Research News Roundup: May 29, 2025

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen .2025.10077

Authors: Rachel A. Vickers-Smith, Kitty H. Gelberg, Janet E. Childerhose, Denise C. Babineau, Redonna Chandler, James L. David, … Bridget Freisthler

Abstract:

Importance: Illegal fentanyl is driving overdose mortality, and fentanyl test strips (FTS) can be used to test drugs for fentanyl at the point of consumption. Evidence on whether FTS use is associated with overdose risk reduction behaviors is encouraging, but largely limited to smaller, single-site studies.

Objective: To determine whether self-reported baseline FTS use among people who use drugs (PWUD) was associated with overdose risk reduction behaviors and nonfatal overdose over a 28-day follow-up.

Design, setting, and participants: Multisite, observational cohort study of PWUD conducted from May to December 2023 as an ancillary study of the HEALing Communities Study, which consists of fixed and mobile direct service provision sites in 14 community partner organizations distributing FTS. Participants lived in Kentucky, New York, or Ohio and reported using heroin, fentanyl, cocaine, methamphetamine, or nonprescribed opioids, benzodiazepines, or stimulants within 30 days before baseline. Participants were followed up for a maximum of 37 days.

Exposure: Baseline FTS use.

Main outcome and measures: The primary outcome was a composite score measuring the self-reported number and frequency of using 8 overdose risk reduction behaviors. Secondary outcomes included multiple measures (eg, self-reported nonfatal overdose).

Results: The study included 732 participants (median [IQR] age, 41 [34.0-48.0] years; 369 [50.4%] male; 64 [8.9%] Black or African American, 587 [81.3%] White, and 71 [9.8%] other races); 414 reported baseline FTS use and 318 did not. Compared with nonusers, a higher percentage of baseline FTS users were from Ohio and White, while a lower percentage were from New York and Hispanic and/or Black. In adjusted analyses, PWUD who used FTS had a mean daily composite score for overdose risk reduction behaviors that was 0.86 (95% CI, 0.34-1.38) units higher across follow-up compared with nonusers (score for FTS users, 7.37; nonusers, 6.51). There was no difference in self-reported nonfatal overdoses between the 2 groups (mean daily risk for FTS users, 0.02; nonusers, 0.02; risk ratio, 1.20; 95% CI, 0.70-2.06).

Conclusions and relevance: In this cohort study, baseline FTS use was associated with greater engagement in overdose risk reduction behaviors during follow-up, but not with the risk of nonfatal overdose during follow-up, suggesting PWUD who use FTS may also engage in a broader set of harm reduction strategies.

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Journal: Addiction Biology, 2025, doi: 10.1111/adb.70047

Authors: Mahan Shafie, Kevin Ing, Yasna Rostam-Abadi, Jeremy Weleff, Mackenzie Griffin, Mohini Ranganathan, Ardavan Mohammad Aghaei, … Anahita Bassir Nia

Abstract:

Cannabidiol (CBD) has emerged as a potential treatment option for various psychiatric disorders, including substance use disorders. This systematic review is aimed at reviewing the evidence regarding the safety and efficacy of CBD as a therapeutic option in opioid use disorder (OUD) treatment in clinical and preclinical studies. We searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, CDSR and CENTRAL up to December 2023. We included original peer-reviewed human and animal studies evaluating CBD for OUD outcomes and excluded those that did not report OUD outcomes or used CBD solely with THC. The risk of bias was assessed with the Cochrane risk-of-bias tool for human studies and SYRCLE’s tool for animal studies. Due to outcome heterogeneity, findings were presented using a qualitative synthesis. Four clinical studies (74 participants) and 16 preclinical studies met the inclusion criteria. The collective evidence from clinical and preclinical studies indicates that CBD holds promise as an adjunctive therapy for OUD with a well-tolerated profile during opioid use and withdrawal. Human clinical studies demonstrated a reduction in craving and alleviation of abstinence-induced anxiety. In preclinical studies, CBD has been shown to reduce withdrawal symptoms and diminish opioid-rewarding effects using the conditioned place preference paradigm, although the results are mixed, and not all preclinical studies reported these effects. The quality assessment for clinical studies indicated an overall evaluation of ‘some concerns’, while a notable level of ‘unclear’ risk was observed across the evaluated domains for preclinical studies. This systematic review highlights the potential of CBD as a beneficial treatment option for addressing cravings and anxiety symptoms during abstinence in individuals with OUD, based on findings from human studies. Continued research and clinical trials will be essential for further improving outcomes in OUD treatment using novel effective treatment approaches. Study limitations include the limited number of clinical studies, small sample size, short-term follow-up, lack of combination therapy and heterogeneity across preclinical studies.

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Journal: JMIR Mental Health, 2025, doi: 10.2196/67670

Authors: Geneva K Jonathan, Qiuzuo Guo, Heyli Arcese, A. Eden Evins, & Sabine Wilhelm

Abstract:

Background: Integrated digital interventions for the treatment of comorbid depression and substance use disorder have been developed, and evidence of their effectiveness is mixed.

