Drug and alcohol dependence reports最新文献

{"title":"Hallucinogen use in the United States, 2021–2023: Diverging trends and subgroup patterns","authors":"Jing-Jer Chen ,&nbsp;Carla J. Berg ,&nbsp;Y. Tony Yang","doi":"10.1016/j.dadr.2026.100410","DOIUrl":"10.1016/j.dadr.2026.100410","url":null,"abstract":"<div><h3>Background</h3><div>While interest in the therapeutic and recreational use of hallucinogens has increased, national surveillance often reports use in aggregate, potentially masking shifting trends among pharmacologically distinct substances. This study assessed trends in specific hallucinogens from 2021 to 2023 and identified correlates of use, with particular attention to subgroup patterns in populations commonly prioritized for prevention and access-focused interventions.</div></div><div><h3>Methods</h3><div>Using nationally representative NSDUH data (2021–2023; ages ≥12), we estimated annual past-year prevalence of LSD, PCP, ecstasy (MDMA), ketamine, Salvia divinorum, and tryptamines (including DMT). We fit survey-weighted logistic regression models with year (continuous) to assess trends and pooled multivariable models to examine demographic correlates.</div></div><div><h3>Results</h3><div>Although overall past-year hallucinogen use was stable (2.83 % [95 % CI: 2.52–3.14] in 2021; 2.82 % [2.52–3.12] in 2023), substance-specific trends diverged. LSD declined (aOR per year=0.83, 95 % CI: 0.75–0.93), from 0.88 % (0.72–1.04) in 2021–0.58 % (0.47–0.68) in 2023. Ketamine increased (aOR=1.11, 95 % CI: 1.02–1.21), from 1.61 % (1.42–1.80) to 1.91 % (1.67–2.16). Ecstasy/MDMA and tryptamines were stable, and PCP and Salvia remained rare. Use concentrated among young adults and males; adjusted models indicated higher odds among uninsured respondents and those below the federal poverty level.</div></div><div><h3>Conclusions</h3><div>Despite stable overall hallucinogen prevalence, significant increases were observed for ketamine alongside declines for LSD, suggesting a shifting landscape of hallucinogen use. Substance-specific monitoring may better inform screening, prevention, and harm-reduction efforts than aggregate hallucinogen indicators, especially as ketamine’s medical availability expands and disparities in access to mental health treatment persist.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100410"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between injection status, cocaine use, overdose, and drug-related behaviors among people who use opioids","authors":"Carl A. Latkin ,&nbsp;Lauren Dayton ,&nbsp;Haley Bonneau ,&nbsp;Melissa A. Davey-Rothwell ,&nbsp;Grace Tian Yi ,&nbsp;Kaori Suga ,&nbsp;Oluwaseun Falade-Nwulia","doi":"10.1016/j.dadr.2025.100398","DOIUrl":"10.1016/j.dadr.2025.100398","url":null,"abstract":"<div><h3>Background</h3><div>The co-use of opioids and stimulants is associated with elevated health risks. This study examined patterns of injection drug use and cocaine use frequency among people who use opioids.</div></div><div><h3>Methods</h3><div>Cross-sectional data were collected from community-recruited adults who use opioids in Baltimore, Maryland, between December 7, 2022 and January 26, 2025. Participants were categorized into four groups based on injection status and cocaine use frequency. Multinomial logistic regression examined factors associated with group membership, calculating relative risk ratios (RRR) and adjusted relative risk ratios (aRRR) with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>Of 777 participants (60.7 % male, 71.6 % Black, median age 52), 29.2 % reported past-month injection drug use. Daily/almost daily use was reported for heroin/fentanyl (79.5 %), crack cocaine (43.2 %), and powder cocaine (9.3 %). Four distinct drug use patterns emerged: not inject/lower frequency cocaine use (42.0 %), inject/lower frequency cocaine use (9.3 %), not inject/higher frequency cocaine use (28.8 %), and inject/higher frequency cocaine use (19.9 %). Factors significantly associated with injecting and higher frequency cocaine use group membership included: overdose history (aRRR=2.58, 95 % CI=1.52–4.38), withdrawal behavior with high overdose risk (aRRR=1.29, 95 % CI=1.14–1.46), and using in multiple locations (aRRR=1.09, 95 % CI=1.02–1.18).