We open this week with virtual care. One of the few silver linings of the public health emergency was the rapid expansion of telehealth—a shift from which our patients in SUD treatment settings stand to benefit immensely. An exploratory analysis of the rollout of a virtual SUD clinic across Texas offers key insights on implementing MOUD via telehealth effectively. Next, an RCT shared ties in culturally grounded interventions for Urban American Indian and Alaska Native populations, addressing a historically underserved community in our field. Shifting from digital care to digital harms, a major headline this week highlights ongoing social media litigation, begging the question: just how addictive are these platforms? We then turn to aging on multiple fronts. First, a study on epigenetic age acceleration reinforces the link between substance use—specifically cigarette smoking and opioid use—and accelerated biological aging. Turning to addiction in later life, alcohol use patterns are examined in the Australia “Beyond 50” cohort, while a systematic review on gambling in older adults helps identify key risk factors in this understudied demographic. To continue in the area of diagnosis, a new ICD code provides much-needed clarity on the rising prevalence of cannabis hyperemesis syndrome (a topic also spotlighted by Forbes in a physician explainer this week). To help clinicians reduce missed diagnoses of opioid use disorder, the SCOPE framework is introduced as a tool to identify OUD using both individual risk factors and social determinants of health. Finally, a KFF News piece highlights how federal policy can inadvertently hinder clinical practice by restricting access to harm-reduction test strips needed to identify what substances our patients are using. While virtual care and digital innovation opened this week’s issue, we turn to our foundation in basic science to close. A study in Translational Psychiatry examines the neurobiological effects of alcohol exposure on behavioral resilience in a rodent model, reminding us that behind every digital tool, policy debate, and diagnostic code lies the complex brain circuitry driving addiction. Whether you work in basic science, clinical practice, or policy, thank you for all you do.

Smita Das, MD, PhD, MPH
Editor in Chief 

with Co-Editors: Brandon Aden, MD, MPH, FASAM; John A. Fromson, MD; Sarah Messmer, MD, FASAM; Jack Woodside, MD;
and Contributing Editor: Jessica Gregg, MD, PhD, FASAM