https://onlinelibrary.wiley.com/journal/15210391?af=R Table of Contents for The American Journal on Addictions. List of articles from both the latest and EarlyView issues. en-US © American Academy of Addiction Psychiatry wileyonlinelibrary@wiley.com (Wiley Online Library) Tue, 09 Jun 2026 07:31:15 +0000 Tue, 09 Jun 2026 07:31:15 +0000 Atypon® Literatum™ https://validator.w3.org/feed/docs/rss2.html 10080 Wiley: The American Journal on Addictions: Table of Contents Wiley The American Journal on Addictions https://onlinelibrary.wiley.com/pb-assets/journal-banners/15210391.jpg https://onlinelibrary.wiley.com/journal/15210391?af=R https://onlinelibrary.wiley.com/doi/10.1111/ajad.70175?af=R Mon, 08 Jun 2026 21:54:14 -0700 2026-06-08T09:54:14-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70175 The American Journal on Addictions, EarlyView. Wei‐Ting Lai, Lien‐Chung Wei LETTER TO THE EDITOR Interpreting divergent mortality outcomes in veterans with substance use disorder and adverse social determinants of health 10.1111/ajad.70175 The American Journal on Addictions 10.1111/ajad.70175 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70175?af=R LETTER TO THE EDITOR https://onlinelibrary.wiley.com/doi/10.1111/ajad.70174?af=R Wed, 03 Jun 2026 21:39:47 -0700 2026-06-03T09:39:47-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70174 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Motives for and contexts of cannabis use (CU) are typically examined as independent characteristics of CU events in ecological momentary assessment (EMA) studies. However, theories posit that some combinations of motives and contexts (e.g., using to cope in a solitary setting) may contribute to heavier substance use than others (e.g., using to cope in a social setting). The current study aimed to test whether these combinations are associated with heavier substance use at the event‐level. We aimed to do so among a sample of young adult females given sex differences in cannabis risk processes, which oversampled sexual minority women and gender diverse individuals due to their high rates of CU. Methods We utilized EMA data from a study of young adult females who regularly used cannabis (n = 571; 77.6% sexual minority women and gender diverse individuals). Results Coping motives and solitary settings interacted such that coping motives for CU were associated with longer and higher subjective intoxication but only in solitary settings. Social and enhancement motives did not interact with social contexts; however, social and enhancement motives, as well as social contexts, were associated with longer intoxication and higher subjective intoxication. Discussion and Conclusions Findings indicated that coping motives were only associated with CU when combined with solitary use. Social and enhancement motives and social contexts produced additive effects. Scientific Significance Findings indicate that studies examining the effects of coping motives or solitary cannabis use in isolation may not accurately characterize these effects. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Motives for and contexts of cannabis use (CU) are typically examined as independent characteristics of CU events in ecological momentary assessment (EMA) studies. However, theories posit that some combinations of motives and contexts (e.g., using to cope in a solitary setting) may contribute to heavier substance use than others (e.g., using to cope in a social setting). The current study aimed to test whether these combinations are associated with heavier substance use at the event-level. We aimed to do so among a sample of young adult females given sex differences in cannabis risk processes, which oversampled sexual minority women and gender diverse individuals due to their high rates of CU.</p> <h2>Methods</h2> <p>We utilized EMA data from a study of young adult females who regularly used cannabis (<i>n</i> = 571; 77.6% sexual minority women and gender diverse individuals).</p> <h2>Results</h2> <p>Coping motives and solitary settings interacted such that coping motives for CU were associated with longer and higher subjective intoxication but only in solitary settings. Social and enhancement motives did not interact with social contexts; however, social and enhancement motives, as well as social contexts, were associated with longer intoxication and higher subjective intoxication.</p> <h2>Discussion and Conclusions</h2> <p>Findings indicated that coping motives were only associated with CU when combined with solitary use. Social and enhancement motives and social contexts produced additive effects.</p> <h2>Scientific Significance</h2> <p>Findings indicate that studies examining the effects of coping motives or solitary cannabis use in isolation may not accurately characterize these effects.</p> Christina Dyar, Elise Green, Christine M. Lee RESEARCH ARTICLE Do motives for and contexts of cannabis use interact to predict heavy cannabis use at the event‐level? 10.1111/ajad.70174 The American Journal on Addictions 10.1111/ajad.70174 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70174?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70173?af=R Mon, 11 May 2026 21:34:44 -0700 2026-05-11T09:34:44-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70173 The American Journal on Addictions, EarlyView. Abstract Background and Objectives This study examined the prevalence of alcohol mixed with energy drinks (AmED) among Spanish adolescents and young adults and analyzed its associations with sociodemographic factors, substance use, and mental health. The primary objective was to compare AmED users specifically against alcohol‐only users to identify unique risk profiles. Methods A cross‐sectional survey was administered to 6156 individuals aged 16–30 enrolled in educational programs. Participants completed self‐report measures assessing substance use, emotional distress, schizotypal traits, and suicidal behavior. Bivariate analyses compared AmED users with alcohol‐only users and non‐drinkers. Logistic regression identified independent correlates of AmED use specifically within the alcohol‐using population. Results Among alcohol users, 31.3% reported consuming AmED. AmED users were more likely to be younger and male, and they initiated alcohol use earlier. They showed a higher prevalence of tobacco, e‐cigarette, and cannabis use, as well as a greater risk of problematic alcohol, nicotine, and cannabis consumption. AmED users also reported elevated emotional distress, suicide behavior, and the schizotypal traits dimensions of anhedonia and interpersonal disorganization. Logistic regression identified younger age, male sex, binge drinking, e‐cigarette use, nicotine dependence, alcohol‐related problems, cannabis abuse risk, suicidal behavior, and schizotypal traits as significant correlates of AmED use. Discussion and Conclusions AmED consumption is common among Spanish youth and is more strongly linked to polysubstance use and poor mental health than alcohol use alone. Scientific Significance Screening for AmED use may help identify youth at higher risk of polysubstance use and suicidal behavior, facilitating earlier detection and targeted prevention efforts. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>This study examined the prevalence of alcohol mixed with energy drinks (AmED) among Spanish adolescents and young adults and analyzed its associations with sociodemographic factors, substance use, and mental health. The primary objective was to compare AmED users specifically against alcohol-only users to identify unique risk profiles.</p> <h2>Methods</h2> <p>A cross-sectional survey was administered to 6156 individuals aged 16–30 enrolled in educational programs. Participants completed self-report measures assessing substance use, emotional distress, schizotypal traits, and suicidal behavior. Bivariate analyses compared AmED users with alcohol-only users and non-drinkers. Logistic regression identified independent correlates of AmED use specifically within the alcohol-using population.</p> <h2>Results</h2> <p>Among alcohol users, 31.3% reported consuming AmED. AmED users were more likely to be younger and male, and they initiated alcohol use earlier. They showed a higher prevalence of tobacco, e-cigarette, and cannabis use, as well as a greater risk of problematic alcohol, nicotine, and cannabis consumption. AmED users also reported elevated emotional distress, suicide behavior, and the schizotypal traits dimensions of anhedonia and interpersonal disorganization. Logistic regression identified younger age, male sex, binge drinking, e-cigarette use, nicotine dependence, alcohol-related problems, cannabis abuse risk, suicidal behavior, and schizotypal traits as significant correlates of AmED use.</p> <h2>Discussion and Conclusions</h2> <p>AmED consumption is common among Spanish youth and is more strongly linked to polysubstance use and poor mental health than alcohol use alone.</p> <h2>Scientific Significance</h2> <p>Screening for AmED use may help identify youth at higher risk of polysubstance use and suicidal behavior, facilitating earlier detection and targeted prevention efforts.</p> Roberto Secades‐Villa, Clara Iza‐Fernández, Ángel García‐Pérez, Layla Alemán‐Moussa, Alba González‐Roz RESEARCH ARTICLE Risks of alcohol–energy drink co‐consumption: Patterns, correlates and psychological outcomes in youth 10.1111/ajad.70173 The American Journal on Addictions 10.1111/ajad.70173 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70173?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70172?af=R Sun, 10 May 2026 03:30:32 -0700 2026-05-10T03:30:32-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70172 The American Journal on Addictions, EarlyView. Abstract Background and Objectives To describe provider preparedness and experiences engaging families after a patient overdose death. Methods We used descriptive statistics to summarize responses to a national survey of interdisciplinary providers. Results Participants (n = 524; 47,937 invited) agreed that providers should communicate with a patient's family after an overdose death (78.2% agreed), yet few felt very well prepared to do so (22.6%). Discussion and Conclusions Providers inconsistently contacted families despite believing these interactions are opportunities to improve family and provider coping. Scientific Significance There is a potential need for interventions addressing this discrepancy between providers' desired behaviors and practice contacting families following a patient death. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>To describe provider preparedness and experiences engaging families after a patient overdose death.</p> <h2>Methods</h2> <p>We used descriptive statistics to summarize responses to a national survey of interdisciplinary providers.</p> <h2>Results</h2> <p>Participants (<i>n</i> = 524; 47,937 invited) agreed that providers should communicate with a patient's family after an overdose death (78.2% agreed), yet few felt very well prepared to do so (22.6%).</p> <h2>Discussion and Conclusions</h2> <p>Providers inconsistently contacted families despite believing these interactions are opportunities to improve family and provider coping.</p> <h2>Scientific Significance</h2> <p>There is a potential need for interventions addressing this discrepancy between providers' desired behaviors and practice contacting families following a patient death.</p> Jessica B. Calihan, Frances R. Levin, Cale N. Basaraba, Agata Bereznicka, Kathryn Cates‐Wessel, Amy M. Yule BRIEF REPORT Brief report: A cross‐sectional survey of provider engagement with family members following patient drug overdose death 10.1111/ajad.70172 The American Journal on Addictions 10.1111/ajad.70172 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70172?af=R BRIEF REPORT https://onlinelibrary.wiley.com/doi/10.1111/ajad.70162?af=R Mon, 27 Apr 2026 21:10:26 -0700 2026-04-27T09:10:26-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70162 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Once‐daily methadone dosing for opioid use disorder (OUD) may leave periods of inadequate analgesia. We tested whether experimental pain sensitivity differs across the inter‐dose interval. Methods Twenty‐five adults (52% female, 43.12 years old) with OUD receiving stable once‐daily methadone completed thermal quantitative sensory testing at early post‐dose and pre‐dose. Results Heat pain threshold (MD −3.75°C; g = −0.78; p < .001) and tolerance (MD −0.92°C; g = −0.49; p = .018) were lower at pre‐dose. Temporal summation and conditioned pain modulation did not differ. Discussion and Conclusions Pain sensitivity increased pre‐dose, consistent with a hyperalgesic window. Scientific Significance Preliminary experimental evidence that once‐daily methadone may contribute to cyclical hyperalgesia in persons with OUD. