Harm Reduction Journal最新文献

{"title":"Utilization of drug checking services in Austria: a cross-sectional online survey.","authors":"Alexandra Karden, Tobias Fragner, Cornelia Feichtinger, Julian Strizek, Daragh T McDermott, Igor Grabovac","doi":"10.1186/s12954-025-01168-1","DOIUrl":"10.1186/s12954-025-01168-1","url":null,"abstract":"<p><strong>Background: </strong>The use of psychoactive substances is a key public health issue due to its impact on mental, physical, and social health. Integrated drug checking is a well-known harm reduction and addiction prevention measure and is currently implemented in four federal states in Austria. The aim of this study is to investigate the prevalence of drug checking use among a web-survey sample of people who use drugs (PWUD) in Austria and to examine differences in socio-demographic and substance use characteristics between individuals with and without drug checking experience. In addition, reasons for not using these services are explored.</p><p><strong>Methods: </strong>A secondary data analysis of the Austrian data from the European Web Survey on Drugs (EWSD), a targeted survey conducted between March and May 2021 was performed. Based on reported drug checking experience, the data set was divided into two groups - those with and without drug checking experience - and compared.</p><p><strong>Results: </strong>In this web-survey sample of PWUD (n = 1113), 20.1% reported prior use of a drug checking service in Austria. The groups with drug checking experience (n = 224) and those without (n = 889) differed significantly in both univariate and multivariate analyses. Univariate analysis revealed significant differences in terms of age, household composition, highest level of education, employment status, region of residence, substance use prevalences and treatment experience. Participants who used cannabis only had significantly less experience with drug checking. No significant differences were found regarding gender and income. While logistic regression analysis showed a significant relationship between sociodemographic predictors and drug checking experience, this relationship was relatively weak. The main reasons for not having used the services yet included a high level of trust in the source of supply (68%), confidence in receiving high quality of substances (64%), and a lack of service availability near the place of residence (62%).</p><p><strong>Conclusions: </strong>The results indicate that drug checking services are well-accepted and trusted but not equally accessed by and accessible to all PWUD. Specifically, people who use only cannabis and those residing with parents or in rural or small-town areas access services less. In conclusion, there is considerable potential for expanding the availability and accessibility of drug checking services in Austria, particularly to reach underserved groups of PWUD who could benefit from this intervention.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"17"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing viral hepatitis C reinfections in a low-threshold programme for people who inject drugs in Slovenia.","authors":"Jasna Černoša, Jelka Meglič Volkar, Mario Poljak, Maja Pohar Perme, Jeffrey Victor Lazarus, Mojca Matičič","doi":"10.1186/s12954-025-01164-5","DOIUrl":"10.1186/s12954-025-01164-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) infection remains a public health threat. Although therapy with direct-acting antivirals made its elimination possible, major challenges remain in treating vulnerable populations, such as people who inject drugs (PWID) enrolled in low-threshold programmes (LTPs). This study analysed the outcome of HCV management focused on HCV reinfection in a specifically designed model-of-care (MoC) for PWID in Slovenia, where treatment is prescribed without limitations, though only by specialist physicians.</p><p><strong>Methods: </strong>All HCV antibody (anti-HCV) positive users of a MoC, combining HCV management at Clinic for Infectious Diseases at the University Medical Centre in Ljubljana and LTP for PWID in 100 km distanced civil society organisation (CSO) Svit Koper, between January 2017 to December 2022, were included. The MoC enabled regular transportation of PWID between LTP and the Clinic, where specifically assigned services for individually tailored HCV management in cooperation with CSO were available. Data on participants´ demographic, epidemiological, and clinical characteristics were collected partly retrospectively and prospectively, with a particular focus on HCV treatment outcome and reinfection status, and analysed accordingly.</p><p><strong>Results: </strong>The study included 49 anti-HCV positive PWID with a mean age of 38.7 (standard deviation (SD) = 7.6) years at first visit. The majority was male (40/49, 81.6%); 16/49 (32.7%) experienced previous incarceration, 14/49 (28.6%) were experiencing homelessness, and 42/49 (85.7%) were receiving opioid agonist therapy. A total of 42/49 (83.7%) were HCV RNA-positive. Of them 36/42 (85.7%) started HCV treatment at a mean age of 42.7 (SD = 5.7) years and 33/36 (91.7%) completed treatment. Six (14.3%) HCV RNA-positive PWID died. Among 28/33 (84.9%) who achieved a sustained virological response 12 weeks post treatment, 6/28 (21.4%) presented with reinfection. The HCV reinfection rate was 13.3 per 100 - PY (95% confidence interval (CI) [6.0, 29.7]), the rate of positive HCV RNA re-test was 12.2 per 100 - PY (95%CI [7.7-16.7]), while hazard of reinfection in our cohort increased with time, with the estimated reinfection probability exceeding 0.5 at 4 years.