Journal of substance use and addiction treatment最新文献

{"title":"Healthcare usage and cost-effectiveness of approach bias modification at 12-months for patients undergoing inpatient withdrawal for alcohol use disorder","authors":"Nicola Huxley ,&nbsp;Joshua B.B. Garfield ,&nbsp;Anthony Harris ,&nbsp;Petra K. Staiger ,&nbsp;Dan I. Lubman ,&nbsp;Victoria Manning","doi":"10.1016/j.josat.2025.209834","DOIUrl":"10.1016/j.josat.2025.209834","url":null,"abstract":"<div><h3>Introduction</h3><div>There is evidence that approach bias modification (ApBM), a type of computerised cognitive training delivered during inpatient alcohol withdrawal treatment, significantly reduces relapse rate. Our analysis examines, for the first time, whether ApBM is cost-effective compared to sham-trained controls.</div></div><div><h3>Methods</h3><div>Patients at four inpatient withdrawal units were randomized to four daily sessions of ApBM, or sham (control) training. Self-reported data on alcohol use, treatment, and healthcare use was collected over 12-months. We conducted a trial-based cost-effectiveness study of ApBM (versus no ApBM) from a health system perspective. Costs were from relevant Australian 2022 sources. We estimated incremental differences between groups in healthcare costs and abstinence rates using mixed generalised linear models.</div></div><div><h3>Results</h3><div>At 12 months after discharge from the index withdrawal treatment episode, two thirds of participants had accessed acute health care services (i.e., inpatient withdrawal, ambulance, emergency department and hospital inpatient). Results generally indicated non-significant increases in cumulative costs ($6747, 95%CI: -$7743, $21,237; <em>p</em> = .361) at 12 months for the ApBM group versus controls. The incremental cost of ApBM versus no intervention for 12 months of continuous abstinence was $201,610, with confidence limits ranging from ApBM being less costly and more effective to more costly and less effective than no ApBM.</div></div><div><h3>Conclusion</h3><div>Although there was evidence of improved abstinence rates in the first 3-months post-discharge, delivering ApBM during acute alcohol withdrawal treatment will not likely generate net benefits over a 1-year period at any willingness-to-pay threshold, due to the continued heavy use of healthcare services in this population. Future research should test whether additional ApBM delivered post-discharge (e.g., via smartphone apps) could extend its relapse prevention effects and ultimately result in cost savings in the long-term.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209834"},"PeriodicalIF":1.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study investigating the role of humor in supporting recovery from addiction","authors":"Samuel W. Stull ,&nbsp;M. Elaine Wakely ,&nbsp;Elizabeth C. Saunders ,&nbsp;Nicholas C. Jacobson ,&nbsp;Lisa A. Marsch ,&nbsp;Stephanie T. Lanza","doi":"10.1016/j.josat.2025.209833","DOIUrl":"10.1016/j.josat.2025.209833","url":null,"abstract":"<div><h3>Introduction</h3><div>Humor can be utilized in adaptive ways (i.e., humor used to reframe negative events) to support mental health. Humor-based interventions can improve mental health, but minimal research exists on humor in people with addiction. We sought to examine whether and how people in recovery from opioid addiction utilize humor in their daily lives and whether they perceive it as supportive of recovery.</div></div><div><h3>Methods</h3><div>Qualitative semi-structured interviews were conducted in one study visit with people in recovery from opioid addiction receiving methadone (<em>n</em> = 11). Extant literature and a reflexive thematic approach informed theme generation and coding; codes were developed inductively and deductively using thematic analysis.</div></div><div><h3>Results</h3><div>Participants had been in recovery for up to two years. Humor was central in most participants' lives, but its role varied considerably. We identified the following themes: <em>Dark Humor and Lived Experience</em> (humor used to make light of a difficult past); <em>For Humor, Timing is Everything</em> (dynamic receptivity to humor); <em>Good Vibrations or Distractions?</em> (pleasurable and distracting qualities of humor); and <em>Read the Room: Social Contexts Can Drive the Supportive Role of Humor</em> (humor to facilitate social connections and conversations about addiction). Most participants expressed enthusiasm for humor therapy, but preferences about the type of humor and setting varied.</div></div><div><h3>Conclusion</h3><div>Humor was integral to participant's lives. Greater investigation is needed into how recovery identity may interplay with preference for substance-use-related humor, whether humor can lead to sustainable mood improvements, and heterogeneity in preferred timing and context for humor.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209833"},"PeriodicalIF":1.