News
The 探花合集 Weekly for November 25th, 2025
This Week in the 探花合集 Weekly
As the Thanksgiving Holiday approaches, we at the 探花合集 Weekly want to support our readers with our traditional Conversation Starters for the Addiction Specialist. This year’s topic is pop culture.
As your guests start rolling in, welcome them with some warm appetizers, good vibes, and a simple remark about how much you liked Season 3 of The White Lotus.鈥疘t’s all but certain that many will praise the show’s relevance; however, some might comment about an association with internet searches for lorazepam. That’s right, your guests also read .
This could lead to a deeper discussion about the ills of the internet. Parents in particular will commiserate about being unable to protect their kids from social media (). Some might support an internet that comes with warning labels, while others find hope in cultural movements like the “Scrolling Kills” billboards of New York. Either way, you can tell them there’s a word for what they’re experiencing: “Enshittification!” ().
While some of your guests silently wonder if that was slang or a swear word, re-direct them to their seats and serve them something more positive with their dinner. Tell them how you recently read in the 探花合集 Weekly that —and it’s not just for methamphetamines (). Go on to explain that it’s a form of harm reduction—something beautifully built on trust, attunement, and competence ().
If they look bewildered, just say, “You know, the opposite of Purdue Pharmaceuticals.” Many will nod in agreement, as they’ve all read about the evil opioid corporation so often featured in .鈥�&苍产蝉辫;
As the turkey coma starts kicking in, it’s time to offer your guests some dessert. Start with the children first, but be very careful when talking to any kids these days. They are known to speak in nonsensical numbers while waving their hands up and down. It’s an infectious phenomenon of unknown cause (likely viral) that spreads quickly and has been known to affect adults too. The only thing that can stop it—and save your Thanksgiving dinner—is a good (bad) dad joke.
Q: How does a turkey say [insert numbers]?
A: “Gobble gobble…gobble gobble…gobble gobble…”
Tell Dad Jokes. Save Lives.
Thanks for reading,鈥�
Nicholas Athanasiou, MD, MBA, DFASAM
Editor in Chief
with Co-Editors: Brandon Aden, MD, MPH, FASAM; John A. Fromson, MD; Sarah Messmer, MD, FASAM; Jack Woodside, MD
Lead Story
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JAMA Health Forum
This cross-sectional study of 796 census tracts prior to the COVID-19 pandemic
(2017-2019) and 792 census tracts during the COVID-19 pandemic (2020-2022) in Chicago, Illinois, assessed the extent to which there is a spatial association between neighborhood-level structural racism and opioid-involved overdose deaths. Researchers found that neighborhoods exposed to high levels of structural racism in the past (historical redlining) and present (contemporary segregation) had the highest fatal overdose incidence rates before the COVID-19 pandemic (2017-2019). Neighborhoods that experienced high levels of contemporary racism had the highest fatal overdose incidence rates during the pandemic (2020-2022).
Research and Science
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Harm Reduction Journal
This paper utilizes longitudinal chart review and semi-structured qualitative interviews (n=20) to describe the development and outcomes of a telemedicine opioid use disorder (OUD) treatment clinic co-located within a community-based harm reduction program in Montreal, Canada. Telemedicine visits with a medical team based out of a hospital addiction medicine service were facilitated by community harm reduction workers. Patients were offered methadone, buprenorphine/naloxone, or slow-release oral morphine for treatment of OUD, with or without hydromorphone co-prescription. Between April 2020 and March 2022, 69 patients started OUD treatment, with the majority reporting injection drug use (96%) and unstable housing (56%). Fifty-four percent of patients chose methadone, 35% chose slow-release oral morphine, 12% chose buprenorphine, with 78% receiving co-prescribed hydromorphone. Retention in care was 83% at one month, 74% at three months, and 54% at 12 months. Patients reported that trust, respect, patient-centered care, and the integration of harm reduction principles were critical to the program’s success.
