Addiction Treatment Research Articles

Offering nurse care management for opioid use disorder in primary care: Impact on emergency and hospital utilization in a cluster-randomized implementation trial

BackgroundPatients with opioid use disorder (OUD) have increased emergency and hospital utilization. The PROUD trial showed that implementation of office-based addiction treatment (OBAT) increased OUD medication treatment compared to usual care, but did not decrease acute care utilization in patients with OUD documented pre-randomization (clinicaltrials.gov/study/NCT03407638). This paper reports secondary emergency and hospital utilization outcomes in patients with documented OUD in the PROUD trial. MethodsThis cluster-randomized implementation trial was conducted in 12 clinics from 6 diverse health systems (March 2015-February 2020). Patients who visited trial clinics and had an OUD diagnosis within 3 years pre-randomization were included in primary analyses; secondary analyses added patients with OUD who were new to the clinic or with newly-documented OUD post-randomization. Outcomes included days of emergency care and hospital utilization over 2 years post-randomization. Explanatory outcomes included measures of OUD treatment. Patient-level analyses used mixed-effect regression with clinic-specific random intercepts. ResultsAmong 1988 patients with documented OUD seen pre-randomization (mean age 49, 53 % female), days of emergency care or hospitalization did not differ between intervention and usual care; OUD treatment also did not differ. In secondary analyses among 1347 patients with OUD post-randomization, there remained no difference in emergency or hospital utilization despite intervention patients receiving 32.2 (95 % CI 4.7, 59.7) more days of OUD treatment relative to usual care. ConclusionsImplementation of OBAT did not reduce emergency or hospital utilization among patients with OUD, even in the sample with OUD first documented post-randomization in whom the intervention increased treatment.

Exploring help-seeking pathways and disparities in substance use disorder care in India: A multicenter cross-sectional study.

Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. This was a cross-sectional study of consecutive, consenting adults (18-65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization's pathway encounter form. Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4-6%) and self-medication (2-8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare.

A Grounded Theory Exploration of Addictions Treatment Within a Commercial Airline Setting.

INTRODUCTION: An Australasian Airline's Alcohol and Other Drug (AOD) Program demonstrates abstinence rates that exceed those of general AOD programs. The reasons for this are unclear. The purpose of this research was to develop a theory as to why this program is successful.METHODS: A qualitative examination following grounded theory methodology was undertaken. AOD program patients and healthcare professionals were interviewed until content saturation was reached. Data analysis followed grounded theory to identify the key concepts associated with the program's success.RESULTS: The core theory that emerged highlighted the pivotal roles of a strong employee-company relationship, shared values, and a safety-focused culture in explicating the program's success. This moves beyond the "carrot and stick" model of motivation, where belonging to this organization and safety consciousness serve as powerful drivers for abstinence. Challenges and barriers highlighted some unique challenges to the program in managing the coronavirus pandemic and the difference in approach to substance use in community spaces versus safety-critical employment.DISCUSSION: This research expands the understanding of this AOD program's success in a safety-critical industry, emphasizing the elements of a working relationship that are beyond positive or negative reinforcement. Future research should work to quantify and test the generalizability of these findings.Nairn J, Bell E, Myers J, Higgins M, Johnston B, Newton-Howes G. A grounded theory exploration of addictions treatment within a commercial airline setting. Aerosp Med Hum Perform. 2024; 95(6):313-320.

Drugs and Juvenile Delinquency based on Educational Research: Case Study at the Drug Rehabilitation Center of YPAP Lhokseumawe City

Drugs and Juvenile Delinquency based on Educational Research: Case Study at the Drug Rehabilitation Center of YPAP Lhokseumawe City

Analysis of factors self-harm behaviour among adolescents undergoing drug rehabilitation in Indonesia

