Journal of substance use and addiction treatment最新文献

{"title":"Recovery capital outcomes associated with an access to recovery program.","authors":"Terry L Bunn, Amber Kizewski, Robin Thompson, Madison Ashworth, Candace Brancato, Kelsey Carter, Ernest Fletcher","doi":"10.1016/j.josat.2026.210013","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210013","url":null,"abstract":"<p><strong>Introduction: </strong>The primary aims of state Access to Recovery (ATR) programs are to provide client choice among substance use disorder (SUD) clinical treatment and recovery support service (RSS) providers, increase access and linkage to a comprehensive range of clinical treatment and recovery support options, and increase SUD treatment and recovery support capacity. The purpose of this study was to assess the effectiveness of the Kentucky ATR (KATR) program in building recovery capital over time through participant utilization of RSSs such as recovery housing, transportation support, and basic needs (including employment support).</p><p><strong>Methods: </strong>KATR study participant data was collected at four time points: 1) intake (0 months); 2) KATR service completion (~3-6 months); 3) 3 months after service completion (~5-8 months); and 4) 12 months after study intake. Mixed random effects regression models were used to examine the impact of RSSs voucher utilization on key outcomes including recovery capital as measured by the Brief Assessment of Recovery Capital (BARC-10), employment, and resumption of substance use.</p><p><strong>Results: </strong>BARC-10 scores (p < 0.01), and rate of employment (p < 0.001) were significantly higher for participants who used recovery housing vouchers compared to participants who did not use recovery housing vouchers at all follow-up time points. After controlling for the effects of other RSS utilizations, there was no significant difference in measured recovery outcomes between those who used basic needs vouchers compared to those who did not utilize basic needs vouchers. Participants who used transportation vouchers had higher BARC-10 scores (p < 0.05) and lower resumption of substance use (p < 0.05) at follow-up time points than participants that did not use transportation voucher services.</p><p><strong>Conclusion: </strong>The KATR program was associated with improved recovery among persons in SUD treatment and/or early recovery. This study shows that utilization of a self-selected voucher-based program that provides access to recovery housing and transportation supports is associated with improved SUD long-term recovery as measured by validated recovery capital instruments.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210013"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857734","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":"Trends in Medicaid managed care benefits for opioid use disorder treatment, 2015-2019.","authors":"Olivia M Hinds, Melissa A Westlake, Sanskruti Patel, Skylar Gross, Amanda J Abraham, Colleen M Grogan, Christina M Andrews","doi":"10.1016/j.josat.2026.210014","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210014","url":null,"abstract":"<p><strong>Introduction: </strong>Medicaid is the largest payor of opioid use disorder (OUD) treatment in the United States and covers a large share of Americans with OUD. The majority of Medicaid enrollees participate in Medicaid managed care organization (MMCO) plans. However, little is known regarding which OUD treatment services and medications MMCO plans cover, which utilization management policies they impose, and whether there have been changes in these treatment benefits and policies over time. This study examined trends in MMCO plan benefits and utilization management for OUD treatment from 2015 to 2019.</p><p><strong>Methods: </strong>This descriptive study used a novel dataset on OUD treatment benefits and utilization management in all comprehensive MMCO plans active in 38 states plus the District of Columbia from 2015 to 2019 (n = 760 plan-years). We calculated the proportion of MMCO plans that provided evidence of coverage for seven OUD treatment services, three OUD treatment medications, and one opioid-overdose reversal medication. For covered treatment services and medications, we assessed whether MMCO plans imposed prior authorization requirements and quantity limits.</p><p><strong>Results: </strong>From 2015 to 2019, the proportion of MMCO plans reporting coverage of OUD treatment medications grew significantly. While only 18% of plans provided evidence of covering all three medications for OUD in 2015, 42% did so in 2019 (p < 0.001). Coverage for treatment services was more uneven, increasing only for residential and peer support services (from 50% to 74%, and from 35% to 45%, respectively). Despite these improvements in coverage, less than 5% of plans reported coverage for the full continuum of treatment in 2019. While prior authorization for OUD treatment medications decreased, use of quantity limits increased. Little change in use of prior authorization was observed for treatment services.