Background: Rapid digital transformation is reshaping health care, but many digital initiatives struggle to deliver sustained organizational value when they are introduced as stand-alone technologies rather than as part of an institutional strategy. In Saudi Arabia, Vision 2030 has intensified pressure on academic medical centers to strengthen digital capability, localize innovation, and reduce dependence on externally driven solutions. Objective: This study aimed to examine organizational factors shaping digital health innovation at King Saud University Medical City (KSUMC) and to develop a preliminary strategic planning framework for a digital health innovation hub tailored to that setting. Methods: We conducted a qualitative exploratory case study at KSUMC between April and June 2025. Fourteen stakeholders from clinical, administrative, research, governance, educational, and innovation-related roles were recruited using maximum variation purposive sampling. Semistructured interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Reporting was guided by the COREQ (Consolidated Criteria for Reporting Qualitative Research). Diffusion of innovation theory and systems thinking informed interpretation, while a context-actor-mechanism-outcome lens was used to examine how institutional conditions shaped innovation processes. No patient data were collected. Results: Five interrelated themes were identified. First, leadership support existed at a symbolic level, but middle-management translation and risk tolerance were inconsistent. Second, innovation was constrained by workload, fragmented systems, and weak operational support, which meant that project work was often treated as discretionary rather than embedded. Third, knowledge transfer and commercialization pathways were fragmented; participants repeatedly described unclear routes from idea generation to prototyping, regulatory review, and market engagement. Fourth, incentives and innovation capability were misaligned with institutional expectations, particularly for clinicians and trainees. Fifth, Vision 2030 created strategic legitimacy and momentum, but participants also cautioned that an overreliance on consultant-led or vendor-led approaches could weaken internal capability building. These findings informed a preliminary framework centered on governance, knowledge transfer, partnership structures, workforce development, and phased implementation rather than a validated institutional model. Conclusions: At KSUMC, digital health innovation is shaped not only by technology availability but also by organizational culture, intermediary structures, governance design, and the extent to which innovation work is made operationally feasible. The framework proposed here should therefore be understood as a preliminary planning model derived from one qualitative case study. Its main contribution is to specify how knowledge transfer, commercialization, and institutional capability building can be integrated into a digital health strategy within a Saudi academic medical center.
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Treating addiction with an addictive drug: the ketamine paradox revisited
BackgroundSubstance use disorders (SUDs) and treatment-resistant depression (TRD) remain a major global health challenge, marked by high relapse rates and limited long-term effectiveness of existing treatments. Ketamine, a glutamatergic modulator with rapid neuroplastic effects, has emerged as a novel intervention for TRD and is increasingly investigated as an adjunctive treatment for addiction, yet concerns about its abuse liability persist.ObjectiveThis review critically evaluates ketamine’s therapeutic potential for SUDs while examining its neurobiological mechanisms, clinical efficacy, and risk of misuse within a unified risk–benefit framework.MethodsA structured narrative review conducted in accordance with the SANRA framework using the PubMed, Scopus, PsycINFO, and Web of Science databases, covering literature published until March 2026. Eligible studies included clinical trials, experimental studies, and mechanistic investigations relevant to ketamine use in addiction and depression. Evidence was synthesized thematically across the domains of efficacy, mechanisms, and safety.ResultsAcross alcohol and cocaine use disorders, ketamine combined with psychotherapy has demonstrated promising reductions in craving and increases in abstinent days in small-to moderate-sized Phase 2 trials. However, findings remain difficult to generalize due to considerable variability in dosing strategies, comparator conditions, and follow-up periods. Effects on relapse prevention have been more inconsistent and less reliably positive. Mechanistically, ketamine promotes synaptic plasticity via NMDA receptor antagonism and downstream glutamatergic signaling, potentially disrupting maladaptive reward-related memories and reversing maladaptive neurocircuitry involved in both depression and addiction. While acute adverse effects are generally transient under clinical supervision, ketamine carries a well-established risk of misuse, particularly in unsupervised or high-dose settings.ConclusionsKetamine represents a promising but still experimental intervention for both refractory depression and selected SUDs. Its clinical use depends on careful patient selection, structured delivery, and integration with psychotherapy. Although ketamine may redefine treatment paradigms for TRD and addiction, larger-scale trials and long-term safety data are essential to define its role within psychiatric and addiction treatment frameworks.
