Research News Roundup: October 1, 2026

Journal: Stigma and Health, 2026, doi: 10.1037/sah0000724

Authors: Melissa R. Schick, Bianca Planas-García, Johanna Perez, & Lourah M. Kelly

Abstract:

Background: The process by which individuals change their substance use is personal and often non-linear, with periods of recovery, return to use, and treatment re-entry. This study characterizes utilization of substance use services and barriers to treatment access among United States (U.S.) adults with a self-identified lifetime alcohol and/or drug use problem who are versus are not in recovery.

Methods: This study uses a subset of adults from the 2023 National Survey on Drug Use and Health (NSDUH) who self-identified as having had a problem with alcohol and/or drugs at some point in their lifetime (unweighted n=5,260, 38.4% female, 24.5% people of color).

Results: Most participants (72.9%) self-identified as being in recovery. Individuals in recovery (relative to those with a lifetime problem but not in recovery) were more likely to report past-year substance use treatment (aOR=1.48); this difference appeared to be driven by the greater likelihood of using support groups (aOR=1.53) and peer support specialists or recovery services (aOR=1.17) among those in recovery. No differences were observed for other treatment types. Among those with past-year perceived unmet need for treatment (8.0% of the overall sample), individuals in recovery were significantly less likely to endorse concerns regarding stigma (aOR=0.25) and readiness to change (aORs=0.17-0.20). Otherwise, no differences were observed for other barriers.

Conclusions: Our findings highlight stigma as a unique distinguishing feature between those who are and are not in recovery from a substance use problem. Stigma-reducing interventions are needed to ensure that a greater proportion of individuals receive effective treatment.

Clinical impact statement: Of people with a lifetime self-identified problem with alcohol and/or drug use, most also self-identified as being in recovery. We found that people in recovery were more likely to use support groups and peer-based services, while stigma stood out as a unique barrier to accessing treatment among those not in recovery. Increasing access to recovery-focused services might help to promote a recovery identity, thereby reducing stigma as a barrier to accessing treatment.

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Journal: Drug and Alcohol Dependence, 2026, doi.org/10.1016 /j.drugalcdep.2026.113378

Authors: Wilson Figueroa, Amy K. Ferketich, Nicholas Breitborde, Joanne G. Patterson, Alayna P. Tackett, Bo Lu, & Megan E. Roberts

Abstract:

Background: E-cigarettes (ECs) remain the most commonly used tobacco product among young people in the United States (US). Psychological distress (PD) is prevalent and associated with EC use and nicotine dependence, although underlying factors are unclear. Psychological reward (PR)—positive internal sensations associated with EC use—may account for the association between PD and nicotine dependence. This study examined whether PR was statistically associated with the relationship between PD and nicotine dependence. Given the cross-sectional design, analyses assessed associations rather than causal or temporal pathways.

Methods Young people aged 14–25 years in the US who had recently initiated EC use participated in a study of nicotine product trajectories. After providing consent or assent, participants completed an online survey. Measures included PD (anxiety and depression symptoms), PR (feeling calm, less irritable, better able to concentrate, more awake, and less hungry after EC use), and nicotine dependence (Hooked on Nicotine Checklist). The indirect association between PD and nicotine dependence through PR was examined using linear regression.

Results The direct association between PD and nicotine dependence remained significant (b = 0.22), as did the estimated indirect association through PR (b = 0.06, 95% CI [0.01, 0.10]).

Conclusion: Findings indicate cross-sectional associations among PD, PR of EC use, and nicotine dependence in young people. Addressing PD may be relevant to efforts to reduce nicotine dependence; longitudinal and experimental studies are needed to determine whether PD management influences dependence.

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Journal: The Permanente Journal, 2026, doi: 10.7812/TPP/26.032

Authors: Pravesh Sharma, Hannah Kolarik, Payton Jorgenson, Christina Smith, Stephan Arndt, Nicholas L Bormann

Abstract:

Background: Youth-directed cannabis messaging is often generic, adult-centered, and does not reflect contemporary patterns of cannabis use. This study examined adolescents’ perceptions of cannabis-related messaging and identified messaging strategies they find relevant.

Methods: The authors conducted qualitative interviews with adolescents aged 14-17 years with past 30-day cannabis use. Interviews were analyzed using thematic analysis with constant comparison. Data collection continued until no new themes were identified (N = 7).

Results: Adolescents reported that fear-based and abstinence-only messaging were ineffective. They viewed nonjudgmental, autonomy-supportive, and youth-centered messaging as more credible. Participants emphasized that clinicians should acknowledge the perceived benefits of cannabis to build trust and credibility. Messages that focused on immediate consequences of cannabis use, such as brain fog and memory impairment, were more effective than generalized long-term harms. Adolescents expressed greater trust in harm reduction messaging and communication strategies that integrate real-world adolescent experiences with clinician expertise.

Conclusions: These preliminary findings suggest that clinicians should consider framing cessation messaging around cognition and memory. Although the long-term goal is cannabis cessation, clinicians should remain ready to transition toward harm reduction guidance, based on adolescents’ receptiveness and their response to initial abstinence-focused conversation, reflecting an adaptive framework that shifts in intensity and orientation with the patient’s response rather than following a static treatment algorithm. Although these strategies may enhance engagement and mitigate treatment dropout, larger-scale studies are needed before these strategies can be broadly recommended for clinical practice. Ethical incorporation of peer-lived experiences to support harm reduction and cessation should be considered.

