Background
The ISAM Global Expert Network (ISAM-GEN), an initiative of ISAM, is dedicated to advancing addiction medicine by creating a robust global infrastructure for expert elicitation and consensus-building in various sub-disciplines. Expert input is crucial in scenarios where empirical data are scarce, issues are complex, or rapid synthesis is needed for decision-making and intervention formulation. By June 2024, ISAM-GEN had developed a comprehensive database of 443 experts from 93 countries, representing diverse fields within addiction science. This was achieved through snowball sampling, alongside contributions from 43 national and regional addiction societies and associations. The network provides a reliable platform for interdisciplinary collaboration, enabling timely and evidence-informed responses to emerging challenges in addiction science.

Objectives
This workshop will highlight ISAM-GEN’s structural achievements, milestones, and ongoing contributions to global addiction medicine. The session will feature detailed updates from the co-chairs of ISAM-GEN’s active working groups, each addressing critical areas within the field. These include Substance Use Disorders (SUD) and Psychosis (Dual Disorders); SUD and PTSD; Problematic Use of Internet (PUI); and Telemedicine for Medication-Assisted Treatment of Opioid Use Disorder (TMOUD). Each presentation will provide insights into the design, progress, and preliminary findings of global surveys and projects spearheaded by these groups. Attendees will gain a comprehensive understanding of ISAM-GEN’s role in addressing comorbid psychiatric disorders, emerging addictive behaviors, and novel therapeutic approaches, reinforcing its position as a pivotal platform for international collaboration in addiction medicine.

Three presenters will discuss new delopments in the treatment of PTSD-SUD.

Kathleen Brady, ast president of ISAM, is a prominent leader in the substance abuse field at a national and international level. She has had a particular focus on the area post-traumatic stress disorder in substance users. She will discuss new undersaning of the neurobiology of PTSD and developments in the treatment of PTSD and SUD, including doxazosin, oxytocin, and TMS (trans magnetic stimulation).

Anil Thomas of NYU Langone will be presenting the latest cutting edge research about the developments of voice recognition and blood biomarker technology that may advance the physiological and molecular profiling of PTSD patients and that may assist addiction physicians in identifying and treating patients with PTSD and co-occurring addictions.  This exciting  current research is spearheaded by the Chair and Distinguished Professor of Psychiatry at NYULangone School of Medicine – Dr. Charles Marmar.

Greg Bunt will describe developments in integrated residential treatment for patients with addictions and co-occuring PTSD. Collaboration with academic centers and governmental agencies have provided those with PTSD and addictions – biopsychosocial treatment continuum of care models needed for full rehabilitation and recovery.

Most countries do not have training programs in addiction, leaving large populations of affected individuals untreated or inadequately treated. Three presenters will discuss their work on surveys to assess training needs in addiction. In addition, the difference between training of addiction medicine and addiction psychiatry will be discussed.

Cornelius deJong, after a review of his comprehensive global addiction medicine- training needs assessment (AM-TNA), discussed in another presentation, will focus on future AM-TNA projects, including an expansion of the survey and establishing a survey platform.

Rania Mamdouh will discuss the ICUDDR Core Competencies Needs Assessment in 29 Egyptian Universities. The ICUDDR needs assessment questionnaire was translated into the Arabic language and was distributed via email to psychiatry, psychology, public health, toxicology, internal medicine, social sciences, nursing and family medicine departments across 29 Egyptian universities. Resulting Data on available addiction curricula in Egyptian universities and the need for which topics and which kind of training are needed will be discussed in the presentation. She will discuss the need for specialised training curriculum in addiction psychiatry and medicine and discuss the difference between the curricula.

Rabia Bilici will discuss a similar survey among trainees and physicians in Turkey.

Carol Weiss will discuss the history of addiction treatment and training in the United States, through the lens of the different approaches to understanding and treating addiction in the two fields of psychiatry and medicine.

Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as an important component of the recovery. Empirical scientific research can shed light on psychological, social, and biological aspects of this construct. The ISAM Spirituality Interest Group makes recommendations for how this construct can be incorporated into research and clinical care. Spirituality has acquired recognition among clinicians because of its close association with twelve-step modalities and its perceived role in the promotion of meaningfulness, healthy lifestyles and successful outcomes in recovery from addiction. It is a common misconception that spirituality and religion are the same things. Many people may be discouraged by the idea of a spiritual road to recovery due to concerns with organized religion. However, one can be spiritual without adhering to a specific faith and it does not diminish the power of the spiritual experience. 12-step anonymous fellowship does not adhere to one specific faith but encourages seekers to find a path towards healing that encompasses their unique worldview. The importance of fellowship in addiction recovery is discussed in relation to recovery and spirituality. 12-step anonymous meetings are accessible in communities throughout the globe and are common among holistically healthy individuals.

