Addiction Science & Clinical Practice最新文献

{"title":"Referral linkages to support pregnant and postpartum individuals with opioid use disorders in Florida: a social network analysis.","authors":"Amandeep Kaur Ratta, Rafaella Stein Elger, Wouter Vermeer, Tanner Wright, Asa Oxner, Kimberly Fryer, Jennifer Marshall","doi":"10.1186/s13722-026-00675-1","DOIUrl":"10.1186/s13722-026-00675-1","url":null,"abstract":"<p><strong>Background: </strong>Opioid Use Disorder (OUD) has emerged as a critical public health issue among pregnant and postpartum individuals. To address this concern, it is of utmost importance that healthcare institutions, community-based programs, and other agencies collaborate to improve the support offered to the concerned population in their OUD recovery journey. A social network analysis was conducted to understand collaborations among multisectoral agencies serving or having potential to serve pregnant and postpartum individuals with OUD.</p><p><strong>Methods: </strong>Collaborations among agencies (n = 79), including three Continuous And Data-drivEN CarE (CADENCE) program clinics, in a large Florida county were mapped. A cross-sectional web-based survey was distributed to these agencies to capture inter-agency collaborations, including services provided (e.g., housing, transportation, etc.), interaction frequency, and perceptions of partner agency confidence, dependence, and value. Open-ended questions identified champion agencies and needs of agencies to better serve the population. Network maps of the agencies were generated to characterize the nature of existing collaborations and identify opportunities for strengthening interagency coordination.</p><p><strong>Results: </strong>Twenty-six out of 79 enlisted agencies (33%) responded, describing connections with 72 enlisted agencies. The social network analysis of total 376 ties among these agencies demonstrated low density (0.108) but high clustering (0.637), indicating a connected core with tightly knit subgroups and cross-sector bridges especially through social services. CADENCE clinics were inter-linked; CADENCE Co-located pediatric/ psychiatric/Maternal-Fetal Medicine clinic was most connected (38 ties), followed by CADENCE Outpatient Prenatal Care clinic (16 ties), and CADENCE Addiction Medicine (9 ties). Collaboration frequency varied, with 34% of referral ties used only once a year or less, 13% used daily, and 17% never used. Agencies reported having confidence in 82% of collaborations, yet more than half (56%) were considered non-essential (no or little dependency) to achieving patient care goals. Qualitative insights emphasized integrated, trauma-informed care, standardized referral pathways and shared data; destigmatization, and harm reduction; simpler resource navigation and supports for housing and transportation.</p><p><strong>Conclusion: </strong>Overall, the county possesses a multisector perinatal OUD network that is yet underutilized. Strengthening structured referrals, interoperability, and wraparound, stigma-free services leveraging CADENCE could reduce fragmentation and improve maternal-infant outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrails.gov (NCT05609669). November 02, 2022.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A thematic analysis of caregiver engagement in adolescent substance use treatment.","authors":"Trey V Dellucci, Brielle L Batch, Stephanie J Strong, Amanda V Broderick, Allyson L Dir, Leslie A Hulvershorn, Zachary W Adams","doi":"10.1186/s13722-026-00669-z","DOIUrl":"10.1186/s13722-026-00669-z","url":null,"abstract":"<p><strong>Background: </strong>While caregiver engagement is a critical component of adolescent substance use disorder (SUD) treatment, it is often limited in practice. Existing research on barriers and facilitators to caregiver engagement has predominately focused on clinician perspectives of caregiver engagement. This study sought to synthesize caregivers' perspectives on their involvement in adolescent SUD treatment.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with 15 caregivers (including parents and legal guardians) of adolescents who participated in an outpatient SUD treatment program in the past year. A hybrid inductive-deductive coding approach using an iterative and concurrent process was utilized to identify themes related to caregiver engagement.