Addiction affects entire families, yet family members often receive little guidance. This article reviews evidence for behavioral couples therapy, community reinforcement, and peer led groups such as Al Anon and SMART Recovery Family and Friends. Learn how to present these options in ways that validate stress and strengthen engagement.

In hospitalized patients with alcohol use disorder, both oral and extended-release injectable naltrexone significantly reduced heavy drinking days at three months, with no meaningful difference between groups. Initiating treatment before discharge may help reduce gaps in care.

A large cohort study found a clear dose response relationship between higher early buprenorphine dosing and reduced mortality. Patients receiving more than 16 mg daily in the first month had substantially lower overdose and all cause death rates compared to lower dose groups.

Two large cohort studies compared retention and ongoing opioid use among patients receiving methadone versus buprenorphine. Methadone showed slightly higher retention, while both medications reduced illicit opioid use effectively. Choosing between them remains a patient centered clinical decision.

A secondary analysis of the X:BOT trial found lower cannabis use among patients treated with buprenorphine compared to extended-release naltrexone. While opioid outcomes were similar once treatment was initiated, this research suggests that buprenorphine may have an edge for patients with comorbid cannabis use disorder.

Two recent studies examine starting long-acting injectable buprenorphine before significant withdrawal develops using a so-called "Direct-to-Inject" approach. Precipitated withdrawal rates were low, and early engagement in care was encouraging. This review outlines the protocols, tolerability, and practical implications for emergency and outpatient settings.

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