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Once-daily methadone dosing for opioid use disorder (OUD) may leave periods of inadequate analgesia. We tested whether experimental pain sensitivity differs across the inter-dose interval.</p> <h2>Methods</h2> <p>Twenty-five adults (52% female, 43.12 years old) with OUD receiving stable once-daily methadone completed thermal quantitative sensory testing at early post-dose and pre-dose.</p> <h2>Results</h2> <p>Heat pain threshold (MD −3.75°C; <i>g</i> = −0.78; <i>p</i> &lt; .001) and tolerance (MD −0.92°C; <i>g</i> = −0.49; <i>p</i> = .018) were lower at pre-dose. Temporal summation and conditioned pain modulation did not differ.</p> <h2>Discussion and Conclusions</h2> <p>Pain sensitivity increased pre-dose, consistent with a hyperalgesic window.</p> <h2>Scientific Significance</h2> <p>Preliminary experimental evidence that once-daily methadone may contribute to cyclical hyperalgesia in persons with OUD.</p> Gabriel P. A. Costa, Christina Riggione, Julia Meyerovich, Declan T. Barry, Joao P. De Aquino BRIEF REPORT Brief Report: Is once daily enough? Assessing the impact of timing of methadone dose on pain sensitivity via quantitative sensory testing in persons with opioid use disorder 10.1111/ajad.70162 The American Journal on Addictions 10.1111/ajad.70162 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70162?af=R BRIEF REPORT https://onlinelibrary.wiley.com/doi/10.1111/ajad.70163?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70163 The American Journal on Addictions, Volume 35, Issue 3, Page 436-436, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION Call for Special Issue Papers 2026 10.1111/ajad.70163 The American Journal on Addictions 10.1111/ajad.70163 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70163?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70164?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70164 The American Journal on Addictions, Volume 35, Issue 3, Page 435-435, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION Call for Review Papers 2026 10.1111/ajad.70164 The American Journal on Addictions 10.1111/ajad.70164 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70164?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70165?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70165 The American Journal on Addictions, Volume 35, Issue 3, Page 443-443, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION SUBMIT YOUR ARTICLE TO ADDICTION INSIGHTS: Addiction Insights is AAAP's newsletter. We're always looking for submissions 10.1111/ajad.70165 The American Journal on Addictions 10.1111/ajad.70165 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70165?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70166?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70166 The American Journal on Addictions, Volume 35, Issue 3, Page 439-439, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION NEW SELF ASSESSMENT EXAM: Get ready for the boards with this re‐vamped self‐assessment exam 10.1111/ajad.70166 The American Journal on Addictions 10.1111/ajad.70166 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70166?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70167?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70167 The American Journal on Addictions, Volume 35, Issue 3, Page 437-437, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION SAVE THE DATE: Don't miss out on next year's Annual Meeting, held in Memphis, TN! 10.1111/ajad.70167 The American Journal on Addictions 10.1111/ajad.70167 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70167?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70168?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70168 The American Journal on Addictions, Volume 35, Issue 3, Page 441-441, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION Annual Meeting Bundle: Three activities highlighted in this 4.25‐CME bundle that includes the psychedelic debate 10.1111/ajad.70168 The American Journal on Addictions 10.1111/ajad.70168 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70168?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70169?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70169 The American Journal on Addictions, Volume 35, Issue 3, Page 440-440, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION NEW BUNDLED COURSES: Save big on these bundled courses as you prepare for the boards 10.1111/ajad.70169 The American Journal on Addictions 10.1111/ajad.70169 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70169?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70170?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70170 The American Journal on Addictions, Volume 35, Issue 3, Page 438-438, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION AAAP MEMBERSHIP: Reap the benefits of belonging to AAAP 10.1111/ajad.70170 The American Journal on Addictions 10.1111/ajad.70170 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70170?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70171?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70171 The American Journal on Addictions, Volume 35, Issue 3, Page 442-442, May 2026. Click on the PDF file for live links <p>Click on the PDF file for live links</p> <p></p> SOCIETY INFORMATION Wanted: SPC Members: Join AAAP's Scientific Program Committee (SPC) and shape the future of the Academy 10.1111/ajad.70171 The American Journal on Addictions 10.1111/ajad.70171 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70171?af=R SOCIETY INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70133?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70133 The American Journal on Addictions, Volume 35, Issue 3, Page 339-361, May 2026. Abstract Background and Objectives 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. Methods 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. Results 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. Discussion and Conclusions 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. Scientific Significance The most comprehensive umbrella review to date on intersections among SDoH, OUD outcomes, and overdose risk. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>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> <h2>Results</h2> <p>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> <h2>Discussion and Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>The most comprehensive umbrella review to date on intersections among SDoH, OUD outcomes, and overdose risk.</p> Lauren B. Loeffel, Ha Rim Kwak, Jeonghyun Shin, Min Lee, Dylan J. Jester, Michael Dawes, Harold S. Kudler, Dilip V. Jeste, Peter Jongho Na REVIEW ARTICLE Associations among social determinants of health and opioid use disorder and overdose: An umbrella review 10.1111/ajad.70133 The American Journal on Addictions 10.1111/ajad.70133 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70133?af=R REVIEW ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70131?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70131 The American Journal on Addictions, Volume 35, Issue 3, Page 431-434, May 2026. Abstract Background 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. Results Methadone dosage was reduced by 50%, with improved pain and craving control, reduced withdrawal symptoms, and greater psychotherapy engagement. Discussion and Conclusions Ketamine‐assisted “bridge therapy” treatment may support opioid tapering in complex cases. Scientific Significance This is a novel report to document a multifaceted improvement in this specific comorbidity cluster. <h2>Abstract</h2> <h2>Background</h2> <p>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> <h2>Results</h2> <p>Methadone dosage was reduced by 50%, with improved pain and craving control, reduced withdrawal symptoms, and greater psychotherapy engagement.</p> <h2>Discussion and Conclusions</h2> <p>Ketamine-assisted “bridge therapy” treatment may support opioid tapering in complex cases.</p> <h2>Scientific Significance</h2> <p>This is a novel report to document a multifaceted improvement in this specific comorbidity cluster.</p> 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 BRIEF REPORT Brief report: Ketamine‐assisted “bridge therapy” for opioid tapering in complex cases 10.1111/ajad.70131 The American Journal on Addictions 10.1111/ajad.70131 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70131?af=R BRIEF REPORT 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70102?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70102 The American Journal on Addictions, Volume 35, Issue 3, Page 370-378, May 2026. Abstract Background and Objectives 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. Methods We recruited 577 Chinese male inpatients with MAUD. CM, depression, and impulsivity were assessed using standardized questionnaires. Results 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]). Discussion and Conclusions 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. Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>We recruited 577 Chinese male inpatients with MAUD. CM, depression, and impulsivity were assessed using standardized questionnaires.</p> <h2>Results</h2> <p>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 <i>p</i> &lt; .001). CM, impulsivity, and depression were significantly interrelated (all <i>p</i> &lt; .01). In addition, impulsivity partially mediated the CM-depression link in patients with MAUD (<i>β</i> = .015, 95% CI [0.007, 0.026]).</p> <h2>Discussion and Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>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> Saad Ullah, Yang Tian, Jia‐Jing Chen, Arsalan Haider, Abdur Rab Tariq Kiyani, Han Chen, Ren Huang, Dong‐Mei Wang, Xiang‐Yang Zhang RESEARCH ARTICLE The mediating role of impulsivity in the relationship between childhood maltreatment and depression in methamphetamine patients 10.1111/ajad.70102 The American Journal on Addictions 10.1111/ajad.70102 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70102?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70103?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70103 The American Journal on Addictions, Volume 35, Issue 3, Page 412-421, May 2026. Abstract Background and Objectives 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. Methods 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. Results 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. Discussion and Conclusions 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. Scientific Significance This study suggests that different ADHD presentations influence SUDs manifestations, challenging the idea that impulsivity is the main contributor in SUDs. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>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> <h2>Results</h2> <p>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> <h2>Discussion and Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>This study suggests that different ADHD presentations influence SUDs manifestations, challenging the idea that impulsivity is the main contributor in SUDs.</p> Maddalena Cesco, Marco Garzitto, Livia Pischiutta, Tiziana Lombardelli, Enrico Moratti, Giuliano Zamparutti, Matteo Balestrieri, Umberto Albert, Marco Colizzi RESEARCH ARTICLE Neurodevelopmental burden in young adults undergoing opioid substitution therapy: The role of inattentive and hyperactive/impulsive symptoms 10.1111/ajad.70103 The American Journal on Addictions 10.1111/ajad.70103 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70103?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70105?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70105 The American Journal on Addictions, Volume 35, Issue 3, Page 422-430, May 2026. Abstract Background and Objectives 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. Methods 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. Results 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. Discussion and Conclusion 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. Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>This secondary analysis used data from active-duty U.S. military service members participating in the 2018 iteration of the Health-Related Behaviors Survey (<i>n</i> = 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> <h2>Results</h2> <p>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> <h2>Discussion and Conclusion</h2> <p>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> <h2>Scientific Significance</h2> <p>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> Matthew R. Beymer, Erin M. Anderson Goodell, Charles W. Hoge RESEARCH ARTICLE Association between experiencing gambling problems and adverse behavioral health outcomes among U.S. military service members, 2018 10.1111/ajad.70105 The American Journal on Addictions 10.1111/ajad.70105 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70105?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70074?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70074 The American Journal on Addictions, Volume 35, Issue 3, Page 379-386, May 2026. Abstract Background and Objectives 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). Methods LD analysis and functional genomics work, including chromosome conformation capture (3C), luciferase assay, and chromatin immunoprecipitation (ChIP), were performed. Results 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. Discussion and Conclusions rs2036527 is the cis‐regulatory variant for CHRNA3 and CHRNA5, which can further influence nicotine dependence. Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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 <i>CHRNA3</i> (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> <h2>Methods</h2> <p>LD analysis and functional genomics work, including chromosome conformation capture (3C), luciferase assay, and chromatin immunoprecipitation (ChIP), were performed.</p> <h2>Results</h2> <p>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 <i>CHRNA3</i> 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 <i>CHRNA5</i> (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> <h2>Discussion and Conclusions</h2> <p>rs2036527 is the <i>cis</i>-regulatory variant for <i>CHRNA3</i> and <i>CHRNA5</i>, which can further influence nicotine dependence.</p> <h2>Scientific Significance</h2> <p>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> Tao Peng, Xiao‐Qian Shi, Hao Guo, Hai‐Yan Li, Xi‐Ting Zhou, Hong‐Li Song, Xin‐Xin Zhang, Wei‐Ping Fu, Chang Sun RESEARCH ARTICLE Identification of rs2036527 as a cis‐regulatory variant for CHRNA3 and CHRNA5 by allele‐specific expression and implications for nicotine dependence and lung cancer 10.1111/ajad.70074 The American Journal on Addictions 10.1111/ajad.70074 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70074?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70087?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70087 The American Journal on Addictions, Volume 35, Issue 3, Page 396-403, May 2026. Abstract Background and Objectives 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. Methods 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. Results 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. Conclusions and Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>We leveraged data from the 2023 National Survey on Drug Use and Health from youth aged 12–17 (<i>N</i> = 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> <h2>Results</h2> <p>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> <h2>Conclusions and Scientific Significance</h2> <p>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> Timothy J. Grigsby, Rachel Hoopsick, Dylan Barker, Elise Devier, Amber Amis, R. Andrew Yockey RESEARCH ARTICLE Substance use and sexual orientation among adolescents: Differences by age group and sex in the 2023 National Survey of Drug Use and Health 10.1111/ajad.70087 The American Journal on Addictions 10.1111/ajad.70087 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70087?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70092?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70092 The American Journal on Addictions, Volume 35, Issue 3, Page 404-411, May 2026. Abstract Background and Objectives 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. Methods 376 (87% female) undergraduates recruited through our psychology department research participant pool with current (past 3‐month) alcohol use completed an online survey. Results 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. Discussion and Conclusions 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. Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>376 (87% female) undergraduates recruited through our psychology department research participant pool with current (past 3-month) alcohol use completed an online survey.</p> <h2>Results</h2> <p>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> <h2>Discussion and Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>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> Amelia Knox, Luke A. Vargo, Julia D. Buckner RESEARCH ARTICLE Imposter syndrome and college students' drinking behaviors: The roles of negative affect and coping motivated alcohol use 10.1111/ajad.70092 The American Journal on Addictions 10.1111/ajad.70092 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70092?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70086?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70086 The American Journal on Addictions, Volume 35, Issue 3, Page 387-395, May 2026. Abstract Background and Objectives Social media use may influence substance use and mental health symptoms differently for urban versus rural sexual minority young adults (SMYAs). Methods 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. Results The sample (N = 493; Mage = 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. Discussion and Conclusions 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. Scientific Significance 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. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Social media use may influence substance use and mental health symptoms differently for urban versus rural sexual minority young adults (SMYAs).</p> <h2>Methods</h2> <p>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> <h2>Results</h2> <p>The sample (<i>N</i> = 493; <i>M</i> _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> <h2>Discussion and Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>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> Erin A. Vogel, McKenna K. Nhem, Mahalaxmi K. Das, Katelyn F. Romm RESEARCH ARTICLE Social media use and health outcomes as moderated by rurality among sexual minority young adults 10.1111/ajad.70086 The American Journal on Addictions 10.1111/ajad.70086 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70086?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70101?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70101 The American Journal on Addictions, Volume 35, Issue 3, Page 362-369, May 2026. Abstract Background and Objectives 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. Methods 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. Results 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). Discussion ChatGPT responses were longer and more complex than FAQs, although the frequency of stigmatizing language was similar. Conclusions 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. Scientific Significance Findings quantify readability and stigma trade‐offs in AI‐generated OUD education and emphasize the need for plain language prompting and human review. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>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> <h2>Methods</h2> <p>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> <h2>Results</h2> <p>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 <i>p</i> &lt; .05). Stigmatizing term frequency was similar, 0.98 vs. 0.28 per answer (95% CI, −1.3 to +3.3).</p> <h2>Discussion</h2> <p>ChatGPT responses were longer and more complex than FAQs, although the frequency of stigmatizing language was similar.</p> <h2>Conclusions</h2> <p>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> <h2>Scientific Significance</h2> <p>Findings quantify readability and stigma trade-offs in AI-generated OUD education and emphasize the need for plain language prompting and human review.</p> Vitor M. Campos, Daniel L. Heringer, Gabriel P. A. Costa, Henrique N. P. Oliva, Akhil Anand RESEARCH ARTICLE Readability, linguistic complexity, and stigma in ChatGPT responses to opioid use disorder FAQs: A comparative analysis 10.1111/ajad.70101 The American Journal on Addictions 10.1111/ajad.70101 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70101?af=R RESEARCH ARTICLE 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70161?af=R Fri, 24 Apr 2026 08:20:33 -0700 2026-04-24T08:20:33-07:00 Wiley: The American Journal on Addictions: Table of Contents Fri, 01 May 2026 00:00:00 -0700 Fri, 01 May 2026 00:00:00 -0700 10.1111/ajad.70161 The American Journal on Addictions, Volume 35, Issue 3, Page 333-337, May 2026. ISSUE INFORMATION Issue Information 10.1111/ajad.70161 The American Journal on Addictions 10.1111/ajad.70161 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70161?af=R ISSUE INFORMATION 35 3 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70159?af=R Mon, 20 Apr 2026 01:27:46 -0700 2026-04-20T01:27:46-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70159 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Readmission to residential treatment increases healthcare costs, strains publicly funded systems, and may not adequately meet clients' needs. This study examined rates and predictors of readmission to residential treatment among clients transitioned from detoxification services. Method Data from 4915 clients admitted between April 2015 and March 2022, encompassing 10,463 treatment admissions, were analyzed. Logistic regression was used to compare readmitted with nonreadmitted clients, focusing on sociodemographic characteristics, primary substance of concern, and program‐related variables. Results Overall, 41.6% (n = 2046) of clients were readmitted, with a mean of 3.7 admissions, indicating that a small subgroup accounted for a disproportionate use of limited treatment capacity. Higher odds of treatment readmission were associated with opiate or alcohol use, unstable employment or marital status, detox noncompletion or repeated cycling between completion and noncompletion, transition delays exceeding 14 days, polysubstance use, urban–rural mobility, and use of multiple detox facilities. Lower odds of treatment readmission were observed in individuals using cocaine, those admitted to integrated facilities offering both detox and residential care, and clients with less frequent detox utilization. Conclusion and Scientific Significance Readmission to residential treatment is common and linked to both individual vulnerabilities and system‐level factors. Strengthening protocols for alcohol and opioid use, enhancing coordination between detox and residential treatment, and targeting high‐risk groups may reduce readmission. Interventions addressing non‐completion of detox and delayed transitions could further reduce treatment readmission. This study uniquely examines readmission in relation to prior detoxification programs and clients' characteristics within a continuum‐of‐care framework. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Readmission to residential treatment increases healthcare costs, strains publicly funded systems, and may not adequately meet clients' needs. This study examined rates and predictors of readmission to residential treatment among clients transitioned from detoxification services.</p> <h2>Method</h2> <p>Data from 4915 clients admitted between April 2015 and March 2022, encompassing 10,463 treatment admissions, were analyzed. Logistic regression was used to compare readmitted with nonreadmitted clients, focusing on sociodemographic characteristics, primary substance of concern, and program-related variables.