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.

Dextromethorphan misuse is common, especially among young people, yet can easily be overlooked by family and healthcare providers alike. This article reviews recognition of toxicity across the four “plateaus,” psychiatric and medical complications, and supportive management strategies—including when to consider benzodiazepines, antipsychotics, or naloxone.

The first randomized controlled trial testing varenicline for e-cigarette cessation shows encouraging results. With 45% of participants achieving 7-day abstinence at week eight compared to 30% on placebo, this study provides preliminary evidence that varenicline may be effective for helping patients quit vaping, expanding its utility beyond traditional tobacco cessation.

Drug overdose mortality has increased nearly every year since the overdose epidemic began three decades ago. However, 2024 saw an unprecedented drop in overdose deaths across the country. Researchers are working to better understand this change, but it is almost certain that increasing availability of naloxone, widespread adoption of harm reduction practices, and improving rates of MOUD treatment played important roles in this encouraging shift.

Buprenorphine induction typically requires that a patient experience moderate opioid withdrawal before starting the medication in order to avoid precipitating severe withdrawal symptoms. This waiting period is uncomfortable and can be a treatment barrier. In this study, researchers develop and test an induction protocol using injectable buprenorphine that gets around this initial waiting period.

A new long-acting injectable formulation of buprenorphine, Brixadi, is now available for the treatment of opioid use disorder. It is the second one to hit the market, after Sublocade. The two formulations share similarities, but there are some important differences to consider when choosing which medication to prescribe.

Psychotherapy and medication management are the two cornerstones of addiction treatment, but they are not equally effective across different substance use disorders. This article reviews evidence from both therapeutic approaches and introduces the concept of a treatment spectrum, with medication on one end and therapy on the other. This spectrum can be a useful framework when discussing treatment options with patients and in treatment planning.

Injectable naltrexone can be an effective treatment for opioid use disorder, but it requires complete abstinence before initiation—a process that can take more than a week and cause significant discomfort. Here, researchers evaluate a new protocol designed to accelerate this induction period and improve patient access.