Women in their 50s and early 60s experience significant, unique life events that may affect their alcohol use. This complex period in a woman's life has co-occurring stressors that can affect alcohol use. Little is understood with regards to what predictors influence the alcohol use of women in this age group.

In this retrospective case-control study we enrolled 283 patients with AUD (261 men, 22 women) admitted between 2021 and 2024, of whom 80 had AIPD. Baseline levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroxine (T4) and triiodothyronine (T3) were measured at the time of admission. A second measurement was performed three to four weeks after detoxification. Baseline values were compared with those of 300 age- and sex-matched healthy controls. Longitudinal changes within the AUD cohort and differences between AIPD and non-AIPD subgroups were analyzed by paired t-tests and chi-square tests as appropriate.

Cocaine use disorder (CUD) is a significant public health issue, and cocaine's common pairing with alcohol has been linked to adverse cardiovascular outcomes. Among adults with unhealthy alcohol use, we investigated whether co-occurring CUD was associated with excess risk of acute coronary syndrome (ACS). We retrospectively studied 413,511 adults in Northern California from June 1, 2013 to December 31, 2022, with documented unhealthy alcohol use, defined as exceeding either the daily limit and/or weekly drinking limits recommended by the U.S. National Institute of Alcohol Abuse and Alcoholism (NIAAA) guidelines. Using health system electronic health record (EHR) data, concomitant CUD was ascertained from ICD-9/10 diagnosis codes, and alcohol consumption from patient self-report on screening questionnaires. During a follow-up period of up to 9.5 years, ACS was defined as a primary hospital discharge ICD-9/10 diagnosis code for unstable angina or myocardial infarction with elevated cardiac troponin I. Logistic regression evaluated the association of concomitant CUD and alcohol consumption levels with ACS. Models were adjusted for demographic, socioeconomic, and clinical covariates, including cardiovascular risk factors. The prevalence of CUD diagnoses was 0.6%, and 12.4% of the cohort exceeded both daily and weekly drinking limits. CUD was not significantly associated with ACS (adjusted odds ratio [aOR] = 1.27 [95% CI: 0.94-1.73]). Patients who exceeded daily and weekly drinking limits had higher odds of ACS, compared to those who exceeded only daily limits (aOR = 1.20 [95% CI: 1.12-1.28, < .001). Among adults with unhealthy alcohol use, diagnosed CUD was not significantly linked to ACS. The heaviest drinking pattern was associated with a modestly higher adjusted risk of ACS.

Reaching the maintenance phase and reducing illicit substance use in those with severe opioid use disorder (OUD) remains a large clinical challenge. The use of intravenous opioid agonist treatment has become a last-line treatment for severe OUD. In this case series, we describe a novel form of this treatment using both long-acting buprenorphine and injectable hydromorphone.

Behavioral addictions exhibit convergent dysregulation of meso-striatal reward, cortico-limbic stress, and executive-control circuits. Top-down interventions such as CBT demonstrate moderate, often transient effects, leaving autonomic dysregulation insufficiently targeted. Somatic and body-oriented psychotherapies (SBPs) may remediate these deficits bottom-up interoceptive and autonomic mechanisms, but quantitative synthesis is lacking.

Substance use disorders (SUDs) are a growing public health concern with high relapse rates. Noninvasive brain stimulation techniques are emerging as potential adjunctive therapies; however, recruitment challenges persist in related clinical trials. To use systematic review and meta-analysis to determine the rate and reasons for nonparticipation in randomized controlled trials (RCTs) involving noninvasive brain stimulation for substance-related and addictive disorders.

Benzodiazepines are widely prescribed, yet their long-term use among patients with substance-use disorders (SUDs) remains poorly understood. This study examined benzodiazepines in a substance use treatment program.

Cannabis use disorder (CUD) is an escalating global public health issue, especially amid growing legalization. Despite its cognitive, psychological, and social harms, many individuals with CUD do not access treatment, often due to stigma, limited awareness, or service inaccessibility. Brief Motivational Interventions (BMIs), based on motivational interviewing, offer a promising, accessible, and cost-effective approach to addressing CUD in routine clinical settings. However, qualitative evidence on the practical implementation and perceived effectiveness of BMIs remains limited. This systematic review aims to synthesize qualitative evidence on the barriers and facilitators to implementing and delivering BMIs for CUD in routine practice, as perceived by healthcare providers, patients, and other stakeholders. A systematic search will be conducted across PubMed, Embase, PsycINFO, CINAHL, Web of Science, and Scopus. The search strategy will incorporate four conceptual domains: cannabis use disorder, brief motivational interventions, implementation/perceptions, and clinical setting. Eligible studies will include qualitative or mixed-methods designs with distinct qualitative components, published in English since 2000. Methodological quality will be assessed using the Joanna Briggs Institute (JBI) checklist, and data will be synthesized using thematic synthesis. The review will identify key contextual factors influencing BMI adoption and success, offering evidence to guide policy, professional training, and implementation strategies for improving cannabis intervention practices. This review highlights that successful implementation of Brief Motivational Interventions for Cannabis Use Disorder depends on provider readiness, training adequacy, systemic support, and culturally sensitive approaches. Addressing these multilevel factors is essential for wider adoption in clinical practice.

