The Challenges and Potential Solutions for Disseminating Evidence-Based Practice in Child Protection: The Parents Under Pressure Program.

Background: Adolescent mental health and substance misuse is a growing issue, disproportionately affecting diverse youth and those in low-resourced, high-stress environments. Yet, despite recent advances in evidence-based practices for adolescent substance use, perpetuating factors remain under-explored and marginalized, and underserved groups continue to be underrepresented. The current study aimed to investigate sociocultural factors impacting substance misuse and treatment outcomes. Methods: Data from adolescents receiving combined mental health and substance misuse treatment at a regional safety-net hospital were analyzed. Using Latent Class Analysis (LCA), demographic variables including insurance coverage, area deprivation, race, ethnicity, age, gender, court involvement, and primary mental health diagnoses were used to identify unique adolescent subgroups based on these different sociocultural risk factors. Identified classes were tested as predictors of treatment engagement, length of treatment, future service utilization, substance misuse, and urine drug screen results. Results: Five unique subgroups were identified, differentially impacting substance misuse, future service utilization, and treatment outcomes. Conclusions: These results highlight the need for improved access to resources for adolescents who have been marginalized and traditionally underserved. Furthermore, the identified subgroups can inform future research and practice.

Schizophrenia, defined by the presence of delusions, hallucinations, and flat affect, is more commonly seen alongside depression, anxiety, and substance misuse in patients. Antipsychotics, including second-generation antipsychotics olanzapine, clozapine, and risperidone, are prescribed to control symptoms of schizophrenia, and function through the antagonism and agonism of various receptors including D2, 5-HT2C, 5-HT2A, and 5-HT1A. The effects of antipsychotics are widespread and often include varying impacts to multiple cerebral areas and functions such as measured cortical thickness, regional homogeneity, and volume of numerous brain components like the caudate, putamen, and gray matter. This study aimed to analyze the widespread effects of antipsychotic use on various brain structures based on a review of current scientific literature. Our review revealed that impacts to brain function were widely varied, showing a need for more robust clinical research. A comprehensive understanding of the effects on brain structures of antipsychotics will help to guide medical professionals in the treatment and management of psychosis-related syndromes.

ABSTRACTImportanceManual inpatient screening for substance misuse is labor-intensive and inconsistently applied. Evaluation of artificial intelligence (AI)–assisted screening during clinical implementation is needed to determine clinical and economic performance.ObjectiveTo assess whether an AI-based screening program with the Substance Misuse Algorithm for Referral to Treatment Using Artificial Intelligence (SMART-AI) maintained delivery of addiction-related services compared with manual screening and to evaluate readmissions and costs.Design, Setting, and ParticipantsProspective, quasi-experimental pre–post study at a large academic medical center in Chicago, Illinois between 2022 and 2025. The pre-implementation period (manual screening) included 31,432 hospitalizations, and the post-implementation period with AI augmentation (SMART-AI) included 33,564.Interventions/ExposuresDuring the post-implementation period, SMART-AI screened clinical documentation within 24 hours of admission to identify patients at-risk for a substance use disorder and notified the Substance Use Intervention Team. In the pre-implementation period, screening relied on manual processes, with nurses and social workers screening with standardized questionnaires.Main Outcomes and MeasuresThe primary outcome was receipt of ≥1 addiction-related service (initiation or adjustment of medication for alcohol or opioid use disorder; brief intervention/motivational interviewing; naloxone dispensing; or a completed addiction medicine consultation). The prespecified noninferiority margin was −0.5 percentage points (1-sided α = 0.025). Secondary outcomes included 6-month readmission, discharge against medical advice, and program costs.ResultsAddiction-related services were received in 1,189 of 31,432 hospitalizations (3.8%) during manual screening and 1,144 of 33,564 (3.4%) during SMART-AI (difference, −0.4 percentage points; 95% CI, −0.7 to −0.1; P = 0.20). The lower limit of the confidence interval was below the noninferiority margin, so noninferiority was not achieved. Six-month readmissions across all hospitalizations occurred in 9,586 patients (30.5%) in the manual period and 10,244 patients (30.5%) in the SMART-AI period (P = 0.95), and discharge against medical advice did not differ (1.3% v. 1.1%). Among patients who received a SUIT intervention (n = 2,296), 6-month readmission occurred in 41.3% (485/1,175) during usual care versus 37.0% (415/1,121) during SMART-AI (odds ratio: 0.86, 95% CI: 0.73-1.03, p=0.10). Program costs over a 1-year period were $6,166.71 lower after SMART-AI automation.Conclusions and RelevanceAI-assisted screening did not meet the prespecified non-inferiority criterion for maintaining service delivery, but it was associated with maintaining secondary outcomes among patients screened for substance use disorder with lower program costs. Findings support the feasibility and potential value of automated screening at scale.Trial RegistrationClinicalTrials.govIdentifierNCT03833804

