Substance Use Research Articles

Modeling the dynamics of addiction relapse via the double-well potential system.

Substance use relapse is difficult to define, and previous work has used one-size-fits-all ad hoc definitions. Researchers have called for a dynamic and personalized understanding of relapse as a concept and model, necessitating novel statistical tools. We aimed to develop and validate a novel statistical model of latent relapse processes: the double-well potential model (DWPM). This model describes posttreatment substance use in terms of a dynamical system with stable equilibria of abstinence and relapse, person-specific dominant equilibria (tilt), the ease of changing between equilibria (steepness), and an overall relapse risk (RR). Using timeline follow-back data from N = 139 adults with a substance use disorder transitioning back to the community after residential treatment, we examined individual differences and the criterion-related validity of DWPM parameters to determine the clinical utility of the double-well model. While nonuse was the predominant stable state across participants, we found significant between-subjects variability steepness and RR. These individual differences were predictable via demographics, baseline psychopathology, treatment history, and treatment condition. Steepness and RR also predicted long-term outcomes, including life satisfaction and criminal behavior, above and beyond traditional metrics of relapse (proportion of days used and time to first use). Thus, the DWPM is a strong theoretical and statistical representation of the underlying relapse processes. Moreover, the parameters show criterion-related validity and may be useful in precision medicine. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Substance use during pregnancy and postpartum among individuals with perinatally-acquired HIV in the United States

Use of cannabis and alcohol were common during pregnancy and the first year postpartum among people with HIV in the United States (2007–2019), but there were no major differences in substance use during pregnancy based on mode of HIV acquisition. The relatively high prevalence of substance use in this population, particularly postpartum alcohol and cannabis use, warrants further attention.

The effect of cognitive control on addiction relapse

Background and Aims When entering substance abuse treatment centers, some individuals with substance use disorder relapse whilst others do not. Predicting who is likely to relapse or not would enable for more effective treatment by targeting those who are at increased risk. Previous research would indicate that aspects related to cognitive control including cognitive bias, inhibitory control, and working memory may all be strong indicators of relapse likelihood. Therefore, this paper explores whether aspects of cognitive control can predict relapse likelihood. Method Participants were patients in substance treatment centers who were abstaining. They were tested on measures of cognitive bias (REsT), inhibitory control (go/no-go), and working memory (nBack). A follow-up survey was then issued after a twelve-week period to ascertain whether participants had remained abstinent or if they had relapsed. Results Relative to abstainers, individuals who relapsed had shown significant impairments in working memory and inhibitory control at baseline. They had also demonstrated increased preoccupation with substance-related stimuli as indicated by the cognitive bias measure. Conclusions These findings demonstrate that deficits in cognitive control contribute to the maintenance of substance use disorder and substance usage. The results indicate that inhibitory and working memory deficits may contribute to initial engagement in substance abuse, followed by an increase in cognitive bias and further deficits in inhibitory control and WM contributing to an increased likelihood of relapse. This suggests that decreased cognitive control may increase relapse likelihood.

The association between minority stressors, intraminority stressors, and borderline personality disorder symptomatology among sexual minority men.

Sexual minority men are more likely to be diagnosed with borderline personality disorder compared to their heterosexual counterparts. Minority stressors have been associated with criteria for borderline personality disorder (e.g., substance use, suicidality, impulsive behaviors, and interpersonal difficulties with rejection). However, to date, there are no known studies examining the association between traditional minority and intraminority stressors and borderline personality disorder symptomatology. The purpose of the study is to examine the association between traditional and intraminority stressors and borderline personality disorder symptomatology among sexual minority men. Data were collected from 312 sexual minority men (Mage = 24.00, SD = 4.04) via Qualtrics panels across the United States. A hierarchical linear regression was conducted with borderline personality disorder symptomatology as the outcome variable. Minority stressors (i.e., internalized homophobia, sexual orientation concealment, major discrimination, and day-to-day discrimination) were entered in Step 1, and intraminority stress was entered in Step 2. In Step 1, both major and day-to-day discrimination were significantly positively associated with borderline personality disorder symptomatology. In Step 2, intraminority stress was significantly positively associated with borderline personality disorder symptomatology, and day-to-day discrimination remained significant. These findings warrant clinicians to evaluate both minority and intraminority stressors, which may be an additional risk factor in the development and/or maintenance of borderline personality disorder symptomatology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reward deprivation is associated with elevated alcohol demand in emerging adults.