Fatherhood and addictive disorders: experiences and support needs – results of a qualitative interview study
ObjectivesParental addictive disorders are a major public health problem. Despite already known negative effects, the parental role of men seeking help is rarely acknowledged within addiction support services. This study aims to identify existing relations between fatherhood and addiction, and the resulting support needs of affected fathers.MethodsFor data collection 15 fathers with addictive disorders were interviewed by using qualitative, guided interviews. The data material was analyzed using qualitative content analysis.ResultsThe effects of addictive disorders on fatherhood are predominantly unfavorable. Conversely, fatherhood can have consumption-reducing as well as consumption-increasing effects. In this context, five topics were identified in which fathers expressed specific support needs. Particularly fathers with substance use disorders expressed their need for further support, while fathers with behavioral addictions expressed a lesser need.ConclusionsPaying attention to fatherhood in the context of addiction services provides a starting point for increasing the motivation to change. Individual support needs should be considered when implementing father-specific programs. Not only the fathers themselves, but also their children can benefit from successful treatment and expected changes in fatherhood.
Case Report: Delirium and complications resulting from the abuse of compound liquorice tablets
BackgroundCompound liquorice tablets is a cough-suppressing compound formulation containing opium powder and liquorice. With the strict regulation of traditional opioids, this medication has emerged as a novel alternative for substance abuse due to its easy accessibility and low cost; however, its addiction potential and severe adverse complications remain underrecognized and insufficiently addressed in clinical practice.Case summaryThe patient is a 29-year-old male who began self-medicating with compound liquorice tablets for a dry cough after COVID-19 infection. His daily dosage gradually escalated to 200–600 tablets within two years, resulting in established drug dependence. Two days after discontinuing the medication, he developed delirium manifested as confusion, disorientation, visual hallucinations and psychomotor agitation, accompanied by palpitations, hypertension, tremors, rhinorrhea, vomiting, severe hypokalemia, and bilateral lower limb edema. Organic brain diseases were excluded by systematic examinations. According to the ICD-10 diagnostic criteria, he was diagnosed with opioid-induced mental and behavioral disorders, hypokalemia and hypertension. We implemented a benzodiazepine tapering regimen to control delirium and sympathetic excitation associated with withdrawal symptoms, combined with antidepressants and antipsychotics to improve mood, anxiety, and psychotic symptoms, Under the guidance of a cardiologist, we actively managing hypertension and correcting internal environmental disturbances. Following comprehensive management, the patient’s withdrawal symptoms and delirium resolved, with stable emotional state and blood pressure, resulting in successful withdrawal.ConclusionThis is the first reported case of delirium caused by withdrawal from compound liquorice tablets. It provides preliminary insights for clinical identification, diagnosis, and multidisciplinary management of dependence on compound liquorice tablets, as well as related withdrawal symptoms and complications. This case also alerts to the emerging risk of abuse associated with new substances such as compound liquorice tablets and underscores the need for stricter prescription controls and patient education regarding the risks of abuse.
The relationship between mobile phone addiction and depression, anxiety among Chinese college students: the mediating role of friendship quality and the moderating effect of preference for solitude
BackgroundThe university stage represents a critical period for the development of individual mental health. Mobile phone addiction is closely linked to depression and anxiety among college students, and both friendship quality and preference for solitude are tightly associated with college students’ mobile phone addiction and emotional health. Therefore, this study aimed to investigate the relationships and internal mechanisms among mobile phone addiction, friendship quality, preference for solitude, depression and anxiety in college students.MethodsA total of 1083 Chinese college students (58.2% female; mean age = 19.87 ± 1.692 years) were included as participants. Data were collected using the Mobile Phone Addiction Index, Friendship Quality Questionnaire, Preference for Solitude Questionnaire, and Depression Anxiety Stress Scale. Data processing and analyses were conducted using SPSS 26.0 and the PROCESS macro.Results(1) Mobile phone addiction was significantly negatively correlated with friendship quality, and significantly positively correlated with both depression and anxiety; friendship quality was significantly negatively correlated with depression and anxiety; preference for solitude was significantly positively correlated with depression and anxiety. (2) Mobile phone addiction not only directly and positively predicted depression and anxiety among college students, but also predicted depression and anxiety through the mediating role of friendship quality. (3) The direct effect of mobile phone addiction on depression and the mediating effect of friendship quality in the relationships between mobile phone addiction and depression/anxiety were both moderated by preference for solitude, whereas the moderating effect of preference for solitude on the association between mobile phone addiction and anxiety was not significant.ConclusionFriendship quality serves as an important mediating pathway between mobile phone addiction and depressive and anxiety symptoms among Chinese college students. Preference for solitude may amplify the associations of mobile phone addiction with poorer friendship quality and elevated depressive symptoms.