</p><p><strong>Conclusions: </strong>In marginalised population of PWID attending LTP, a sustainable HCV RNA re-screening and follow-up after HCV cure are necessary, as the risk of reinfection remains high.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"16"},"PeriodicalIF":4.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limit-setting in online gambling: a comparative policy review of European approaches.","authors":"Virve Marionneau, Elli Luoma, Tobias Turowski, Tobias Hayer","doi":"10.1186/s12954-024-01150-3","DOIUrl":"10.1186/s12954-024-01150-3","url":null,"abstract":"<p><strong>Background: </strong>Online gambling products involve a heightened risk of harm, but there are some possibilities to prevent and reduce these harms. Notably, mandatory identification in online gambling environments allows for a range of pre-commitment tools such as limit-setting. Previous research has found that limit-setting tools can be helpful, but effectiveness depends on how policies are outlined and implemented. Limits can be financial or temporal, voluntary or mandatory, and system-level or operator-based. The current paper presents a policy review of European approaches to limit-setting in online environments.</p><p><strong>Methods: </strong>We first compared legal provisions on pre-commitment and limit-setting in N = 30 European countries (27 European Union Member States, Great Britain, Norway, and Switzerland). Data were retrieved from Vixio Gambling Compliance country reports and verified against original legal texts. The analysis focused on financial, temporal, maximum wager limits, and any other limits pertaining to online gambling. Second, based on the policy review, we produced a more in-depth analysis of limit-setting provisions in countries with system-level pre-commitment (Finland, Norway, Germany).</p><p><strong>Results: </strong>Results show important divergence in terms of limit-setting across Europe. While almost all countries (n = 27) have some form of limit-setting, implementation details vary. Financial limits can include loss limits (n = 15 countries), deposit limits (n = 18), and wagering limits (n = 14), with the majority of countries providing several types of financial limits. Temporal limits were available in ten countries. Eleven countries had some mandatory limits, in other countries operators were expected to provide the option to set limits. Statutory maximum limits and lower limits for young adults were not common, but available in some countries. Germany was the only country with a system-level limit-setting scheme that covered multiple licensed operators.</p><p><strong>Conclusions: </strong>Contextual variations in pre-commitment and limit-setting policies are likely to impact effectiveness in terms of preventing and reducing harm. Our review shows some promising practices, including system-level regimes, mandatory policies, reasonable maximum caps on limits and wagers, the possibility to set limits for various time periods, lower limits for young adults, and coupling limit-setting with other duty-of-care obligations. Learning from other jurisdictions can constitute good practice for future policies on pre-commitment.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"15"},"PeriodicalIF":4.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid consumption frequency and its associations with potential life problems during opioid agonist treatment in individuals with prescription-type opioid use disorder: exploratory results from the OPTIMA Study.","authors":"Anne Bouthillier, Gabriel Bastien, Christina McAnulty, Hamzah Bakouni, Bernard Le Foll, M Eugenia Socias, Didier Jutras-Aswad","doi":"10.1186/s12954-025-01157-4","DOIUrl":"10.1186/s12954-025-01157-4","url":null,"abstract":"<p><strong>Background: </strong>Traditional treatment approaches for prescription-type opioid use disorder (POUD), centered on abstinence, have limitations and hinder the development of interventions that meet the needs of people with POUD. Reduction in use without complete abstinence presents a promising avenue for intervention enhancement, but supporting data is scarce regarding its translation into positive patient outcomes. This study explores whether reducing opioid use frequency (OUF) during opioid agonist treatment correlates with reduced potential life problems in individuals with POUD, including those using fentanyl.</p><p><strong>Methods: </strong>This study is an exploratory analysis of the OPTIMA trial, a pragmatic, open-label, randomized controlled study comparing the effectiveness of flexible take-home dosing of buprenorphine/naloxone and supervised methadone in reducing opioid use amongst individuals with POUD. OUF was assessed every two weeks for 24 weeks after treatment initiation using the Timeline Followback. Potential life problems were evaluated at baseline and study completion using the Addiction Severity Index Self-Report. The 114 participants who completed both baseline and end-of-study questionnaires were included. A repeated-measures generalized linear mixed model (GLMM) was used to evaluate the influence of OUF on potential life problems.</p><p><strong>Results: </strong>Reducing OUF was significantly associated with fewer problems related to medical status (p = 0.049), psychiatric status (p = 0.019), and alcohol problem severity (p = 0.001). The interaction was non-significant for employment (p = 0.264), family status (p = 0.352) and legal status (p = 0.050). Life improvements emerged with ≤ 21 days of opioid use per 28-day period.</p><p><strong>Conclusion: </strong>Findings underscore the significance of harm reduction goals focusing on opioid use reduction, which translated in improvements across many life domains.