</p><p><strong>Findings: </strong>Thematic analysis identified three themes related to caregiver engagement: Caregiver Motivations for Treatment Initiation, Conceptualizations of Caregiver Involvement in Adolescent SUD Treatment, and Barriers and Facilitators of Caregiver Engagement.</p><p><strong>Conclusions: </strong>There is a need for early substance use screening and intervention development targeting caregivers' motivation and psychoeducation on the benefits of caregiver engagement in adolescent SUD treatment and recovery.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microcosting the optimization of PrEP implementation among sexual and gender minority individuals with a substance use disorder.","authors":"Danielle Ryan, Cathy J Reback, Raymond P Mata, Michael Li, Ali Jalali, Philip J Jeng, David Benkeser, Sean M Murphy","doi":"10.1186/s13722-026-00672-4","DOIUrl":"https://doi.org/10.1186/s13722-026-00672-4","url":null,"abstract":"<p><strong>Aim: </strong>Substance Use Disorder (SUD) increases HIV risk and is often a barrier to advancement along the PrEP Care Continuum. In the United States ~ 40,000 new HIV diagnoses occur annually, the majority among sexual and gender minorities who use substances. Insufficiently treated HIV and SUD results in substantial costs to society. Effective strategies that focus on SUD as part of a client-centered approach to improve PrEP engagement and address social determinants of health (SDoH), are critical. Understanding resources/cost requirements is important to know for prospective sites.</p><p><strong>Methods: </strong>The parent R01 was a single-site, randomized stepped-care and cost-effectiveness trial of Assisted Service Knowledge (A.S.K)-PrEP vs. standard of care (SOC), where \"non-responders\" in the A.S.K-PrEP arm were stepped to additional attention for SUD via contingency management (CM), resulting in three strategies against SOC (A.S.K-PrEP; A.S.K-PrEP + CM; A.S.K-PrEPàCM alone). Resources needed to implement and sustain each strategy were captured as part of a detailed microcosting analysis. Resources were categorized as fixed start-up, time-dependent, or variable, and organized within the implementation or sustainment phase. Costs were assigned using nationally representative prices.</p><p><strong>Results: </strong>Start-up costs (first year costs) were $25,958 and time-dependent costs (annually based) were $68,442 across strategies. Variable costs (annually based) differed across strategies resulting in $31,716 for A.S.K-PrEP alone, $31,994 for A.S.K-PrEP + CM and $30,271 for CM alone. The per-participant intervention cost was $55 for Standard of Care, $104 for A.S.K-PrEP alone, $73 for A.S.K-PrEP + CM, and $16 for CM alone.</p><p><strong>Conclusion: </strong>This study provides key insights into the \"real-world\" resource/cost requirements for implementing and sustaining each A.S.K.-PrEP strategy. Our results and publicly available budget impact tool provide support for potential stakeholders to ensure both feasibility and long-term sustainability for PrEP uptake and adherence for sexual and gender minority individuals with a SUD.</p><p><strong>Trial registration number: </strong>NCT05934877 and was registered on 05/23/23 as a clinical trial.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences and perceived efficacy of a newly implemented hospital-based withdrawal management unit in Vancouver, Canada: findings from the Road to Recovery evaluation.","authors":"Sidney Roberge, Seonaid Nolan, Cheyenne Johnson, Piper Dickhout, Ava Abramowich, Travis De Wolfe, Renee Janssen, Erika Mundel, Andrea Ryan, Ian Haynes, Laurel Lemchuk-Favel, Harmony Johnson, Brittany Dennis","doi":"10.1186/s13722-026-00671-5","DOIUrl":"10.1186/s13722-026-00671-5","url":null,"abstract":"<p><strong>Background: </strong>The Road to Recovery (R2R) initiative represents an innovative approach to substance use care in British Columbia, Canada, that is designed to provide timely, comprehensive, and culturally safe services for individuals with a substance use disorder (SUD). This survey sought to understand patient experiences with this new care model.