Research News Roundup: April 30, 2026

Journal: JAMA Network Open, 2026, doi: 10.1001/jamanetworkopen

Authors: Thanh T. Lu, William N. Dowd, Tami L. Mark, Marianne Kluckman, Barrett Wallace Montgomery, Chelsea Katz, Dylan E. DeLisle, & Gary A. Zarkin

Abstract:

Importance: Opioid use disorder (OUD) is a major cause of death and disability among Medicaid beneficiaries. Understanding progress on engaging Medicaid beneficiaries in effective treatment is vital for reducing burden.

Objective: To examine changes over time and state variation in rates of OUD diagnosis, receipt of medications for OUD (MOUD), MOUD continuity, and OUD-related hospitalization or emergency department (ED) visits among Medicaid beneficiaries.

Design, setting, and participants: This repeated cross-sectional study used 2018-2023 Medicaid claims data for measurement years 2019 to 2023. The study included non-dual eligible Medicaid beneficiaries aged 18 to 64 years residing in 47 states and the District of Columbia. The data analyses were performed between July 1 and December 11, 2025.

Exposure: Medicaid coverage.

Main outcomes and measures: The main outcome was the percentage of Medicaid beneficiaries with (1) an OUD diagnosis, (2) MOUD, (3) MOUD continuity for at least 180 days, and (4) OUD-related hospitalization or emergency department visit.

Results: Among 126 430 422 Medicaid beneficiary-year observations (aged 35-64 years range, 47.7%-52.3%; female range, 59.5%-61.2%), the percentage diagnosed with OUD declined from 4.2% in measurement year 2019 to 3.6% in measurement year 2023 and declined in 34 states. The percentage of all Medicaid beneficiaries with OUD who received MOUD increased from 60.0% to 69.1% and increased in 45 states. The percentage of Medicaid beneficiaries who continued MOUD for at least 180 days decreased from 62.6% to 57.6% and decreased in 29 states. The percentage of beneficiaries with OUD who had an OUD-related hospitalization or ED visit decreased from 10.9% to 10.6% but increased in 31 states.

Conclusions and relevance: This cross-sectional study found a substantial increase in the percentage of individuals with OUD who received MOUD among almost all states. The increase in MOUD use may have contributed to reductions in overdose deaths, but more research is needed.

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Journal: Addiction, 2026, doi: 10.1111/add.70424

Authors: Thomas J. Reese, Hilary A. Tindle, Justin Bachmann, Adam Wright, Jessica S. Ancker, Carolyn M. Audet, … John F. P. Bridges

Abstract:

Background and aims: Measurement-based care (MBC) is a structured approach using standardized, repeated assessments to monitor treatment progress and guide clinical decision-making. MBC improves outcomes for substance use treatment but can be time consuming due in part to lengthy assessment tools. Single-item, patient-reported outcome measures (PROMs) offer a more acceptable alternative for routine monitoring, yet their psychometric properties have not been systematically evaluated. We sought to identify constructs assessed by single-item PROMs in substance use treatment and critically appraise their validity, reliability and overall quality using standardized criteria.

Methods: We conducted a systematic review following COSMIN and PRISMA guidelines. MEDLINE, Embase and PsycINFO were searched from January 2005 to August 2025 for studies evaluating single-item PROMs in adults with substance use. We assessed psychometric properties, including content validity, test-retest reliability, construct validity, responsiveness and predictive validity using COSMIN criteria. Quality of evidence was assessed using a modified GRADE approach.

Results: Of 4722 records screened, 35 studies met inclusion criteria, evaluating 68 single-item PROMs across 9 clinical constructs for more than 50 000 participants. Fifteen studies achieved an overall rating of sufficient measure properties and moderate-or-above level of evidence rating across domains. Test-retest reliability ranged approximately from Intraclass Correlation Coefficient = 0.60-0.85; construct validity correlations approximately ranged r = 0.11-0.98. Predictive validity was strong for several measures, with odds ratios up to 7.3 for treatment readiness. Measures assessing craving, treatment readiness and self-efficacy demonstrated the most robust evidence and, in some cases, outperformed multi-item scales. However, over half of measures lacked empirically validated thresholds and responsiveness to change analyses, limiting clinical interpretability and treatment monitoring.

