News
The ASAM Weekly for March 3, 2026
This Week in the ASAM Weekly
Addiction has often come with a struggle. For example, a prescription epidemic born 30 years ago has become a crisis of more than just opioids (WKRC). Cannabis use in adolescence has come to look more like a cause of psychiatric illness rather than just an exacerbator (JAMA Health Forum). Even the concept of lived experience has come a long way. No longer is it just personal; or racial; or cultural; or socio-economical; or developmental; etc (Drug and Alcohol Dependence Reports).
Often, there is a desire to control the struggle. For example, local governments might be tracking fentanyl contamination to protect the public but they really need to measure concentration in order to better protect against overdose deaths (International Journal of Drug Policy). Globally, authorities might disrupt supply chains or take down criminal organizations, only to see a rebound in drug wars and drug trades soon after (Psychology Today). Control has its limits.
There is also a desire to seek out knowledge. Biomedical research has found that some of the most important human functions, like learning and motivation (and drug use), are influenced by dopamine, whose levels are controlled by tiny, obscure proteins (PNAS). Even the relationship between addiction and depression is best understood at the granular level of gene regulation and neural function (Communications Biology). But knowledge has its limits too (STAT).
For many with addiction, their struggle can become a search for meaning. An article from The New York Times tells the story of artists throughout Manhattan theatres as they search for purpose on the stage and within their community. A first-of-its-kind meta-analysis confirms the importance of spirituality in reducing drug and alcohol use (JAMA Psychiatry). Together they demonstrate how it is actually the sense of community—with others, in purpose, in spirit, with self, with God, in meaning, in knowledge, etc—that is often the endpoint of a path that started from struggle.
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!
Apply to be the ASAM Weekly Editor in Chief!
ASAM Weekly, with a circulation of 70,000 readers, is conducting a search for a new Editor in Chief (EIC). The EIC will serve a 1-year term from July 1, 2026, to June 30, 2027, with the option to renew for additional years. Benefits and compensation offered.
Lead Story
JAMA Psychiatry
This meta-analysis of 55 rigorous studies on spirituality and harmful or hazardous drug use (alcohol, tobacco, marijuana, or illicit drugs) examined the association between spiritual exposures and related drug use outcomes. Researchers documented a significant protective association of 13% related to both prevention and recovery. The risk reduction, which extended across all 4 drug categories, reached 18% for individuals with greater than weekly religious service attendance. These results have implications for clinicians and communities regarding future strategies to address harmful or hazardous alcohol or other drug use.
Research and Science
Drug and Alcohol Dependence Reports
This retrospective cross-sectional study of 420,361 Medicaid-enrolled adolescents aged 12—17 in Indiana examined rates of OUD diagnosis, MOUD receipt, and MOUD initiation delay from 2019—2023. Within the study population, 871 (0.2%) adolescents had an OUD diagnosis; of that group, only 73 (8.4%) received MOUD. From 2019 to 2023, OUD diagnosis rates increased 67%, particularly among males and white adolescents. Older adolescents (15—17) accounted for most OUD diagnoses (76.8%) and MOUD receipt (89%). Black adolescents were 89% less likely to receive MOUD and experienced the longest delay in MOUD initiation (781 days). The patterns found in this study highlight stark differences in OUD diagnosis and treatment, particularly for Black adolescents.
International Journal of Drug Policy
This study from British Columbia, Canada, examined data collected from drug checking services from October 2018 to June 2025 about the concentration of fentanyl in the drug supply. Fentanyl concentration data were then compared to drug overdose mortality data. Fentanyl concentration rose from 7.5% in 2018 to a peak of 9.9% in 2023 and then declined to 7.1%. There was considerable geographic variation in fentanyl concentration with urban areas in general having higher concentrations compared to rural areas. There was a strong association between fentanyl concentration and overdose mortality with a 1% increase in fentanyl concentration resulting in a mortality increase of 0.072 deaths/100,000 (p=0.03). The authors reference a recent paper by Vangelov suggesting that decreased availability of fentanyl precursors have reduced fentanyl supply.
Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders 🔓
JAMA Health Forum
This cohort study of 463,396 adolescents aged 13 to 17 years who were universally screened for cannabis use and past-year cannabis use assessed if adolescent cannabis use is associated with an increased risk of developing psychiatric disorders by young adulthood. Researchers found a significantly increased risk of incident psychotic, bipolar, depressive, and anxiety disorders by age 26 years. Data affirmed that adolescent cannabis use is associated with increased risk of psychiatric disorders in adolescence and young adulthood, highlighting the importance of early prevention efforts, effective public health messaging, and policy development to limit youth exposure as cannabis legalization expands.
Medicaid Expansion and Buprenorphine Dispensing in Early vs Recent Expansion States 🔓
JAMA Network Open
This is a cross-sectional study of 149,648,295 dispensations of buprenorphine to 4,596,264 unique patients from 2013 to 2024. The study found that Medicaid expansion was associated with a 21.1% increase in all-payer buprenorphine dispensing in recent expansion states (from 2019 to 2023), but not in earlier expansion states (2014—2016). Among recent expansion states, Maine, Virginia, Oklahoma, and Idaho experienced significant increases in buprenorphine treatment. Results suggested that Medicaid expansion is associated with a true increase in treatment rather than a payer substitution system leading to increased Medicaid claims. The study highlights that Medicaid expansion is critical to ensure access to buprenorphine and should be a key policy item when addressing opioid overdoses.
Learn More
Proceedings of the National Academy of Sciences
Synaptogyrin-3 (Syngr3) is a synaptic vesicle protein known to influence dopamine release and uptake. Humans who used cocaine and died of cocaine overdose have reduced levels of Syngr3 in postmortem samples of dopamine neurons in the ventral tegmental area. Syngr3 levels were also reduced in rats who self-administered cocaine, and higher Syngr3 levels were associated with reduced cocaine self-administration. When researchers induced viral overexpression of Syngr3 levels in rats, dopamine levels in the nucleus accumbens doubled. With Syng3 overexpression, both cocaine self-administration and dose escalation were reduced. Syng3 overexpression suppressed these key addiction-like behaviors. The ability of Syngr3 to regulate dopamine makes it a potential therapeutic agent for cocaine use disorder.
Addictive drug abuse and depression-a focus on epigenetics 🔓
Communications Biology
Substance use has been linked to increased vulnerability to depression, but the mechanisms are not completely understood. Researchers conducted a review examining the current data on epigenetic effects of substance use and in depression as a framework for understanding the linkage and possible therapeutic targets in the future. The first part of the review explores links between various substances and depression before describing epigenetic effects of various substances including DNA methylation, histone modification, and changes in non-coding RNA. Many of the epigenetic changes identified with various substances also occur in depression. The authors do note that a great deal more research is needed as there is significant heterogeneity in effects of various substances and more precision would be needed for any targeted treatments.
Journal of General Internal Medicine
Efforts to increase the use of medications for opioid use disorders (MOUD) in primary care settings include use of clinical prediction models embedded in the electronic health record (EHR). EPIC Systems developed the Risk of Opioid Abuse or Overdose model to predict patients who will have an opioid overdose or be diagnosed with OUD in the next 12 months. Researchers conducted a prospective cohort study to validate the model and found 99.6% of patients were classified as low risk and 0.03% of patients had an overdose or diagnosis of OUD in 12 months of follow-up. The sensitivity (7.8%) and positive predictive value (6.9%) for having a high-risk score were low, while specificity (99.7%) and negative predictive value (99.7%) were high. The authors suggest that while such models may have some clinical utility, health systems should be cautious before adopting them.
In the News
12 Steps and Cups of Coffee: Sobriety Has Its Moment Onstage
The New York Times
Nicotine makes surprise comeback as a wellness, productivity tool
STAT
'Susceptible to overdose or death': Deadly new drug shows up on Tri-State streets 🔓
WKRC
The military’s complicated history with tobacco 🔓
Navy Times
Kratom helps my parents, please don’t take it away 🔓
Clarion Ledger
Dentists can help fight the drug overdose crisis
STAT
A Global Glut in Cocaine Shocks the World 🔓
Psychology Today