</p><p><strong>Conclusions: </strong>While coverage of OUD treatment medications improved, coverage of treatment services did not. Only a small minority of MMCO plans provided evidence of coverage for the full continuum of OUD treatment. Future policy is needed to address these gaps in treatment service benefits to improve OUD-related outcomes.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210014"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857718","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":"Online support and co-rumination experiences among adults in substance use recovery.","authors":"Xiangyu Tao, María E Contreras Pérez, Arielle Estes, Vincent DiGioia-Laird, Margaret Swarbrick, Kristina Jackson","doi":"10.1016/j.josat.2026.210007","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210007","url":null,"abstract":"<p><strong>Objective: </strong>This study examined patterns of perceived social support and co-rumination (e.g., repeatedly discussing problems) in social media recovery groups and associated whole-person wellness among adults in recovery from substance use disorder (SUD).</p><p><strong>Methods: </strong>A cross-sectional online survey (n = 468) was conducted in collaboration with a Community Advisory Board (CAB). The CAB reviewed and refined the survey, led recruitment, interpreted results, and co-authored this manuscript. Latent profile analysis (LPA) identified subgroups based on four online social support domains and three co-rumination domains. Differences were tested in eight wellness dimensions across profiles, adjusting for demographics and engagement frequency.</p><p><strong>Results: </strong>Four profiles emerged: Low Support-Low Co-rumination, Moderate Support-Moderate Co-rumination, High Support-Minimal Co-rumination, and Very High Support-High Co-rumination. Support and co-rumination consistently co-occurred, and in most profiles, their levels aligned. Both high-support profiles reported higher wellness across all dimensions than the other groups.</p><p><strong>Conclusions: </strong>High-quality perceived support, whether paired with minimal or frequent co-rumination, was linked to greater engagement in wellness behaviors, challenging the view of co-rumination as uniformly maladaptive. Findings underscore the value of moving beyond abstinence-focused metrics toward outcomes that capture connection, purpose, and quality of life. Intentionally designed online recovery spaces that foster multidimensional support can harness co-rumination as a constructive force for sustaining recovery and promoting holistic wellness.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210007"},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847161","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":"Assessing impact of buprenorphine for opioid use disorder on infectious disease management.","authors":"Jamie Lo, Anusorn Thanataveerat, Amanda Manfredo, Jennifer Falk, Ni Zeng, Stephanie Wall, Taylor Ryan, William Pratt, Sami El-Dalati, Sabrina Gaiazov","doi":"10.1016/j.josat.2026.210010","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210010","url":null,"abstract":"<p><strong>Introduction: </strong>Injection opioid misuse is associated with the transmission of infectious diseases (IDs) such as hepatitis B and C, and skin and soft tissue infections. Medications for opioid use disorder (MOUD) are effective treatments for opioid use disorder (OUD) and can reduce ID risk and improve outcomes. This study compared the effect of buprenorphine extended-release (BUP-XR; SUBLOCADE®) vs. transmucosal buprenorphine (TM-BUP) treatment on ID-specific incidence rates, all-cause healthcare resource utilization (HCRU), and ID-specific HCRU among patients treated for OUD continuously for ≥90 days.</p><p><strong>Methods: </strong>This retrospective cohort study compared outcomes between patients receiving BUP-XR vs. TM-BUP using the Veradigm® Network EHR electronic health records and linked claims dataset. The study period spanned January 1, 2018 to June 30, 2024, with an index selection window from July 1, 2018 to December 31, 2023. The first qualifying buprenorphine treatment claim (either BUP-XR injection or TM-BUP prescription) during the selection window defined the index date. Descriptive analyses compared baseline characteristics of the BUP-XR and TM-BUP cohorts, while inverse probability of treatment weighting (IPTW) controlled for confounding. The analysis utilized generalized linear models with a difference-in-differences design to examine the primary outcomes.