Policies vary substantially in terms of providing sources of psychosocial enrichment. Behavioral economic models of substance use and addiction emphasize that deficits in access to substance-free sources of reward increase substance reinforcing value and risk for addiction. The current study used an alcohol demand curve approach to test the hypothesis that various indices of reward deprivation would be associated with elevated alcohol reinforcing efficacy. We examined associations between alcohol demand indices and several facets of reward deprivation in a sample of young adults (N = 1,331; ages 19-25 years) recruited from the United States and Canada who reported recent binge drinking. Additionally, we created an index of cumulative reward deprivation that integrated the various reward facets and examined its association with alcohol demand intensity and maximum expenditure on alcohol. Our findings indicate that reward deprivation is associated with elevated alcohol demand and provide support for alcohol prevention and intervention approaches that emphasize environmental enrichment.

Factors Associated with Mental Health Care among Adolescents in Southern California.

Mental health care is critical to improving mental health but factors associated with student utilization are poorly understood. Data were from high school students (N = 2933; mean age = 15.7 ± .6) enrolled in a California cohort. We examined associations of sociodemographic factors, substance use, and mental health symptoms at baseline (Fall 2021) with mental health care at follow-up (Spring 2022). At follow-up, 7.7% of students reported out-of-school therapy, and 16.0% reported in-school counseling. Generally, therapy was more common for female and gender minority (vs male), some sexual minority youth (vs heterosexual), black, non-Hispanic white, and multi-ethnic (vs Asian), and English language speakers. Higher socioeconomic status was associated with greater use of out-of-school therapy, but not in-school counseling. Students with clinical levels of mental health symptoms, or alcohol or e-cigarette use had greater odds of mental health care (ORs = 1.42-2.61;ps <.05), though utilization was less than 20% for out-of-school therapy and less than 30% for in-school counseling among these students. Mental health care is underutilized, and disproportionately used by certain student sub-groups. Findings indicate a need to increase mental health care utilization in- and out-of-school.

Personalized interventions for behaviour change: A scoping review of just-in-time adaptive interventions.

Examine the development, implementation and evaluation of just-in-time adaptive interventions (JITAIs) in behaviour change and evaluate the quality of intervention reporting. A scoping review of JITAIs incorporating mobile health (mHealth) technologies to improve health-related behaviours in adults. We searched MEDLINE, Embase and PsycINFO using terms related to JITAIs, mHealth, behaviour change and intervention methodology. Narrative analysis assessed theoretical foundations, real-time data capturing and processing methods, outcome evaluation and summarized JITAI efficacy. Quality of intervention reporting was assessed using the template for intervention description and replication (TIDieR) checklist. Sixty-two JITAIs across physical activity, sedentary behaviour, dietary behaviour, substance use, sexual behaviour, fluid intake, treatment adherence, social skills, gambling behaviour and self-management skills were included. The majority (71%) aimed to evaluate feasibility, acceptability and/or usability. Supporting evidence for JITAI development was identified in 46 studies, with 67% applying this to develop tailored intervention content. Over half (55%) relied solely on self-reported data for tailoring, and 13 studies used only passive monitoring data. While data processing methods were commonly reported, 44% did not specify their techniques. 89% of JITAI designs achieved full marks on the TIDieR checklist and provided sufficient details on JITAI components. Overall, JITAIs proved to be feasible, acceptable and user-friendly across behaviours and settings. Randomized trials showed tailored interventions were efficacious, though outcomes varied by behaviour. JITAIs offer a promising approach to developing personalized interventions, with their potential effects continuously growing. The recommended checklist emphasizes the importance of reporting transparency in establishing robust intervention designs.

