Comparison of buprenorphine treatment by virtual-only vs. traditional clinicians 

Journal of Substance Use and Addiction Treatment 

Few patients with opioid use disorder (OUD) receive medications for OUD (MOUD), such as buprenorphine. Given that many patients, particularly those in rural communities, do not live near a clinician who prescribes MOUD, telemedicine could increase MOUD access. However, clinicians and policymakers are concerned about the quality of the virtual-only model.  This study compared the care provided by virtual-only versus traditional clinicians.  The authors found few substantive differences in who used virtual-only care. For example, patients initiating buprenorphine with virtual-only versus traditional clinicians were equally likely to live in urban areas. Patients initiating buprenorphine with virtual-only clinicians had more visits in the 6 months after the initiation and were more likely to be on buprenorphine at 6 months, but had fewer days of continuous buprenorphine treatment. These results can inform ongoing debates about the strengths and weaknesses of virtual-only OUD care. 

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Adjunctive psychosocial interventions and opioid abstinence among patients receiving buprenorphine: A randomized clinical trial

JAMA Network Open

This randomized clinical trial of 340 adults with opioid use disorder (OUD) taking buprenorphine examined the comparative effectiveness of 2 psychosocial treatments—cognitive- behavioral therapy (CBT) and peer recovery support (PRS)—on opioid abstinence when used as adjunctive therapy to office-based buprenorphine treatment in adults with OUD.  Researchers found that neither PRS, CBT, nor a combination of these psychosocial interventions yielded differential effects on opioid abstinence. These results suggest that adjunctive psychosocial interventions may not enhance buprenorphine treatment outcomes in the early stages of treatment.

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Alcohol intake and health study: No protective effect at low levels, with mortality increasing to 1 in 25 at 14 Drinks per week

Journal of Studies on Alcohol and Drugs

This study used a cause-specific modeling approach to estimate the lifetime risk of alcohol-attributable mortality and morbidity in the United States based on a person’s average lifetime weekly alcohol consumption to assess the impact of per-occasion alcohol consumption on health. Researchers found that alcohol consumption, including at what may be perceived as “moderate” levels, is associated with increased mortality and morbidity risks. These results support tightening alcohol use guidance in the United States, for both males and females, to no more than 1 drink per day.

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Social media use trajectories and substance use experimentation: A prospective cohort study

The American Journal of Psychiatry

An analysis of data from more than 7,000 adolescents over 5 years found significant associations between rising social media use trajectories and substance use. Four distinct social media use trajectories were identified, with greater social media use over time throughout early adolescence being proportionally associated with an elevated likelihood of substance use.

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Benzodiazepine tapering: Evidence limitations and research recommendations

This systematic review of publications (2000-2023) concerning tapering benzodiazepines (BZDs) was used to inform the Joint Clinical Practice Guideline on Benzodiazepine Tapering, published in 2025. Rates of taper were often faster than recommended, such as 25%-50% reduction in the initial 1-2 weeks. There was little information on long-term outcomes such as protracted withdrawal and quality of life, and some studies had high rates of attrition. Patients were often switched from short- to long-acting BZDs; however, there are no data on the effect on withdrawal severity or outcomes. There is little information about adverse events such as mortality and suicidality, despite insurance data associating discontinuing BZDs and mortality. The authors conclude the evidence base for tapering BZDs is deficient and list 10 areas for future research. 

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Tobacco industry contributions to the development of ultraprocessed food in the United States, 1985–2007: A case study of Lunchables

American Journal of Public Health

Tobacco firms began acquiring US food companies in the 1960s-1990s to increase revenues and leverage research and development across holdings in tobacco, alcohol, and ultra-processed foods (UPF) subsidiaries. In this case study, the authors examine the development of Lunchables® following Phillip Morris (PMC) acquisition of Kraft and General Foods (KGF). PMC applied a “consumer-driven product development” strategy, previously used for tobacco, in the development process to maximize consumer appeal. PMC also used technologies from KGF to make lower-nicotine cigarettes and then low-fat versions of Lunchables®, in a “better-for-you” strategy to preserve market share in the face of health concerns about both products. The authors suggest public health strategies and policies used to address tobacco could be expanded to UPFs to reduce harm to children.

