Center on Substance Use & Health

09/19/2025

This analysis of opioid and stimulant deaths suggests we are counting wrong. Deaths involving both opioids (or just fentanyl) and stimulants are really similar to those not involving stimulants. But stimulant deaths without opioids are different - and require different prevention strategies. We can’t respond right if we’re not counting correctly.

Background and aims Deaths attributed to a combination of opioids and stimulants have risen dramatically in recent years, largely attributed to fentanyl, yet little is understood about which drug cl...

09/12/2025

Our very own Dr. Phillip Coffin was featured on Curbsiders Addiction Medicine podcast! Tune into episode #497 to learn more!

Transcript available via YouTube In this high-yield episode of Curbsiders Addiction Medicine, we dive deep into a practical and compassionate approach to caring for patients using m**hamphetamines and/or living with m**hamphetamine use disorder. We explore the latest pharmacologic options, harm redu...

09/11/2025

Our very own Dr. Phillip Coffin was featured on The Curbsiders Addiction Medicine podcast! Tune in to Episode #497. Link in Bio!

08/13/2025

Fentanyl-related cardiac arrests had less bystander CPR, fewer shockable rhythms, and more severe brain injury on EEG, but good neurological outcomes were similar to other causes. This highlights unique challenges in fentanyl-linked cardiac arrest cases.

Cardiac arrest associated with fentanyl use was linked to decreased rates of bystander cardiopulmonary resuscitation, increased incidence of nonshockable Rhythms, and greater neurological injury as indicated by electroencephalography (EEG) suppression measures. However, the proportion of good neurol...

08/13/2025

Naltrexone-bupropion significantly reduced depressive symptoms early in people with m**hamphetamine use disorder, boosting chances of remission and cutting m**h use. Early depression improvement explained nearly 25% of its effect on m**hamphetamine treatment success.

Objective: This study evaluated whether depressive symptom severity improved early with extended-release naltrexone and bupropion combination (naltrexone bupropion) compared to a placebo in individuals with moderate/severe m**hamphetamine use disorder and predicted subsequent use of met...

08/04/2025

This study found that opioid overdose survivors who perceive themselves at higher risk are over twice as likely to overdose again within four months. Assessing risk perception can help target and improve overdose prevention efforts.

Incorporating an assessment of risk perception into opioid overdose prevention efforts may help prioritize prevention efforts.

08/04/2025

Among opioid overdose survivors, less than half of overdoses involved EMS, about one-third led to emergency visits, and few resulted in hospitalization. Most overdoses had naloxone given by bystanders. Relying only on healthcare data underestimates non-fatal overdose rates.

08/04/2025

The ADAPT-2 trial found, higher craving and impulsivity predicted worse outcomes in m**hamphetamine treatment with naltrexone and bupropion. Targeting these factors may improve treatment response.

Further investigations are necessary to optimize NTX-BUP treatment, focusing on the impact of craving and impulsivity on outcomes.

08/04/2025

This study looked at whether people with chronic pain who stop receiving prescribed opioids continue to get recommended preventive healthcare. We found that those who kept getting opioids were more likely to receive important screenings and vaccines. Losing access to opioids was linked to lower engagement in preventive care, highlighting the need for opioid policies that also support ongoing healthcare access.

Background In response to increasing opioid overdose, US providers reduced opioid prescribing, resulting in several unintended consequences. Methods We assessed the impact of opioid receipt on quality health indicators (QHI) among 300 adults prescribed opioids ≥ 3 months in the past year for c...

06/30/2025

Check out this dynamic Conversation with Mental Health Experts (CME) podcast episode as Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health, about managing stimulant use disorders. Explore treatment challenges and how harm reduction is changing lives.

In this CME podcast episode, Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health in San Francisco, CA, about the management of stimulant use disorders. They explore the challenges of treatment and highlight the importance of harm reduction strategies t...

06/27/2025

In the M3 study, 15 participants (including cisgender and transgender individuals) received intravenous m**hamphetamine under both placebo and mirtazapine conditions. Methamphetamine produced typical stimulant effects under placebo, while mirtazapine significantly reduced hypothetical drug demand without altering subjective or cardiovascular responses. All treatments were well tolerated. These findings support continued evaluation of mirtazapine as a promising pharmacotherapy for m**hamphetamine use disorder.

05/21/2025

In this commentary, Dr Coffin clarifies the role of naloxone in reversing overdose, and notes that more is not necessarily better.

"Opioid overdose reversal requires just enough naloxone, with appropriate respiratory and cardiovascular support. There is precious little evidence or justification for higher dose or longer acting overdose reversal medications."

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