The 探花合集 Weekly for September 30th, 2025
This Week in the 探花合集 Weekly
We all bring a different experience to substance use. This is partly the reason for and importance of incorporating peer support services into addiction treatment models. But since we don’t all share the same experience, the unique strengths of peers (and providers) can also come with biases ().
Those experiences and biases, though, are part of how we shape opinions. Whether it’s a libertarian author critiquing the evidence showing “no amount of alcohol is safe” () or a business magazine making sense of how Gen Z drinks at restaurants (), groups are formed around shared opinions. Sometimes, an experience can challenge our opinion about a certain group—like when an addiction doc realizes that she and her patient are both “doctors” and “dope(amine) fiends” ().
Unfortunately, people don’t always get to choose which group they belong to or how that affects them. Pregnant people, for example, face increased mortality from opioid use disorder (OUD) () and excessive punishment because of urine drug tests (), more so than their non-pregnant peers. And in the past twenty years, women aged 25-44 experienced an increase in alcohol-induced deaths (255%) greater than men of the same age (188%) ().鈥�&苍产蝉辫;
One of the challenges of grouping individuals together with data is then being able to convey that group's experience. A profile on the life of a harm reduction advocate shows how dangerously brilliant and difficult a life of lived experience can be (), while a study on the association of youth suicide and deaths of despair shows how a research concept becomes an epidemiological phenomenon ().鈥�&苍产蝉辫;
What they both share is a sense of phenomenology () anchored in a real-world experience of addiction.鈥�
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
ASAM’s Latest Benzodiazepine Tapering Tools
ASAM has expanded its benzodiazepine tapering resource suite to better support both clinicians and patients. New resources include:
- The clinical practice guideline, now published in JGIM
- Self-paced microlearning videos highlighting key takeaways
- A digital pocket guide for patients, families, and caregivers
- A visual infographic poster for patients
Lead Story
馃敁
American College of Obstetricians & Gynecologists
Cannabis is the most commonly used illicit drug under US federal law. With increasing social acceptability, accessibility, and legalization in many states, the prevalence of cannabis use among pregnant and lactating individuals has increased significantly. Substance use in pregnancy, including cannabis use, has been associated with adverse outcomes such as spontaneous preterm birth, low birth weight, and developmental delay. Clinicians should be aware of the possibility of pregnant and lactating patients' use of cannabis and be prepared to counsel and screen all patients and utilize evidence-based practices, including supportive home visits, psychobehavioral strategies, or brief electronic or text messaging interventions, to reduce cannabis use in pregnancy and the postpartum period to promote parental and newborn health.
Research and Science
馃敁
JAMA Network Open
The adolescent suicide rate increased 60% between 2007 and 2020. This study used insurance claims data to look for a relationship between suicidal events (SE) in children 8-15 years old and deaths of despair (DoD—suicide, drug overdose, or alcohol related diseases) in their parents. Researchers included 561,837 families with parental DoD between 2011 and 2020. Having a parent with DoD was associated with an increased risk of SE in the children (hazard ratio (HR), 1.67). Exposure to 2 parents with DoD was associated with a greater risk of SE in children (HR, 2.06) than exposure to 1 parent with DoD (HR, 1.18). In younger children age 8-11 years, this association was greater for girls than boys. There was a stronger association for maternal DoD than paternal DoD. The authors conclude that the epidemic of DoD in adults and the epidemic of suicidal behavior in children are associated.
JAMA Pediatrics
This is a cost-effectiveness, population-based analysis of a simulated cohort of 100,000 pregnant individuals looking at the clinical progression and outcomes of OUD treatment during pregnancy. The main outcomes were return to illicit use, fatal and nonfatal overdose, incremental discounted costs, quality-adjusted life-years (QALYs), net health benefits, infant mortality within the first year of life, preterm birth, low birth weight, and neonatal opioid withdrawal syndrome. Both methadone and buprenorphine were viable options for treatment; however, in the model, buprenorphine showed an incremental effect of 0.262 QALYs per person and mean cost savings of $21,512 per person.
