The ASAM Weekly for March 31, 2026

Cannabis cessation and neurocognitive recovery: Patterns, predictors, and clinical implications—a systematic review

The American Journal on Addictions

Researchers conducted a literature review of the neurocognitive effects of cannabis use and recovery from those effects. They found a range of neurocognitive effects including neuroreceptor adaptation, decrease in memory, processing speeds, and attention. Deficits increased with higher frequency and amount of use, but recovery can occur. Receptor normalization can occur within weeks of abstinence while cognitive recovery can take months and years. Adolescent-onset users have more severe and persistent deficits, suggesting effects to neurodevelopment beyond reversible neuroadaptation. The authors suggest treatment for cannabis use disorder should focus on both the disorder and its neurocognitive effects.

Treating Opioid Use Disorder With Methadone in Pharmacies 🔓

JAMA Network Open

This study analyzed the return on investment for two pharmacy-based models for providing methadone: a pharmacy-based medication unit and pharmacy-dispensed methadone. A pharmacy-based medication unit refers to an opioid treatment program (OTP) medication unit located within a community-based pharmacy and from which pharmacists dispense methadone per a partnership agreement. In contrast, pharmacy-dispensed methadone would require regulatory changes allowing medical professionals to prescribe methadone, which would then be dispensed from the pharmacy. The two models included startup costs and three years of operating costs and revenue. The medication unit model averaged 95 patients per month, with a net profit of $3.53 per each $1.00 spent. The pharmacist-dispensed model averaged 22 patients per month, with a net profit of $2.64 per each $1.00 spent. Ultimately the economic evaluation showed a positive ROI over three years for both models, indicating that leveraging community pharmacies for methadone access would be profitable, if allowed by policy regulations.

Care trajectories among people with opioid use disorder after release from New York City jails: a state sequence analysis approach

Drug and Alcohol Dependence

This retrospective cohort study used matched NYC health care administrative data of adults with opioid use disorder (OUD) who were incarcerated between May 2011 and 2014–2017 to examine care trajectories of community OUD treatment after incarceration. Of the 14,923 individuals eligible for inclusion in the study, 26.2% received in-jail medication for OUD (MOUD). Using state sequence analysis, eight different care trajectories were identified: continuous methadone treatment (9.7%), methadone treatment discontinuation (3.7%), methadone treatment and reincarceration (6.7%), methadone treatment initiation (4.8%), continuous reincarceration (3.5%), short reincarceration with little community treatment (20.3%), long reincarceration with little community treatment (7.0%), and no community OUD treatment or reincarceration (44.5%). Receipt of MOUD while in jail was associated with belonging to the continuous methadone treatment group as compared to the no community OUD treatment or reincarceration group, with an adjusted OR of 12.5. The study highlights the importance of in-jail initiation of MOUD.

Associations of parental smoking throughout childhood with adolescent smoking and vaping: Mediation via adolescent substance use attitudes

Drug and Alcohol Dependence

Data for this study came from a previous longitudinal study of child cognitive development during preschool (2006–2012) and follow-up during adolescence (2017–2022). At follow-up, adolescents’ (n=230) attitudes toward cigarette and e-cigarette use were measured, as well as their use of cigarettes and e-cigarettes. Paternal smoking was significantly associated with both adolescent attitudes toward and use of cigarettes and e-cigarettes. Path analysis indicates that paternal smoking affected adolescent attitudes, which in turn affected smoking behavior. An unexpected result was that maternal smoking had no significant association with adolescent smoking. These results were similar for male and female offspring.

Social Media Portrayals of Nitrous Oxide Normalize Use and Encourage Youth Exposure

Journal of Studies on Alcohol and Drugs

Nitrous oxide misuse is widely visible on major social media platforms and often portrayed without risk information, potentially encouraging youth uptake. This study systematically reviewed 30 nitrous oxide-related videos posted between January–March 2025 on YouTube and TikTok. Videos averaged 23 million views, 64,753 likes, and 9,500 shares. Half depicted personal experiences, 16.7% demonstrated use, and 10% promoted free trials. Most messengers were perceived as male (70%) and Black/African American (73.3%). No videos included age restrictions or health warnings. Content frequently framed use as socially acceptable or entertaining. Public health strategies should include education campaigns, stricter regulations (eg, age limits, warning labels), and platform collaboration to reduce exposure.

Integrating addiction care in hepatology: Impact of liver consultation on post-discharge AUD treatment in alcohol-associated hepatitis

Journal of Substance Use and Addiction Treatment

Alcohol-associated hepatitis (AH) has significant morbidity and mortality, and long-term prognosis for AH is associated with alcohol abstinence. Researchers conducted a retrospective cohort study to evaluate receipt of counseling, pharmacotherapy, and referral to rehabilitation for alcohol use disorder (AUD) during hospitalization for AH. Overall, 96% of patients with AH received counseling, but relatively few received referral to rehabilitation (17%) and pharmacotherapy (30%). Patients who received a hepatology consult were more likely to receive referrals to rehabilitation (aOR=3.99). These patients were also more likely to receive pharmacotherapy, though this was not statistically significant. The authors note these findings support training for hepatologists and gastroenterologists to address AUD and integration of addiction services.

Liver Injury Associated With Kratom (Mitragyna speciosa): A Systematic Review

Journal of Addiction Medicine

Kratom is a tropical evergreen tree in Southeast Asia. Mitragynine, its primary alkaloid, is a partial agonist at the mu-opioid receptor, and a metabolite, 7-hydroxymitragynine, is a potent full agonist at the mu-opioid receptor. A survey of US adults estimates past year kratom use of 9%. This systematic review identified 31 case reports of liver injury associated with kratom. Resolution in several weeks of kratom cessation was documented in 69%, however all cases required hospitalization and four cases required liver transplantation. In three cases a rechallenge with kratom provoked a recurrence of liver injury. The pattern of liver injury was cholestatic (51%), hepatocellular (26%), and mixed (23%). Kratom is often promoted as a natural pain reliever, but it does have risks.