Lead: Benzodiazepine tapering: Evidence limitations and research recommendationsLead: Benzodiazepine tapering: Evidence limitations and research recommendations
This Week in Addiction Medicine from ASAM
A concise news briefing summarising recent addiction medicine studies on benzodiazepine tapering, stimulant pharmacotherapies, harm reduction, gambling risks, and overdose patterns. The episode focuses on what the current evidence shows, where major gaps remain, and how new findings may shape future guidelines and care.
7:28•16 Jun 2026
Benzodiazepine Tapers, Stimulant Medications and Harm Reduction: A Week in Addiction Research
Episode Overview
- Evidence for benzodiazepine tapering is limited, with many studies using faster dose reductions than current recommendations and offering little long-term outcome data.
- Pharmacotherapy trials for stimulant use disorder have not shown clear benefits over placebo for abstinence, though reduced use may still hold clinical value.
- Xylazine has a longer half-life in humans than in animals and is linked with hypotension, bradycardia, and hyperglycaemia in overdose cases.
- Initiating opioid agonist taper within 12 months may increase taper completion but is also associated with higher all-cause mortality, supporting longer stabilisation on treatment.
- Provision of safer smoking equipment for people who use crack can reduce pipe sharing and injecting while improving engagement with health and social services.
“The authors conclude the evidence base for tapering benzodiazepines is deficient and list 10 areas for future research.”
What can we learn from those who have battled addiction? This weekly round-up from "This Week in Addiction Medicine" gives anyone interested in treatment, research, or policy a fast snapshot of what’s happening in the field, with a strong focus on evidence and clinical practice. Hosted by Zach Caruso for the American Society of Addiction Medicine, the episode headlines a systematic review on benzodiazepine tapering that fed into the 2025 Joint Clinical Practice Guideline.
You’ll hear how many published taper schedules cut doses far more quickly than current recommendations, sometimes by 25–50% in the first couple of weeks, and how there’s “little information on long-term outcomes such as protracted withdrawal and quality of life.” It’s a clear signal that people prescribed benzodiazepines, and those supporting them, still don’t have the solid data they deserve.
The episode then moves briskly through several major studies: a meta-analysis showing no medication yet clearly outperforms placebo for stimulant use disorder, research on xylazine and fentanyl overdoses, and data on when people taper off opioid agonist treatment and how that links to mortality. Harm reduction gets attention too, with evidence that providing safer smoking equipment for people who use crack can reduce pipe sharing, injection, and boost engagement with services.
Caruso also summarises a call for better screening and treatment of gambling problems, a look at postmortem toxicology in Illinois opioid overdose deaths, and a study on how methamphetamine and MDMA affect tryptophan pathways differently and may relate to depression and psychosis. The style is concise and clinical, but still accessible enough that you don’t need to be a researcher to follow along.
If you’re in recovery, supporting others, or working in addiction care, this episode offers a quick but rich update on where the evidence currently stands—and where it’s still missing. Which of these research gaps matters most to you right now?
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