Lead: Projected health and economic outcomes in people who inject drugs in the United States, 2025-2034: A modeling studyLead: Projected health and economic outcomes in people who inject drugs in the United States, 2025-2034: A modeling study
This Week in Addiction Medicine from ASAM
Zach Caruso presents a rapid-fire review of recent addiction medicine studies, from projected outcomes for people who inject drugs to barriers in methadone access and chronic pain care. The episode summarises key data on costs, clinical risks, and treatment experiences across multiple research articles.
8:00•20 Oct 2026
Big Numbers, Real Barriers: Fresh Research in Addiction Medicine
Episode Overview
- A microsimulation model (MYRIAD) projects large numbers of deaths, new HIV and HCV infections, and hospitalisations among people who inject drugs in the US from 2025–2034, with substantial healthcare costs.
- Daily methadone dosing visits create major travel, time, and cost burdens and may expose patients to people using and selling drugs, increasing risk of return to use.
- US mental health and substance use disorder expenditures are high in total but vary widely by diagnosis, with substance use disorders, schizophrenia, and bipolar disorder having the highest per-person costs.
- Long-term smoking cessation in people with type 2 diabetes is linked to progressively lower risks of diabetic microvascular complications, including nephropathy and neuropathy.
- Patients with opioid use disorder and chronic pain face barriers such as system–life mismatches, stigma in pain care, and treatment settings where pain management is not prioritised.
“For 3.3 million people who inject drugs over 10 years, the model predicted 487,000 deaths, 29,000 new HIV infections, 218,000 new HCV infections and reinfections, and 1.7 million hospitalizations related to injection drug use.”
How do different strategies aid in addiction recovery and treatment? This weekly news briefing from "This Week in Addiction Medicine" brings together fresh research that anyone interested in substance use care will want to hear about. Host Zach Caruso walks through a series of recent studies, starting with a sobering modelling analysis of people who inject drugs in the United States.
Using the MYRIAD microsimulation model, researchers projected that for 3.3 million people over ten years there could be "487,000 deaths, 29,000 new HIV infections, 218,000 new HCV infections and reinfections, and 1.7 million hospitalizations related to injection drug use," alongside a staggering projected healthcare cost of $565 billion. From there, the episode turns to everyday realities in treatment.
A JAMA Network Open study on methadone dosing visits shows how daily travel, fuel costs, childcare clashes, and long wait times make care hard to sustain. Patients even reported that clinic visits brought them into contact with people "using and selling drugs, risking return to use." The Modernizing Opioid Treatment Access Act is highlighted as a potential way to ease these burdens by allowing methadone access in pharmacies and addiction specialist settings.
You’ll also hear headline figures on mental health and substance use disorder expenditures in the US, long-term benefits of smoking cessation for people with type 2 diabetes, and a protocol for handling medetomidine withdrawal in intermediate care units. Other featured research compares buprenorphine and methadone outcomes for opioid use disorder, examines how often alcoholic ketoacidosis is missed in emergency departments, and shares qualitative findings on chronic pain treatment barriers among patients receiving opioid agonist therapy who inject drugs.
It’s a brisk, fact-packed roundup designed for people who need the latest evidence at their fingertips and appreciate straight-to-the-point summaries. Which of these findings might change the way you think about addiction treatment and recovery?
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