Objective: This study aimed to explore potential reasons for mixed findings in the literature on integrated digital treatments. We described the methodologies and core characteristics of these interventions, identified the presence of evidence-based treatment strategies, examined patterns across digital modalities, and highlighted areas of overlap as well as critical gaps in the existing evidence base.

Methods: In June 2024, a literature search was conducted in Google Scholar to identify digital integrated interventions for comorbid major depressive disorder and substance use disorder. Articles were included if they described interventions targeting both conditions simultaneously; were grounded in cognitive behavioral therapy, motivational interviewing, or motivational enhancement therapy; and were delivered at least in part via digital modalities. In total, 14 studies meeting these criteria were coded using an open-coding approach to identify intervention characteristics and treatment strategies (n=25). Statistical analyses summarized descriptive statistics to capture the frequency and overlap of these strategies.

Results: Studies included a range of digital modalities: internet (n=6, 43%), computer (n=3, 21%), smartphone (n=2, 14%), and supportive text messaging interventions (n=3, 21%). Half (n=7, 50%) of the studies included participants with mild to moderate depression symptom severity and hazardous substance use. Only 36% (n=5) of the studies required participants to meet full diagnostic criteria for major depressive disorder for inclusion and 21% (n=3) required a substance use disorder diagnosis. Most interventions targeted adults (n=11, 79%), with few targeting young or emerging adults (n=4, 29%), and only 36% (n=5) reported detailed demographic data. Treatment duration averaged 10.3 (SD 6.8) weeks. Internet-based interventions offered the widest range of treatment strategies (mean 11.7), while supportive text messaging used the fewest (mean 4.6). Common treatment strategies included self-monitoring (n=11, 79%), psychoeducation (n=10, 71%), and coping skills (n=9, 64%). Interventions often combined therapeutic strategies, with psychoeducation frequently paired with self-monitoring (n=9, 64%), assessment (n=7, 50%), coping skills (n=7, 50%), decisional balance (n=7, 50%), feedback (n=7, 50%), and goal setting (n=7, 50%).

Conclusions: Among integrated digital interventions for comorbid depression and substance use, there was noteworthy variability in methodology, inclusion criteria, digital modalities, and embedded treatment strategies. Without standardized methods, comparison of the clinical outcomes across studies is challenging. These results emphasize the critical need for future research to adopt standardized approaches to facilitate more accurate comparisons and a clearer understanding of intervention efficacy.

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Journal: Frontiers in Public Health, 2025, doi: 10.3389/fpubh.2025.1529078

Authors: Kimberly Horn, Ryan E. Flinn, Angela Marie Hagaman, Kristyn Zajac, Lauren A. Hoffman, Melissa N. Poulsen, … Aaron Hogue

Abstract:

Background: Recovery from substance use disorder (SUD) is a complex and individualized process requiring multifaceted support systems. Peer recovery support services (PRSS), provided by Peer Workers, bridge the gap between formal intervention and personal recovery experiences. Drawing on shared lived experience, Peer Workers offer essential support to fellow Peers navigating recovery. However, variability in PRSS roles, training, and settings creates challenges for consistent evaluation and measurement of effectiveness.

Objective: Introduce a systematic taxonomy to clarify the roles, functions, and activities within PRSS, providing a structured framework for evaluating their impact on key SUD recovery milestones.

Methods: The taxonomy was developed through a rapid narrative literature review, expert consultation, and an iterative consensus process informed by a Delphi-like approach. A multidisciplinary task group of PRSS scientists and practitioners, SUD treatment providers, and individuals in recovery contributed to its refinement. The framework aligns with key components from SAMHSA’s national standards (SAMHSA, 2023) to enhance consistency across practice settings.

Results: Comprising six primary taxons and 20 branches, the taxonomy organizes PRSS components into structured categories. It classifies variations in lived experience (e.g., direct, indirect, and hybrid), training levels (e.g., basic, specialized, continuous education, and formal education), support approaches (e.g., Peer Worker-led services), and support settings (e.g., community-based, clinical, and justice system). Additionally, it categorizes peer support activities into four core domains: emotional, informational, instrumental, and affiliational support. The taxonomy integrates a structured model for PRSS evaluation, identifying mediators (e.g., support approaches) and moderators (e.g., training levels) that influence recovery outcomes.

Conclusion: The proposed taxonomy and integrated evaluation model provide a standardized framework for researchers and practitioners to systematically assess PRSS impact on recovery milestones. By establishing a common language, the taxonomy enhances consistency in PRSS research, identifies empirically supported peer support practices, and informs targeted training and strategic implementation. Future research should prioritize empirical testing of this framework to refine its applicability across diverse PRSS settings and enhance intervention effectiveness and scalability.

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