Journal: Drug and Alcohol Dependence, 2026, doi: 10.1016/j.drugalcdep. 2026.113374
Authors: Michael J. Lynch, Evan S. Cole, Jie Li, & Julie M. Donohue
Abstract:
Purpose: Medications for opioid use disorder improve survival and health outcomes, yet access remains limited. Telemedicine bridge clinics offer rapid, low-barrier treatment initiation and retention. This study evaluated whether care through a telemedicine bridge clinic was associated with improved medication engagement, emergency department (ED) utilization, and Medicaid expenditures compared with usual office-based care.
Methods: Pennsylvania Medicaid claims were linked with clinical data to identify adults aged 18–64 who received care from a telemedicine bridge clinic between April 2020 and July 2022. Bridge clinic patients were matched to up to four Medicaid enrollees initiating care with other opioid use disorder providers based on demographic and eligibility characteristics. Difference-in-differences models compared medication use, proportion of days covered (PDC) by medications for opioid use disorder, and ED utilization in the 6 months before and after the index visit. Medicaid expenditures were examined descriptively.
Results: The sample included 552 bridge clinic patients and 2208 matched comparison patients. A greater proportion of bridge clinic patients filled a buprenorphine prescription in the month after qualifying encounter (91.3% vs. 73.6%). Relative to the comparison group, bridge clinic patients experienced a 6.9% increase in medication PDC and an 18.2% relative reduction in the proportion with any ED visit. Medicaid expenditures were lower among bridge clinic patients, driven primarily by lower inpatient spending.
Conclusions: Telemedicine bridge clinic care was associated with improved continuity of medication treatment and reduced ED utilization among Medicaid enrollees, supporting its role as an effective, low-barrier model for opioid use disorder care.
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Journal: International Journal of Drug Policy, 2026, doi: 10.1016/j.drugpo. 2026.105428
Authors: Madeline C. Frost, Lara N. Coughlin, & Maureen T. Stewart
Abstract:
Introduction: Stimulant-associated harms are increasing in the U.S. Contingency management (CM) is the most effective available stimulant use disorder (StUD) treatment; guidelines recommend CM in conjunction with other psychosocial treatments. Unfortunately, there are barriers to CM provision, and it is unclear to what extent recommended StUD treatment is available in substance use treatment facilities. We examined provision of recommended StUD treatment reported by U.S. treatment facilities and associated facility characteristics.
Methods: We used 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS) data. Outcomes included facility report of frequent use of CM/motivational incentives (CM/MI) for non-opioid substances, and CM/MI plus other recommended treatments (cognitive behavioral therapy [CBT], community reinforcement approach [CRA], or Matrix Model [MM]). We estimated associations between facility characteristics and outcomes using multivariable logistic regression models.
Results: Less than half of facilities reported frequent use of recommended StUD treatment (42% CM/MI, 41% CM/MI+CBT, 8% CM/MI+CRA, 25% CM/MI+MM). In general, reported provision of CM/MI alone or in combination with other treatment was positively associated with state licensure/certification, accepting state-financed insurance, offering opioid agonist treatment, and higher state percent rural population (except CM/MI+CRA), and negatively associated with primarily providing substance use services (vs. mental health and substance use services), private non-profit ownership (vs. private for-profit), accepting Medicare or Medicaid, cash/self-pay only, and higher state-level stimulant-involved overdose mortality rate.
Conclusion: Increasing the availability of recommended StUD treatments, especially CM, is crucial in U.S. substance use facilities. These exploratory findings can inform future research to help policymakers and administrators improve access.
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Journal: JRSM Cardiovascular Diseases, 2026, doi: 10.1177/20480040 261485004
Authors: Sachin Sapkota, Vijay Chennareddy, Suman Paudel, Suchita Acharya, Sakshi Nepal, Chioma Eliogu, Sandesh Murali, & Mehran Abolbashari
Abstract:
Background: Acute myocardial infarction (AMI) remains a leading cause of premature death (<65 years) in the United States, with a significant association with psychoactive substance use (PSU). However, long-term trends and future projections of this combined burden remain unclear.
Methods: We conducted a retrospective observational study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research Multiple Cause of Death database to assess premature mortality (ages 25-65 years) related to AMI and PSU from 1999 to 2023. Age-adjusted mortality rates (AAMRs) were derived, and annual percentage changes (APCs) were calculated using joinpoint regression. An autoregressive integrated moving average (ARIMA) model was used to forecast mortality through 2035.