</p><p><strong>Results: </strong>A total of 467 patients met criteria for the BUP-XR cohort and 118,112 patients for the TM-BUP cohort. After applying IPTW, the weighted sample size was 437 in the BUP-XR cohort and 118,104 in the TM-BUP cohort. During the 6-month baseline period pre-index date, skin conditions and hepatitis B and C were the most common acute infections observed in both unweighted cohorts. The adjusted analyses demonstrated a statistically significant reduction of 62% in the incidence of bacteremia in the BUP-XR cohort during follow-up (95% CI: 26%-81%). Patients on BUP-XR consistently had lower overall HCRU compared to TM-BUP during follow-up, including 56% fewer inpatient visits (95% CI: 38%-69%), 22% fewer emergency department visits (95% CI: 6%-35%), 21% fewer all-cause outpatient visits (95% CI: 17%-24%), and 77% fewer outpatient visits for treating sexually transmitted infections (95% CI: 43.4%-90.5%).</p><p><strong>Conclusions: </strong>Patients on BUP-XR showed a reduction in the incidence of bacteremia and overall HCRU relative to those on TM-BUP.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210010"},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847201","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 conceptual integration model of spiritual inclusivity in the Twelve Steps.","authors":"Kristy Carlisle, Richie Kubilus, Aaron Albright, Levi Roberts","doi":"10.1016/j.josat.2026.210011","DOIUrl":"10.1016/j.josat.2026.210011","url":null,"abstract":"<p><strong>Introduction: </strong>Twelve-Step programs such as Alcoholics Anonymous (AA) remain among the most influential and widely utilized frameworks for addiction recovery. However, their Euro-Christian language and cultural assumptions can limit accessibility for individuals from non-Christian or diverse backgrounds. This paper explores the spiritual inclusivity of the Twelve Steps by examining their philosophical parallels with multiple world traditions, including mindfulness, Buddhism, Hinduism, Islam, Judaism, and Indigenous spiritualities.</p><p><strong>Methods: </strong>Using interpretive comparative analysis, the manuscript examines foundational Twelve-Step literature alongside scholarly sources from diverse spiritual traditions. The analysis identifies shared constructs across traditions and organizes them into comparable spiritual processes embedded within the Twelve Steps.</p><p><strong>Results: </strong>The analysis identifies shared constructs of surrender, humility, accountability, purification, and service that transcend religious boundaries. These parallels reveal the Twelve Steps as a trans-religious and psychologically integrative model capable of adaptation across diverse belief systems.</p><p><strong>Conclusions: </strong>Recognizing this universality expands the cultural reach of Twelve-Step programs and strengthens their relevance to contemporary recovery practice. Articulating cross-spiritual parallels supports culturally responsive treatment, counselor education, and spiritual integration in behavioral health settings.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210011"},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847231","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":"Program personnel perspectives and outcomes of the Minnesota Addiction Recovery Initiative (MARI) Safe Station program: A fire station-based substance use deflection program","authors":"Nathan W. Koranda ,&nbsp;Jeremiah Fairbanks ,&nbsp;Sheila Specker ,&nbsp;Julie M. Krupa ,&nbsp;Jaymie Mark ,&nbsp;Christine Klein ,&nbsp;Breanna Barrett ,&nbsp;Esther (Seol Ju) Moon ,&nbsp;Brandon A. Knettel","doi":"10.1016/j.josat.2026.209891","DOIUrl":"10.1016/j.josat.2026.209891","url":null,"abstract":"<div><h3>Introduction</h3><div>The Minnesota Addiction Recovery Initiative (MARI) Safe Station program, launched in April 2023, provides a self-referral pathway for individuals with substance use disorders, including opioid use disorder. Operating through a coalition of government and community organizations, MARI Safe Station uses fire stations as access points for immediate support provided by certified peer recovery specialists (CPRSs). The program also emphasizes community outreach and harm-reduction efforts such as distributing naloxone and other supplies and delivering training to reduce provider stigma. In this study, we report early data on program engagement and perspectives of personnel involved in implementation.