</p><p><strong>Trial registration: </strong>Study was registered with ClinicalTrials.gov (NCT03033732) prior to participant enrollment.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"14"},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of knowledge and behaviors of an opioid overdose education and naloxone distribution program during the coronavirus disease 2019 pandemic.","authors":"Alexis E Horace, Ojochogwu Atawodi-Alhassan","doi":"10.1186/s12954-025-01161-8","DOIUrl":"10.1186/s12954-025-01161-8","url":null,"abstract":"<p><strong>Background: </strong>The state of Louisiana ranked 4th in the US for per capita overdose rates as 56 out of 100,000 persons died due to overdose and 1,300 of those deaths involved opioids. Opioid involved deaths increased 131% between 2019 and 2022. A pharmacist-led opioid overdose education and naloxone distribution (OEND) program was developed at a SSP in New Orleans during the COVID-19 pandemic. The purpose of this research is to characterize the clients who participated in the OEND and to assess their learned knowledge and behaviors over time.</p><p><strong>Methods: </strong>A pharmacist led OEND program was created in April 2020 at a syringe service program (SSP) in New Orleans, Louisiana. OEND was provided by a licensed pharmacist and student pharmacists. OEND coincided with the SSPs activities one time a week. Participants first received harm reduction supplies through the SSP and then had the option of receiving OEND. Patients' demographic information was collected. Participants who said they received opioid overdose education from our OEND program were verbally given a knowledge and behavior assessment. Participants knowledge and behaviors were scored using a rubric.</p><p><strong>Results: </strong>A total of 32 OEND sessions were held from July 2020 through February 2023 resulting in 1453 overall participant interactions. Repeat participants completed 269 visits and averaged 2.3 visits in three years. The average age of participants who received OEND was 40 years old. Additionally, participants who accessed OEND were primarily white (67.77%, n = 811/1300) and mostly male (59.15%, n = 769/1300). Among the participants who visited the OEND station more than once, 160 responses were collected for how helpful the previous education session had been. Of these responses, 75% (= 120/160) were \"Very helpful\". Participants who repeated the program retained knowledge and showed a positive change in their behaviors regarding opioid overdose reversal.</p><p><strong>Conclusions: </strong>OEND programs established at SSPs play an important role in providing education to PWUD. Participants knowledge sustained over time; however, refresher education sessions may be valuable to ensure participants stay accurately informed. Participants find OEND helpful. As naloxone continues to become increasingly available, OEND is necessary in preventing opioid overdose deaths.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"12"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to uptake of harm reduction techniques for GBMSM who use drugs in night-clubs and sex-on-premises venues in London and the Southeast: a mixed-methods, qualitative study.","authors":"Stephen Naulls, K Oniti, J Eccles, J M Stone","doi":"10.1186/s12954-025-01159-2","DOIUrl":"10.1186/s12954-025-01159-2","url":null,"abstract":"<p><strong>Background: </strong>Drug-related harm is a significant public health concern in the UK, particularly among underserved groups such as gay, bisexual, and other men who have sex with men (GBMSM). This study explores the role of night-time venues (for example night clubs or sex-on-premises venues) in promoting harm reduction strategies for GBMSM who use drugs, highlighting unique challenges within these spaces.</p><p><strong>Methods: </strong>The study used a mixed-methods approach, including an online survey (n = 53) and semi-structured interviews (n = 8). Participants included GBMSM with lived experience of substance use in night-time venues, as well as those providing support to this population. Data was collected through a Likert-scale survey and thematic analysis of qualitative responses.</p><p><strong>Results: </strong>Findings reveal dissatisfaction among survey respondents about the level of support for harm reduction provided by night-time venues, which are perceived as inconsistent in their approach towards substance use. The study also identifies economic and legal barriers faced by venues that prevent the endorsement of harm reduction techniques.</p><p><strong>Conclusions: </strong>Addressing these barriers could transform night-time venues into effective sites for harm reduction, particularly by targeting \"afters\" culture (the phenomenon where club-goers will return to a residential setting and continue substance use for prolonged periods 'after' the night-time venue closes or the event ends) and promoting safer practices. This research suggests that coordinated efforts with local government and policy reform are crucial to fostering safer environments for GBMSM.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"13"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a comprehensive inventory to define harm reduction housing.","authors":"Sofia Zaragoza, Joseph Silcox, Sabrina Rapisarda, Charlie Summers, Patricia Case, Clara To, Avik Chatterjee, Alexander Y Walley, Miriam Komaromy, Traci C Green","doi":"10.1186/s12954-025-01156-5","DOIUrl":"10.1186/s12954-025-01156-5","url":null,"abstract":"<p><strong>Background: </strong>The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a \"housing first\" approach where abstinence is not required and harm reduction services and supports are co-located. Despite the importance of HRH, the specific characteristics and operations of these sites are not well understood. This study sought to address this gap by cataloging the common features of Boston's HRH sites to generate a comprehensive inventory tool for evaluating implementation of harm reduction strategies at transitional housing locations.