Addiction

BackgroundPsychotherapy is proven efficacious for the treatment of alcohol use disorder (AUD). However, the patient-perceived importance of its effect is not fully appreciated in the evidence base. The smallest worthwhile difference (SWD) represents the smallest beneficial effect of an intervention that patients deem worthwhile in exchange for the harms, expenses, and inconveniences associated with the intervention, and facilitates the interpretation of patient perceived worthiness of an interve...

ImportanceAlcohol use is a leading cause of morbidity and mortality worldwide. Growing evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may represent a novel potential pharmacotherapeutic tool for alcohol use disorder (AUD). ObjectiveTo examine the association between GLP-1RA prescriptions and alcohol use. DesignThis cohort study used a cross-sectional measure of alcohol consumption and longitudinal electronic health record (EHR) data collected between 1981 and Octob...

IntroductionTobacco smoking remains a leading cause of preventable death in the UK. Although e-cigarettes are promoted as a harm-reduction option, longitudinal evidence on short-term health outcomes across different smoking transition pathways is limited. This study examined short-term associations between transitions to exclusive e-cigarette use, dual use, or cessation and physical health, mental health, and health-related quality of life, compared with continued smoking. MethodsA target trial...

BackgroundGabapentin and pregabalin have potential utility for treating alcohol use disorder (AUD), but their comparative effectiveness in reducing alcohol consumption in real-world settings is unknown. We compared changes in alcohol consumption associated with gabapentin or pregabalin treatment with those of matched unexposed comparators. MethodsWe identified patients who were prescribed gabapentin or pregabalin for [≥]60 days for any indication between 1 January 2009 and 30 June 2022 using...

Background and AimsAlcohol use disorder (AUD) remains a major public health concern, with persistent disparities in access to evidence-based treatment. This study aimed to examine associations between perceived discrimination in healthcare settings (PDHS), patient-clinician communication (PCC), and receipt of treatment for AUD, and compared these with sociodemographic and insurance-related factors. DesignCross-sectional analysis using structural equation modeling (SEM), logistic and multinomial...

Background and AimsThe UK legalised medical cannabis in 2018, yet little is known about people accessing cannabis legally via prescription or those using cannabis for medical purposes without a prescription. This study aimed to estimate: 1) the percentage of people who use cannabis medically with and without a prescription; 2) the sources used to obtain cannabis; 3) the products used; and 4) the associations between monthly or more frequent (MMF) product use and medical cannabis use status. Des...

BackgroundEarly low-level alcohol use predicts subsequent alcohol use and problems. Impulsivity and poor inhibitory control also predict later problematic alcohol use. However, few studies prospectively examine early sipping in combination with modeling impulsivity and inhibitory control change over time as predictors of adolescent alcohol use. MethodsData Release 6.0 from the Adolescent Brain Cognitive Development (ABCD) Study was used (n=11,866; 48% Female). A series of linear mixed-effect mo...

Tobacco use disorder (TUD) remains a leading cause of preventable mortality, and existing pharmacotherapies yield 12-month abstinence rates below 30%. As cannabis legalization expands, approximately 18-22% of people who use tobacco report concurrent cannabis use, yet the impact of co-use on cessation outcomes and the therapeutic potential of endocannabinoid system (ECS) modulation remain unclear. We conducted a translational systematic review and meta-analysis following PRISMA 2020 guidelines, s...

Objective: Minimum unit pricing (MUP) aims to reduce use of cheap, high strength alcoholic beverages that drive harm, yet concerns remain about inequitable effects for structurally vulnerable groups. As part of the Costs, Harms, Expenditures and Alcohol Prices (CHEAP) study, we linked individual-level, product-specific alcohol consumption data from a customized survey with provincial retail price data to estimate prices per standard drink (PPSD) and examine their association with alcohol-related...

BackgroundThe UK has the fourth highest estimated prevalence globally of maternal alcohol consumption during pregnancy (41%). It is therefore important to understand the long-term impacts of prenatal alcohol exposure (PAE) by examining its impact on the development of adolescent multiple risk behaviours (MRBs) which may increase morbidity and premature mortality across the life-course. MethodsUsing Avon Longitudinal Study of Parents and Children (ALSPAC) cohort data with multiple imputation (n=...

