Journal of substance use and addiction treatment最新文献

{"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":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824466","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":"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}

{"title":"Differences in MOUD receipt by legal referral type in outpatient treatment","authors":"John Moore ,&nbsp;Tanya Renn ,&nbsp;Christopher Veeh ,&nbsp;Sara Beeler","doi":"10.1016/j.josat.2026.209888","DOIUrl":"10.1016/j.josat.2026.209888","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid use and opioid use disorder (OUD) are prevalent among persons with legal system involvement. Medications for opioid use disorder (MOUD) are recommended for treatment, yet access is limited for legal-involved populations. In outpatient treatment settings, persons with legal-system involvement are less likely to receive MOUD. However, the influence of the type of legal system involvement on MOUD access is understudied. The purpose of this study was to examine if MOUD receipt differs by the type of legal system referral among adults referred to outpatient treatment by the legal system.</div></div><div><h3>Methods</h3><div>Data came from the 2021–2022 Treatment Episode Dataset-Admissions (TEDS-A). The sample included 32,213 legal-involved adult admissions to outpatient treatment for primary opioid use. The independent variable was the type of legal system referral; court/diversionary program, probation or parole, prison, or other. The outcome was whether MOUD was included in the treatment plan. Covariates included the following sociodemographic, substance use, and treatment-related variables: sex, age, race/ethnicity, education, employment, living arrangement, prior substance use treatment, co-occurring mental disorder, type of opioid use, attendance of a substance use self-help group, outpatient treatment type, injection drug use, past-month arrest, and past-month opioid use frequency. Multivariable logistic regression was used to examine associations of referral type with MOUD, adjusting for sociodemographic, substance use, and treatment-related covariates.</div></div><div><h3>Results</h3><div>Compared to court/diversionary referral, probation or parole referral (AOR = 0.80, 95% CI = 0.76–0.85), prison referral (AOR = 0.85, 95% CI = 0.76–0.94) and other referral (AOR = 0.42, 95% CI = 0.39–0.46) were each associated with lower odds of MOUD when adjusting for covariates. Use of other opioid analgesics and synthetic opioids was associated with lower odds of MOUD than heroin use (AOR = 0.48, 95% CI = 0.46–0.51).</div></div><div><h3>Conclusions</h3><div>MOUD access in the community varies by the type of legal system referral. To inform MOUD community linkage policies and practices, research is needed to identify gaps in referral processes for specific legal system institutions. Examining how opioid use behavior characteristics impact MOUD community linkage is an appropriate next step for future research.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209888"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042216","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":"Treatment of opioid use disorder in pregnancy among individuals with and without co-occurring stimulant use disorder: A retrospective cohort study","authors":"Elizabeth Charron ,&nbsp;Amanda A. Allshouse ,&nbsp;Casey Tak ,&nbsp;Kristine A. Campbell ,&nbsp;Adam J. Gordon ,&nbsp;Gerald Cochran ,&nbsp;Marcela C. Smid","doi":"10.1016/j.josat.2026.209902","DOIUrl":"10.1016/j.josat.2026.209902","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid use disorder (OUD) exists in approximately 1% of US pregnancies and is associated with increased risk of severe maternal morbidity and mortality. Many pregnant individuals with OUD also have a stimulant use disorder (StUD), but it is unclear whether this co-occurring condition changes the types of treatment services they receive. We compared treatment services received during pregnancy between individuals with both OUD and StUD and those only with OUD.</div></div><div><h3>Methods</h3><div>A retrospective cohort study used 2014–2017 data from the Utah All-Payer Claims Database. The sample included pregnancies ≥20 weeks' gestation among individuals aged 15–49 years with ≥4 weeks of insurance enrollment and excluded pregnancies with outcome events occurring &lt;28 weeks after the estimated conception date. Identification of OUD and StUD relied on ICD-9/10 diagnosis codes. Outcomes were receipt of (1) medication for OUD (MOUD; formulations of buprenorphine or methadone administration), (2) outpatient psychosocial services (evaluation and management/assessment services and psychotherapy/counseling or other psychosocial visits), and (3) higher-intensity treatment (intensive outpatient, partial hospitalization, or residential treatment). Logistic generalized estimating equation models, adjusted for demographic and clinical covariates, estimated odds of receiving each service and any service overall.