American Society of Addiciton Medicine
Feb 11, 2026 Reporting from Rockville, MD
The ASAM Weekly for February 10, 2026
https://www.asam.org/news/detail/2026/02/11/the-asam-weekly-for-february-10--2026
Feb 11, 2026
Association of alcohol intake over the lifetime with colorectal adenoma and colorectal cancer risk

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American Society of Addictin Medicine

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The ASAM Weekly for February 10, 2026

Feb 11, 2026
ASAM weekly

This Week in the ASAM Weekly

Stigma casts a long shadow over addiction. We’ve seen this with the removal of the X-waiver, which led to only a modest increase in buprenorphine prescribing (Substance Use and Addiction Journal), and with Overdose Prevention Centers (OPC,) whose success is often limited by the stigma beyond their walls (JAMA Network Open). We’ve become so accustomed to this shadow that we reflexively seek ways to destigmatize addiction and the people it affects (JGIM).

But we may not always acknowledge when stigma works in our favor. The success of tobacco cessation is rightly attributed to cancer awareness and the availability of cost-effective treatments (JAMA Network Open), but there were times when society shunned those who smoked. Similarly, people are increasingly aware of the cancer risks with alcohol (Cancer), and that effective treatments exist, but we can’t deny that online shaming has had a chilling effect on how younger generations relate to alcohol.

Cannabis illustrates this in a different way. There aren’t noteworthy links to cancer or FDA-approved medications, but there has been a recent and rapid reversal of stigma—for which even the risk of psychosis and “scromiting” hasn’t seemed to slow (North Carolina Health News).

The New York Times opinion columnist, Ross Douthat, has some thoughts about this. He writes of how the haze of marijuana in our cities, the ubiquity of online porn, and the accessibility of gambling apps exemplify a crisis of liberalism— brought on by a destigmatization of vice (The New York Times).

But it’s important not to confuse this with the destigmatization of vice with the destigmatization of addiction. Reinventing gambling as an investment instead of a vice (NBC News), or using technology to isolate it from traditional settings of stigma (The Deseret News), will undoubtedly expose more people to its harms. Reflexively stigmatizing gambling addiction will only make things worse. 

Thanks for reading,

Nicholas Athanasiou, MD, MBA, DFASAM
Editor in Chief

with Co-Editors: Brandon Aden, MD, MPH, FASAM, John A. Fromson, MD; Sarah Messmer, MD, FASAM; Jack Woodside, MD 

2026 Addiction Medicine Research Priorities

ASAM is requesting your input on which areas of addiction clinical practice are most in need of further research. This input will be shared with federal research agencies, including the National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Agency for Healthcare Research and Quality (AHRQ). We are also planning a listening session called "Bridging the Gap between Science and Clinical Practice" with federal research agency representatives at the ASAM 57th Annual Conference.

If you have any questions, please email Radhika Sagar, OTR/L, MOT, Clinical Algorithm Analyst, at rsagar@asam.org. Thank you! 

Lead Story

Association of alcohol intake over the lifetime with colorectal adenoma and colorectal cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial🔓

Cancer

This study analyzed data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to look for an association between alcohol intake and colorectal cancer (CRC) or colorectal adenoma. Participants' lifetime pattern of alcohol intake was determined from a dietary history recorded as part of the PLCO trial. Current drinkers with a lifetime average of over 14 drinks per week had a higher CRC risk than those with under 1 drink per week (HR 1.25, p = .003) and an even higher risk of rectal cancer (HR 1.95). There was no consistent association between alcohol intake and colorectal adenoma risk, however results suggested that former drinkers may have a reduced risk of adenoma. They discussed potential mechanisms such as acetaldehyde, a known carcinogen and product of alcohol metabolism, and effects of alcohol on gut microbiome. They conclude that heavy alcohol intake increases CRC risk and that alcohol cessation may lower adenoma risk.

Research and Science

Economic Evaluation of Tobacco Treatments From the Screen ASSIST Lung Cancer Screening Trial🔓

JAMA Network Open

This economic evaluation study included 642 participants. It assessed which of the 8 smoking cessation strategies used in the Screen ASSIST trial among patients undergoing lung cancer screening was most cost-effective. The study found that 8 sessions of telehealth counseling combined with 2 weeks of nicotine replacement therapy was the most cost-effective intervention, with an incremental cost per quit of $3,050. Sensitivity analyses illustrate potential cost differences in alternative settings. These findings suggest that health systems can use this favorable incremental cost per quit and transparent cost estimation to promote wider implementation of the intervention.

