EClinicalMedicine
January 1, 2026
Henrique Nunes Pereira Oliva, Tiago Paiva Prudente, Alisson M Paredes Naveda et al.
5 citations
Sleep disturbances are common in people with substance use disorders and often persist after stopping use. This systematic review and meta-analysis of 43 studies with about 7500 participants examined sleep abnormalities linked to alcohol, benzodiazepine, cannabis, cocaine, methamphetamine, nicotine, and opioid use disorders. Total sleep time was reduced in alcohol, nicotine, and opioid use disorders. Slow-wave sleep was reduced in alcohol and cocaine use disorders. Sleep quality, measured by the Pittsburgh Sleep Quality Index, was poorer in alcohol, cocaine, and nicotine use disorders. No studies met criteria for benzodiazepine or methamphetamine use disorders. Results suggest specific substances relate to distinct sleep problems, highlighting areas for further research.
Addiction (Abingdon, England)
January 29, 2026
Yi-Hsuan Liu, Chia-Chun Hung, Marc N Potenza et al.
Recreational ketamine use, primarily administered by smoking, is associated with dose-dependent psychiatric symptoms and cognitive deficits. Heavier use correlates with greater psychological distress, especially anxiety and hostility. Users show reduced accuracy on high-load working memory tasks and have smaller left hippocampal volume, most notably in the hippocampal-amygdaloid-transition-area. Functional connectivity between this region and several brain networks is increased and aligns with NMDA-receptor distribution. These findings suggest that chronic, smoking-administered ketamine use selectively affects hippocampal subregions and related circuitry, potentially explaining working memory impairments.
Expert opinion on pharmacotherapy
February 1, 2025
Alejandra Pulido-Saavedra, Anna Borelli, Razi Kitaneh et al.
Substance use disorders remain a public health challenge; few have FDA-approved treatments, and those that do suffer from high dropout rates. This narrative review examined clinical evidence for non-psychedelic medications that primarily target the 5-HT2A receptor. Results on craving and abstinence were mixed, with some positive effects but no consistent pattern. Comparing these findings with those for psychedelic agents (which are typically 5-HT2A agonists) suggests that mixed results are not unique to non-psychedelics. Because most non-psychedelic agents reviewed are 5-HT2A antagonists, while psychedelic agonists show more uniformly positive outcomes, the authors propose that 5-HT2A receptor agonists are a promising avenue for treating substance use disorders, possibly by addressing a common underlying chronic hypodopaminergic state.