Sleep Disturbance in Opioid Use Disorder: Systematic Review of Insomnia Prevalence and Sedative-Hypnotic Utilization

A systematic review examined the prevalence of insomnia and sedative-hypnotic use among people with OUD, analyzing 37 studies meeting inclusion criteria. Insomnia was highly prevalent, with rates ranging from 21% to 88% (mean 53%) depending on the measure used — and insomnia itself emerged as a predictor of relapse and overdose. Sedative-hypnotics provided limited sleep benefits, and regular benzodiazepine use was strongly associated with overdose risk. Commonly used treatments included antidepressants, anticonvulsants and mood stabilizers, with mirtazapine showing improvements in sleep efficiency. Emerging evidence also suggests that orexin receptor antagonists may improve sleep without adversely affecting OUD outcomes, representing a promising area for further research.

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Association Between GLP-1 Receptor Agonists and Alcohol-related Hospitalisations Among Adults With Alcohol Use Disorder: Multi-target Trial Emulation Study



A retrospective cohort study using target trial emulation examined the association between newer glucagon-like peptide-1 receptor agonists (GLP-1 RAs) — specifically semaglutide and tirzepatide — and alcohol-related hospitalizations among adults with alcohol use disorder and type 2 diabetes or obesity. Researchers found that initiating GLP-1 RAs was associated with a lower observed risk of alcohol-related hospitalization in this population. The findings add to a growing body of evidence suggesting GLP-1 RAs may have potential benefits beyond metabolic health for people with AUD.

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The Association Between Naloxone Distribution, Buprenorphine Treatment and Retention and Incident High-risk Opioid Prescribing With Opioid Overdose Death in Kentucky, Massachusetts, New York and Ohio, United States: An Exploratory Community-level Cohort Study of Data From the HEALing Communities Study

This exploratory analysis examined data from 67 communities (8.2 million adults) with high opioid overdose death rates across Kentucky, Massachusetts, New York and Ohio to assess whether naloxone distribution, buprenorphine treatment and high-risk opioid prescribing rates were associated with opioid overdose death rates from 2019 to 2023. Increases in both buprenorphine treatment and retention were significantly associated with decreases in community opioid overdose death rates, after adjusting for baseline treatment levels. Naloxone distribution and incident high-risk opioid prescribing were not associated with changes in quarterly opioid overdose death rates. Substantially expanding the number of people initiated on and retained in buprenorphine treatment may be one of the most impactful strategies available to reduce overdose deaths in communities disproportionately affected by the opioid crisis, underscoring the urgent need for further implementation research to scale access to medication for opioid use disorder.

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Collaborative Care Intervention for Risky Opioid Use Among Primary Care Patients: The STOP Randomized Clinical Trial



A target trial emulation study analyzed more than 100,000 medically managed opioid withdrawal treatment discharge episodes in Massachusetts to compare real-world outcomes of buprenorphine-naloxone versus extended-release naltrexone over a 24-week follow-up period. Patients who initiated buprenorphine-naloxone experienced fewer nonfatal opioid overdoses than those who started extended-release naltrexone (11.6% vs 13.9%), while all-cause mortality was identical between groups. Buprenorphine-naloxone users also demonstrated higher treatment retention, and overdose and death rates rose sharply across both groups when patients stopped receiving medication. The findings highlight the importance of rapid treatment initiation and sustained engagement following withdrawal, regardless of the chosen MOUD pathway.

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Perceived Risk of Fentanyl Use Among US Adolescents



This cross-sectional survey study analyzed nationally representative data from 3,820 adolescents in the 8th, 10th and 12th grades across the United States to evaluate their perceived risk of harm associated with fentanyl use. Utilizing 2025 data from the long-running Monitoring the Future survey, researchers examined how adolescent perceptions of risk varied across different frequencies of use — experimental, occasional and regular — as well as across distinct demographic and regional subgroups. The study revealed a substantial gap in risk awareness among younger adolescents, finding that more than half of 8th graders (52.2%) did not attribute great risk to trying fentanyl experimentally. While risk perception was significantly higher among older students, nearly one-third of 12th graders (30.2%) still failed to recognize experimental use as highly dangerous. Demographically, students in rural areas and non-Hispanic white students reported the highest levels of perceived risk, while Hispanic 8th graders and Black 10th and 12th graders demonstrated the lowest levels of risk awareness across the categories. These findings serve as an urgent call to action for schools, parents, clinicians and community outreach programs to strengthen and implement tailored, early-intervention educational messaging that explicitly highlights the lethal, single-use dangers of fentanyl before students enter high school.

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