The ISAM Spirituality Interest Group recognizes that the condition of addiction as a disorder is related to biological, psychological, and social characteristics as well as views, values and beliefs about the meaning, purpose and personal connections in the lives of individuals that motivate them to mutually seek and remain in recovery. Additionally, the families and communities of addicted individuals may have common spiritual beliefs that may be relevant to treatment and recovery. The importance of international collaborative relationships among addiction medicine physicians is recognized in mutually understanding the integration of spiritual constructs to treatment planning of individuals and families afflicted with addictive disorders from many diverse cultures and value systems. The complicated overlap of spiritual philosophy and addiction medical science will be discussed and debated during this vigorous interactive discourse.

Drug Policy and Harm Reduction are an evolving landscape. The drug overdose/poisoning crisis and Covid pandemic underscore the urgency of these topics.

Decriminalization, legalization, alternatives to incarceration programs, prescribed safe supply, consumption in public places, and overdose prevention services such as supervised injection sites and naloxone distribution, are examples that will be discussed and debated in this workshop. Carl Erik Fisher, an addiction physician and bioethicist and assistant professor of clinical psychiatry at Columbia University in the Division of Law, Ethics, and Psychiatry and is an expert in the Portugal model of Drug Policy where he lived for several months and will describe this model. The focus of the workshop will be on what can be learned from various international models on a comparative basis.

Panelists are all members of the International Society of Addiction Medicine (ISAM) from Canada, Portugal, Egypt, and the US. Greg Bunt MD, past president of ISAM will compare various international models including the Oregon experience. Rania Mamdouh MD, North and West Africa ISAM Regional Representative, will discuss Alternatives to Incarceration in Egypt. Pouya Azar and Nick Mathew from Vancouver will discuss new harm reduction drug policy in British Columbia. Panelists and the audience will then engage in vigorous discussion and discourse.

Concurrent substance use and psychotic disorders pose significant challenges for healthcare systems worldwide, demanding integrative and multidimensional approaches to treatment. This workshop will share insights from a recently completed survey on the global landscape of the field. The findings will form the basis for discussions on essential training priorities and recommendations to address foundational infrastructural requirements

Global ISAM Survey: Arash Khojasteh Zonoozi and Pooria Ahamadi will summarize the results from a completed ISAM Global Experts Network (ISAM GEN) based assessment of capacity and needs in the treatment of concurrent Substance Use and Psychotic Disorders. The worldwide assessment is the first step and basis of developing a network to support address the current gaps.

Training Needs for Treatment Providers: Christian G. Schütz will report on an in-depth assessment of the training gaps faced by professionals working with dual-diagnosis patients. Emphasis will be placed on core competencies, interdisciplinary collaboration, and culturally informed care, with recommendations for enhancing workforce readiness to deliver integrated treatment.

Infrastructure Needs for Effective Care Delivery: Kathleen T. Brady will examine systemic barriers and infrastructure needs, focusing on access, resource allocation, and policy support. This session will offer strategic recommendations for building resilient and responsive healthcare systems.

This session is designed for clinicians, policymakers, and researchers committed to advancing care for this vulnerable population. The workshop will combine overview presentations with the possibility to discuss the barriers and options in local context.

This workshop will be complementary to a workshop provided by Solja Niemelä focusing on clinical aspects to treat concurrent substance use and psychosis disorders.

Introduction/Objectives: Substance use among adolescents remains a concern globally, with adolescence being a peak period for initiating substance use while brain development is still ongoing and young people are exposed to many risk factors. The prevalence of cannabis use in the age group 15-16 (5.5%) was estimated higher than in the general population (4.4%) globally [1]. With the aim to address this public health issue, UNODC, in close coordination with WHO, developed a science-informed, skills-based training package, called Treatnet Family, to support practitioners working with adolescents with substance use disorders and their families, including those in contact with or at risk in contact with the criminal justice system. Treatnet Family, aligned with the UNODC-WHO International Standards for the Treatment of Drug Use Disorders [2], consists of elements of family therapy. The feasibility and acceptability of Treatnet Family was demonstrated through feasibility studies in low- and middle-income countries (LMICs).