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention among Medicaid beneficiaries in opioid treatment programs in California","authors":"William N. Dowd ,&nbsp;Daniel H. Barch ,&nbsp;Tami L. Mark ,&nbsp;Chelsea Katz ,&nbsp;Barrett W. Montgomery ,&nbsp;Dylan DeLisle ,&nbsp;Thanh T. Lu ,&nbsp;Gary A. Zarkin","doi":"10.1016/j.josat.2025.209837","DOIUrl":"10.1016/j.josat.2025.209837","url":null,"abstract":"<div><h3>Background</h3><div>Continuing medications for opioid use disorders (MOUD) for an extended period is important to achieve good outcomes, but many patients do not remain in treatment for even six months. The goal of this study was to develop and describe case-mix adjusted retention rates among California Opioid Treatment Programs (OTP).</div></div><div><h3>Methods</h3><div>We developed measures of 30-, 90-, and 180-day retention using data from the California Outcomes Management System for Medicaid beneficiaries admitted as an outpatient to an OTP between July 1, 2021 and June 30, 2022. We applied case-mix adjustment to the measures to ascertain whether differences in patient characteristics drive differences in OTP-level retention rates and assessed the proportion of total variance in retention rates attributable to differences between OTPs. Finally, we identified statistically underperforming and overperforming OTPs relative to expected retention based on case-mix and described the potential impact of improvement among underperforming OTPs on overall retention rates.</div></div><div><h3>Results</h3><div>The average case-mix adjusted OTP-level retention rate (N = 131 OTPs) at 30 days was 76 % (range: 45 %–99 %), at 90 days was 54 % (range: 32 %–91 %), and at 180 days was 40 % (range: 8 %–85 %); only 18 % of OTPs retained at least half of their patients for at least 180 days. The distribution of case-mix adjusted and unadjusted measures was similar, indicating that variation in retention rates was explained by factors other than patient demographic and clinical baseline characteristics. Measures were shown to reliably indicate differences between OTPs across all retention periods, with between-OTP variance accounting for no less than 87 % of total variance in the median OTP. We showed that increasing retention among statistically underperforming OTPs to levels expected given their case-mix would result in an additional 4 %, 5 %, and 7 % of patients retained for 30, 90, and 180 days, respectively.</div></div><div><h3>Conclusion</h3><div>There is considerable room for improvement in retention. The wide range of retention rates at the OTP level after case-mix adjustment suggests that such improvements are attainable. Efforts should be made to support dissemination of successful strategies to improve retention among OTPs. Policymakers should explore opportunities to facilitate improvement, such as enacting quality reporting programs for OTPs.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209837"},"PeriodicalIF":1.9,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships of patient risk profiles and receipt of specialty treatment with early, sustained, and stable cessation of heavy alcohol use across populations","authors":"Vanessa A. Palzes ,&nbsp;Felicia W. Chi ,&nbsp;Constance Weisner ,&nbsp;Andrea H. Kline-Simon ,&nbsp;Derek D. Satre ,&nbsp;Asma Asyyed ,&nbsp;Stacy Sterling","doi":"10.1016/j.josat.2025.209836","DOIUrl":"10.1016/j.josat.2025.209836","url":null,"abstract":"<div><h3>Background</h3><div>Identifying individual-level factors that predict cessation of heavy alcohol use would inform the prevention, intervention, and treatment of heavy alcohol use. This study examined whether and how patient risk profiles and specialty treatment predict early, sustained, and stable cessation of heavy alcohol use, and whether there are differences by patient characteristics.</div></div><div><h3>Methods</h3><div>This electronic health records-based cohort study included 128,471 adults with heavy alcohol use (exceeded national daily or weekly drinking limits) in an integrated healthcare system between 6/1/2013 and 12/31/2014. Cessation of heavy alcohol use was examined over 1-year (early), 5-year (sustained), and 7-year follow-ups (stable), through 6/30/2022. Latent class analysis identified five patient risk profiles differentiated by type of heavy alcohol use and levels of health risk behaviors and comorbidities. Associations of risk profiles, specialty addiction or psychiatry treatment, race and ethnicity with cessation outcomes were examined with logistic regression.</div></div><div><h3>Results</h3><div>Approximately 65.8 % of the sample had early cessation at 1-year. Compared with patients in the heavy daily drinking and fewer health risks profile (DAILY), patients in the heavy daily drinking and more health risks profile (DAILY-R) had higher odds of early cessation (aOR [95 % CI] = 1.28 [1.23, 1.33]), while patients in risk profiles with heavy weekly drinking and substance use and mental health disorders had lower odds of early cessation (aORs = 0.40 to 0.77). Specialty treatment (versus no treatment) was associated with higher odds of early cessation (1.27 [1.18, 1.35]), which varied by risk profile. Hispanic/Latino patients in the DAILY-R profile had lower odds of early cessation than their White counterparts (0.84 [0.76, 0.91]). At 5 and 7 years, 60.7 % and 88.0 % had sustained and stable cessation after achieving the prior cessation status, respectively. Results of sustained and stable cessation were largely consistent with those of early cessation, but interactions with race and ethnicity were non-significant.