Fentanyl-related cardiac arrests had less bystander CPR, fewer shockable rhythms, and more severe brain injury on EEG, but good neurological outcomes were similar to other causes. This highlights unique challenges in fentanyl-linked cardiac arrest cases.

pubmed.ncbi.nlm.nih.gov/40747898/

ADAPT-2 found naltrexone-bupropion quickly cut depression in meth users, boosting remission and reducing use. Early depression drop explained ~25% of its success.

pubmed.ncbi.nlm.nih.gov/40767786/

This study found that opioid overdose survivors who perceive themselves at higher risk are over twice as likely to overdose again within four months. Assessing risk perception can help target and improve overdose prevention efforts.

pubmed.ncbi.nlm.nih.gov/40698403/

Among opioid OD survivors, less than half of OD's involved EMS, about one-third led to emergency visits, & few resulted in hospitalization. Most overdoses had naloxone given by bystanders. Relying only on healthcare data underestimates non-fatal overdose rates.

www.sciencedirect.com/science/arti...

The ADAPT-2 trial found, higher craving and impulsivity predicted worse outcomes in methamphetamine treatment with naltrexone and bupropion. Targeting these factors may improve treatment response.

Patients with chronic pain who continued receiving opioids were more likely to get recommended preventive care. Those who lost access received less. Opioid stewardship should include support for ongoing healthcare engagement.

Check out this dynamic Conversation with Mental Health Experts (CME) podcast episode as Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health, about managing stimulant use disorders. Explore treatment challenges and how harm reduction is changing lives.

In the M3 study, mirtazapine reduced methamphetamine demand without changing its effects or safety profile. All treatments were well tolerated, supporting mirtazapine's potential as a treatment for methamphetamine use disorder.

In this commentary, Dr Coffin clarifies the role of naloxone in reversing overdose, and notes that more is not necessarily better.

New CSUH paper published in Drug and Alcohol Dependence:

Many stimulant-only drug deaths are witnessed and often linked to heart issues, unlike opioid cases. Analyzing medical examiner records helps uncover patterns and improve prevention efforts.

Study of 600 opioid patients: Stimulant use didn’t boost emergencies or deaths, yet those positive were nearly three times as likely to have treatment stopped. Researchers urge discussing substance use rather than automatically halting opioids.

CSUH collaborated with Boston Medical Center to demonstrate the reliability of self-reported substance use data over a 4-month lookback period!

During the pandemic, doctors tried microdosing buprenorphine to help fentanyl users avoid withdrawal and start treatment. A UC San Francisco study found this low-dose approach worked only 34% of the time, with most patients unable to reach a full dose despite gradual increases over several days.

CSUH conducted a highly innovative study to better understand deaths attributed to stimulants. Lots more to come!

Dr Coffin published a commentary in Addiction this week noting that high and variable opioid potency has a dynamic impact on overdose risk, limiting the impact of our traditional overdose prevention strategies.

Check out the full publication here: