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Recent United States alerts on fentanyl analogues, medetomidine, cychlorphine, drug mixtures and concentrated 7-OH products highlight evolving challenges across the substance use workforce. They invite us to review local preparedness, understand testing limitations and strengthen links between frontline services, laboratories and public-health partners. A useful response brings together clinical, prevention, recovery and peer perspectives, with clear responsibilities for turning relevant findings into action. For the global ISSUP community, these alerts offer lessons in preparedness while requiring careful consideration of local evidence, resources and service arrangements. Staying informed through trusted sources and sharing practical responses through ISSUP can help translate emerging knowledge into safer care and more responsive support for individuals, families and communities.

It’s been more than 50 years since the United States launched a “war on drugs.” History has demonstrated the ineffectiveness of “tough-oncrime” drug-use policies, including laws requiring mandatory minimum sentencing for possession of...

Introduction: For adults involved with the criminal justice system who are reentering their communities postincarceration, there is a large need for community-based substance use treatment. Little is known, however, about the types...

Abstract Importance The number of US adults with alcohol use disorder (AUD) has declined, whereas the number with cannabis use disorder (CUD) has increased. Little is known about how changes in the prevalence and severity of AUD and CUD...

Abstract Importance The US opioid crisis is currently driven by illicitly manufactured fentanyl combined with an evolving mix of stimulants and adulterants, such as the veterinary sedative xylazine, which further complicate clinical and...