Drug and alcohol dependence最新文献

{"title":"Labour productivity losses from premature death due to alcohol in Spain (2002–2018): Estimation and comparative analysis with tobacco-related estimates","authors":"Juan Oliva-Moreno ,&nbsp;Marta Trapero-Bertran ,&nbsp;Luz Maria Peña-Longobardo","doi":"10.1016/j.drugalcdep.2024.112462","DOIUrl":"10.1016/j.drugalcdep.2024.112462","url":null,"abstract":"<div><h3>Aim</h3><div>To estimate premature deaths, years of potential labour productivity lost, and productivity losses attributable to alcohol consumption in Spain (2002–2018) and, compare these losses with those from tobacco consumption.</div></div><div><h3>Methods</h3><div><strong>Using</strong> the human capital approach, data on employment, wages and mortality were analysed from national sources. Alcohol-related mortality risks were drawn from the Spanish Ministry of Health. Labour productivity losses were calculated based on working-age mortality (35–64 years), with adjustments for productivity growth and discount rates. Sensitivity analyses were conducted to validate the findings.</div></div><div><h3>Results</h3><div>Between 2002 and 2018, premature deaths and productivity losses related to alcohol consumption decreased significantly, with losses declining from 1959 million euros in 2002–936 million euros in 2018, representing a 52.2 % reduction. Although there was also a favourable trend in this area, productivity losses due to tobacco-related deaths amounted to 68.6 %.</div></div><div><h3>Conclusion</h3><div>This study reveals a marked decline in alcohol-related labour productivity losses in Spain over the analysed period. Nevertheless, tobacco and alcohol continue to pose a greater economic burden, highlighting the need for sustained public health efforts targeting both alcohol and tobacco consumption to mitigate productivity losses.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112462"},"PeriodicalIF":3.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation into the biomolecular bases of blunted cocaine-induced glutamate release within the nucleus accumbens elicited by adolescent exposure to phenylpropanolamine","authors":"Casey A. Wilson ,&nbsp;Bailey W. Miller ,&nbsp;Rachel M. Renton ,&nbsp;Kevin D. Lominac ,&nbsp;Karen K. Szumlinski","doi":"10.1016/j.drugalcdep.2024.112465","DOIUrl":"10.1016/j.drugalcdep.2024.112465","url":null,"abstract":"<div><div>Globally, phenylpropanolamine (PPA) is a prevalent primary active ingredient in over-the-counter cough and cold, as well as weight-loss medications. Previously, we showed that a sensitization of cocaine-induced glutamate release within the nucleus accumbens (NAC) and the expression of cocaine-conditioned reward is not apparent in adult mice with a prior history of repeated PPA exposure during adolescence. As NAC glutamate is a purported driver of cocaine reward and reinforcement, the present study employed <em>in vivo</em> microdialysis and immunoblotting approaches to inform as to the receptor and transporter anomalies that might underpin the disrupted glutamate response to cocaine in adolescent PPA-exposed mice. For this, male and female C57BL/6<!--> <!-->J mice were pretreated, once daily, with either 0 or 40<!--> <!-->mg/kg PPA during post-natal days 35–44. Adolescent PPA pretreatment significantly altered the expression of mGlu2/3 and α2 receptors in the NAC, with less robust changes detected for EAAT2, D2 receptors, DAT and NET. However, we detected no overt change in the capacity of these receptors or transporters to affect extracellular glutamate levels in adolescent PPA-pretreated mice. The present findings contrast with the pronounced changes in the capacity of mGlu2/3 receptors, EAAT, DAT and NET to regulate NAC extracellular glutamate reported previously for juvenile PPA-pretreated mice, indicating further that the long-term biochemical consequences of PPA depend on the critical period of neurodevelopment during which an individual is PPA-exposed, although the specific biomolecular changes underpinning the cocaine phenotype produced by adolescent PPA remain to be elucidated.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112465"},"PeriodicalIF":3.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing web-based interventions for alcohol use screening and alcohol education administered by village health volunteers in the community setting","authors":"Polathep Vichitkunakorn ,&nbsp;Chutarat Sathirapanya ,&nbsp;Napakkawat Buathong ,&nbsp;Phoomjai Sornsenee ,&nbsp;Sitthichok Chaichulee ,&nbsp;Teerohah Donraman","doi":"10.1016/j.drugalcdep.2024.112461","DOIUrl":"10.1016/j.drugalcdep.2024.112461","url":null,"abstract":"<div><h3>Background</h3><div>Given technology’s rising importance in addressing alcohol issues, this study aimed to compare the effectiveness of web-based interventions and that of traditional paper-based methods for alcohol use screening and education administered by village health volunteers (VHVs) in Thailand.