The Heterogeneous Effects of College Education on Outcomes Related to Deaths of Despair.

College education features prominently in research on determinants of deaths from substance use disorders and self-harm-outcomes collectively referred to as "deaths of despair" (DoD). Limited attention has been given to whether the protective effects of college education on indicators of despair vary by individuals' likelihood of college completion. We use data from the National Longitudinal Study of Adolescent to Adult Health for 6,145 individuals to test whether the protective effects of college completion on precursors to DoD vary according to individuals' propensity to attain a college degree. Understanding whether the benefits of college education differ depending on the propensity to complete it is important for designing effective educational policies. Using the heterogeneous treatment effects approach, we find that individuals with a relatively low propensity for graduating from college but who complete it have a lower likelihood of depressive symptoms, binge drinking, prescription drug abuse, and hard drug use.

Determining Whether State Policy Is in Line With Substance- and Alcohol-Related Best Practices for Domestic Violence Intervention Programs

Enhancing the effectiveness of Domestic Violence Intervention Programs (DVIPs) is necessary and may require up-to-date state-specific or national guidance. Currently, many U.S. states provide recommendations and requirements for DVIP length, content, and treatment curriculum through one or more of three types of documents: state laws, standards, and/or guidelines. However, these documents are updated irregularly and vary substantially in length, content, enforceability, and authorship expertise (i.e., legislators versus domestic violence [DV] experts and/or DV coalition members). Meanwhile, one robust yet controversial finding is that DV perpetrators with co-occurring substance use conditions have increased difficulty engaging with, sustaining attendance at, and benefiting from standard DVIP treatment (Jewell &amp; Wormith, 2010). Yet, the degree to which state-specific DVIP documents address how perpetrator substance use is to be assessed and treated within DVIPs is understudied. To fill this gap, guiding state documents were obtained as available (n= 47 states; 94%); these were coded with excellent interrater reliability (agreement = 91%). Consistent with research advances, state documents generally encouraged DVIPs to assess perpetrator substance use at intake (n= 41). However, fewer documents directed DVIP facilitators to address the link between substance use and DV within their curriculum (n= 25). Some state documents even prohibited substance use-related messages to be incorporated into the DVIP curriculum (n= 19). Unfortunately, even fewer states’ documents recommended follow-up of the perpetrator’s substance use during DVIP participation or after a substance abuse-related referral (n= 14). Efforts to align DVIP-guiding documents with knowledge related to increasing DVIP treatment effectiveness are necessary as is determining adherence to guiding documents.

The Use of Joyce J. Fitzpatrick's "Life Perspective Rhythm Theory" in a Case with Substance Use Disorder Diagnosed with Craving Severity: Case Report

Objective: In this study, it was aimed to plan the patient care of a male patient with craving severity diagnosed with substance use disorder according to Joyce J. Fitzpatrick's "Life Perspective Rhythm Theory". Theoretical Framework: In this study, nursing care was applied based on the Life Perspectives Rhythm theory. Method: A male patient with severe cravings diagnosed with substance use disorder treated in a psychiatric ward was evaluated according to the rhythmic patterns in Joyce J. Fitzpatrick's "Life Perspective Rhythm Theory". Patient care was planned and implemented based on the five main assumptions of the theory. Results and Discussion: Based on Fitzpatrick's Life Perspective Rhythm Theory, it was determined that the 32-year-old male patient with craving severity who was followed up with a diagnosis of substance use disorder had problems in the process of adaptation to life perspectives in the temporal behavior pattern, increased the number of cigarettes smoked daily in the motor behavior pattern, had impulse uncontrol in the cognitive behavior pattern, and had discourses that his parents mistreated him in the perceptual behavior pattern. According to Fitzpatrick, we determined the priority of care of this case as ineffective coping, decreased self-esteem, denial, risk of violence against self or others, anxiety, ineffectiveness in maintaining health, impaired social interaction and impaired family processes. Research Implications: In this study, the planning, implementation and evaluation stages of the patient care of a male patient with craving severity diagnosed with substance use disorder were carried out according to the Life Perspective Rhythm Theory with the priorities determined by using observation and communication skills. At the end of the process, the patient stated that his level of knowledge increased in order to maintain his physical and mental well-being, and that he knew the symptoms of craving severity and the measures to be taken when these symptoms occur. Since there are very few studies based on the theory developed by Fitzpatrick, it is recommended to study with different patient groups in order to obtain precise results by concretizing the usability of the theory in patterns.

Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship.

Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are prevalent psychiatric conditions, each affecting a substantial portion of the global population. When these conditions coexist with a Substance Use Disorder (SUD), the complexity of the clinical presentation is heightened. Herein, we describe two cases of individuals who have comorbid OCD and/or MDD and substance use disorder that highlight the importance of addressing the coexisting psychiatric illness when treating the SUD. These cases highlight the importance of tailored, multidisciplinary care, offering a potential therapeutic strategy based on medications for comprehensive recovery in individuals facing complex comorbid disorders. An integrated treatment approach, encompassing both psychiatric and substance treatment perspectives, is imperative.

Prevalence of Unorthodox Psychoactive Substance Use Amongst Secondary School Students in Calabar South Local Government Area, Cross River State, Nigeria

Guided by six research questions, this study adopted survey design to investigate the prevalence of unorthodox psychoactive substance use amongst students. 700 students were drawn from a population of 10,560 students. ‘Prevalence of Use of Unorthodox Psychoactive Substances Questionnaire’ (PUUPSQ) was used for gathering data, which was analyzed using frequency, percentage, bar charts and pie charts. The results showed, amongst others, that 57% of the respondents had taken at least one of the 20 investigated substances, which indicates high prevalence. It was recommended, amongst others, that adequate awareness on these substances should be created amongst the stakeholders in schools.

Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder.

Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. To test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual. This cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD. The primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD. The primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)-related hospitalization, somatic hospitalization, and suicide attempt. The cohort included 227 866 individuals with AUD; 144 714 (63.5%) were male and 83 154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0-13.3) years. A total of 133 210 individuals (58.5%) experienced AUD hospitalization. Semaglutide (4321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; any SUD: aHR, 0.68; 95% CI, 0.54-0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57-0.92; any SUD: aHR, 0.78; 95% CI, 0.64-0.97) of both AUD and SUD hospitalization. Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96-1.00). Semaglutide (aHR, 0.78; 95% CI, 0.68-0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69-0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23-1.30; liraglutide: aHR, 1.08; 95% CI, 0.55-2.15). Among patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.

Emergency Department Visits Involving Hallucinogen Use and Risk of Schizophrenia Spectrum Disorder.

Interest in and use of hallucinogens has been increasing rapidly. While a frequently raised concern is that hallucinogens may be associated with an increased risk of psychosis, there are limited data on this association. To examine whether individuals with an emergency department (ED) visit involving hallucinogen use have an increased risk of developing a schizophrenia spectrum disorder (SSD). This population-based, retrospective cohort study (January 2008 to December 2021) included all individuals aged 14 to 65 years in Ontario, Canada, with no history of psychosis (SSD or substance induced). Data were analyzed from May to August 2024. An incident ED visit involving hallucinogen use. Diagnosis of SSD using a medical record-validated algorithm. Associations between ED visits involving hallucinogens and SSD were estimated using cause-specific adjusted hazard models. Individuals with an incident ED visit involving hallucinogens were compared with members of the general population (primary analysis) or individuals with ED visits involving alcohol or cannabis (secondary analysis). The study included 9 244 292 individuals (mean [SD] age, 40.4 [14.7] years; 50.2% female) without a history of psychosis, with a median follow-up of 5.1 years (IQR, 2.3-8.6 years); 5217 (0.1%) had an incident ED visit involving hallucinogen use. Annual rates of incident ED visits involving hallucinogens were stable between 2008 and 2012 and then increased by 86.4% between 2013 and 2021 (3.4 vs 6.4 per 100 000 individuals). Individuals with ED visits involving hallucinogens had a greater risk of being diagnosed with an SSD within 3 years compared with the general population (age- and sex-adjusted hazard ratio [HR], 21.32 [95% CI, 18.58-24.47]; absolute proportion with SSD at 3 years, 208 of 5217 with hallucinogen use [3.99%] vs 13 639 of 9 239 075 in the general population [0.15%]). After adjustment for comorbid substance use and mental health conditions, individuals with hallucinogen ED visits had a greater risk of SSD compared with the general population (HR, 3.53; 95% CI, 3.05-4.09). Emergency department visits involving hallucinogens were associated with an increased risk of SSD within 3 years compared with ED visits involving alcohol (HR, 4.66; 95% CI, 3.82-5.68) and cannabis (HR, 1.47; 95% CI, 1.21-1.80) in the fully adjusted model. In this cohort study, individuals with an ED visit involving hallucinogen use had a greater risk of developing an SSD compared with both the general population and with individuals with ED visits for other types of substances. These findings have important clinical and policy implications given the increasing use of hallucinogens and associated ED visits.