Methods: This workshop will showcase the impact of Treatnet Family for adolescents with substance use disorders and their families, such as reduced drug-related problems among youths, reduced substance consumption, reduced mental health problems, and improved family interaction. Updates on implementation in 34 LMICs will be provided, and opportunities and challenges with regard to Treatnet Family implementation, follow-up and scaling up will be discussed. The acceptability and feasibility of using digital technology to train community practitioners on Treatnet Family has been tested during the COVID-19 pandemic, and in 2024, UNODC launched a self-paced Treatnet Family course on the UNODC Global e-Learning platform to compliment in-person training.

Conclusions: UNODC, in coordination with UN Member States and partner agencies, continues to provide technical support to enhance the national-level health and social systems addressing substance use and substance use disorders among adolescents focused on capacity development of practitioners.

This workshop will engage participants in exploring how people who use drugs (PWUD) and people with lived experience (PWLE) can be meaningfully involved in the development of digital innovations for substance use disorder prevention and treatment. Drawing on models of co-design, ladders of participation, and community-based research, the session will facilitate a collaborative discussion on the ethical, cultural, and geographical considerations by PWLE in digital health interventions.

Key themes will include the challenges and opportunities of incorporating PWLE perspectives in the design and testing of digital tools, with a particular focus on high levels of participation and empowerment. Participants will critically examine the roles of pharmaceutical and tech companies, as well as explore the motivations behind digital health initiatives, including profit-driven interests and their implications for community-led solutions.

Through case studies and real-world examples from diverse regions—such as Tehran,Vancouver, and New York—the workshop will highlight the importance of culturally sensitive, geographically specific approaches to digital health innovations. Ethical principles will be discussed, including how to ensure the mindful incorporation of PWLE while safeguarding their privacy and dignity.

We will also assess gaps in current protocols from organizations like the National Institute on Drug Abuse (NIDA) and National Institutes of Health (NIH) related to PWLE involvement. This includes reviewing study designs published through open science frameworks, and policies around compensation and involvement. Special attention will be given to the ethical and cultural challenges involved in ensuring that PWLE from diverse communities are meaningfully engaged, particularly in relation to product testing and implementation in grassroots organizations. This workshop will foster dialogue around best practices for inclusive digital health innovation, empowering PWLE to take an active role in shaping solutions that address their needs.

Introduction/Objectives: Drug use remains high globally, posing a public health concern. The UNODC World Drug Report 2024 [1] estimates the prevalence of drug use at 5.6%, with 292 million people having used an internationally controlled substance worldwide, and 64 million people living with drug use disorders. The treatment gap widened in the last 5 years, with only one in 11 having access to treatment. In order to address this gap while ensuring quality of drug dependence treatment, since 2009, UNODC and WHO have promoted evidence- and human rights-based drug use disorder treatment through the implementation of the UNODC-WHO Programme on Drug Dependence Treatment and Care [2] and developed a range of initiatives, including the UNODC-WHO International Standards for the Treatment of Drug Use Disorders (the Standards) [3] and the S-O-S initiative on overdose management to demonstrate the feasibility of evidence-based responses in different settings. Urgent investment is needed in the light of the growing threat from synthetic drugs to strengthen national health systems to provide effective responses for people with drug use disorders, their families, and communities.

Methods: This workshop will provide an overview of milestones from 15 years of the UNODC-WHO work in response to synergic mandates from UN Member States. The workshop will seek feedback on emerging initiatives and tools such as the Implementation toolkit of the Standards, the #ScaleUp initiative on scalable interventions for the treatment and care of stimulant use disorders and new guidelines on opioid use disorder treatment.

Conclusions: UNODC and WHO count on a longstanding interagency partnership, supporting UN Member States in implementing health-centred, ethical responses to drug use disorders, with a view to improving the health of people using drugs, their families, and communities. The workshop will provide an opportunity for suggestions and considerations to develop the programme into the future.

Intergenerational trauma (IGT) refers to the transmission of trauma from one generation to the next, significantly impacting individuals with substance use disorders (SUD) and their families. This keynote presentation will explore the intricate connection between IGT and SUD, drawing on recent research that demonstrates how trauma can influence neurodevelopment, attachment, and addiction vulnerability across generations.

