Real-world effectiveness of medication-assisted treatment and psychotherapy for opioid use disorder: a national multi–health care organization analysis

BackgroundHarm reduction strategies for opioid use disorder (OUD) emphasize pragmatic, evidence-based approaches that reduce overdose risk, relapse, and other adverse outcomes without requiring abstinence. Medication for opioid use disorder (MOUD) and structured psychotherapy represent core harm-reduction modalities, yet their real-world comparative effectiveness, alone and in combination, remains underexplored at scale.MethodsA retrospective cohort study was conducted using the TriNetX Research Network, comprising de-identified electronic health records from 112 U.S. health systems. 18,047 adults aged 18–45 were identified with a diagnosis of opioid dependence (ICD-10 F11.20) between 2016 and 2025. Subjects were assigned to eight mutually exclusive treatment cohorts: no treatment (Cohort 1); buprenorphine alone (Cohort 2); methadone alone (Cohort 3); psychotherapy alone (30 minutes (Cohort 4), 45 minutes (Cohort 5), or 60 minutes (Cohort 6)); buprenorphine + psychotherapy (Cohort 7); and methadone + psychotherapy (Cohort 8), with combination treatments defined within a ±30-day window. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) for remission (F11.21, F11.11) within 12 months.ResultsBuprenorphine (aHR = 2.33; 95% CI: 1.85–2.94), methadone (aHR = 2.50; 95% CI: 2.05–3.04), and psychotherapy (30 min: aHR = 2.18; 45 min: aHR = 2.38) were each independently associated with significantly higher remission compared to no treatment. The combination of buprenorphine + psychotherapy yielded the strongest effect (aHR = 5.26; 95% CI: 2.68–10.32). Anxiety diagnoses and gabapentinoid prescriptions were positively associated with remission; benzodiazepine co-prescription was negatively associated.ConclusionsIn this first national-scale, multi–health-care-organization analysis, both pharmacologic and psychosocial harm-reduction interventions were independently associated with improved OUD remission, with additive benefit when integrated. These findings underscore the value of embedding comprehensive, multimodal harm-reduction services within routine care and support policies promoting equitable access to both MOUD and behavioral health supports across diverse health systems.

Scoping review of therapeutic approaches among individuals with secondary exercise addiction

Secondary exercise addiction shows high comorbidity with eating and body image disorders. Despite its substantial impact on physical and mental health and daily functioning, evidence on effective therapeutic interventions remains limited. The aim of this scoping review was to identify and describe therapeutic interventions applied to adult individuals with secondary exercise addiction. This review followed the PRISMA Sc-R guidelines and covered the years 2002–2024. Ultimately, five studies were included (four randomized controlled trials and one quasi-experimental study). Three studies applied psychotherapeutic interventions based on cognitive-behavioral models (Cognitive Behavioral Therapy, Lifestyle, Exercise, Attitudes, and Relationships Program, Physical Exercise and Dietary Therapy), while two integrated physical or nutritional components. A secondary analysis published in 2024 based on the LEAP trial dataset was identified but not treated as an independent study to avoid duplication. EBSCOhost, Web of Science, PubMed, and Google Scholar were searched from January to May 2025 using terms related to exercise addiction, exercise abuse, psychotherapy, intervention, and treatment. English-language studies were eligible if they described an intervention with at least one treated group with pre- and post-test measures; the participants of the study were adult patients suffering from eating disorders and exercise addiction (the therapy programs involved one inpatient and four outpatient treatments) and therapeutic intervention was carried out with outcomes based on exercise addiction level data. Four out of five included studies reported improvements in variables related to compulsivity, although these did not always imply a reduction in the amount of exercise, indicating that qualitative changes may be more relevant. Longer interventions showed more consistent effects, but even brief treatments generated positive changes in non-clinical populations. The examination of the research revealed a gap in studies addressing interventions for those with secondary exercise addiction, especially highlighting the need for randomized controlled trials (RCTs) with proper randomization methods.

Trump administration warns against using federal dollars on fentanyl test strips

The Trump administration is doubling down on its opposition to harm reduction services for people who use illicit drugs. 

In an open letter on April 24, the federal agency overseeing addiction and mental health policy warned its grantees against using federal funds to buy harm reduction supplies including sterile syringes and pipes, or to distribute test strips for common drug supply adulterants like fentanyl, xylazine, and medetomidine. 