</div></div><div><h3>Results</h3><div>Among 146,239 insurance beneficiaries, we identified 1206 pregnancies with OUD, including 305 (25.3%) with co-occurring StUD and 901 (74.7%) only with OUD. Pregnant individuals with StUD and OUD compared to those only with OUD had lower odds of receiving MOUD (adjusted odds ratio [aOR], 0.68; 95% CI, 0.48–0.96) and higher odds of receiving psychotherapy/counseling or other psychosocial visits (aOR, 2.73; 95% CI, 2.01–3.71) and higher-intensity treatment (aOR, 3.47; 95% CI, 1.58–7.59). There were no differences between groups in receipt of evaluation and management/assessment services (aOR, 0.97; 95% CI, 0.83–1.14) or of any treatment service overall (aOR, 1.07; 95% CI, 0.94–1.21).</div></div><div><h3>Conclusions</h3><div>In this sample of Utah insurance beneficiaries, pregnant individuals with co-occurring StUD and OUD were less likely to receive MOUD and more likely to receive psychosocial and higher-intensity services than those only with OUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209902"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015552","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 role of relationship impairment on the link between posttraumatic stress severity and heavy episodic drinking varies by sex","authors":"Katharine L. Thomas ,&nbsp;Anka A. Vujanovic ,&nbsp;Michael J. Zvolensky ,&nbsp;Tanya Smit ,&nbsp;Julia D. Buckner","doi":"10.1016/j.josat.2026.209889","DOIUrl":"10.1016/j.josat.2026.209889","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Posttraumatic stress symptoms are related to higher rates of heavy episodic drinking (HED). Given that women are at higher risk for posttraumatic stress symptoms and long-term health effects from HED, identification of factors related to HED among women with posttraumatic stress symptoms could have important implications for prevention and treatment. One such factor is romantic relationship impairment given the association between posttraumatic stress and greater relationship conflict. Further, women, but not men, are more likely to drink in heavy quantities when experiencing relationship difficulties. Thus, it may be that for women, but not men, PTSD is related to heavier drinking via relationship impairment.</div></div><div><h3>Method</h3><div>This study tested whether sex moderated the indirect effect of posttraumatic stress symptoms on HED through relationship impairment among 319 community-recruited adults with probable PTSD who endorsed current hazardous alcohol use and were living with a romantic partner and/or married.</div></div><div><h3>Results</h3><div>Posttraumatic stress symptoms were positively correlated with HED and relationship impairment. The indirect effect of posttraumatic stress symptoms on HED through relationship impairment was moderated by sex, such that posttraumatic stress symptoms were related to HED indirectly via relationship impairment for women, but not men.</div></div><div><h3>Discussion and conclusions</h3><div>Results highlight the importance of considering sex to better understand the role of posttraumatic stress symptoms on HED. Failure to consider sex could obfuscate the impact of factors relevant to women.</div></div><div><h3>Scientific significance</h3><div>This is the first known study to examine the differential relations between posttraumatic stress, romantic relationship impairment, and HED by sex.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209889"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031918","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":"Differences in take-home methadone receipt by state policy and individual social factors in a multistate survey of people who use drugs: A cross-sectional study","authors":"Olivia K. Sugarman ,&nbsp;Jirka Taylor ,&nbsp;Samantha J. Harris ,&nbsp;Sachini Bandara ,&nbsp;Brendan Saloner ,&nbsp;Noa Krawczyk","doi":"10.1016/j.josat.2026.209909","DOIUrl":"10.1016/j.josat.2026.209909","url":null,"abstract":"<div><h3>Background</h3><div>Methadone is a highly effective, strictly regulated medication to treat opioid use disorder. COVID-19 flexibilities allowed for up to 28 days of take-homes versus daily travel to clinics for observed dosing, but receiving take-homes differed widely across clinics and individuals. We examined the relationship between state take-home policies and social vulnerability on take-home methadone receipt and days' supply.