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Journal: Journal of the American Academy Child & Adolescent Psychiatry, 2026, doi: 10.1016/j.jaac.2025.09.025

Authors: Lindsay M. Squeglia, Rachel L. Tomko, Nathaniel L. Baker, Anna E. Kirkland, Erin A. McClure, & Kevin M. Gray

Abstract:

Objective: The aim of this study was to evaluate the efficacy of N-acetylcysteine, compared to placebo, in reducing alcohol use among treatment-seeking adolescents and young adults with alcohol use disorder (AUD).

Method: Between March 2019 and February 2024, a fully powered, double-blind, parallel, randomized, placebo-controlled, intent-to-treat clinical trial was conducted in an outpatient setting among treatment-seeking young people 15 to 25 years of age who met criteria for AUD. Participants (N = 126; mean [SD] age, 21.0 [2.4] years; 78 [62%] female) were randomized in a 1:1 ratio to an 8-week course of 2,400 mg/day (administered as 1,200 mg twice daily) of N-acetylcysteine (n = 65) or placebo (n = 61) and were followed for 6 months total. All participants received weekly clinician-led alcohol intervention sessions, including elements of motivational interviewing and goal setting. Adverse events were assessed by the medical clinician, and medication adherence videos were observed asynchronously by study staff to confirm medication taking. The primary efficacy endpoint was reduction in alcohol use (total standard drinks during the last 4 weeks of treatment), compared between the N-acetylcysteine and placebo groups. Secondary outcomes included number of drinking days, heavy drinking days, and drinks per drinking day during the last 4 weeks of treatment.

Results: Video-confirmed medication adherence (overall, 82.7%) and rates of adverse events did not differ between groups. There were no overall differences in primary or secondary alcohol use outcomes between participants in the N-acetylcysteine versus placebo group (primary efficacy endpoint: 37.9 [SE = 3.8] standard drinks over the last 4 weeks of treatment in the N-acetylcysteine group vs 42.6 [6.3] in the placebo group; risk ratio = 1.19, 95% CI = 0.89, 1.61, p = .24); however, baseline AUD severity modified treatment efficacy. In participants with moderate to severe AUD, N-acetylcysteine significantly reduced alcohol consumption compared to placebo (31.7 vs 44.4 standard drinks over the last 4 weeks of treatment, p = .01) but not frequency of alcohol use. In participants with mild AUD, N-acetylcysteine did not significantly reduce alcohol use compared to placebo.

Conclusion: N-acetylcysteine may be a useful adjunctive treatment for moderate to severe AUD, but it is potentially less suitable for mild cases. In exploratory analyses, N-acetylcysteine was effective in reducing alcohol consumption among youth with moderate to severe AUD, but not among those with mild AUD; nor was there an effect on frequency of alcohol use for any group. This could be especially relevant for adolescents, who typically drink less often than adults but tend to consume larger amounts of alcohol when they do drink; thus, changes in alcohol consumption may be more impactful than changes in frequency. These findings highlight the importance of considering AUD severity in both clinical treatment planning and the design of youth AUD trials. Because individuals with more severe AUD are the most likely to seek treatment, trials may consider oversampling youth with moderate to severe AUD to improve the relevance and effectiveness of interventions. Future studies should consider similar stratified approaches to evaluate other potential treatments for adolescents and young adults with AUD.

To read the full text, please visit the PubMed Central.

Journal: Drug & Alcohol Dependence Reports, 2026, doi: 10.1016/j.dadr.2026.100478

Authors: Jack Larsen, Patrick Kenney, Tonya Milam, Joyce Troxler, Caleb Osborne, & Maria Zambrano

Abstract:

Introduction: Buprenorphine is internationally recognized as an effective treatment for Opioid Use Disorder (OUD). Pill counting, a quantitative assessment of medication supply to monitor prescription medication adherence, is often recommended to monitor buprenorphine adherence. However, there is little evidence to support pill counting or examine its impact on addiction treatment. This retrospective review seeks to examine retention in treatment before and after implementation of a novel pill count protocol in outpatient substance use treatment.

Methods: This observational retrospective cohort study consisted of patients receiving buprenorphine or buprenorphine/naloxone for treatment of OUD as part of an outpatient university-affiliated substance use treatment program in the United States. Patients seen prior to the introduction of pill counts (n = 103) were compared to patients (n = 107) who had a pill count performed after the introduction of pill counts.

Results: Retention in treatment was higher after pill count implementation, but the statistical evidence was not consistent across analyses. The incidence of an inappropriate pill count was 36.4%. No significant difference in retention in treatment was found between those with appropriate counts and inappropriate counts (94.8% versus 95.5%, p = 0.87). The most common clinician response to an inappropriate pill count was closer follow up (43.6%). We describe our pill count protocol as a prototype.

Conclusions: The findings from this study show inconsistent statistical support for a positive association between buprenorphine pill counts and retention in OUD treatment. A prototype pill count may allow for standardization and validation of this commonly performed yet poorly understood practice.

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