Introduction: The study aimed to analyse the factors associated with self-harm behaviour in adolescents in drug rehabilitation. Methods: This study used a descriptive-correlative design with a cross-sectional approach. The sample in this study was 241 adolescents who were in drug rehabilitation using the purposive sampling technique. This research was conducted in the Lido Centre for the Rehabilitation of the National Narcotics Agency, the Lampung Centre for Rehabilitation of the National Narcotics Agency, the Cipinang Besar Utara Narcotics Penitentiary, the Special Prison for Children of Jakarta, Lampung Narcotics Penitentiary, and the Al Islamy Foundation. This study used five questionnaires, namely the Internalized Stigma of Mental Illness, Self-Identity Questionnaire, UCLA Loneliness Scale Version 3, and the Deliberate Self-Harm Inventory. This study was analysed using a logistic regression test. Results: The results of the logistic regression analysis showed that, from several factors related to self-harm, namely loneliness, self-identity, and stigma, two factors that are most related to self-harm behaviour are self-identity and stigma, with a p-value of 0.000 (p<0.05). Conclusions: Self-harm behaviour can occur due to factors such as self-identity and stigma. This research can be a basis for providing nursing interventions to adolescents undergoing drug rehabilitation. Appropriate nursing interventions can help adolescents undergoing drug rehabilitation control the self-harm behaviour they want to engage in. Researchers recommend the importance of interventions aimed at strengthening self-identity and reducing stigma in efforts to prevent and treat self-harm behaviour. Additionally, future research is recommended to consider other variables that may also contribute to this behaviour.

Clinical specificities of patients with substance use disorder and comorbid borderline personality disorder compared to patients with substance use disorder only: a retrospective study

Introduction Substance use disorder (SUD) is a common condition often associated with borderline personality disorder (BPD), and patients with both disorders (SUD + BPD) have more complex presentations and poorer outcomes in treatment. Thus, there is a need to identify more clearly the clinical differences between patients with SUD + BPD and those with SUD only to help clinicians in their diagnostic process. Methods Data from medical files of 92 patients with SUD (SUD only: n = 42; SUD + BPD: n = 50) treated in an outpatient psychiatry and addiction treatment center were extracted to compare the differences in terms of sociodemographic characteristics, substance used, psychopathological dimensions, comorbidity prevalence, and functional impairment. Results Compared to the SUD only group, patients in the SUD + BPD group were younger, more disabled, and less satisfied with their social life. Regarding substance used, the comorbid group had more frequently cannabis use disorder and poly nonalcoholic SUD. Regarding psychopathological dimensions, the comorbid group had higher levels of impulsivity, emotion regulation difficulties and alexithymia. Finally, regarding comorbidities, the comorbid group had a higher risk of comorbid anxiety, obsessive-compulsive, and post-traumatic stress disorders. Conclusion While being only exploratory, these results add evidence on the impact of the BPD comorbidity in patients with SUD and underline important dimensions that should be considered by clinicians working with this population.

Pertanggungjawaban Pidana Anak Pelaku Penyalahguna Narkotika Perspektif Hukum Pidana Islam

Decision number 03/Pid.sus-Anak/2018/PN.Skt regarding child offenders who abuse narcotics even though the child has been legally and convincingly proven guilty in article 127 paragraph 1 letter a of law number 35 of 2009, but the child is only given a lenient criminal sentence. The research was conducted to examine the criminal liability of children as drug users. The research method used is qualitative research with normative research. The data analysis techniques used is content analyis. The result of this research explain that the criminal responsibility of children who abuse drugs in verdict number 03/Pid.sus-Anak/2018/PN.Skt is because children have fulfilled the theory of criminal responsibility and based on law number 11 of 2012 children can be held accountable for their actions, the sentence given is to undergo treatment at the SINAI Sukoharjo Mental and Drug Rehabilitation Foundation for 6 (six) months, the decision is also based on the judge’s consideration. Meanwhile, in Islamic criminal law, children as perpetrators of criminal acts will not be subject to punishment in the form of hudud, qishas/diyat, or ta’zir. Children will only be subject to ta’dibi which is coaching that provides lessons but does not affect their psycholog.

