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The Carlat Addiction Treatment Report

Drug Trends (April/May/June) | 2026

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Learning Objectives, Outpatient Treatment of Substance Use Disorder, CATR, January/February/March 2026

April 1, 2026

After reading these articles, you should be able to…

What Psychiatrists Should Know About Inhalants

April 1, 2026

Jared Bozeman, MD

Inhalant misuse is often missed in routine practice, especially when drug screens are negative. This update reviews common products, acute risks such as sudden sniffing death, long-term neurologic injury, and nitrous oxide related B12 deficiency. Learn practical screening questions, red flags, and management strategies relevant to both adolescents and adults.

Trends in Illicit Drug Use

April 1, 2026

Joseph Palamar, PhD

Illicit fentanyl now dominates the opioid supply and is often mixed with other dangerous drugs. Dr. Palamar reviews many of these drugs including xylazine, medetomidine, nitazenes, and even industrial chemicals. He explains how these additives alter risk, why geography matters, and how clinicians can stay current using regional alerts and drug checking data.

Family Support in Substance Use Disorders

April 1, 2026

Jared Bozeman, MD

Jared Bozeman, MD. Psychiatrist, Montana VA Healthcare System, Bozeman, MT.

Dr. Bozeman has no financial relationships with companies related to this material.

Prescription Drug Misuse and Diversion in Correctional Settings

April 1, 2026

Brian Holoyda, MD, MPH, MBA

Medication misuse in correctional settings reveals how prescribing practices intersect with diversion risk. Dr. Holoyda discusses high demand agents such as gabapentin and bupropion, system level strategies like crush and float, and how to balance safety with adequate treatment. The lessons extend beyond jails to hospitals and outpatient units.

Oral vs Injectable Naltrexone for Hospitalized Patients With AUD

April 1, 2026

Jasmine Kaur, MD

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.

Higher Buprenorphine Doses Lower Death Rates in the Fentanyl Era

April 1, 2026

Jasmine Kaur, MD

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.

Methadone vs Buprenorphine-Naloxone: Real-World Comparisons

April 1, 2026

Maryam Soltani, MD, PhD.

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.

Cannabis Use in OUD: Does Medication Type Make a Difference?

April 1, 2026

Maryam Soltani, MD, PhD.

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.

Early and Injectable-Only Buprenorphine Induction: Can You Skip Withdrawal?

April 1, 2026

Noah Capurso, MD, MHS

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.

CME Post-Test, Drug Trends, CATR, April/May/June 2026

April 1, 2026

By successfully completing the test you will be awarded a certificate for 2 CME credits.

Psychiatry Practice Boosters, Fifth Edition (2026)
This fifth edition teaches you the key points of 66 of the most clinically relevant studies in...
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