The 探花合集 Weekly for December 9, 2025
This Week in the 探花合集 Weekly
Medicaid Unwinding May Have Substantially Disrupted
Buprenorphine Treatment
By Rachel Landis, PhD, MPP, and Bradley D. Stein, MD, PhD
The opioid crisis remains one of the most pressing public health emergencies facing the United States. A 2023 KFF poll found that nearly one-third of adults reported that they or a family member had experienced an opioid addiction. In the same year, about 5.7 million Americans were diagnosed with an opioid use disorder (OUD), a chronic medical condition characterized by persistent use of opioids despite harmful consequences, including overdose and death. Nearly 80,000 people died from opioid overdose in 2023—almost 10 times the number of deaths in 1999.
Unsurprisingly, OUD prevalence varies substantially across population subgroups, and low-income individuals with Medicaid insurance are among the hardest hit. Indeed, Medicaid provided coverage to 47% of nonelderly adults with OUD in 2023 and paid for medication for opioid use disorder (MOUD) treatment for 56% of those receiving it. MOUD, including buprenorphine and methadone, is the gold standard of OUD care, dramatically increasing treatment retention and reducing the risk of overdose and death.
Lead Story
Substance Use and Addiction Journal
This is a narrative review of methadone and buprenorphine regulations, prescriber eligibility, dispensing models, and coverage across eight countries: the United States, Canada, the United Kingdom, Russia, France, Iran, Australia, and Portugal. The study identified several key barriers to medications for OUD (MOUD): requirements for daily supervised dosing, restricted community prescribing, and stigmatizing drug scheduling. The authors highlight policies that improved MOUD access without compromising safety, such as: 1) community pharmacy dispensing supports in the UK and Australia, 2) liberal buprenorphine prescribing in primary care in France, and 3) decriminalization and expansion of low-threshold public health models in Portugal and Iran.
Research and Science
Journal of Substance Use and Addiction Treatment
This is a randomized, wait-list controlled trial of the Communities That HEAL (CTH) intervention which sought to expand MOUD within jails and linkage to MOUD upon release. A total of 34 communities were randomized to the CTH intervention group and 33 to the wait-list control group. The CTH intervention included an integrated set of community coalition-selected evidence-based practices. The study monitored jails’ provision of MOUD via surveys of jail administrators. More of the wait-list control jails provided MOUD at baseline. During the evaluation period, CTH jails increased MOUD induction from 63.3% to 71%. Although there was no statistically significant effect of the CTH intervention on MOUD induction or linkage, community coalitions were thought to play an important role in MOUD linkage and initiation.
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BMJ Open Quality
Scotland has the highest drug death rate in Europe. For this study, researchers used a trigger checklist (TC) followed by assertive outreach between January and September 2023 in a rural Scottish community of 21,291. The TC consisted of two questions establishing drug/alcohol use and 10 questions about high-risk behavior. The TC could be completed by anyone concerned about a person’s drug use such as a hospital, the police, family members, or loved ones. The assertive outreach consisted of a pair of support workers visiting the person’s home and offering harm reduction and treatment services. A total of 48 TCs were received and all had assertive outreach within 48 hours. The median number of days between non-fatal overdoses was 6.5 prior to this project and 23 at the end. There were no drug-related deaths during the project. This proactive approach can reduce drug-related harm.
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Academic Emergency Medicine
While opioid overdose deaths have decreased, OUD remains a significant public health concern, and emergency departments (ED) are vital potential points of intervention. Researchers evaluated short-term outcomes after initiation of extended-release buprenorphine (XR-BUP) in EDs between 2020 and 2023, assessing substance use in the first week after initiation. Among those who received XR-BUP 63% reported no opioid use in the initial 7 days after the ED visit. In addition, by self-report there was a significant decrease in use of multiple substances, including cocaine, benzodiazepines, methamphetamines, and cannabinoids. These findings continue to highlight the importance of initiation of MOUD in the ED.鈥�
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JAMA Psychiatry
Annual opioid overdose deaths have dropped an unprecedented 41% since peaking at 85,000 in June 2023. Two factors drive overdose trends: the size of the at-risk population and its mortality rate. This study used the authors’ peer-reviewed model of the US opioid crisis, SOURCE, to demonstrate how a falling at-risk population combined with probable plateauing of the mortality rate produced the recent decline in US overdose deaths. Reductions to lifesaving services may not increase deaths, but instead slow the decline, making harm harder to detect.
Journal of the American Medical Association
Approximately 27% of adults in the US and Canada report having ever used cannabis for medical purposes. An estimated 10.5% of the US population reports using cannabidiol (CBD), a chemical compound extracted from cannabis that does not have psychoactive effects, for therapeutic purposes. Evidence is insufficient for the use of cannabis or cannabinoids for most medical indications. Clear guidance from clinicians is essential to support safe, evidence-based decision-making. Clinicians should weigh benefits against risks when engaging patients in informed discussions about cannabis or cannabinoid use.
In the News
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British Broadcasting Corporation (BBC)
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The Maine Monitor/The Associated Press
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Fierce Healthcare
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Behavioral Health Business
National Geographic
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STAT
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The Hill