Articles That Changed Our Practice 2026 (Part 1)Articles That Changed Our Practice 2026 (Part 1)
Addiction Medicine Journal Club
Two addiction specialists review four recent studies that changed how they treat opioid and stimulant use disorders, using real patient cases to show what they now do differently. The conversation focuses on practical outcomes like mortality, treatment retention and how much behavioural therapy is actually needed alongside medication.
36:43•30 Mar 2026
Four Research Papers That Changed Addiction Practice in 2026
Episode Overview
- Contingency management for stimulant use disorder in the VA cohort was linked with a 41% reduction in mortality and higher healthcare use, strengthening its role as a key intervention despite funding and regulatory barriers.
- A rapid induction protocol for injectable extended-release buprenorphine (4 mg sublingual then 300 mg injection same visit) showed better early retention, especially in fentanyl-positive patients, without higher withdrawal rates than standard induction.
- Comparative data from Canada suggest methadone keeps more people in treatment over 24 months than buprenorphine–naloxone, with low mortality in both groups, supporting methadone as a strong option where accessible.
- Secondary analysis of four randomised trials found that adding structured behavioural therapy to buprenorphine and medical management did not improve opioid use, retention, or functional outcomes across multiple subgroups.
- The hosts describe moving away from rigid requirements for counselling or intensive programmes, instead individualising behavioural support while keeping medication access central.
“"If you want to just get off opioids, medication is pretty much what you need, if that's your end goal."”
What drives someone to seek a life without alcohol and other drugs, and how can research actually make that easier in day-to-day practice? Addiction Medicine Journal Club tackles that question head-on by picking four "articles that changed our practice" and turning dense data into practical, clinic-ready tips. Hosted by addiction medicine doctors Dr. Sonia Del Tredici and Dr. John Keenan, the show speaks directly to clinicians, trainees and researchers who are drowning in Medline.
With more than 2 million medical papers out there, they joke about the "ever-ballooning" literature and offer this journal club as a way to find "needles in the research haystack" you can actually use with real patients. Across four detailed case studies, you'll hear how one large VA study on contingency management for stimulant use shaped their approach to methamphetamine use disorder, including a striking "41%" reduction in mortality. They share the very human side too—Dr.
Del Tredici’s self-funded prize box and the many barriers to funding proper incentives. A second case walks through rapid versus standard induction to injectable buprenorphine, giving hope for patients stuck in fear of precipitated withdrawal: "This is one of the few times where I've like read an article and I'm like, yeah, I can do that. And I did.
And it worked." The hosts then compare buprenorphine/naloxone and methadone using modern Canadian data, using it to have more honest conversations about transport, regulations and what actually keeps people in treatment.
Finally, they revisit their old habit of requiring intensive behavioural treatment for everyone, and a pooled analysis of four trials reassures them that medication alone can be enough for many people who "just want to get off opioids." It’s evidence-heavy, candid, and full of the kind of self-reflection that experienced clinicians rarely say out loud—perfect if you want research that genuinely shifts how you talk to patients tomorrow. Which of these four changes might influence your own practice first?
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