</div></div><div><h3>Methods</h3><div>This cluster randomised controlled trial was conducted in two Thai villages with similar demographics and alcohol-use patterns. The villages were randomly assigned to either a web-based or a paper-based intervention group. The web-based group accessed screenings and interventions through a digital platform designed to facilitate participant interaction and data collection, whereas the paper-based group used conventional face-to-face screenings, paper questionnaires, and printed educational materials.</div></div><div><h3>Results</h3><div>Of the 1396 participants, those in the web-based group (n = 421) demonstrated a significantly higher likelihood of abstaining from or discontinuing alcohol use by the third session compared to those in the paper group (n = 975) (adjusted odds ratio 1.88–8.11). Additionally, satisfaction among VHVs regarding the ease of use and data accuracy was notably higher in the web-based group, with scores averaging 20 % higher than those in the control group.</div></div><div><h3>Conclusion</h3><div>Web-based interventions are more effective and efficient than traditional methods and provide a promising tool for expanding alcohol use disorder screening and education. This approach not only enhances participation rates but also improves the accuracy and reliability of health data collection.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112461"},"PeriodicalIF":3.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time course of kratom effects via ecological momentary assessment, by product type, dose amount, and assayed alkaloid content","authors":"Kirsten E. Smith ,&nbsp;Leigh V. Panlilio ,&nbsp;Abhisheak Sharma ,&nbsp;Christopher R. McCurdy ,&nbsp;Jeffrey D. Feldman ,&nbsp;Sushobhan Mukhopadhyay ,&nbsp;Siva Rama Raju Kanumuri ,&nbsp;Michelle A. Kuntz ,&nbsp;Katherine Hill ,&nbsp;David H. Epstein","doi":"10.1016/j.drugalcdep.2024.112460","DOIUrl":"10.1016/j.drugalcdep.2024.112460","url":null,"abstract":"<div><h3>Background and aims</h3><div>Using ecological momentary assessment (EMA), we undertook a natural experiment wherein kratom-product variability was a tool to assess kratom dose-response relationships based on product form and alkaloid level.</div></div><div><h3>Methods</h3><div>Between July-November 2022, 357 US kratom consumers (56.6 % male, 90.2 % non-Hispanic white) completed 15 days of EMA; 348 participants submitted samples of the products used most often during EMA. These were assayed for ten alkaloids using ultra-performance liquid chromatography-tandem mass spectrometry. Self-reported kratom effects were modeled as a function of kratom amount and alkaloid content.</div></div><div><h3>Results</h3><div>Participants used over 220 brands. The most-reported product forms were loose powder (55.8 %) and encapsulated powder (26.8 %); extracts were used less (419 uses across 9.48 % of participants). Of the 12,244 use-event entries, 7726 had follow-up data (15–180<!--> <!-->minutes after use) on felt effects. Effects were stronger in participants with a higher average amount per use. Within-person dose-response relationships were obscured by highly-consistent within-person dosages. Effects of loose powder decreased over three hours; effects of extracts started higher but decreased more rapidly. Dose-response relationships for specific alkaloids could not be reliably established because total alkaloid content and relative levels of specific alkaloids showed limited variability between products. Higher levels of corynoxine alkaloids were associated with slightly stronger effects, possibly an artifact of modeling data with low alkaloid variability.</div></div><div><h3>Conclusions</h3><div>Alkaloid content was surprisingly consistent across kratom products, and participants were consistent in the amount they used across events. Firm conclusions about alkaloid-effect relationships for kratom will require experimenter-controlled manipulations of agent and dose.