Research News Roundup: April 3, 2025

Journal: Addiction, 2025, doi: 10.1111/add.70021

Authors: Irene Kwan, Helen Elizabeth Denise Burchett, Wendy Macdowall, Preethy D’Souza, Claire Stansfield, Dylan Kneale, & Katy Sutcliffe

Abstract:

Background and aims: Although remote drug/alcohol interventions have been widely reviewed, their effectiveness specifically for people in treatment remains unclear. We aimed to systematically review the effectiveness of remote interventions (delivered by telephone or computer) in alcohol/drug treatment and recovery support.

Methods: We searched 29 databases including Medline and PsycINFO for randomised controlled trials (RCTs) of remote interventions for adults diagnosed with alcohol/drug use disorder conducted in Organization for Economic Co-operation and Development (OECD) countries published 2004-2023. We grouped interventions according to whether they supplemented or replaced/partially replaced in-person care. We used random effects meta-analyses to estimate pooled odds ratios (OR) for relapse, and standardised mean differences (SMD) for days of alcohol/drug use. We appraised outcomes using Cochrane Risk of Bias 2.

Results: We identified 34 RCTs (6461 participants) evaluating 42 remote interventions, with diverse therapeutic approaches. Over 70% of outcomes were judged to be at high risk-of-bias. When remote interventions supplemented in-person care, there was a 39% lower odds of relapse [17 interventions; OR 0.61; 95% confidence interval (CI) = 0.46, 0.81; P = 0.001; I2 = 40.3%) and a reduction in the mean days of use (17 interventions; SMD -0.18; 95% CI = -0.28 to -0.08; P = 0.001; I2 = 27.3%) compared with in-person care alone. When remote interventions replaced/partially replaced in-person care, there was a 49% lower odds of relapse (7 interventions; OR 0.51; 95% CI = 0.34, 0.76; P = 0.001; I2 = 39.7%) and a very slight and uncertain reduction in mean days of use (8 interventions; SMD -0.08; 95% CI = -0.24 to 0.07; P = 0.301; I2 = 48.4%) compared with in-person care. Subgroup analyses by type of substance and therapeutic approach were mixed and inconclusive.

Conclusions: Remote interventions which supplement in-person alcohol/drug treatment appear to reduce relapse and days of use. The evidence is less conclusive regarding remote interventions that replace/partially replace in-person care due to a smaller body of evidence and uncertainty (days of use). High risk-of-bias means findings should be interpreted with caution.

To read the full text of the article, please visit the publisher’s website.

Journal: Addiction Behaviors Reports, 2025, doi: 10.1016/j.abrep. 2025.100593

Auth0rs: Stephanie Pike Moore, Craig S. Fryer, Eugenia Lee, & Kymberle L. Sterling

Abstract:

Introduction: There is a general paucity of research describing the relationship between racial and ethnic discrimination (RED) and coping strategies on use of little filtered cigars and cigarillos (LCCs) across racial and ethnic identities. This research sought to unravel some of the complex, multilayered experiences of RED and subsequent coping strategies to examine the impact on LCC use.

Methods: Data come from a cross-sectional survey conducted among a nationally representative sample of U.S. young adults (n = 1,178) in May 2022. Respondents were asked about their exposure to LCC marketing (systemic RED), interpersonal experiences of RED, coping strategies, and use of LCCs as-sold (tobacco only) or as a blunt (with marijuana). Multivariable logistic regression was used to examine odds of LCC use examining systemic and interpersonal RED and the relationship between emotion-focused and problem-focused coping strategies among those who have experienced RED.

Results: Exposure to systemic RED was associated with increased odds of blunt use. Interpersonal experiences of RED were associated with increased odds of LCC use as-sold and as blunts. Among those who experienced any RED, the impact of problem-focused and emotion-focused coping was differential across racial and ethnic identities in the impact on LCC use modality.

Conclusion: Systemic and interpersonal RED are independently associated with LCC use. There are considerable differences in how young adults cope with RED which necessitates additional research to further elucidate the complex pathways between RED and product use to more effectively inform strategies to address the undeniable racial and ethnic inequities in tobacco-related health outcomes.

To read the full text of the article, please visit the publisher’s website.

