American Journal of Psychiatry

Substance use disorders (SUD) present a worldwide challenge with few effective therapies except for the relative efficacy of opioid pharmacotherapies, despite limited treatment access. However, the proliferation of illicit fentanyl use initiated a ...

https://doi.org/10.1176/appi.ajp.20230828

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Harm Reduction for Opioid Use Disorder: Strategies and Outcome Metrics

Publication date: 01 May 2024

Pages372–380

Opioid overdose deaths and opioid-related harms have reached unprecedented levels, particularly as compounds such as xylazine and fentanyl have infiltrated the drug supply. Harm reduction strategies are especially relevant in this climate, as they aim to ...

https://doi.org/10.1176/appi.ajp.20230918

Understanding and Addressing Widening Racial Inequalities in Drug Overdose

Publication date: 01 May 2024

Pages381–390

The fourth wave of the United States overdose crisis—driven by the polysubstance use of fentanyl with stimulants and other synthetic substances—has driven sharply escalating racial/ethnic inequalities in drug overdose death rates. Here the authors present ...

https://doi.org/10.1176/appi.ajp.20230917

Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic

Publication date: 01 May 2024

Pages391–402

Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely ...

https://doi.org/10.1176/appi.ajp.20230886

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CME

Topiramate Versus Naltrexone for Alcohol Use Disorder: A Genotype-Stratified Double-Blind Randomized Controlled Trial

Publication date: 01 May 2024

Pages403–411

Objective:There have been no well-controlled and well-powered comparative trials of topiramate with other pharmacotherapies for alcohol use disorder (AUD), such as naltrexone. Moreover, the literature is mixed on the effects of two polymorphisms—rs2832407 ...

https://doi.org/10.1176/appi.ajp.20230666

Neural Correlates of Stress and Alcohol Cue-Induced Alcohol Craving and of Future Heavy Drinking: Evidence of Sex Differences

Publication date: 01 May 2024

Pages412–422

Objective:Stress and alcohol cue reactivity are associated with poor treatment outcomes in alcohol use disorder (AUD), but sex-specific neural correlates of stress and alcohol cue–induced craving compared with neutral cue–induced craving and of heavy ...

https://doi.org/10.1176/appi.ajp.20230849

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Predictors of Substance Use Initiation by Early Adolescence

Publication date: 01 May 2024

Pages423–433

Objective:Substance use initiation during early adolescence is associated with later development of substance use and mental health disorders. This study used various domains to predict substance use initiation, defined as trying any nonprescribed ...

https://doi.org/10.1176/appi.ajp.20230882

CME

Associations Between a Primary Care-Delivered Alcohol-Related Brief Intervention and Subsequent Opioid-Related Outcomes

Publication date: 01 May 2024

Pages434–444

Objective:The co-occurrence of unhealthy alcohol use and opioid misuse is high and associated with increased rates of overdose, emergency health care utilization, and death. The current study examined whether receipt of an alcohol-related brief ...

https://doi.org/10.1176/appi.ajp.20230683

CME

Associations of Menstrual Cycle and Progesterone-to-Estradiol Ratio With Alcohol Consumption in Alcohol Use Disorder: A Sex-Separated Multicenter Longitudinal Study

Publication date: 10 January 2024

Pages445–456

Objective:Alcohol use disorder (AUD) constitutes a critical public health issue and has sex-specific characteristics. Initial evidence suggests that progesterone and estradiol might reduce or increase alcohol intake, respectively. However, there is a need ...

https://doi.org/10.1176/appi.ajp.20230027