American Journal on Addictions最新文献

{"title":"Social media use and health outcomes as moderated by rurality among sexual minority young adults.","authors":"Erin A Vogel, McKenna K Nhem, Mahalaxmi K Das, Katelyn F Romm","doi":"10.1111/ajad.70086","DOIUrl":"10.1111/ajad.70086","url":null,"abstract":"<p><strong>Background and objectives: </strong>Social media use may influence substance use and mental health symptoms differently for urban versus rural sexual minority young adults (SMYAs).</p><p><strong>Methods: </strong>SMYAs aged 18-25 in Oklahoma and surrounding states were recruited via social media for a two-wave online survey study in 2023-2024. Among participants reporting any social media use, multivariable logistic regressions examined associations of social media use variables and rural-urban residence with health outcomes. Multiple group regressions examined whether associations varied for rural- versus urban-residing participants.</p><p><strong>Results: </strong>The sample (N = 493; M_age = 21.68 [SD = 2.15]) was 35.7% rural-residing, 72.1% female sex, 47.1% gender-minoritized, and 41.6% racially and/or ethnically minoritized. Most participants (61.9%) had moderate-to-severe depressive and/or anxiety symptoms; 39.8% reported current tobacco use (49.7% cannabis, 74.6% alcohol). Rural-urban residence moderated associations between social media use and substance use. Among urban participants only, social media use frequency was associated with tobacco and alcohol use. Among rural participants, community connectedness was associated with lower odds of mental health symptoms, tobacco use, and cannabis use and social media-based social support was associated with lower odds of cannabis use.</p><p><strong>Discussion and conclusions: </strong>Urban SMYAs may experience negative effects of social media use, including increased risk of substance use. Rural SMYAs may benefit from supportive connection from SMYA peers on social media, reducing their substance use risk.</p><p><strong>Scientific significance: </strong>Prior research has identified benefits (e.g., social support) and harms (e.g., substance use) of social media use. This study found that associations of social media use with substance use among SMYAs differed by urbanicity.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"387-395"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use and sexual orientation among adolescents: Differences by age group and sex in the 2023 National Survey of Drug Use and Health.","authors":"Timothy J Grigsby, Rachel Hoopsick, Dylan Barker, Elise Devier, Amber Amis, R Andrew Yockey","doi":"10.1111/ajad.70087","DOIUrl":"10.1111/ajad.70087","url":null,"abstract":"<p><strong>Background and objectives: </strong>Adolescent substance use is a critical public health concern with significant long-term consequences, yet research on disparities by sexual orientation remains limited. Despite the unique stressors faced by sexual minority youth-particularly bisexual individuals-that increase their risk for substance use, most studies investigate disparities among older adolescents and adults. Using recent national data, this study aims to fill this gap and inform targeted prevention and intervention efforts for sexual minority youth.</p><p><strong>Methods: </strong>We leveraged data from the 2023 National Survey on Drug Use and Health from youth aged 12-17 (N = 10,361). Using weighted logistic regression models, we examined the separate relationships between sexual orientation and past-year substance use (i.e., tobacco, marijuana, and alcohol) stratified by age and sex assigned at birth.</p><p><strong>Results: </strong>Among adolescents, 4.73% reported tobacco use, 11.2% reported marijuana use, and 17.2% reported alcohol use. Logistic regression models indicated that, compared to heterosexual youth, bisexual youth had higher odds of using tobacco (OR = 2.00, 95% CI = 1.37-2.90), marijuana (OR = 1.85, 95% CI = 1.43-2.40), and alcohol (OR = 1.32, 95% CI = 1.02-1.69), while gay/lesbian youth had lower odds of tobacco use (OR = 0.47, 95% CI = 0.24-0.94), but higher odds of alcohol (OR = 1.60, 95% CI = 1.06-2.44). Notable differences were observed across sex and age.</p><p><strong>Conclusions and scientific significance: </strong>Findings from the current study highlight significant disparities in substance use among youth based on sexual orientation, particularly among bisexual adolescents. We recommend that prevention and intervention efforts incorporate age-specific and gender-sensitive approaches to address the unique stressors faced by sexual minority youth.