Research News Roundup: July 30, 2026

Journal: Substance Use, 2026, doi: 10.1177/29768357261465591

Authors: Jordan R. Covvey, Oliver Grundmann, Nina Vadiei, & Kirk E. Evoy

Abstract:

Introduction: Kratom use is growing for both therapeutic and non-therapeutic effects. This survey assessed the temporal relationship between kratom initiation and prior, subsequent, or concurrent substance use or medical treatment.

Methods: This cross-sectional, anonymous electronic survey was disseminated to American Kratom Association and Global Kratom Coalition members from 3/2025-9/2025. Adults aged ≥18 years who reported past or current kratom use were eligible. A novel questionnaire was generated assessing: kratom and other substance use characteristics; pursuit of medical treatment for selected diagnoses; and temporal relationships between kratom use and substance use or medical treatment.

Results: Of 161 respondents included, most (95.7%) currently versus previously used kratom. Whole-leaf product use was reported most often (90.3%), with 38.3% reporting concentrated kratom extracts and 16.9% single alkaloid isolates. Reasons for kratom use were therapeutic (50.3%), non-therapeutic (16.1%), or both (33.5%). Therapeutic (self-treatment) use was most commonly cited for pain (86.2%), mental focus (52.3%), mental health (46.9%), sleep (43.1%), and substance use disorder (27.7%). Most respondents had used ≥1 other psychoactive substance in their lifetime, including cannabis (74.3%), alcohol (68.2%), stimulants (43.2%), sedatives (33.1%), non-prescribed opioids (26.4%), or tobacco (6.1%); 10.1% reported no prior substance use besides kratom. Whether used for non-therapeutic or therapeutic purposes, kratom was rarely initiated first. Among those with a substance use history, only 3-10% reported trying kratom prior to other substances reported. Among those with pertinent medical conditions, 0-20% initiated kratom before receiving medical care for their reported conditions.

Conclusion: This study builds on previous research assessing kratom use motivations, providing insight into the temporal relationship between kratom initiation and substance use or medical treatment. Kratom was rarely the first substance or therapeutic treatment tried, but rather most individuals initiated it concurrently with or after discontinuing other substances or medical care. Larger follow-up studies are warranted to confirm these results.

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Journal: Alcohol Clinical & Experimental Research, 2026, doi: 10.1111/acer .70373

Authors: Angelo M. DiBello, Mary Beth Miller, Kate B. Carey, & Clayton Neighbors

Abstract:

Background: Alcohol-induced blackouts are widely recognized as markers of acute intoxication and elevated risk for alcohol-related harm. Blackout experiences may also represent psychologically salient events capable of influencing subsequent drinking behavior. The present study examined whether recent blackout predicts changes in alcohol use, alcohol-related consequences, and blackouts over time.

Method: Data were drawn from three independent longitudinal samples of college student drinkers (Ns = 568, 484, and 200). Generalized linear mixed models with negative binomial distributions were used to evaluate whether baseline blackout status predicted follow-up drinks per week, alcohol-related consequences, and subsequent blackouts over 12 months of follow-up, controlling for baseline drinking and consequences, age, sex, intervention condition, and time.

Results: Across samples, baseline blackout was not associated with increases in subsequent alcohol use. In one sample, blackout predicted lower follow-up drinking, and in two of three samples, blackout predicted significantly lower rates of alcohol-related consequences over time (i.e., a 21%-40% reduction in consequences among those who experienced a blackout across follow-ups). Conversely, baseline blackout was associated with increased odds of subsequent blackout across all samples. These associations were found after adjusting for baseline alcohol-related consequences and concurrent drinking.

Conclusion: Blackouts may function not only as a marker of high-risk drinking but also as a potential turning point associated with reductions in alcohol-related harm. At the same time, effects were not uniform across samples. Results underscore the importance of assessing blackout in research and clinical settings, and they highlight its potential dual role as both a risk indicator and a catalyst for behavioral change.

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Journal: JAMA Network Open, 2026, doi: 10.1001/jamanetworkopen .2026.22039

Authors: Richard Miech, Megan E. Patrick, Justin Jager, & Joy Bohyun Jang

Abstract:

Importance: Youth awareness of the dangers of fentanyl use has become increasingly important as adolescent overdose mortality has increased in recent years.

Objective: To present US nationally representative estimates of perceived risk of fentanyl use among adolescents.

