The article, “Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis,” has been published in SAj.

In this commentary, the authors state that outpatient methadone guidelines recommend starting at a low dose and titrating slowly. As fentanyl prevalence and opioid-related mortality increases, there is a need for individuals to rapidly achieve a therapeutic methadone dose. Hospitalization offers a monitored setting for methadone initiation, however dosing practices and safety are not well described.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“In this retrospective analysis of hospitalized patients with OUD who were newly initiated on methadone by an inpatient addiction consult team, patients were titrated more rapidly than traditional OTP initiation dosing with only 3.5% of patients experiencing a safety event probably or definitely related to methadone. In all cases the safety event was oversedation not requiring naloxone. Patients who experienced an oversedation event that was possibly related to methadone had higher final methadone doses than those who did not experience any sedation events. More than three-quarters (76%) of patients were successfully connected to an OTP prior to discharge.”

“These findings suggest that hospitalization may offer an opportunity to safely initiate methadone with a more rapid dosing titration than what is currently utilized in outpatient settings.”

The article, “Dispensary Staff Perceptions About the Benefits, Risks, and Safety of Cannabis for Medical Purposes,” has been published in SAj.

In this commentary, the authors state that therapeutic use of cannabis is common in the United States (up to 18.7% of Americans aged ≥12), and dispensaries in the US are proliferating rapidly. However, the efficacy profile of medical cannabis is unclear, and customers often rely on dispensary staff for purchasing decisions. The objective was to describe cannabis dispensary staff perceptions of medical cannabis benefits and risks, as well as its safety in high-risk populations.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Not surprisingly, it follows that very few (<3%) dispensary customers use advice from a medical professional to guide their product choice, relying on dispensary staff. Other studies have documented dispensary staff roles in offering recommendations to treat a variety of medical conditions with cannabis products.

The purpose of this study was to conduct a descriptive study to better understand cannabis dispensary staff perceptions of medical cannabis benefits and risks for several medical conditions, as well as its safety in high-risk populations (pregnant individuals, older adults). This study is significant in that our findings provide new knowledge to help medical professionals provide anticipatory guidance to patients about how dispensary staff think about cannabis benefits and risks in the context of available medical evidence. This may have important implications for policy guidance on dispensary staff training, and lead to key next steps (e.g., training development) that improve customer safety and efficacy outcomes.”

The article, “Evaluating a Video-Based Addiction Curriculum at a Safety Net Academic Medical Center,” has been published in SAj.

In this commentary, the authors state that since 2019, the United States has witnessed an unprecedented increase in drug overdose and alcohol-related deaths. Despite this rise in morbidity and mortality, treatment rates for substance use disorder remain inadequate. Insufficient training in addiction along with a dearth of addiction providers are key barriers to addressing the current addiction epidemic. Addiction-related clinical experiences can improve trainee knowledge, yet they remain dependent on practice sites and residency training environments. Asynchronous learning, in the form of video-based modules, may serve as a complement to formal, scheduled lectures and clinical experiences.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“The rising morbidity and mortality associated with SUD highlights the importance of making addiction education materials available to all medical providers. Asynchronous learning modalities such as brief addiction videos have the capacity to improve confidence in and knowledge around management of OUD and AUD among medical trainees.”

“While evidence demonstrates that brief addiction-related clinical experiences improve trainee knowledge, these clinical experiences are not always available or feasible. Further, formal or scheduled didactic lectures are often not adequate to reach large groups of residents or faculty who have varied practice schedules. Asynchronous learning—self-paced, efficient learning—is a potential solution for busy medical trainees and can complement clinical experiences. Asynchronous learning became more feasible during the COVID-19 pandemic when in-person lectures transitioned to interactive virtual platforms.”

What is peer review? Peer review is the independent assessment of your research paper by experts in your field. The purpose of peer review is to evaluate the paper’s quality and suitability for publication. It’s a collaborative process where authors engage in a dialogue with peers in their field and receive constructive support to advance their work. Peer review is designed to assess the validity, quality, and often the originality of articles for publication. Its ultimate purpose is to maintain the integrity of science by filtering out invalid or poor quality articles.

Peer review plays a valuable and essential role in upholding the high standards of scholarly communications and maintaining a journal’s quality. It is also an important support for the researchers who author the papers.

SAj depends on the hard work of reviewers, who are the ones at the forefront of the peer review processs and are the ones who refine each article before publication. The feedback and comments of carefully selected reviewers are an essential guide to inform the Editor in Chief’s decision on a paper.

The peer review process can alert you to any errors in your work, or gaps in the literature you may have overlooked. What peer review does best is improve the quality of published papers by motivating authors to submit good quality work – and helping to improve that work through the peer review process. 

Adèle Morvannou, one of two recipients of the 2023 SAj Best Peer Reviewer Award, says:

“Personally, I consider peer review as an opportunity to feel part of a community where its members collaborate to make scientific productions of high quality. But it is also a way for me to keep my mind sharp by cultivating a critical eye towards the literature, while having the opportunity to stay up to date with scientific knowledge and best practices. In recent years, I have given a lot of thought to how to provide feedback after reading an article in peer review.”

“It is not always easy as an author of an article to receive criticism from a reviewer. I personally think that the way to transmit these comments must be critical but argued, precise by giving examples and empathetic, while recognizing the contribution of each article. When doing the review I usually try to remember the good practices when as a clinician we give feedback to a trainee for example, this allows I think to have interesting ingredients for the authors to take into consideration the comments and be motivated to make beneficial changes for the article.”

To learn more about joining SAj as a peer reviewer, please email SAj@amersa.org.

The article, “Outcomes of State Targeted/Opioid Response Grants and the Medication First Approach: Evidence of Racial Inequities in Improved Treatment Access and Retention,” has been published in SAj.

In this commentary, the authors state that the opioid overdose epidemic in the United States persists as a public health crisis despite recent increases in funding and public attention. Nationally, overdose deaths among Black Americans have outpaced deaths among White Americans since 2019.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“These mortality data demonstrate the importance of assessing racial equity within opioid-related substance use disorder (SUD) services. The current study examines racial differences in the St. Louis region for outcomes of Missouri’s low-barrier “Medication First” approach to opioid use disorder (OUD) treatment, aimed at improving access to and retention on medications for opioid use disorder (MOUD).”

“The overdose crisis is disproportionately affecting Black communities across the United States. Despite a significant need for effective substance use services, Black people who use drugs often experience substantial barriers to entering and maintaining treatment and recovery. In Missouri, the Medication First approach was developed and disseminated through STR/SOR funding with the intention of broadly reducing structural barriers to MOUD treatment to enable all people coming from a variety of life circumstances maintain their care. We found that despite these efforts, STR/SOR funding fueled racial inequities in OUD treatment access and retention in the St. Louis region, with proportionally larger enrollment and increases in MOUD among White clients than Black clients, and shorter treatment retention of Black clients than White clients. Critically, treatment initiatives aimed to better serve people with OUD must prioritize racial equity in the planning and implementation phases or risk introducing or worsening racial inequities.”