</p><p><strong>Methods: </strong>Adults (≥ 18 years) with a SUD who accessed R2R's new hospital-based withdrawal management unit in Vancouver, Canada between May 2024 and April 2025 were invited to participate in a cross-sectional survey that captured their individual experiences. Descriptive statistics were used to summarize responses.</p><p><strong>Results: </strong>87 participants completed the survey. The mean age was 41 years (Standard Deviation [SD] = 15); 57% (n = 50) identified as male, and 49% (n = 43) as Indigenous. The majority (n = 58, 67%) of respondents reported access to withdrawal management services in ≤ 48 h. A total of 91% (n = 79) of participants felt the quality of care was 'good' or 'excellent', 90% (n = 78) reported positive interactions with staff, 88% (n = 68) of respondents felt their withdrawal symptoms were adequately managed, 91% (n = 71) believed the program helped them achieve their treatment goals. Among participants visited by Indigenous Wellness Liaisons (IWLs) (n = 56), 77% (n = 43) completely trusted IWLs, and 52% (n = 17) reported that their cultural and spiritual needs were completely met by IWLs. Peer support was valued by 85% of respondents for providing empathy and motivation. One-third (n = 29, 33%) of participants contemplated leaving during their admission, most commonly because of the absence of engaging activities (n = 12, 41%,). Overall, 95% said they would recommend the program to others.</p><p><strong>Conclusions: </strong>Findings highlight that the R2R model delivers timely, high-quality, and culturally safe withdrawal management care. Patients emphasized the value of respectful staff, effective medical management, and integration of Indigenous and peer supports. Enhancing structured programming and expanding access to psychosocial and cultural services may further improve engagement and reduce early discharge. Embedding trauma-informed, interdisciplinary, and culturally grounded approaches within hospital-based withdrawal management may improve patient experience and retention, informing future models of addiction care in Canada.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational trial of the preventive impact of a social risk factor focused program for co-occurring opioid and methamphetamine use disorders and suicide risk in parents: study protocol.","authors":"Lisa Saldana, Gracelyn Cruden, Jason E Chapman, Ryan R Singh, Jamie Jaramillo, Ally Dir, Mark Campbell, Jeffrey M Peterson, Maria Bybee, John Radich, Kaylee Becker, Megan Spain, Holle Schaper, Joseph E Glass","doi":"10.1186/s13722-026-00667-1","DOIUrl":"10.1186/s13722-026-00667-1","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of social determinants on opioid use disorder treatment engagement after release from jail: a case note content analysis.","authors":"Justin S Bell, Jodie M Dewey, Dennis P Watson, Carol Johnstone, John S Palmer, Rachel Kurz, Christine E Grella","doi":"10.1186/s13722-026-00666-2","DOIUrl":"https://doi.org/10.1186/s13722-026-00666-2","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lifeline on wheels: perspectives of stakeholders on the implementation and impact of a mobile medications for opioid use disorder unit.","authors":"Augustine Kang, Amelia Bailey, Linda Hurley, Rosemarie Martin","doi":"10.1186/s13722-026-00664-4","DOIUrl":"10.1186/s13722-026-00664-4","url":null,"abstract":"<p><strong>Introduction: </strong>Mobile health units (MHUs) providing medications for opioid use disorder (MOUD) have emerged as a critical strategy to address gaps in opioid treatment access, particularly for marginalized populations. Research has yet to explore stakeholder perspectives on MHUs' implementation, challenges, and long-term sustainability.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 15 stakeholders, including MHU staff, administrators, community partners, and policymakers. Interviews explored experiences with the MHU, barriers and facilitators to patient engagement, and operational challenges. Data were transcribed, coded, and analyzed using a template thematic approach to identify key themes related to implementation and sustainability.