71-80 Round-Up71-80 Round-Up
Addiction Medicine Journal Club
This round‑up brings together ten recent addiction medicine studies, from buprenorphine and alcohol withdrawal to stimulants, opioids and liver disease. The hosts offer quick evidence summaries and practical clinical bottom lines for time‑pressed clinicians and recovery professionals.
52:35•24 Aug 2026
Ten High‑Impact Addiction Studies in One Fast Round‑Up
Episode Overview
- Transmucosal buprenorphine is associated with a modestly increased rate of coded dental problems, prompting stronger dental hygiene counselling rather than stopping treatment.
- Symptom‑triggered alcohol withdrawal managed by telemedicine with diazepam appears feasible, safe and well‑accepted, with high completion rates and strong linkage to medications for alcohol use disorder.
- Longer initial opioid prescriptions, long‑acting opioids and tramadol are linked to higher risk of year‑long opioid use, reinforcing the need to keep early courses short and cautious.
- Contingency management for stimulant use disorder in a large VA cohort is associated with substantially lower mortality, supporting wider adoption despite funding and stigma barriers.
- Phenobarbital‑based hospital protocols for alcohol withdrawal reduce benzodiazepine use, withdrawal scores, treatment duration and length of stay without increasing intubation or mortality.
“I just really feel like I have yet to see a study that shows that injectable buprenorphine is worse.”
What drives someone to seek a life without alcohol and other drugs, and how can busy clinicians keep up with the research that actually helps? This round‑up episode brings together ten recent studies on addiction care, stitched into a fast, funny and very practical conversation between two addiction doctors. You’ll hear Sonya and John move briskly from buprenorphine and dental problems to telemedicine alcohol withdrawal, long‑term opioid use after a first prescription, and multiple angles on injectable buprenorphine.
They joke about dementia screening with “apple, penny, church” and clock‑drawing, but the thread is serious: giving front‑line clinicians quick evidence they can actually use. Each paper gets a compressed summary plus a clear “clinical bottom line”. For example, telehealth symptom‑triggered diazepam for uncomplicated alcohol withdrawal looks safe and acceptable, while a hospital‑wide phenobarbital order set cuts withdrawal severity and shortens admissions without extra safety problems.
On buprenorphine, they weigh dental risk, quick‑start injections, use in pregnancy, and a bold **direct‑to‑inject** protocol for people using fentanyl, where many patients had little or no withdrawal and stuck with treatment.
They also tackle broader system issues: contingency management for stimulant use disorder linked to markedly lower mortality in a large VA cohort, a harsh critique of Epic’s opaque opioid risk score that barely identifies those who go on to overdose, and powerful survival benefits from using one, two or even three medications for alcohol use disorder in people with severe liver disease.
The style is conversational, slightly irreverent, and aimed squarely at clinicians and recovery professionals who are short on time but want solid data. If you’re juggling clinics, groups or hospital shifts and wondering which new findings are worth attention, this rapid round‑up might help you decide what to try next in your practice—what’s the one change you’d start with?
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