Adjunctive psychosocial interventions and opioid abstinence among patients receiving buprenorphine: A randomized clinical trial

JAMA Network Open

This randomized clinical trial of 340 adults with opioid use disorder (OUD) taking buprenorphine examined the comparative effectiveness of 2 psychosocial treatments—cognitive- behavioral therapy (CBT) and peer recovery support (PRS)—on opioid abstinence when used as adjunctive therapy to office-based buprenorphine treatment in adults with OUD. Researchers found that neither PRS, CBT, nor a combination of these psychosocial interventions yielded differential effects on opioid abstinence. These results suggest that adjunctive psychosocial interventions may not enhance buprenorphine treatment outcomes in the early stages of treatment.

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Comparison of buprenorphine treatment by virtual-only vs. traditional clinicians

Journal of Substance Use and Addiction Treatment

Few patients with opioid use disorder (OUD) receive medications for OUD (MOUD), such as buprenorphine. Given that many patients, particularly those in rural communities, do not live near a clinician who prescribes MOUD, telemedicine could increase MOUD access. However, clinicians and policymakers are concerned about the quality of the virtual-only model.  This study compared the care provided by virtual-only versus traditional clinicians.  The authors found few substantive differences in who used virtual-only care. For example, patients initiating buprenorphine with virtual-only versus traditional clinicians were equally likely to live in urban areas. Patients initiating buprenorphine with virtual-only clinicians had more visits in the 6 months after the initiation and were more likely to be on buprenorphine at 6 months, but had fewer days of continuous buprenorphine treatment. These results can inform ongoing debates about the strengths and weaknesses of virtual-only OUD care.

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Trends in alcohol-related deaths in the United States over 55 years: 1968-2023

Alcohol, Clinical and Experimental Research

This study of alcohol-related mortality trends since 1968 used primarily death certificate data from the CDC WONDER database. Between 1998 and 2023 there were 1.3 million alcohol-related deaths. Overall age-adjusted mortality rates (AAMR) per 100,000 increased from 13 to 19. Rates increased from 1968 to 1980, declined from 1980 to 2000, and began an accelerating increase from 2000 to 2023, with a peak during COVID. AAMRs were higher for males (increasing from 20 to 28) than for females (increasing from 7 to 11). AAMR declined by 50% for Black individuals (from 28 to 14) and nearly doubled for Whites (increasing from 11 to 21) resulting in a dramatic racial inversion. Among age groups, the highest mortality was for 65+, attributed to baby boomer heavy drinking plus frailty of age. The largest increases were seen in the Midwest with the Northeast remaining stable.

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