Introduction: Cardiovascular disease (CVD) is the leading cause of death among Indigenous Peoples in Canada, who experience significantly higher rates of chronic illnesses compared to non-Indigenous populations. Despite this disparity, Indigenous communities remain underrepresented in CVD research, contributing to ongoing gaps in care and prevention. One major contributor is substance misuse (SM), which is both a consequence of intergenerational trauma and a key risk factor for CVD. This scoping review explores the social determinants that drive SM in Indigenous populations and contribute to their elevated CVD risk. Methods: This scoping review synthesized peer-reviewed studies from major academic databases using MeSH (medical subject headings) terms related to Indigenous health, SM, CVD, and social determinants of health. It identified and categorized key social determinants influencing health outcomes in Indigenous populations in Canada, guided by the WHO framework and assessed for relevance and feasibility based on available data. Results: Substance misuse among Indigenous communities is embedded in systemic, intergenerational, and structural inequities—many of which also elevate CVD risk. Three primary determinants emerged as most influential: (1) Historical trauma stemming from colonization, (2) barriers to healthcare quality, access and systemic discrimination, and (3) poverty and inadequate infrastructure. These interconnected factors contributed to different outcomes such as chronic stress, maladaptive coping strategies, and limited access to timely, quality care—all linked to poor cardiovascular health. Discussion: Our findings reveal a critical need for research and policy that center on Indigenous perspectives and address the structural roots of health disparities. Interventions must move beyond individual-level treatments and engage with the broader sociohistorical context of colonization, historical trauma, and systemic exclusion. Conclusion: Historical trauma, barriers to healthcare access and quality, built environment and poverty are central social determinants impacting SM and CVD in Canadian Indigenous populations. Long-term, ethical engagement with indigenous knowledge systems and community leadership is essential to achieving sustainable health equity.

Background: Social media has become a space for sharing personal experiences and shaping public opinion. This study explored how people respond to substance misuse recovery journeys shared on TikTok. Methods: The researchers collected 3583 comments from 350 TikTok videos under the hashtags #wedorecover, #recovery, and #sobertok using a scraper tool. A discourse analysis categorized comments into Narrative Strategies, Rhetorical Strategies, Linguistic Features, and Power Relationships, each with subcategories revealing public perceptions of substance use and recovery. A correlation analysis was also conducted to examine the role of emojis across narrative and linguistic features. Results: Most comments (94%) expressed support or positivity toward recovery videos. The heart emoji was the most common (93.35% of all emojis), symbolizing connection, encouragement, and solidarity. Four themes emerged reflecting public attitudes: encouragement and positive messaging, acknowledgment of struggle, the culture of sharing, and the influence of broader social narratives. Conclusions: These results provide insight into public responses to recovery content on TikTok, suggesting that peer support may be facilitated through the platform’s algorithmic design. While TikTok shows promise as a supportive digital space, further research is needed to understand its broader implications for substance use recovery support.

