Research News Roundup: July 3, 2025

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen. 2025.18493

Authors: Utsha G. Khatri, Christopher Lopez, Yun-Ting Yen, Emilia J. Ling, Lynne D. Richardson, & Ka Ming Ngai

Abstract:

Importance: Despite expanded efforts to improve treatment access, inequities exist in the receipt of medications for opioid use disorder by race and ethnicity and insurance type.

Objective: To examine inequities in access to medications for opioid use disorder (MOUD)—specifically buprenorphine and naltrexone—by race and ethnicity and insurance type after opioid-related health care events.

Design, Setting, and Participants: This retrospective cohort study used data from the Institute for Health Equity Research Multi-Payor Claims Database, which includes more than 130 million individuals across commercial, Medicaid, and Medicare Advantage insurance plans. The cohort consisted of patients aged 18 years or older with an opioid use disorder (OUD)–related health care event (opioid-related overdose, infection, or treatment event) that occurred between January 1, 2017, and December 31, 2022. Statistical analysis was conducted from October 2023 to December 2024.

Exposure: Race and ethnicity and insurance type, including commercial insurance, Medicaid, and Medicare Advantage, were the primary exposures.

Main Outcomes and Measures: The primary outcome was receipt of MOUD (buprenorphine or naltrexone) within 180 days of an OUD-related health care event. Logistic regression models were used to assess the associations of MOUD receipt with race and ethnicity and with insurance type, adjusting for demographic, clinical, time, and geographical covariates.

Results: Among 176 997 index events involving 164 728 patients between 2017 and 2022, the mean (SD) patient age was 40.0 (13.1) years; 104 005 (58.8%) involved men; 1083 events (0.6%) were among Asian patients, 23 424 (13.2%) were among Black patients, 10 302 (5.8%) were among Hispanic patients, 90 124 (50.9%) were among White patients, and 4697 (2.7%) were among patients of other race and ethnicity; and 147 257 (83.2%) were covered by Medicaid. Black (adjusted estimated probability, 17.1% [95% CI, 13.0%-21.1%]) and Hispanic (adjusted estimated probability, 16.2% [95% CI, 11.6%-20.8%]) patients were significantly less likely than White patients (adjusted estimated probability, 20.5% [95% CI, 16.4%-24.7%]) to receive buprenorphine (Black patients: adjusted odds ratio [AOR], 0.75 [95% CI, 0.63-0.90]; adjusted risk difference [ARD], −3.4 percentage points [pp] [95% CI, –6.5 to –0.4 pp]; Hispanic patients: AOR, 0.69 [95% CI, 0.51-0.92]; ARD, –4.4 pp [95% CI, –9.1 to 0.4 pp]) but received naltrexone at similar rates. Patients with Medicaid (AOR, 1.39 [95% CI, 1.14-1.69]; ARD, 3.5 pp [95% CI, 0.9-6.1 pp]) or Medicare Advantage (AOR, 1.40 [95% CI, 1.05-1.86]; ARD, 3.6 pp [95% CI, –0.6 to 7.7 pp]) were more likely to receive buprenorphine compared with those with commercial insurance. Buprenorphine access improved incrementally from 2017 to 2022, reflecting recent clinical and policy changes; however, disparities persisted.

Conclusions and Relevance: In this cohort study of more than 17 600 opioid-related index health care events, race and ethnicity–based and insurance-based disparities in access to MOUD persisted despite efforts to expand treatment availability. These findings underscore the need for targeted interventions, including culturally tailored care, expanded access points, and policy reforms to address structural barriers and reduce inequities contributing to the overdose crisis.

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

Journal: Alcohol Research: Current Reviews, 2025, doi: 10.35946/arcr. v45.1.05

Authors: Chelsea Vanderpeet, Lisa Akison, Karen Moritz, Nicole Hayes, & Natasha Reid

Abstract:

Purpose: Individuals with fetal alcohol spectrum disorders (FASD) or neurodevelopmental disorder associated with prenatal alcohol exposure (PAE) can experience a wide range of whole-body health conditions. A survey by the International Adult Leadership Collaboration (ALC) FASD Changemakers found that many adults with FASD have comorbidities relating to metabolic disorders; body composition; cardio-renal, reproductive, and/or immune health; as well as difficulties with hearing/vision and sleep. This review summarizes current knowledge of these health domains and provides an overview of the latest literature on the whole-body effects of PAE/FASD across the life span.

Search methods: The literature search was conducted on July 8, 2024, using CINAHL, PubMed, and Web of Science databases. To investigate the whole-body health of individuals with PAE, search terms were based on the findings of the ALC FASD Changemakers Health Survey and covered areas relating to sleep; hearing/vision; body composition; and metabolic, cardiovascular, renal, immune, and reproductive health. The search was conducted in two phases. To summarize current knowledge on these topics, the latest systematic reviews and other reviews were identified for each health domain (phase one). In addition, recent primary research articles published since these review searches were completed were identified for each domain (phase two). Inclusion/exclusion was based on article relevance to the physical health challenges reported in the ALC FASD Changemakers Health Survey.