Comparison of psychological reactions, fear of negative evaluation and mood–emotional alexithymia in successful and unsuccessful people in addiction recovery: a survey of Baluchestan in Iran

The aim of this study was to examine psychological responses, fear of negative evaluation, and mood-related alexithymia in individuals in addiction recovery who have succeeded versus those who have not. This study employed a causal-comparative design. The research focused on all individuals who sought treatment for addiction at clinics within a specific district in Zahedan city, Iran. Out of the group, 100 individuals were chosen (50 who successfully stopped their addiction and 50 who were unsuccessful in their attempts to quit) through convenience sampling. Data were gathered using the depression, Anxiety, and Stress Scale (DASS-21), Lori’s fear of negative evaluation scale, and Toronto’s mood–emotional alexithymia scale. Data were examined through both descriptive statistics and multivariate analysis of variance. Based on the results, successful and unsuccessful individuals in addiction recovery showed varying levels of depression, stress, fear of negative evaluation, and having no fear of negative evaluation (p < .01). In simpler terms, unsuccessful individuals in addiction recovery scored higher in depression, stress, fear of negative evaluation, inability feeling emotions, inability to express feelings compared to successful individuals. But successful individuals in addiction recovery obtained higher mean scores than unsuccessful individuals in addiction recovery on having no fear of negative evaluation. According to the findings psychological reactions, fear of negative evaluation and mood–emotional alexithymia play a significant role in addiction treatment and can be helpful in addiction recovery in unsuccessful people in addiction recovery. It is feasible to enhance the effectiveness of addiction recovery by implementing interventions that target the reduction of depression, stress, fear of negative evaluation, and alexithymia.

Nanotechnology-Enhanced Naloxone and Alternative Treatments for Opioid Addiction.

Opioids are commonly prescribed to address intense, ongoing pain associated with cancer, as well as long-lasting noncancer-related pain when alternative methods have proven ineffective. Individuals who exhibit both chronic pain and misuse of opioids face a significant danger of experiencing adverse health outcomes and the potential loss of life related to opioid use. Thus, there is a current movement to prescribe naloxone to those considered high-risk for opioid overdose. Naloxone has been explored as an antidote to reverse acute respiratory depression. Conversely, naloxone can give rise to other problems, including hypertension and cardiac arrhythmias. Thus, the importance of nanotechnology-enabled drug delivery strategies and their role in mitigating naloxone side-effects are significant. In this review, we explore the latest advancements in nanotechnology-enabled naloxone and alternative methods for addressing the opioid crisis through the utilization of non-opioid natural alternatives for chronic pain management.

Proteomic Landscape Associated with Cognitive Impairment in Individuals with Long-term Methamphetamine Dependence.

Methamphetamine (METH) is a highly addictive drug that directly affects the central nervous system. METH use not only harms the user's health but also poses risks and costs to society. Prolonged METH dependence has been shown to impair cognition, which may be the primary factor in impulsive drug-seeking behaviors and high relapse rates. However, the molecular mechanisms underlying METH addiction and METH-induced cognitive decline remain poorly understood. To illuminate the potential molecular mechanisms underpinning METH addiction, we compared serum protein expression levels between 12 long-term METH users and 12 healthy controls using label-free quantitative proteomics. Bioinformatic analyses were conducted to determine functional networks and protein-protein interactions. In total, 23 differentially expressed proteins were identified between the two groups. The differentially expressed proteins were related to cognitive dysfunction, neuroinflammation, immune impairment, metabolic disturbances, and calcium binding and regulation. These 23 proteins may underpin the multi-system damage induced by chronic METH exposure. Our findings provide novel insights into the molecular basis of METH addiction and inform potential prevention and treatment strategies for individuals with METH dependence.

Feasibility of a pioneer social service treatment for gambling disorder—The first 6-month follow-up data

Gambling disorder can be treated with cognitive behavioral therapy (CBT), but treatment is under-dimensioned in many settings. For example, in Sweden, a setting with mixed responsibility for addiction treatment between health care and social services, treatment for gambling disorder has only recently been introduced in the responsibilities of public institutions. After the introduction of gambling in treatment legislation in 2018, few studies have assessed the real-world feasibility of such treatment. In addition, treatment in social services specifically has not been documented or evaluated, and therefore, in a pioneer gambling treatment facility in such a setting, this study aimed to investigate treatment outcome in patients with gambling disorder six months after completed CBT treatment within a social service setting. Twenty patients receiving CBT treatment during 2018–2020 were followed with respect to gambling habits at end of treatment and at follow-up six months after treatment. The National Opinion Research Center DSM Screen for Gambling Problems (NODS) was used as screening tool. Rates of gambling abstinence, as well as subjective experience of the treatment, are reported. Ninety percent of the patients were abstinent from gambling at six-month follow-up, and 95 percent of the patients no longer fulfilled criteria of a gambling disorder. In conclusion, these pilot results suggest that CBT treatment is a feasible method for treatment of gambling disorder also in a social service setting. However, due to the limited sample size of this pilot study, and the limited background information of clients who could not be reached, future studies with larger sample sizes are needed.