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Journal of Addiction Medicine
Dutasteride inhibits the enzyme 5-alpha reductase involved in the production of neuroactive steroids that modify GABAA receptors. These neuroactive steroids are increased by ethanol, and this study explores whether inhibiting the production of these steroids will reduce alcohol use. Participants meeting criteria for alcohol use disorder (n=155) were randomly assigned to receive either dutasteride 1 mg daily or placebo for 12 weeks. Dutasteride compared to placebo reduced both standard drinks/week (-32% dutasteride vs -16% placebo, p=.016) and heavy drinking days (>5 drinks/day) (-40% dutasteride vs -23% placebo, p=.041). Reductions in phosphatidyl ethanol confirmed the self-reported reductions in drinking. Adverse events did not differ significantly in the two groups. The drinking reductions were less in women due to a greater placebo response in women than men. The authors conclude that dutasteride reduced heavy drinking.
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Harm Reduction Journal
This paper describes the implementation and evaluation of a peer-led chemsex intervention (M3THOD) based in New South Wales, Australia, which seeks to address barriers to care and improve harm reduction engagement for gay, bisexual, and other men who have sex with men (GBMSM) who use crystal methamphetamine and gamma hydroxybutyrate (GHB) in sexual contexts. The study assessed acceptability, feasibility, and appropriateness of the service through 33 semi-structured qualitative interviews with clients, community members, M3THOD peer workers, M3THOD managers, and clinicians. Researchers found the M3THOD program was acceptable and appropriate, with appreciation from clients for peers’ personal experiences which allowed for the rapid development of rapport and trust. The intervention was feasible as long as robust support for training, technical support, care for peers, and strong referral pathways were in place.
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PLOS Medicine
Tobacco use remains a leading cause of cardiovascular (CV) disease and mortality, and to better understand this relationship researchers assessed risk by pack-years, cigarettes per day (CPD), and years since cessation. Researchers found that even low-intensity use (2-5 CPD) was associated with increased risk of various CV outcomes. Cessation provided substantial immediate decrease in risks, which decreased further over time. Notably, former smokers with >20 pack-years of use had lower risk than current smokers with <5 pack-years of use. Researchers note that while duration and CPD are important in determining risk for current smokers, in former smokers, time since quitting may be more important than total pack-years. These findings highlight that helping patients quit smoking—not just cut down--should always be the goal.鈥�&苍产蝉辫;
Learn More
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Addiction
Contingency management (CM) can be effective in changing behaviors, including abstinence, and adherence to other evidence-based treatments, including medication, for substance use and non-substance use (behavioral) related disorders. Researchers conducted a scoping review to evaluate implementation of CM in the United Kingdom. Overall, researchers found CM to be clinically effective, including digital approaches, but they also identified several barriers including resource limitations such as staff shortages, direct cost, and training requirements. Other barriers included possible ethical concerns about CM potentially being manipulative, risk of relapse when CM stops, and negative impact on therapeutic relationships. Given the demonstrated effectiveness of CM, the authors underscore the need to address these barriers.
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JAMA Health Forum
On February 16, 2025, HBO Max released the third season of The White Lotus, which featured a central storyline in which a character repeatedly used lorazepam for anxiety, with frequent on-screen references to this benzodiazepine. Given that shows on streaming platforms can contribute to public interest and health behaviors, and lorazepam carries misuse risk, this study evaluated whether The White Lotus season 3 release was associated with increased public interest in lorazepam and compared trends with other commonly prescribed benzodiazepines. Researchers found that weekly internet search rates for lorazepam remained stable from January 2022 through the first week of February 2025, then increased following the release of the third season of The White Lotus (February 16, 2025) and remained elevated for 12 additional weeks (through the week of May 4, 2025). During this 12-week period, lorazepam queries were cumulatively 98.6% higher than expected, representing approximately 1.6 million additional searches. During the same time frame, queries for alprazolam and clonazepam remained at expected levels, at 1.4% and 0.7% of expected volumes, respectively.
Substance Use and Addiction Journal
This commentary describes the position on drug policy of The Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA). The authors note that in the past, the War on Drugs was punitive, not evidence based, and produced societal damage. Currently, xylazine scheduling and drug-induced homicide laws also criminalize people who use drugs and make them reluctant to access harm reduction services and help with overdoses for fear of arrest. The authors state that drug use is a public health concern that should be approached with evidence-based and compassionate approaches. Evidence-based approaches include drug checking programs, overdose prevention centers, and Good Samaritan laws. AMERSA recommends that health care experts and people with lived experience be included in drug policy making, and opposes policies that impose criminal penalties.
In the News
The New York Times
The Washington Post
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Digital Trends
Fortune
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USA Today
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The Guardian