose (nearly 1500 oral AME) about 25-fold higher than the maximum typical recommended clinical dose of mixed amphetamine salts (60 mg). This may help contextualize why prescription stimulant treatment trials using substantially lower doses have shown limited efficacy. Given this high dose, these findings shed light on the rising incidence of methamphetamine-related sequelae, such as psychosis, cardiovascular complications, and sudden death. Although exposure quantification is commonplace for alcohol and tobacco use disorders, uncertainties in illicit drug markets have complicated this practice for most illicit drugs. This study supports leveraging emerging information from drug checking programs so that clinicians can approximate exposure quantification.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684634","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":"Development of SCOPE: Social and Clinical Opioid Use Disorder Predisposition Evaluation.","authors":"Soraya Mehdipour, Carla Marienfeld, Gregory Polston, Rodney A Gabriel","doi":"10.1097/ADM.0000000000001761","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001761","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to identify social determinants of health (SDoH), demographic, and clinical features associated with opioid use disorder (OUD) and then to develop a risk calculator, termed Social and Clinical Opioid Use Disorder Predisposition Evaluation (SCOPE), that clinicians may use at the bedside to risk-stratify for OUD.</p><p><strong>Methods: </strong>Participant data from the All of Us Research Program were used. Multivariable logistic regression was used to identify various SDoH, demographic, and clinical predictors for OUD. The dependent variable of OUD was defined as occurring ≥90 days after participants completed a survey that queried questions related to SDoH. Calculated odds ratios from the model were used to construct a score-based calculator, SCOPE, and model performance was measured by area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity.</p><p><strong>Results: </strong>There were 624,431 included participants, of whom 2475 (0.39%) had OUD that was diagnosed >90 days after survey completion. SCOPE's performance was assessed using 10-fold cross-validation, resulting in an average AUROC [SD] of 0.85 [0.011], specificity of 78% [0.16%], and sensitivity of 78% [2.42%]. Defining a cutoff score of 8 as high-risk yielded a sensitivity of 0.79 [95% CI: 0.76-0.83], specificity of 0.76 [95% CI: 0.75-0.76], positive likelihood ratio of 3.35, and negative likelihood ratio of 0.26.</p><p><strong>Conclusions: </strong>We identified individual- and SDoH-related risk factors for OUD and developed SCOPE, which may be used as a clinical decision-making aid for personalized risk identification of OUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673725","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 HPTN 094 Peer Navigation Model: Integration of Substance Use Treatment and HIV Prevention and Care for People Who Inject Drugs.","authors":"Nabila El-Bassel, Steven Shoptaw, Brett Hanscom, Timothy Skalland, Albert Hasson, Cecile Denis, David Goodman-Meza, Irene Kuo, Jordan E Lake, Rashaunna Redd, Amy M Richards, Rahul Paul Choudhury, Melissa Cummings, Jayla Harris-Wisecarver, Jessica Fogel, Paul Richardson, Redonna Chandler, Laramie R Smith, David Metzger, Philip Andrew","doi":"10.1097/ADM.0000000000001759","DOIUrl":"10.1097/ADM.0000000000001759","url":null,"abstract":"<p><strong>Objectives: </strong>To describe HPTN 094 study's peer navigation (PN) intervention, implemented in 5 urban US cities among people who inject drugs (PWID) at risk for or living with HIV, including guiding theories, core components, navigator training, available services, implementation challenges, and implications for future PN intervention research dissemination.</p><p><strong>Methods: </strong>This 2-arm, randomized, open-label study assessed outcomes for PWID receiving integrated care services delivered in a mobile health unit that provided medication for opioid use disorder (MOUD), HIV prevention/treatment, and other health care in addition to PN to community services compared with PN to community services alone. Participants were PWID with opioid use disorder (OUD) not receiving MOUD and were either at risk for HIV or living with HIV. The PN model was grounded in 5 complementary theories addressing individual, interpersonal, social, systemic, and structural determinants of care. Variables used to measure PN intervention utility were number of sessions attended, session length, session topics, and in-person versus remote navigation sessions.</p><p><strong>Results: </strong>Across study sites, participants without HIV (PWOH; n = 409) completed 3390 PN sessions and participants with HIV (PWH; n = 38) completed 365 PN sessions; the median number of sessions per participant was 6 in both groups. Most sessions were conducted in person and commonly addressed MOUD, HIV prevention or HIV care, and other medical or social service needs. These findings support the feasibility of delivering a flexible, theory-informed PN model for urban PWID and help characterize how peer navigation was used to address substance use, HIV, and broader service needs within HPTN 094.