</div></div><div><h3>Methods</h3><div>Program participants could enter a fire station, where a CPRS performed comprehensive substance use assessment and made referrals for treatment needs. We obtained descriptive data from Safe Station participants at intake, including demographics and recovery needs. We collected additional mixed-methods data from program personnel, including qualitative interviews (<em>n</em> = 28) and one group interview (<em>n</em> = 3) to understand perspectives on the program, and a brief evaluation of attitudes toward opioid use disorder before and after an educational session.</div></div><div><h3>Results</h3><div>During the 18-month data collection period, 174 individuals completed the MARI Safe Station intake and screening process. Clients were demographically diverse and presented with housing instability, barriers to recovery, and substance use. Program personnel expressed programmatic strengths such as accessibility and scalability, while noting challenges including staff turnover, communication gaps, and concerns for long-term sustainability. The educational session led to a modest reduction in provider stigma, which should be interpreted with caution given the <strong>s</strong>mall and unpaired samples.</div></div><div><h3>Conclusions</h3><div>Preliminary findings highlight MARI Safe Station's ability to provide accessible, equitable addiction recovery services and reduce stigma, while identifying areas for continued improvement as the program evolves.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209891"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047522","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":"“It's like scratching at the door”: Experiences of outpatient buprenorphine low dose initiation among people using fentanyl","authors":"Leslie W. Suen ,&nbsp;Elyssa Samayoa ,&nbsp;Matthew A. Spinelli ,&nbsp;Maia Scarpetta ,&nbsp;Kelly R. Knight ,&nbsp;Julia Chael ,&nbsp;Christine S. Soran ,&nbsp;Michelle Geier ,&nbsp;Hannah R. Snyder ,&nbsp;Phillip O. Coffin","doi":"10.1016/j.josat.2026.209893","DOIUrl":"10.1016/j.josat.2026.209893","url":null,"abstract":"<div><h3>Background</h3><div>The fentanyl-driven overdose crisis has heightened challenges in buprenorphine initiation, as traditional methods risk precipitated withdrawal due to fentanyl's prolonged presence in the body. Buprenorphine low-dose initiation (LDI) offers a gradual approach to starting buprenorphine but requires continued full-agonist opioid use in outpatient settings, where success rates remain low and patient experiences have not been evaluated.</div></div><div><h3>Objectives</h3><div>To identify barriers and facilitators to successful LDI completion and inform strategies to improve outpatient buprenorphine treatment.</div></div><div><h3>Methods</h3><div>We conducted 19 semi-structured interviews with people with opioid use disorder using fentanyl who had attempted LDI in the past three months. Using the COM-B framework, we applied thematic analysis to identify barriers and facilitators to LDI completion from interviews until reaching thematic saturation.</div></div><div><h3>Results</h3><div>We found that barriers and facilitators to LDI completion were linked to five COM-B model components: physical capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation. Despite high desirability and acceptability among participants towards starting LDI, several main barriers to LDI completion emerged, including difficulty tolerating “waves” of discomfort throughout LDI, anticipatory anxiety of precipitated withdrawal with each buprenorphine dose, lack of symptomatic response from small buprenorphine doses, loss of “high” from fentanyl, readily available fentanyl access leading to temptations to use, unstable or triggering housing environments, and being around others using fentanyl. Facilitators for completing LDI included increased optimism for success, the appeal of gradual recovery, bubble-packing medications, use of prescribed and non-prescribed drugs, supportive personal relationships, and non-stigmatizing clinic and pharmacy environments.</div></div><div><h3>Conclusions</h3><div>Our study applied a novel behavior-change framework to understanding barriers and facilitators to LDI completion. Barriers aligned closely with the COM-B model, providing a foundation for developing future interventions to enhance buprenorphine uptake and acceptability among people with OUD using fentanyl. Addressing barriers to automatic motivation is likely to have the largest benefit, with interventions such as incentivization (<em>e.g.</em>, gift cards for completing LDI), environmental restructuring (<em>e.g.</em>, temporary housing or comfort spaces for LDI), behavior modeling (<em>e.g.</em>, peer coaches), and enablement (<em>e.g.</em>, 24/7 phone lines for patients to call) most directly addressing this barrier category.