Substance Abuse Treatment, Prevention, and Policy最新文献

{"title":"Does media channel matter? exploring the disparities of online and offline anti-tobacco messages and their impacts on e-cigarette harm perception and use.","authors":"Sha Sarah Qiu, Luxi Zhang, Muhan Liu, Xinshu Zhao, Song Ao","doi":"10.1186/s13011-026-00717-6","DOIUrl":"10.1186/s13011-026-00717-6","url":null,"abstract":"<p><p>BACKGROUND: Prior studies emphasize the impact of anti-tobacco campaigns on tobacco prevention; there needs to be more understanding of the variations across different media channels. This study examines the associations between cigarette use, harm perception of e-cigarettes, and e-cigarette use, and explores how exposure to offline and online anti-tobacco messages is related to these associations. METHODS: Utilizing data from the HINTS 6 (N = 5,268), this study employs mediation analysis to explore two primary mediating mechanisms: [1] the mediating role of offline and online anti-tobacco message exposure and [2] the sequential mediating effect involving offline and online anti-tobacco messages and harm perception of e-cigarettes. RESULTS: Our findings revealed that cigarette use was positively associated with e-cigarette use (B=0.260, β = 0.256, p<.001). While offline anti-tobacco messages exposure showed no significant mediating effect (B=0.002, β = 0.002, [-0.001, 0.005]) between cigarette use and e-cigarette use, and it became a substantial and negative mediator when introducing harm perception of e-cigarettes (B=-0.001, β=-0.001, [-0.002, − 0.001]). Conversely, online anti-tobacco messages exposure positively mediated the link between cigarette use and e-cigarette use (B=0.004, β = 0.004, [0.001, 0.007]), but was not significantly associated with harm perception of e-cigarettes (B=-0.022, β=-0.007, p>.05). CONCLUSIONS: This study reaffirms the prevalence of dual use and reveals the disparities between online and offline anti-tobacco messages exposure. The distinctive roles played by online and offline media channels and the pivotal influence of harm perception of e-cigarettes on e-cigarette use carry significant implications for public health and tobacco control. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"21 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781442","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":"Awareness about opioids crisis, policies and regulation of opioid stewardship at hospitals settings: a nationwide cross-sectional study among healthcare professionals from Pakistan.","authors":"Hafsa Arshad, Ali Hassan Gillani, Jamshaid Ur Rehman, Manthar Ali Mallah, Muhammad Arshed, Yu Fang","doi":"10.1186/s13011-025-00689-z","DOIUrl":"10.1186/s13011-025-00689-z","url":null,"abstract":"<p><p>BACKGROUNDS: Opioid crisis is surging globally including Pakistan. Opioid stewardship programs can play a fundamental role in avoiding and dealing with this crisis. The objective of this study was to evaluate the awareness of policies and regulations of opioid stewardship practices in hospitals and attitudes of healthcare professionals towards strategies to optimize appropriate opioid use in the hospital setting across the whole country. METHODS: In this cross-sectional study data was gathered conveniently from 34 government and 25 private hospitals selected across the whole country from February 2023 to September 2023. Data were acquired from various healthcare professionals (doctors, surgeons, pharmacist, nurses etc.) operating in diverse hospital environments. A self-structured questionnaire of 49 items was employed to gather data on healthcare professionals’ understanding of the opioid epidemic, their awareness and adherence to legislation regarding opioid stewardship, and proposed strategies for optimizing opioid usage. Descriptive statistics were employed for nominal and continuous variables utilizing R (version 4.4.2, R Foundation for Statistical Computing, Vienna, Austria). RESULTS: Out of 3983 approached individuals, 2838 answered the questionnaire (71.2%), with a predominance of males (59.6%) and government employees (55.0%). The majority of the populace was concerned about the situation of opioid crisis, perceiving it as both a national and global issue, with around two-thirds viewing the stewardship program as a solution. Awareness and adherence to opioid regulations were inadequate and only 27.7% were aware of the requirement for patients to sign an agreement for opioid medication, and just 22.2% mindful of access to the drug monitoring program. Likewise, healthcare professionals exhibited inadequate clinical practices, with the greatest rates pertaining to access to treatment recommendations on dose and monitoring for chronic pain (55.5%), whereas 55.3% said that healthcare professionals review the appropriateness of palliative drugs following discharge. CONCLUSION: Healthcare professionals deemed opioid crisis as a threat and despite of its emergence globally and nationally they demonstrated poor adherence to guidelines. This further strengthened by their views about opioids stewardship program as solution to crisis. To contribute to safer consumption practices of opioids in hospitals additional, structured opioid education and formal stewardship practices are required. