Research News Roundup: May 14, 2026

Journal: Addiction Science & Clinical Practice, 2026, doi: 10.1186/s13722-026-00669-z

Authors: Trey V. Dellucci, Brielle L. Batch, Stephanie J. Strong, Amanda V. Broderick, Allyson L. Dir, Leslie A. Hulvershorn, & Zachary W. Adams

Abstract:

Background: While caregiver engagement is a critical component of adolescent substance use disorder (SUD) treatment, it is often limited in practice. Existing research on barriers and facilitators to caregiver engagement has predominately focused on clinician perspectives of caregiver engagement. This study sought to synthesize caregivers’ perspectives on their involvement in adolescent SUD treatment.

Methods: Qualitative interviews were conducted with 15 caregivers (including parents and legal guardians) of adolescents who participated in an outpatient SUD treatment program in the past year. A hybrid inductive-deductive coding approach using an iterative and concurrent process was utilized to identify themes related to caregiver engagement.

Findings: Thematic analysis identified three themes related to caregiver engagement: Caregiver Motivations for Treatment Initiation, Conceptualizations of Caregiver Involvement in Adolescent SUD Treatment, and Barriers and Facilitators of Caregiver Engagement.

Conclusions: There is a need for early substance use screening and intervention development targeting caregivers’ motivation and psychoeducation on the benefits of caregiver engagement in adolescent SUD treatment and recovery.

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

Journal: Journal of Studies on Alcohol & Drugs, 2026, doi: 10.15288/ jsad.25-00221

Authors: Bernard Pereda, & Craig R. Colder

Abstract:

Objective: Learning theories suggest an aversive learning process whereby negative consequences of alcohol use curtail drinking. However, the literature examining this prospective association is mixed. We aimed to clarify this aversive learning process by identifying how (mediators), for whom (moderators), and when (differences across development) such learning occurs. Negative alcohol expectancies were proposed as a mediator, and sensitivity to punishment was proposed as a moderator. Negative consequences were hypothesized to lead to increases in negative expectancies and, in turn, reductions in alcohol use. Associations were expected to be strongest among those with high sensitivity to punishment. This proposed aversive learning pathway was estimated in adolescence (limited alcohol experience) and young adulthood (significant alcohol experience) to examine differences in learning across the developmental period.

Method: Data from a longitudinal community sample (N = 387) were analyzed using prospective path models, with annual assessments conducted over 3 years in adolescence (ages 12-14) and young adulthood (ages 19-21).

Results: In adolescence, negative consequences were not associated with negative expectancies, but negative expectancies were inversely associated with alcohol use. In contrast, negative consequences were positively associated with negative expectancies in young adulthood, but negative expectancies were not associated with alcohol use. Moderation was not supported.

Conclusions: Negative consequences are uncommon among community adolescents and, as a result, may not shape negative expectancies, yet negative expectancies are protective against alcohol use. In young adulthood, negative consequences appear salient enough to shape negative expectancies, but they no longer serve a protective function. Findings suggest a shifting role of drinking experience in the development of expectancies and the influence of expectancies on alcohol use.

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

Journal: Substance Abuse Treatment, Prevention, & Policy, 2026, doi: 10.1186/s13011-026-00728-3

Authors: Katherine Hill, Cianna Piercey, Hollis C. Karoly, & Kirsten E. Smith

Abstract:

Background: ‘Kava,’ or ‘kava kava,’ (Piper methysticum) is a psychoactive plant indigenous to the Pacific Islands. Historical consumption is reported to provide anxiolytic and sedating effects. In regions where kava is native, it has been used in religious and cultural practices, as well as for medicinal purposes. The mechanisms by which kavalactones – the best studied psychoactive constituent of kava – may mediate pharmacological effects include enhancing the GABAA receptor, blocking of sodium and calcium channels, blocking reuptake of norepinephrine dopamine, and inhibiting MAO-B. In the United States, products containing kava have proliferated in recent years alongside the rise of ethnobotanical tea bars serving kava preparations.