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"396-403"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopmental burden in young adults undergoing opioid substitution therapy: The role of inattentive and hyperactive/impulsive symptoms.","authors":"Maddalena Cesco, Marco Garzitto, Livia Pischiutta, Tiziana Lombardelli, Enrico Moratti, Giuliano Zamparutti, Matteo Balestrieri, Umberto Albert, Marco Colizzi","doi":"10.1111/ajad.70103","DOIUrl":"10.1111/ajad.70103","url":null,"abstract":"<p><strong>Background and objectives: </strong>Attention-deficit/hyperactivity disorder (ADHD) is recognized as a condition that can persist into adulthood, often with psychiatric comorbidities that worsen the overall prognosis. ADHD has been associated with substance use disorders (SUDs), especially through symptoms like hyperactivity and impulsivity, while the role of inattentive symptoms remains more difficult to judge. This study aimed to estimate the likelihood of ADHD in a sample of young adults with SUDs undergoing opioid agonist treatment, and to evaluate how inattentive and hyperactive/impulsive traits affect their clinical, psychological, and social functioning.</p><p><strong>Methods: </strong>57 individuals were evaluated using comprehensive clinical interviews and self-administered questionnaires to assess characteristics of SUDs, current and childhood ADHD symptoms, levels of impulsivity, and psychiatric comorbidities.</p><p><strong>Results: </strong>Overall, 22.8% of participants were classified as possible ADHD cases (p-ADHD). Compared to the comparison group, p-ADHD patients exhibited more severe SUDs symptomatology and greater impairments in specific domains of adaptive functioning. They also had a higher lifetime prevalence of social anxiety disorder, unspecified Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) diagnoses, and clinically relevant impulsivity. Further, p-ADHD individuals were more likely to experience limitations and craving, with the inattentive symptoms significantly mediating these associations.</p><p><strong>Discussion and conclusions: </strong>ADHD frequently co-occurs in SUDs patients in OAT and can worsen the SUDs clinical presentation. Moreover, inattentive symptoms may play a prominent role in SUDs development.</p><p><strong>Scientific significance: </strong>This study suggests that different ADHD presentations influence SUDs manifestations, challenging the idea that impulsivity is the main contributor in SUDs.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"412-421"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of rs2036527 as a cis-regulatory variant for CHRNA3 and CHRNA5 by allele-specific expression and implications for nicotine dependence and lung cancer.","authors":"Tao Peng, Xiao-Qian Shi, Hao Guo, Hai-Yan Li, Xi-Ting Zhou, Hong-Li Song, Xin-Xin Zhang, Wei-Ping Fu, Chang Sun","doi":"10.1111/ajad.70074","DOIUrl":"10.1111/ajad.70074","url":null,"abstract":"<p><strong>Background and objectives: </strong>Numerous genome-wide association studies suggest that rs1051730 is significantly associated with nicotine dependence and further lung cancer in Caucasian. Since rs1051730 is a synonymous variant at CHRNA3 (cholinergic receptor nicotinic alpha 3 subunit), it might be hypothesized that the causal variant might be other SNP(s) in strong linkage disequilibrium (LD).</p><p><strong>Methods: </strong>LD analysis and functional genomics work, including chromosome conformation capture (3C), luciferase assay, and chromatin immunoprecipitation (ChIP), were performed.</p><p><strong>Results: </strong>Allele-specific expression indicates an overexpression of C allele than T at rs1051730 in lung tissues, thus verifying the hypothesis. Through LD analysis for 1000 genomes project data, 17 genetic variants are identified in strong LD with rs1051730. 3C indicates that two restrictive segments, chr15:78845145-78852557 and chr15:78867861-78872762, display high interaction efficiency with CHRNA3 promoter and contain two SNPs in core haplotype, rs72740964 and rs2036527, respectively. Luciferase assay suggests that only rs2036527 can alter enhancer activity. Further 3C indicates that CHRNA5 (cholinergic receptor nicotinic alpha 5 subunit) is an additional target of the enhancer containing rs2036527, which is verified by expression quantitative trait locus analysis. By ChIP, the related transcription factor, FOXA2 (forkhead box A2), is identified and their interaction is evaluated.