News
The ASAM Weekly for April 14, 2026
This Week in the ASAM Weekly
New ASAM Implementation Guide for Hospital and
Emergency Department Substance Use Disorder Care
Patients with substance use disorder (SUD) have frequent touchpoints with general hospitals and emergency departments (EDs). Between 2014 and 2018, 11.9% of inpatient hospitalizations and 9.4% of ED visits were for patients with SUD. The toll of not treating SUD is enormous, with high rates of premature discharge, cost, and mortality after discharge. Patients with SUD have also reported feeling dehumanized and experiencing stigma in hospital and ED settings, which can result in individuals not seeking needed health care services. Not treating SUD in general medical settings additionally breeds pessimism amongst clinicians who may not have the tools needed to provide good care and feel demoralized, which in turn amplifies negativity toward patients with SUD. Integrating SUD care into hospitals can address these challenges and it also aligns with hospitals’ responsibility to not just treat immediate crises, but also to address the underlying medical condition—reversing an overdose and not offering SUD care would be akin to treating diabetic ketoacidosis but not offering ongoing diabetes care.
Thankfully a broad body of research has demonstrated that treating SUD in hospital and ED settings improves outcomes, including increasing post-discharge addiction treatment engagement, reducing readmission and the associated costs, and reducing addiction severity. Recognizing the necessary and important role that hospitals and EDs can play in SUD care, the American Society of Addiction Medicine (ASAM) recently updated The ASAM Criteria®, to include standards for general hospitals. This framework offers one example for setting a benchmark for the elements of care that all hospitalized patients with SUD should receive.
Join the ASAM Criteria Task Group on Interoperable Data Standards
ASAM is seeking experts to serve on this Task Group, which will help define and recommend approaches for integrating interoperable data standards into ASAM tools and resources for substance use disorder (SUD) assessment and treatment planning.
Interested?
Learn more and apply here.
Lead Story
Methadone Dose and Patient-Directed Discharge in Hospitalized Patients with Opioid Use Disorder 🔓
JAMA Network Open
This retrospective observational cohort study of 554 individuals examined rates of patient-directed discharge (PDD) among hospitalized patients with opioid use disorder who received methadone during the first 72 hours of hospitalization (July 2019 to June 2022). Higher doses of methadone were associated with a decreased rate of PDD. For each additional 10 mg of methadone received in the first 24 hours, there was a decrease in odds of PDD at 48 hours (adjusted OR, 0.71). This study highlights the importance of adequate treatment of opioid withdrawal to reduce the risk of PDD.
Call for Volunteers! ASAM is looking for volunteers to write mock clinical cases for patients in jail or prison, and those reentering the community. Contributors will be mentioned in The ASAM Criteria®, Fourth Ed., Volume 3: Correctional Settings and Community Reentry. Applications accepted until April 17, 2026. To learn more and apply click here.
Research and Science
Mirtazapine for Methamphetamine Use Disorder: A Randomized Clinical Trial 🔓
JAMA Psychiatry
In this phase III randomized trial, use of the antidepressant mirtazapine (30 mg/day) in routine clinical practice reduced methamphetamine (METH) use in adults with methamphetamine use disorder (MUD). Participants used METH for a median of 24 days over the past 28 days. The mean reduction in days of METH use from baseline to week 12 was greater in the mirtazapine group than in the placebo group. There were no unexpected safety concerns from mirtazapine.
ECM remodeling in the mPFC exacerbates cocaine-induced hyperactivity and impairs threat vigilance 🔓
Translational Psychiatry
The extracellular matrix (ECM) plays a crucial role in addiction-related neuroplasticity. While chondroitinase ABC (chABC)-mediated ECM degradation has been shown to impair drug-conditioned place preference, its effects on cocaine-induced locomotor activity remain unknown. Using 3D motion capture combined with unsupervised behavioral clustering in a chronic cocaine exposure mouse model, this study demonstrates that cocaine treatment significantly increases locomotor activity while impairing environmental threat perception. The results highlight the complex, context-dependent role of ECM in addiction-related behaviors and suggest the need for more targeted approaches to ECM-based interventions for substance use disorders.
Early onset of cannabis use and risk for opioid use disorder across two decades in the United States 🔓
Addictive Behaviors
This study used data from the National Survey on Drug Use and Health (NSDUH) from 2002–2024 and the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) from 2001–2002 and 2012–2013 to evaluate the association between early cannabis use (defined as before age 15) and development of opioid use disorder (OUD). Approximately one-fifth of respondents who used cannabis reported use prior to age 15. After adjusting for socioeconomic factors and other substance use (such as alcohol or tobacco use), individuals who used cannabis before age 15 had increased odds of past year OUD (OR range: 1.57 to 4.20) and lifetime OUD (OR range: 1.88 to 2.28). Early cannabis use was also associated with increased odds of injection heroin use and fentanyl use.
Learn More
Annals of Neurosciences
Researchers conducted a cross-sectional study in India among 12- to 17-year-old students to assess the prevalence of internet addiction and its association with depression, anxiety, and quality of life (QOL). Overall, researchers found 41.23%, 16.86%, and 1.45% of students were classified as having mild, moderate, and severe internet addiction, respectively. In addition, 27% had significant depression and 3.2% had severe anxiety. The researchers found a correlation between higher internet addiction test (IAT) scores and higher Beck’s depression and anxiety inventory scores. Higher IAT scores were also correlated with lower QOL. The authors note that the association between internet addiction and psychiatric comorbidities could be bidirectional and recommend screening students with problematic internet use for depression and anxiety.
Addiction
Researchers conducted a network meta-analysis, including 21 psychosocial and 36 pharmaceutical studies, to evaluate the effectiveness of multiple possible treatments for cannabis use disorder (CUD). Overall, while there was some evidence for various psychological and pharmaceutical interventions to reduce cannabis use and improve abstinence, there was low to very low certainty for efficacy. Psychological interventions that may have some benefit included dialectical behavioral and commitment therapies, cognitive-behavioral therapy with contingency management, and contingency management alone. Pharmaceutical interventions that may be of benefit included cannabidiol, n-acetylcysteine, and varenicline. The authors note that, given low certainty, these findings should be viewed cautiously, and more research will be needed.
In the News
- Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome 🔓 Centers for Disease Control and Prevention (CDC)
- ‘Pregnancy doesn’t cure addiction’: Overdose top cause of death for new Indiana mothers 🔓 WFIU/Louisville Public Media
- Dangers of long-term use of benzodiazepines such as Xanax, Valium The Palm Beach Post
- Insurance changes can undo years of addiction recovery 🔓 STAT
- Guests Are Drinking Less, Impacting Restaurants Profit In 2026. 🔓 Forbes
- Inside a One-Man Workshop for Ultrapotent Drugs The New York Times
- The Fast-Changing Chemistry of New, Dangerous Drugs The New York Times