Providers can expect that their patients’ MH/SUD coverage will no longer be designed using information, evidence, sources, and standards that discriminate against MH conditions and SUDs. They also allow providers to obtain more information from these plans and companies about how nonquantitative treatment limitations comply with the requirements. The market is expected to grow steadily based on technology adoption, evolving consumer behavior, and regional investment trends.

• This includes developing approaches to prevention and intervention that meet the specific needs of children, teens, and young adults.
• The attitudes and beliefs that family members have about SUDs are also of importance as these will influence the individuals as they try to get sober and will influence the efficacy of treatment interventions.
• Modifications have been made to Column 2 to identify concepts relevant to the family with a SUD, and Columns 3 and 4 are contributions of the authors of this article.
• If you’re currently using a substance regularly and are concerned it’s turning into a habit you’re unable to stop on your own, talk to a healthcare provider.
• Please refer to clinicaltrials.gov and nih.gov for up-to-date information on NIH research.
• Human studies to assess epigenetic modifications have been limited to measures made in blood cells or in post‐mortem brain115, 116.

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Adoption is particularly strong in data-driven decision-making, automation of business processes, and digital platforms. Regulatory clarity around AI ethics and data protection is influencing technology strategies. Investment in AI talent, fintech-driven innovation, and cloud integration is supporting competitive differentiation. The United States market is being shaped by aggressive AI adoption across enterprise operations, analytics-driven decision-making, and platform-centric technology ecosystems. Companies are leveraging automation, machine learning, and predictive intelligence to improve scalability, reduce operational friction, and enhance competitive positioning. Strong venture funding, early adoption of generative AI, and deep integration of cloud-native architectures continue to accelerate market innovation and commercialization.

Management and Treatment

Vaping devices can deliver nicotine, cannabinoids or other products, and are often supplied with flavors and packaging that are appealing to youth. Several strategies can be used to decrease risk of HIV infection among individuals with SUDs310, including pre‐exposure prophylaxis and syringe services programs for injection drug users. In addition to existing research gaps, a common barrier is the lack of dedicated funds for preventive interventions outside research settings. Without ongoing funding, prevention interventions are difficult to implement and evaluate, leading to downstream pressure on the treatment system.

• Patches have a slow delivery, requiring more than one hour for nicotine to peak, but result in long‐lasting nicotine plasma levels for 24 hours.
• The specific biology, manifestations, and treatment of intoxication and withdrawal vary by substance or substance class.
• Nalmefene, like naltrexone, is an antagonist of mu receptors that also acts as a partial agonist of kappa receptors211.

Social environments

The evidence-based family treatment Community Reinforcement And Family Training (CRAFT) has demonstrated its effectiveness in increasing the rate at which abusers enter treatment (Roozen, de Waart, & van der Kroft, 2010). As a general rule, the care provided to individuals in the justice system should meet the same standards as health services in the community, based on the principle of equity. Thus, diagnostic assessment should include all the individual’s medical, mental health, or social problems, as well as any factors affecting the individual’s risk for reoffending or recidivism. However, resource constraints, societal attitudes, or other factors can interfere with this approach. There is also a paucity of evidence on pharmacotherapies for SUDs among adolescents.

• Routine review of prescription monitoring data, cautious opioid prescribing, and patient education about medication safety are essential components of prevention.
• Parents who have substance use problems will likely have their own affect dysregulation that may have preceded or resulted from their substance use.
• The special circumstances of justice‐involved women should also be considered355.
• Out of this theory multiple models of family therapy developed including but not limited to strategic, structural, experiential, and more recently the multisystemic family systems therapy (MFT) model.
• Substance use and SUDs are multidetermined, with the different risk factors playing varying roles at different life stages, from the prenatal period and childhood to early and late adulthood78, 79, 164.
• Substance use and SUDs can also negatively affect adherence to medications for HIV and HCV infections309.

Understanding the family’s specific developmental stage can help with assessing the interventional needs of a family. Carter and McGoldrick (1989) identify eight stages of the family life cycle and corresponding developmental tasks. SUDs can disrupt these developmental tasks depending on who has the SUD and at what developmental stage the family is in when the SUD develops. Table 1 is an adaptation of Carter and McGoldrick’s family life cycle stages as applied to families with SUDs.

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Multiple behavioral therapies have been shown to be beneficial in the treatment of SUDs, by themselves or as adjuncts to pharmacotherapy. The most frequently used interventions are motivational interviewing, cognitive behavioral therapy (CBT), contingency management, and twelve‐step facilitation (see Table 5). A checklist of diagnostic criteria or, in research settings, a structured or semi‐structured interview can be used to obtain a formal SUD diagnosis. Screening for substances in blood, urine or saliva can be useful to detect current use and to help monitor progress. Drug screening can also be useful if a patient cannot participate in an in‐person interview151. This is likely a multidirectional relationship, and its exact mechanisms continue to be a subject of debate130.

Boundaries define internal and external limits of a system and are established to conserve energy by creating a protective barrier around a system. In a healthy family, boundaries surround the parental subsystem and the child subsystem by keeping them separate. In a family with a parent who has a SUD, boundaries around the parental and child subsystems are typically permeable as the parental subsystem does not function well as a cohesive unit. Boundaries around the family itself are rigid substance use disorder to maintain the family secret of substance abuse. Healthy boundaries are important in the normal development of a family and children.