</p><p><strong>Conclusions: </strong>The PN model is acceptable with urban PWID and potentially for people with other public health concerns in underserved communities. The findings have implications for future research examining the effectiveness and dissemination of the PN intervention.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701424","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":"Who Funds the Police? Fiscal Determinants of Opioid Settlement Spending on Law Enforcement.","authors":"Zoe Lindenfeld, Amanda I Mauri","doi":"10.1097/ADM.0000000000001756","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001756","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the proportion and amount of opioid settlement funds allocated to law enforcement activities, including remediation-aligned activities (ie, that directly address the harms associated with opioid use) and nonremediation uses, and to assess whether local fiscal characteristics related to policing are associated with allocation decisions.</p><p><strong>Methods: </strong>We constructed a longitudinal data set linking detailed, mandated reports of Indiana local government settlement expenditures (2023-2025) with administrative data on local revenue sources, expenditures, and demographic characteristics. Outcomes included the percentage of settlement funds allocated to (1) any law enforcement activities, (2) remediation-aligned law enforcement activities, and (3) nonremediation law enforcement activities. Regression models estimated associations between reliance on fines, fees, and forfeitures, and policing expenditures per capita and settlement spending patterns.</p><p><strong>Results: </strong>Across years, local governments allocated a mean of 9.81% (SD: 16.14%) of settlement funds [$3916.86 (SD: $27,922.8000)] to law enforcement. This included $3222.83 (SD: $23,120.37) for remediation-aligned activities and $8703.75 (SD: $41728.45) for nonremediation. Greater reliance on fines, fees, and forfeitures was associated with higher allocation to law enforcement overall (AOR: 1.11; 95% CI: 1.05-1.18) and to nonremediation activities (AOR: 1.15; 95% CI: 1.08-1.22). Higher policing expenditures per capita were also associated with greater allocation to nonremediation activities (AOR: 1.85; 95% CI: 1.06-3.24).</p><p><strong>Conclusions: </strong>Jurisdictions that rely more heavily on law enforcement-generated revenue and spend more on policing had higher odds of directing settlement resources toward strategies not aligned with opioid remediation. Future research evaluating settlement effectiveness should account for these local fiscal incentives.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603294","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":"Utilizing the Transitional Pain Service to Provide Perioperative Contingency Management for Stimulant Use.","authors":"Josephine Pham, Thomas Kyle Harrison, Edward R Mariano, Gunjan Kumar, Oluwatobi O Hunter","doi":"10.1097/ADM.0000000000001752","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001752","url":null,"abstract":"<p><strong>Objectives: </strong>Preoperative use of nonprescribed stimulants can negatively affect surgical outcomes. When patients screen positive for stimulants on the day of surgery, many anesthesiologists and surgeons will postpone elective surgery to prevent negative anesthetic and surgical outcomes. However, cancelling elective surgery can lead to negative consequences such as delayed treatment, decreased patient satisfaction, increased surgical wait times, and increased costs to the institution due to lost productivity. In response, our facility's perioperative pain management team, the transitional pain service, established a perioperative contingency management program, an evidence-based treatment for substance use disorders that provides reinforcing consequences for healthy behaviors. We present the case of one patient enrolled in this program.</p><p><strong>Methods: </strong>An adult patient with a history of stimulant use and osteoarthritis scheduled for right total hip arthroplasty at a tertiary care Veterans Affairs hospital tested positive for methamphetamines on routine preoperative urine drug screen and was cancelled on the day of surgery. The patient was referred to the transitional pain service for perioperative contingency management.</p><p><strong>Results: </strong>The patient completed the 12-week program, and had a successful right total hip arthroplasty. The patient self-reported continued abstinence from methamphetamines 9 weeks after completing the perioperative contingency management program.</p><p><strong>Conclusions: </strong>This case report demonstrates that it is possible for a nonaddiction medicine specialty group to implement perioperative contingency management, which may improve patient access to surgery while offering a treatment that some patients may not otherwise pursue. This presents an opportunity for addiction medicine specialists to collaborate with multidisciplinary team members to expand addiction care beyond traditional settings.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584288","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}