The Intersection of Traumatic Brain Injury, Substance Abuse, and Mental Health Disorders in Incarcerated Women Addressing Intergenerational Trauma through Neuropsychological Rehabilitation

The intersection of traumatic brain injury (TBI), substance abuse, and mental health disorders presents a significant challenge within the incarcerated female population, where rates of these conditions are alarmingly high. This paper explores the multifaceted relationships among TBI, substance abuse, and mental health disorders, emphasizing the impact of intergenerational trauma on this vulnerable group. Women in correctional facilities often experience a history of trauma, exacerbating their mental health challenges and increasing the likelihood of substance use as a maladaptive coping mechanism. The cumulative effects of TBI can further complicate their psychological and emotional well-being, leading to a cycle of trauma that is perpetuated across generations. Through a review of current literature and case studies, this paper advocates for the implementation of neuropsychological rehabilitation programs that address the unique needs of incarcerated women. Such interventions are crucial not only for improving individual outcomes but also for breaking the cycle of trauma that affects families and communities. Recommendations for policy reforms and future research directions are provided to enhance the efficacy of rehabilitation efforts and support the reintegration of these women into society.

Unveiling the roadblocks: exploring substance use disorder treatment policies in Iran through a qualitative lens.

Different countries, including Iran, have implemented various policies to address substance use disorder. This study aims to describe the policies related to substance use disorder treatment and identify challenges related to these policies in Iran since the beginning of the Iranian Revolution in 1979. This qualitative study utilized document analysis and interviews with policymakers and implementers. We reviewed a total of 22 documents related to substance use disorder treatment and harm reduction. The results from document analysis complemented and validated the interview data. The research population comprised policymakers and implementers, including individuals directly involved in formulating and implementing substance use disorder treatment policies. Purposive sampling was employed, with a snowball strategy utilized to maximize diversity. Data saturation was achieved after conducting 32 semi-structured interviews. Conventional content analysis was used for data analysis. In general, the policy landscape for substance use disorder treatment in the Islamic Republic of Iran can be divided into two periods: the "Moral Model" era (1979-1993) and the "Disease Model" era (1993-present). Challenges within the content of substance use disorder treatment policies in Iran encompass the lack of law revisions, existence of contradictions in laws and nature of disease, the absence of evidence-based policymaking, and an inadequate comprehensive perspective on the phenomenon of substance use disorder. The presence of multiple authorities with different perspectives on substance use disorder and its treatment, coupled with the application of personal preferences in policymaking and the absence of evidence-based policymaking, have contributed to weaknesses in decision-making and policy formulation. The true philosophy of Disease Model appears not to have been fully grasped by health policymakers in Iran, as all Disease Model policies have been pursued with an emphasis on abstinence and quitting. Iran and other nations facing similar challenges should place more reliance on evidence-based approaches and shift away from the "Moral Model" paradigm to develop more effective substance use disorder treatment policies.