Studies indicate that approximately two-thirds of individuals with SUD have a history of childhood trauma or adverse experiences (Khatzian, 1997; Hien & Honeyman, 2000; Koob & Le Moal, 2006). Recent epigenetic research has provided compelling evidence for the biological transmission of trauma effects, potentially perpetuating cycles of SUD and related mental health challenges across generations (Meaney et al., 2010; Heim & Nemeroff, 2001; Kendler et al., 2012). This epigenetic inheritance may be influenced by changes in DNA methylation patterns and gene expression, which can be passed down from one generation to the next, potentially influencing the development of mental health disorders.

This presentation will introduce evidence-based strategies for behavioral health professionals to effectively address IGT within SUD treatment frameworks. Participants will learn how to integrate trauma-informed care with specific IGT-focused interventions, applicable across various treatment modalities including inpatient, outpatient, and family therapy settings.

Through a combination of current research findings, case studies, and practical intervention techniques, attendees will gain valuable insights into interrupting the cycle of intergenerational trauma. This knowledge will enhance their ability to provide comprehensive, multigenerational healing for individuals with SUD and their families.

According to the International Olympics Community (2021), the substances most commonly used or misused by elite athletes across countries, sports and genders are alcohol, nicotine and cannabis. A 2018 meta-analysis found that 19% of athletes and 21.1% of former athletes reported symptoms of alcohol use disorder.

8,2% of athletes had gambling problems.

A 2020 study reported that hazardous drinking was found in 25.8% of athletes.

Although health benefits of sport are widely known and recognized, environment plays a major role in the initiation and maintenance of addictive behaviors, and the work environment of athletes is no exception.On the other hand athletes often present individual vulnerability factors.

Objective: The workshop aims to share theoretical and clinical knowledge about:
– Addiction prevention program specifically dedicated to athletes
– Elite athletes addiction screening & care during career and at the cessation
– sports environments & sport betting

This workshop aims to explore the use of psychedelic-assisted psychotherapy (PAP) in treating patients with addiction, focusing on substances like LSD and psilocybin. As addiction continues to challenge traditional therapeutic methods, emerging research highlights the promising role of psychedelics in treating substance use disorders. The workshop will provide participants with a comprehensive understanding of how these substances are utilized in a psychotherapeutic in Geneva University Hospital.

Participants will be introduced to the key psychotherapeutic skills required when working with patients undergoing psychedelic-assisted treatment. This includes understanding the set and setting, establishing trust, and navigating the emotional and psychological responses that arise during sessions. Specific psychotherapeutic interventions will be discussed, emphasizing the importance of integration sessions post-experience to ensure lasting therapeutic effects.

Additionally, the workshop will cover the clinical indications and contraindications for using psychedelics in addiction treatment. Discussion will include patient screening processes, assessing readiness for treatment, and managing potential risks associated with psychedelic substances, including psychological distress or adverse reactions. Participants will learn about the careful balance required to maximize therapeutic benefits while minimizing harm.

Preliminary data on the success rates of psychedelic-assisted psychotherapy for addiction in Geneva Universit Hospital will be presented, along with insights from clinical trials and case studies. These examples will illustrate the potential benefits, challenges, and outcomes of treatment, offering a realistic perspective on the integration of psychedelics in clinical practice.

By the end of the session, attendees will have a deeper understanding of how psychedelic-assisted psychotherapy can be effectively used as a tool in addiction treatment.

Background

Substance use disorder (SUD) is a well-recognized comorbidity in schizophrenia spectrum disorders, and rates of substance use are significantly higher among patients with first-episode psychosis (FEP) than in the general population (1). When a patient presenting with FEP has co-occurring substance use, such as cannabis or stimulant use, it can be extremely difficult to distinguish by clinical presentation whether the psychosis is substance-induced (SIP) or a primary psychosis, where substance use is only temporally connected (2). We do know, however, that patients presenting with FEP diagnosed as a SIP have high conversion rates into the schizophrenia spectrum in the following years (3).

Current knowledge on the efficacy of antipsychotic treatment among persons with FEP and comorbid SUD is scarce, and we know even less about treatment of FEP-SIP. Real-world treatment outcomes of patients with psychotic disorders and SUD have been examined in nationwide register-based studies (4). A recent study found evidence to support the use of clozapine, LAI formulations of second-generation antipsychotics other than olanzapine, or oral aripiprazole to prevent hospitalization in FEP and co-occurring cannabis use disorder (CUD) (5). There is a need for more research to guide clinicians in their decision making when patients present with FEP and co-occurring substance use.

Objectives

This interactive, hands-on skills-building workshop will include three case vignettes concerning differential diagnostics, course and treatment of psychosis with co-occurring substance use. Participants will discuss the cases in small groups (15 min per case) after which there will be a general discussion led by the facilitators (10 min), as well as brief fact sheets concerning the most recent literature relevant to each case. To close, the participants will have the chance to bring forth own cases and experiences relevant to the topic (15 min).