Methods: Between December-July 2024, an anonymous online survey on legal psychoactive products was conducted using convenience sampling. Eligible individuals had to be ≥ 18 years old and endorse lifetime use of kratom, kava, tianeptine, and/or akuamma seed.

Results: Of the 368 participants, almost half (n = 180, 48.9%) had used kava during their lifetime. Those who reported lifetime use of kava were younger on average (p = 0.001), more racially diverse (p = 0.041), and had a higher proportion of being employed or in school (p = 0.012) than those where did not use kava in their lifetime. Kava was purchased online (40.6%) or in ethnobotanical tea bars (31.7%). Many reported infrequent consumption (average = 4.4 months/year and 9.1 days/30 days). Lifetime use of alcohol, kratom, and cannabis was common. Approximately one-third of participants had consumed kava more than 100 times, with commonly reported perceived effects from kava experienced in the minutes and hours after consumption included reduced general anxiety (33.7%), improved mood (32.9%), reduced social anxiety (25.5%), and sedation (23.4%). Most respondents had favorable conceptualizations of kava, with only 11.7% characterizing that kava alone as habit-forming. Many (51.7%) conceptualized kava as an alcohol replacement with 18.3% and 16.7% using kava as a short- and/or long-term substitute for alcohol, respectively.

Conclusions: Kava use practices are diverse, though perceived kava effects appear mostly mild. The proliferation and diversification of kava products pre-mixed with other psychoactive botanicals requires study as the benefit-risk profile may change. Clinicians should be aware of kava use for harm-reduction and other purposes.

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

Journal: Harm Reduction Journal, 2026, doi: 10.1186/s12954-026-01459-1

Authors: Katherine Hill, Emma T. Biegacki, Gabrielle Bogut, Elizabeth Znamierowski, Cameron Breen, River Rose, … Kimberly L. Sue

Abstract:

Background: In the context of the fourth wave of the opioid overdose crisis, defined by fentanyl and stimulant co-use, we aimed to explore if there might be a relationship between exposure to xylazine in the fentanyl supply and patterns of crack/cocaine use.

Methods: This mixed methods study used data from four Connecticut-based sources: (1) the Office of the Chief Medical Examiner for fatal overdoses, 2019-2023, (2) community-based drug checking data, 2023-2024, (3) a structured survey of people who use drugs, 2024, and (4) one-on-one in-depth interviews, 2024.

Results: Xylazine was detected in 19.2% of overdose fatalities involving fentanyl or a fentanyl analog (n = 5,849). Those with xylazine detected had a higher proportion of cocaine simultaneously detected, though this was not statistically significant (54.0% vs. 51.1%, p = 0.085). Cocaine detection rose over time in the fatality data, regardless of xylazine detection. There were 1,048 drug samples submitted to harm reduction organizations for drug checking. Using Fourier Transform Infrared Spectroscopy, 573 of the samples submitted tested positive for fentanyl or a fentanyl analog; 45.2% of these also tested positive for xylazine. Of 1048 samples, 276 tested positive for cocaine. Among the survey sample (n = 88), 62.5% of participants self-reported xylazine exposure. Those who reported lifetime xylazine exposure also reported higher past-year crack/cocaine use, though this was not statistically significant (89.1% vs. 81.8%, p = 0.336). Among our interview sample (n = 31), three themes emerged: (1) participants felt there was an inevitability of polysubstance use due to an increasingly volatile drug supply, (2) participants increased their crack/cocaine use in response to perceived exposure to xylazine in their fentanyl supply, and (3) participants’ drug patterning changed due to xylazine’s presence (e.g., timing, drug sequencing, etc.). Two meta-inferences were identified: (1) overdose fatality data likely underestimate the “true” prevalence of xylazine in the street supply, and (2) people who use drugs are using crack/cocaine in response to xylazine in their local fentanyl supply.

Conclusions: Xylazine exposure has likely contributed to an adaptive and increasing use of crack/cocaine among people who use drugs in Connecticut. It is imperative that practitioners and policymakers are prepared to manage this triad of opioid-stimulant-sedative polysubstance use.

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