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209893"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088085","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":"Economic analysis of a low-threshold mobile medical unit dispensing buprenorphine for opioid use disorder","authors":"Kanya K. Shah ,&nbsp;Sarah Messmer ,&nbsp;Abigail Elmes-Patel ,&nbsp;Daniel R. Touchette","doi":"10.1016/j.josat.2026.209900","DOIUrl":"10.1016/j.josat.2026.209900","url":null,"abstract":"<div><h3>Background</h3><div>The University of Illinois Chicago (UIC) Community Outreach Intervention Project (COIP) established a low-threshold mobile medical unit that is among the first to carry and dispense buprenorphine on-site at point of care in Chicago neighborhoods with high opioid overdose rates. A deeper understanding of the mobile medical unit implementation and operation costs is needed to inform sustainability and financial planning for healthcare systems across the country. This study measured the implementation, operation, and indirect patient costs of the UIC COIP mobile medical unit.</div></div><div><h3>Methods</h3><div>We conducted three analyses to determine start-up, direct fixed operating, direct variable operating, and indirect costs of the UIC COIP mobile medical unit. (1) Micro-costing of administrative purchasing records and on-site time-motion studies determined operation costs. (2) Interviews with staff and providers identified resources and time invested in implementation, and supplemented time-motion observations. (3) Interviews with patients collected indirect costs (i.e. transportation time/cost, missed commitments, perceived alternatives). Additionally, we conducted sensitivity analyses to assess uncertainty in resources used, costs, and mobile medical unit operation assumptions.</div></div><div><h3>Results</h3><div>The startup costs for a mobile medical unit with buprenorphine dispensing capabilities were $148,690, including buildout, supplies, and labor. Annual fixed operating costs were $131,040, encompassing vehicle operations (i.e. fuel, maintenance) and resources for medical operations (i.e. cellular network, urine testing). Variable operating costs included patient care cost of $85.24 per patient, and aggregate salaries for staff on the mobile medical unit, which were $1082 per day. Indirect patient costs were assessed in 30 individuals; the average transportation time to the care site was 35 min, most individuals did not miss other obligations to present for care, and 40% of individuals would not seek care elsewhere if the mobile unit was not available.</div></div><div><h3>Conclusion</h3><div>We report start-up and operation costs of a mobile medical unit that provides care and on-site buprenorphine dispensing in Chicago neighborhoods with high need. Understanding the implementation and operation costs of a low-threshold mobile medical unit is imperative to justify the continuation and expansion, as well as inform future research assessing the value and cost-effectiveness of such an intervention for the health system and community.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209900"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042229","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":"Hope, resilience, and ambiguous loss among affected family members of individuals with substance use disorders","authors":"Alexia Florentin ,&nbsp;Kathleen Rice","doi":"10.1016/j.josat.2026.209912","DOIUrl":"10.1016/j.josat.2026.209912","url":null,"abstract":"<div><h3>Introduction</h3><div>Substance use disorders (SUDs) profoundly affect not only individuals but also their families. Affected family members (AFMs) frequently experience ambiguous loss (AL) – a form of loss marked by uncertainty and lack of closure – as their loved one is physically present but psychologically absent due to addiction. Despite its prevalence, limited quantitative research examines the role of psychological strengths such as hope and resilience in mitigating AL among AFMs. This study investigates the statistical associations of hope and resilience on AL, with demographic factors explored as potential moderators.</div></div><div><h3>Methods</h3><div>This cross-sectional, quantitative study recruited 708 AFMs (e.g., spouses, parents, siblings, close friends “like family”) of individuals with SUDs through the use of Qualtrics as the main recruitment medium. Participants completed the Ambiguous Loss Inventory Plus (ALI+), Adult Hope Scale (AHS), and Brief Resilient Coping Scale (BRCS). Data were analyzed using multiple regression to examine statistical associations, and moderation analyses to assess the influence of age, gender, and relationship type.