</p><p><strong>Results: </strong>Stakeholders endorsed the MHU as a highly accessible and flexible intervention that reduces barriers for people experiencing homelessness, economic instability, and transportation limitations. The MHU facilitated strong patient-provider relationships and access to harm reduction, primary care, and social services. Challenges included staffing shortages, inconsistent funding, limited clinical space, and environmental barriers. Additionally, stigma, political resistance, and law enforcement interactions affected service delivery and patient engagement.</p><p><strong>Discussion: </strong>Findings highlight the importance of policy and funding mechanisms to ensure the long-term viability of MHUs. Stakeholders recommended expanding outreach, increasing staffing, and integrating additional services. Addressing these challenges is essential to sustaining MHUs as an effective public health intervention for opioid use disorder.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does perceived stigma impact opioid use disorder treatment uptake? A cross-sectional secondary analysis of buprenorphine engagement among syringe service program participants.","authors":"Bailey Campbell, Lindsey R Riback, Juan Gatica Portillo, Stephanie Maricic, Aaron D Fox","doi":"10.1186/s13722-026-00665-3","DOIUrl":"10.1186/s13722-026-00665-3","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of low-dose buprenorphine induction at a syringe services program.","authors":"Maia H Hauschild, Peyton V Warp, William H Eger, Ryan Hood, Monica Bahamon, David W Forrest, Tyler S Bartholomew, Edward Suarez, Teresa A Chueng, Katrina J Ciraldo, Hansel E Tookes, David P Serota","doi":"10.1186/s13722-026-00661-7","DOIUrl":"10.1186/s13722-026-00661-7","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl's penetration into the unregulated drug supply has complicated the treatment of opioid use disorder (OUD), particularly by increasing the risk of buprenorphine-precipitated opioid withdrawal (BPOW). Buprenorphine, a partial opioid agonist, remains a first-line treatment for OUD, but traditional induction methods can be intolerable for people using fentanyl. Low-dose induction (LDI), a strategy characterized by gradual buprenorphine titration without prior withdrawal, has emerged as a promising alternative to mitigate BPOW. However, the feasibility and acceptability of LDI in low-barrier, real-world settings such as syringe services programs (SSPs) remain underexplored.</p><p><strong>Methods: </strong>We conducted a mixed-methods prospective cohort study from June 2023-2024 at an SSP in Miami, Florida, offering a 4-day LDI protocol to patients with OUD who were interested in starting buprenorphine. Follow-up, conducted on a walk-in basis within four weeks, included urine drug screens (UDS), symptom surveys and semi-structured qualitative interviews. The primary outcome was successful buprenorphine initiation, defined by a positive UDS for buprenorphine at follow-up.</p><p><strong>Results: </strong>Of the 30 participants enrolled in the 4-day LDI protocol, most (n = 29) had prior buprenorphine experience and nearly 90% (n = 26) reported past BPOW. Only 16 (53%) returned for follow-up. Nine (56%) of those followed up tested positive for buprenorphine, 11 (68.8%) reported that LDI worked for them, and 12 (75%) said they would use the method again. Qualitative interviews revealed six key themes: (1) LDI mitigates withdrawal symptoms; (2) instructions were helpful but could be improved; (3) fear of BPOW motivated LDI use; (4) LDI enabled autonomy in recovery; (5) unstable living environments hindered adherence; and (6) LDI allowed participants to maintain social roles.</p><p><strong>Conclusions: </strong>While only 30% of the cohort had objective evidence of buprenorphine induction, most reported successful attempts and found LDI acceptable and empowering. High loss to follow-up and environmental instability limited our conclusions in this outpatient harm reduction setting. Further research is needed to refine LDI protocols and address the structural determinants affecting treatment success among people who use fentanyl.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"App-based skills training to reduce problem drinking among adult internet help-seekers: a double-blinded randomized controlled trial.","authors":"Yaoyu Chen, Anne H Berman, Claes Andersson, Matthijs Blankers, Olof Molander","doi":"10.1186/s13722-026-00663-5","DOIUrl":"10.1186/s13722-026-00663-5","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}