</p> <h2>Results</h2> <p>Overall, 41.6% (<i>n</i> = 2046) of clients were readmitted, with a mean of 3.7 admissions, indicating that a small subgroup accounted for a disproportionate use of limited treatment capacity. Higher odds of treatment readmission were associated with opiate or alcohol use, unstable employment or marital status, detox noncompletion or repeated cycling between completion and noncompletion, transition delays exceeding 14 days, polysubstance use, urban–rural mobility, and use of multiple detox facilities. Lower odds of treatment readmission were observed in individuals using cocaine, those admitted to integrated facilities offering both detox and residential care, and clients with less frequent detox utilization.</p> <h2>Conclusion and Scientific Significance</h2> <p>Readmission to residential treatment is common and linked to both individual vulnerabilities and system-level factors. Strengthening protocols for alcohol and opioid use, enhancing coordination between detox and residential treatment, and targeting high-risk groups may reduce readmission. Interventions addressing non-completion of detox and delayed transitions could further reduce treatment readmission. This study uniquely examines readmission in relation to prior detoxification programs and clients' characteristics within a continuum-of-care framework.</p> Abreham Mekonnen RESEARCH ARTICLE Factors associated with readmission to residential treatment among clients transitioned from detoxification services in Alberta, Canada 10.1111/ajad.70159 The American Journal on Addictions 10.1111/ajad.70159 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70159?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70160?af=R Mon, 20 Apr 2026 01:23:44 -0700 2026-04-20T01:23:44-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70160 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Participation in physician health programs (PHPs) is associated with positive outcomes for healthcare professionals (HCPs) with potentially‐impairing conditions, but more information is needed about PHP completer experiences. The present study explored program completers' perceptions of their involvement with one state PHP. Methods A PHP staff member with no monitoring role conducted exit interviews via telephone with all individuals who completed the program between January 2019 and September 2023 (n = 666). Deidentified interview responses were examined using quantitative descriptive analysis and thematic analysis. Results The HCPs who completed PHP participation were generally satisfied with the program. Three major themes emerged: (1) PHP offers valuable support; (2) Helpful components of the PHP; and (3) Challenges encountered during PHP monitoring. The HCPs generally expressed appreciation for the PHP, with many describing a bittersweet journey. Components of the program identified as helpful included peer support, availability and expertise of case managers, accountability, advocacy and support offered by the program, and mental healthcare. Key challenges faced by program completers included the financial burden, feeling overwhelmed by program requirements, and perceived stigma and negative treatment related to their PHP involvement. Discussion and Conclusions Many PHP completers perceive PHP support as critical to improving their recovery outcomes. Additional resources may be needed to relieve the perceived financial burden of PHP participation, mitigate disruption to daily life/responsibilities, and reduce emotional distress following referral to PHP. Scientific Significance This is a large qualitative study of the perspectives and experiences of PHP completers. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Participation in physician health programs (PHPs) is associated with positive outcomes for healthcare professionals (HCPs) with potentially-impairing conditions, but more information is needed about PHP completer experiences. The present study explored program completers' perceptions of their involvement with one state PHP.</p> <h2>Methods</h2> <p>A PHP staff member with no monitoring role conducted exit interviews via telephone with all individuals who completed the program between January 2019 and September 2023 (<i>n</i> = 666). Deidentified interview responses were examined using quantitative descriptive analysis and thematic analysis.</p> <h2>Results</h2> <p>The HCPs who completed PHP participation were generally satisfied with the program. Three major themes emerged: (1) PHP offers valuable support; (2) Helpful components of the PHP; and (3) Challenges encountered during PHP monitoring. The HCPs generally expressed appreciation for the PHP, with many describing a bittersweet journey. Components of the program identified as helpful included peer support, availability and expertise of case managers, accountability, advocacy and support offered by the program, and mental healthcare. Key challenges faced by program completers included the financial burden, feeling overwhelmed by program requirements, and perceived stigma and negative treatment related to their PHP involvement.</p> <h2>Discussion and Conclusions</h2> <p>Many PHP completers perceive PHP support as critical to improving their recovery outcomes. Additional resources may be needed to relieve the perceived financial burden of PHP participation, mitigate disruption to daily life/responsibilities, and reduce emotional distress following referral to PHP.</p> <h2>Scientific Significance</h2> <p>This is a large qualitative study of the perspectives and experiences of PHP completers.</p> Cristiana N. P. Araujo, Sidney Fire, Anna D'Ambrosio, Heather Thomas, Tish Conwell, Alexandria Polles, Lisa J. Merlo RESEARCH ARTICLE Healthcare professionals' perceptions of participation in one state physician health program 10.1111/ajad.70160 The American Journal on Addictions 10.1111/ajad.70160 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70160?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70158?af=R Fri, 03 Apr 2026 00:00:00 -0700 2026-04-03T12:00:00-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70158 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Veterans face disproportionate suicide and mortality risks driven by intersecting social determinants of health (SDH), including housing instability, unemployment, and justice involvement, and co‐occurring substance use disorders (SUD). This study examined how these intersecting factors influence mortality and whether SUD treatment mitigated mortality risks among US veterans. Methods Using national Veterans Health Administration data (2014–2019), we identified 215,944 veterans with SUD and an indicator of one of three adverse SDH: housing instability, justice involvement, or unemployment. We tracked suicide and all‐cause mortality for 1 year following SDH exposure. We used discrete‐time survival models to assess associations between month‐specific SUD treatment and mortality outcomes, controlling for demographic, clinical (i.e., mental health conditions, suicidal behavior), and contextual covariates. Results Nearly half of veterans (48%) received SUD treatment. Those who received treatment had lower all‐cause mortality (2.1% vs. 4.3%; p < .001) but no significant difference in suicide mortality (0.14% vs. 0.15%; p = .75). [Correction added on 22 April 2026, after first online publication: The preceding sentence has been revised in this version.] SUD treatment was associated with a 24% (aOR = 1.24; 95% CI: 1.16–1.34) reduction in all‐cause mortality, though its interaction with each adverse SDH was not statistically significant. Suicide deaths remained concentrated among White veterans, those aged 18‐34, with no service connection, and with time‐varying suicidal ideation or attempts (p < .001). Discussion and Conclusions Engagement in SUD treatment reduces all‐cause mortality among veterans facing compounded social adversity but does not independently mitigate suicide deaths. Scientific Significance Integrated approaches that embed suicide prevention within addiction and SDH‐focused care are essential to address the multifactorial drivers of veterans' suicidal mortality. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Veterans face disproportionate suicide and mortality risks driven by intersecting social determinants of health (SDH), including housing instability, unemployment, and justice involvement, and co-occurring substance use disorders (SUD). This study examined how these intersecting factors influence mortality and whether SUD treatment mitigated mortality risks among US veterans.</p> <h2>Methods</h2> <p>Using national Veterans Health Administration data (2014–2019), we identified 215,944 veterans with SUD and an indicator of one of three adverse SDH: housing instability, justice involvement, or unemployment. We tracked suicide and all-cause mortality for 1 year following SDH exposure. We used discrete-time survival models to assess associations between month-specific SUD treatment and mortality outcomes, controlling for demographic, clinical (i.e., mental health conditions, suicidal behavior), and contextual covariates.</p> <h2>Results</h2> <p>Nearly half of veterans (48%) received SUD treatment. Those who received treatment had lower all-cause mortality (2.1% vs. 4.3%; <i>p</i> &lt; .001) but no significant difference in suicide mortality (0.14% vs. 0.15%; <i>p</i> = .75). [Correction added on 22 April 2026, after first online publication: The preceding sentence has been revised in this version.] SUD treatment was associated with a 24% (aOR = 1.24; 95% CI: 1.16–1.34) reduction in all-cause mortality, though its interaction with each adverse SDH was not statistically significant. Suicide deaths remained concentrated among White veterans, those aged 18-34, with no service connection, and with time-varying suicidal ideation or attempts (<i>p</i> &lt; .001).</p> <h2>Discussion and Conclusions</h2> <p>Engagement in SUD treatment reduces all-cause mortality among veterans facing compounded social adversity but does not independently mitigate suicide deaths.</p> <h2>Scientific Significance</h2> <p>Integrated approaches that embed suicide prevention within addiction and SDH-focused care are essential to address the multifactorial drivers of veterans' suicidal mortality.</p> Kashfi Pandit, Aerin deRussy, John Blosnich, Gala True, Ann E. Montgomery RESEARCH ARTICLE Differential mortality among US veterans: Social determinants of health, substance use disorder, and substance use treatment 10.1111/ajad.70158 The American Journal on Addictions 10.1111/ajad.70158 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70158?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70157?af=R Sun, 29 Mar 2026 02:15:28 -0700 2026-03-29T02:15:28-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70157 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Opioid use has been linked to increased stroke incidence and severity; however, data on effects during acute stroke hospitalization are limited. Methods We used the 2016–2020 National Inpatient Sample to evaluate the effects of opioid disorders on patient‐directed discharge (PDD) and length of stay (LOS) in 3,101,545 patients. Results On multivariate analysis, opioid disorders were independently associated with discharge AMA (aOR: 2.29; 95% CI: 1.98–2.65) and longer LOS (β: 1.5, SE: 0.138; p < .001). Discussion and Conclusions Opioid disorders may predispose PDD and prolonged hospital courses in stroke admissions. Scientific Significance Opioid disorders may warrant targeted inpatient management and health system planning in stroke. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Opioid use has been linked to increased stroke incidence and severity; however, data on effects during acute stroke hospitalization are limited.</p> <h2>Methods</h2> <p>We used the 2016–2020 National Inpatient Sample to evaluate the effects of opioid disorders on patient-directed discharge (PDD) and length of stay (LOS) in 3,101,545 patients.</p> <h2>Results</h2> <p>On multivariate analysis, opioid disorders were independently associated with discharge AMA (aOR: 2.29; 95% CI: 1.98–2.65) and longer LOS (β: 1.5, SE: 0.138; <i>p</i> &lt; .001).</p> <h2>Discussion and Conclusions</h2> <p>Opioid disorders may predispose PDD and prolonged hospital courses in stroke admissions.</p> <h2>Scientific Significance</h2> <p>Opioid disorders may warrant targeted inpatient management and health system planning in stroke.