</div></div><div><h3>Results</h3><div>Hope (β = −0.28, <em>p</em> &lt; .001) and resilience (β = −0.23, <em>p</em> &lt; .001) were both significantly and negatively associated with ambiguous loss, collectively accounting for 13.6% of the variance. Hope demonstrated a slightly stronger association with ambiguous loss than resilience. A second regression model supported the robustness of these associations (R² = 0.042, <em>p</em> &lt; .001). Moderation analyses indicated that age (β = −0.731, <em>p</em> &lt; .001) and relationship type (β = 0.215, <em>p</em> = .014) were significantly associated with ambiguous loss, such that older age was linked to lower ambiguous loss and closer relationships were linked to higher ambiguous loss; however, no demographic variables significantly moderated the associations between hope, resilience, and ambiguous loss.</div></div><div><h3>Conclusions</h3><div>Findings highlight the universal protective role of hope and resilience in mitigating AL for AFMs, regardless of demographic differences. Addiction counselors should integrate evidence-based interventions such as solution-focused therapy, CBT, and positive psychology to cultivate hope and resilience in AFMs. Counselor supervisors and educators should ensure training emphasizes ambiguous loss and strength-based strategies to better support families impacted by SUDs.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209912"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127628","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":"Understanding health literacy and perceptions of substance use disorder among racial and ethnic minority communities: Insights from the health belief model","authors":"Amanda I. Aguila Gonzalez ,&nbsp;Elizabeth Ablah","doi":"10.1016/j.josat.2026.209907","DOIUrl":"10.1016/j.josat.2026.209907","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2022, approximately 23.1% of U.S. adults had a substance use disorder (SUD). In the same year, approximately 17.7% of Kansas adults had a SUD. Racial and ethnic minority communities often experience disproportionate impacts of SUD, including greater prevalence and mortality. Limited research exists on how individuals in these communities conceptualize SUD. The current study sought to: 1) assess SUD health literacy among individuals from racial/ethnic minority communities, 2) describe how members of four racial/ethnic communities (specifically American Indian/Alaska Native, Asian/Asian American, Black/African American, and Hispano/Latino) define SUD, and 3) characterize perceptions of SUD through the lens of the Health Belief Model.</div></div><div><h3>Methods</h3><div>Semi-structured, one-hour qualitative interviews were conducted virtually or by phone with participants from each racial/ethnic community.</div></div><div><h3>Results</h3><div>Eighty-one interviews were completed with adults residing in Wichita, Kansas, who identified within one of the groups. Across all groups, participants defined SUD as “<em>dependence,</em>” a “<em>lack of control,</em>” and a means of coping with daily stressors. Perceptions of SUD prevalence, overall and within one's own racial/ethnic community, were greater among American Indian/Alaska Native, Black/African American, and Hispanic/Latino participants than among Asian/Asian American participants. All groups identified historical trauma, grief, discrimination, and mental health challenges as contributing factors to SUD. Depression was emphasized by Black and Hispanic/Latino participants. Across all four racial/ethnic groups, it was most reported that they would consider seeking treatment if SUD began to significantly interfere with daily life or if encouraged by loved ones.</div></div><div><h3>Conclusion</h3><div>Participants' definitions of SUD were shaped more by cultural background, education, and personal or familial exposure, rather than clinical definitions. Definitions emphasized the impact of SUD on the family rather than on mental and physical health implications. Perceptions of SUD revealed both shared and distinct views across communities. All groups identified perceived benefits of abstaining from substance use (e.g. improved health, longevity, functional ability), which may inform culturally sensitive prevention and outreach efforts.</div><div>This study underscores the importance of tailoring interventions to reflect the cultural values and lived experiences of racial/ethnic communities. Understanding how these communities conceptualize and perceive SUD is critical to designing culturally responsive health literacy materials.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209907"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115129","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}