</div></div><div><h3>Conclusions</h3><div>Specialty treatment may be effective for most types of patients with varying levels of health risks, across populations. Findings suggest that Hispanic/Latino patients with heavy daily drinking and more health risks may need tailored interventions in primary care to support cessation of heavy alcohol use.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209836"},"PeriodicalIF":1.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a public health surveillance system for the opioid crisis: The experience of the HEALing Communities Study","authors":"Bridget Freisthler ,&nbsp;Daniel J. Feaster ,&nbsp;Charles Knott ,&nbsp;Marc LaRochelle ,&nbsp;John McCarthy ,&nbsp;Svetla Slavova ,&nbsp;Sharon L. Walsh ,&nbsp;Jennifer Villani","doi":"10.1016/j.josat.2025.209832","DOIUrl":"10.1016/j.josat.2025.209832","url":null,"abstract":"<div><h3>Introduction</h3><div>Efforts to reduce opioid overdose deaths in the United States have been stymied by the lack of timely and standardized population-level data for local, state, and national levels. The U.S. has a strong national need for linking opioid and other drug overdose surveillance data to service utilization data for overdose prevention and treatment to inform resource allocation and response planning.</div></div><div><h3>Methods</h3><div>We provide insight on the challenges of identifying, obtaining, and harmonizing administrative outcome data across four states using the collective experience from the HEALing Communities Study to test a community-engaged, data-driven, population-level intervention to reduce opioid overdose deaths. We also discuss the opportunities that arose from those challenges, as well as the relationships across state agencies that were strengthened.</div></div><div><h3>Results</h3><div>Challenges experienced by the research sites on obtaining administrative outcome data included issues around who owned the data, what level of data access and use was allowed, and difficulties related to the timeliness of the data, ability to harmonize the data elements, and lack of demographic data available for stratification. Opportunities arose from these challenges whereby research sites developed new partnerships with state agencies (including a key governmental official in the state administration), provided an additional layer of quality control for these data, and facilitated democratizing data so local communities could access them.</div></div><div><h3>Conclusions</h3><div>The overall lessons show the importance of adapting to external changes and maintaining strong partnerships to pursue shared goals. The HCS serves as an exemplar of how local and state jurisdictions can create comprehensive data systems for monitoring and responding to the opioid overdose epidemic.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209832"},"PeriodicalIF":1.9,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shattering the STIGMA: Talking openly about MOUD in 12-step recovery programs","authors":"Steven Klein ,&nbsp;Juan Franco ,&nbsp;Adam Scioli","doi":"10.1016/j.josat.2025.209829","DOIUrl":"10.1016/j.josat.2025.209829","url":null,"abstract":"<div><div>Despite overwhelming evidence supporting Medications for Opioid Use Disorder (MOUD) for substance use disorders (SUDs), stigma persists within recovery communities—particularly in some circles of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)—that view Medications as incompatible with sobriety. This perspective piece explores the tension between life-saving pharmacologic interventions such as MOUD and deeply held beliefs within 12-step fellowships. Through the lens of a clinically grounded, narrative-driven, and first-person perspective we examine the origins of this stigma, including the historical ambivalence toward psychiatric medication in AA's founding literature. We also examine contemporary NA literature especially as it relates to the term “clean.” While many 12-step programs have increasingly accepted medications like antidepressants, MOUD remains stigmatized despite its proven effectiveness in reducing cravings, relapse, and overdose deaths. We argue that this resistance—often reinforced by sponsors, literature, and group norms—places patients at risk and undermines recovery. We use our personal experience as physicians and people in long-term recovery to call for a renewed interpretation of fellowship principles that embrace evidence-based treatment and affirms each individual's path to recovery. True sobriety should not require choosing between medication and belonging.