Patient-Centered Podcasts: An Educational Innovation to Improve Attitudes Toward Patients with Opioid Use Disorder Among Internal Medicine Practitioners🔓

Journal of General Internal Medicine 

Stigma is a well-documented issue affecting people with substance use disorder, particularly within healthcare settings. This study piloted a new learning method to address stigma—podcasts featuring patient stories. The intervention included a series of three 30-minute patient-centered podcasts focused on Opioid Use Disorder (OUD). A non-controlled pre-post pilot study was conducted with 15 internal medicine practitioners (including residents, junior faculty, and experienced faculty) at an academic medical center from October to November 2024. Participants rated the podcast highly in terms of ease of access, satisfaction, relevance, clarity, and application to practice. The podcast series resulted in a statistically significant improvement in the Medical Condition Regard Scale, which is a validated tool to assess attitudes towards patients with particular medical conditions (in this case, OUD). While larger longitudinal studies are needed to determine the impact of this learning model, this pilot study is encouraging as it provides a potential tool that may be more accessible for busy clinicians. 

Assessing the Initial Impact of X-Waiver Elimination on Buprenorphine Prescribing for Opioid Use Disorder🔓

Substance and Addiction Journal

The x-waiver requirement was eliminated as a strategy to increase access to buprenorphine for treatment of OUD. While prior studies demonstrated an increase in buprenorphine prescriptions filled after change, studies did not account for prescribing for OUD versus pain disorder. Researchers utilized electronic health records to assess prescribing rates for new diagnosis of OUD comparing pre and post policy change. In a logistic modelling analysis, researchers found people with a new OUD diagnosis were more likely to receive buprenorphine during post-waiver elimination period (aOR 1.14, 95% CI 1.12,1.16), but still only 19.6% did receive a prescription. Authors note that while the waiver-elimination was associated with an increase in treatment initiation, there are still significant barriers that need to be addressed.  

Health, Costs, and Injection-Related Infections at a Hypothetical Overdose Prevention Center🔓

JAMA Network Open

This decision analytical modeling study estimated the 10-year impact of a hypothetical overdose prevention center (OPC) in Denver, Colorado. Specific outcomes included were injection-related infections, hospitalizations, mortality, and associated costs. Data inputs included people who inject drugs (n=9697) in Denver from 2023 to 2032, based on the 2022 National HIV Behavioral Surveillance survey. A hypothetical OPC was compared to Denver’s current treatment service model, which includes three syringe service programs. The model found that a hypothetical OPC decreased skin and soft tissue infections by up to 11.5%, infective endocarditis by up to 22%, hospitalizations by up to 8.5%, and all-cause mortality by up to 5.8%. The model could save between $7 million to $46 million from a payer perspective over ten years. 

ASAM Needs Your Expertise 

ASAM’s Clinical Practice Guideline Methodology and Oversight Subcommittee (CPG-MOS) is seeking additional volunteers to join the group.

The CPG-MOS provides advice and guidance for the implementation of ASAM’s CPG methodology. Members with an understanding of GRADE methodology and CPG development are encouraged to apply.

For more information or to apply, click here.
The deadline to apply is February 15.

Learn More

Predicting substance use behaviors with machine learning using small sets of judgment and contextual variables🔓

NPJ

Machine learning approaches have shown the ability to predict other medical and mental health conditions. Researchers utilized machine learning to try to predict substance use, substance use disorder (SUD) behavior, and SUD severity using 15 reward and aversion judgment variables. The researchers were able to predict SUD behaviors and SUD severity with high accuracy. In addition, they were able to predict substance use for cannabis, opioids and stimulants with high accuracy. Prediction of alcohol use was less accurate in the study. The authors suggest these findings could be useful in helping to improve diagnosis of SUD and prognosis. 

Online gambling requires greater government regulation

BMJ

This BMJ Analysis highlights online gambling products, which are rapidly gaining popularity worldwide and are disproportionately associated with harms, including addiction and suicide. Some governments are beginning to enact regulations to mitigate harm while others allow gambling providers to self-regulate.  Evidence indicates industry self-regulation is insufficient to prevent harm.  Thus, policies on the design, marketing, and advertising of online gambling products should be brought into alignment with those governing other addictive products and digital services. 

Ibogaine for Opioid Use Disorder: An Unrecognized Risk

Journal of Addiction Medicine 

This commentary raises concerns about the use of ibogaine for the treatment of OUD. The authors cite the known risk of cardiac arrhythmia due to QT prolongation by ibogaine. They are concerned by conference presentations on “use of ibogaine for treatment of methadone dependence” and “ibogaine in the treatment of methadone detoxification” that promote the use of ibogaine to discontinue established MOUD. They note legislation in at least seven states that would facilitate the use of ibogaine. It is well established that MOUD cuts the mortality associated with OUD by 50%, whereas ibogaine lacks robust clinical trial data. The authors cite a study showing that 50% continue to use opioids one month after ibogaine and note they would have lost opioid tolerance, thus increasing the overdose risk. Although ibogaine may prove to be useful, it should not substitute for proven lifesaving treatments.