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781355","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":"Context-dependent asymmetries in intertemporal decision-making: a comparative study of substance use disorder and control groups.","authors":"Hao Zhang, Shinian Ou, Huoyin Zhang, Cunfeng Yuan, Peng Lei","doi":"10.1186/s13011-026-00729-2","DOIUrl":"10.1186/s13011-026-00729-2","url":null,"abstract":"<p><p>This study investigated context-dependent intertemporal decision-making patterns in substance use disorder (SUD) through a comprehensive experimental paradigm examining both gain and loss contexts. Using mixed-effects analysis of 26,144 decisions from 186 participants (100 SUD, 86 controls), we found significant group differences in context-dependent choice patterns (OR = 0.39, p <.001). The SUD group showed enhanced preference for delayed losses (lnk = 4.67 vs. 4.81, p <.001) but only marginally stronger immediate reward preference (lnk = 4.40 vs. 4.37, p =.089). While temporal processing remained intact across groups (OR = 0.98, p =.785), magnitude sensitivity varied significantly by context, particularly in loss scenarios. These findings challenge traditional views of uniformly impaired decision-making in SUD and suggest the need for context-aware intervention strategies that leverage preserved temporal processing abilities.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781372","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":"A hospital-based multi-centric observational study to explore the prevalence and correlates of non-medical use and dependence of pregabalin among the patients with substance use disorder in Punjab & Chandigarh.","authors":"Jitender Aneja, Neeru Bala, Ajeet Sidana, Rohit Garg, Sandeep Goyal, Sharanjot Kaur, Lokesh Goyal, Ira Domun, Rahul Bangar, Madhur Verma, Bharat Udey, Jawahar Singh","doi":"10.1186/s13011-026-00730-9","DOIUrl":"10.1186/s13011-026-00730-9","url":null,"abstract":"<p><strong>Background and aim: </strong>Pregabalin (a Gabapentinoid) has been shown to have potential for non-medical use. We aimed at exploring the prevalence and clinical correlates of non-medical use of pregabalin and dependence in patients seeking treatment for substance use disorders (SUDs).</p><p><strong>Materials and methods: </strong>Patients with ICD-10 diagnosis for various SUDs, in the age range of 18-70 years who consented for participation in this study were evaluated for non-medical use and dependence of pregabalin across three different regions of Punjab and the union territory of Chandigarh. ICD-10 criteria for a dependence syndrome (three or more criteria) were used for defining dependence on pregabalin.</p><p><strong>Results: </strong>Out of a total 974 patients enrolled in this study, 44.6% of study participants were using pregabalin and 24.8% fulfilled ICD-10 criteria for a dependence syndrome. Compared to study subjects having non-medical use of pregabalin, a significant number of persons using pregabalin in dependent fashion consumed pregabalin with a frequency of more than 3 times/day (p < 0.001), with daily consumption of pregabalin in doses more than 1200 mg/day (p < 0.001) and suffered from seizures (p < 0.001). Significantly high rates of pregabalin non-medical use and dependence were observed in Sikh patients (p < 0.01), living in rural areas (p < 0.01), who were unmarried/single (p < 0.001), educated more than 10 years (p < 0.01), and with an opioid use disorder (p < 0.001). Pregabalin non-medical use and dependence were also significantly higher in younger patients (p < 0.001), with a younger age of onset of substance use disorder (p = 0.014) and with shorter duration of substance use (p < 0.001). The odds of use of pregabalin were higher in patients with opioid use disorder (aOR = 5.3, 95% CI 3.5-7.9; p < 0.001) in comparison to those with alcohol use disorder.</p><p><strong>Conclusion: </strong>These high estimates for non-medical use and dependence of pregabalin in our study are an early indication of rising problem of pregabalin use amongst the patients with substance use disorders. We draw attention of the healthcare providers and policy makers in formulation of strategies to screen for pregabalin non-medical use and dependence, formulate treatment strategies and devise policy changes to address diversion of pregabalin in view of its non-medical use potential.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700240","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":"Community-level perceptions of housing services for people with opioid use disorder: a qualitative analysis of community stakeholders in the HEALing communities study.","authors":"Nishita Dsouza, Mary Russo, Dawn Goddard-Eckrich, Diana Hernandez, Nasim Sabounchi, David Lounsbury, Patrick Fowler, Shoshana N Benjamin, Aimee N C Campbell, Anindita Dasgupta, Nabila El-Bassel, Louisa Gilbert","doi":"10.1186/s13011-025-00683-5","DOIUrl":"10.1186/s13011-025-00683-5","url":null,"abstract":"<p><p>BACKGROUND: Housing insecurity, or the inability to afford or maintain residence in a safe and quality place, is a barrier to accessing and staying in substance use treatment and/or recovery support services. There is a gap in knowledge in how housing insecurity influences substance use disorder (SUD) prevalence, and the role housing security plays