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"181 ","pages":"Article 209829"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overdose Data to Action: A qualitative analysis of funded activities tailored for women.","authors":"Laura J Cremer, Ayana L Miles, Miranda E Gali, Nida Ali, Marissa Roberts, Minda Reed, Donjanea F Williams, Cherie R Rooks-Peck","doi":"10.1016/j.josat.2025.209768","DOIUrl":"10.1016/j.josat.2025.209768","url":null,"abstract":"<p><strong>Background: </strong>According to the Centers for Disease Control and Prevention (CDC), there was a 480 % increase in overdose deaths among all women from 1999 to 2021 (Jones et al., 2024). Women are uniquely impacted by substance use and overdose due to biological and cultural differences compared to men. CDC launched the Overdose Data to Action (OD2A) cooperative agreement in 2019 with the goal of helping to mitigate the opioid overdose crisis across the United States by supporting state and local health departments.</p><p><strong>Methods: </strong>This study focused on a review of programmatic data submitted by OD2A jurisdictions that detail their prevention activities to identify how jurisdictions implemented activities to address the unique needs of women. The team conducted systematic content analysis using multiple rounds of coding.</p><p><strong>Results: </strong>Most activities were tailored for pregnant women or women who had recently given birth and focused on expanding capacity to meet their needs. The most common activities were capacity-building activities to enhance efforts to address overdose needs for women (specifically pregnant women), resource development/sharing, and implementation/evaluation of best or promising practices for women.</p><p><strong>Conclusion: </strong>While it is important that activities tailored for pregnant women continue, our study showed a gap in activities tailored to other populations of women where the problem may be the greatest, such as women who are incarcerated, women who engage in sex work, and other female sub-populations. To address overdose rates in women, future efforts would benefit from continuing activities for pregnant women but also attempting to reach other at-risk female populations.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209768"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and knowledge about medications for alcohol use disorder among treatment-seeking adults","authors":"Blake T. Hilton ,&nbsp;Mia A. Haidamus ,&nbsp;Victoria R. Votaw ,&nbsp;Gerardo Gonzalez ,&nbsp;Roger D. Weiss ,&nbsp;Margaret L. Griffin ,&nbsp;R. Kathryn McHugh","doi":"10.1016/j.josat.2025.209831","DOIUrl":"10.1016/j.josat.2025.209831","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite demonstrated effectiveness, medications for alcohol use disorder (MAUD) are underutilized. While studies have considered structural and provider-level barriers, little is known about patient-level factors associated with MAUD initiation. We aimed to examine stigma, knowledge, and beliefs about MAUD and their associations with intention to take them among a sample with severe AUD.</div></div><div><h3>Methods</h3><div>Adults receiving treatment for alcohol use disorder at an inpatient withdrawal management and treatment initiation program completed a cross-sectional survey (<em>N</em> = 171). MAUD knowledge (i.e., correctly identified medications for AUD), beliefs (i.e., perceived effectiveness), and stigma (i.e., internalized and perceived) in general and by medication type (i.e., naltrexone, acamprosate, and disulfiram) were assessed using a measure developed for this study.</div></div><div><h3>Results</h3><div>Knowledge about which medications are indicated for AUD was low, with the highest awareness for naltrexone (61 % of participants correctly identified this medication). Most (55 %) participants believed MAUD helps people recover, however approximately half were uncertain about the effectiveness of each specific medication type. Participants with greater MAUD knowledge and more positive beliefs about effectiveness reported greater intention to take MAUD (<em>p</em>s &lt; 0.05). Stigma was low across all medications (mean scores &lt;3 on a scale of 10), though a substantial portion of participants endorsed uncertainty about stigma.</div></div><div><h3>Conclusions</h3><div>Greater knowledge and positive beliefs about MAUD were significantly associated with intentions to pursue MAUD, yet many participants reported uncertainty in these domains. MAUD knowledge was low overall, as was stigma. Targeted efforts to enhance patient knowledge of MAUD could be a promising strategy for increasing medication uptake.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"180 ","pages":"Article 209831"},"PeriodicalIF":1.9,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local level of social inequity moderates implementation of evidence-based practices tailored to minoritized populations to reduce opioid overdose deaths","authors":"Avik Chatterjee ,&nbsp;Rachel P. Chase ,&nbsp;Rouba A. Chahine ,&nbsp;Jill Davis ,&nbsp;Nishi Dsouza ,&nbsp;Sylvia Ellison ,&nbsp;Sarah M. Bagley ,&nbsp;Tiarra Fisher ,&nbsp;LaShawn Glasgow ,&nbsp;Miriam T.H. Harris ,&nbsp;Terry T.-K. Huang ,&nbsp;JaNae Holloway ,&nbsp;David W. Lounsbury ,&nbsp;Emmanuel Oga ,&nbsp;Kat Asman ,&nbsp;Sara M. Roberts ,&nbsp;Nasim Sabounchi ,&nbsp;Hilary L. Surratt ,&nbsp;Lisa M. Lines ,&nbsp;Henry W. Stadler ,&nbsp;Alissa Davis","doi":"10.1016/j.josat.2025.209828","DOIUrl":"10.1016/j.josat.2025.209828","url":null,"abstract":"<div><h3>Introduction</h3><div>Evidence-based practices (EBPs) tailored to reduce opioid-related fatalities among minoritized populations may help reduce inequities, but research elucidating the relationship between local-level inequities in social determinants of health (SDH) and selection and implementation of tailored EBPs.