</p><p><strong>Discussion and conclusions: </strong>rs2036527 is the cis-regulatory variant for CHRNA3 and CHRNA5, which can further influence nicotine dependence.</p><p><strong>Scientific significance: </strong>This is the first report to indicate that rs2036527 genotype might be a better marker to predict the probability of developing nicotine dependence and that FOXA2, CHRNA5, and CHRNA3 might be treatment targets for nicotine dependence.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"379-386"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imposter syndrome and college students' drinking behaviors: The roles of negative affect and coping motivated alcohol use.","authors":"Amelia Knox, Luke A Vargo, Julia D Buckner","doi":"10.1111/ajad.70092","DOIUrl":"10.1111/ajad.70092","url":null,"abstract":"<p><strong>Background and objectives: </strong>College students are known to frequently engage in alcohol consumption, and are at risk for developing dangerous drinking patterns (e.g., binge drinking). Since imposter syndrome occurs at high rates among undergraduate students, it is reasonable to assume that college students may experience its negative effects, such as anxiety and depression. Given the relation of anxiety and depression to worse drinking outcomes, imposter syndrome may also be related to greater drinking and related problems. Yet, this is the first known study to test whether imposter syndrome is related to drinking behaviors.</p><p><strong>Methods: </strong>376 (87% female) undergraduates recruited through our psychology department research participant pool with current (past 3-month) alcohol use completed an online survey.</p><p><strong>Results: </strong>Imposter syndrome was statistically significantly related to anxiety, depression, coping-motivated drinking, peak estimated blood alcohol content (eBAC), drinking frequency, and alcohol-related problems. Imposter syndrome, via the serial effects of depression and coping motives, was significantly indirectly related to eBAC, drinking frequency, and alcohol-related problems. Similarly, via the serial effects of anxiety and coping motives, imposter syndrome was significantly indirectly related to eBAC, drinking frequency, and alcohol-related problems.</p><p><strong>Discussion and conclusions: </strong>The results of this study can inform treatment and prevention efforts by suggesting that imposter syndrome may be an important yet thus far neglected target for interventions.</p><p><strong>Scientific significance: </strong>The present study provides novel insight by identifying that imposter syndrome is related to worse alcohol outcomes and that these relations occur via negative affect and coping-motivated drinking.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"404-411"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief report: Ketamine-assisted \"bridge therapy\" for opioid tapering in complex cases.","authors":"Mariana C de Oliveira, Cláudia C de Araujo Palmeira, André B Negrão, Ziyad A Hadi, Julia R Arana, Rita de Cássia Ferreira Duarte, Joice L P da Silva, Gustavo K Matsui, João F D Rapozero, Douglas H Crispim, André Malbergier, João M Castaldelli-Maia","doi":"10.1111/ajad.70131","DOIUrl":"https://doi.org/10.1111/ajad.70131","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) presents major challenges, especially when combined with chronic pain and psychiatric comorbidities. A 25-year-old woman with OUD, chronic pain, and major depressive disorder underwent an 8-week protocol of intravenous ketamine infusions (0.5 mg/kg weekly) as an adjunct to opioid tapering.</p><p><strong>Results: </strong>Methadone dosage was reduced by 50%, with improved pain and craving control, reduced withdrawal symptoms, and greater psychotherapy engagement.</p><p><strong>Discussion and conclusions: </strong>Ketamine-assisted \"bridge therapy\" treatment may support opioid tapering in complex cases.</p><p><strong>Scientific significance: </strong>This is a novel report to document a multifaceted improvement in this specific comorbidity cluster.