Latest research: Substance use & addiction

What it found: In a simulation study with three adults, behavioral skills training produced mastery of opioid overdose response steps across three training scenarios and correct responding in new contexts, whereas access to written directions and a naloxone trainer alone did not.

Why it matters: The findings suggest that rehearsing and assessing the full overdose response sequence may be more useful than relying on written naloxone instructions alone, although real-world emergency performance was not tested.

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What it found: In a longitudinal study of 1,395 community adults, lower sensitivity to alcohol price predicted greater later alcohol use and problems, while greater alcohol use also predicted changes in alcohol demand.

Why it matters: Assessing alcohol price sensitivity and maximum expenditure may help track risk for increasing alcohol use and related problems, although this observational study did not test treatment effects.

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What it found: Daily surveys of 75 rural adults with at-risk drinking found that alcohol demand and the proportion of alcohol-free activities predicted next-day drinking in unadjusted analyses, with demand–drinking relationships varying by alcohol use severity in adjusted analyses.

Why it matters: Brief daily measures of alcohol demand and alcohol-free activities may help identify when drinking support is needed, although this study did not test an intervention.

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What it found: Across two crowdsourced studies, alcohol demand generally increased with suicide risk, while greater discounting of delayed monetary gains was associated with recent suicide preparations but not suicidal ideation.

Why it matters: These findings suggest alcohol demand and delay discounting may help researchers understand alcohol-related suicide risk, but do not establish these measures as clinical screening tools.

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What it found: This community case study found that contingency management supported by staff training, coaching, and organizational preparation more than doubled intake completion and increased group therapy attendance by 11% among justice-involved clients compared with historical controls.

Why it matters: Pairing reinforcement for service engagement with staff coaching and organizational support may help substance use programs implement and sustain contingency management in routine care.

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What it found: This protocol describes a cluster-randomised feasibility study of peer-delivered financial incentives targeting treatment attendance, alongside text reminders and peer support, for people with psychosis and substance-use problems; no outcome results are reported.

Why it matters: It outlines a potentially useful approach to improving treatment engagement, but feasibility and effectiveness must still be evaluated before practice recommendations can be made.

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What it found: A retrospective review of pharmacist-involved contingency management at three VA facilities found that patients attended 88.3% of injectable medication appointments on time and 80% of urine samples were negative for the targeted substance.

Why it matters: Partnering with clinical pharmacists may expand access to incentive-based support for substance abstinence and medication adherence.

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What it found: A community program offered points-based rewards for treatment engagement and prosocial activities to youth with psychosis and substance use, with 12 of 31 enrolling, 10 earning points, and 2 reaching the raffle phase within six months.

Why it matters: Contingency management appears feasible in this setting, but staff may need strategies to improve participation, and these findings do not establish reduced substance use.

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What it found: This scoping review of 29 UK studies found that contingency management generally supported abstinence and medication adherence and was well accepted, although resource, training and ethical concerns limited implementation.

Why it matters: Staff implementing contingency management should plan for training, resources and fit with local harm reduction services while maintaining fidelity to its reinforcement principles.

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What it found: This review summarized eight states’ applications for Section 1115 waivers to fund contingency management for substance use disorders, finding five approvals and differences in targeted substances, program length, incentives, and reinforcement schedules.

Why it matters: Providers planning contingency management services can use approved waiver programs to inform funding applications and program design, although treatment outcomes were not reported.

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What it found: Following coaching-to-criterion, all 115 addiction professionals and peer specialists met contingency management competency standards in standardized patient encounters, with similar performance and coaching resources across groups.

Why it matters: Coaching with observed practice, immediate feedback, and skill-specific retries may help prepare both addiction professionals and peer specialists to deliver contingency management.

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What it found: In a 12-month quasi-experimental study, patients receiving digital contingency management plus usual treatment had higher urine-confirmed abstinence rates (92% vs 85%) and appointment attendance rates (69% vs 50%) than matched patients receiving usual treatment alone.

Why it matters: Digital contingency management may help substance use treatment teams support abstinence and improve attendance, although the nonrandomized design limits causal conclusions.

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What it found: The authors reviewed changes in stimulant, opioid, tobacco, and cannabis use and proposed adjustments to contingency management for future research rather than testing their effectiveness.

Why it matters: Practitioners should consider how changing substance potency, overdose risk, and mixed-substance use may affect contingency management targets, incentives, and treatment structure.

AI-written summary of the published abstract. Read the original before applying it.