Journal of Dual Diagnosis最新文献

{"title":"Development of Forman Scale for Codependency Measure Among Wives of Men with Substance Use Disorders in Pakistan.","authors":"Ayesha Abid, Ivan Suneel","doi":"10.1080/15504263.2026.2720398","DOIUrl":"https://doi.org/10.1080/15504263.2026.2720398","url":null,"abstract":"<p><p><b>Background</b>: Codependency among wives of men with substance use disorders (SUDs) remains under-examined in non-Western, patriarchal contexts where gender roles and cultural expectations shape relational behavior. In societies such as Pakistan, norms surrounding marital loyalty, family honor, and emotional restraint may intensify gendered expressions of codependency. <b>Objective</b>: The present study aimed to develop and validate a culturally grounded Urdu-language instrument the Forman Scale for Codependency of Spouses of Substance Abusers (FSCSSA) designed to capture gendered and culturally embedded manifestations of codependency among Pakistani wives of men with SUDs. <b>Methods</b>: A sequential exploratory mixed-methods design was employed. Semi-structured interviews (N = 20) informed item generation, followed by expert review and pilot testing. The refined scale was administered to 170 married women recruited from rehabilitation centers and NGOs in Lahore, Pakistan, who had lived with a husband diagnosed with SUD for at least one year. Exploratory factor analysis (EFA) using principal component analysis with Varimax rotation was conducted (KMO = 0.83; Bartlett's <i>p <</i> .001). <b>Results</b>: A 49-item scale was retained, explaining 45.4% of the total variance. Five factors emerged: Control and Compliance, Low Self-Worth, Self-Sacrifice, Suppression of Emotions, and Conflicting Relationship. Internal consistency was strong across subscales (<i>α =</i> .73-.88), with excellent reliability for the total scale (<i>α =</i> .93). <b>Conclusions</b>: The FSCSSA is a psychometrically sound and culturally responsive measure of codependency among wives of men with SUDs in Pakistan. By integrating gender norms and socio-cultural expectations into its conceptual framework, the scale advances culturally sensitive assessment of relational dynamics in addiction-affected families.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring The Role of GLP-1 Receptor Agonists and DPP4 Inhibitors in the Treatment of Opioid Use Disorder: A Scoping Review.","authors":"Kait Baldwin, Anthony Lau, Martha J Ignaszewski, James S H Wong, Pouya Azar, Jacky T P Siu","doi":"10.1080/15504263.2026.2720402","DOIUrl":"https://doi.org/10.1080/15504263.2026.2720402","url":null,"abstract":"<p><p><b>Background:</b> Substance use disorders continue to cause significant morbidity and mortality. Of the drug use disorders, opioid use disorder is associated with the largest disease burden globally, however, the number of people treated with pharmacotherapy remains low. Emerging literature has highlighted incretin-based medications as potential novel treatments for opioid use disorder. This review aims to synthesize the current and upcoming literature on glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP4i) in this context. <b>Methods:</b> We searched the scientific databases PubMed, Embase, PsychINFO, ClinicalTrials.gov, and EuropePMC for pre-clinical and clinical studies analyzing effects of GLP-1 RA and DPP4i in opioid use disorder. Results were narratively synthesized. <b>Results:</b> Our search yielded 857 papers to screen, of which a total of 21 studies (preclinical, observational, and clinical trials - ongoing and completed) were included. There were 13 pre-clinical studies published, and most of these rodent studies found reduction in opioid-seeking and self-administration behaviors. Four observational studies suggest glucagon-like peptide-1 receptor agonists, especially semaglutide, may be associated with reduced opioid overdose, substance use, and other neuropsychiatric outcomes. Our search identified one published, preprint randomized controlled trial and three studies that are ongoing but not yet published. Ongoing randomized trials are examining effects on overdose, cravings, and treatment retention. <b>Discussion:</b> This review summarizes current evidence on GLP-1 RA and DPP4i in opioid use disorder. Retrospective observational data with GLP-1 RA have shown benefits. Controlled GLP-1 RA trials are ongoing, which are necessary for definitive conclusions, but preliminary findings suggest they may be associated with reductions in opioid-related outcomes. Further studies are needed to clarify their role, including its use alongside opioid agonist therapy.