Journal of substance use and addiction treatment最新文献

{"title":"Pilot testing a multi-level stigma intervention to improve substance use care with providers in mental health settings: A cluster-randomized trial.","authors":"Erin Fanning Madden, Fares Qeadan, Jennifer Hettema, Benjamin Tingey, Mark K Greenwald, Felicia Frabis, Mindy Vincent, Kimberly Page","doi":"10.1016/j.josat.2026.210026","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210026","url":null,"abstract":"<p><strong>Introduction: </strong>Stigma toward substance use disorders (SUD) lowers care quality, but little is known about such stigma in mental health (MH) settings. Past research suggests training reduces stigma among healthcare professionals. Additional approaches addressing upstream drivers of stigma are largely unknown, despite evidence that organizational context contributes to SUD stigma. This study aimed to develop and test a multi-level intervention addressing both professional and organizational SUD stigma.</p><p><strong>Methods: </strong>This study used mixed methods to evaluate an intervention composed of professional training and organizational policy change at two outpatient MH sites. The policy change was identified via systematic policy review and qualitative interviews with site staff. The Controlled Substances Agreement (CSA) was selected as the modifiable policy, which encouraged clinicians to provide documents listing patient behavioral expectations for CS prescriptions and repercussions for violations. The CSA policy was altered to include a conversation tool and CSA text eliminated stigmatizing language and promoted shared decision-making. A cluster-randomized trial assessed the multi-level intervention with an experimental arm (policy+training) and a control arm (only training). Prescribing MH providers were the primary sampling unit/clusters and patient electronic health records were secondary. Surveys and qualitative interviews assessed primary intervention feasibility outcomes and secondary attitude outcomes. Mixed-effect modified Poisson regressions evaluated changes in primary efficacy outcomes of diagnosing SUD, prescribing SUD pharmacotherapy, and retention in MH care among patients with SUDs.</p><p><strong>Results: </strong>Ten prescribing providers (n = 5 per arm) participated in surveys and n = 20 MH staff participated in interviews. Qualitative and quantitative data demonstrated intervention feasibility. Pilot efficacy data suggested only the control arm increased diagnosing SUD from pre- to post-intervention periods (aPR = 1.94, 95% CI: 1.05-3.61). Neither arm significantly changed prescribing SUD pharmacotherapy, retention, or stigmatizing attitudes. Triangulation with qualitative data revealed that MH professionals agreed SUD stigma may occur at their site but justified avoiding SUD patients and SUD treatment provision as a legitimate limit to their scope of practice.</p><p><strong>Conclusion: </strong>The intervention was feasible, but future SUD stigma research may explore organizational policies that expand MH clinicians' scope of practice perceptions, such as through integrated care programs, consultations with specialized SUD clinicians, or referral support.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210026"},"PeriodicalIF":1.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984608","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":"\"We need to keep in mind that battle fatigue\": A commentary on moral injury among substance use treatment and community service providers.","authors":"Elizabeth C Saunders, Bethany McLeman, Lisa A Marsch, Sarah K Moore, Brittney Ackerson, Amanda Cowan, Shauna M Filion, Ryan Fowler, Lindsay Fox, John Gary, John Hamilton, Rich Jones, Ayana Jordan, Roxanne Kibben, Malika Lamont, Tricia Lawdahl, Jay Pee, Jennifer Potter, Michelle Peavy, Thekla B Ross, David Scott, Edward Suarez, Noel Vest, Hoa Vo, Quandra Blackeney, Carmen Rosa, Steven H Chapman","doi":"10.1016/j.josat.2026.210023","DOIUrl":"10.1016/j.josat.2026.210023","url":null,"abstract":"<p><strong>Introduction: </strong>Moral injury is the psychological distress resulting from actions, or the lack thereof, which violate one's moral or ethical code. There is a notable gap in literature exploring moral injury among substance use disorder (SUD) treatment and community service providers. Despite the lack of literature describing moral injury among the SUD workforce, moral injury was discussed extensively during meetings of the Community Representative Council (CIRCL) of the National Drug Abuse Treatment Clinical Trials Network (CTN), which engages community members within the CTN Nodes to understand perspectives of people with lived/living experience and those providing substance use services.