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A retrospective comparison of two state-funded smartphone-based contingency management programs with different incentives 

Drug and Alcohol Dependence

This retrospective study compared outcomes for patients with stimulant use disorder enrolled in a smartphone-based contingency management program based on the amount of total incentives possible, either $75 (“low-value”) or $599 (“moderate-value”). The low-value program was based in New Jersey, funded through SAMHSA (which limited reimbursement to $75/patient at the time of implementation, which has since been increased), and rewarded completing drug testing, attending counseling visits, and completing CBT modules rather than abstinence over 16 weeks. The moderate-value program was funded by West Virginia’s Medicaid managed care organizations, lasted up to 26 weeks, and largely rewarded negative drug screening results, with additional rewards for counseling and CBT modules. Patients in the moderate-value program submitted significantly higher rates of negative substance tests (36%, with an average of 3.2 negative tests) compared to those in the low-value group (24.7%, with an average of 24.8 negative tests).

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Methamphetamine use among adult patients presenting with acute coronary syndrome: A single‐center retrospective cohort study🔓

Journal of the American Heart Association

This study included 1,309 patients treated for an acute myocardial infarct (MI) at a California health system between 2012 and 2022. A total of 194 patients (15%) were methamphetamine users. The Meth-MI group had less diabetes than the No-Meth-MI group (38% vs 51%, p=.001) but many more smokers (72% vs 28%, p<.001). Nonobstructive coronary disease (eg, vasospasm) was more common in the Meth-MI group (24% vs 11%, p<.001), which consequently had lower rates of revascularization, aspirin, and statin therapy. The Meth-MI group had double the mortality (HR, 2.1, p<.001), and methamphetamine use was the strongest predictor of mortality, greater than diabetes. The Meth-MI group was more likely to have a subsequent MI (42% vs 27%, p<.001). The risk of MI with methamphetamine use is 19% higher than the risk with cocaine use (this study excluded cocaine users). The authors believe presentations with methamphetamine use and angina, without MI, is even more common. 

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Best practices for hospital-based initiation of medications for opioid use disorder: A consensus statement

JAMA Network Open

This survey study used a 2-round Delphi process to develop expert consensus on best practices for hospital-based MOUD initiation for patients with OUD, with a goal to provide guidance on changing inpatient addiction treatment in response to increased synthetic opioids in the unregulated drug supply. A total of 42 expert clinicians participated; clinicians were considered a national expert if they had cared for at least 100 hospitalized patients with OUD in the last two years. There was consensus that buprenorphine and methadone initiation in the hospital setting were appropriate, with less support for hospital-based naltrexone initiation. Consensus was also reached to support rapid methadone initiation; high- and low-dose buprenorphine initiation; and provision of non-MOUD full agonist opioids for treatment of opioid withdrawal during methadone initiation, as a bridge to buprenorphine initiation, and for those declining MOUD.

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Access to Medications for Opioid Use Disorder Among Veterans With Homeless Experience in Permanent Supportive Housing

JAMA Network Open

This cohort study assessed 10,110 US veterans with homeless experience and opioid use disorder (OUD) residing in permanent supportive housing (PSH), in terms of what factors are associated with receipt of medications for opioid use disorder (MOUD).  Only 17% received MOUD within 12 months. Greater behavioral health engagement was associated with MOUD receipt, while older age, race minority status, and prior inpatient hospitalization were associated with lower odds. These results suggest that MOUD access in supportive housing should be expanding, which could require embedding addiction care into PSH teams, leveraging behavioral health touchpoints, and addressing persistent disparities.

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