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It Becomes, Uh, Muddy.\" Navigating Treatment Complexities and Uncertainties: Medical Doctors' Discourses on Patients with Dual Diagnosis.","authors":"Signe Wegmann Düring, Ditte Sivertsen, Katrine Schepelern Johansen","doi":"10.1080/15504263.2026.2720393","DOIUrl":"https://doi.org/10.1080/15504263.2026.2720393","url":null,"abstract":"<p><p>Treatment of dual diagnosis patients is multifaceted and requires, among other things, a strong professional approach to complex medical conditions and a strong professional attitude, uninfluenced by prejudice and moral judgment. However, studies have shown that these patients remain a challenge for many health professionals in the sense that they seem to elude sufficient treatment. In this study we have examined the possible contributions from the staff attitude by analyzing discourse. <b>Methods:</b> qualitative interviews and observation of iterations and descriptions of dual diagnosis patients in medical doctors of differentiated experience in psychiatry and dual diagnosis were used as data collection methods. Discourse theory was used to analyze and depict attitudes and discourses surrounding the patient group. <b>Result:</b> three main discourses were identified in the material, as well as the influence of private opinions and blind spots. The three discourses are \"professional uncertainty,\" \"flipped power balance\" and \"clinical compassion.\" <b>Conclusion:</b> medical doctors are not solely professional in their assessment of dual diagnosis but influenced by surrounding discourses in society and clinical contexts, meanwhile contributing to the maintenance of discourses related to this group of patients.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Alcohol Use and Smoking Among US Adults with Hepatitis C.","authors":"Mohammad Alabbas, Yuqi Guo, Jingyi Shi, Hongke Wu, Walaa Mahmoud, Shreya Sengupta, Omar T Sims","doi":"10.1080/15504263.2026.2676698","DOIUrl":"10.1080/15504263.2026.2676698","url":null,"abstract":"<p><strong>Objective: </strong>Concurrent alcohol use and smoking exert super-additive toxic effects that accelerate hepatic injury in people living with hepatitis C (HCV). Objectives of this study were to estimate the prevalence of concurrent alcohol use and active smoking at the population-level over the last decade among adults living with HCV in the United States (U.S.), examine trends in the prevalence of concurrent alcohol use and active smoking, and to identify risk factors associated with concurrent alcohol use and active smoking.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional analysis using six NHANES cycles (2007-2018). The study population included adults aged ≥20 years with current HCV infection, defined as detectable HCV RNA with confirmatory anti-HCV seropositivity, and complete data on alcohol use and smoking status. Analyses incorporated NHANES' complex survey design (strata, primary sampling units, and MEC examination weights). Prevalence estimates and temporal trends were derived using design-based methods, with linear regression applied to test for trends. Associations were examined using design-adjusted multinomial logistic regression to calculate adjusted odds ratios (aORs).</p><p><strong>Results: </strong>The pooled, survey-weighted prevalence of concurrent alcohol use and active smoking among adults living with HCV in the U.S. between 2007 and 2018 was 39.5%. Trends in the prevalence of concurrent alcohol use and active smoking did not decrease but instead remained relatively high over the 11-year period (Trend P = 0.71). In multivariate analysis, current marijuana use (aOR = 2.88, 95% CI 2.84-2.92), lifetime substance use (aOR = 5.98, 95% CI 5.87-6.10), depression (aOR = 2.59, 95% CI 2.55-2.63), and a history of cancer (aOR = 1.50, 95% CI 1.45-1.54) were positively associated with concurrent alcohol use and active smoking.</p><p><strong>Conclusions: </strong>Markedly high and non-decreasing rates of concurrent alcohol use and active smoking at the population-level may contribute to higher incident cases of HCV-related morbidity and mortality in the near future.