While acute complications of traumatic spinal cord injury (TSCI) are well characterized, long-term systemic sequelae remain poorly understood, particularly in previously healthy individuals. To evaluate the long-term risk of neurologic, psychiatric, cardiovascular, and endocrine comorbidities and associated mortality in patients with TSCI compared with matched uninjured controls. This retrospective cohort study analyzed longitudinal data from 2 large hospital-based registries (January 1996 to January 2024): Mass General Brigham (MGB) and the University of California (UC) Health System. Individuals with preexisting diagnoses of studied comorbidities were excluded. Uninjured controls were matched 3:1 by age, sex, and race. The data were analyzed in September to December 2024. TSCI. Incidence of cardiovascular, endocrine, neurologic, and psychiatric conditions, as defined by International Classification of Diseases, Ninth Revision (ICD-9) or Tenth Revision (ICD-10). Associations between TSCI and comorbidities, and their association with all-cause mortality, were evaluated using multivariable Cox and logistic regression models. A total of 1038 patients with TSCI in the MGB cohort (602 [58%] male; median [IQR] age, 44 [31-59] years) and 1711 in the UC cohort (1111 [65%] male; median [IQR] age, 45 [32-58] years) were matched with 3114 uninjured control participants in MGB (median [IQR] age, 43 [31-59] years) and 5133 uninjured control participants in UC (median [IQR] age, 45 [31-60] years). Compared with controls, patients with TSCI had significantly higher risk of hypertension (hazard ratio [HR], 1.6; 95% CI, 1.3-1.9), hyperlipidemia (HR, 1.5; 95% CI, 1.3-1.8), ischemic stroke (HR, 2.5; 95% CI, 1.7-3.7), coronary artery disease (HR, 1.8; 95%CI: 1.3-2.5), and diabetes (HR, 1.5; 95% CI, 1.1-2.1), along with other neurologic and psychiatric conditions. The risk of post-TSCI comorbidities was elevated across different age groups, including patients aged 18 to 45 years compared with age-matched controls, with higher rates of hypertension (HR 1.5, 95% CI 1.1-2.1) and ischemic stroke (HR 2.8, 95% CI 1.3-6.0) observed in the TSCI group. Similar findings were seen in a separate cohort of 1711 patients with TSCI from UC Health. Postinjury hypertension (odds ratio [OR], 2.0; 95% CI, 1.2-3.5), pituitary dysfunction (OR, 6.5; 95% CI, 1.1-33.2), adrenal insufficiency (OR, 5.0; 95% CI, 1.04-20.2), depression (OR, 2.9; 95% CI, 1.6-5.2), substance misuse (OR, 4.0; 95% CI, 1.5-9.8), seizures (OR, 6.4; 95% CI, 2.7-14.5), and dementia (OR, 4.8; 95% CI, 2.0-11.6) were associated with higher mortality. In this cohort study, TSCI was associated with increased long-term risk of multisystem morbidity and elevated mortality-even in previously healthy patients. These findings underscore the need for proactive, longitudinal, and multidisciplinary approaches to prevent complications and protect this high-risk population.

Aysha Mendes looks at recent research and practice developments indicating the vital role of prescribers in supporting harm reduction through safe prescribing for substance misuse

Adverse childhood experiences from birth to age 6 years and changes in dental caries experience from age 7 to 10 years.

Service delivery models and care cascade outcomes for people living with chronic hepatitis B: a global systematic review and meta-analysis.

Individuals diagnosed with addiction or mental health (AMH) conditions are more likely to experience potentially adverse outcomes of homelessness. Despite their link to later outcomes, research on initial episodes of AMH outcomes is limited. This study aims to use administrative data to identify the factors associated with the first healthcare encounters with indicators of homelessness (FHE-H) for individuals diagnosed with AMH. We assessed logistic regression and compared its performance with machine learning models, including random forests and extreme gradient boosting (XGBoost). We conducted a retrospective cohort study linking several administrative datasets for 232,253 individuals with Alberta health insurance in Calgary, Canada, who were aged between 18 and 65 and diagnosed with AMH between April 1, 2013, and March 31, 2018. We assessed outcomes in two years following cohort entry. Individuals with episodes of FHE-H (2,606 individuals) before the index date were excluded. Multivariable logistic regression models were used to identify factors associated with outcomes by estimating adjusted odds ratios (AORs) with 95% confidence intervals. Among 229,647 individuals diagnosed with AMH, 1,886 (0.82%) experienced FHE-H during the follow-up period. Mental health emergency visits (AORs=5.28 [95% CI: 4.41, 6.33]), substance misuse (AORs=3.87 [95% CI: 3.28, 4.56], substance use disorders (AORs=2.03 [95% CI: 1.64, 2.50]), and male sex (AORs=1.28 [95% CI: 1.14, 1.44]) were associated with FHE-H. XGBoost performance improved over logistic regression, with increases in area under the curve (AUC) by 1% and precision by 2%. Overall, several AMH features were associated with FHE-H, and machine learning models outperformed logistic regression, although to a small degree.

