The Log
Archive
261 stories, newest first.
June 2026
- Jun 3Policy & Funding
Eighty Hours a Month. Prove It or Lose Medicaid. For People With Addiction, the Exemption That Looks Like a Solution Isn't.
CMS finalized Medicaid work requirements on June 2, 2026. The SUD treatment exemption exists on paper — but implementation dynamics identical to Arkansas 2018, where 18,000 lost coverage, are set to repeat nationally by December 31.
- Jun 2Lived Experience & Community
The Peer Recovery Workers Who Got Their Grants Back — and Still Don't Know If They'll Have a Job in September
SAMHSA reversed its January 2026 grant terminations within 24 hours. Peer recovery support workers got their funding back — on paper. What's still missing is any certainty it will last.
- Jun 2Science & Medicine
The FDA Fast-Tracked Three Psychedelic Drugs. That's Not the Same as Approving Them.
FDA priority vouchers went to three psychedelic companies in April 2026. Here's what a priority voucher does, what it doesn't do, and where psilocybin and methylone actually stand on the path to approval.
- Jun 2Treatment & Recovery
Five States Are Now Paying People to Stay Sober. It's Working.
Five states now offer contingency management as a Medicaid benefit, targeting stimulant use disorder. For a condition with no FDA-approved medications, it's the strongest evidence-based tool available — and it remains unavailable in most of the country.
- Jun 2Science & Medicine
The Medication That Could Help 14.5 Million People — and That Fewer Than 5% of Them Ever Receive
Naltrexone was FDA-approved for alcohol use disorder in 1994. Fewer than 3% of primary care physicians prescribe it for AUD. An honest look at why — and what the craving science says about how the medication works.
- Jun 2Science & Medicine
Ozempic for Alcohol: What the May 2026 Lancet Trial Actually Proves
The May 2026 Lancet trial of semaglutide for alcohol use disorder showed significant reductions in heavy drinking days and cravings. A breakdown of the findings, the limitations, and what comes next for AUD pharmacotherapy.
- Jun 2Policy & Funding
The Line Items They'd Kill Are the Ones Funding the Human Work
The proposed Behavioral Health Innovation Block Grant cuts $813M in categorical grants that paid for syringe programs, peer recovery workers, overdose data, and workforce development. A guide to what actually gets eliminated — and why the 5% headline number misses the point.
- Jun 1Arizona Watch
Maricopa County Is Starting Medications in Jail. That’s the Point.
Maricopa County's $4.3M opioid settlement disbursement includes targeted investment in MOUD initiation inside county jails — starting buprenorphine or methadone before release, with a warm handoff to a community prescriber.
- Jun 1Treatment & Recovery
Five States Can Now Pay People to Stay Sober. Here’s Why That Number Is Still Too Small.
CMS has approved Medicaid contingency management programs in California, Delaware, Hawaii, Montana, and Washington. Michigan and Rhode Island are pending. The treatment works — coverage doesn't.
- Jun 1Science & Medicine
The Brain That Meth Built, and the Drug That’s Starting to Fix It
Methamphetamine has no FDA-approved medication treatment — but ADAPT-2 Phase 3 secondary analysis confirms naltrexone plus bupropion reduces cue-induced craving and withdrawal dysphoria. Here's the brain science, the treatment breakthrough, and what recovery actually looks like.
- Jun 1Policy & Funding
The 5 Percent They Want You to Focus On
The FY2026 SAMHSA budget proposal would consolidate three grant streams into a Behavioral Health Innovation Block Grant, eliminating $813M in categorical programs. The 5% nominal cut is the wrong number. The categorical mandates that kept peer support, harm reduction, and workforce training funded are what disappear.
May 2026
- May 30Policy & Funding
The Work Requirement Exemption for SUD Treatment Exists on Paper. That's the Problem.
HR1's Medicaid work requirements technically exempt people in SUD treatment — but AHCCCS says 400K Arizonans are still at risk. The exemption exists on paper. The navigation system to claim it doesn't exist yet.
- May 30Lived Experience & Community
Ryan Hampton Made TIME's 100 Most Influential in Health. Ask Him Why Peer Support Works.
Ryan Hampton's TIME100 Health recognition is the moment to examine what peer support actually does neurologically — and why defunding 4,200 peer support positions since January isn't a budget line. It's a clinical cost.
- May 30Science & Medicine
The First Drug That Works for Cocaine Use Disorder Is a Psychedelic
A JAMA Network Open RCT published May 8 found psilocybin achieved 30% verified cocaine abstinence at six months versus 0% placebo. No FDA-approved medications exist for cocaine use disorder. Here's what the finding means and what it doesn't.
- May 30Science & Medicine
Medetomidine Is Not Xylazine. That's the Problem.
DEA flagged four new adulterants in the drug supply on May 12. Medetomidine — now appearing in every Massachusetts county — is 100-200x more potent than xylazine and not reversed by naloxone. Here's what changed and what harm reduction needs to do about it.
- May 30The Crisis, By the Numbers
The Rest of the Country Is Celebrating. In Maricopa County, People Are Still Dying.
While the U.S. celebrates its third straight year of declining overdose deaths, Arizona's toll rose 21 percent. The drug supply is more dangerous, the harm reduction tools were pulled, and the settlement billions haven't reached the people in active use. Here's why.
- May 29Science & Medicine
The Cheap High That's Killing Teenagers: Nitrous Oxide's 2026 Surge
Nitrous oxide deaths have risen more than 500% since 2010, with 12- and 13-year-olds now the highest-risk group. A University of Mississippi researcher explains what's driving the surge, what it does to the brain, and why our prevention architecture isn't built for it.
- May 29Lived Experience & Community
The Opposite of Addiction Is Community — And We Keep Defunding It
Peer recovery support is neurologically essential to recovery — not a soft add-on. The evidence says so. The federal cuts hitting peer programs say something else entirely.
- May 29The Crisis, By the Numbers
Cocaine Killed 29,449 People in 2023. There's Still No Medication For It.
Cocaine-involved overdose deaths hit 29,449 in 2023, up from 4,681 in 2011. There is no FDA-approved medication for stimulant use disorder. Here's where the field is, and what's in the way.
- May 29Arizona Watch
Maricopa's Bet: MOUD Behind Bars Is Working
Maricopa County is now treating 400+ incarcerated people with medications for opioid use disorder, funded by opioid settlement money. This is what the research says should happen — and it's working.
- May 29Harm Reduction
Federal Grantees Have Thirty Days
On April 24, 2026, SAMHSA banned federal grantees from publicly distributing fentanyl test strips. The Kentucky Harm Reduction Coalition had 30 days of supply left. Here's what the policy does, who it hurts, and why it may be illegal.
- May 28Science & Medicine
Substance Spotlight: Nicotine & Tobacco — The Vaping Cessation Gap and the Drug That Could Fill It
Cytisinicline's FDA PDUFA date is June 20, 2026. It would be the first new smoking cessation medication in ~20 years and the first with vaping cessation data.
- May 28Harm Reduction
Xylazine's Treatment Gap: Why 'Tranq' Wounds and Withdrawal Still Lack a Clinical Playbook
Xylazine ('tranq') has no reversal agent and no FDA-approved treatment for withdrawal or wounds. Here's where treatment science stands in 2026.
- May 28Policy & Funding
SAMHSA's $2B Grant Cuts and Block Grant Consolidation: What It Means for Treatment Programs
FY2026 budget proposes consolidating SAMHSA's three major behavioral health grants into a single block grant at a 14% cut. Programs disrupted by January's $2B termination are bracing for more.