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"277-286"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide-Related Mortality Among Individuals with Mental and Behavioral Disorders Due to Psychoactive Substance Use: A 25-Year U.S. Nationwide Analysis (1999-2023).","authors":"Sufyan Shahid, Hamza Saeed, Uzair Majeed, Hasnain Wajeeh Saqib, Muhammad Ibrahim Shah, Minahil Iqbal, Akhil Anand","doi":"10.1080/15504263.2026.2676701","DOIUrl":"10.1080/15504263.2026.2676701","url":null,"abstract":"<p><p><b>Objective:</b> Mental and behavioral disorders due to psychoactive substance use, as defined by ICD-10 codes F10-F19, include a spectrum of substance use disorders such as acute intoxication, withdrawal, harmful use, and dependence related to alcohol, opioids, stimulants, cannabis, tobacco, and other substances. These conditions significantly increase the risk of suicide, yet national trends in suicide-related mortality among affected individuals remain underexplored. This study aimed to evaluate national trends in suicide and self-harm mortality among individuals with these disorders from 1999 to 2023. <b>Methods:</b> We conducted a retrospective analysis of U.S. death certificate data from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database (1999-2023). Decedents with mental and behavioral disorders due to psychoactive substance use were identified using ICD-10 codes F10-F19, encompassing acute intoxication, withdrawal, harmful use, and dependence. Suicide and self-harm deaths were defined by ICD-10 codes U03, X60-X84, and Y87. Age-adjusted mortality rates (AAMRs) per million and average annual percentage changes (AAPCs) were estimated using Joinpoint regression. Analyses were stratified by sex, age, race/ethnicity, and metropolitan status. <b>Results:</b> Between 1999 and 2023, 37,473 suicide-related deaths were identified among U.S. individuals with mental and behavioral disorders due to psychoactive substance use. AAMRs increased from 2.2 to 5.7 per million (AAPC: 3.31; <i>p <</i> .01). Males had higher mortality than females (6.6 vs. 2.9), though females had a steeper rate of increase over time. Middle-aged adults had the highest AAMR (8.2), followed by younger (6.9), older adults (3.4) and children and adolescents (1.1). Non-Hispanic (NH) American Indian/Alaska Native individuals (AI/AN) had the highest AAMR (13.5), followed by NH White (6.2), Hispanic/Latino (1.6), NH Black (1.6), and NH Asian/Pacific Islander (API) (1.4). From 1999 to 2000, non-metropolitan areas had higher AAMRs than metropolitan areas (6.5 vs. 4.3), with significant increases in both settings. <b>Conclusions:</b> Suicide-related mortality among individuals with mental and behavioral disorders due to psychoactive substance use has increased significantly increased in the United States from 1999 to 2023, demonstrating substantial disparities by sex, age, race/ethnicity, and geographic region. These findings highlight the critical need for integrated approaches in suicide prevention and substance-related treatment settings.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"236-244"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inconsistent Self-Reports of Lifetime Suicide Attempts During Residential Treatment for Opioid Use Disorder.","authors":"Julia Thomas, Kevin Wenzel, Jennifer Carrano, Marc Fishman","doi":"10.1080/15504263.2026.2675226","DOIUrl":"10.1080/15504263.2026.2675226","url":null,"abstract":"<p><p><b>Objective:</b> Individuals with opioid use disorder (OUD) are disproportionately at risk for suicide. Residential OUD treatment programs routinely assess suicide risk factors. However, the degree to which patients consistently self report lifetime suicide attempts (LSAs) on these measures is unknown. Using patient data from electronic health records, we examined the prevalence of self-reported LSAs, consistency of reporting on assessment measures within one treatment episode and across multiple episodes, and predictors of consistent reporting. <b>Methods:</b> Our sample consisted of all patient records for residential OUD treatment from 12/01/2020- 11/30/2021 with data on LSAs (<i>N</i> = 1,206). Three self-report assessments conducted by clinical staff during the treatment episodes measured LSAs. <b>Results:</b> LSAs were reported during 22% of residential treatment episodes on at least one measure. Within one treatment episode, 13% of individuals inconsistently self-reported LSAs across the different measures, and across multiple episodes, 23%. Those who were younger, female, identified as LGB, endorsed co-occurring anxiety or depressive symptoms and reported lifetime intravenous opioid use were more likely to inconsistently self report LSAs. <b>Conclusions:</b> These results suggest that single administration self-report instruments may be insufficient to adequately assess LSAs in patients with OUD. Care should be taken to assess suicide in this population that is already at increased risk.