</div></div><div><h3>Conclusions</h3><div>Nearly one-fifth of people who use opioids reported both injection drug use and high-frequency cocaine use, and greater frequency of cocaine use was associated with higher overdose risk. Targeted interventions addressing polysubstance use patterns, social networks, and environmental factors are urgently needed to reduce harm among this high-risk population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100398"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A short communication of pain outcomes following a pharmacist-delivered alcohol and opioid use reduction intervention","authors":"Gerald Cochran ,&nbsp;Grace Broussard ,&nbsp;Yingjia Wei ,&nbsp;Craig Field ,&nbsp;Adam J. Gordon ,&nbsp;Kenneth C. Hohmeier","doi":"10.1016/j.dadr.2026.100418","DOIUrl":"10.1016/j.dadr.2026.100418","url":null,"abstract":"<div><h3>Background</h3><div>Co-use of alcohol and opioid medications increases risk for sedation, respiratory depression, and overdose, yet remains common among patients prescribed opioids. The Alcohol Brief Intervention–Medication Therapy Management (ABI-MTM) intervention was developed for delivery by community pharmacists and demonstrated feasibility, acceptability, and preliminary reductions in co-use. Given possible pain-related motives for co-use, this exploratory secondary analysis assessed whether ABI-MTM affected pain symptomatology.</div></div><div><h3>Methods</h3><div>This study utilized data from a randomized trial of 44 community pharmacy patients from 25 pharmacies prescribed opioids and who reported alcohol co-use. Participants were randomized to ABI-MTM or standard medication counseling (SMC). Pain intensity/interference were assessed at baseline, 2-, and 3-months using the Brief Pain Inventory–Short Form. Analyses included descriptive statistics, Cohen’s d effect sizes, and mixed-effects models comparing pain across conditions and timepoints.</div></div><div><h3>Results</h3><div>Pain scores did not differ between groups (p &gt; 0.05). For pain intensity, ABI-MTM and SMC showed similar baseline means (4.31 vs. 5.05), decreased modestly at 2-months (2.80 vs. 3.74), and returned to baseline levels at 3-months (4.21 vs. 4.83). Pain interference followed a comparable pattern, with ABI-MTM and SMC starting similarly (4.83 vs. 5.07), decreasing modestly at 2-months (3.19 vs. 3.87), and returning near baseline at 3-months (4.92 vs. 4.42). Effect sizes between group differences were small (Cohen’s d≤0.33). Mixed-model analyses showed no significant treatment effects on pain intensity/interference across time (p &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>This underpowered study found no evidence of pain differences between ABI-MTM and SMC, tentatively suggesting possible alcohol-opioid co-use improvements associated with the intervention without worsening pain.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100418"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicians’ experiences of delivering online Community Reinforcement and Family Training (CRAFT) for families affected by substance use in rural Australia","authors":"Subash Thapa ,&nbsp;Heidi Gray ,&nbsp;Nicole Snowdon ,&nbsp;Brian Serna ,&nbsp;Brianna Jacobson ,&nbsp;Julaine Allan","doi":"10.1016/j.dadr.2026.100416","DOIUrl":"10.1016/j.dadr.2026.100416","url":null,"abstract":"<div><h3>Background</h3><div>Interventions that support family members or concerned significant others (CSOs) of people with alcohol or drug dependence can enhance recovery, strengthen family functioning, and reduce recurrence rates. Yet factors influencing successful implementation of CSO-focused online programs, especially in rural Australia remain poorly understood. This study explored the implementation experiences of clinicians delivering online Community Reinforcement and Family Training (CRAFT).</div></div><div><h3>Methods</h3><div>This exploratory descriptive qualitative study involved semi-structured interviews with seven clinicians who delivered CRAFT. Data were analysed thematically using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.</div></div><div><h3>Results</h3><div>CRAFT was perceived as well-structured, feasible, and compatible with routine clinical practice, enhancing clinicians’ confidence and enabling CSOs to develop skills in self-care, positive communication, problem-solving, and supporting healthy behaviours among loved ones. Successful implementation depended on clinician enthusiasm, flexible delivery modes (online as well as in-person), tailored content, and ongoing feedback, while challenges included CSO emotional overwhelm, competing responsibilities, limited digital literacy, and insufficient alcohol and drug services for loved ones. Socio-cultural factors, including reluctance to discuss alcohol or substance dependence, also limited engagement. Clinicians intended to retain key program components in practice but time constraints, telehealth limitations, and rural service gaps hindered sustained integration. Suggested improvements included cultural adaptation and structured opportunities for family–service collaboration.</div></div><div><h3>Conclusions</h3><div>Online CRAFT is a promising, practice-ready intervention for supporting and empowering rural families affected by alcohol and drug use. Its integration into health services will depend on addressing workforce capacity, digital access, and rural service inequities, alongside policy-level commitment to family-focused programs.