</p> Rohan M. Shah, Shiv Patel, Brent Schnipke, Brandon Hamm BRIEF REPORT Brief Report: Opioid‐related disorders increase patient‐directed discharge in admissions for hemorrhagic or ischemic stroke 10.1111/ajad.70157 The American Journal on Addictions 10.1111/ajad.70157 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70157?af=R BRIEF REPORT https://onlinelibrary.wiley.com/doi/10.1111/ajad.70156?af=R Mon, 23 Mar 2026 20:50:19 -0700 2026-03-23T08:50:19-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70156 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Cannabis use disorder affects millions globally, with growing interest in neurocognitive recovery following cessation. The reversibility of cannabis‐induced neuroadaptations remains critical for clinicians, given increasing cannabis potency and early initiation. This systematic review examines neurocognitive recovery patterns and biomarker changes following cannabis cessation, focusing on clinical implications and factors influencing recovery trajectories. Methods A comprehensive literature search was conducted using PubMed, EMBASE, PsycINFO, and Cochrane databases (2000–2025). Studies examining neurocognitive recovery following cannabis cessation were included, with abstinence periods ranging from acute (≥72 h) to extended (months to years). Primary outcomes included neuroimaging changes, cognitive performance, and biomarker recovery patterns. Study quality was assessed using Newcastle‐Ottawa Scale and Cochrane Risk of Bias tools. Narrative synthesis was employed due to heterogeneity. Results Twenty‐six studies met the inclusion criteria. Neuroimaging demonstrated CB1 receptor normalization within 4 weeks and cognitive improvements within the first week of cessation. Recovery patterns varied by age of onset and use intensity. Adolescent‐onset users showed less complete recovery than adult‐onset users; heavy users required extended recovery periods. Cognitive deficits in attention and executive function persisted beyond acute cessation. Discussion and Conclusions Cannabis cessation produces substantial neurocognitive recovery, particularly within the first year. However, recovery requires extended clinical support, age‐stratified approaches, and systematic cognitive monitoring. Current evidence challenges assumptions about permanent cannabis‐related brain damage while highlighting vulnerabilities in adolescent populations. Scientific Significance These findings provide evidence‐based guidance for treatment duration, realistic expectation‐setting, and individualized prognosis determination in cannabis use disorder recovery. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Cannabis use disorder affects millions globally, with growing interest in neurocognitive recovery following cessation. The reversibility of cannabis-induced neuroadaptations remains critical for clinicians, given increasing cannabis potency and early initiation. This systematic review examines neurocognitive recovery patterns and biomarker changes following cannabis cessation, focusing on clinical implications and factors influencing recovery trajectories.</p> <h2>Methods</h2> <p>A comprehensive literature search was conducted using PubMed, EMBASE, PsycINFO, and Cochrane databases (2000–2025). Studies examining neurocognitive recovery following cannabis cessation were included, with abstinence periods ranging from acute (≥72 h) to extended (months to years). Primary outcomes included neuroimaging changes, cognitive performance, and biomarker recovery patterns. Study quality was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias tools. Narrative synthesis was employed due to heterogeneity.</p> <h2>Results</h2> <p>Twenty-six studies met the inclusion criteria. Neuroimaging demonstrated CB1 receptor normalization within 4 weeks and cognitive improvements within the first week of cessation. Recovery patterns varied by age of onset and use intensity. Adolescent-onset users showed less complete recovery than adult-onset users; heavy users required extended recovery periods. Cognitive deficits in attention and executive function persisted beyond acute cessation.</p> <h2>Discussion and Conclusions</h2> <p>Cannabis cessation produces substantial neurocognitive recovery, particularly within the first year. However, recovery requires extended clinical support, age-stratified approaches, and systematic cognitive monitoring. Current evidence challenges assumptions about permanent cannabis-related brain damage while highlighting vulnerabilities in adolescent populations.</p> <h2>Scientific Significance</h2> <p>These findings provide evidence-based guidance for treatment duration, realistic expectation-setting, and individualized prognosis determination in cannabis use disorder recovery.</p> Valerio Ricci, Thomas Fraccalini, Giovanni Martinotti, Giuseppe Maina REVIEW ARTICLE Cannabis cessation and neurocognitive recovery: Patterns, predictors, and clinical implications—a systematic review 10.1111/ajad.70156 The American Journal on Addictions 10.1111/ajad.70156 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70156?af=R REVIEW ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70155?af=R Thu, 12 Mar 2026 10:35:06 -0700 2026-03-12T10:35:06-07:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70155 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Injection drug use is a driver of hepatitis C virus (HCV) transmission, thus integrating HCV care into addiction care is likely necessary for HCV elimination. Here we describe how we integrated HCV care into our addiction medicine (AM) clinic and evaluate its effect on HCV treatment. Methods Integrated care involves HCV screening and treatment with either DAA prescription directly in AM clinic or via telemedicine with an infectious diseases (ID) specialist. Using retrospective chart review, we assessed if the program affected rates of direct‐acting antivirals (DAA) initiation, DAA completion, and sustained virological response (SVR). Results Among 72 treatment naïve patients, the rate of DAA initiation increased after integrated care (HR 2.21, 95% CI 1.05–4.66), but rates of DAA completion or SVR did not significantly increase. Integrated care was associated with more DAA prescriptions (0.6 vs. 0 prescriptions per month, p = .004) and decreased referrals to hepatology (0.2 vs. 1 referrals per month, p = .001). Compared to referring patients to hepatology, prescribing DAAs in AM clinic was associated with higher rates of DAA initiation (HR 42.46; 95% CI: 15.25–118.24) and completion (HR 8.33; 95% CI: 2.76–25.16). Discussion and Conclusions An integrated care program that involved both in‐person and telemedicine options improve access to DAA therapy. Enhancing interprofessional collaboration and expanding telemedicine services offers a practical model for strengthening HCV care delivery. Scientific Significance This study demonstrates a practical approach to integrating HCV care into addiction treatment through development of inter‐professional collaboration between healthcare specialties. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Injection drug use is a driver of hepatitis C virus (HCV) transmission, thus integrating HCV care into addiction care is likely necessary for HCV elimination. Here we describe how we integrated HCV care into our addiction medicine (AM) clinic and evaluate its effect on HCV treatment.</p> <h2>Methods</h2> <p>Integrated care involves HCV screening and treatment with either DAA prescription directly in AM clinic or via telemedicine with an infectious diseases (ID) specialist. Using retrospective chart review, we assessed if the program affected rates of direct-acting antivirals (DAA) initiation, DAA completion, and sustained virological response (SVR).</p> <h2>Results</h2> <p>Among 72 treatment naïve patients, the rate of DAA initiation increased after integrated care (HR 2.21, 95% CI 1.05–4.66), but rates of DAA completion or SVR did not significantly increase. Integrated care was associated with more DAA prescriptions (0.6 vs. 0 prescriptions per month, <i>p</i> = .004) and decreased referrals to hepatology (0.2 vs. 1 referrals per month, <i>p</i> = .001). Compared to referring patients to hepatology, prescribing DAAs in AM clinic was associated with higher rates of DAA initiation (HR 42.46; 95% CI: 15.25–118.24) and completion (HR 8.33; 95% CI: 2.76–25.16).</p> <h2>Discussion and Conclusions</h2> <p>An integrated care program that involved both in-person and telemedicine options improve access to DAA therapy. Enhancing interprofessional collaboration and expanding telemedicine services offers a practical model for strengthening HCV care delivery.</p> <h2>Scientific Significance</h2> <p>This study demonstrates a practical approach to integrating HCV care into addiction treatment through development of inter-professional collaboration between healthcare specialties.</p> Arya Zandvakili, Joseph Rattenni, James Burton, Lakshmi Guduguntla, Marcus Osman, Sayeh Sabbagh, Stephan Arndt, Ben Miskle, Quanhathai Kaewpoowat, Michael Ohl, Andrea Weber, Alison Lynch RESEARCH ARTICLE Improving access to direct acting antivirals via a multimodal integrated care program in an addiction medicine clinic 10.1111/ajad.70155 The American Journal on Addictions 10.1111/ajad.70155 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70155?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70154?af=R Tue, 03 Mar 2026 04:50:32 -0800 2026-03-03T04:50:32-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70154 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Rates of tobacco use disorder (TUD) are high among individuals with opioid use disorder (OUD), who consistently show lower response rates to evidence‐based treatment approaches for TUD relative to the general population. This systematic review aims to provide a comprehensive and updated examination of the current evidence regarding TUD treatments for individuals with OUD. We first summarize potential mechanisms driving TUD and treatment nonresponse among those with OUD, given the likely roles of overlapping reward and withdrawal processes in co‐occurrence and treatment challenges. We then provide an updated review of the relevant literature on treating TUD among those with OUD. Methods Our review identified a total of 25 studies, with 9 examining pharmacological treatments, 5 examining behavioral treatments, and 11 examining a combination treatment approach. Results Consistent with previous research, pharmacological treatments were generally ineffective for smoking cessation among those with OUD. No studies reported continuous abstinence at 6 months post‐quit date. Contingency management interventions showed some promise but smoking largely resumed after incentives were removed. Discussion and Conclusions Overall, findings demonstrate limited progress in identifying durable, effective smoking cessation interventions for individuals with OUD. Scientific Significance Traditional cessation treatment approaches fail to address smoking in individuals with OUD. Novel pharmacological and behavioral strategies that can be implemented into existing medications for OUD clinical care are necessary. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Rates of tobacco use disorder (TUD) are high among individuals with opioid use disorder (OUD), who consistently show lower response rates to evidence-based treatment approaches for TUD relative to the general population. This systematic review aims to provide a comprehensive and updated examination of the current evidence regarding TUD treatments for individuals with OUD. We first summarize potential mechanisms driving TUD and treatment nonresponse among those with OUD, given the likely roles of overlapping reward and withdrawal processes in co-occurrence and treatment challenges. We then provide an updated review of the relevant literature on treating TUD among those with OUD.</p> <h2>Methods</h2> <p>Our review identified a total of 25 studies, with 9 examining pharmacological treatments, 5 examining behavioral treatments, and 11 examining a combination treatment approach.</p> <h2>Results</h2> <p>Consistent with previous research, pharmacological treatments were generally ineffective for smoking cessation among those with OUD. No studies reported continuous abstinence at 6 months post-quit date. Contingency management interventions showed some promise but smoking largely resumed after incentives were removed.