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"205-213"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis of Attention Deficit Hyperactivity Disorder: First Estimates of the Prevalence by Sex Amongst People Who Use Psychoactive Substances and Alcohol.","authors":"Catherine Comiskey, David McDonagh, Sonam Prakashini Banka-Cullen, Philip James, Sadie Lavelle Cafferkey, Jessica Eustace-Cook","doi":"10.1080/15504263.2026.2686088","DOIUrl":"10.1080/15504263.2026.2686088","url":null,"abstract":"<p><p><b>Objective:</b> The World Health Organization describes neurodevelopmental disorders as behavioral and cognitive disorders that occur during a baby's developmental period: these include autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) amongst others. The original aim of this study was to provide estimates of the prevalence of ADHD and ASD by sex and by substance used amongst people who engage with services for drug and alcohol use. This study ultimately focused on people who use substances, are attending treatment and support services and have ADHD symptoms. <b>Methods:</b> A systematic review and meta-analysis were conducted within acute hospitals, community and prison healthcare settings. All participants were adults over the age of 18. Measurements included a diagnosis of ADHD or ASD, defined as having used a suitable tool to diagnose in childhood including a current adult assessment or diagnosis. <b>Results:</b> A total of 84 studies and 99 estimates were included forming a combined sample of 34,036 individuals. A prevalence rate of 22%, 95% CI [19, 25] was found. A significant heterogeneity in studies was detected. Only one paper reported on ASD and a meta-analysis of the prevalence of ASD was not feasible. The highest ADHD prevalence rates were found amongst people using cannabis 33%, 95% CI [28, 39]. This was significantly higher than the overall prevalence rate. The same rate of 33%, 95% CI [23, 44%] was found among women using benzodiazepines. The highest rate amongst males was also found amongst those using benzodiazepines 31%, 95% CI [23, 44%]. The lowest prevalence rate at 5%, 95% CI [1, 11] was found among women using cocaine and this was also significant. Rates amongst those using opioids was 27%, 95% CI [20, 36] for women and 24%, 95% CI [19, 30] for men. These estimates had low or moderate heterogeneity. <b>Conclusions:</b> Rates of ADHD can vary greatly between sex and choice of substance used. It is essential that the international consensus documents on treatment for, and training in ADHD symptom management are implemented to ensure an evidence informed approach to service delivery.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"265-276"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Outcomes and Treatment Utilization Among Post-9/11 Veterans with PTSD: The Impact of Current and Remitted Substance Use Disorders.","authors":"Samantha J Meckes, Jeremy Grove, Jaclyn C Kearns, Jonathan W Miao, Zoe Bridges-Curry, Jack D Wiese, Nathan A Kimbrel, Patrick S Calhoun","doi":"10.1080/15504263.2026.2676697","DOIUrl":"10.1080/15504263.2026.2676697","url":null,"abstract":"<p><p><b>Objective:</b> U.S. veterans experience comorbid posttraumatic stress disorder and substance use disorders (PTSD-SUD) at high rates, resulting in poorer psychosocial outcomes when compared to the effects of either condition alone. However, it is unclear how veterans with PTSD and a current or remitted SUD compare to those with PTSD alone. <b>Methods:</b> This study compared post-9/11 era veterans with PTSD only, PTSD + current SUD, and PTSD + remitted SUD on psychological outcomes and treatment history. <b>Results:</b> Veterans with PTSD + current SUD reported greater suicidality, PTSD symptom severity, and psychiatric distress, compared to those with PTSD only and PTSD + remitted SUD. Veterans with PTSD only and PTSD + remitted SUD reported comparable symptom levels. <b>Conclusions:</b> Findings highlight that the combination of PTSD and a current SUD is a potential risk factor for suicidality. Enhancing the effectiveness of and access to PTSD-SUD interventions may be an important pathway to suicide risk reduction.