Center on Substance Use & Health

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 m**hamphetamine 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 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.