in SUD treatment initiation and retention. The HEALing Communities Study (HCS) is a large multisite trial aiming to reduce overdose risk through the implementation of evidence-based interventions delivered by community coalitions to reduce overdose deaths among 67 counties in 4 states. This study explored diverse perspectives of HCS community coalition members on housing systems for populations with SUD to better understand how housing insecurity attenuates SUD prevalence and initiation or retention in various drug treatment services. METHODS: The aim of this study was to explore various mechanisms at multiple levels through which housing insecurity adversely affects individuals with SUD. Semi-structured key informant interviews (n = 85) were conduct with HCS community coalition members in New York State from 2019 to 2020. The transcripts were coded using the PRISM/RE-AIM framework and further subcoded with the following five themes: 1) cost (housing affordability); 2) conditions (housing quality); 3) consistency (residential stability); 4) context (neighborhood opportunity); and 5) considerations (unique aspects affecting substance use-related populations). RESULTS: Findings include housing insecurity driven by cycles of poverty or poor economic reality in NY counties, substandard or poor-quality housing, experiences of stigma or social isolation within the home, a lack of transitional housing for individuals exiting the criminal legal system, housing insecurity associated with a return to use or overdose, neighborhood challenges such as accompanying transportation or food insecurity, or environmental triggers to return to use, and challenges associated with housing insecurity for SUD treatment, such as missed appointments. CONCLUSIONS: The results suggest that structural housing interventions are needed to improve the health and quality of life of individuals with SUD directly and that they may also strengthen the effectiveness and sustainability of other interventions with this population. Future research can explore the community co-design of innovative solutions across the continuum of housing security. CLINICALTRIALS.GOV IDENTIFIER: NCT04111939 </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"21 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692178","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":"Do theory of planned behaviour constructs change during adolescent alcohol use onset?","authors":"Richard Cooke, Geraldine Mabille, Frode Adolfsen, Roman Koposov, Henriette Kyrrestad","doi":"10.1186/s13011-026-00726-5","DOIUrl":"10.1186/s13011-026-00726-5","url":null,"abstract":"<p><p>BACKGROUND: Adolescence is a critical period for the initiation of alcohol use. It is uncertain how predictors of alcohol onset, such as Theory of Planned Behavior (TPB) constructs, change in response to alcohol onset. This study tests for longitudinal changes in TPB constructs during adolescents’ onset of alcohol consumption. METHOD: Data were collected longitudinally in three waves (T1, T2, T3) in Norway. Participants (N = 1,548; Mage = 13.54, 51% girls, 49% boys) reported alcohol use and TPB constructs (attitudes; subjective norms (SN); Perceived Behavioural Control (PBC); intentions) at each wave. Multilevel modelling was used to test whether the constructs changed over time, and intraclass correlation coefficients were used to assess the total variance explained by differences between individuals and waves. In addition, we tested different lagged versions of the TPB model, to determine whether alcohol use at wave 3 was linked to TPB constructs at earlier waves. RESULTS: Alcohol consumption and the TPB constructs varied between waves (58% − 72%). Alcohol use, attitudes and friends-related SN significantly increased from T1 to T2 and from T1 to T3. Intentions and parent-related SN significantly increased only from T1 to T3. PBC significantly decreased only from T1 to T3. Attitudes changed the most, and PBC changed the least over time. Tests of lagged models showed that alcohol use was predicted by constructs measured at earlier waves. CONCLUSION: Adolescent alcohol use was mirrored by changes in attitudes and friends-related SN, whereas changes in intentions, parents-related SN and PBC took longer to manifest. In addition, constructs assessed early in adolescence retained their ability to predict alcohol use later in adolescence, although intentions measured closer to the actual behaviour showed higher accuracy in predicting alcohol use. These findings can be used to determine the optimal timing to intervene in different constructs to delay adolescent drinking onset. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654691","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":"Higher risk cannabis use indicators among people living in Canada: a cross-sectional study examining the association with socio-demographic and socio-economic factors.","authors":"Samantha Goodman, Matthew Dann, Hanan Abramovici","doi":"10.1186/s13011-026-00722-9","DOIUrl":"10.1186/s13011-026-00722-9","url":null,"abstract":"<p><p>BACKGROUND: In 2018, the Cannabis Act regulated the production and sale of cannabis for non-medical purposes in Canada. With the aim of continuing to protect the public health and safety of Canadians as the legal cannabis market matures, we conducted a thorough data disaggregation to identify segments of the cannabis consumer base in Canada who are more likely to engage in ‘higher risk’ cannabis use behaviours. The analysis also aligned with the Canadian federal department of health’s Sex- and Gender-Based Analysis Plus Action Plan. METHODS: Participants were respondents from the 2023 and 2024 cycles of the Canadian Cannabis Survey who reported consuming cannabis in the previous 12 months (n = 7,238). Sixteen higher risk cannabis use outcomes were identified, along with 11 socio-demographic/socio-economic characteristics (herein ‘covariates’). Outcomes were arranged in four categories: heavy cannabis consumption; use of higher risk cannabis products; negative effects of cannabis use on one’s life; and threats to personal or public safety. Prevalence of each outcome was estimated among past 12-month consumers. For each outcome, adjusted logistic regression models tested differences between subgroups for each covariate. After Bonferroni correction for multiple comparisons, a threshold of p < 0.003 was used. RESULTS: Over three-quarters (78%) of consumers engaged in at least one higher risk outcome (mean = 2.9, SD = 2.8). After adjustment, models revealed that several subgroups tended to engage in higher risk outcomes. These included younger people, males, those reporting lower education and household income levels, and those who reported having poor/fair mental health. There were also higher rates of certain higher risk outcomes among specific ethnic groups and sexual and gender minorities, but these differences became non-significant in adjusted models. CONCLUSIONS: Study results may be used to identify subgroups of cannabis consumers in Canada who are more likely to engage in higher risk cannabis behaviours and who may benefit from more targeted public education or harm reduction initiatives. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628762","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":"The positivity rate of opioid drug urine testing in an emergency department between 2016 and 2024, before and after the introduction of fentanyl testing.","authors":"Oren Miron, David Zeltser, Shaul Schreiber, Einat Peles","doi":"10.1186/s13011-026-00721-w","DOIUrl":"10.1186/s13011-026-00721-w","url":null,"abstract":"<p><p>BACKGROUND: Despite all Health Maintenance Organizations in Israel having documented an increased use of prescription opioids, a decrease in admissions with positive opioid toxicology was observed in emergency departments (EDs). We hypothesized that following the fentanyl test introduction in 2023 in the largest acute care facility in Israel, opioid detection and naloxone usage would increase, and death rates would decrease. METHODS: Between 2016 and June 2024, 20,337 ED-admitted individuals were screened for drugs via urine toxicology tests. Opioid trends, their characteristics, the administration of naloxone, and death rates were analyzed. The pre- and since fentanyl testing initiation periods were compared. RESULTS: The proportion of individuals screened via urine toxicology increased from 0.7% in 2016 to 1.3% in 2024. Individuals screening positive for opioids were predominantly male, older-aged, non-Israeli born, with opioid and benzodiazepine prescriptions, screened positive for other substances, naloxone-treated, hospitalized, and had a higher death rate. Excluding fentanyl results, the proportion of opioid-positive tests decreased from 15.4% in 2016 to 11.6% in 2024, but when including fentanyl (available since 2023), the proportion in 2024 was 14% and did not show a significant trend. A higher opioid proportion was observed at the period with fentanyl tests (2023–2024) (12.7% vs. 10.4%, p < 0.001) with no differences in death within first day rate (0.8% vs. 0.5%, p = 0.1) and naloxone usage (3.4% vs. 3.8%, p = 0.2). During the fentanyl testing period (2023–2024), among those receiving naloxone, a higher opioid proportion observed when fentanyl testing was included (56.7%) than excluded (45%). CONCLUSIONS: As was hypothesized, a gradual decrease in opioid-positive tests was attenuated after the fentanyl test was introduced. Given the absence of evidence for a large-scale illicit fentanyl market in Israel, fentanyl exposure is likely to originate primarily from legally prescribed medications, which may reflect a tendency to prescribe fentanyl more often than less potent opioids (hence not detected before the fentanyl test was added). Additionally, the higher opioid positivity among naloxone-treated patients observed after the fentanyl test was introduced supports the need to add fentanyl to the urine toxicology test battery in all EDs across the country. Still, stable low death and naloxone-use rates suggest no impact on overdose diagnosis and treatment. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618770","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":"Staff perspectives on delivering inpatient care in a newly developed addiction medicine unit in Northern Ontario.","authors":"Danielle Labrosse, Kasunka Kankanam Gamage, Paola Nikodem, Adele Bodson, Shannon Knowlan, Natalie Aubin, Tara Leary, Kristen A Morin","doi":"10.1186/s13011-026-00725-6","DOIUrl":"10.1186/s13011-026-00725-6","url":null,"abstract":"<p><p>BACKGROUND: Healthcare providers working in addiction care often navigate complex clinical, social, and systemic challenges that can affect both care delivery and provider well-being. Yet, despite increasing recognition of the need for specialized addiction services within hospital settings, there remains limited research exploring the perspectives of staff working in these environments. The Addictions Medicine Unit (AMU) in Northern Ontario represents a novel model of inpatient addiction-focused care. This study seeks to explore the lived experiences of staff who work on the AMU to better understand the opportunities and challenges encountered in this novel model of care. The intention is to generate transferable insights relevant to similar inpatient addiction care models, while reducing unnecessary operational detail. METHODS: A qualitative study was conducted using focus groups between January and June 2024. Fourteen front line staff members (70% of the unit’s staff), including social workers, nurses, and addiction workers, participated in three focus groups. Eight guided open-ended questions were used to facilitate in-depth discussions. All sessions were recorded, transcribed, and subjected to thematic analysis to identify recurring patterns and themes. RESULTS: The study highlighted both strengths and challenges of the AMU from the staff perspective. Identified challenges included opportunities to improve collaboration with other units in the hospital and community service providers. Focus groups highlighted several strengths, including the patient-centered approach used in the AMU and a genuine commitment to supporting individuals. When staff were asked about their perspectives on contributing factors to substance use they cited trauma, social and familial influences, economic hardship, and barriers to access to treatment or outpatient services. CONCLUSION: Building a healthcare system that effectively supports individuals with Substance Use Disorder (SUD) and the professionals who care for them requires overcoming systemic barriers. The AMU is a step toward patient-centered addiction care, but challenges like health care providers feeling stigmatized and isolated from other providers because they work in addictions care emphasize the need for stronger collaboration, harm reduction integration, and policy-driven solutions to improve care and support both patients and frontline workers. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616782","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":"Single state agency licensure requirements for substance use disorder treatment programs in the United States: results of a national survey.","authors":"Brooks Yelton, Melissa A Westlake, Amanda J Abraham, Colleen M Grogan, Olivia Hinds, Christina M Andrews","doi":"10.1186/s13011-026-00724-7","DOIUrl":"10.1186/s13011-026-00724-7","url":null,"abstract":"<p><p>BACKGROUND: Substance use disorder (SUD) remains a critical public health crisis in the United States, with high prevalence and overdose mortality rates. Despite the availability of effective treatments, including medications that significantly reduce overdose risk, fewer than 20% of Americans with active SUD receive treatment annually. Single State Agencies (SSAs), which oversee federal funding and regulate SUD treatment programs, hold significant authority to impose licensure and reporting requirements intended to promote treatment quality. METHODS: This study presents findings from a national survey of SSAs across 50 states and the District of Columbia (94% response rate) conducted between 2020 and 2021, examining their roles in licensing SUD programs and setting requirements to promote evidence-based clinical practice. RESULTS: Results reveal that 58.3% of SSAs were responsible for licensing SUD treatment programs, with most requiring reporting primarily from publicly funded programs rather than all licensed providers. Staffing and clinical practice requirements varied substantially across treatment settings: opioid treatment programs and inpatient withdrawal management services were most frequently subject to medical staffing and supervision mandates, while outpatient programs were less regulated in these respects. Few SSAs required minimum staffing ratios or mandated medical professionals on staff in outpatient settings, limiting access to medication-based treatments. While patient placement criteria and clinical assessments were commonly required, clinical supervision requirements were inconsistent, and data reporting was often limited. Across treatment settings, treatment and aftercare/discharge planning were commonly required. CONCLUSIONS: The study findings indicate that agency requirements in many states allow for SUD treatment practices and staffing arrangements that are inconsistent with evidence-based care. Balancing quality improvements with maintaining access to care may necessitate additional resources and technical support for treatment programs to meet higher standards. Enhancing licensure requirements may be a critical step toward closing persistent gaps in SUD treatment quality and expanding access to lifesaving interventions. </p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610055","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}