Editorial: Beyond abstinence: harm reduction and its impact on addiction disorders
Bipartisan bill seeks to allow direct prescribing of methadone for opioid addiction
Two senators are renewing their push to greatly expand access to methadone treatment for opioid addiction.
On Thursday, Sens. Ed Markey (D-Mass.) and Rand Paul (R-Ky.) are introducing an updated version of legislation that would allow doctors who hold board certifications in addiction medicine to prescribe methadone directly to patients for pickup at a pharmacy.
Applications of machine learning algorithms to detect digital addiction: a meta-analysis
Digital addiction (DA) has emerged as a significant global concern, yet traditional diagnostic methods relying on self-report questionnaires face subjective bias and threshold inconsistencies. Recent advances in machine learning (ML) offer promising alternatives for automated DA detection. This study conducted a systematic meta-analysis of 64 eligible studies (75 independent datasets; N = 165,624), employing both single-group proportion and bivariate diagnostic test accuracy (DTA) models. The pooled classification accuracy was 0.87 (95% CI [0.85, 0.90]), and the DTA framework yielded a robust AUC of 0.92, with balanced sensitivity and specificity (both 0.86). Subgroup analyses showed high accuracy across subtypes, particularly for internet (0.90) and social media addiction (0.86). Accuracy was comparable between survey-based and physiological data, though physiological markers demonstrated superior specificity (0.90). These findings underscore the potential of ML-driven tools as scalable screening instruments while emphasizing the need for representative sampling and standardized diagnostic criteria to advance digital mental health practice.
4-STEP-Training Program for Doomscrolling, Cyberchondriac Behavior and Psychiatric Symptoms (4-STEP-TPS) Among Individuals With Social Media Addiction
Conditions: Doomscrolling; Cyberchondriac Behavior; Social Media Addiction
Interventions: Behavioral: 4-STEP-Training Program for Social Media Addiction (4-STEP-TPS)
Sponsors: Government College University Faisalabad
Not yet recruiting
Interventions: Behavioral: 4-STEP-Training Program for Social Media Addiction (4-STEP-TPS)
Sponsors: Government College University Faisalabad
Not yet recruiting
QAIAx (AIhealth4U) – AI Public Health Central: Microcity-A (re Quantum AI Agency Aka AI City Hall Project, UPSTO App Nos. 64/074,526, 64/063,557, 63/903,181, 63/729,428
Conditions: Asperger’s Disorder; Asperger Disorder; Autism Disorder; Autism; ADHD – Attention Deficit Disorder With Hyperactivity; ADHD; ASD; Alcohol Abuse/Dependence; Alcohol Addiction; Alcohol and Other Drug Use Disorders; Alcohol and Other Substance Use Prevention; Gambling Addiction; Gambling Disorder; Sex Abuse; Sex Behavior; Sex Crimes; Sex Disorder; Sex Disorders; Gender Dysphoria, Adult; Eating Behavior Disorders; Narcotic-Related Disorders; Narcotic Addiction; Narcissism; Psychiatric Disorder; Psychedelic Effects in Healthy Volunteers; Psychedelic Experiences; Psychedelic Drug Dependence; Marijuana Use Disorder; Marijuana Abuse and Dependence; Smoking (Tobacco) Addiction; Smoking Among Youth; Smoking Abstinence; Abstinence, Sex; Opiate Substitution Treatment; Opioid Abuse (Disorder); Opioid Abuse and Addiction; Cocaine Abuse; MDMA (‘Ecstasy’); Addiction Disorders; Homeless and Low Incomes People, Refugees; Homelessness; Reliability and Validity; Anger Problems; Child Abuse, Sexual
Interventions: Behavioral: AI City Hall Project (AIhealth4u – Public Health Central); Behavioral: AI City Hall Project (QAIAx Microcity A – AI Public Health Central)
Sponsors: Veterans Recovery Network Inc.; U.S. Special Operations Command; Central Virginia VA Health Care System; AI-119 Vulcan Project Research & Educational Technology Company (fka Henry Nanpei Academy Project)
Not yet recruiting
Interventions: Behavioral: AI City Hall Project (AIhealth4u – Public Health Central); Behavioral: AI City Hall Project (QAIAx Microcity A – AI Public Health Central)
Sponsors: Veterans Recovery Network Inc.; U.S. Special Operations Command; Central Virginia VA Health Care System; AI-119 Vulcan Project Research & Educational Technology Company (fka Henry Nanpei Academy Project)
Not yet recruiting