</div></div><div><h3>Methods</h3><div>The HEALing Communities Study was a multisite, wait-listed, community-level cluster-randomized trial with the objective to reduce opioid overdose deaths. Community coalitions selected and partner organizations implemented EBP strategies to increase access to Overdose Education and Naloxone Distribution (OEND) and Medications for Opioid Use Disorder (MOUD). The research team utilized negative binomial and zero-inflated Poisson models to assess whether the relationship between (a) communities' need for tailored OEND and MOUD strategies, as indicated by opioid overdose death rates among minoritized groups; and (b) the selection, implementation, and reach of those strategies was moderated by local-level inequities in SDH, quantified by the Local Social Inequity in Drug Overdoses (LSI-DO) index. The analysis included data from 33 communities across four states.</div></div><div><h3>Results</h3><div>Eleven of 33 communities implemented tailored OEND and MOUD strategies. Adjusted analysis revealed that LSI-DO scores moderated the relationship between 2021 opioid overdose death rates among minoritized groups and the proportion of community-implemented tailored strategies (<em>p</em> = 0.015). The research team found no moderation for the number of strategies selected or number of individuals reached by EBPs.</div></div><div><h3>Conclusion</h3><div>Few communities selected EBPs tailored to minoritized populations. For those that did, higher local-level social inequity was associated with decreased implementation of tailored strategies. Continued research on how to address overdose inequities—and local-level social inequity—is vital. Findings highlight the need for policy approaches that pair overdose prevention strategies with investments to reduce local-level social inequities that impede equitable implementation.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"180 ","pages":"Article 209828"},"PeriodicalIF":1.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“If he did it, I can do it, too. I can change my life around”: The social model of recovery within the context of recovery homes accepting residents prescribed medications for opioid use disorder","authors":"Jodie M. Dewey ,&nbsp;Kathryn R. Gallardo ,&nbsp;Meenakshi S. Subbaraman ,&nbsp;Amy A. Mericle","doi":"10.1016/j.josat.2025.209830","DOIUrl":"10.1016/j.josat.2025.209830","url":null,"abstract":"<div><h3>Introduction</h3><div>This paper provides an in-depth examination of examines four recovery residences, that serve individuals prescribed medications for opioid use disorder (MOUD). The study has two primary aims: first, to deepen understanding of how recovery residences adopt and operationalize Social Model of Recovery principles; and second, to identify gaps in staff integration of residents receiving MOUD—gaps that may either support or undermine the integrity of the social model within these settings.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with 17 residents receiving MOUD living in four participating recovery homes. The interviews were conducted between August 2022 and January 2024 using a semi-structured interview guide designed to explore residents' experiences upon entering and living in the recovery home. Qualitative software was used to organize and qualitatively analyze transcripts through multiple rounds of coding. Themes were discussed across the research team and grouped across each of the various principles of the Social Model of Recovery.</div></div><div><h3>Results</h3><div>Residents reported feeling supported in safe, structured environments that promoted accountability and community, while staff with lived experience played a central role in fostering trust and modeling long-term recovery. Structured programming, peer coaching, and access to essential resources further reinforced recovery-supportive conditions. However, inconsistent staff attitudes toward MOUD revealed underlying stigma, which some residents found intrusive or isolating.</div></div><div><h3>Conclusion</h3><div>This study addresses key gaps in recovery science by offering qualitative insights into Level 3 recovery residences, emphasizing the perspectives of residents navigating staff relationships, organizational policies, and recovery programming. Despite increasing MOUD acceptance, recovery homes rarely address MOUD-related stigma formally, creating tension between medical and social models of recovery and contributing to judgment or marginalization of MOUD recipients. These findings highlight the urgent need for evidence-based MOUD integration strategies, staff education, and stigma reduction efforts to ensure that recovery homes fully support all residents' recovery pathways.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"180 ","pages":"Article 209830"},"PeriodicalIF":1.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}