Psychosocial screening is inconsistently administered in pediatric primary care and rarely includes older children. This cross-sectional study compares screening outcomes from and interventions related to expanded use of the safe environment for every kid (SEEK) approach in children aged 0 to 17 versus the usual application to families with children under 5. Caregivers (N = 450) of children aged 0 to 17 years completed screening between April and December 2021. Screening results were compared across 3 age categories (0-5, 6-11, and 12-17) using the exact binomial method and Fisher's exact test. The prevalence of problems was similar across all age groups except for stress (P < .001) and substance misuse (P = .002). Publicly insured families had higher rates of identified problems versus privately insured families for stress (P = .035) and partner violence (P = .031). Interventions for positive screens were offered for 61% of participants. Expanded SEEK screening enables increased detection of social needs and offerings of resources for all ages and insurance types.

Culturally Informed and Flexible Family Based Treatment for Adolescents (CIFFTA) is a manualized treatment that has been shown to reduce youth substance misuse and a variety of behavior problems but it has not been used to treat self-harm behavior in youth. The purpose of this manuscript is to describe enhancements that can address the treatment needs of diverse youth reporting suicide risk, cutting, and other self-harming behavior. We describe the enhancements to psychoeducational, individual therapy and family therapy content and processes as well as technological enhancements to improve access to treatment and to engage the adolescent in therapeutic work between therapy sessions. We believe that to help reduce barriers to service utilization in diverse populations, the treatment must also be ecologically valid. We present the case of a 15 year old Latine female who received treatment for cutting behavior and demonstrate CIFFTA's components in action. As we have reported separately, the acceptability of this enhanced intervention is supported by data showing that 93% of the youth and families attended at least 8 sessions and that on average they received over 23 sessions of treatment. This treatment enhancement effort resulted in new tools that were integrated into the manualized CIFFTA making it easier to engage families and deliver interventions. These enhancements culminated in an adaptive, replicable, and culturally informed treatment for diverse youth reporting self-harm and their families.

Addressing complex and persistent issues such as substance misuse requires sustained collaboration by individuals and organizations. This exploratory study investigates factors that predict coalition members’ perceptions of their inter-organizational relationships and the effects those relationships have on the community. Ego-centric network data were collected via online survey from participants in substance misuse prevention coalitions across Tennessee. Each respondent (i.e., ego) was asked to indicate other organizations (i.e., alters) with whom their organization worked to prevent substance misuse in the last six months. The resulting dataset comprised 256 unique ego-alter relationships (representing inter-organizational collaborations) from 66 organizations across 31 coalitions. We used two-level mixed-effects logistic regression models to examine the factors that affect a respondents’ perception that each ego-alter relationship is highly impactful to the community. Implications for our understanding of inter-organizational collaboration, as well as the value of ego-centric inter-organizational network analysis for examining collaboration networks across locales, are discussed.

Racial discrimination can greatly affect access to opioids and raise the risks of substance misuse in individuals presenting to emergency departments with low back and acute kidney pain.

This article discusses the experimental models of complex decision environments to better understand risky behaviors. Risky behaviors-such as substance misuse, aggression, and rule breaking-span many clinical conditions, including attention deficit/hyperactivity disorder, substance use disorders, antisocial personality disorder, and bipolar disorder. A robust body of research indicates that these behaviors are often rooted in impairments in decision making. This conclusion is supported by experimental research that estimates how people evaluate and respond to information. Experimental methods are particularly powerful because they enable researchers to observe decision making as it unfolds in real time, while also providing precise control over aspects of the decision environment that shape behavior. Despite these strengths, the experimental tasks traditionally used to study decision making as it relates to risky behavior have remained relatively static over the past three decades. The authors argue for developing innovative experimental tasks that better capture the complex real-world environments where risky decisions occur and their implications for clinical conditions. The authors highlight the initial steps for capturing conditions where momentary decisions are embedded within context. This work still needs to be extended to the study of risky behaviors relevant to clinical conditions. By more richly representing the landscape of decision making, one may better understand which environments promote, or even discourage, risky behaviors across clinical populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