Search results: In phase one, 744 reviews were identified in the initial search, of which 722 articles were excluded and 22 recent and relevant reviews were included. In phase two, 1,102 articles were identified, with 665 screened at the title/abstract level and 169 articles undergoing full-text review. A total of 1,066 articles were excluded. Following the addition of five articles from other sources, 41 recently published primary articles were included in the current review.

Discussion and conclusions: A growing body of evidence suggests that individuals with PAE/FASD may experience comorbidities relating to metabolism; body composition; cardio-renal, immune, and/or reproductive health; as well as hearing, vision, and sleep difficulties. These findings support the concept of FASD as a whole-body diagnosis, emphasizing the importance of a holistic approach that supports the overall health and well-being of those with PAE. There are opportunities for future clinical research to focus on further understanding these physical health challenges, how they evolve, and how effective intervention approaches could improve outcomes for individuals with PAE/FASD.

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

Journal: Drug and Alcohol Dependence, 2025, doi: 10.1016/j.drugalcdep. 2025.112738

Authors: Svetla Slavova, Jennifer Villani, Daniel J. Feaster, Austin Booth, JaNae L. Holloway, Peter J. Rock, … Sharon L. Walsh

Abstract:

Introduction: The HEALing Communities Study (HCS) tested a community-based intervention in 67 communities across Kentucky, Massachusetts, New York, and Ohio to reduce opioid overdose deaths. This paper introduces the HCS measures for monitoring the intervention uptake, reports crude rates for benchmarking, and highlights the importance of interpreting jurisdictional trends in the context of state policies.

Methods: We present technical specifications for the HCS measures and the common data model. Crude rates for the evaluation period (July 2021- June 2022) are reported by state and study arm (intervention/Wave 1 or wait-listed/Wave 2 communities), along with longitudinal trends from 2017 to 2023. Year 2023 serves as a post-intervention period for Wave 1 communities and an intervention year for Wave 2 communities.

Results: After unprecedented increases in 2020-2021, the HCS crude opioid overdose death rates declined in 2023, but remained higher than the 2019 pre-pandemic rates. Opioid overdose death rates exceeded 100/100,000 adults among Non-Hispanic Black individuals in several states. In response to the rapid increase in opioid overdose deaths in Kentucky, the HCS team expanded the naloxone distribution in Kentucky intervention communities, reaching a 10-fold increase in Quarter 3 of 2021 (1498.2 units/100,000 residents). The methadone medication for opioid use disorder (MOUD) treatment rate for Medicaid enrollees with opioid use disorder during the evaluation period was highest in Massachusetts intervention communities (274/1000), while the buprenorphine MOUD treatment rate was highest in Kentucky (441/1000).

Conclusions: The HCS measures support comprehensive planning and evaluation of population-level opioid overdose prevention interventions and policies.

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

Journal: Drug and Alcohol Dependence, 2025, doi: 10.1016/j.drugalcdep. 2025.112712

Authors: Angela Han, Christal N. Davis, Zeal Jinwala, Jackson SooHoo, Joel Gelernter, Richard Feinn, & Henry R. Kranzler

Abstract:

Introduction: Reducing or stopping substance use can result in withdrawal symptoms in physically dependent individuals. Appropriate management of withdrawal symptoms may be critical to the safety of individuals with substance use disorders (SUDs) and could help prevent a return to substance use. Although childhood adversity and genetic factors contribute to the development of SUDs, their individual and joint effects on withdrawal symptoms and severity are less clear. This study is a secondary analysis of existing data in which we examined the main and interactive effects of genetic variation and adverse childhood events (ACEs) on the severity of withdrawal from tobacco, alcohol, and opioids.

Methods: Participants were 10,275 individuals (4851 of African-like (AFR) ancestry and 5424 of European-like (EUR) ancestry) from the Yale-Penn sample. Tobacco, alcohol, and opioid withdrawal symptoms and 10 ACEs were measured using a semi-structured diagnostic instrument. Multivariate regression models examined the association of SUD polygenic scores (PGS), ACEs, and their interaction with withdrawal severity and individual withdrawal symptoms.

Results: ACEs were positively associated with withdrawal severity, except for opioid withdrawal among AFR individuals. Among EUR individuals, PGS were positively associated with tobacco and alcohol withdrawal severity. There was a negative interaction between ACEs and PGS on tobacco withdrawal severity and specific tobacco withdrawal symptoms.

Conclusions: Individuals who experience ACEs and, to a lesser extent, those with higher PGS for SUDs, are susceptible to more severe withdrawal symptoms. In EUR individuals, there was evidence for a complex interplay of genetic and environmental factors on substance withdrawal. These exploratory findings require independent validation.

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