Healing is an Act of Communion
By Jessica Gregg, MD, PhD, FASAM
Contributing Editor
When my son was very young and crying with a fever or because he was afraid of things that might be hiding in the dark, I'd hold him close and murmur comforting nonsense, things like "Hey, hubba bubba," or "Oh, sweet potato."
My son is grown now and no longer comes to me in tears. But one day at work, toward the end of a long day of patient care, three men in a row cried in the exam room, each having lost jobs, homes, and families to substance use. It was an avalanche of despair, and I was tired and empty. As I sat with the last of them, a burly, bearded man in his 40s, he said through his tears, "I'm just so sad. So f***ing sad."
I replied without thinking, "Oh, sweet potato."
He was quiet for a moment, then wiped his eyes. "Did you just call me sweet potato?"
I nodded and half-laughed, embarrassed. Then he grinned and laughed too, and we sat there, smiling at each other, each of us enjoying the moment's ridiculousness and, I think, its tenderness.
The philosopher and author bell hooks once wrote, "Rarely, if ever, are any of us healed in isolation. Healing is an act of communion." That is, healing requires connection. That was what I felt that day with that patient: an almost palpable connection, an energy shift, resonant and replenishing.
But connection usually requires time, and often, in medicine, we don't have enough of it.
Long-Acting Injectables for Substance Use Disorders
This resource guide compares the three formulations of extended-release, long-acting treatments for substance use disorder. It highlights differences in dosing, administration, and proper injection technique.
Lead Story
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The American Journal of Psychiatry
Accumulating preclinical and observational evidence suggests that glucagon-like peptide-1 receptor agonists, including semaglutide, reduce alcohol consumption. This phase 2 double-blind, randomized, parallel-arm trial evaluated the effects of oral semaglutide on alcohol craving and consumption among treatment-seeking adults with alcohol use disorder (AUD). Researchers found that semaglutide did not significantly reduce laboratory-assessed craving or drinks per day compared with placebo but significantly reduced heavy drinking days. Semaglutide also significantly reduced drinks per drinking day, naturalistic alcohol craving, and cannabis use days. Semaglutide reduced alcohol-related consequences at a significantly greater rate than placebo. Significantly more participants in the semaglutide group than the placebo group reduced their risk drinking level by one or more levels. These findings confirm previous results among non-treatment seekers with less severe AUD and suggest that continued development of semaglutide for AUD is warranted.
The National Institute on Drug Abuse (NIDA) has issued a Request for Information (RFI) inviting feedback on the .
To view the RFI and submit feedback, please see:
To ensure consideration, responses must be submitted by: September 21, 2026, 11:59:59 PM EST
Research and Science
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Addiction Biology
Heart rate variability (HRV) is the fluctuation in the interval between heartbeats and is known to reflect activity of the autonomic nervous system. This study examined the relation between HRV and craving in patients being treated for AUD in their first year of recovery. Patients (n=40) underwent 4 days of continuous ECG recordings to measure HRV and randomly completed estimates of their level of craving. The results showed a significant but complex association between HRV and craving: an index of HRV associated with respiration increased during craving (p=.01), and an index of HRV that reflects simple beat-to-beat variability decreased during craving (p=.02). The authors speculate that this could indicate that craving involves both automatic as well as cognitive processes. These results confirm the feasibility of using HRV calculated by smartwatches and fitness trackers as a real-time measure of craving.
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Respiratory Medicine
Small airway dysfunction (SAD) was defined by spirometry with maximal mid-expiratory flow values less than 65% of predicted value (MMEF<65%). For this study, data were obtained from a previous study of the prevalence of SAD in the general population of Lausanne, Switzerland. THC use disorder was identified from patient history using DSM IV criteria. The original study included a baseline group (n=2,826) and a follow-up group (n=1,841). In an unadjusted model, SAD and THC use disorder were significantly associated in both groups (baseline group OR=2.37, follow-up group OR=1.83). However, after correcting for BMI, smoking status, age, and sex, there was a significant association of THC use disorder and SAD only in the baseline sample (OR=1.94). The authors note the low prevalence of THC use disorder in both groups as a weakness. They conclude that THC use disorder seemed to be associated with an increased prevalence of SAD.