The aim of this study is to report on a patient case in which transcranial direct current stimulation (tDCS) was used to treat gambling disorder (GD).

Injectable extended-release buprenorphine is an effective treatment for opioid use disorder (OUD), but injection site reactions (ISRs) are common treatment-emergent adverse events that may impact patient comfort, adherence, and outcome. This report examines the clinical presentation, prevalence, and management of Sublocade-related ISRs through two case studies and a review of existing literature.

Comorbidity between opioid use disorder (OUD) and chronic pain is substantial. Pain has been shown to be a motivator for OUD onset, maintenance, relapse, and treatment delay. A cluster of pain conditions known as chronic overlapping pain conditions (COPCs), also now referred to in contemporary ICD classification as primary pain conditions, are particularly refractory to traditional forms of pain treatment, and likely adversely impact comorbid OUD.

Methamphetamine use disorder (MUD) currently lacks FDA-approved treatments. Previous studies involving transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (L.dlPFC) have shown promise in TMS's effectiveness at decreasing craving for methamphetamine. Theta burst stimulation (TBS), which includes intermittent (iTBS) and continuous (cTBS) protocols, is increasingly being used for substance use disorders, including MUD. Previous reviews of TMS in MUD performed subgroup meta-analyses of studies that delivered TBS in MUD. However, these meta-analyses included studies with overlapping participant cohorts, limiting their validity. To address this limitation, we reviewed randomized controlled trials (RCTs) using unique patient cohorts from PubMed/Medline, EMBASE, and Google Scholar until September 1, 2024, comparing the impact of TBS versus sham on cue-induced methamphetamine craving in patients with MUD. We performed a meta-analysis with four eligible RCTs that delivered iTBS. Results suggest iTBS was more effective in reducing cue-induced methamphetamine craving than sham iTBS (standardized mean difference [SMD] in change = 1.04; 95% CI [0.16, 1.92]). Two additional RCTs without sham control arms were reviewed, and one demonstrated a significant reduction in craving following accelerated iTBS. Future studies should examine whether neuroimaging-targeted iTBS can impact outcome measures other than craving, such as methamphetamine use, by measuring return to use. Exploring accelerated iTBS and cTBS for MUD, targeting alternative cortical sites such as the frontal pole, and studying their effects on relevant MUD biomarkers is also pertinent. This review demonstrates the effectiveness of TBS for MUD, emphasizing its potential to advance treatment options for MUD.

Services for individuals severely physically dependent on alcohol, wishing to undergo detoxification are limited. This is partly due to a lack of evidence surrounding safe alcohol reduction advice.

Alcohol withdrawal syndrome (AWS) and serotonin syndrome (SS) share several overlapping symptoms, complicating diagnosis in patients with alcohol use disorder (AUD) on serotonergic treatment.

Substance use disorders (SUDs) are chronic, relapsing conditions characterized by significant neurobiological and behavioral disruptions. Emerging evidence highlights the critical roles of oxidative stress, mitochondrial dysfunction, and neuroinflammation in the pathophysiology of drug misuse. Coenzyme Q10 (CoQ10), a mitochondrial cofactor with potent antioxidant and anti-inflammatory properties, has gained attention as a potential adjunctive therapy for managing substance-related neurotoxicity. This review explores the mechanistic role of CoQ10 in mitigating the oxidative damage and neuroinflammation induced by substances misuse, emphasizing its ability to restore mitochondrial function and support neuronal health. Preclinical studies demonstrate that CoQ10 supplementation reduces apoptosis, preserves neurotransmitter systems, and improves behavioral outcomes in models of cocaine, alcohol, nicotine, and opioid addiction. Clinical evidence, though limited, suggests CoQ10's safety and therapeutic potential in oxidative stress-related conditions, reinforcing its relevance to addiction. Despite these promising findings, challenges such as low bioavailability and the lack of SUD-specific clinical trials remain significant barriers. This review underscores the need for further research to optimize CoQ10's formulation, dosing strategies, and clinical applications in the treatment of SUDs. Integrating CoQ10 into multidisciplinary approaches could advance our ability to address the complex neurobiological challenges of SUDs and improve long-term recovery outcomes.

Literature highlighted a higher sweet preference among patients with alcohol use disorder (AUD) that may act as an endophenotypical vulnerability. However, results remain heterogenous and seldom information is available regarding possible origins, such as hedonic abilities, reward sensitivity or impulsivity.