Research News Roundup: June 4, 2026

Journal: JAMA Network Open, 2026, doi: 10.1001/jamanetworkopen .2026.14115

Authors: Yao Wu, Stephanie L. Merhar, Carla M. Bann, Jamie E. Newman, Kushal Kapse, Josepheen De Asis-Cruz, … Catherine Limperopoulos

Abstract:

Importance: Antenatal opioid exposure is associated with adverse neurodevelopmental outcomes and smaller brain volumes, but the effects of opioids on newborn cortical folding maturation have not been defined. The Advancing Clinical Trials in Neonatal Opioid Withdrawal Outcomes of Babies with Opioid Exposure (OBOE) Study is a multisite prospective longitudinal cohort study examining the association of antenatal opioid exposure with brain maturation and outcomes in newborns.

Objective: To compare cerebral cortical folding in newborns exposed to opioids vs nonexposed controls.

Design, setting, and participants: In this cohort study, full-term newborns from the OBOE study with antenatal opioid exposure and nonexposed controls were recruited at 4 US sites, including obstetric clinics, maternal substance use treatment programs, and birth hospitals, from August 5, 2020, to December 28, 2023. Data analysis was performed from August 19, 2020, to March 25, 2026.

Exposure: Newborn opioid exposure, including opioid-only and polysubstance exposure as well as exposure to specific opioids.

Main outcomes and measures: Nonsedated T2-weighted magnetic resonance imaging (MRI) data were acquired via harmonized protocols, and 3D brain images were segmented and parcellated using the Developing Brain Region Annotation With Expectation-Maximization pipeline. The inner cortical gray matter surface was used to measure cortical folding across the frontal, parietal, temporal, and occipital lobes. Group differences between opioid-exposed and nonexposed newborns were compared via analysis of covariance, adjusting for postmenstrual age at MRI, sex, birth weight, maternal age, smoking status, and education level.

Results: A total of 259 newborns (mean [SD] gestational age at birth, 39.1 [1.0] weeks; 145 [56.0%] male) were included in the analysis, of whom 164 had antenatal exposure to opioids and 95 were nonexposed controls (mean [SD] postmenstrual age at MRI, 42.8 [2.2] and 42.9 [2.0] weeks, respectively). Compared with nonexposed controls, newborns who had been exposed to opioids had significantly decreased sulcal depth in the frontal (difference, -0.11 mm [95% CI, -0.20 to -0.02 mm]), parietal (difference, -0.19 mm [95% CI, -0.31 to -0.07 mm]), and global (difference, -0.09 mm [95% CI, -0.18 to -0.01 mm]) regions, as well as decreased surface area in the frontal (difference, -1048 mm2 [95% CI, -1497 to -598 mm2]), parietal (difference, -501 mm2 [95% CI, -834 to -168 mm2]), temporal (difference, -422 mm2 [95% CI, -682 to -162 mm2]), occipital (difference, -232 mm2 [95% CI, -439 to -26 mm2]), and global (difference, -2185 mm2 [95% CI, -3327 to -1043 mm2]) surfaces. Compared with controls, newborns exposed to methadone showed larger reductions in frontal, parietal, and global surface areas than those exposed to buprenorphine, with parietal surface area significantly reduced only in the methadone-exposed group (difference, -656 mm2 [95% CI, -1111 to -202 mm2]). Newborns with polysubstance exposure had significantly reduced sulcal depth in the frontal, parietal, and global surfaces, as well as reduced surface area across all lobes compared with controls, whereas opioid-only exposed newborns showed fewer significant differences from controls, with reduced parietal sulcal depth and decreased frontal and global surface areas.

Conclusions and relevance: In this cohort study, newborns with antenatal exposure to opioids had reduced cerebral cortical sulcal depth and surface area compared with nonexposed controls, with greater reductions among newborns exposed to methadone compared with those exposed to buprenorphine, and in newborns with polysubstance exposure compared with those with opioid exposure only. Ongoing serial MRI and long-term follow-up are under way to assess the impact of these early cortical maturational differences on later neurodevelopment and behavior.

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Journal: Prevention Science, 2026, doi: 10.1007/s11121-026-01929-9

Authors: Yoon S. Hur, Sarah M. Chilenski, Patrick R. O’Neill, Damon E. Jones, Richard L. Spoth, Mark E. Feinberg, & D. Max Crowley

Abstract:

Programming to prevent behavioral problems can effectively build youth skills and enhance bonding to parents and prosocial peers to delay substance use for adolescents, an important challenge for adolescents given the links between early adolescent experimentation and the chance of developing problems related to substance use as an adult. For youth at higher risk, the effective delivery of such programs could be particularly critical. This study examined the impact of implementation outcomes of family-focused evidence-based prevention programming in sixth grade on substance use in ninth grade based on youths’ initial levels of risk. Three implementation outcomes were assessed: (1) adherence, (2) facilitation quality, and (3) participant responsiveness. Using multi-level analysis of data from two cohorts across 14 school districts, we examined whether community-level implementation quality moderated the relationship between individual-level baseline risk and later substance use. Results showed higher implementation quality, particularly facilitation quality and participant responsiveness, was significantly associated with lower substance use among high-risk youth. Notably, high implementation quality was significantly associated with lower substance initiation index scores for high-risk students (p < 0.05). Similar results were also found for the initiation of marijuana and cigarette use, as well as for alcohol consumption in the past month.

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Journal: Harm Reduction Journal, 2026, doi: 10.1186/s12954-026-01467-1

Author: Diego Renteria, Adetayo Fawole, Jason Alexandre, Haley Allen, Joshua Aleksanyan, Sugy Choi, … Charles J. Neighbors

Abstract:

Background: Transition-age (TA) adults are less likely than adults aged 26 and older to receive medications for opioid use disorder (MOUD), and among those treated, disproportionately receive naltrexone over more effective agonist MOUD (buprenorphine and methadone). Given that prescribers ultimately determine medication selection, understanding how age influences their clinical decisions is essential to addressing these disparities. This study examines how prescribers incorporate age into MOUD prescribing decisions for this developmentally vulnerable population.

Methods: Using 2022 New York State Medicaid claims, we identified MOUD prescribers with substantial experience (treating n ≥ 5 TA adults) and conducted semi-structured interviews with 18 outpatient prescribers (MD/DOs, NPs, PAs) from diverse geographic and clinical settings. We applied an inductive thematic analysis approach to explore how prescribers incorporated age and age-related factors into their clinical decision-making around MOUD.

Results: Most prescribers did not endorse chronological age as a factor influencing their prescribing patterns, but rather described tailoring treatment based on age-related factors more commonly seen in TA adults. These included developmental characteristics (perceived lack of commitment, peer influence), socioeconomic barriers (e.g., unreliable transportation leading to missed appointments), family influence, and concerns about MOUD dependence. In response to these age-related factors, prescribers implemented harm-reduction principles by adjusting MOUD type prescribing to accommodate TA adults’ life-stage realities. In contrast, a small subset of prescribers explicitly cited chronological age as directly influencing MOUD prescribing, expressing hesitations about initiating buprenorphine or referring TA adults for methadone due to long-term dependence concerns.

Conclusion: These findings suggest two key mechanisms through which age may influence MOUD prescribing disparities among TA adults: (1) prescribers’ responses to age-related life-stage challenges (e.g., developmental and social factors, structural barriers) and (2) explicit prescriber age-based hesitancy about initiating long-term agonist maintenance in younger patients. The first mechanism appeared more influential than explicit hesitancy. These mechanisms may help explain documented disparities in MOUD type prescribed. Addressing these disparities may require multi-level interventions: prescriber education affirming agonist MOUD effectiveness for TA adults, efforts to reduce MOUD misconceptions among patients and families, peer-based approaches that leverage social influence positively, and flexible harm-reduction-oriented clinic policies that accommodate structural barriers while supporting access to evidence-based MOUD.

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Journal: Translational Psychiatry, 2026, doi: 10.1038/s41398-026-04101-7

Authors: Yixin Wang, Eva M. Müller-Oehring, Stephanie A. Sassoon, Kalin Z. Salinas, Adolf Pfefferbaum, Edith V. Sullivan, Qingyu Zhao, & Kilian M. Pohl

Abstract:

Alcohol Use Disorder (AUD), with a lifetime prevalence of 29.1% in the U.S., is associated with functional impairment affecting visuospatial working memory, executive functions, and motor control. The objective of this study was to distinguish people with AUD from controls on the basis of functional brain and neuropsychological measures that would contribute to identifying mechanisms of AUD-related dysfunction. A data-driven, deep-learning framework jointly analyzed 6105 region-to-region connections from resting-state functional MRI and 16 cognitive and motor performance scores. The deep learning method first derived 16 brain networks aligned with neuropsychological functions and then combined them into 14 functional units. After determining the most important functional unit for diagnostic classification, mediation analysis identified the neural pathways of that unit through which AUD affects neuropsychological performance. The Temporal Attention Network (TAN) fully mediated the effect of AUD diagnosis on spatial working memory (Visual Span). TAN also fully mediated the effects of AUD on visually guided attention, set-shifting, and motor performance (Trail Making Test), which, in parallel was mediated by a second network, the Sensorimotor Network (SMN). In conclusion, selective and dissociable brain functional and neuropsychological relationships differentiated individuals with AUD from controls. These relations, which were identified with deep learning technology and replicated on an independent dataset of people with HIV (with or without AUD comorbidity), provide support for brain functional substrates of commonly observed, AUD-related neuropsychological deficits.

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