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112460"},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased prevalence of alcohol use and related sociodemographic factors in an urban district of Shanghai, China: Evidence from three cross-sectional surveys (2010–2021)","authors":"Li Cao ,&nbsp;Xiaolin Qian ,&nbsp;Liangfeng Wang ,&nbsp;Yun Chen ,&nbsp;Zhenmei Pu ,&nbsp;Deng Niu ,&nbsp;Jianhua Shi ,&nbsp;Haiyan Gu ,&nbsp;Chaowei Fu","doi":"10.1016/j.drugalcdep.2024.112452","DOIUrl":"10.1016/j.drugalcdep.2024.112452","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use contributes considerably to the global impact of disease. However, limited research has been conducted recently to explore the changes in the prevalence of alcohol use, especially in urban Shanghai, China.</div></div><div><h3>Objectives</h3><div>To estimate the prevalence changes of alcohol use and explore related sociodemographic factors among urban residents of Xuhui district, Shanghai, China.</div></div><div><h3>Methods</h3><div>Using a multistage probability proportionate-to-size sampling method, three waves of household investigations via a structured questionnaire were conducted in Xuhui district, Shanghai, China, between 2010 and 2021. Data were collected by face-to-face interviews among residents aged 15 or older who responded to the 2010, 2015, and 2021 Health Status and Health Service Utilization Survey. Age and sex standardized prevalence of alcohol use was calculated, and the linear trend was tested using logistic regression models. Multilevel mixed-effects logistic regression models with robust covariance matrix estimators were used to estimate related factors of alcohol use.</div></div><div><h3>Results</h3><div>A total of 24 552 participants aged 15–109 years were included. The standardized overall prevalence of current regular alcohol use statistically declined from 8.8 % in 2010 to 5.5 % in 2021. This decreasing trend was statistically significant, especially among men aged 30–59 and ≥ 75 years old. However, the prevalence of overall alcohol use, regardless of frequency, increased from 19.6 % in 2015 to 24.0 % in 2021. Multivariate regression analysis showed that men had a significantly higher likelihood of regular alcohol use than women. Also, age was positively related to regular alcohol use, while education level was negatively related to this behavior.</div></div><div><h3>Conclusions</h3><div>Alcohol use was still common, although a significant decreasing trend in the prevalence of regular alcohol use was observed overall, in this study population. The findings call for strengthened health education and alcohol control in the context of the harmful effects of alcohol use at any level.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112452"},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A way to liberate myself\": A qualitative study of perceived benefits and risks of chemsex among gay, bisexual, and other men who have sex with men in Almaty, Kazakhstan","authors":"Nikolay Lunchenkov ,&nbsp;Nadezhda Cherchenko ,&nbsp;Kuanysh Altynbekov ,&nbsp;Assel Terlikbayeva ,&nbsp;Sholpan Primbetova ,&nbsp;Denis Gryazev ,&nbsp;Elena German ,&nbsp;Uluk Batyrgaliev ,&nbsp;Janina Isabel Steinert","doi":"10.1016/j.drugalcdep.2024.112464","DOIUrl":"10.1016/j.drugalcdep.2024.112464","url":null,"abstract":"<div><h3>Background</h3><div>In Kazakhstan, the HIV epidemic has a significant impact on marginalized groups such as gay, bisexual and other men who have sex with men (GBMSM), exacerbated by homophobic attitudes (in society) and (resulting) minority stress. This stress often leads to coping behaviors such as chemsex - the use of synthetic stimulants to enhance sexual experiences. Our study explores the motivations and perceived risks associated with chemsex among GBMSM in Almaty.</div></div><div><h3>Methods</h3><div>We conducted semi-structured in-depth interviews with 21 chemsex participants self-identified as GBMSM in Almaty, Kazakhstan. Participants were recruited through community-based organizations to ensure a diverse sample in terms of age and ethnicity. Thematic analysis was used to identify key themes related to motivations and risks.</div></div><div><h3>Results</h3><div>Participants practiced chemsex to seek liberation from societal norms and personal inhibitions, increase sexual pleasure, and escape daily stressors. Chemsex sessions provided intensified sexual experiences, emotional comfort, and social connections, challenging constraints on sexual behavior. Participants recognized significant risks, including mental and physical health issues, social stigma, and violence victimisation. Despite these risks, the desire for the perceived benefits of chemsex, particularly feelings of freedom and happiness, underscored its appeal.