Coverage of addiction treatment including smoking cessation, alcohol use, and opioids https://www.thecarlatreport.com/rss en-us Physicians seek help for addiction and mental health issues later and with greater shame than most patients, yet their outcomes are among the best. Dr. Chris Bundy explains why this is and covers how clinicians can reduce stigma, navigate mandatory reporting, and support colleagues in crisis. Physicians seek help for addiction and mental health issues later and with greater shame than most patients, yet their outcomes are among the best. Dr. Chris Bundy explains why this is and covers how clinicians can reduce stigma, navigate mandatory reporting, and support colleagues in crisis.

]]> http://www.thecarlatreport.com/articles/6361 Tue, 14 Jul 2026 13:48:24 -0400 https://www.thecarlatreport.com/articles/6361-stigma-shame-and-recovery-in-physician-health-programs CATR_QA2 Chris Bundy_photo_Sm.png Vending machines stocked with naloxone, syringes, and HIV tests are spreading across communities. But do they reach the people who need them most, and what does the evidence say about their impact? Vending machines stocked with naloxone, syringes, and HIV tests are spreading across communities. But do they reach the people who need them most, and what does the evidence say about their impact?

]]> http://www.thecarlatreport.com/articles/6356 Tue, 14 Jul 2026 12:55:00 -0400 https://www.thecarlatreport.com/articles/6356-harm-reduction-vending-machines After reading these articles, you should be able to… After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/6364 Wed, 01 Jul 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6364-learning-objectives-the-carlat-addiction-treatment-report-catr-july-august-september-2026 By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/6355 Wed, 01 Jul 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6355-cme-post-test-medical-workers-and-addiction-catr-july-august-september-2026 This article reviews what the evidence shows. This article reviews what the evidence shows.

]]> http://www.thecarlatreport.com/articles/6363 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6363-ibogaine-for-opioid-use-disorder-what-patients-are-hearing-and-what-you-should-know CATR_JulAugSep 2026_Ibogaine.png Many clinicians have misconceptions about physician health programs or have never encountered one at all. Dr. Scott Humphreys clarifies how PHPs evaluate, monitor, and support physicians with SUDs, and what separates the PHP model from standard addiction care. Many clinicians have misconceptions about physician health programs or have never encountered one at all. Dr. Scott Humphreys clarifies how PHPs evaluate, monitor, and support physicians with SUDs, and what separates the PHP model from standard addiction care.

]]> http://www.thecarlatreport.com/articles/6362 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6362-the-role-of-physician-health-programs-in-addiction-and-mental-health-care CATR_QA1 Scott Humphreys_photo_sm.png Many patients assume nicotine pouches are safe. But what does the evidence show? This article will teach you all about nicotine pouches: how they are used, who is using them, and how to counsel patients who want to reduce or quit nicotine altogether. Many patients assume nicotine pouches are safe. But what does the evidence show? This article will teach you all about nicotine pouches: how they are used, who is using them, and how to counsel patients who want to reduce or quit nicotine altogether.

]]> http://www.thecarlatreport.com/articles/6360 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6360-nicotine-pouches-what-providers-need-to-know Can skipping the standard sublingual induction and moving directly to injectable buprenorphine improve early retention in patients using fentanyl? And does the maintenance dose actually matter? Can skipping the standard sublingual induction and moving directly to injectable buprenorphine improve early retention in patients using fentanyl? And does the maintenance dose actually matter?

]]> http://www.thecarlatreport.com/articles/6359 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6359-xr-buprenorphine-in-the-fentanyl-era Does quitting smoking during addiction recovery help or destabilize patients who are already working hard to stay sober? A four-year longitudinal cohort study offers a cleare answer. Does quitting smoking during addiction recovery help or destabilize patients who are already working hard to stay sober? A four-year longitudinal cohort study offers a cleare answer.

]]> http://www.thecarlatreport.com/articles/6358 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6358-smoking-cessation-and-sud-recovery For smokers who have already tried and failed to quit smoking, what works better: e-cigarettes or combination NRT? A randomized trial compares their outcomes head-to-head. For smokers who have already tried and failed to quit smoking, what works better: e-cigarettes or combination NRT? A randomized trial compares their outcomes head-to-head.

]]> http://www.thecarlatreport.com/articles/6357 Wed, 01 Jul 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6357-e-cigarettes-versus-combination-nrt-for-quitline-smokers-who-already-failed-once http://www.thecarlatreport.com/blogs/1/post/6315 Sat, 06 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6315-free-research-summary-cannabis-use-frequency-and-cannabis-use-disorder-addiction-psychiatry PB5e_Cover_sm.png Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD). Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD).

]]> http://www.thecarlatreport.com/articles/6201 Tue, 21 Apr 2026 16:33:31 -0400 https://www.thecarlatreport.com/articles/6201-topiramate-eprontia-qudexy-xr-topamax-trokendi-xr-fact-sheet Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD). Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD).