The Role of Dopamine in Impulsivity and Substance Abuse: A Narrative Review

Substance use disorder (SUD), based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is defined by symptoms caused by utilizing a substance that a person continues taking despite its negative effects. Impulsive decision making is commonly defined as a reduced ability to choose a delayed large reward instead of a small immediate reward. Dopamine has been implicated as a prominent neurotransmitter implicated in the development and pattern of addiction and impulsivity, especially in regard to substance use disorder. Discovery as a key player in the development of addiction dates to the 1950s, with a study performed by Olds and Milner on rats placed in a Skinner box. Their original discovery is part of the beginning of what would become the search into the main mechanistic source of addiction, and how exactly it works at a cellular, physiological, and psychological level. The dopaminergic pathways of our brains are well-studied. It is well established that most of the dopaminergic neurons of the brain are located in the ventral mid-brain and consists of four main pathways: mesocortical, mesolimbic, nigrostriatal, and tuberoinfundibular pathways. Dopamine acts various receptors, with dopamine (D) receptors 1, 2, and 3 playing a major role in motor function and receptors D1 and D2 playing a major role in reward. There are additional studies warranted, especially finding ways to manipulate the dopaminergic system to treat addiction disorders of all varieties. The focus of the present investigation is to delve into the current literature regarding dopamine and its clinical implications in substance use disorder and impulsive behavior.

Life After EBPs: Characterizing Subsequent Engagement in Evidence-Based Psychotherapy After Completion of an Initial Trauma-Focused EBP in a National Sample of VA Patients.

Many Veterans who complete prolonged exposure (PE) or cognitive processing therapy (CPT) report residual symptoms, but it is unclear how to best address the mental health needs of these individuals. Examining patterns of mental health service utilization following completion of these two treatments may provide insight into how to best serve this group of individuals. In a large cohort of Veterans (N = 12,514) who sought treatment in the Veterans Health Administration during Fiscal Years 2015-2019, logistic regression models were used to assess the odds of initiating an additional course of trauma-focused (i.e., PE or CPT) or depression-focused psychotherapy in the year following completion of PE or CPT based on demographic, psychiatric, and treatment effectiveness-related variables. Approximately 9% of Veterans engaged in either trauma-(6%) or depression-(3%) related psychotherapy in the year following discharge from PE or CPT. Factors associated with increased odds of trauma-focused treatment initiation included having a sleep disorder diagnosis (OR = 1.23), a substance use disorder diagnosis (OR = 1.27), or experiencing military sexual trauma (OR = 1.64). Factors associated with increased odds of depression-focused treatment initiation included having a depression diagnosis (OR = 2.02). This study suggests that certain subgroups of Veterans who engage in PE or CPT (e.g., Veterans with comorbid sleep or substance use problems) are more likely to seek additional evidence-based treatment and may require augmentations to maximize clinical benefits, either during the initial course of treatment or subsequent to PTSD treatment.

Evaluating Stigma Toward Individuals With Substance Use Disorder Among Prelicensure Nursing Students

Background: Seventeen percent of individuals in the United States live with substance use disorder (SUD). Nursing curricula may not adequately address SUD, and stigma can impact care. Purpose: This project aimed to measure stigma toward people with SUD among nursing students. Methods: Surveys were administered to prelicensure nursing students. Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid-Use Scale. Students were asked about personal experience with SUD and perceived adequacy of SUD-related curricula. Results: A total of 193 students participated. The mean stigma score was 31.35. Those with personal experience had lower stigma scores than those without ([95% CI 2.26-9.23]; P value = .0014). Most students (71.0%) desired to see content from individuals with lived experience incorporated into curriculum. Conclusion: Addressing stigma in SUD education is critical for improving future patient care. Nursing schools should consider incorporating stigma-reducing content, including perspectives from individuals with lived experiences, into SUD curricula.

Correction to: Managing Pain with Opioids in the Setting of Substance Use Disorder

Correction to: Managing Pain with Opioids in the Setting of Substance Use Disorder