馃敁
Journal of Social Work Practice in the Addictions
Researchers interviewed both patients and providers to evaluate potential benefits and downsides of shared lived experience between the two in OUD treatment. Patients identified feeling less alone and having models of successful treatment as potential benefits. Both patients and providers identified developing better rapport and connection as benefits, while providers also noted it helped them communicate with their colleagues the importance of compassion for this population. Providers noted potential bias in comparing patient progress or treatment pathway to their own journey, but this can be mitigated with training. The authors suggest these findings support the need to assist persons with lived experience entering careers such as counseling, nursing, and addiction medicine.
馃敁
PLOS Global Public Health
This study analyzed alcohol-induced deaths by race, gender, age, and geography on a yearly (1999–2024) and monthly (2018–2024) basis, using data from the National Vital Statistics System. Crude rates for alcohol-induced deaths increased by 89% from 1999 to 2024. The largest relative increase occurred among females aged 25–34, with a 255% increase, and males aged 25–34, with a 188% increase. American Indian and Alaska Native populations remain the most affected. While alcohol-induced deaths are higher among males, crude rates are rising faster among females across all demographics, a concerning trend. The largest monthly increases in alcohol-induced deaths occurred in American Indian and Alaska Native males (41% increase between May and June 2020) and females (32% increase between June and July 2020), Black females (32% increase between April and May 2020), males aged 15–34 (28% increase between April and May 2020), and females aged 35–44 (28% increase between April and May 2020). In Oglala Lakota County (SD), McKinley County (NM), and Apache County (AZ), crude rates have exceeded an astonishing 80 fatalities per 100,000 annually since 2020. These findings emphasize the urgent need for targeted policies to reduce excessive alcohol consumption and improve access to treatment.
Learn More
Journal of Gambling Studies
This is a systematic review of randomized controlled trials aimed at reducing gambling behaviors among college students. Fourteen total studies met inclusion criteria. Cognitive behavioral therapy (CBT)—particularly group-based CBT—and motivational interviewing (MI) reduced gambling frequency and harm, whereas personalized normative feedback (PNF) interventions significantly lowered perceived gambling norms and self-reported behaviors. Digital approaches, cultural adaptations, and interventions targeting online gambling are areas in need of future research.
馃敁
Journal of Internal Medicine
Gut-brain hormones and stress-related hormones have been shown to be involved in reinforcing behaviors related to not just eating, but also alcohol and other substances.
In this paper, the authors review pre-clinical and clinical evidence for various neuroendocrine pharmacotherapies, including glucagon-like peptide-1 receptors (GLP-1R), ghrelin, growth hormone secretagogue receptors, glucocorticoid, and mineralocorticoid receptors. While there are limited clinical trials, pre-clinical trials have shown positive results across multiple substances, particularly for alcohol use disorder. The most research, including human studies, has been done with GLP-1 agonists. The authors note that while much additional research is needed, these pathways appear to be promising treatment approaches for alcohol and substance use disorders.
Substance Use and Addiction Journal
The “stacking” of anabolic-androgenic steroids (AAS) describes combining AAS (often multiple AASs) with other substances such as fat-burning agents, diuretics, growth hormones, thyroid hormone, insulin, estrogen receptor modulators, and CNS depressants (for example benzodiazepines, opioids). This study used the FDA Adverse Event Reporting System to identify 218 cases of adverse events from misuse of AAS among men. The events were serious in 47% of cases including deaths (6%). Serious outcomes were reported in 98% of cases involving stacking compared to 26% in nonstacking cases (p<.001). The most common adverse events were cardiovascular (23%), endocrine, and psychological. High-complexity stacking was more common in younger individuals, and death or life-threatening events were associated with younger age and number of drugs stacked. The authors call for public health education about the risks of AAS.
In the News
馃敁
Reason
The New York Times
San Francisco Chronicle
The New York Times
馃敁
Women’s Health
馃敁
Forbes