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 3","pages":"431-434"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations among social determinants of health and opioid use disorder and overdose: An umbrella review.","authors":"Lauren B Loeffel, Ha Rim Kwak, Jeonghyun Shin, Min Lee, Dylan J Jester, Michael Dawes, Harold S Kudler, Dilip V Jeste, Peter Jongho Na","doi":"10.1111/ajad.70133","DOIUrl":"10.1111/ajad.70133","url":null,"abstract":"<p><strong>Background and objectives: </strong>In 2022, over 6 million individuals in the United States were affected by opioid use disorder (OUD), and more than 81,000 died from opioid-related overdoses. This umbrella review synthesized evidence on the associations between a broad range of social determinants of health (SDoH) and OUD/overdose.</p><p><strong>Methods: </strong>An umbrella review of meta-analyses and reviews on SDoH and OUD/overdose was conducted using PubMED, PsycINFO, Embase, and Web of Science. A total of 29 reviews were deemed appropriate for inclusion.</p><p><strong>Results: </strong>Adverse childhood experiences and unemployment were associated with OUD outcomes. In the United States, immigrant status was associated with a lower risk of OUD, though this risk increased in subsequent generations. Individuals who experienced intimate partner violence and sexual minority individuals showed high prevalence of OUD. For overdose, associations were found in unemployment, low income, high poverty, and justice system involvement. Significant increases in odds of overdose were noted among individuals experiencing homelessness, lacking private insurance, engaging in sex work for pay, or witnessing an overdose.</p><p><strong>Discussion and conclusions: </strong>This study identified SDoH associated with OUD outcomes and overdose risk, with findings having implications from a public health perspective for clinical practice, public health policy, and research priorities. There is a need for meta-analyses to clarify the magnitude of SDoH influences on OUD/overdose, with the goal of informing targeted interventions to reduce opioid-related morbidity and mortality.</p><p><strong>Scientific significance: </strong>The most comprehensive umbrella review to date on intersections among SDoH, OUD outcomes, and overdose risk.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"339-361"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between experiencing gambling problems and adverse behavioral health outcomes among U.S. military service members, 2018.","authors":"Matthew R Beymer, Erin M Anderson Goodell, Charles W Hoge","doi":"10.1111/ajad.70105","DOIUrl":"10.1111/ajad.70105","url":null,"abstract":"<p><strong>Background and objectives: </strong>Gambling screening in the US military was mandated in 2019, but few studies have assessed the prevalence of experiencing gambling problems or its association with adverse behavioral health concerns.</p><p><strong>Methods: </strong>This secondary analysis used data from active-duty U.S. military service members participating in the 2018 iteration of the Health-Related Behaviors Survey (n = 17,098). Individuals experiencing gambling problems were identified with the 2-item Lie-Bet screener, a well-validated screener. Psychological distress was measured with the Kessler-6. Outcomes also included measures for insufficient sleep, tobacco use, marijuana use, and binge drinking. Weighted multivariable logistic regressions were used to evaluate associations.</p><p><strong>Results: </strong>Approximately 1.6% of the weighted sample were identified as service members experiencing gambling problems. Individuals experiencing gambling problems had 3.1-fold greater odds of severe psychological distress when compared to those who screened negative (95% Confidence Interval (CI): 2.06-4.67). Similar associations were observed for individuals experiencing gambling problems and insufficient sleep, tobacco use, and binge drinking. There was no association detected between individuals experiencing gambling problems and marijuana use.</p><p><strong>Discussion and conclusion: </strong>A very small percentage of U.S. military service members were identified as experiencing gambling problems. Service members experiencing gambling problems had a significantly greater adjusted odds of psychological distress, insufficient sleep, tobacco use, and binge drinking.</p><p><strong>Scientific significance: </strong>Additional research is needed to assess the potential benefits and risks of the new mandatory military screening effort, and how best to support service members and their families in mitigating deleterious health concerns associated with experiencing gambling problems.