Read the rest…

The Download: DeepSeek’s latest AI breakthrough, and the race to build world models

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Three reasons why DeepSeek’s new model matters

On Friday, Chinese AI firm DeepSeek released a preview of V4, its long-awaited new flagship model. Notably, the model can process much longer prompts than its last generation, thanks to a new design that handles large amounts of text more efficiently.

While the model remains open source, its performance matches leading closed-source rivals from Anthropic, OpenAI, and Google. It is also DeepSeek’s first release optimized Huawei’s Ascend chips—a key test of China’s dependence on Nvidia.

Here are three ways V4 could shake up AI.

—Caiwei Chen

The rise of world models

AI systems have already gained impressive mastery over the digital world, but the physical world remains humanity’s domain. As it turns out, building an AI that composes novels or code apps is far easier than developing one to fold laundry or navigate city streets. To bridge this gap, many researchers believe you need something called a world model.

Proponents like Stanford professor Fei-Fei Li and AMI Labs founder Yann LeCun argue these models can overcome the well-known limitations of LLMs—and realize AI’s promise for robotics. Find out why they’ve brought world models to the forefront of the field.

—Grace Huckins

World models are on our list of the 10 Things That Matter in AI Right Now, our essential guide to what’s really worth your attention in the field.

Subscribers can watch an exclusive roundtable unveiling the technologies and trends on the list, with analysis from MIT Technology Review’s AI reporter Grace Huckins and executive editors Amy Nordrum and Niall Firth.

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 China has blocked Meta’s $2 billion acquisition of AI startup Manus
Regulators cited national security grounds. (WSJ $)
+ Beijing called the deal a “conspiratorial” attempt to hollow out its tech base. (FT $)
+ The country is tightening its grip on AI firms that try to leave. (TechCrunch)
+ The decision escalates China’s AI rivalry with the US. (Bloomberg $)
+ But there will be no winners in their competition. (MIT Technology Review)

2 Google is investing up to $40 billion in Anthropic
In a deal valuing the AI firm at $350 billion. (CNBC)
+ The funding will support the firm’s growing computing needs. (TechCrunch)
+ Anthropic and OpenAI are fighting for compute capacity. (Axios)

3 President Trump just fired the entire National Science Board
The NSF has played a crucial role in developing technology. (The Verge)
+ The move heightens fears over political interference in US science. (Nature)

4 Conspiracy theories about the Washington shooting are proliferating online
Over 300,000 posts appeared on X using the keyword “staged.” (NYT $)
+ The theories are also swirling on Bluesky and Instagram. (Wired)

5 The AI compute crunch is starting to hit the broader economy.
It’s affecting jobs, gadgets, and electricity prices. (404 Media)
+ The AI compute explosion is the tech story of our time. (MIT Technology Review)

6 Elon Musk says a new banking tool brings X close to a “super app”
He’s pledged to launch the tool this month. (Bloomberg)

7 AI optimism is surging across Asia while US sentiment cools
The divide could shape where adoption happens fastest. (Rest of World)

8 Apple is tying its new CEO’s ascent to its first foldable iPhone
It wants to build the buzz around John Ternus. (Gizmodo

9 Twelve firms are developing the Golden Dome’s space-based interceptors
They’ve won contracts worth up to $3.2 billion. (Ars Technica)

10 NASA has shared promising results from Artemis II
The spacecraft and rocket fared well. (Engadget)

Quote of the day

“Getting out the truth and establishing facts and reliable information takes time. But our audiences really don’t have that kind of patience.”

—Amanda Crawford, associate professor at the University of Connecticut, tells the NYT why conspiracy theories are gaining traction online.

One More Thing

MIRIAM MARTINCIC


Welcome to Kenya’s Great Carbon Valley: a bold new gamble to fight climate change

Kenya’s Great Rift Valley is home to five geothermal power stations, which harness clouds of steam to generate about a quarter of the country’s electricity. But some of the energy escapes into the atmosphere, while even more remains underground for lack of demand. That’s what brought Octavia Carbon here.

Last year, the startup began harnessing some of that excess energy to remove CO2 from the air. The company says the method is efficient, affordable, and—crucially—scalable. But the project also faces fierce opposition. 