Design, setting, and participants: This cross-sectional survey study of 8th-, 10th-, and 12th-grade students in 2025 included a nationally representative sample of students in the 48 contiguous US states who filled out surveys in class at school. Data were from the 2025 Monitoring the Future study, analyzed between January 15 and May 11, 2026.

Main outcomes and measures: Responses to questions on perceived risk of experimental (trying once or twice), occasional, and regular fentanyl use. Analyses used multiple imputation and Poisson regression models.

Results: In this study, 3820 adolescents self-reported their perceived risk of fentanyl use (32.8% [1156] in 8th, 34.7% [1482] in 10th, and 32.5% [1182] in 12th grade; by demographic category, participants were 50.1% [1843] female; 35.2% [1185] Hispanic, 15.2% [544] non-Hispanic Black, 36.1% [1507] non-Hispanic White, and 13.5% [487] non-Hispanic other race). Less than half of 8th-grade students (47.8% [549]) attributed great risk to experimental use, while 57.2% (660) attributed great risk to occasional use, and 66.5% (768) attributed great risk to regular use. For students in 10th grade, 63.6% (925) attributed great risk to experimental use, 71.5% (1061) attributed great risk to occasional use, and 77.3% (1144) attributed great risk to regular use. For students in 12th grade, 69.8% (834) attributed great risk to experimental use, 78.5% (929) attributed great risk to occasional use, and 84.8% (1003) attributed great risk to regular use. Students in rural areas had the highest levels of perceived risk in 8th and 10th grade. Non-Hispanic White students were most likely to ascribe great risk to fentanyl use in all grades across all 3 categories of fentanyl use (experimental, occasional, and regular). In 8th grade, Hispanic students had the lowest levels of perceived risk for all 3 fentanyl categories, and in 10th and 12th grade, non-Hispanic Black students had the lowest levels.

Conclusions and relevance: In this survey study, an appreciable portion of adolescents-particularly the younger ones-were not aware of the dangers of fentanyl use. Clinicians, parents, schools, and public education programs all have important roles in communicating the potentially life-threatening risks of fentanyl misuse to adolescents.

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

Journal: BMJ Open, doi: 10.1136/bmjopen-2025-109259

Authors: Patricia J. Rodriguez, Jay B. Lusk, Hemalkumar B. Mehta, Joseph F. Levy, Andreas P. Kalogeropoulos, Samir Soneji, … Nicholas Stucky

Abstract:

Objective: To evaluate the association between use of newer glucagon-like peptide-1 receptor agonists (GLP-1 RAs; semaglutide, tirzepatide) and alcohol-related hospitalisations among adults with alcohol use disorder (AUD) and type 2 diabetes (T2D) or obesity. Retrospective cohort study using target trial emulation.

Setting: Electronic health record data from a collective of US healthcare systems.

Participants: Adults with AUD and T2D or obesity who started a newer GLP-1 RA (semaglutide or tirzepatide) or a relevant active comparator between 1 January 2018 and 31 December 2024.

Interventions: Initiation of a newer GLP-1 RA compared with an active comparator across four target trials: (1) anti-diabetic medication (ADM) trial, (2) anti-obesity medication (AOM) trial, (3) medications for alcohol use disorder with T2D (MAUD-T2D) trial, and (4) medications for alcohol use disorder with obesity (MAUD-obesity) trial.

Main outcome measures: Time to first alcohol-related emergency department visits or hospitalisation within 1 year of treatment initiation. Non-alcohol-related hospitalisation was assessed as a negative control outcome. Propensity score based methods (weighting and matching) were used to control confounding and Cox proportional hazards models were used to estimate treatment effects.

Results: A total of 40 703 adults met study criteria, including 18 676 in the ADM trial, 9391 in the AOM trial, 8942 in the MAUD-T2D trial and 11 198 in the MAUD-obesity trial. Initiation of a newer GLP-1 RA was associated with a lower hazard of alcohol-related hospitalisation in the ADM trial (HR 0.74, 95% CI 0.62 to 0.89 vs sulfonylureas; HR 0.78, 95% CI 0.65 to 0.92 vs other ADMs), the AOM trial (HR 0.68, 95% CI 0.54 to 0.85 vs other AOMs), the MAUD-T2D trial (HR 0.37, 95% CI 0.29 to 0.46) and the MAUD-obesity trial (HR 0.35, 95% CI 0.26 to 0.47).

Conclusions: Among adults with AUD and T2D or obesity, initiation of newer GLP-1 RAs was associated with a lower observed risk of alcohol-related hospitalisation.

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