Journal: BMC Pregnancy and Childbirth, 2025, doi: 10.1186/s12884-025-07473-8

Authors: Carol Y. Franco-Rowe, Angela E. Lee-Winn, Venice Ng Williams, Connie Lopez, Gregory J. Tung, & Mandy A. Allison

Abstract:

Background: Clinical guidelines in the United States (U.S.) recommend a patient-centered approach to healthcare for pregnant people with substance use disorders (SUD); however, pregnant people with SUD often describe experiencing stigmatization and shame when seeking prenatal care. We explored the perspectives of pregnant and parenting people engaged with SUD treatment regarding their experiences with healthcare providers during the perinatal period to improve guidance for patient-centered care.

Materials and methods: Using an adapted phenomenological approach, we conducted in-depth interviews with 22 pregnant and parenting people recruited from inpatient or outpatient substance use treatment centers in the U.S. state of Colorado. We developed an interview guide to explore participants’ experiences during pregnancy, childbirth, and postpartum. We audio recorded, transcribed, and validated interviews for analyses. A codebook was developed using an iterative process. Three coders analyzed the data and synthesized data into thematic memos.

Results: Participants reported challenges within the healthcare system, including barriers to receiving services, connection to or education on resources, challenges in and reasons for sharing their history of substance use with healthcare providers, provider reactions to this information, and the impact of providers’ response to knowing about their substance use history. Participants described shame regarding their substance use but also a strong desire to ensure the health of their infants. This desire motivated them to share their history of substance use with healthcare providers. When participants perceived nonjudgmental and empathetic responses, they reported feeling pride and empowerment. Participants who reported judgmental responses from providers stated that it made them less likely to share and engage with other healthcare providers in the future.

Conclusion: The perspectives and experiences of people engaged in SUD treatment can inform the implementation of clinical guidelines for patient-centered care for pregnant and parenting people in perinatal healthcare settings. Learnings from this study addresses ongoing challenges to compassionate care during this critical window, leading to disengagement of patients. Support through connection of resources can be helpful for ongoing recovery. Recommendations are made to establish trust through transparency and non-judgmental care and to reinforce receipt of appropriate healthcare services.

To read the full text of the article, please visit the publisher’s website.

Journal: BMC Public Health, 2025, doi: 10.1186/s12889-025-22210-8

Authors: Leah S. Fischer, Alice Asher, Renee Stein, Jeffrey Becasen, Amanda Doreson, Jonathan Mermin, Martin I. Meltzer, & Brian R. Edlin

Abstract:

Background: It is estimated that over 111,000 people in the U.S. died from a drug overdose in the twelve-month period ending in July 2023. More than three-quarters of those deaths were attributed to opioids. Naloxone has long been available in healthcare facilities to reverse opioid overdose rapidly and safely but is not universally accessible for use in community settings where overdoses occur. We conducted a systematic literature review and meta-analysis to assess the effectiveness of overdose education and naloxone distribution (OEND) programs in three types of community settings to reduce overdose deaths among people who use opioids nonmedically.

Methods: We systematically searched electronic databases, including Medline (OVID), Embase (OVID), Psycinfo (OVID), and Global Health (OVID), for peer-reviewed studies of OEND programs published during 2003-2018 (Group 1) that reported overdose outcomes individual level survivals or deaths immediately following naloxone administration. The PRISMA checklist guided screening, quality assessment, and data abstraction. We later identified studies published during 2018-2022 (Group 2), when drug usage and fentanyl-related overdose deaths notably increased, differed from earlier ones. We conducted meta-analyses on both Groups using random effects models to estimate summary survival proportions.

Results: Among the 44 Group 1 studies published during 2003-2018, survival did not differ by time (year), location, naloxone dose, or route of administration, but studies of OEND programs serving people who use drugs reported 98.3% (95% CI: 97.5-98.8) survival; those serving family of people who use drugs or other community members reported 95.0% (95% CI: 91.4-97.1) survival; and those for police reported 92.4% (95% CI: 88.9-94.8) survival (p < 0.01). Five Group 2 studies (2018-2022) yielded similar results.

Conclusions: Community-based naloxone distribution programs can be effective in preventing opioid overdose deaths. The paper demonstrates that in the face of increasing overdose deaths over time, survival after naloxone administration has been sustained. The very high survival rates provide clear evidence for public health to continue efforts to expand channels for naloxone distribution in community settings.

To read the full text of the article, please visit the publisher’s website.