Read the full story on the future of Kenya’s “Great Carbon Valley.”


—Diana Kruzman

We can still have nice things

A place for comfort, fun and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ Fred Again’s Tiny Desk Concert is a masterclass in intimate performance.
+ Here’s a delightful look at how we’re all linked through geography and shared heritage.
+ Take a short, peaceful break to watch Tokyo’s cherry blossoms from a bird’s eye view.
+ There’s something oddly satisfying about watching an industrial shredder turn everyday items into confetti.

How adolescent cannabis use reshapes the developing brain — a systematic review

Background and hypothesisCannabis use initiation during adolescence has increased globally, raising concerns about neurodevelopmental consequences during this critical period when the brain undergoes extensive remodeling in cannabinoid receptor-rich regions.Study designThis systematic review examines neurodevelopmental consequences of adolescent cannabis use, focusing on structural brain changes, cognitive impacts, addiction vulnerability, and long-term outcomes. We searched PubMed, EMBASE, PsycINFO, and Web of Science (2000-2025) for studies examining cannabis effects in adolescent populations. Following PRISMA guidelines, two reviewers screened 3,421 records and assessed 156 full-text articles, including studies with neuroimaging, cognitive assessments, or longitudinal follow-up.Study resultsThirty-six studies involving 8,432 participants met criteria: 23 longitudinal cohorts (62.2%), 8 cross-sectional (22.2%), 4 RCTs (11.1%), and 1 case-control study (2.8%). Neuroimaging revealed dose-dependent alterations including reduced prefrontal cortical and hippocampal/amygdala volumes, accelerated cortical thinning in longitudinal studies, and impaired white matter connectivity correlating with initiation age. Cognitive findings were mixed — some showed persistent deficits after prolonged abstinence in adolescent-onset users, others found no effects after controlling for confounders. Epidemiological studies consistently showed elevated addiction risk (ORs 3.9–7.2) in adolescents versus adults. Long-term associations included educational difficulties, mental health problems, and functional impairment, though causal relationships remained unclear.ConclusionsAdolescent cannabis use associates with structural brain changes, elevated addiction risk, and variable cognitive effects, suggesting greater vulnerability versus adult-onset use. However, methodological limitations including confounders, heterogeneous definitions, and observational designs limit causal inference. Findings support age-specific prevention and specialized interventions while highlighting needs for rigorous longitudinal research establishing causality.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifierCRD420251165329.

Three reasons why DeepSeek’s new model matters

On Friday, Chinese AI firm DeepSeek released a preview of V4, its long-awaited new flagship model. Notably, the model can process much longer prompts than its last generation, thanks to a new design that helps it handle large amounts of text more efficiently. Like DeepSeek’s previous models, V4 is open source, meaning it is available for anyone to download, use, and modify.

V4 marks DeepSeek’s most significant release since R1, the reasoning model it launched in January 2025. R1, which was trained on limited computing resources, stunned the global AI industry with its strong performance and efficiency, turning DeepSeek from a little-known research team into China’s best-known AI company almost overnight. It also helped set off a wave of open-weight model releases from other Chinese AI firms. 

DeepSeek has kept a relatively low profile since then—but earlier this month, it effectively teased V4’s release when it added “expert” and “flash” modes to the online version of its model, prompting speculation that the updates were tied to a bigger upcoming release.

While the company has become a powerful symbol of China’s AI ambitions, its big return to cutting-edge frontier models comes after months of scrutiny—including major personnel departures, delays to previous model launches, and growing scrutiny from both the US and Chinese governments. 

So, will V4 shake the AI field the way R1 did? Almost certainly not, but here are three big reasons why this release matters.

1. It breaks new ground for an open-source model.

As with R1 before it, DeepSeek claims that V4’s performance rivals the best models available at a fraction of the price. This is great news for developers and for companies using the tech, because it means they can access frontier AI capabilities on their own terms, and without worrying about skyrocketing costs.

The new model comes in two versions, both of which are available on DeepSeek’s website and in its app, with API access also open to developers. V4-Pro is a larger model built for coding and complex agent tasks, and V4-Flash is a smaller version designed to be faster and cheaper to run. Both versions offer reasoning modes, in which the model can carefully parse a user’s prompt and show each step as it works through the problem.