</p><p><strong>Methods: </strong>In response to this consistently raised topic, this commentary reviews the literature on moral injury related to the SUD workforce, as well as the perspectives of CIRCL members on the unique and persistent challenges faced by SUD treatment and community services providers.</p><p><strong>Results: </strong>Members of CIRCL in the SUD treatment and community provider workforce consistently described experiencing morally injurious events, including acts of commission and omission, bearing witness, and observing betrayal from those in power. While some experiences are akin to those experienced by providers in other healthcare settings, some were unique to front-line SUD treatment and community services providers. These experiences caused intense experiences of guilt, isolation, and hopelessness, sometimes contributing to turnover.</p><p><strong>Conclusions: </strong>Addressing moral injury among the SUD provider workforce may require unique mitigation and prevention strategies, potentially involving structural changes at the organizational, social, and policy levels that support the SUD treatment and community service workforce, ultimately improving not just the wellbeing of providers and patients, but the wellbeing of our communities.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210023"},"PeriodicalIF":2.8,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of patients declining to participate in opioid overdose prevention clinical research in an emergency department setting.","authors":"Ralph C Ward, Gabriel Brigham, Kelly S Barth, Lindsey K Jennings, Carrie E Papa, Allison J Smith, Alain H Litwin, Louise Haynes, Tim Matheson, Susan Sonne, Leah Heineck, Erin A McClure","doi":"10.1016/j.josat.2026.210028","DOIUrl":"10.1016/j.josat.2026.210028","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency Departments (ED) are important settings for initiating care following a non-fatal opioid overdose (NFOO). While ED-based interventions, including peer-led recovery support and initiation of medications for opioid use disorder (MOUD), are promising methods for reducing subsequent overdoses and mortality, randomized trials of ED-based overdose prevention or treatment- linkage interventions demonstrate that a substantial proportion of patients decline participation. The current secondary analysis is designed to characterize individuals who declined to participate in one such study.</p><p><strong>Methods: </strong>Data were used from the Peer Intervention to Link Overdose Survivors to Treatment (PILOT) trial, which was a multi-site study conducted in three US-based EDs that randomized participants to a 6-month peer-led overdose prevention intervention or treatment as usual in the ED. Demographics and clinical characteristics of those enrolled in PILOT (n = 150) were compared to those who declined to participate but completed a screening exit survey (ScrES; n = 46).</p><p><strong>Results: </strong>Among those who declined study participation, 76% had experienced a prior overdose preceding the current overdose that brought them into the ED (58.7% within the past 72 h), 56.5% were not currently engaged in substance use treatment and among those, 65.4% expressed a desire for treatment. Odds of declining study participation decreased with age by 6% per year (OR = 0.94, 95% CI: 0.9, 0.99); those with any college experience had odds of declining at 3 times greater than those without a high school diploma (OR = 3.4, 95% CI: 1.2, 10.1). Those without health insurance had odds of declining nearly 3 times those with insurance (OR = 2.9, 95% CI: 1.2, 7.0). Frequently cited reasons for declining were a desire to leave the ED or feeling unwell (39.1%), lack of interest in research (30.4%) and a belief the intervention would not be helpful (17.4%).</p><p><strong>Conclusions: </strong>Results from this analysis characterize ED patients declining to participate in peer-led overdose prevention research with the goals of enhancing future recruitment strategies and enrolling more representative samples to reduce subsequent overdoses. Future work is needed to determine how to better engage priority populations at critical touch points, while ensuring that interventions are flexible, patient-centered, and potentially offer remote access.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210028"},"PeriodicalIF":2.8,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"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":"“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":"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}