</div></div><div><h3>Conclusions</h3><div>The study reveals a complex dynamic in which chemsex serves as a coping mechanism for minority stress, a source of sexual liberation, and a social connector for GBMSM in Kazakhstan, while also posing significant health risks. These findings emphasize the need for targeted harm reduction strategies, mental health support, and community-building efforts that are responsive to the experiences and needs of GBMSM who engage in chemsex.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112464"},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Housing instability increases for stimulant-involved overdose deaths after linking surveillance data to electronic health records in Kentucky","authors":"Daniel R. Harris ,&nbsp;Dana Quesinberry ,&nbsp;Nicholas Anthony ,&nbsp;Jungjun Bae ,&nbsp;Anna L. Smith ,&nbsp;Chris Delcher","doi":"10.1016/j.drugalcdep.2024.112455","DOIUrl":"10.1016/j.drugalcdep.2024.112455","url":null,"abstract":"<div><h3>Background</h3><div>According to the U.S. Centers for Disease Control and Prevention, approximately 10.2 % of fatal overdoses in 2022 were among people experiencing homelessness or housing instability. In the United States, the majority of all drug overdoses now involve stimulants.</div></div><div><h3>Methods</h3><div>We linked stimulant-involved fatal overdose records occurring between 2017 and 2021 from Kentucky’s Drug Overdose Fatality Surveillance System to the electronic health records (EHR) of the state’s largest safety-net hospital network. We used State Unintentional Drug Overdose Reporting System (SUDORS) definitions of homelessness or housing instability to establish baseline estimates before linking decedents to medical records. After linkage, we augmented SUDORS data with structured administrative billing codes, semi-structured address data, and unstructured clinical notes identifying homelessness from the EHR.</div></div><div><h3>Results</h3><div>There were 313 individuals with stimulant-involved fatal overdoses linked to at least one medical encounter in the EHR (2017–2021). Thirty-three individuals (10.5 %) were identified as having unstable housing according to SUDORS. After linkage, 130 individuals (41.5 %) had evidence of housing instability. For this period, these 313 individuals represent 8.0 % of stimulant-involved overdoses in KY or 38.5 % of stimulant-involved overdoses from residents of the primary and secondary catchment area of our healthcare network.</div></div><div><h3>Conclusions</h3><div>The single-site increase in observed housing instability in stimulant-involved fatal overdoses suggests that increased data linkage between state medicolegal death investigation system and EHRs would significantly improve the public health surveillance of overdoses.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112455"},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive effects of genetic liability and combat exposure on risk of alcohol use disorder among US service members","authors":"Laura Campbell-Sills ,&nbsp;Karmel W. Choi ,&nbsp;Sam D. Strizver ,&nbsp;Jason D. Kautz ,&nbsp;Santiago Papini ,&nbsp;Pablo A. Aliaga ,&nbsp;Paul B. Lester ,&nbsp;James A. Naifeh ,&nbsp;Caitlin Ray ,&nbsp;Ronald C. Kessler ,&nbsp;Robert J. Ursano ,&nbsp;Murray B. Stein ,&nbsp;Paul D. Bliese","doi":"10.1016/j.drugalcdep.2024.112459","DOIUrl":"10.1016/j.drugalcdep.2024.112459","url":null,"abstract":"<div><h3>Background</h3><div>An improved understanding of pathways to alcohol use disorder (AUD) among service members may inform efforts to reduce the substantial impact of AUD on this population. This study examined whether the relationship between a service-related risk factor (combat exposure) and later AUD varied based on individual differences in genetic liability to AUD.</div></div><div><h3>Methods</h3><div>The sample consisted of 1203 US Army soldiers of genetically determined European ancestry who provided survey and genomic data in the Army STARRS Pre/Post Deployment Study (PPDS; 2012–2014) and follow-up survey data in wave 1 of the STARRS Longitudinal Study (2016–2018). Logistic regression was used to estimate the conditional effect of combat exposure level (self-reported in PPDS) on odds of probable AUD diagnosis at follow-up, as a function of a soldier’s polygenic risk score (PRS) for AUD.</div></div><div><h3>Results</h3><div>The direct effect of combat exposure on AUD risk was non-significant (AOR=1.12, 95 % CI=1.00–1.26, p=.051); however, a significant combat exposure x PRS interaction was observed (AOR=1.60, 95 % CI=1.03–2.46, p=.033). Higher combat exposure was more strongly associated with elevated AUD risk among soldiers with heightened genetic liability to AUD.