For V4-Pro, DeepSeek charges $1.74 per million input tokens and $3.48 per million output tokens, a fraction of the cost of comparable models from OpenAI and Anthropic. V4-Flash is even cheaper, at about $0.14 per million input tokens and about $0.28 per million output tokens, making it one of the cheapest top-tier models available. This would make it a very appealing model to build applications on.

In terms of performance, V4 is, perhaps unsurprisingly, a huge jump from R1—and it seems to be a strong alternative to just about all the latest big AI models. On the major benchmarks, according to results shared by the company, DeepSeek V4-Pro competes with leading closed-source models, matching the performance of Anthropic’s Claude-Opus-4.6, OpenAI’s GPT-5.4, and Google’s Gemini-3.1. And compared to other open-source models, such as Alibaba’s Qwen-3.5 or Z.ai’s GLM-5.1, DeepSeek V4 exceeds them all on coding, math, and STEM problems, making it one of the strongest open-source models ever released. 

DeepSeek also says that V4-Pro now ranks among the strongest open-source models on benchmarks for agentic coding tasks and performs well on other tests that measure ability to carry out multistep problems. Its writing ability and world knowledge also leads the field, according to benchmarking results shared by the company. 

In a technical report released alongside the model, DeepSeek shared results from an internal survey of 85 experienced developers: More than 90% included V4-Pro among their top model choices for coding tasks.

DeepSeek says it has specifically optimized V4 for popular agent frameworks such as Claude Code, OpenClaw, and CodeBuddy.

2. It delivers on a new approach to memory efficiency.

One of the key innovations of V4 is its long context window—the amount of text the model can process at once. Both versions can handle 1 million tokens, which is large enough to fit all three volumes of The Lord of the Rings and The Hobbit combined. The company says this context window size is now the default across all DeepSeek services and it matches what is offered by cutting-edge versions of models like Gemini and Claude. 

But it’s important to know not just that DeepSeek has made this leap, but how it did so. V4 makes significant architectural changes to the company’s former models—especially in the attention mechanism, which is the feature of AI models that helps them understand each part of a prompt in relation to the rest. As the prompt text gets longer, these comparisons become much more costly, making attention one of the main bottlenecks for long-context models.

DeepSeek’s innovation was to make the model more selective about what it pays attention to. Instead of treating all earlier text as equally important, V4 compresses older information and focuses on the parts most likely to matter in the present moment, while still keeping nearby text in full so it does not miss important details. 

DeepSeek says this sharply reduces the cost of using long context. In a 1-million-token context, V4-Pro uses only 27% of the computing power required by its previous model, V3.2, while cutting memory use to 10%. The reduction in V4-Flash is even larger, using just 10% of the computing power and 7% of the memory. In practice, this could make it cheaper to build tools that need to work across huge amounts of material, such as an AI coding assistant that can read an entire codebase or a research agent that can analyze a long archive of documents without constantly forgetting what came before.

DeepSeek’s interest in long context windows didn’t start with V4. Over the past year and a half, the company has quietly published a series of papers on how AI models “remember” information, experimenting with compression and mathematical techniques to extend what AI models could realistically handle.

3. It marks the first steps on the hard road away from Nvidia.

V4 is DeepSeek’s first model optimized for domestic Chinese chips, such as Huawei’s Ascend—a move that has turned the launch into something of a test of whether China’s homegrown AI industry can begin to loosen its dependence on US chip giant Nvidia. 

This was largely expected, since The Information reported earlier this month that DeepSeek did not give American chipmakers like Nvidia and AMD early access to V4, though prerelease access is common to allow chipmakers to optimize support of the new model ahead of a launch. Instead, the company reportedly gave early access only to Chinese chipmakers. 

On Friday, Huawei said its Ascend supernode products, based on the Ascend 950 series, would support DeepSeek V4. This means that companies and individuals who want to run their own modified version of Deepseek V4 will be able to use Huawei chips easily.

