Lead: Methadone Dose and Patient-Directed Discharge in Hospitalized Patients with Opioid Use DisorderLead: Methadone Dose and Patient-Directed Discharge in Hospitalized Patients with Opioid Use Disorder
This Week in Addiction Medicine from ASAM
Zach Caruso summarises recent addiction medicine research, from methadone dosing and methamphetamine treatment to cannabis use, internet addiction, and brain markers of opioid craving. The episode highlights key findings that may influence clinical decisions and future studies across multiple substance use disorders.
6:03•14 Apr 2026
Methadone Dosing, Drug Use Disorders, and New Addiction Science in Focus
Episode Overview
- Higher methadone doses in the first 24 hours of hospitalisation were associated with reduced odds of patient-directed discharge in people with opioid use disorder.
- Mirtazapine reduced days of methamphetamine use compared with placebo in adults with methamphetamine use disorder without unexpected safety issues.
- Early cannabis use before age 15 was associated with increased odds of opioid use disorder and heroin and fentanyl use, even after adjusting for other factors.
- Higher levels of internet addiction in adolescents were linked with more depression and anxiety and lower quality of life, suggesting a need for mental health screening.
- Evidence for psychological and pharmaceutical treatments for cannabis use disorder exists but is rated as low to very low certainty, indicating more research is needed.
“This study highlights the importance of adequate treatment of opioid withdrawal to reduce the risk of PDD.”
Understand the complexities of addiction with insights from cutting-edge research in this fast-paced news briefing from "This Week in Addiction Medicine". Hosted by Zach Caruso, the episode rounds up several major new studies, making it ideal for clinicians, researchers, and anyone who likes their science evidence-heavy and straight to the point. The lead story focuses on hospital care for people with opioid use disorder.
A JAMA Network Open study of 554 patients looked at methadone dosing in the first 72 hours of hospitalisation and how it relates to patient-directed discharge (PDD). Higher early methadone doses were linked with fewer patients leaving hospital against medical advice, summed up clearly with the line: "This study highlights the importance of adequate treatment of opioid withdrawal to reduce the risk of PDD." From there, the episode moves through several other big topics.
A phase 3 trial in JAMA Psychiatry reports that mirtazapine reduced methamphetamine use in adults with methamphetamine use disorder, with no unexpected safety issues. Another study digs into brain changes and behaviour in cocaine use, showing how extracellular matrix changes can affect hyperactivity and threat perception in mice. Listeners also hear about population-level data on early cannabis use and later opioid use disorder, including links with injection heroin and fentanyl use.
On the behavioural side, there’s an overview of internet addiction among Indian adolescents and its association with depression, anxiety, and reduced quality of life. The episode wraps with a network meta-analysis on treatments for cannabis use disorder, and a brain imaging study identifying whole-brain connectivity patterns that predict incubation of opioid craving in rats.
If you like concise, research-focused updates that can inform practice and spark discussion about treatment options and risks, this one packs a lot into a short listen. Which finding challenges your assumptions most?
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