</div></div><div><h3>Conclusions</h3><div>The effect of combat exposure on AUD risk appeared to vary based on a service member’s level of genetic risk for AUD. Continued investigation is warranted to determine whether PRS can help stratify AUD risk within stress-exposed groups such as combat-deployed soldiers. Such efforts might reveal opportunities to focus prevention efforts on smaller subgroups at the intersection of having both environmental exposures and genetic vulnerability to AUD.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112459"},"PeriodicalIF":3.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with medications for opioid use disorder (MOUD) treatment success during the pregnancy and postpartum periods: A scoping review","authors":"Maureen Mburu ,&nbsp;Rita Masese ,&nbsp;Elizabeth T. Knippler ,&nbsp;Melissa H. Watt ,&nbsp;Amnazo Muhirwa ,&nbsp;Leila Ledbetter ,&nbsp;Margaret Graton ,&nbsp;Brandon A. Knettel","doi":"10.1016/j.drugalcdep.2024.112454","DOIUrl":"10.1016/j.drugalcdep.2024.112454","url":null,"abstract":"<div><h3>Background</h3><div>Medications for opioid use disorder (MOUD) are a crucial intervention for pregnant and postpartum individuals with opioid use disorder (OUD). However, there is paucity of data on the factors associated with MOUD treatment success in this population. This scoping review aimed to evaluate factors associated with MOUD success during the pregnancy and postpartum period.</div></div><div><h3>Methods</h3><div>We completed a structured search of MEDLINE, CINAHL, PsycINFO, Web of Science, and ProQuest databases. Eligible studies included a metric of success in outpatient treatment in the pregnancy and postpartum period and were conducted in the United States after the Food and Drug Administration’s approval of buprenorphine in 2002. Reviewers independently screened studies for inclusion and extracted data. The primary outcome was treatment success (i.e., treatment adherence, abstinence from illicit opioids, or retention in care) during pregnancy and up to 12 months postpartum.</div></div><div><h3>Results</h3><div>Data from 15 studies were included. Medications included methadone, naltrexone and buprenorphine (mono or combination therapy). High daily dose of buprenorphine as mono or combination therapy, early initiation and longer duration of MOUD were associated with treatment success. Legal involvement, homelessness, and rural residency were negatively associated with treatment success. There were no differences in outcomes of individuals receiving telemedicine versus in-person care.</div></div><div><h3>Conclusion</h3><div>We identified several factors associated with MOUD treatment success among individuals with OUD during the pregnancy and postpartum periods. These factors may help guide future research and inform the development and adaptation of interventions tailored to better meet the needs of this key population.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112454"},"PeriodicalIF":3.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solving the “last mile” problem in overdose prevention: Lessons from the HEALing Communities Study","authors":"Scott T. Walters,&nbsp;Mari-Lynn Drainoni,&nbsp;Emmanuel A. Oga,&nbsp;Jeremy Byard,&nbsp;Redonna K. Chandler","doi":"10.1016/j.drugalcdep.2024.112453","DOIUrl":"10.1016/j.drugalcdep.2024.112453","url":null,"abstract":"<div><div>The concept of the \"last mile,\" crucial in logistics for its complexity and cost, has a parallel in public health services. The last mile in public health is fraught with issues such as fragmented services, regulatory barriers, and resistance to evidence-based interventions. This commentary draws parallels between the challenges in delivering goods to consumers’ doorsteps and the difficulties in delivering interventions to reduce overdoses in the community. The HEALing Communities Study (HCS), a large implementation science research study, provides an example of how to navigate some of these last-mile challenges. HCS used a community-driven process that considered local characteristics and preferences, and engaged people with lived experience to create effective and sustainable solutions. However, the study also encountered significant challenges in building a delivery infrastructure, working with delayed and incomplete data, and overcoming stigma around substance use interventions. Lessons from the logistics sector can help improve the efficiency and equity of overdose prevention efforts, ensuring that people receive the life-saving interventions they need.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"264 ","pages":"Article 112453"},"PeriodicalIF":3.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}