Addiction nursing in Europe constitutes, on average, over 50% of addiction care providers. However, this critical workforce remains significantly underrepresented in leadership roles, research initiatives, and policy development efforts.

Connected causes: pervasive stigma, insufficient integration of addiction education into
nursing curricula, and the emotional toll of providing care in stressful environments.

Addiction nurses from Ireland, the United Kingdom, the Netherlands, Portugal, Finland,
Spain, Poland, Cyprus, and Iceland, share a common mission: to address stigma, advance education, and build resilience in the nursing workforce.

Chris Loth’s (2009) early research highlighted how nurses face professional stigma, where they are marginalised as ‘dispensers’; rather than being recognised professionals. This stigma undermines professional identity, fosters self-stigmatisation, and limits nurses’ ability to advocate for their patients and their own roles within the healthcare system.

Carmel Clancy’s (2007/2019) research showed limited addiction-specific content in nursing curricula across Europe exacerbates the workforce challenges, leading to gaps in both care quality and professional development opportunities.

Nicki Annunziata’s work (2024) on trauma and resilience highlights the need to prioritise trauma-informed practices and create systems that mitigate vicarious trauma(VT). Building resilience is critical to retaining skilled nurses but, to ensuring they can continue delivering compassionate, trauma-informed care without compromising their well-being.

Catherine Comiskey and colleagues (2021) have documented the effectiveness of nurse-led addiction treatment centres on patient outcomes while empowering nurses to challenge professional stigma and showcase their expertise.

This workshop will weave together these themes.

Vapes, vaporizers, vape pens, hookah pens, e-cigarettes or e-cigs, and e-pipes are some terms used to describe electronic nicotine delivery systems (ENDS), which are battery-powered tobacco products that typically deliver inhalable, aerosolized nicotine. E-cigarettes are the most used tobacco product among U.S. middle school and high school students, with the vast majority of these products using flavors such as fruit, candy, or desserts that specifically target youth. Research has demonstrated multiple adverse effects, including increased risk of anxiety, depression, suicidal ideation, and impact on brain development. Despite this, clinicians often have difficulty addressing vaping as many patients still perceive it as a safe alternative to combustible tobacco use and a way to self-medicate anxiety and depression.

This interactive skill-building workshop will review the most recent statistics regarding the prevalence of ENDS use in the United States. Our group will review the harms specifically associated with ENDS and present research connecting the use of ENDS with mental health diagnoses, as well as substance-related and addictive disorder outcomes. The workshop will analyze current advertising and counter-advertising strategies that target youth and compare these to similar strategies used to impact cigarette sales in the 20th century. We will address individual and population barriers to reducing END use and provide strategies and motivational interviewing tools for helping youth reject or quit vaping. We will also allow participants to share cases and personal experiences working with youth attempting to abstain from or reduce END use.

Objectives:
1. Understand the adverse effects of ENDS usage on mental health
2. Understand how to support and inform patients who vape about treatment options and support youth to quit

The overprescribing of opioids is associated with harms, such as opioid use disorder, overdose, and death, thus the development and evaluation of non-pharmacological treatments are paramount in reducing dependence on opioids and opioid-induced adverse effects and optimizing pain management.

Mindfulness is a practice characterized by bringing attention to the present moment through awareness and acceptance of thoughts, feelings, bodily sensations, and surroundings. It has been increasingly utilized to manage physical and mental health conditions by helping with relaxation and counteracting stressors. Virtual reality/augmented reality (VR/AR) guided mindfulness interventions allow the user to isolate from external distractions and experience multisensory environments, which can facilitate the effectiveness of the mindfulness practice. The Apple Vision Pro is a recently released advanced VR/AR headset that incorporates an array of high-resolution cameras, sensors, and displays with powerful processors, surpassing many of the devices that preceded it. The elevated realistic and immersive experiences enabled by this technology can deepen the mindfulness practice and improve its effectiveness on the user.

This workshop presents one of the first clinical uses of the Apple Vision Pro, an advanced virtual reality/augmented reality headset, in managing pain, anxiety, and opioid requirements in a hospitalized patient with mixed connective tissue disease. Utilizing the mindfulness app, the intervention reduced the patient’s pain from an average of 4.67/10 pre-intervention to 1.83/10 post-intervention, and anxiety from 6.5/10 to 2.83/10. Despite challenges with the device’s fit, the results suggest that the intervention could serve as an effective non-pharmacological treatment modality. The workshop will further explore how the Apple Vision Pro can be utilized for other applications in managing substance use disorders, mental health disorders, and pain. Participants will engage in discussions on the technology’s versatility.