</div></div><div><h3>Methods</h3><div>Data were from the VOICES study, a telephone survey conducted between 1/2023–8/2024 of people who use drugs from Wisconsin, Michigan, New Mexico, and New Jersey. We estimated average marginal effects of state methadone policy (flexibility-adoption vs non-adoption) on methadone take-home receipt and days' supply. Models were fully adjusted for individual sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Most participants were recruited from flexibility-adoption states (<em>n</em> = 285/428, 67%). Over half received take-home methadone (65%; average 3.1 days' supply, SD 6.2); 19% of take-home recipients (<em>n</em> = 54) received ≥3 days' supply. Take-home receipt was higher for participants in flexibility-adoption states (AME 0.52, <em>p</em> &lt; 0.0001). Receiving ≥3 days' supply was lower in people reporting unemployment (vs. employment, AME −0.23, <em>p</em> = 0.0032) and past 30-day drug use (vs. no drug use, AME −0.23, <em>p</em> = 0.0014).</div></div><div><h3>Conclusions</h3><div>State take-home policy was most strongly associated with take-home methadone receipt. Receiving longer days of take-home supplies remains rare. Take-home eligibility guidelines should be established and consider potential social vulnerability factors to daily on-site dosing.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209909"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127659","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 the impact of nicotinic partial agonists compared to NRT on opioid and cigarette use: A secondary analysis investigating treatment outcomes for co-occurring nicotine and opioid use","authors":"Zachary C. Rich ,&nbsp;Hilary A. Tindle ,&nbsp;Debbie M. Cheng ,&nbsp;Michael D. Stein ,&nbsp;Natalia Gnatienko ,&nbsp;Sally Bendiks ,&nbsp;Leah Forman ,&nbsp;Gregory J. Patts ,&nbsp;Evgeny Krupitsky ,&nbsp;Matthew S. Freiberg ,&nbsp;Jeffrey H. Samet","doi":"10.1016/j.josat.2026.209904","DOIUrl":"10.1016/j.josat.2026.209904","url":null,"abstract":"<div><h3>Introduction</h3><div>Cigarette and opioid use are two leading causes of preventable death and disability in the United States and are often comorbid. Nicotinic partial agonists, such as varenicline and cytisine, are considered highly effective for Nicotine Use Disorder in the general population. However, their efficacy and safety in smokers who use opioids remain unclear, with concerns about reduced efficacy or increased opioid use. We evaluated the impact of nicotinic agonists compared to nicotine replacement therapy (NRT) on opioid and cigarette use.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of the St PETER HIV study, a randomized, double-blinded, placebo-controlled trial of 400 HIV-positive individuals recruited from July 2017 to December 2020 at HIV care sites in St. Petersburg, Russia. Participants (daily smokers with risky alcohol use) were randomized to varenicline, cytisine, or NRT. Our analysis focused on the 97 participants who reported opioid use at baseline. Logistic regression assessed the relationship between treatment arms and our primary outcome of self-reported opioid use. Hochberg-adjusted <em>p</em>-values accounted for multiple comparisons.</div></div><div><h3>Results</h3><div>The 97 St. PETER HIV participants with baseline opioid use exhibited significant differences from non-opioid users: higher rates of HCV infection; lower CD4 counts; and higher alcohol consumption and smoking rate. Among this opioid use subgroup, there was no significant difference in self-reported opioid use between participants randomized to nicotinic partial agonists and those randomized to NRT at 1, 3, 6 or 12 months.</div></div><div><h3>Conclusions</h3><div>Nicotinic partial agonists do not significantly impact opioid use outcomes compared to NRT in persons who use opioids. Clinicians should consider these options as part of a treatment approach to address nicotine use in this population.