Results: From 1999 to 2023, 176,641 premature deaths were attributed to AMI and PSU. The AAMR rose from 1.4 per 100,000 in 1999 to 4.16 in 2023. Mortality increased sharply from 1999 to 2005 (APC 19.04), continued rising through 2021 (APC 2.63), and declined between 2021 and 2023 (APC -9.13). Middle-aged adults (45-65 years) had substantially higher mortality than younger adults (25-45 years) (AAMR 9.63 vs 0.91, 2018-2023). Men had higher mortality than women (6.81 vs 2.53). American Indian/Alaska Native and White populations showed the higher racial burden. Nonmetropolitan areas had markedly higher mortality than metropolitan regions. South Dakota, Kentucky, and Arkansas had the highest state-level mortality. Forecasting predicts only a modest decline to 3.80 per 100,000 by 2035.
Conclusion: Despite recent declines, premature mortality from AMI and PSU is projected to remain high through 2035, underscoring the need for targeted, evidence-based prevention strategies.
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Journal: Addictive Behaviors Reports, 2026, doi: 10.1016/j.abrep. 2026.100739
Authors: Priscilla Martinez-Matyszczyk, Laurie A. Drabble, Cat Munroe, Anthony Surace, & Katherine J. Karriker-Jaffe
Abstract:
Purpose: Despite a decline in drinking in the United States, current reasons for alcohol abstention remain underexplored. We aimed to estimate the prevalence of reasons for not drinking among lifetime abstainers and former drinkers, compare reasons across demographics, and examine associations between awareness of alcohol’s health risks and not drinking for health reasons.
Methods: We used data from a 2024 nationally representative online survey of U.S. adults. Respondents reporting no past-year or lifetime alcohol use (n = 1772) rated the importance of five reasons for not drinking and indicated their awareness of alcohol health risks. We used bivariate comparisons and multivariate logistic regressions to examine subgroup differences in reasons for not drinking and associations with awareness of alcohol’s health effects.
Results: The most common reasons for not drinking were concerns about health and impaired control. In bivariate analysis, fewer gender and sexual minority individuals cited health and impaired control as reasons for not drinking, while more Black and Hispanic respondents endorsed health concerns and family/friend concerns as reasons. Awareness of alcohol’s health risks was higher among those who cited health as a reason for not drinking. In multivariate analyses, gender, race, ethnicity, sexual identity, and awareness of alcohol’s effect on cancer risk remained significant correlates of reasons for not drinking.
Conclusions: The most common reasons for not drinking related to concerns about health and impaired control, and reasons varied between population subgroups. These reasons for not drinking offer candidate content for future research testing alcohol reduction messaging.
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Journal: Psychological Assessment, 2026, doi: 10.1037/pas0001502
Authors: Ashley L. Watts, Joseph F. Sexton, Cassandra L. Boness, & Alexander P. Christensen
Abstract:
Psychometric techniques are increasingly critical for refining the diagnostic criteria for substance use disorders (SUDs), but core assumptions of these techniques are often untested and potentially unmet. We examined the assumption of local independence-that indicators are uncorrelated after conditioning on their latent variable-among SUD criteria across 11 classes of psychoactive drugs using data from the National Survey of Drug Use and Health surveys from 2021 to 2023 (N = 165,249) by applying unique variable analysis, factor analysis, and item response theory analysis to identify psychometric redundancy. Across all drugs, unique variable analysis identified 44 instances of psychometric redundancy (out of the 585 possible instances) in the SUD criteria set, with variation across drugs. Item response theory suggested that redundancy also varied across SUD severity. Gave up activities and role interference were redundant across all drugs, and time spent and larger/longer were redundant for six drugs. Dropping any of these redundant criteria resulted in a gain in SUD information, with information gained being nearly equivalent within redundant pairs. We discuss psychometric and diagnostic implications of criterion redundancy, including but not limited to inflated support for a unidimensional SUD structure, skewing of the SUD definition toward sources of redundancy (e.g., functional impairment), and inflated misclassification rates (particularly false positives). We offer several remedies to psychometric redundancy, including modeling residual covariances, consolidating redundant items into testlets, applying gating criteria where applicable, and using cognitive interviewing to maximally distinguish conceptually unique but psychometrically overlapping criteria.
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