Clinical reviews on addiction

Chronic use of prescription opioids and initiation of injecting drug use

24 Feb 2022Registered users

The risk of initiating injecting drug use is eight times higher for patients who receive long-term prescription opioid medication for non-cancer pain compared with that of opioid naïve patients, a large retrospective cohort study from Canada has found. However, the five-year cumulative probability of injecting drug use initiation in this group was only 4%.

Naltrexone lowers hospital admissions in alcohol use disorder

27 Oct 2021Registered users

The risk of hospitalisation for an alcohol-related or other cause is lower when patients with alcohol use disorder are treated with naltrexone alone or in combination with disulfiram or acamprosate, a nationwide Swedish study has found. However, acamprosate monotherapy was associated with an increased risk of hospital admission for an alcohol-related cause.

Increased risk of attempted suicide in young problem gamblers

21 Feb 2021Registered users

Men and women, under the age of 25, with problem gambling are at increased risk of trying to take their own lives, a UK study has found.

Which treatments are effective for maintaining abstinence from alcohol in primary care?

25 Jan 2021Registered users

Acamprosate was the only intervention with evidence that it was better than placebo in maintaining alcohol abstinence for up to 12 months, following detoxification, in a network meta-analysis.

Engagement with HCV therapy linked to lower deaths from all causes in injecting drug users

27 Oct 2020Registered users

Engagement with hepatitis C treatment by people who inject drugs is associated with a lower risk of all-cause mortality and drug-related death, a study set in Scotland has found.

Patient safety incidents in opioid substitution therapy analysed

24 Jul 2020Registered users

Errors in prescribing, supervised or non-supervised dispensing, and monitoring and communication were responsible for patient safety incidents in opioid substitution treatment, a study from England and Wales has shown.

Increased risk of fatal overdose or suicide associated with stopping opioids

25 May 2020Registered users

Ceasing treatment with opioids is associated with an increased risk of death from overdose and suicide, an observational study from the United States has found.

Most deaths in patients on methadone are not drug related

23 Jan 2020Paid-up subscribers

Non drug-related morbidities are the most common cause of death as methadone-treated opioid dependent patients age, a study from Scotland has found. The study authors used information from the Community Health Index and data on methadone prescriptions held within the Scottish National Prescribing Information System for 36,606 patients who had received one or more methadone prescriptions between 2009 and 2015.

Tramadol associated with longer use of opioids after surgery

24 Jun 2019Paid-up subscribers

A study from the United States has found that patients prescribed tramadol for postoperative pain have a higher risk of prolonged opioid use relative to those given other short-acting opioids.

Alcohol use disorder affects offspring’s behaviour in adulthood

25 Mar 2019Registered users

Parental alcohol use disorder is associated with an increased likelihood of marriage to a spouse with alcohol use disorder, a Swedish population-based study has found. In particular, daughters of affected mothers were more likely to have an affected spouse.

Deaths associated with opioid overdose increase

22 Feb 2019

A study from Ontario, Canada, has found that prescribed, diverted and illicit opioids all play an important role in the recent increase in opioid-related deaths.

Childhood trauma raises risk of drug misuse later on

23 Jan 2019Registered users

Individuals who suffer abuse as children are more likely to use marijuana or cocaine later in life, a study from the United States has found.

Patients prescribed opioids for analgesia at risk of dependence

25 Jul 2018Registered users

A systematic review and meta-analysis has estimated that the incidence of iatrogenic opioid dependence or abuse in patients prescribed opioids for pain is almost 1 in 20.

Marked regional variations identified in primary care opioid prescribing

23 Apr 2018Registered users

Opioid prescribing rates are increasing and show notable geographical variations across England. They are highest in the North and in areas of social deprivation, a study on primary care prescribing has shown. Virtually all the low prescribing areas were in the south of England and nine of the ten highest prescribing areas were northern clinical commissioning groups (CCGs).

Benzodiazepines and Z-drugs are being widely used long term

23 Jan 2018Registered users

A UK primary care survey has found that many patients are taking benzodiazepines or Z-drugs, recommended for short-term use, for at least a year.

Are differing emotional responses to alcohol associated with choice of drink?

20 Dec 2017Paid-up subscribers

Emotional responses to drinking appear to vary according to the type of drink imbibed and differ between men and women, an analysis of data from the Global Drug Survey (GDS) has found.

Mortality risk raised during induction with methadone in opioid substitution therapy

23 Nov 2017Paid-up subscribers

Patients undergoing opioid substitution treatment have an increased mortality risk during the induction phase with methadone but not with buprenorphine, a meta-analysis has found. Mortality risk is also raised in the period immediately after leaving treatment with both drugs.

Gambling linked to mental health problems

22 Jun 2017Registered users

Patients with depression and those who drink at risky levels are more than twice as likely to report gambling problems, a UK primary care study has shown.

Benzodiazepine and opioid co-prescribing raises risk of opioid overdose

24 Apr 2017Paid-up subscribers

Stopping concurrent benzodiazepine and opioid prescribing could reduce the risk of inpatient admissions for opioid overdose and attendance at emergency departments by 15%, a study from the US has found.


Smoking cessation

E-cigarettes fail to help smokers quit

24 Feb 2022Registered users

Using e-cigarettes for smoking cessation neither improved the chance of quitting successfully nor helped to improve relapse rates, in a large nationally representative cohort study from the USA.

Evaluating interventions to help smokers quit

09 Aug 2021Registered users

Varenicline and a combination of pharmacological and behavioural interventions were the two most effective methods for smoking cessation, a systematic review by the US Preventive Services Task Force has found. Data on the effectiveness and safety of e-cigarettes for smoking cessation in adults were limited and study results inconsistent.

Even smoking some days increases risk of premature death

25 Jun 2021Registered users

Individuals who do not smoke every day have a significantly higher risk of all-cause mortality compared with those who have never smoked. For those who smoke daily, the mortality risk increases as the number of cigarettes smoked increases, a large study from the USA has found.

Smokers’ dependence on cigarettes has decreased over the past decade

24 Nov 2020Registered users

Between 2008 and 2017 smokers appear to have become less dependent on cigarettes but also less likely to try to quit or cut down. For those who tried to quit, fewer used behavioural support and more used pharmacological support, a study has found.

Nausea may affect adherence to varenicline

24 Sep 2020Registered users

Nausea during the first few weeks of varenicline therapy may reduce adherence, a study from North America has found. The authors analysed data on 870 adults receiving varenicline in two smoking cessation trials conducted at multiple sites in Canada and the USA.