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Substance Use and Addiction Journal
Training programs to improve self-management for many chronic diseases already exist but have not been previously implemented for substance use disorders (SUD). Researchers conducted a pilot randomized controlled trial to assess a nurse-led Self-Management of Substance Addiction Consequences program (ADS program) compared to treatment as usual (TAU) among patients in medication-based treatment programs. In both the ADS program and TAU arms there was a statistically significant decrease in substance addiction consequences. Positive mental health improved in both arms, but the improvement was statistically significant only in the ADS arm. Notably there was a significant dropout rate in both arms. The researchers plan for a follow-up study with a larger sample size and increasing period of intervention from 6 to 18 weeks.
JAMA Psychiatry
Among adolescents who vaped nicotine and were undergoing substance use disorder treatment, this study observed an abrupt increase in cotinine concentrations from 2023 to 2025. This finding suggests new exposures among this population to products with higher nicotine concentrations or additives that make nicotine more bioavailable or engender greater use or deeper inhalation. E-cigarette products have evolved rapidly from low-concentration e-liquids to pod-based systems with higher concentration nicotine salts and to disposable devices with larger-capacity tanks. The amount of concentrated nicotine salt containing fluid in disposable e-cigarettes rose dramatically from 2019 to 2024; any innovation increasing nicotine absorption could explain the study's observations.
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JAMA Psychiatry
This is a cross-sectional study using data from the 2021 to 2024 National Surveys on Drug Use and Health (NSDUH) to evaluate trends in AUD and CUD prevalence and severity by age and sex. Data from 186,823 participants aged 18 and older were included. From 2021 to 2024, past-year CUD prevalence increased from 7.3% to 9.3% in males, while AUD prevalence remained stable. In this same time period, CUD prevalence in females increased from 4.5% to 5.6% while AUD prevalence declined from 9.7% to 8.2%. In individuals between 18-20 years of age, CUD prevalence (14.5%–14.9%) exceeded AUD prevalence (10.3%–10.4%).
ASAM Publications Council Call for Applications
ASAM is seeking up to 3 members to serve on the Publications Council beginning in January 2027. Council members should have experience in addiction medicine and familiarity with the writing and publishing process. The Publications Council is charged with overseeing ASAM publications. The Council approves publication editors, evaluates proposals for new publications, ensures adequate publisher performance, and regularly furnishes the Board of Directors with updates on publication activities.
Please first log into your ASAM member portal and . The closing date is September 21, 2026.
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Journal of Substance Use and Addiction Treatment
For this qualitative study, researchers conducted semi-structured interviews with 23 individuals who had recently survived an opioid overdose, focusing on service utilization and drug use history, contextual factors related to overdose, service use after overdose, and wellbeing. About half of participants reported a 911 call at the time of overdose, and one-third went to the hospital. Several beliefs were highlighted that impacted health care engagement: a belief that they could manage the overdose at home, a lack of trust in responders, concerns about legal issues/unintended consequences, and financial costs.
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Alcohol
Animal studies have shown that adolescent alcohol exposure can impair behavioral flexibility, but the link in humans needs exploration. Researchers examined the association between adolescent binge alcohol use and past-year alcohol use in adults with habitual behavior and attentional bias, both of which contribute to behavioral inflexibility. Adolescent binge drinking was associated with increased habitual behavior, while both adolescent binge drinking and increased past-year alcohol use in adulthood were associated with attentional bias. These findings suggest both behaviors may contribute to behavioral inflexibility, but in different ways. However, the researchers note additional longitudinal research is needed, particularly examining age of binge use in adolescents.
Now through August 31st, the American Society of Addiction Medicine (ASAM) has made available for public comment a draft of the proposed standards for the Correctional Settings and Reentry Volume of the 4th Edition of The ASAM Criteria®. For more information and instructions to review, please .
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