Introduction/Objectives:

Opioid agonist treatment (OAT) is essential for managing opioid use disorder (OUD), with buprenorphine being a preferred treatment due to its safer profile. However, its partial agonism at the mu-opioid receptor can lead to precipitated withdrawal, complicating the induction process. Innovative protocols have been developed to minimize withdrawal during induction. Our team previously reported two successful cases of fentanyl-related OUD transitioning to buprenorphine using a transdermal buprenorphine patch protocol over 48 hours.

Methods:

We conducted a retrospective chart review of 76 inpatients consented and treated with one of three transdermal buprenorphine induction protocols from January 2022 to November 2023. Each protocol involved staggered applications of 20 μg/h buprenorphine patches over 48 hours (6 patches every 24 hours), 24 hours (6 patches every 12 hours), or 8 hours (4 patches every 8 hours). Patients also received oral hydromorphone (16–32 mg) every 2 hours as needed for withdrawal symptoms. After induction, patients transitioned to full-dose sublingual or injectable buprenorphine, and all patches were removed. Withdrawal symptoms were monitored throughout the process.

Results:

Of the 76 patients, 28 were included in the primary outcome analysis. 48 were excluded due to insufficient COWS scores. Of the 28, 21 successfully transitioned to buprenorphine without significant withdrawal. Two patients did not complete the induction, opting for methadone, detox, or leaving against medical advice. 7 cases had elevated COWS scores, but expert review confirmed these were not due to precipitated withdrawal, likely due to insufficient opioid agonist PRNs. The highest recorded COWS score was 15 (range 10–15).

Conclusions:

This study demonstrates that high-tolerance patients, particularly those using fentanyl, can transition to buprenorphine with minimal withdrawal. This approach eliminates the need for withdrawal prior to induction, simplifies dosing, reduces nursing workload, and shortens the induction period. Further research in larger cohorts is needed to confirm its efficacy and safety, which could improve treatment outcomes and retention if validated.

Randomized controlled trials (RCTs) are the gold standard for testing the safety and comparative effectiveness of treatments for substance use disorders (SUDs). Yet, many regions of the developing world—as well as minoritized communities in North America and Europe—are underrepresented in large, multi-centre RCTs in addiction medicine. Given these limitations, we bring together leading global experts in comparative effectiveness research to discuss innovations for optimizing RCT development in addiction medicine.

Co-chairs: Drs. Kevin Xu (Washington University in St. Louis, USA) and Vitor Tardelli (UNODC, Austria)

1) Dr. Vitor Tardelli and Dr. Thiago Fidalgo (Universidade Federal de São Paulo, Brazil) are leaders in global efforts to design RCTs for stimulant use disorders. Dr. Tardelli will discuss how to choose outcomes for clinical trials on stimulant use disorders. Dr. Fidalgo will present best practices for picking efficacy outcomes and mitigating attrition.

2) Dr. Adam Bisaga (Columbia University, USA) has received funding from NIDA for over 25 years to conduct randomized controlled trials on novel pharmacotherapies for addiction. He also serves as a member of the UN Office on Drugs and Crime (UNODC) Expert Panel and acts as a consultant for the WHO. He will discuss actionable strategies to address the challenges in developing RCTs in addiction medicine.

3) Dr. Alireza Noroozi (Iranian National Center for Addiction Studies, Iran) is an expert on the pilot testing of behavioral interventions of SUDs in Iran and Afghanistan. He will discuss cultural adaptation of evidence-based behavioral treatments for SUDs into Afghanistan.

4)Finally, Dr. Xu, a pharmaco-epidemiologist, will discuss trending approaches to address limitations of RCTs , including target trial emulation (a framework for applying RCT principles to emulate trials using observational data). Drs. Tardelli and Xu will subsequently lead a discussion among speakers and the audience.

Addiction is often viewed through clinical and scientific lenses, but its nuanced portrayal in literature can provide profound insights into the human experience of substance use and recovery. This workshop delves into addiction themes in J.R.R. Tolkien’s The Lord of the Rings through an interdisciplinary approach combining literature, psychology, and addiction psychiatry. It highlights how Tolkien’s lived experiences as a trench writer post-World War I inform his exploration of trauma, despair, and resilience, offering timeless lessons relevant to contemporary discussions on recovery.