Data from NAATP build case for value of extended residential treatment

On a conference day that National Association of Addiction Treatment Providers (NAATP) CEO Marvin Ventrell dubbed “science day,” one statistic stood out to qualify as the data point of the day. The chief science officer at Cumberland Heights Foundation, an active participant in NAATP's groundbreaking Foundation for Recovery Science and Education (FoRSE) outcomes project, cited 2023 readmission statistics across all levels of care in the Nashville‐based organization. At one‐year post‐discharge, patients whose treatment stay had been shorter than 30 days had a readmission rate of 25%. For those whose stay had been longer than 30 days, the readmission rate was only 3%.

Multiple marginalized identities: A qualitative exploration of intersectional perinatal experiences of birthing people of color with substance use disorder in Massachusetts

IntroductionRacial and ethnic inequities persist in receipt of prenatal care, mental health services, and addiction treatment for pregnant and postpartum individuals with substance use disorder (SUD). Further qualitative work is needed to understand the intersectionality of racial and ethnic discrimination, stigma related to substance use, and gender bias on perinatal SUD care from the perspectives of affected individuals. MethodsPeer interviewers conducted semi-structured qualitative interviews with recently pregnant people of color with SUD in Massachusetts to explore the impact of internalized, interpersonal, and structural racism on prenatal, birthing, and postpartum experiences. The study used a thematic analysis to generate the codebook and double coded transcripts, with an overall kappa coefficient of 0.89. Preliminary themes were triangulated with five participants to inform final theme development. ResultsThe study includes 23 participants of diverse racial/ethnic backgrounds: 39% mixed race/ethnicity (including 9% with Native American ancestry), 30% Hispanic or Latinx, 26% Black/African American, 4% Asian. While participants frequently names racial and ethnic discrimination, both interpersonal and structural, as barriers to care, some participants attributed poor experiences to other marginalized identities and experiences, such as having a SUD. Three unique themes emerged from the participants' experiences: 1) Participants of color faced increased scrutiny and mistrust from clinicians and treatment programs; 2) Greater self-advocacy was required from individuals of color to counteract stereotypes and stigma; 3) Experiences related to SUD history and pregnancy status intersected with racism and gender bias to create distinct forms of discrimination. ConclusionPregnant and postpartum people of color affected by perinatal SUD faced pervasive mistrust and unequal standards of care from mostly white healthcare staff and treatment spaces, which negatively impacted their treatment access, addiction medication receipt, postpartum pain management, and ability to retain custody of their children. Key clinical interventions and policy changes identified by participants for antiracist action include personalizing anesthetic plans for adequate peripartum pain control, minimizing reproductive injustices in contraceptive counseling, and addressing misuse of toxicology testing to mitigate inequitable Child Protective Services (CPS) involvement and custody loss.

Sexual Integration Therapy: a sex-positive sexual health model supporting authentic sexual expression, while addressing sexual compulsivity, shame, fear and trauma

Sexual Integration Therapy (SIT) is a client-centered sexual health model that focuses on the holistic integration of authentic sexuality and pleasure. SIT prioritizes working with clients to resolve the impact of sexual shame, fear, and past traumas that interfere with pleasurable sexual expression. While some clients may find pathology or addiction-based models helpful for their sexual concerns, SIT supports those who do not find solely cognitive-behavioral pathology, nor addiction treatment models effective. Through an examination of the evolution of psychology’s problematic, subjective codifications of normal versus abnormal, paraphilic, or deviant sexuality, the authors demonstrate the potential risks of diagnostic pathologization. SIT moves beyond such problematic pathology-based diagnostic models and redefines normal sexuality as uniquely personal. The authors then detail how SIT builds upon recent sexual health models to shift the therapeutic paradigm and better address individualized desires, compulsive behaviors, or inhibitions, not supported by standardized therapeutic models.

Evaluating mobile harm reduction services for youth and young adults.