</p> <h2>Discussion and Conclusions</h2> <p>Overall, findings demonstrate limited progress in identifying durable, effective smoking cessation interventions for individuals with OUD.</p> <h2>Scientific Significance</h2> <p>Traditional cessation treatment approaches fail to address smoking in individuals with OUD. Novel pharmacological and behavioral strategies that can be implemented into existing medications for OUD clinical care are necessary.</p> Suprit Parida, Victoria Ameral, Noah Wolkowicz, Megan M. Kelly, Jessica A. Patterson, Mehmet Sofuoglu, R. Ross MacLean REVIEW ARTICLE Addressing tobacco use in the context of opioid use disorder: A systematic review of smoking cessation interventions 10.1111/ajad.70154 The American Journal on Addictions 10.1111/ajad.70154 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70154?af=R REVIEW ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70151?af=R Wed, 25 Feb 2026 20:05:12 -0800 2026-02-25T08:05:12-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70151 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Patients using fentanyl have worse treatment outcomes; however, little is known about other drugs that complicate treatment. Methods A national survey (n = 396) was conducted using a random sample of clinicians waivered to prescribe buprenorphine in the United States. This study reports the results of a single survey item on clinicians' perceptions of other drugs, besides IMF, complicating treatment. Results Clinicians reported methamphetamine (86.4%), synthetic cannabinoids (42.7%), and xylazine (41.4%) were complicating treatment; reports varied by geographic region. Conclusions and Scientific Significance Rapid clinician surveys can provide real‐time data on changing patterns of drug use's impact treatment outcomes. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Patients using fentanyl have worse treatment outcomes; however, little is known about other drugs that complicate treatment.</p> <h2>Methods</h2> <p>A national survey (<i>n</i> = 396) was conducted using a random sample of clinicians waivered to prescribe buprenorphine in the United States. This study reports the results of a single survey item on clinicians' perceptions of other drugs, besides IMF, complicating treatment.</p> <h2>Results</h2> <p>Clinicians reported methamphetamine (86.4%), synthetic cannabinoids (42.7%), and xylazine (41.4%) were complicating treatment; reports varied by geographic region.</p> <h2>Conclusions and Scientific Significance</h2> <p>Rapid clinician surveys can provide real-time data on changing patterns of drug use's impact treatment outcomes.</p> Erin L. Winstanley, Jane M. Liebschutz, Cristina Murray‐Krezan, Galen E. Switzer, Samantha Nash, Sarah Kawasaki BRIEF REPORT Brief report: Meth, tranq, gas station heroin & other drugs complicating addiction treatment 10.1111/ajad.70151 The American Journal on Addictions 10.1111/ajad.70151 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70151?af=R BRIEF REPORT https://onlinelibrary.wiley.com/doi/10.1111/ajad.70152?af=R Mon, 23 Feb 2026 00:00:00 -0800 2026-02-23T12:00:00-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70152 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Although buprenorphine is effective and approved for treating opioid use disorder (OUD), it remains underutilized in primary care settings. This study's objective was to explore what primary care teams need to overcome barriers in treating OUD, and to assess whether those needs change after receiving education on OUD treatment. Methods The American Academy of Family Physicians hosted a 12‐month Project ECHO® educational series on OUD for primary care teams. Thematic analysis was conducted on participant responses pre‐ and post‐series to the survey item “Please list your most pressing needs related to OUD” (N = 92). Results Ninety‐two participants from 25 primary care practices from the US and Canada responded to the pressing needs item across both surveys. The most prevalent need reported at baseline was Education and Training, which became second to Health System Resources at endpoint. Respondents cited organizational protocols for OUD treatment as a pressing need among other Health System Resources such as support for reimbursement. Needs relating to transportation and housing; engaging patients to start and continue in OUD treatment; and addressing stigma within the community and health system were indicative of overlapping barriers. Discussion and Conclusions Responses from primary care teams echo previous studies on barriers to OUD treatment and provide specific, actionable insight to addressing these barriers. Scientific Significance Actionable insights, for example, implementing health system‐level OUD protocols and guidelines and promoting availability of OUD treatment and education, are ways that primary care teams could increase treatment of patients with OUD. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Although buprenorphine is effective and approved for treating opioid use disorder (OUD), it remains underutilized in primary care settings. This study's objective was to explore what primary care teams need to overcome barriers in treating OUD, and to assess whether those needs change after receiving education on OUD treatment.</p> <h2>Methods</h2> <p>The American Academy of Family Physicians hosted a 12-month Project ECHO® educational series on OUD for primary care teams. Thematic analysis was conducted on participant responses pre- and post-series to the survey item “Please list your most pressing needs related to OUD” (<i>N</i> = 92).</p> <h2>Results</h2> <p>Ninety-two participants from 25 primary care practices from the US and Canada responded to the pressing needs item across both surveys. The most prevalent need reported at baseline was Education and Training, which became second to Health System Resources at endpoint. Respondents cited organizational protocols for OUD treatment as a pressing need among other Health System Resources such as support for reimbursement. Needs relating to transportation and housing; engaging patients to start and continue in OUD treatment; and addressing stigma within the community and health system were indicative of overlapping barriers.</p> <h2>Discussion and Conclusions</h2> <p>Responses from primary care teams echo previous studies on barriers to OUD treatment and provide specific, actionable insight to addressing these barriers.</p> <h2>Scientific Significance</h2> <p>Actionable insights, for example, implementing health system-level OUD protocols and guidelines and promoting availability of OUD treatment and education, are ways that primary care teams could increase treatment of patients with OUD.</p> Elise A. Robertson, Kaitlyn K. Frick, Cory B. Lutgen, Elisabeth F. Callen, Tarin L. Clay, Gabriela Gaona Villarreal, Kathryn Cates‐Wessel, Joshua A. Smith, Melissa K. Filippi RESEARCH ARTICLE Primary care's most pressing needs to address opioid use disorder: A qualitative study 10.1111/ajad.70152 The American Journal on Addictions 10.1111/ajad.70152 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70152?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70148?af=R Thu, 12 Feb 2026 02:00:42 -0800 2026-02-12T02:00:42-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70148 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Although Asian American and Pacific Island (AAPI) individuals are less likely to use alcohol than other racial/ethnic groups, health disparities regarding alcohol‐related outcomes indicate a need to study factors relevant to the AAPI community that may be related to alcohol use and related problems. Experiences of racism are related to greater alcohol use and related problems, presumably due to alcohol use in an attempt to manage heightened negative affect due to experiencing racism. Yet, no known studies have tested whether negative affect specifically related to racism is associated with alcohol outcomes among AAPI individuals. Methods The current study tested this hypothesis among 411 (58.2% male, aged 18–75) nationally recruited AAPI adults who endorsed current alcohol use. Results Experiences of AAPI‐based racism and racism‐related negative affect were statistically significantly related to drinking quantity and use‐related problems. Racism‐related negative affect was robustly related to alcohol outcomes after controlling for variance attributable to relevant demographic variables, anxiety, and depression. The relation of racism to alcohol problems occurred via racism‐related negative affect and typical drinking quantity. Discussion and Conclusions Results highlight the deleterious effects of racism on mental and behavioral health among AAPI individuals. Scientific Significance AAPI individuals have been underrepresented in research on alcohol use and related problems. The greater negative affect and alcohol problems associated with experiences of racism are concerning, given the high rates of racism experienced by AAPI individuals. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Although Asian American and Pacific Island (AAPI) individuals are less likely to use alcohol than other racial/ethnic groups, health disparities regarding alcohol-related outcomes indicate a need to study factors relevant to the AAPI community that may be related to alcohol use and related problems. Experiences of racism are related to greater alcohol use and related problems, presumably due to alcohol use in an attempt to manage heightened negative affect due to experiencing racism. Yet, no known studies have tested whether negative affect specifically related to racism is associated with alcohol outcomes among AAPI individuals.</p> <h2>Methods</h2> <p>The current study tested this hypothesis among 411 (58.2% male, aged 18–75) nationally recruited AAPI adults who endorsed current alcohol use.</p> <h2>Results</h2> <p>Experiences of AAPI-based racism and racism-related negative affect were statistically significantly related to drinking quantity and use-related problems. Racism-related negative affect was robustly related to alcohol outcomes after controlling for variance attributable to relevant demographic variables, anxiety, and depression. The relation of racism to alcohol problems occurred via racism-related negative affect and typical drinking quantity.</p> <h2>Discussion and Conclusions</h2> <p>Results highlight the deleterious effects of racism on mental and behavioral health among AAPI individuals.</p> <h2>Scientific Significance</h2> <p>AAPI individuals have been underrepresented in research on alcohol use and related problems. The greater negative affect and alcohol problems associated with experiences of racism are concerning, given the high rates of racism experienced by AAPI individuals.</p> Julia D. Buckner, Justin M. Shepherd, Jessica M. Thai, Khoa D. Le, Michael J. Zvolensky RESEARCH ARTICLE Racism and alcohol use and related problems among Asian American and Pacific Island adults: The role of negative emotions in responses to experiencing racism 10.1111/ajad.70148 The American Journal on Addictions 10.1111/ajad.70148 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70148?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70135?af=R Tue, 10 Feb 2026 19:25:37 -0800 2026-02-10T07:25:37-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70135 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Social media exposure may influence early nicotine experimentation, a behavior linked to later nicotine dependence and health risks. Few studies have examined the role of smoking expectancies (i.e., beliefs about the anticipated positive or negative effects of nicotine) as a pathway underlying this association, especially in early adolescence. The objective of this study is to examine the prospective association between social media use and nicotine experimentation in early adolescence, and whether smoking expectancies mediate this relationship. Methods Using longitudinal data from the Adolescent Brain Cognitive Development Study (N = 8292; mean age 12.0 years at Year 2; 2018–2020), we estimated associations between social media time (Year 2) and nicotine experimentation (Year 4), adjusting for confounders and testing positive and negative smoking expectancies (Year 3) as mediators using generalized structural equation modeling. Results Social media time at Year 2 was associated with nicotine experimentation at Year 4. Positive smoking expectancies (but not negative expectancies) were associated with nicotine experimentation. Positive smoking expectancies mediated 5.97% (95% CI: 1.27%–10.67%, p = .013) of the social media‐nicotine experimentation association. Discussion and Conclusions Early social media exposure may be associated with favorable beliefs about nicotine, increasing adolescents' risk of experimentation. Regulatory policies, clinical screening, and prevention programs could mitigate early nicotine use. Future research should explore how these relationships evolve across adolescence. Scientific Significance This study advances understanding of how social media use contributes to early nicotine experimentation in adolescents by identifying positive smoking expectancies as a potential pathway. