Center on Substance Use & Health

02/13/2026

New paper alert 🚨

Our LASSO paper comparing antecedents of stimulant deaths involving fentanyl to stimulant-only deaths found that past-year fentanyl use and opioid-related emergency department visits in the 3 years before death were associated with higher odds of having a fentanyl involved death. Additionally, having a cardiac condition was associated with lower odds of fentanyl involvement in death.

Read more here:

Our findings add to existing evidence that fentanyl-stimulant deaths are markedly different than stimulant-no-opioid deaths. The association of opioid-related emergency department history with fentanyl involvement in death reinforces a potential touch point for overdose prevention efforts (eg, nalox...

02/04/2026

New paper alert 🚨
Study led by CSUH Research Scientist Dr. Leslie Suen, interviewed 19 OBIC patients who tried low-dose buprenorphine starts.

Key takeaways:
• Many valued being able to ease into treatment without stopping use right away
• Bubble packs helped build trust and made the process feel more manageable
• Precipitated withdrawal was uncommon, but discomfort, loss of the fentanyl “high,” and lack of supportive environments/housing still made continuing challenging

These findings help understand barriers to treatment and how more flexible, patient-centered approaches could improve access and retention.

Read more here!

01/16/2026

🚨 New Paper Alert! 🚨
CSUH's Dr Appa once again advances care in HIV and stimulant use with an innovative contingency management program!

Contingency management for stimulant use and/or ART adherence (using point-of-care tenofovir assays) embedded into HIV care was associated with reduced stimulant use and gains in viral suppression. Scalability of integrating HIV and stimulant use disorder management using CM merits further evaluatio...

12/17/2025

🚨 New study alert!

Wearing many hats, CSUH scientist, Dr. Appa somehow finds time for this cutting-edge trial of XR-naltrexone to help prevent overdose from unintentional fentanyl exposure among people who use stimulants.

Exciting work that could expand the toolbox for overdose prevention and harm reduction!

Read the full article to learn more about the NOD study here!

Drug-related mortality in the United States continues to transform, marked by a surge in overdose deaths involving both fentanyl and stimulants. This patte

11/25/2025

Women can be distrustful of research. We explored strategies to improve their involvement in substance use work. Read more about our HEAR study below!

Objectives We assessed the acceptability of four recruitment strategies and explored facilitators and barriers to research engagement among women who use opioids. Methods We recruited self-identified women reporting past 14-day non-prescribed opioid use using four recruitment approaches: community o...

11/20/2025

Our REBOOT study paper is out. Our phase 3 trial of REBOOT failed to reduce opioid overdose. We suspect it was both the shift to fentanyl and the robust services already in SF and Boston. Read more about it here.

Background and aims The emergence of fentanyl in the street market for opioids has limited the benefits of some interventions to manage opioid overdose; thus, preventing the occurrence of opioid ove...

11/13/2025

Negative science is just as important as positive findings. Participants in our behavioral overdose prevention intervention already responded to nearly all overdoses they witnessed, an outcome that was not further improved by the intervention. Read more about it here.

10/23/2025

CSUH is pleased to release our annual report on trends in substance use mortality through 2024 for the City and County of San Francisco. Deaths attributed to acute toxicity from opioids, co***ne, or methamphetamine decreased by 25% from 2023 to 2024. Read the full report on our website for detailed analyses including demographic trends and trends by substance.

10/14/2025

Big news For substance use research! Governor Newson Signed and passed AB 1103, establishing a smooth and rapid approvals for studies and helping to bring more groundbreaking studies to the communities we serve. Click the link in our bio to learn more!

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 methamphetamines and/or living with methamphetamine 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!