</div></div><div><h3>Clinical trial registration</h3><div>ACTRN12623000796684 (registered 26 July 2023)</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100416"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural community peer partnerships for improving methamphetamine -associated heart failure screening and engagement in cardiology care (PEER-Heart): Study protocol","authors":"Maria Alias-Ferri ,&nbsp;Cooper B. Kersey ,&nbsp;Evan F. Shalen ,&nbsp;Ryan Cook ,&nbsp;Devin Gregoire ,&nbsp;Kim Hoffman ,&nbsp;Michelle Beam ,&nbsp;Ximena A. Levander ,&nbsp;Kellie Pertl ,&nbsp;Alexis Stensby ,&nbsp;Paul Gonzales ,&nbsp;Shanna Smith ,&nbsp;Tabetha Evernden ,&nbsp;Chris T. Longenecker ,&nbsp;P. Todd Korthuis ,&nbsp;Brian Chan","doi":"10.1016/j.dadr.2026.100411","DOIUrl":"10.1016/j.dadr.2026.100411","url":null,"abstract":"<div><h3>Background</h3><div>Methamphetamine-associated heart failure (MAHF) is increasingly prevalent in rural communities, where limited specialty care and barriers to healthcare engagement hinder early diagnosis and treatment. Peer-led screening with brain natriuretic peptide (BNP) testing, supported by telemedicine, may enhance early detection and linkage to cardiology care.</div></div><div><h3>Aim</h3><div>PEER-Heart is a hybrid type 1 effectiveness-implementation trial to evaluate the feasibility, acceptability, and effectiveness of a peer-assisted point-of-care screening protocol and telecardiology intervention for MAHF in rural Oregon.</div></div><div><h3>Methods</h3><div>We will recruit 122 adults reporting methamphetamine use within the past 30 days from two rural Oregon counties. Individuals will be screened for MAHF by peers using a symptom questionnaire, brain natriuretic peptide (BNP) testing, and a mobile electrocardiogram. Individuals who screen positive will be randomized to a peer-facilitated telecardiology intervention or enhanced usual care (EUC). Primary outcome is linkage to heart failure treatment at 2 months. Secondary outcomes include changes in symptom severity, knowledge, and engagement in guideline-directed medical therapy. Implementation barriers and facilitators will be assessed through interviews and focus groups using thematic analysis and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We hypothesize that peer-assisted telecardiology will result in higher linkage to care. The study will assess the feasibility and acceptability of peer-delivered cardiovascular screening and telecardiology in high-risk populations.</div></div><div><h3>Conclusion</h3><div>PEER-Heart addresses a critical gap in early detection and management of heart failure for people who use methamphetamine in rural settings. Findings will inform efforts to scale peer-integrated telemedicine programs for underserved populations with complex needs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100411"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and comorbidities of patients on opioid agonist therapy in Switzerland: A descriptive analysis of the nationwide SAMMSU cohort","authors":"Michael Lütolf ,&nbsp;Andrea Bregenzer ,&nbsp;Philip Bruggmann ,&nbsp;Alberto Moriggia ,&nbsp;Claude Scheidegger ,&nbsp;Katharina Hensel-Koch ,&nbsp;Erika Castro Batänjer ,&nbsp;Maria Christine Thurnheer ,&nbsp;Pascale Della Santa ,&nbsp;Oliver Senn ,&nbsp;Thomas Grischott","doi":"10.1016/j.dadr.2025.100404","DOIUrl":"10.1016/j.dadr.2025.100404","url":null,"abstract":"<div><h3>Background</h3><div>Opioid agonist therapy (OAT) is the gold standard of treatment for opioid dependence and a cornerstone of Swiss drug policy. The Swiss Association for the Medical Management in Substance Users (SAMMSU) cohort was established to monitor health trends and improve care for OAT patients across Switzerland.</div></div><div><h3>Methods</h3><div>Baseline and follow-up data collected from eight centres between 2014 and 2024 were analysed descriptively, including demographic and psychosocial characteristics, substance use history, prescribed OAT, co-medications, and somatic and psychiatric comorbidities.</div></div><div><h3>Results</h3><div>During the study, the SAMMSU cohort included 1 502 participants. Median individual age at registration was 44.3 years, rising to a cohort median of 50.9 years by the end of 2024; 75.7 % of participants were male. Lifetime heroin use was reported by 97.2 %, with 73.2 % having a history of intravenous drug use. Ongoing illicit and intravenous drug use declined over time, while prescribed OAT shifted from methadone to long-acting morphine and diacetylmorphine. The most prevalent lifetime somatic comorbidities were hepatitis C (56.5 %), (pre)hypertension (18.6 %), musculoskeletal disorders (13.8 %), and needle abscesses (13.7 %). Psychiatric disorders – primarily affective (34.8 %), personality (23.2 %), and anxiety disorders (18.0 %) – contributed to multimorbidity and a high prevalence of polypharmacy (49.2 %). There were 120 deaths, mainly from malignancy, overdose, and liver failure, with a median age at death of 51.6 years.