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Social media exposure may influence early nicotine experimentation, a behavior linked to later nicotine dependence and health risks. Few studies have examined the role of smoking expectancies (i.e., beliefs about the anticipated positive or negative effects of nicotine) as a pathway underlying this association, especially in early adolescence. The objective of this study is to examine the prospective association between social media use and nicotine experimentation in early adolescence, and whether smoking expectancies mediate this relationship.</p> <h2>Methods</h2> <p>Using longitudinal data from the Adolescent Brain Cognitive Development Study (<i>N</i> = 8292; mean age 12.0 years at Year 2; 2018–2020), we estimated associations between social media time (Year 2) and nicotine experimentation (Year 4), adjusting for confounders and testing positive and negative smoking expectancies (Year 3) as mediators using generalized structural equation modeling.</p> <h2>Results</h2> <p>Social media time at Year 2 was associated with nicotine experimentation at Year 4. Positive smoking expectancies (but not negative expectancies) were associated with nicotine experimentation. Positive smoking expectancies mediated 5.97% (95% CI: 1.27%–10.67%, <i>p</i> = .013) of the social media-nicotine experimentation association.</p> <h2>Discussion and Conclusions</h2> <p>Early social media exposure may be associated with favorable beliefs about nicotine, increasing adolescents' risk of experimentation. Regulatory policies, clinical screening, and prevention programs could mitigate early nicotine use. Future research should explore how these relationships evolve across adolescence.</p> <h2>Scientific Significance</h2> <p>This study advances understanding of how social media use contributes to early nicotine experimentation in adolescents by identifying positive smoking expectancies as a potential pathway.</p> Jason M. Nagata, Andrew Caffrey, Alexander Heuer, Keira Beltran Murillo, Christiane K. Helmer, Isaac Frimpong, Colbey Ricklefs, Abubakr A. Al‐Shoaibi, Alexander Testa, Claire D. Brindis, Glenn‐Milo Santos, Fiona C. Baker RESEARCH ARTICLE Social media use, smoking expectancies, and nicotine experimentation in early adolescents: A prospective cohort study 10.1111/ajad.70135 The American Journal on Addictions 10.1111/ajad.70135 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70135?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70150?af=R Sun, 08 Feb 2026 22:16:26 -0800 2026-02-08T10:16:26-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70150 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Alcohol use disorder (AUD) is one of the deadliest psychiatric conditions. Previous studies indicate that AUD is linked to several neurological biomarkers in the human brain; however, how alcohol use manifests in brain volumes and the relationships between the subcortical brain regions affected by AUD and clinical outcomes are not fully understood. This study attempts to compare subcortical brain volume differences between patients with AUD and healthy controls (HC) to understand how alcohol use relates to brain volume changes. Methods Patients with AUD, as determined by alcohol dependence and abuse criteria from the DSM‐IV, (n = 71) were recruited and matched with HC (n = 71) by demographic characteristics. We examined group differences in the volumes of 40 bilateral subcortical structures between patients with AUD and HC. We assessed the relationship between changes in subcortical brain volumes and common co‐occurring psychiatric symptoms. Results Our results revealed a significant increase of third ventricle volume in patients with AUD compared to HC. Moreover, we also found a positive correlation between the third ventricle volume and generalized anxiety in patients with AUD. Discussion and Conclusions Our findings indicate significant enlargement of the third ventricle volume in patients with AUD, as well as relatedness between the volume of this area and generalized anxiety. Scientific Significance This study is the first in the literature to find volume alterations correlated with clinical outcomes among AUD patients, reflecting a complex relationship between brain volumes and psychological symptoms in this population. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Alcohol use disorder (AUD) is one of the deadliest psychiatric conditions. Previous studies indicate that AUD is linked to several neurological biomarkers in the human brain; however, how alcohol use manifests in brain volumes and the relationships between the subcortical brain regions affected by AUD and clinical outcomes are not fully understood. This study attempts to compare subcortical brain volume differences between patients with AUD and healthy controls (HC) to understand how alcohol use relates to brain volume changes.</p> <h2>Methods</h2> <p>Patients with AUD, as determined by alcohol dependence and abuse criteria from the DSM-IV, (<i>n</i> = 71) were recruited and matched with HC (<i>n</i> = 71) by demographic characteristics. We examined group differences in the volumes of 40 bilateral subcortical structures between patients with AUD and HC. We assessed the relationship between changes in subcortical brain volumes and common co-occurring psychiatric symptoms.</p> <h2>Results</h2> <p>Our results revealed a significant increase of third ventricle volume in patients with AUD compared to HC. Moreover, we also found a positive correlation between the third ventricle volume and generalized anxiety in patients with AUD.</p> <h2>Discussion and Conclusions</h2> <p>Our findings indicate significant enlargement of the third ventricle volume in patients with AUD, as well as relatedness between the volume of this area and generalized anxiety.</p> <h2>Scientific Significance</h2> <p>This study is the first in the literature to find volume alterations correlated with clinical outcomes among AUD patients, reflecting a complex relationship between brain volumes and psychological symptoms in this population.</p> Jenna Lee, Michelle A. Patriquin, Ramiro Salas, Hyuntaek Oh RESEARCH ARTICLE Third ventricle volume and psychometric alterations in patients with alcohol usage 10.1111/ajad.70150 The American Journal on Addictions 10.1111/ajad.70150 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70150?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70132?af=R Tue, 27 Jan 2026 23:39:10 -0800 2026-01-27T11:39:10-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70132 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Despite the availability of treatments for alcohol use disorder (AUD), relapse prevalence and health‐related consequences associated with AUD remains high. Using data‐driven approaches that enhance generalizability can help elucidate relationships between treatment outcomes and alcohol consumption, aiding in the discovery of novel treatment targets for AUD subtypes. Methods We merged data (n = 2045) across four Phase 2 randomized clinical trials affiliated with the NIAAA Clinical Investigations Group and a Phase 3 trial (NIAAA Sponsored). Participants were clustered based on self‐reported drinking during treatment maintenance. A gradient boosted machine learning model with end‐of‐treatment clinical features was used to predict the clusters we identified. Results We identified a three‐cluster solution corresponding to low (MStandard Drinking Units (SDU) = 1.68, n = 1677), moderate (MSDU = 6.70, n = 253), and high (MSDU = 12.92, n = 115) clusters of alcohol consumption during treatment maintenance. We achieved modest prediction of the clusters (AccuracyTrain = 71.0%; AUCTrain = 0.79) using demographics and end‐of‐treatment clinical and biological assessments. Between‐cluster differences were observed between low and high clusters on measures of depression and anxiety (MDifference = 0.49, SE = 0.13, p = .004), drinking consequences (MDifference = 1.02, SE = 0.13, p < .001) and liver functioning (0.39 ≤ MDifference ≤ 0.52, 0.12 ≤ SE ≤ 0.13, 0.001 ≤ p ≤ .005) Discussion and Conclusions These findings suggest that generalizable clusters of alcohol consumption exist across these clinical trials characterized by core demographics, clinical, and biological phenotypes, irrespective of the treatment received. We further show that some assessments may not be useful in distinguishing between higher levels of consumption. Scientific Significance Identifying predictive features of AUD subtypes, across different phases of treatment, can assist clinicians in identifying individuals who require additional support. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Despite the availability of treatments for alcohol use disorder (AUD), relapse prevalence and health-related consequences associated with AUD remains high. Using data-driven approaches that enhance generalizability can help elucidate relationships between treatment outcomes and alcohol consumption, aiding in the discovery of novel treatment targets for AUD subtypes.</p> <h2>Methods</h2> <p>We merged data (<i>n</i> = 2045) across four Phase 2 randomized clinical trials affiliated with the NIAAA Clinical Investigations Group and a Phase 3 trial (NIAAA Sponsored). Participants were clustered based on self-reported drinking during treatment maintenance. A gradient boosted machine learning model with end-of-treatment clinical features was used to predict the clusters we identified.</p> <h2>Results</h2> <p>We identified a three-cluster solution corresponding to low (<i>M</i> _{Standard Drinking Units (SDU)} = 1.68, <i>n</i> = 1677), moderate (<i>M</i> _SDU = 6.70, <i>n</i> = 253), and high (<i>M</i> _SDU = 12.92, <i>n</i> = 115) clusters of alcohol consumption during treatment maintenance. We achieved modest prediction of the clusters (Accuracy_Train= 71.0%; AUC_Train = 0.79) using demographics and end-of-treatment clinical and biological assessments. Between-cluster differences were observed between low and high clusters on measures of depression and anxiety (<i>M</i> _Difference= 0.49, SE = 0.13, <i>p</i> = .004), drinking consequences (<i>M</i> _Difference= 1.02, SE = 0.13, <i>p</i> &lt; .001) and liver functioning (0.39 ≤ <i>M</i> _Difference ≤ 0.52, 0.12 ≤ SE ≤ 0.13, 0.001 ≤ <i>p</i> ≤ .005)</p> <h2>Discussion and Conclusions</h2> <p>These findings suggest that generalizable clusters of alcohol consumption exist across these clinical trials characterized by core demographics, clinical, and biological phenotypes, irrespective of the treatment received. We further show that some assessments may not be useful in distinguishing between higher levels of consumption.</p> <h2>Scientific Significance</h2> <p>Identifying predictive features of AUD subtypes, across different phases of treatment, can assist clinicians in identifying individuals who require additional support.</p> Robert J. Kohler, Hang Zhou, Yasmin Zakiniaeiz, Terril L. Verplaetse, Vernon Garcia‐Rivas, MacKenzie R. Peltier, Bubu A. Banini, Sherry A. McKee, Walter Roberts RESEARCH ARTICLE Identifying clinical correlates of drinking clusters during treatment for alcohol use disorder 10.1111/ajad.70132 The American Journal on Addictions 10.1111/ajad.70132 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70132?