Research News Roundup: December 11, 2025

Journal: Nature Health, 2025, doi: 10.1038/s44360-025-00010-z

Authors: Tyra Boomer, Lily Hoerner, Kaitlyn Larkin, Kaitlin Maciejewski, Tassos C. Kyriakides, & Lynn E. Fiellin

Abstract:

The opioid epidemic greatly impacts adolescents, especially those with low perceived risk of harm—an important predictor of misuse initiation. Here, to address this, we developed and evaluated PlaySmart, a videogame targeting perceived risk, in a two-arm parallel superiority unblinded randomized controlled trial with a placebo comparator. We randomized 532 participants (mean age 16.6 years; 47% female) to PlaySmart (n = 269) or control games (n = 263). Eligible students—16–19 years old, no prior opioid misuse and ‘high-risk’ based on substance use or mental health screens—agreed to 60-min gameplay sessions, and provided assent and parental consent if under 18 years old. Participants played during supervised after-school sessions (1 or 2 times per week for approximately 6 weeks) at 15 Connecticut high schools. Self-reported data were collected at baseline, 6 weeks and 3 months (21 October 2021 to 27 February 2024). Follow-up rates were high (231/266 (87%) PlaySmart and 234/261 (90%) control). The primary outcome was perceived risk of harm of opioid misuse at 3 months. The secondary outcomes were self-efficacy, intentions, knowledge and attitudes (positive and negative expectancies). At 3 months, 29% of PlaySmart versus 23% of control participants reported ‘great risk’ with no statistically significant difference between groups (95% CI, –2% to 14%; P = 0.14). Self-efficacy, intentions and positive expectancies did not differ. PlaySmart participants demonstrated knowledge gains from baseline to 3 months (2.1 (95% CI, 1.4–2.7) versus 0.1 (95% CI, –0.6–0.7); P < 0.001), and negative expectancies gains at 6 weeks (2.3 (95% CI, 1.4–3.1) versus 0.2 (95% CI, –0.7–1.1); P = 0.001). Further research is needed to enhance PlaySmart, maximizing its impact on scalable opioid misuse prevention.

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Journal: npj Artificial Intelligence, 2025, doi: 10.1038/s44387-025-00049-z

Authors: Shravika Mittal, Darshi Shah, Shin Won Do, Mai ElSherief, Tanushree Mitra, & Munmun De Choudhury

Abstract:

Widespread stigma, both offline and online, hinders harm reduction efforts in the context of opioid use disorder (OUD). This stigma targets clinically approved medications for OUD (MOUD), people with the condition, and the condition itself, among several others. Given the potential of artificial intelligence in promoting health equity, this work examines whether large language models (LLMs) can abate stigmatizing attitudes in virtual healthcare communities. To answer this, we conducted a series of randomized controlled experiments, where participants read LLM-generated, human-written, or no responses to help-seeking OUD-related content. The experiment was conducted under two setups: participants read the responses either once (N = 2, 141) or repeatedly for 14 days (N = 107). Participants reported the least stigmatized attitudes toward MOUD after consuming LLM-generated responses. This study offers insights into strategies that can foster inclusive discourse on OUD. Based on our findings LLMs can serve as an education-based intervention to promote positive attitudes and increase people’s propensity toward treatments for OUD.

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Journal: Addiction Science & Clinical Practice, 2025, doi: 10.1186/s13722-025-00625-3

Authors: Courtney Phillips, Maria C. Mejia, Darian Peters, Jacob Kalathoor, Lea Sacca, & Belma Andric

Abstract:

Objectives: Accessible, evidence-based treatment for substance use disorders (SUDs) remain a public health challenge due to complex clinical and social needs and barriers to long-term engagement. This study describes a five-year evaluation of a low-barrier, outpatient SUD treatment program implemented by the Health Care District of Palm Beach County, Florida, focusing on trends in functional recovery using the Brief Addiction Monitor (BAM) functional assessment.

Methods: Between February 2018 to March 2023, participants with substance use disorders received care through a Federally Qualified Healthcare Center (FQHC) based integrated model offering medication for opioid use disorder, other Medication assisted treatment, behavioral health services, medical , psychiatric, peer services, and care coordination. The BAM was administered at baseline and approximately every three months to assess substance use, risk, and protective factors. Data were analyzed per assessment to reflect variability in patient engagement and follow-up.

Results: A total of 2,425 patients completed 5,277 BAM assessments. Among those with repeated assessments (n = 982), the average substance use score declined from 5.19 to 3.45, while the risk score dropped from 14.61 to 11.01. Protective scores increased from 10.65 to 12.40. Reported opiate use decreased from 26.1% at baseline to 17.3% at follow-up. Self-reported overdose history declined from 38.6% to 17.5% (added in 2021). Patient satisfaction improved, with “extremely satisfied” responses rising from 21.6% to 36.5%.

Conclusions: This descriptive evaluation highlights the potential of low-threshold, integrated care models to support recovery-oriented outcomes in real-world settings. Routine use of tools like the BAM enabled multidimensional monitoring of progress despite challenges with retention and data completeness. Findings underscore the importance of flexible, patient-centered approaches to managing the chronic nature of SUD.

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Journal: Journal of Adolescent Health, 2025, doi: 10.1016/j.jadohealth.2025 .10.021

Authors: James H. Buszkiewicz, Yanmei Xie, Catherine A. Vander Wouder, Steven Cook, Bukola Usidame Peters, Megan E. Patrick, Michael R. Elliott, James F. Thrasher, & Nancy L. Fleischer

Abstract:

Purpose: We examined whether workplace and hospitality vape-free air law (VAL) population coverage was associated with adolescent e-cigarette use and related disparities in the United States.

Methods: We analyzed associations between county-level workplace and hospitality VAL coverage (100% vs. <100%) and current e-cigarette use (2014–2022) and first e-cigarette initiation (2015–2022) among US 8th, 10th, and 12th graders using nationally representative, cross-sectional Monitoring the Future data. We implemented weighted, grade-stratified, modified Poisson regression models, adjusted for individual-, county-, and state-level confounding factors, examining disparities by sex, race and ethnicity, parental education, and college educational expectations through two-way interactions.

Results: Workplace and hospitality VAL coverage was not associated with adolescent e-cigarette use or initiation overall. However, we did find that VAL coverage was associated with lower current e-cigarette use in some sociodemographic subgroups. Full (100%) hospitality VAL coverage was linked to lower e-cigarette use among male 8th and 12th graders, 12th graders with parents without a bachelor’s degree, Hispanic 8th and 12th graders, and 8th and 12th graders of other races and ethnicities than their peers living in partially covered (<100%) counties. Full hospitality VAL coverage was linked to higher e-cigarette use among non-Hispanic Black 8th graders and non-Hispanic White 12th graders than their peers living in partially covered counties.

Discussion: Though not linked to adolescent e-cigarette use behaviors overall, we found that male adolescents and adolescents from low socioeconomic status backgrounds were more responsive to VAL with associations by race and ethnicity depending on grade and subgroup.

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