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"422-430"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of impulsivity in the relationship between childhood maltreatment and depression in methamphetamine patients.","authors":"Saad Ullah, Yang Tian, Jia-Jing Chen, Arsalan Haider, Abdur Rab Tariq Kiyani, Han Chen, Ren Huang, Dong-Mei Wang, Xiang-Yang Zhang","doi":"10.1111/ajad.70102","DOIUrl":"10.1111/ajad.70102","url":null,"abstract":"<p><strong>Background and objectives: </strong>Childhood maltreatment (CM) significantly increases the risk of depression in patients with methamphetamine use disorder (MAUD). However, the underlying psychological mechanism remains unclear. The purpose of this study was to explore whether impulsivity mediates the relationship between CM and depression in patients with MAUD.</p><p><strong>Methods: </strong>We recruited 577 Chinese male inpatients with MAUD. CM, depression, and impulsivity were assessed using standardized questionnaires.</p><p><strong>Results: </strong>A total of 321 of 577 (55.63%) patients with MAUD had experienced at least one form of CM. Maltreated patients exhibited elevated impulsivity and severe depression compared to nonmaltreated patients (both p < .001). CM, impulsivity, and depression were significantly interrelated (all p < .01). In addition, impulsivity partially mediated the CM-depression link in patients with MAUD (β = .015, 95% CI [0.007, 0.026]).</p><p><strong>Discussion and conclusions: </strong>Our findings indicate that CM has a long-term effect on depression, and impulsivity is an essential contributor to depressive symptoms in patients with MAUD who have experienced CM. Future research should investigate these associations using multimodal approaches and assess focused interventions that may reduce impulsivity and mitigate the psychological impact of adverse childhood experiences (ACEs) in patients with MAUD.</p><p><strong>Scientific significance: </strong>We identified impulsivity as a key mechanism in the CM-depression link, offering a novel intervention target. Our findings advance the understanding of the psychological mechanisms in addiction psychiatry and suggest that interventions targeting impulsivity may help mitigate depression in this population.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"370-378"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability, linguistic complexity, and stigma in ChatGPT responses to opioid use disorder FAQs: A comparative analysis.","authors":"Vitor M Campos, Daniel L Heringer, Gabriel P A Costa, Henrique N P Oliva, Akhil Anand","doi":"10.1111/ajad.70101","DOIUrl":"10.1111/ajad.70101","url":null,"abstract":"<p><strong>Background and objectives: </strong>AI chatbots are increasingly used in patient education. For opioid use disorder (OUD), content must be readable and non-stigmatizing. We compared ChatGPT responses with U.S. health organization FAQs on readability, complexity, and stigma.</p><p><strong>Methods: </strong>We analyzed 50 OUD FAQs paired with ChatGPT GPT-4o responses. Outcomes included word and sentence counts, lexical density, and six readability indices. Paired differences were tested with t tests or Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>ChatGPT responses were longer than FAQs, with a mean word count of 253.7 vs. 76.6 (difference 177; 95% CI, 151-203) and sentence count of 18.2 vs. 9.0 (difference 9.2; 95% CI, 7.6-10.9). Lexical density was higher by 6.5 percentage points (95% CI, 4.0-9.0), with more characters (0.55; 95% CI, 0.40-0.70) and syllables per word (0.19; IQR, 0.14-0.24). Readability grade levels were consistently higher: Coleman-Liau +3.43, Gunning Fog +3.47, SMOG + 2.96, Flesch-Kincaid +3.61, Automated Readability Index +4.33, and Flesch Reading Ease -20.4 (all p < .05). Stigmatizing term frequency was similar, 0.98 vs. 0.28 per answer (95% CI, -1.3 to +3.3).</p><p><strong>Discussion: </strong>ChatGPT responses were longer and more complex than FAQs, although the frequency of stigmatizing language was similar.</p><p><strong>Conclusions: </strong>ChatGPT produced more comprehensive but less readable content than FAQs, revealing a gap with health literacy standards. While stigmatizing terms were uncommon unless simplified, length and complexity may hinder use.</p><p><strong>Scientific significance: </strong>Findings quantify readability and stigma trade-offs in AI-generated OUD education and emphasize the need for plain language prompting and human review.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"362-369"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}