Using key moments in the narrative—such as Frodo’s burden of the One Ring and Gollum’s self-destructive obsession—participants will analyze addiction’s psychological, spiritual, and social dimensions. The workshop will explore themes of hope and purpose as antidotes to despair, the transformative power of community in recovery, and the role of mercy and moral choice in confronting addiction.

Through guided group analysis, interactive discussions, and application exercises, attendees will engage with these themes in depth, connecting them to real-world addiction and recovery experiences. Participants will reflect on how literature can illuminate the human condition, enhance empathy, and inform clinical practice.

This workshop aims to foster interdisciplinary dialogue, encouraging participants to integrate narrative understanding into addiction psychiatry, psychology, or personal perspectives. By the end, attendees will have gained not only a deeper appreciation for Tolkien’s work but also actionable insights into how themes of recovery and resilience resonate across disciplines and contexts.

Background

There is a growing concern in international public health systems due to increasing worldwide benzodiazepine prescription prevalence and associated risks. The resulting movement toward benzodiazepine de-prescribing also comes with risks. Benzodiazepines are among the most highly used groups of pharmaceuticals, especially in industrialized countries. In the United States of America, benzodiazepine overdoses have increased seven-fold from 1999 to 2016. Other risks include complicated withdrawal and post-acute withdrawal syndromes, harm when co-administered with other substances, risk of dependence after a short time of use, risks of long-term use, risk of benzodiazepine misuse, risk of complex persistent dependence, and increased harm in older adults and other special populations. Reports of failed discontinuation programs emphasize the difficulty for many of stopping and staying off benzodiazepines, with one-third of participants unable to fulfill their intention to do so; there is recent data of increased mortality within twelve months for those who discontinued benzodiazepines after chronic use.

RADIUS, a certified medical device (online intervention), is employed in a blended treatment approach. This method combines face-to-face psychotherapy based on the Community Reinforcement Approach (CRA) with the RADIUS web app to treat patients with alcohol dependence in an outpatient setting. It is designed to be implemented immediately following a qualified withdrawal treatment. Building on a behavioral therapy manual, the approach aims to motivate patients toward abstinence-oriented behavior. Enhanced confrontation with one’s own dysfunctional or symptomatic behaviors could facilitate behavioral change within psychotherapy, potentially reducing the required number of therapy sessions. A live demonstration of the RADIUS web app, as utilized in the EVA-RADIUS study, will be included in this presentation. Participants are encouraged to bring their own internet-enabled devices, such as smartphones, laptops, or tablets, to test the application firsthand. For further insights into the structure of the EVA-RADIUS study, see the presentation: EVA-RADIUS: A Blended Approach to Continuing Therapy After Alcohol Withdrawal.

Background: The addicted use of new media applications, such as digital games, social media platforms, and video-streaming services, has become highly prevalent among adolescents. Associated parents are often distressed. Since the inclusion of Gaming Disorder in the ICD-11, WHO has officially recognized the clinical relevance of internet use disorders (IUDs). Though, effective and evidence-based treatment offers addressing both the affected adolescents and their parents are highly warranted. Res@t is a new therapy program which aims to close this gap. It is a fully manualized CBT offer and addresses affected adolescents as well as their parents in seperate but parallel face-to-face group settings. The adolescent program (Res@t-A) is recommended for groups of 4–10 participants between 10 and 19 years and consists of 8 sessions. It focuses on the psychoeducation about the etiology of IUDs in adolescence, the improvement of motivation to change, and the development of intra- and interpersonal skills, such as mindfulness, self-control, sleep hygiene, self-care, emotion regulation, social skills, and relapse prevention. The corresponding parental program (Res@t-P) consists of 8 sessions as well. After a similar psychoeducational introduction, Res@t-P focusses on intrafamiliar communication, self-reflection of parenting styles, and supports parents to implement sufficient media usage rules and self-care strategies. Via regular family appointments, which are conducted individually at 3 points during the treatment duration, the transfer of therapeutical effects is supported. Both programs showed good feasability, with significant reduction in adolescent symptomology and improvement in parental self-efficacy, in their respective pilot evaluations. A randomized-controlled trial of an app-based Res@t version is currently being conducted. Objectives: During the workshop participants will be offered ideas and techniques on potentially successful interactions with affected clients and their family members. They will be introduced to the theoretical background, materials, and procedures of both Res@t-A and Res@t-P and interactively practice selected exercises.