{"title":"The community representative council of the National Drug Abuse Treatment Clinical Trials Network: Co-design and early impact.","authors":"Sarah K Moore, Bethany McLeman, Elizabeth C Saunders, Steven H Chapman, Lisa A Marsch, Brittney Ackerson, Amanda Cowan, Deanna P Doss, Shauna Filion, Ryan Fowler, Lindsay Fox, John Gary, John Hamilton, Rich Jones, Ayana Jordan, Roxanne Kibben, Malika Lamont, Tricia Lawdahl, Jeremy Martin, Jay Pee, Jennifer Potter, Michelle Peavy, Thekla B Ross, David Scott, Edward Suarez, Noel Vest, Hoa Vo, Carmen Rosa","doi":"10.1016/j.josat.2026.210012","DOIUrl":"10.1016/j.josat.2026.210012","url":null,"abstract":"<p><p>Authentic community engagement requires partnership with those who share similar situations, concerns, or challenges. Community engagement in research can promote equitable representation, help inform important research questions and deliverables, and increase the likelihood of developing relevant and appropriate interventions that will be implemented and sustained. Established in 1999, the National Drug Abuse Treatment Clinical Trials Network (CTN) is a cooperative agreement within the National Institute on Drug Abuse (NIDA) and functions as a nationwide consortium of research scientists, treatment providers and other community members collaborating to improve care for substance use in communities across the US. The CTN is committed to community-engaged research. Developed in 2023, the CTN Community Representative Council (CIRCL) formed as a natural progression of this commitment, designed to systematically identify front line challenges warranting research and to recognize emerging community-based innovations - forms of \"practice-based evidence\" developed in response to real-world needs. CTN Nodes (regional hubs) nominated community members, many of whom are people with lived experience (PWLE) of substance use to serve as Council representatives to enhance the identification, communication, and dissemination of the needs and experiences of individuals served by CTN research across the US. This commentary provides an overview of CIRCL's conceptualization and creation, operation, and impacts on CTN communities in its first year.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210012"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing patterns of indigenous neglect in co-occurring posttraumatic stress and substance use disorder research: A systematic review","authors":"Mallet R. Reid ,&nbsp;Nikki K. Apana ,&nbsp;Steffi M. Kim ,&nbsp;Susana Helm","doi":"10.1016/j.josat.2026.209906","DOIUrl":"10.1016/j.josat.2026.209906","url":null,"abstract":"<div><h3>Introduction</h3><div>American Indian/Alaska Native (AI/AN) and Native Hawaiian/Pacific Islander (NH/PI) peoples experience disproportionate burdens of posttraumatic stress disorder (PTSD) and substance use disorder (SUD), which frequently co-occur (PTSD/SUD). Historical trauma, structural inequities, and discrimination may exacerbate the severity and chronicity of these disorders. This review aimed to assess the extent to which PTSD/SUD clinical research includes these Indigenous groups and whether interventions are designed or adapted to meet their specific experiences and risk factors.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of PTSD/SUD studies in the United States. From 135 studies identified in prior systematic reviews and meta-analyses, 66 studies met inclusion criteria. We extracted participant demographic data to quantify Indigenous (AI/AN and NH/PI) representation, assessed whether interventions tested effectiveness across racial groups with attention to Indigenous participants, examined whether interventions were culturally adapted for Indigenous groups, and evaluated whether studies that included higher proportions of Indigenous participants employed distinct recruitment strategies or methodological approaches.</div></div><div><h3>Results</h3><div>Indigenous participants comprised only 2.2% of all participants. Over half of all studies failed to include Indigenous participants. Only one study tested a culturally adapted intervention. In contrast, over half of studies recruited women or veterans and studied their challenges. Only two studies evaluated outcomes by race, yet neither included Indigenous people. Studies that included higher numbers of Indigenous participants often recruited women exposed to violent trauma or veterans in regions with larger Indigenous populations; however, most studies recruited few or no Indigenous participants regardless of population or location.</div></div><div><h3>Conclusions</h3><div>We identified a pattern of Indigenous neglect marked by underinclusion, a lack of attention to Indigenous groups relative to other groups, and insufficient evaluation of treatment outcomes for these groups. These issues limit our understanding of what works for Indigenous groups with PTSD/SUD. We make recommendations for addressing these issues.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209906"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145048","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}