Ozempic, along with exercise and diet, is effective in helping individuals lose weight. Prior studies have reported misuse of Ozempic. This descriptive study used a nationally representative sample of persons in the U.S. from the National Survey on Drug Use and Health to identify self-reported use of an Ozempic injection for which the person was not prescribed. In 2024, 28,691 individuals ages 12 and older self-reported ever injecting Ozempic that was not prescribed to them. The entire sample wh...

Alcohol use disorder (AUD) remains a major public health problem, with few effective medications and suboptimal adherence. L-type calcium channel blockers (LTCCBs) have genetic and preclinical support as potential treatments for AUD. We evaluated whether brain penetrant (BP)-LTCCBs are associated with reduced alcohol consumption by conducting two preregistered (https://osf.io/huawv) observational cohort studies using electronic health records (EHRs) from the US Department of Veterans Affairs (VA...

ImportanceThe tobacco industry exploits legislative loopholes by introducing products with novel constituents, sensory features, and/or branding to bypass flavor restrictions and maintain appeal, particularly among young populations. Post Californias 2022 flavor ban, leading oral nicotine pouch (ONP) brand (ZYN) started marketing two new "unflavored" products, Classic and Original, but it is unknown if they differed from pre-ban products marketed as "flavor-ban approved" (Chill and Smooth) in th...

Background and AimsCocaine use disorder (CUD) is an increasingly widespread concern worldwide. Various pharmacological treatments have been investigated for CUD, but their efficacy remains unclear, and none have been licensed for treatment. Therefore, we assessed the comparative effectiveness, safety, and acceptability of pharmacological interventions for the treatment of CUD and prevention of relapse. DesignSystematic review and network meta-analyses of double-blind randomized controlled trial...

BackgroundA growing population of working-aged men are not in employment, education, or training (NEET). The COVID-19 pandemic increased rates of substance use disorders (SUDs) and affected treatment seeking in the general population, but the COVID era substance use patterns among NEET men are unknown. MethodsWe estimated the prevalence and correlates of NEET status among working-aged (18-64) men using data from the 2022 National Survey on Drug Use and Health, a nationally representative survey...

BackgroundSubstance use disorders (SUD) are associated with a high global burden of disease, with 5.4% of all disability-adjusted life years lost due to alcohol and illicit drugs. Highly prevalent multimorbidity includes polysubstance use, mental health conditions, and other non-communicable and infectious diseases. Where traditional treatments are insufficient alone, music therapy (MT) is highly engaging and improves motivation and reduces craving; however, its long-term effects are unknown. Th...

BackgroundAlcohol consumption and binge drinking during pregnancy have been rising in the US since 2006. Unfortunately, capacity to diagnose fetal alcohol spectrum disorder (FASD) remains suboptimal. Incorporating the lived experiences of affected populations improves service access and responsiveness, and enhances quality of care. This qualitative study thus explored barriers and facilitators in the FASD diagnostic journey from the perspectives of caregivers of children diagnosed with FASD and ...

Alcohol Use Disorder (AUD) is a multifactorial condition with severe individual and societal impacts. Extending our 2024 study, this work examines lifestyle, background, and family history determinants of AUD using an expanded dataset from the All of Us Research Program. The updated analysis includes approximately 2.5 times more participants than the prior study, enabling improved statistical power and evaluation of result stability over time. Using interpretable machine learning models and stat...

BackgroundOral nicotine pouches (ONPs) have become the second most commonly used nicotine product among U.S. youth. However, little is known about how ONP use is distributed across population subgroups and how strongly it is patterned by use of other tobacco or nicotine products. MethodData were drawn from the 2021-2023 waves of the National Youth Tobacco Survey (NYTS), a nationally representative survey of U.S. middle and high school students (N = 66,349). We estimated the annual survey-weight...

Background and AimsAlcohol is the top substance used by US emerging adults under legal drinking age (underage emerging adults; U-EA; ages 18-19). U-EA are unlikely to seek or receive indicated alcohol interventions. It is imperative to find brief, effective interventions to reduce U-EA drinking. Developmental neuroscience reflects that peers hold higher neural salience during adolescence, as evidenced by differential neural response with real and/or simulated peers, even when those peers were no...