]]> http://www.thecarlatreport.com/articles/6200 Tue, 21 Apr 2026 16:33:31 -0400 https://www.thecarlatreport.com/articles/6200-naltrexone-revia-vivitrol-fact-sheet Gabapentin is effective as an off-label medication to ease alcohol withdrawal symptoms and to reduce cravings over the long term in patients with alcohol use disorder (AUD). Gabapentin is effective as an off-label medication to ease alcohol withdrawal symptoms and to reduce cravings over the long term in patients with alcohol use disorder (AUD).

]]> http://www.thecarlatreport.com/articles/6199 Tue, 21 Apr 2026 16:33:31 -0400 https://www.thecarlatreport.com/articles/6199-gabapentin-gralise-horizant-neurontin-fact-sheet Disulfiram is an aversive treatment, causing a buildup of ethanol’s metabolite acetaldehyde in the serum, which in turn causes symptoms such as flushing, dizziness, nausea, and vomiting if patient consumes alcohol. Disulfiram is an aversive treatment, causing a buildup of ethanol’s metabolite acetaldehyde in the serum, which in turn causes symptoms such as flushing, dizziness, nausea, and vomiting if patient consumes alcohol.

]]> http://www.thecarlatreport.com/articles/6198 Tue, 21 Apr 2026 16:33:31 -0400 https://www.thecarlatreport.com/articles/6198-disulfiram-antabuse-fact-sheet Acamprosate is best for maintaining abstinence in patients who have already quit drinking, but it can be helpful even after patients relapse. Naltrexone is the better choice for patients who are still drinking, since it is better at helping patients quit. Acamprosate is preferred over naltrexone in patients with hepatic impairment. Acamprosate is best for maintaining abstinence in patients who have already quit drinking, but it can be helpful even after patients relapse. Naltrexone is the better choice for patients who are still drinking, since it is better at helping patients quit. Acamprosate is preferred over naltrexone in patients with hepatic impairment.

]]> http://www.thecarlatreport.com/articles/5082 Tue, 21 Apr 2026 16:33:31 -0400 https://www.thecarlatreport.com/articles/5082-acamprosate-campral-fact-sheet-g After reading these articles, you should be able to… After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/5923 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/5923-learning-objectives-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/5913 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/5913-copy-of-cme-post-test-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 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. 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.

]]> http://www.thecarlatreport.com/articles/5919 Wed, 01 Apr 2026 00:00:08 -0400 https://www.thecarlatreport.com/articles/5919-prescription-drug-misuse-and-diversion-in-correctional-settings 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. 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.

]]> http://www.thecarlatreport.com/articles/5922 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5922-what-psychiatrists-should-know-about-inhalants CATR_AprMayJun2026.jpg 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. 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.

]]> http://www.thecarlatreport.com/articles/5921 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5921-trends-in-illicit-drug-use CATR_QA1 Joseph Palamar_photo_sm.png 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. 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.

]]> http://www.thecarlatreport.com/articles/5920 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5920-family-support-in-substance-use-disorders 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. 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.

]]> http://www.thecarlatreport.com/articles/5918 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5918-oral-vs-injectable-naltrexone-for-hospitalized-patients-with-aud 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. 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.

]]> http://www.thecarlatreport.com/articles/5917 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5917-higher-buprenorphine-doses-lower-death-rates-in-the-fentanyl-era 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. 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.

]]> http://www.thecarlatreport.com/articles/5916 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5916-methadone-vs-buprenorphine-naloxone-real-world-comparisons 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. 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.

]]> http://www.thecarlatreport.com/articles/5915 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5915-cannabis-use-in-oud-does-medication-type-make-a-difference 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. 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.

]]> http://www.thecarlatreport.com/articles/5914 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5914-early-and-injectable-only-buprenorphine-induction-can-you-skip-withdrawal By successfully completing the test you will be awarded a certificate for 2 CME credits. By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/5846 Thu, 01 Jan 2026 23:00:00 -0500 https://www.thecarlatreport.com/articles/5846-cme-post-test-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 The Subjective Opiate Withdrawal Scale (SOWS) is a scale that can be used to define the severity of opioid withdrawal symptoms at home without the involvement of a health care provider.

The Subjective Opiate Withdrawal Scale (SOWS) is a scale that can be used to define the severity of opioid withdrawal symptoms at home without the involvement of a health care provider. ]]> http://www.thecarlatreport.com/articles/6089 Thu, 01 Jan 2026 15:35:47 -0500 https://www.thecarlatreport.com/articles/6089-subjective-opiate-withdrawal-scale-sows-fact-sheet-for-patients Opioids can cause a bad and potentially fatal reaction (overdose) that makes your breathing slow or even stop, which can be fatal.

Opioids can cause a bad and potentially fatal reaction (overdose) that makes your breathing slow or even stop, which can be fatal.]]> http://www.thecarlatreport.com/articles/6088 Thu, 01 Jan 2026 15:35:47 -0500 https://www.thecarlatreport.com/articles/6088-opioid-overdose-overview-fact-sheet-for-patients