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"245-257"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Symptoms and Psychiatric Comorbidities in People with Methamphetamine Use Disorder.","authors":"Rodrigo Marín-Navarrete, Ricardo Sánchez-Domínguez, Carmen Fernández-Cáceres, Ricardo Saracco-Álvarez","doi":"10.1080/15504263.2026.2686086","DOIUrl":"10.1080/15504263.2026.2686086","url":null,"abstract":"<p><p>Long-term methamphetamine use is associated with health problems such as chest pain, cardiac complications, hypertension, and gastric problems. It also leads to mental health issues such as hallucinations, anxiety and depressive disorders, psychosis, and paranoia.</p><p><strong>Objective: </strong>Characterize and identify the medical symptoms and psychiatric comorbidities reported by people with methamphetamine use disorder (MUD).</p><p><strong>Methods: </strong>Secondary database analysis using information on physical and mental health problems obtained during history taking from 2014 to 2021. A total of 208,764 patients with medical records, all those who met the diagnosis of MUD were selected, analyzing a sample of 8,713 people with MUD.</p><p><strong>Results: </strong>Tobacco (85.8%), alcohol (68.1%), and marijuana (31.2%) were used in the past month. Anxiety (25.2%), depressive (23.9%), and psychotic (11.3%) disorders were the most prevalent disorders, with tachycardia (10.1%), gastritis (9.8%), depression (16.7%), anxiety (13.3%), insomnia (12.1%), psychosis (13.6%), myalgia (7.8%) and dyspnea (6.4%) being the most frequently reported conditions.</p><p><strong>Conclusions: </strong>Methamphetamine use is associated with a range of medical and psychiatric conditions, creating problems that require multidisciplinary care to address the complications arising from its use.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"191-204"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dopamine Receptor Modulation in Co-Occurring Disorders: Potential of Cariprazine and D3 Receptor Activity.","authors":"Sean T Lynch, John J Mariani, Frances R Levin","doi":"10.1080/15504263.2026.2676699","DOIUrl":"10.1080/15504263.2026.2676699","url":null,"abstract":"<p><p><b>Objective:</b> Substance use disorders (SUDs) frequently co-occur with serious mental illness (SMI) and remain undertreated, in part due to limited pharmacologic options for many substances. Dopamine receptor-modulating agents (DRMAs), particularly antipsychotics with partial agonist activity, have been investigated for their potential to influence craving, reward processing, and relapse. This commentary reviews the evolving evidence for dopamine receptor modulation in SUDs, with particular emphasis on second-generation antipsychotics (SGAs) and the D3-preferring partial agonist cariprazine. <b>Methods:</b> A narrative review of preclinical, clinical, and observational literature was conducted, focusing on dopamine receptor antagonists and partial agonists studied in populations with SUDs, including individuals with co-occurring SMI. Particular attention was given to pharmacologic mechanisms involving D2 versus D3 receptor activity and to emerging evidence regarding cariprazine. <b>Results:</b> Early studies of first-generation antipsychotics, characterized by potent and sustained D2 receptor antagonism, generally demonstrated limited benefit or worsening of substance use outcomes. SGAs have shown more heterogeneous effects, likely reflecting variability in receptor-binding profiles and study methodologies. Increasing evidence highlights the role of the dopamine D3 receptor in substance-related motivation, reward, and cue reactivity. Cariprazine, the only currently approved antipsychotic with high affinity and preferential activity at the D3 receptor, has demonstrated potential benefits across preclinical models, case reports, and observational studies. Reported improvements include reductions in substance use, craving, and relapse-particularly for stimulant and cannabis use disorders-alongside improvements in psychiatric symptoms and functioning. However, most clinical evidence remains limited to small samples, non-randomized designs, and variable outcome measures. <b>Conclusions:</b> Dopamine receptor modulation, particularly targeting the D3 receptor, represents a promising but still emerging strategy for the treatment of SUDs, especially in individuals with co-occurring psychiatric disorders. Cariprazine's unique pharmacologic profile and broad clinical indications position it as a compelling candidate for further investigation. Rigorous randomized controlled trials using standardized substance use outcomes are needed to clarify its efficacy and role in integrated treatment models for dual diagnosis populations.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"258-264"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}