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"184 ","pages":"Article 209904"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013414","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":"Experiences of pregnant and postpartum people of color engaged in a randomized clinical trial of medication to treat opioid use disorder during pregnancy: A \"Positive Outliers\" analysis.","authors":"Alexindra Wheeler, Erin Major, Julyvette Vazquez, Latisha Goullaud, Frankie Kropp, Shelly F Greenfield, Grace Humiston, Marcela C Smid, Bettina B Hoeppner, John T Winhusen, Davida M Schiff","doi":"10.1016/j.josat.2026.209988","DOIUrl":"10.1016/j.josat.2026.209988","url":null,"abstract":"<p><strong>Introduction: </strong>Racial and ethnic inequities persist in medication treatment initiation and adherence for pregnant and postpartum people with opioid use disorder (OUD). Our objective was to understand the experiences of \"positive outliers,\" specifically pregnant and postpartum people of color with OUD who utilized medication treatment and engaged in a randomized clinical trial for buprenorphine despite historical, cultural, and structural barriers.</p><p><strong>Methods: </strong>We conducted two sets of semi-structured qualitative interviews. First, trained peers with lived expertise as mothers in recovery interviewed individuals who identified with a non-white race and/or ethnicity and enrolled in the Medication Treatment for OUD in Expectant Mothers (MOMs) trial (NCT03918850). Second, we interviewed principal investigators, clinicians, and research coordinators from the 13 MOMs trial sites. We used an inductive thematic approach informed by the Social Ecological Model of Racism and Anti-Racism. Transcripts were double-coded and reviewed until consensus was reached. Preliminary findings from participant and staff interviews were merged and triangulated with peers to inform theme development.</p><p><strong>Results: </strong>We completed 17 interviews with MOMs trial participants from 7 sites. Participants identified as Hispanic (29%), Black non-Hispanic (24%), multi-racial Hispanic (18%), multi-racial non-Hispanic (18%), and American Indian, Native Hawaiian, or Pacific Islander (12%). Thirty-two interviews with trial staff were also completed. Three themes emerged: (1) Although some participants expected racist treatment and research exploitation, all participants interviewed reported non-discriminatory, non-judgmental care within the MOMs trial; (2) Compassionate care, frequent, personalized, and integrated encounters, and emotional support helped counteract prior stigmatizing and discriminatory health care interactions, enabling participants of color to feel particularly supported, trusted, and empowered during the MOMs trial; and (3) Despite pervasive cultural stigma around addiction and concerns about taking an investigational drug while pregnant, participants expressed that pregnancy status, care team trust, and transparent communication with MOMs trial staff encouraged medication utilization and adherence.</p><p><strong>Conclusion: </strong>Facilitators of successful engagement in the MOMs trial and retention in medication treatment among pregnant and postpartum people of color with OUD included non-judgmental care, sustained trust, and frequent contact. Key perinatal OUD clinical interventions and trial improvements include personalized communication and scheduling flexibility to promote engagement of marginalized populations.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209988"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824498","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":"Would we, could we? Measuring attitudinal and capacity barriers to supporting recovery housing residents on medication for opioid use disorder.","authors":"Rachel P Winograd, Brandon Park, Rashmi Ghonasgi, Maria Paschke, Amy A Mericle","doi":"10.1016/j.josat.2026.210009","DOIUrl":"10.1016/j.josat.2026.210009","url":null,"abstract":"<p><strong>Background: </strong>Recovery housing provides critical support for individuals with opioid use disorder (OUD), yet residents who use medications for OUD (MOUD) often face barriers to entry and long-term support. No existing validated instruments currently assess these barriers, which can differ by MOUD type and reflect both attitudinal stigma and logistical capacity within recovery housing settings.</p><p><strong>Methods: </strong>We developed and tested two parallel versions (Operator and Resident) of a novel tool, the Recovery Housing Barriers to Medications for Addiction Treatment (RHB-MAT) measure. Item generation was informed by literature review and structured input from current housing operators and residents, resulting in scales addressing attitudinal barriers (for both operators and residents) and capacity barriers (for operators) and MOUD type (buprenorphine, methadone, naltrexone). Surveys were administered to 145 recovery housing operators and 250 residents across the United States. Exploratory and confirmatory factor analyses were conducted to establish dimensionality. Internal consistency, and convergent, divergent, and concurrent criterion validity were examined using established measures of stigma and related constructs.