ObjectivesOur study aims to investigate the associations between sexual minority stressors, resilience factors and substance misuse outcomes, using an intersectional framework to examine heterogeneities across sexual minority populations (SMPs) in the United States of America (USA). We hypothesised that stressors would be positively associated with substance use, and that resilience factors would be negatively associated, with these associations varying across intersectional strata.DesignThe current study employed a secondary data analysis strategy to analyse cross-sectional data using Bayesian hierarchical modelling and Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA).SettingData were obtained from the Generation Study Wave 1 (data collected from 2016 to 2018), a nationally representative cohort of SMPs in the USA.ParticipantsThe study included 1518 participants aged 18–59. Combinations of education, birth sex, sexual orientation, income and race/ethnicity defined intersectional strata. Participants were selected based on self-reported demographic and behavioural data.Primary and secondary outcome measuresPrimary outcomes were the risks of alcohol use and drug use, measured using validated scales (AUDIT (Alcohol Use Disorders Identification Test) and DUDIT (Drug Use Disorders Identification Test)). Explanatory variables included resilience factors (social support, life satisfaction, social well-being and community connectedness) and sexual minority stressors (everyday discrimination, perceived stigma, healthcare stereotype threat and internalised homophobia).ResultsIn descriptive analyses, group differences on psychosocial scales were small to modest, with higher everyday discrimination in lower-income and Black participants. In Bayesian regressions, everyday discrimination was the strongest positive correlate of both alcohol and drug use, whereas perceived stigma was inversely associated. In MAIHDA models, demographic factors were associated with higher AUDIT among males and those with college-or-more education, and with higher DUDIT among low-income participants; relative to bisexual participants, gay (AUDIT) and lesbian (DUDIT) groups had lower scores. The strata-level variance component was small in null models and approached zero after adjusting for demographics and psychosocial factors, indicating that disparities are primarily driven by differential exposure to these factors rather than unexplained heterogeneity between strata.ConclusionsWhile minority stressors and resilience factors are salient predictors of substance use among SMPs, their effects are consistent across diverse intersectional identities. The application of MAIHDA demonstrates that substance use disparities are better explained by the main effects of demographics and psychosocial experiences than by the unique combination of identities. This highlights the importance of universal interventions in reducing discrimination and enhancing resilience across the entire SMP population.

Abstract Disclosure: E. Rosario Diaz: None. T. Patel: None. T. Hor: None. Background: Thyrotoxicosis factitia is a term to describe exogenous hуреrthуrοiԁism in the setting of surreptitious ingestion of thyroid hormone. This case demonstrates the appropriate management and important laboratory findings associated with this condition. Body: A 41-year-old male with a medical history of depression, ADHD, anxiety, substance misuse, and hypogonadism presented to the emergency department following the ingestion of an unregulated weight loss supplement containing liothyronine (LT3) 100 mcg/mL and levothyroxine (LT4) 100 mcg/mL. Prior to his presentation, the patient consumed 50 mcg of LT3 with 50 mcg of LT4 on days 1-3 and 50 mcg of LT3 with 100 mcg of LT4 on day 4, totaling 200 mcg of LT3 and 250 mcg of LT4 over the course of 4 days. He developed chest pain, palpitations, shortness of breath, tachycardia, fever, flushing, and muscle pain, which promptedhis presentation to the emergency department. The patient presented with tachycardia with heart rate 160 bpm, BP 112/89 mm Hg, fever to 101°F, with TSH &amp;lt; 0.008 uIU/mL (0.35 - 4.94 uIU/mL), free T3 &amp;gt; 20 pg/mL (1.58 - 3.91 pg/mL), total T3 5.96 ng/mL (0.35 - 1.93 ng/mL), free T4 1.4 ng/dL (0.7 - 1.5 ng/dL), and highsensitivity troponin I level (hs-cTnI) 11,304 ng/L (0 - 35 ng/L). ECG showed sinus tachycardiaand TTE revealed a left ventricular ejection fraction of 45-50%. The patient was monitored in the ICU and treated with propranolol to target a heart rate &amp;lt; 90 bpm, a one-time dose of dexamethasone 4 mg to inhibit T4-to-T3 conversion, and cholestyramine 4 mg TID to enhance thyroxine excretion. Markedly increased hs-cTnI was attributed to demand from thyrotoxicosis. Within 10 hours of initiating therapy, his heart rate normalized and hs-cTnI decreased to 5446 ng/L. 2 days later, TSH remained at &amp;lt; 0.008 uIU/mL but free T3 normalized to 3.77 pg/mL, and free T4 decreased to 0.9 ng/dL. He was discharged on day 3 in stable condition. He received extensively counselingto avoid unregulated weight loss supplements. Conclusion: This case underscores the importance of recognizing factitious thyrotoxicosis and prompt treatment to reduce thyroid hormone levels and symptoms. Rapid normalization of free T3 and reduction in free T4 can be attributed to the above treatment, but it is also important to note that thyroid hormone half-life is reduced in the setting of thyrotoxicosis. Unique to this case is the marked troponin elevation without hemodynamic or inotropic compromise. To our knowledge, this is the highest level of hs-cTnI associated with thyrotoxicosis factitia. Presentation: Monday, July 14, 2025