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70134?af=R Tue, 27 Jan 2026 23:25:41 -0800 2026-01-27T11:25:41-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70134 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Prescription drug misuse (PDM) has serious health and social consequences, highlighting the importance of identifying early risk factors. This study examines longitudinal pathways linking low academic performance in adolescence, substance use in emerging adulthood, and PDM in young adulthood, with attention to sex differences. Methods Participants were 5114 individuals (54% female) from Waves 1, 3, and 4 of the National Longitudinal Study of Adolescent to Adult Health. A two‐group structural equation model stratified by sex was performed to examine the pathways to PDM. Moderated mediation was also tested between males and females. Results Low academic performance in adolescence was associated with substance use in emerging adulthood for both males (p < .001) and females (p < .001), which in turn was associated with PDM in young adulthood (males: p < .001; females: p < .001). Only among females, low academic performance in adolescence was negatively associated with PDM in young adulthood (p < .001). The moderation effects of sex on the pathways from substance use to PDM (p < .05) and from low academic performance to PDM (p < .05) were significant at one‐tailed test. Discussion and Conclusions Adolescents with poor academic performance represent a high‐risk group for later PDM, emphasizing the need for early preventions. Prevention strategies should consider sex‐specific pathways, particularly targeting substance use in emerging adulthood. Scientific Significance Identifying early academic and behavioral risk factors provides valuable insight for clinicians and prevention professionals aiming to reduce PDM across the life course. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Prescription drug misuse (PDM) has serious health and social consequences, highlighting the importance of identifying early risk factors. This study examines longitudinal pathways linking low academic performance in adolescence, substance use in emerging adulthood, and PDM in young adulthood, with attention to sex differences.</p> <h2>Methods</h2> <p>Participants were 5114 individuals (54% female) from Waves 1, 3, and 4 of the National Longitudinal Study of Adolescent to Adult Health. A two-group structural equation model stratified by sex was performed to examine the pathways to PDM. Moderated mediation was also tested between males and females.</p> <h2>Results</h2> <p>Low academic performance in adolescence was associated with substance use in emerging adulthood for both males (<i>p</i> &lt; .001) and females (<i>p</i> &lt; .001), which in turn was associated with PDM in young adulthood (males: <i>p</i> &lt; .001; females: <i>p</i> &lt; .001). Only among females, low academic performance in adolescence was negatively associated with PDM in young adulthood (<i>p</i> &lt; .001). The moderation effects of sex on the pathways from substance use to PDM (<i>p</i> &lt; .05) and from low academic performance to PDM (<i>p</i> &lt; .05) were significant at one-tailed test.</p> <h2>Discussion and Conclusions</h2> <p>Adolescents with poor academic performance represent a high-risk group for later PDM, emphasizing the need for early preventions. Prevention strategies should consider sex-specific pathways, particularly targeting substance use in emerging adulthood.</p> <h2>Scientific Significance</h2> <p>Identifying early academic and behavioral risk factors provides valuable insight for clinicians and prevention professionals aiming to reduce PDM across the life course.</p> Jung Yeon Lee, Wonkuk Kim RESEARCH ARTICLE Longitudinal pathway from low academic performance in adolescence to prescription drug misuse in adulthood: The mediating role of substance use and the moderating role of sex 10.1111/ajad.70134 The American Journal on Addictions 10.1111/ajad.70134 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70134?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70107?af=R Mon, 19 Jan 2026 20:27:42 -0800 2026-01-19T08:27:42-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70107 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Disproportionate use of tobacco among psychiatric patients exacerbates psychiatric symptoms, increases suicide risk, alters therapeutic drug levels, and negatively affects adherence. Patient‐directed discharge (PDD) rates are higher among patients who smoke, and smoking cessation treatments have been reported to reduce this risk. This study investigates the association of tobacco use and cessation treatments with PDD rates. Methods A retrospective analysis was performed on a random sample of 25,829 adult patients admitted voluntarily to inpatient psychiatric facilities nationwide. Exclusion criteria included medical discharge, electroconvulsive therapy, hospital stays longer than 29 days, and incomplete demographic or smoking status data. Binary logistic regression with a Firth correction assessed the associations between PDD rates and smoking status, smoking cessation treatments, demographic variables, comorbidities, and smoking use patterns. Results Smoking was significantly associated with an increased likelihood of PDD (χ² = 49.42, p < .0001, OR = 2.16). Nicotine replacement therapy (NRT) alone significantly reduced PDD rates (χ² = 8.16, p < .01, OR = 1.42), whereas bupropion and varenicline did not show significant effects. Smoking‐related PDD rates remained elevated despite treatment compared to non‐smokers (χ² = 22.02, p < .0001, OR = 1.86). Discussion and Conclusions A significant association was found between smoking status and PDD rate. NRT alone was associated with lower PDD rates. Scientific Significance This study is the first to investigate the association of individual smoking cessation treatments with PDD rates. Contrary to previous findings, the risk remained elevated despite treatment in our large national sample. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Disproportionate use of tobacco among psychiatric patients exacerbates psychiatric symptoms, increases suicide risk, alters therapeutic drug levels, and negatively affects adherence. Patient-directed discharge (PDD) rates are higher among patients who smoke, and smoking cessation treatments have been reported to reduce this risk. This study investigates the association of tobacco use and cessation treatments with PDD rates.</p> <h2>Methods</h2> <p>A retrospective analysis was performed on a random sample of 25,829 adult patients admitted voluntarily to inpatient psychiatric facilities nationwide. Exclusion criteria included medical discharge, electroconvulsive therapy, hospital stays longer than 29 days, and incomplete demographic or smoking status data. Binary logistic regression with a Firth correction assessed the associations between PDD rates and smoking status, smoking cessation treatments, demographic variables, comorbidities, and smoking use patterns.</p> <h2>Results</h2> <p>Smoking was significantly associated with an increased likelihood of PDD (χ² = 49.42, <i>p</i> &lt; .0001, OR = 2.16). Nicotine replacement therapy (NRT) alone significantly reduced PDD rates (χ² = 8.16, <i>p</i> &lt; .01, OR = 1.42), whereas bupropion and varenicline did not show significant effects. Smoking-related PDD rates remained elevated despite treatment compared to non-smokers (χ² = 22.02, <i>p</i> &lt; .0001, OR = 1.86).</p> <h2>Discussion and Conclusions</h2> <p>A significant association was found between smoking status and PDD rate. NRT alone was associated with lower PDD rates.</p> <h2>Scientific Significance</h2> <p>This study is the first to investigate the association of individual smoking cessation treatments with PDD rates. Contrary to previous findings, the risk remained elevated despite treatment in our large national sample.</p> Steven Sprenger, Robyn Meadows, Olivia Gawrych RESEARCH ARTICLE Nicotine use and patient‐directed discharge rate in psychiatric inpatients: A retrospective cohort 10.1111/ajad.70107 The American Journal on Addictions 10.1111/ajad.70107 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70107?af=R RESEARCH ARTICLE https://onlinelibrary.wiley.com/doi/10.1111/ajad.70106?af=R Tue, 16 Dec 2025 16:15:17 -0800 2025-12-16T04:15:17-08:00 Wiley: The American Journal on Addictions: Table of Contents 10.1111/ajad.70106 The American Journal on Addictions, EarlyView. Abstract Background and Objectives Substance use disorders (SUD) among healthcare professionals threaten both patient safety and workforce stability. Professional health programs (PHPs) aim to support recovery and safe practice reentry, yet outcomes for non‐physician professionals remain underexplored. This study assessed return to use and professional outcomes among healthcare professionals monitored through the Utah Professionals Health Program (UPHP), a cohort predominantly composed of non‐physician participants. Methods A retrospective cohort study used data from 183 UPHP participants with SUD (60.7% nurses) enrolled between 2013 and 2024. The primary outcome was return to use, defined by positive toxicology results or self‐report. Logistic regression was used to identify predictors of return to use. Results Return to use occurred in 48.6% of participants, with the highest incidence (33.9%) in year one. By year five, 81.4% had completed monitoring, and 55.9% were working full‐time in healthcare. In adjusted models, age (OR = 0.93 per year, p = .039), duration of SUD before UPHP enrollment (OR = 1.14 per year, p = .004), and injury history (OR = 0.23, p = .017) were significantly associated with return to use. Discussion and Conclusions This non‐physician dominant cohort highlights need for early recovery support and profession‐specific care. Return to use was most frequent in year one, underscoring the need for intensive early‐phase monitoring. Tailored support for injury‐related substance use, along with peer support and employment services may improve outcomes. Scientific Significance Findings provide novel insight into recovery outcomes for non‐physician healthcare professionals in a PHP, a group underrepresented in addiction research. <h2>Abstract</h2> <h2>Background and Objectives</h2> <p>Substance use disorders (SUD) among healthcare professionals threaten both patient safety and workforce stability. Professional health programs (PHPs) aim to support recovery and safe practice reentry, yet outcomes for non-physician professionals remain underexplored. This study assessed return to use and professional outcomes among healthcare professionals monitored through the Utah Professionals Health Program (UPHP), a cohort predominantly composed of non-physician participants.</p> <h2>Methods</h2> <p>A retrospective cohort study used data from 183 UPHP participants with SUD (60.7% nurses) enrolled between 2013 and 2024. The primary outcome was return to use, defined by positive toxicology results or self-report. Logistic regression was used to identify predictors of return to use.</p> <h2>Results</h2> <p>Return to use occurred in 48.6% of participants, with the highest incidence (33.9%) in year one. By year five, 81.4% had completed monitoring, and 55.9% were working full-time in healthcare. In adjusted models, age (OR = 0.93 per year, <i>p</i> = .039), duration of SUD before UPHP enrollment (OR = 1.14 per year, <i>p</i> = .004), and injury history (OR = 0.23, <i>p</i> = .017) were significantly associated with return to use.</p> <h2>Discussion and Conclusions</h2> <p>This non-physician dominant cohort highlights need for early recovery support and profession-specific care. Return to use was most frequent in year one, underscoring the need for intensive early-phase monitoring. Tailored support for injury-related substance use, along with peer support and employment services may improve outcomes.</p> <h2>Scientific Significance</h2> <p>Findings provide novel insight into recovery outcomes for non-physician healthcare professionals in a PHP, a group underrepresented in addiction research.</p> Mubo O. Olufemi, Lisa J. Merlo, Melissa Cheng, Hongwei Zhao, Justin Yang, Matthew S. Thiese RESEARCH ARTICLE Monitoring outcomes of substance use disorder among healthcare professionals in Utah: A retrospective study of the professionals health program 10.1111/ajad.70106 The American Journal on Addictions 10.1111/ajad.70106 https://onlinelibrary.wiley.com/doi/10.1111/ajad.70106?af=R RESEARCH ARTICLE