</p><p><strong>Results: </strong>Factor analyses supported a multidimensional structure, distinguishing attitudinal barriers across both groups and capacity barriers among operators. Internal consistency across scales was acceptable to strong (α = 0.74-0.92) across all but one subscale. Convergent validity was supported while divergent validity was less consistent. Concurrent criterion validity was generally demonstrated with associations between Operator RHB-MAT scores and their house's unique medication acceptance policies by MOUD type. Overall, residents evidenced higher attitudinal barrier scores than operators.</p><p><strong>Conclusions: </strong>The RHB-MAT represents the first validated measure of MOUD-related barriers in recovery housing, with tailored versions for both operators and residents. This tool can be used in research, policy, and practical quality improvement efforts to identify and address attitudinal and capacity-related barriers that impede access to evidence-based OUD treatment in recovery residences.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210009"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824449","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 scoping review of implementation strategies to reduce stigma toward people who use substances in healthcare settings.","authors":"C Cioffi, J Baloh, M Brunner, H Cheng, E DiFiore, A D Davis, C Fenstemaker, S Fisher, R Finlayson, B Franz, D Franz, M A Hosseini, A N Rains, A Schmidt, C Smith, N Vest, B Hartzler","doi":"10.1016/j.josat.2026.210005","DOIUrl":"https://doi.org/10.1016/j.josat.2026.210005","url":null,"abstract":"<p><strong>Background: </strong>Stigma toward people with substance use disorders (SUD) remains a major barrier to care. There have been multiple calls to action to address SUD stigma in healthcare settings and other reviews have clarified the need for more rigorous effectiveness research. In addition to attention to effectiveness research, there is a need to attend to the implementation strategies used to deliver SUD stigma reduction interventions. Delineating discrete implementation strategies that have been used to address stigma will support future research efforts to arrive at the most optimal interventions to address SUD stigma.</p><p><strong>Methods: </strong>We searched three databases and extracted data to identify interventions tested to reduce SUD stigma. We used the adapted Expert Recommendations for Implementing Change (ERIC) taxonomy to characterize the discrete implementation strategies used to support the adoption, implementation, sustainment, and scale-up (or spread) of each intervention.</p><p><strong>Results: </strong>This scoping review synthesized 108 peer-reviewed studies reporting on interventions which to address SUD stigma among healthcare professionals. Most interventions were implemented in training environments, including higher education and continuing education settings, and focused on providing basic education on SUD broadly or opioid use disorder. Within interventions, educational and training implementation strategies were most prominent with 74% of studies using educational meetings and 39% distributing training materials. Far fewer studies used implementation strategies that used experiential approaches such interactive assistance, simulation, case-based learning, or contact with people with lived experience. Most studies (73%) reported reductions in stigmatizing attitudes, most often immediately post-intervention, though the need for higher study quality was notable.</p><p><strong>Conclusions: </strong>Existing stigma-reduction interventions are overwhelmingly education-focused and primarily implemented in academic settings, with limited use of strategies that promote reflective learning, contact-based engagement, or organizational change. Future work should employ more rigorous designs that systematically test implementation strategies to create packaged SUD stigma reduction interventions optimized for effectiveness and implementation.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"210005"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824444","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}