The adolescent and young adult (AYA) population has experienced an increase in both emergency room visits and deaths related to substance use. However, AYA are less likely to engage in existing addiction treatment infrastructure. A youth-specific mobile harm reduction program has the potential to reduce substance-related morbidity and mortality including infections, overdose, and death. Launched in 2019, the Community Care in Reach AYA pilot program seeks to address the difference in patterns of substance use between AYA and adults. The results of this evaluation suggest the importance of a youth-oriented program in increasing AYA engagement with harm reduction.

Diagnosis of methamphetamine-induced psychotic disorder: Findings of an expert consensus panel.

We define criteria for methamphetamine-induced psychotic disorder (MIPD) to aid in accurate and reliable diagnosis. An expert panel was recruited and engaged in an iterative consensus process. A literature search supported this work. The a priori level for consensus was considered ≥80% of voting panellists. The final expert panel included 22 physicians from different backgrounds and practice environments. The panel produced two consensus diagnoses: (1) acute MIPD and (2) persisting MIPD, which is further separated into subacute and chronic timeframes. Although certain characteristics differentiate methamphetamine-induced psychosis shortly after use, identification of persisting MIPD depends largely on a history of symptom onset. All respondents voted in the final round, and both criteria were fully endorsed by 91% (20/22) of respondents. Panellists further recommended next steps in validation and research on this topic. These diagnostic criteria aid clinicians in differentiating methamphetamine-induced psychotic symptoms from psychosis because of other psychiatric disorders and can guide future studies. Future research might examine these criteria's prognostic significance, interrater reliability and acceptability including among persons in recovery. This work is a necessary and vital step in advancing the science of methamphetamine addiction treatment.

Using Latent Profile Analysis to Characterize Clinical Heterogeneity and Impulsivity in a Large Residential Addiction Treatment Program

Objectives: Clinical heterogeneity among patients in addiction treatment settings represents a challenge as most of the treatment programs are designed to treat substance use disorders (SUD) generally rather than offering more tailored approaches addressing individual patient needs. Systematic characterization of clinical heterogeneity may permit more individualized care paths toward improving outcomes. Methods: Data were collected from a large inpatient SUD treatment program between April 2018 and March 2020 (n = 1519). Latent profile analysis (LPA) was applied to identify latent clusters based on differences in substance use and co-occurring depression, anxiety, and post-traumatic stress disorder. Results: Five distinct profiles emerged: Profile 1 (38%) exhibited the lowest substance use and lowest psychiatric severity (Overall Low); Profile 2 (39%) exhibited high alcohol and psychiatric severity; Profile 3 (13%) exhibited high opioid severity and low psychiatric severity. Profile 4 (8%) exhibited high cannabis use and high psychiatric severity, and profile 5 (3%) exhibited high polysubstance use other than alcohol and cannabis use. The latter two profiles were younger and exhibited higher self-regulatory deficits. The (High Alc/high psych) and the (High Cann/Psych) profiles exhibited differentially higher psychiatric severity. Profiles showing high polysubstance use, as well as high cannabis use and high psychiatric severity, showed significantly higher impulsive behavior than the others. Conclusions: LPA revealed five clusters of patients varying substantially in terms of SUD and psychiatric severity. Addressing common features of clinical heterogeneity for tailored care paths in a personalized treatment approach may improve treatment outcomes.

Evaluation of medications used for opioid use disorder in emergency departments: A cross-sectional analysis of the 2020 National Hospital Ambulatory Medical Care Survey