A Citizens’ Assembly on Drugs Use Was established in early 2023 to examine the legislation and policies in Ireland in an effort to reduce the harmful impacts of illicit drugs on people, their families, communities and wider Irish society. The workshop presentation outlines the work of the Assembly and the recommendations contained in the report and an up-to-date outline of the implementation of those recommendations.

The assembly consisted of 100 people, including 99 members of the general public and one independent chairperson. The 99 members of the general public were selected at random in accordance with the most recent census data to ensure the people selected were nationally representative. A number of experts in the drug treatment and policy field were also selected to provide expert support to the citizens.

The members of the Assembly were asked to take into consideration the lived experience of people impacted by drugs use, as well as their families and communities, and to look at international best practice in an effort to reduce stigma and drug related deaths.

Following an extensive consultative process that occurred from April to October 2023 the process produced a report which was published and launched by the Minister responsible for Drug Strategy, Hildegarde Naughton, in January 2024. The report contained 36 recommendations It also outlined the work of the 100-member Assembly over six months.

The wide-ranging recommendations included a decriminalised model to replace criminal sanctions and a change to a comprehensive health-led response. It also recommended a dedicated Cabinet Committee on Drugs, chaired by the Taoiseach (Prime Minister); prioritisation of supports for marginalised groups and disadvantaged communities; a greater focus on prevention and recovery and greater supports for families and children impacted by drug use; an expansion of harm reduction responses in both the prisons and communities; Supply reduction, supporting the continued efforts of the Gardaí while strengthening the response to drug-related intimidation and violence by organised crime groups.

Earlier this year a committee was set up to look at implementing the recommendations contained in the report.

Background

International consensus statements and current research stress the importance of ADHD treatment in patients with concomitant SUD [1, 2], recommending multimodal, integrated treatment, including pharmacological and psychosocial interventions for both ADHD and SUD. ADHD medication in those with SUD is still controversial [1]. Both treatment access and treatment type vary widely across clinical sites. Treatment continuation in ADHD is in general low [3]. Adherence in those with comorbid SUD is still unclear.

Consensus statements and guidelines recommend long-acting stimulants with lower misuse potential as first line treatment [1], given the increased risk for medication misuse in those with ADHD and comorbid SUD [4]. There is however no evidence suggesting that stimulant treatment should increase SUD risk [5]. Somewhat higher stimulant doses may be necessary in this population [6, 7]. Improving treatment adherence and better understanding barriers to treatment access and continuation are necessary to improve clinical outcomes for this vulnerable patient group.

Objective

The speakers will present current research and clinical insights based on extensive experience from working with patients with ADHD and comorbid SUD, covering various aspects of pharmacological treatment of ADHD and SUD with relevance for improving clinical practice, including:
– Factors influencing treatment access and outcomes from a multicenter European study, (Brynte)
– How can we improve continuity of care and reduce treatment discontinuation in patients with ADHD and SUD taking patient and clinical site related factors into account (Capusan)
– Reaching to most vulnerable – prevalence of ADHD and comorbid SUD in the urban homeless population based on clinical survey data (Söderpalm)

Speakers are clinical scientists combining clinical experience and research in ADHD and SUD in three clinical and academic settings in Sweden, overarching a wide range of populations from socially vulnerable urban homeless people to smaller rural clinical settings, and national and multicenter data.

Workshop will include Q/A using mentimeter and discussion with participants moderated by chair and participants will be able to ask questions to the panel including all speakers at the end of the workshop.

Stimulant use disorder presents an ongoing and significant global health challenge, characterized by increasing rates of use and limited treatment options. The disorder’s severe medical, psychological, and social impacts emphasize the need for effective, evidence-based treatment strategies. This interactive skill-building workshop will explore comprehensive SUD treatment approaches, focusing on psychosocial and pharmacological interventions. We will review findings from a comprehensive systematic review evaluating the efficacy of SUD treatment modalities. We will discuss the evidence surrounding distinct treatment approaches, including integrative modalities like acupuncture, psychosocial methods like contingency management (CM) and cognitive-behavioral therapy (CBT), as well as pharmacological options including psychostimulants, antidepressants, opioid agonist therapy, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, and N-Acetylcysteine.

The workshop will identify the most effective strategies, address current limitations in treatment efficacy, and highlight areas that require further research. Additionally, participants will gain practical insights into applying these modalities in clinical practice and learn about strategies to enhance treatment accessibility and patient outcomes.