Reuters previously reported that Chinese government officials recommended that DeepSeek integrate Huawei chips in its training process. And this pressure fits a broader pattern in China’s industrial policy: Strategic sectors are often pushed, and sometimes effectively required, to align with national self-reliance goals. But there’s a particular urgency when it comes to AI. Since 2022, US export controls have cut Chinese firms off from Nvidia’s most powerful chips, and they later also restricted access to downgraded China-market versions. Beijing’s response has been to accelerate the push for a domestic AI stack, from chips to software frameworks to data centers.

Chinese authorities have reportedly been pushing data centers and public computing projects to use more domestic chips, including through reported bans on foreign-made chips, sourcing quotas, and requirements to pair Nvidia chips with Chinese alternatives from companies such as Huawei and Cambricon. 

Still, replacing Nvidia is not as simple as swapping one chip for another. Nvidia’s advantage lies not only in its chips, but in the software ecosystem developers have spent years building around them. Moving to Huawei’s Ascend chips means adapting model code, rebuilding tools, and proving that systems built around those chips are stable enough for serious use.

To be clear, DeepSeek does not appear to have fully moved beyond Nvidia. The company’s technical report reveals that it is using Chinese chips to run the model for inference, or when someone asks the model to complete a task. But Liu Zhiyuan, a computer science professor at Tsinghua University, told MIT Technology Review that DeepSeek appears to have adapted only part of V4’s training process for Chinese chips. The report does not say whether some key long-context features were adapted to domestic chips, so Liu says V4 may still have been trained mainly on Nvidia chips. Multiple sources who spoke on the condition of anonymity, due to political sensitivity around these issues, told MIT Technology Review that Chinese chips still don’t perform as well as Nvidia chips but are better suited for inference than training.

DeepSeek is also tying the future costs of V4 to this hardware shift. The company says V4-Pro prices could fall significantly after Huawei’s Ascend 950 supernodes begin shipping at scale in the second half of this year. 

If that works, V4 could be an early sign that China is successfully building a parallel AI infrastructure.

A longitudinal inquiry into the vicious cycle of social media addiction and self-injury: the moderating role of resilience

BackgroundThe reciprocal relationship between social networking addiction (SNA) and non-suicidal self-injury (NSSI) represents a critical, yet poorly understood, feedback loop in adolescent psychopathology. This study aimed to longitudinally test a “vicious cycle” model, examining the bidirectional effects between SNA and NSSI, and to investigate psychological resilience as a potential protective factor that could disrupt this harmful dynamic.MethodsA three-wave longitudinal study was conducted with a large cohort of 2,628 Chinese high school students (mean age = 16.1 years; 53.1% female) over a 12-month period. Participants completed measures of SNA, NSSI frequency, and psychological resilience at each wave. A cross-lagged panel model (CLPM) was used to examine the reciprocal, prospective relationships between SNA and NSSI. A multi-group CLPM was then employed to test the moderating role of resilience.ResultsThe CLPM revealed significant, positive, and reciprocal cross-lagged effects. SNA at T1 and T2 prospectively predicted increases in NSSI at T2 and T3, respectively (βs = .19 and.17). Conversely, NSSI at T1 and T2 prospectively predicted increases in SNA at T2 and T3 (βs = .14 and.12), providing robust evidence for a vicious cycle. Furthermore, resilience significantly moderated the pathway from SNA to NSSI. For adolescents with low resilience, the effect was strong and significant (β = .25), whereas for those with high resilience, the effect was rendered non-significant (β = .07).ConclusionsSocial networking addiction and non-suicidal self-injury are not merely comorbid but are locked in a mutually reinforcing developmental spiral over time. However, this dangerous cycle is not deterministic. Psychological resilience acts as a powerful protective buffer, effectively uncoupling the link from addictive social media use to self-harm. These findings underscore the urgent need for integrated, dual-focus interventions that address both online and offline maladaptive behaviors, while championing resilience-building as a primary strategy for prevention.

Psychedelics get a boost from the White House

President Trump recently signed an executive order which aims to increase access to psychedelic drug treatments. He was joined at the signing by podcaster Joe Rogan, who said he’ ha’d messaged the president about research on the psychedelic ibogaine. 

In this week’s STATus Report, host Alex Hogan chats with STAT Washington correspondent Daniel Payne about what the executive order does and doesn’t do. Hogan also looks at why ibogaine, and psychedelic drugs more broadly, are increasingly being taken seriously for stubbornly hard-to-treat conditions like addiction, depression, and PTSD.