Conclusions: Single-item patient-reported outcome measures (PROMs) are pragmatic tools for implementing measurement-based care in substance use treatment, offering strong implementation feasibility and, in some cases, predictive performance comparable to longer instruments. PROMs lacking validated thresholds or responsiveness may be best used as complementary tools, whereas those with strong evidence and thresholds can support primary monitoring.

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Journal: Case Reports in Psychiatry, 2026, doi: 10.1155/crps/2981699

Authors: Valeria A. Saldana, Paul H. Earley, David S. Silverstein, & Yi-Lang Tang

Abstract:

Tianeptine, an antidepressant approved only in Europe, Asia, and Latin America, is available without regulation in the United States through online vendors and various retail locations. The rise in its misuse has raised public concerns, marked by dramatic dose escalation, rapid tolerance, toxicity, and withdrawal symptoms. Substance use disorder due to another substance (tianeptine) commonly presents with symptoms similar to opioid use disorder. Symptoms of intoxication include euphoria, respiratory depression, and CNS sedation. Withdrawal symptoms may include anxiety, agitation, and gastrointestinal distress. Acute intoxication management may include the use of naloxone and supportive measures. Withdrawal management should consider the use of buprenorphine as a first-line treatment. Clonidine and other medications used for opioid withdrawal may also be beneficial. Cases with chronic use may require intensive interventions, including residential care, long-term follow-up, and close monitoring, as relapse rates are high. This report presents three cases of tianeptine misuse, detailing their presentation, withdrawal symptoms, and treatment, including pharmacological interventions and treatment setting. We further highlight the problems associated with misuse, the unique presentation of the disorder, treatment options for substance use disorder due to another substance (tianeptine), and the urgent need for regulatory oversight.

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Journal: Prevention Science, 2026, doi: 10.1007/s11121-026-01889-0

Authors: Shirley S. Liu, Elvira Elek, Natalie Blackburn, Feker Wondimagegnehu, Parissa J. Ballard, & Phillip W. Graham

Abstract:

Youth and adolescent substance use remains a persistent public health challenge in the United States; the delivery of evidence-based interventions (EBIs) is critical to improving related negative consequences. The Substance Abuse and Mental Health Services Administration funds a large portion of the implemented substance use prevention interventions in the United States by supporting a funding infrastructure that plays an important role in the adoption and scaling of interventions. Prevention intervention developers and researchers need to understand this infrastructure and its influence on local practitioners to increase the adoption of their EBIs. This study sought to identify which agencies in each state and jurisdiction are involved in funding allocation, how they prioritize and distribute funding to intervention implementers, and, subsequently, how they guide the selection of EBIs. This study used a mixed-methods, cross-sectional design to understand the infrastructure of prevention funding that underlies EBI decision-making. In 2023, we conducted surveys with 40 National Prevention Network representatives (NPNs) and 222 community-level practitioners; in early 2024, we conducted qualitative interviews with a subset of 16 NPNs. NPNs’ priorities were shaped by the agencies in which they were housed and the partners with whom they collaborated. Most were located within their state’s or jurisdiction’s department of health or behavioral health, and many engaged in partnerships with departments of public health or education. Most NPNs reported that they prioritized school and health settings and youth populations for prevention intervention delivery. Almost all NPNs directly distributed funding to intervention implementers (community, regional, or state entities); about half distributed some funds through an intermediary that then subcontracted another entity to implement interventions. More NPNs required or recommended that funded recipients select EBIs from lists or registries (75%) than required or recommended a specific strategy for at least some of their programs (53%). Many practitioners (47%) reported that they selected a recent strategy from a list of interventions provided by their funder, but 27% received no funder guidance on intervention selection. Prevention developers and researchers could increase the adoption of EBIs by focusing them on the priority areas for NPNs, including the health, behavioral health, and education sectors. Developers need to get their EBIs onto registries or intervention lists and increase the EBIs’ wide-scale dissemination. Audiences for information about specific EBIs should include NPNs, regional entities, and their funded community practitioner recipients.

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