IntroductionOpioid use disorder (OUD) is a significant health issue impacting millions in the United States (US). Medications used for OUD (MOUD) (e.g., buprenorphine, methadone, naltrexone) and medications for overdose and symptom management (e.g., naloxone, clonidine) have been shown to be safe and effective tools in clinical management. MOUD therapy in Emergency Departments (EDs) improves patient outcomes and enhances engagement with formal addiction treatment; however, provider factors and institutional barriers have created hurdles to ED-based MOUD treatment and heterogeneity in ED based OUD care. We used a nationally representative dataset, the National Hospital Ambulatory Medical Care Survey (NHAMCS) to characterize MOUD prescribing practices across patient demographics, geographic regions, payers, providers, and comorbidities in EDs. MethodsNHAMCS is a survey conducted by the US Census Bureau assessing utilization of ambulatory healthcare services nationally. Survey staff compile encounter records from a nationally representative sample of EDs. We conducted a cross-sectional study using this data to assess visits in 2020 among patients aged 18–64 presenting with an opioid overdose or OUD. We estimated the proportion of patients who had any MOUD, clonidine, or naloxone treatment and 95% confidence intervals (CI). We modeled the association between patient demographic, location, comorbidities, and provider characteristics with receipt of MOUD treatment as unadjusted odds ratios (OR) and 95% CI. ResultsThere was a weighted frequency of 469,434 patients who were discharged from EDs after being seen for OUD or overdose. Naloxone, clonidine, and buprenorphine were the most frequent treatments administered and/or prescribed for OUDs or overdose. Overall, 54,123 (11.5%, 95%CI 0–128,977) patients who were discharged from the ED for OUDs or overdose received at least one type of MOUD. Hispanic race, (OR 17.9, 95%CI 1.33–241.90) and Western region (OR43.77, 95%CI 2.97–645.27) were associated with increased odds of receiving MOUDs, while arrival by ambulance was associated with decreased odds of receiving MOUDs (OR0.01, 95%CI 0.001–0.19). Being seen by an APP or physician assistant was associated with MOUD treatment (OR 16.68, 95%CI: 1.41–152.33; OR: 13.84, 95%CI: 3.58–53.51, respectively). ConclusionOur study findings suggest that MOUD and other medications for opioid overdose are infrequently used in the ED setting. This finding was especially notable in race, geographic region, mode of arrival, and those seen by APP, underscoring the need for further study into the root causes of these disparities. Our study provides a foundational understanding of MOUD patterns, guiding future research as the landscape of OUD treatment continues to shift.

The Application of Religion as a Method of Drug Rehabilitation for Victims of Drug Abuse at Baitusyifa Rehabilitation Center

Drugs are a complex problem that needs to be resolved, one of the efforts that can be made is to undergo rehabilitation for drug abusers. Drug rehabilitation centers have different methods to achieve their clients' goals in the healing period. Baitusyifa Rehabilitation Center is one of the rehabilitation centers located in Deli Serdang City, North Sumatra which applies religion as a method of drug rehabilitation. The purpose of this study is to describe the religious methods or efforts applied at Baitusyifa Rehabilitation Center. This research uses a qualitative approach. Data were obtained through interviews, observations, and documentation at the research location. Furthermore, the data was analyzed using descriptive qualitative to answer the effectiveness of the application of religion in handling drug abuse clients. The results showed that the application of religion was very influential on clients at Baitusyifa Rehabilitation Center. Clients feel a change for the better and make habits that are carried out in rehabilitation to life after completing the rehabilitation period. Baitusyifa Rehabilitation Center takes an approach by creating self-awareness through study/recitation, changing habits with worship activities such as prayer and murojaah, increasing motivation through reward and punishment models, implementing anonymous letters so that clients evaluate themselves, cupping healing therapy recommended in Islam, and morning exercises to keep clients fit.

Evaluation of metacognition, difficulties in emotion regulation and addiction severity levels of individuals diagnosed with substance use disorder

ABSTRACT Aim This study aimed to evaluate the relationship between metacognition, difficulties in emotion regulation, and level of addiction severity in individuals with substance use disorder. Methods This cross-sectional study was carried out with 121 participants at the Alcohol and Drug Addicts Treatment and Research Center between February and June 2023. The data were collected using the Metacognition Questionnaire-30 (MTQ-30), Difficulties in Emotion Regulation Scale-Brief Form (DERS-16), and Addiction Profile Index (API). Results All the participants were male and polysubstance users; the age of the onset of substance use was 16.43 ± 5.95; they had been receiving treatment for addiction for an average of 1.79 ± 2.16 years. There was a strong positive significant correlation between the mean total MTQ-30 score and the mean total DERS-16 and API scores (r = .704, p < .001; r = .776, p < .001) and a moderate positive significant correlation between the mean total DERS-16 score and the mean total API score (r = .628, p < .001). It was determined that metacognition had an effect at a rate of 60.3% and difficulty in emotion regulation had an effect at a rate of 39.5% on the addiction severity of individuals. Conclusion Addiction severity was found to increase as the levels of metacognitive impairment and difficulty in emotion regulation increased.