</div></div><div><h3>Conclusion</h3><div>SAMMSU cohort trends corroborate the effectiveness of OAT in reducing illicit drug use and underscore the need for OAT services to evolve from an addiction-focused model to comprehensive chronic care for an ageing and highly vulnerable population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100404"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statewide trends in access to medications for opioid use disorder (moud) among adolescents with opioid use disorders in Indiana","authors":"Sumedha Gupta ,&nbsp;Katherine Schwartz ,&nbsp;Lauren Arnold Bell ,&nbsp;Nicole Siegal ,&nbsp;Matthew C. Aalsma","doi":"10.1016/j.dadr.2026.100417","DOIUrl":"10.1016/j.dadr.2026.100417","url":null,"abstract":"<div><h3>Purpose</h3><div>Opioid use disorder (OUD) and related harms have risen among adolescents, yet access to medications for OUD (MOUD) remains limited, particularly among Medicaid-enrolled youth. This study examines trends in OUD diagnosis and MOUD receipt among Indiana Medicaid adolescents and differences by race, ethnicity, and age.</div></div><div><h3>Design</h3><div><strong>Setting, and participants</strong> Retrospective cross-sectional study of 2019–2023 Indiana Medicaid claims for adolescents aged 12–17.</div><div><strong>Main outcomes and measures</strong> Outcomes were initial OUD diagnosis, MOUD receipt conditional on diagnosis, and MOUD initiation delay, examined at beneficiary and population levels. Analyses were stratified by demographics, with linear regression assessing predictors.</div></div><div><h3>Results</h3><div>Of 420,361 Medicaid adolescents, 871 (0.2 %) had an OUD diagnosis and 73 (8.4 %) among them received MOUD. Diagnosis rates increased 67 % between 2019 and 2023, with higher rates among males and White adolescents. Black and Hispanic adolescents were less likely than White peers to be diagnosed (–11 % and –7 %, respectively); among those diagnosed, Black youth were far less likely to receive MOUD (–89 %), while Hispanic youth had the highest treatment rate (15.8 %). Delays in MOUD initiation was longest for Black adolescents (781 days), followed by White (665 days) and Hispanic (588 days) youth. Younger teens (12–14) were less likely to be diagnosed (–20 %) and treated (–56 %) than older peers.</div></div><div><h3>Conclusions</h3><div><strong>AND RELEVANCE</strong> MOUD access among Indiana Medicaid adolescents remains low, with persistent racial and ethnic differences in diagnosis and treatment rates. Targeted policies are needed to expand equitable access, particularly for Black and younger adolescents.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100417"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to methadone dispensing for opioid use disorder in community pharmacies: A scoping review","authors":"Caroline Shubel ,&nbsp;Mary Ava Nunnery ,&nbsp;Grace Marley ,&nbsp;Bayla Ostrach ,&nbsp;Delesha M. Carpenter","doi":"10.1016/j.dadr.2026.100413","DOIUrl":"10.1016/j.dadr.2026.100413","url":null,"abstract":"<div><h3>Background</h3><div>Methadone, an evidence-based medication for opioid use disorder (MOUD), is available through prescription at community pharmacies in countries like Canada, Australia, and the United Kingdom, but not in the United States (U.S.). The objective of this scoping review was to summarize barriers and facilitators related to dispensing methadone in community pharmacies to inform future implementation efforts in the U.S.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using PubMed, Embase, SCOPUS, and CINAHL. Original research articles related to barriers and/or facilitators around community pharmacy-based methadone dispensing were included. No search limits (year of publication, geographic boundaries) were applied to the search strategy. Two independent researchers screened all articles for eligibility, extracted data, and met to reach consensus. Data were extracted on 12 items, with a particular focus on barriers and facilitators to dispensing methadone in community pharmacies.</div></div><div><h3>Results</h3><div>Forty-one articles were included in the review. The most common barriers to methadone dispensing were workload (n = 14), safety concerns for staff and property (n = 13), concern about patient behavior and interactions (n = 12), financial hardship (for pharmacists and patients) (n = 11), and stigma and discrimination towards patients (n = 11). The most common facilitators were pharmacist training and education (n = 14), positive pharmacist-patient relationships (n = 14), and privacy (n = 10).</div></div><div><h3>Conclusions</h3><div>The findings from this review can be used to address barriers and incorporate known facilitators into future protocols or practice of pharmacy-based methadone dispensing. Further research is needed to identify U.S. and state-specific anticipated needs for pharmacy-based methadone dispensing.