Each year, I review the most important addiction science in medical, neuroscience, and public health journals. In 2025, research addressed questions experts grapple with daily: What are realistic goals of treatment? How should we conceptualize recovery in an era of fentanyl? Are addictions neurobiologically reversible? Where do emerging therapies—such as GLP-1 agonists or ketamine—fit into evidence-based care?

The 15 studies below are unranked and selected for scientific rigor, clinical relevance, and potential to shift thinking/practice in addiction medicine.

1. Rethinking Medication Treatment Goals for Opioid Use Disorder

McLellan and Volkow confront one of the most persistent, emotionally-charged addiction questions: What are acceptable treatment outcomes? We have no cures, so what are we trying to achieve with medications for opioid use disorder? The authors propose a three-stage framework—protection, remission, and recovery. Protection emphasizes survival and overdose prevention; remission focuses on stabilization of cravings/use; recovery encompasses long-term health and functioning.

A person can be in recovery but treated with methadone, buprenorphine, or naltrexone. The authors contend that medication tapering should not be a default goal, and long-term or even lifelong treatment with methadone or buprenorphine may be appropriate for many patients.

2. Fentanyl: Not Just an Opioid Problem

Using national poison center data from 2015–2023, Fitzgerald et al. document a dramatic rise in nonfatal fentanyl exposures involving stimulant co-use. Cocaine-fentanyl exposures increased nearly sevenfold, while methamphetamine-fentanyl exposures rose more than sixfold. The findings underscore a fundamental change in illicit drug use and supply: Polysubstance exposure is the norm. Emergency physicians, addiction specialists, and public health systems must adapt to increasingly complex intoxication and withdrawal syndromes rather than single-substance models. This study reinforces fentanyl contamination as a supply-chain/overdose problem affecting all drug classes.

3. Is Ultra-Processed Food Addictive?

In one of the year’s most provocative papers, LaFata and colleagues argue that addiction to ultra-processed foods meets diagnostic criteria comparable to substance use disorders. Reviewing nearly 300 studies across 36 countries, they showed consistent evidence of craving, impaired control, continued use despite harm, and failed attempts at cutting down. The estimated global prevalence—around 14 percent—mirrors alcohol use disorder.

Neuroimaging and behavioral data demonstrate striking overlaps between food and drug reward circuitry, particularly dopaminergic and self-regulation systems.

Recognizing food addiction may reduce stigma, opening the door to effective treatment approaches, especially with emerging pharmacotherapies.

4. Esketamine Five Years Later—Cautious Promise

Five years after FDA approval, this editorial evaluates the role of esketamine in treatment-resistant

© Psychology Today