Abstract Disclosure: V. Zhao: None. M. Nair: None. J.M. Hall: None. R. Feinn: None. Background: Adolescents living with chronic illnesses, such as diabetes, often face unique stressors that may increase their vulnerability to risky coping behaviors. Limited research exists on the relationship between chronic illness in adolescents and rates of substance misuse. This study aims to evaluate the relationship between diabetes and patterns of substance misuse, including alcohol, marijuana, and prescription pain relievers. By highlighting disparities in substance use behaviors among adolescents with diabetes, this research emphasizes the importance of targeted mental health support and early prevention of substance misuse in medically vulnerable adolescent populations. Methods: The National Survey on Drug Use and Health (NSDUH) 2023 database was used to analyze data regarding substance use among non-institutionalized adolescents in the United States. Adolescents ages 12-20 were included. Self-reported diabetes diagnosis was used as the primary independent variable. Outcome variables included: 1) days of marijuana use in the past year, 2) days of alcohol use in the past year and 3) past-year misuse of prescription pain relievers. A generalized linear model was done to check to see whether the number of days of alcohol consumption and marijuana use within the past year differed by diabetes diagnosis. For prescription pain relievers, a chi-squared test was done to check for associations between the misuse of pain relievers and diabetes diagnosis. Results: A total of 2,563 adolescents aged 12-20 were included in the analysis, of whom 274 reported a diagnosis of diabetes and 2,289 did not. Statistical comparisons were made between the diabetes and non-diabetes groups. Adolescents with diabetes were found to have a significantly higher number of days of alcohol use in the past year (12.92 days, 95% CI: 11.44-14.59) compared to their non-diabetic peers (8.83 days, 95% CI: 8.46-9.22), with a mean difference of 4.09 days (p &amp;lt; 0.001). No statistically significant difference was found in marijuana use between groups, with diabetic adolescents reporting 3.86 days (95% CI: 3.34-4.47) versus 3.56 days (95% CI: 3.38-3.74) in non-diabetic adolescents (p = 0.308). There was also no significant association between diabetes status and past-year misuse of prescription pain relievers (X^2 = 9.324, df = 5, p = 0.097). Conclusion: Adolescents with diabetes demonstrated significantly higher alcohol consumption compared to their nondiabetic peers, with no significant findings in marijuana or prescription pain reliever use. These findings suggest that alcohol may be used as a coping strategy for some adolescents with a diabetes diagnosis. By providing more targeted risk prevention programs for medically vulnerable populations, such as those with a diabetes diagnosis, can empower them to make informed, safe choices regarding substance use. Presentation: Monday, July 14, 2025

Unlike previous reviews on quality of life (QoL) and substance use disorders (SUD), this scoping review focuses on QoL within the context of SUD treatment and active substance misuse. This review delineates and describes QoL measures, assesses their application, and explores the influence of demographics on QoL outcomes. Five databases were searched (EMBASE, Web of Science, PsycINFO, PubMed, and Scopus) using keywords related to QoL, clinician-verified SUD, and SUD treatment. All studies were published in English before June 1st, 2025. Two reviewers screened abstracts and full text for eligibility and study elements. The first author extracted data regarding methodology, substance use, treatment, and QoL measures. The PRISMA-ScR checklist guided this study and the reporting process for rigor and transparency. Of the 11,078 initially identified articles, 108 were extracted for analysis. QoL measures accounted for multiple domains (e.g., physical, psychological, social, environmental, independence, security, and spiritual). Studies included male and female participants, all over the age of 18. Results found that many studies under-reported race, ethnicity, and cultural contexts, as well as high variability in the definition of QoL domains and standardization across treatment locations and geographic regions. Studies from Asia primarily showed preference for the WHOQOL-BREF measure compared to North America and Europe, which showed varied preference for measures. The most common QoL domains assessed were psychological, physical, and social. This review highlights the need to operationalize QoL domains and assessment approaches in SUD treatment research to facilitate meaningful comparisons and enhance our understanding of treatment effectiveness.