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100413"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring gender differences in tobacco cue-induced craving and heart rate variability in individuals with a tobacco use disorder","authors":"Lucia Hoffmann ,&nbsp;Annel, P. Koomen ,&nbsp;Taco J. De Vries ,&nbsp;Anne Marije Kaag","doi":"10.1016/j.dadr.2025.100407","DOIUrl":"10.1016/j.dadr.2025.100407","url":null,"abstract":"<div><h3>Introduction</h3><div>Women face greater challenges quitting smoking and higher health risks than men, yet gender remains understudied in tobacco use disorder (TUD). This study investigates gender differences in subjective craving and heart rate variability (HRV) following tobacco cue exposure in abstinent individuals with a tobacco use disorder. Unlike heart rate, HRV reflects parasympathetic modulation, critical for understanding risk and resilience in addiction, but has rarely been studied as a cue-reactivity biomarker.</div></div><div><h3>Methods</h3><div>Data from 41 men and 40 women who smoked cigarettes for more than 10 years were analyzed. Participants underwent a cue-exposure paradigm consisting of a relaxation phase (75<!--> <!-->s), exposure to smoking videos (150<!--> <!-->s) and pictures (150<!--> <!-->s), and handling tobacco paraphernalia (120<!--> <!-->s). Relief craving (the urge to use nicotine to alleviate negative emotions) and reward craving (the urge to use nicotine for its pleasurable effects) were measured pre/post cue exposure via the brief Questionnaire on Smoking Urges. HRV was continuously measured as root mean square of successive differences (RMSSD).</div></div><div><h3>Results</h3><div>Cue exposure increased relief and reward craving and reduced HRV across participants (p &lt; .001) without gender differences. Significant craving-HRV associations emerged only in women: those with higher exposure-induced reward craving showed the largest HRV reductions and recovery during paraphernalia handling (p &lt; 0.01), whereas those with higher exposure-induced relief craving had smaller HRV declines and weaker recovery (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>These findings reinforce HRV as a clinically relevant biomarker for tobacco cue reactivity and highlight gender differences in the autonomic nervous system’s role in craving among individuals with TUD, suggesting stronger involvement in women.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100407"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-volume buprenorphine prescribers: Examining state policy contexts","authors":"Megan S. Schuler ,&nbsp;Flora Sheng ,&nbsp;Brendan Saloner ,&nbsp;Adam J. Gordon ,&nbsp;Bradley D. Stein","doi":"10.1016/j.dadr.2025.100406","DOIUrl":"10.1016/j.dadr.2025.100406","url":null,"abstract":"<div><h3>Background</h3><div>Most patients prescribed buprenorphine depend on a small number of high-volume prescribers. However, little is known about how state policies may affect high-volume prescribing.</div></div><div><h3>Methods</h3><div>We used 2009–2018 IQVIA Real World Data – Longitudinal Prescriptions (a national dataset capturing approximately 90 % of U.S. retail pharmacy transactions) to examine associations between four state policies and high-volume buprenorphine prescribing (i.e., clinicians averaging ≥30 active buprenorphine patients/month). Using multivariable event-time linear probability models, we estimated the percentage-point changes in the share of prescribers qualifying as high-volume in the three years following the implementation of: (1) mandatory behavioral health counseling when prescribing buprenorphine, (2) mandatory substance use disorder-related continuing medical education (CME) for licensure, (3) Affordable Care Act (ACA) Medicaid expansion, and (4) mandatory prescription drug monitoring program (PDMP) laws.</div></div><div><h3>Results</h3><div>Of 109,218 clinicians who prescribed buprenorphine, 8.8 % were classified as high-volume prescribers for at least one year. Both high- and low-volume prescribers increased substantially over the study period, with total prescribers rising nearly 70 %. Policies mandating behavioral health counseling were consistently significantly associated with an increase in the share of high-volume prescribers post-implementation (Y1: +3.4 %age points; Y2: +5.1 %age points; Y3: +3.2 %age points). Conversely, mandatory PDMP laws were correlated with a decreased share of high-volume prescribers (Y1: −1.6 %age points; Y2: −3.2 %age points; Y3: −4.1 %age points). No significant associations were found for mandatory CME or ACA Medicaid expansion.</div></div><div><h3>Conclusions</h3><div>The proportion of buprenorphine prescribers who are high-volume increased during 2009–2018, reflecting faster growth among high-volume prescribers. Our findings indicate that state policies coincided with differential patterns of growth.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100406"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}