Lead: Comparison of buprenorphine treatment by virtual-only vs. traditional cliniciansLead: Comparison of buprenorphine treatment by virtual-only vs. traditional clinicians
This Week in Addiction Medicine from ASAM
A concise news briefing walks through recent studies in addiction medicine, from tele-buprenorphine and rural methadone access to xylazine trends and COVID risks in substance use disorders. It also touches on emerging treatment approaches for methamphetamine use and the impact of cannabis use in early-onset psychosis.
7:42•14 Jul 2026
Buprenorphine, Telemedicine, and New Frontiers in Addiction Care
Episode Overview
- Virtual-only buprenorphine care showed more follow-up visits and higher six-month treatment presence, though with fewer continuous treatment days.
- Methadone opioid treatment programmes are far less available in rural counties than urban ones, revealing a major access gap.
- Xylazine positivity and concentration in fentanyl-positive urine tests were higher in eastern states and increased with higher fentanyl levels.
- Substance use disorders more than doubled mortality odds among adults with COVID-19, reflecting clinical and social risk factors.
- Effective care for methamphetamine use disorder often requires combining pharmacological, behavioural, and neuromodulation approaches rather than relying on a single modality.
“Having an SUD more than doubled the odds of mortality from COVID.”
Understand the complexities of addiction with insights from current research as this news briefing walks through a packed line-up of recent studies in addiction medicine. Aimed at clinicians, policy makers, and anyone interested in evidence-based care, you'll get a rapid-fire tour of what’s changing in treatment and risk assessment across multiple substances. The episode opens with a look at buprenorphine care, comparing virtual-only clinicians with traditional in-person prescribers.
Patients starting buprenorphine virtually had more follow-up visits and were more likely to still be on buprenorphine at six months, but had fewer days of continuous treatment, a finding that feeds into ongoing debates about telemedicine quality. Rural access comes into sharp focus with data on methadone treatment: 46% of urban counties had a Medicare-enrolled opioid treatment programme, compared with just 6% of rural counties, highlighting significant geographic barriers.
The conversation then shifts to xylazine mixed with fentanyl, noting that “for every tenfold increase in fentanyl concentration, the odds of xylazine detection increased 55%,” with higher xylazine positivity and concentration in eastern states. You’ll also hear about a qualitative study of people on methadone who use cocaine, where emotional distress, cravings, and environmental triggers drive ongoing cocaine use, even as opioid use falls.
Another key segment examines substance use disorders and COVID-19, where having an SUD more than doubled the odds of mortality, underlining the role of medical comorbidities and social determinants of health. Short, practical highlights follow on intranasal versus intravenous naloxone in paediatric opioid poisoning, emerging and established treatments for methamphetamine use disorder, and the impact of cannabis use and cannabis use disorder in early-onset psychosis.
If you’re looking to keep your practice aligned with the latest evidence, this brief is a handy way to stay up to date and spark deeper reflection on your own approach to treatment.
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