</p><p><strong>Methods: </strong>We collected data between June and September 2023 and included semi-structured qualitative interviews with HRH staff (n = 19), ethnographic observations and photos at six HRH sites. Candidate inventory components were derived through triangulation of the data. Two expert medical staff unaffiliated with data collection reviewed a draft inventory measuring awareness and utility of HRH inventory components. We then pilot tested the inventory with three HRH residents across two sites for readability and reliability. Awareness, frequency of use, and perceived helpfulness of key inventory items were further tested in a survey to 106 residents.</p><p><strong>Results: </strong>HRH staff identified best practices, resources, and policies in HRH sites that were further contextualized with ethnographic field notes. Common to all were overdose prevention protocols, behavioral policies, security measures, and distribution of harm reduction supplies. The initial 44-item inventory of services, policies and site best practices was further refined with expert and participant feedback and application, then finalized to generate a 32-item inventory. Residents identified and valued harm reduction services; medical supports were highly valued but less utilized.</p><p><strong>Conclusion: </strong>The HRH inventory comprehensively assesses harm reduction provision and residents' awareness and perceived helpfulness of HRH operational components in staying safe from drug-related harms. Characterizing the critical components of HRH through this tool will aid in standardizing the concept and practice of HRH for PWUD and may assist other cities in planning and implementing HRH.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"11"},"PeriodicalIF":4.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future destinations: how people cured of hepatitis C using direct acting antiviral drugs progress in a new HCV-free world. A thematic analysis.","authors":"Sarah R Donaldson, Andrew Radley, John F Dillon","doi":"10.1186/s12954-024-01142-3","DOIUrl":"10.1186/s12954-024-01142-3","url":null,"abstract":"<p><strong>Background: </strong>The introduction of Direct-Acting Antivirals (DAAs) transformed Hepatitis C (HCV) treatment, despite this uptake of DAAs remains lower than required to meet the WHO Sustainable Development Goal (3.3). Treatment with interferon was suggested to be able to deliver important outcomes for people who use drugs in addition to a viral cure, such as social redemption, and shift from a stigmatised identity. There is a lack of understanding if DAAs can deliver these transformative outcomes.</p><p><strong>Methods: </strong>This recurrent cross-sectional study combines qualitative semi-structured interviews and demographic data of 15 participants receiving DAAs in Tayside, Scotland. A thematic analysis explored the non-clinical outcomes of DAA treatment viewed through the lens of the Social Identity Model of Recovery (SIMOR) to build understanding of the influence DAAs have in a recovery journey from drug use.</p><p><strong>Results: </strong>Three key themes emerged: identity, relationships and social networks; building recovery capital; and reflecting on re-infection and the shift to DAAs. Concern about the transmission of HCV resulted in self-imposed isolation which weakened support structures. Cure provides a mechanism to strengthen family bonds, however social networks in the wider community remain limited. Participants gained opportunities to undertake activities that build health and wellbeing providing a shift in identity, future plans and aspirations. Social isolation remained for some, revealing unmet need in post-cure support.</p><p><strong>Conclusion: </strong>DAAs may support recovery journeys through the SIMOR, individuals reduced the number of active users within their social network and reconnected with family members, building recovery capital. Individuals, however, remained socially isolated in the context of the wider community. HCV services should support links to community resources to deliver the social inclusion people desire.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"10"},"PeriodicalIF":4.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of desired abstinent and non-abstinent recovery outcomes among people who use methamphetamine.","authors":"Alex Elswick, Amanda Fallin-Bennett, Karen L Roper, Evan Batty, Christopher J McLouth, William Stoops, Hilary L Surratt, Carrie B Oser","doi":"10.1186/s12954-025-01155-6","DOIUrl":"10.1186/s12954-025-01155-6","url":null,"abstract":"<p><strong>Background: </strong>In the United States, complete abstinence persists as the standard for demonstrating recovery success from substance use disorders (SUDs), apart from alcohol use disorder (AUD). Although the FDA has recently indicated openness for non-abstinence outcomes as treatment targets, the traditional benchmark of complete abstinence for new medications to treat SUDs remains a hurdle and overshadows other non-abstinent outcomes desired by people with SUDs (e.g., improved sleep, employment, family reunification). This study sought to expand the definition of recovery to include non-abstinent pathways by exploring non-abstinence-based outcomes desired by people who use methamphetamine (PWUM).</p><p><strong>Methods: </strong>Participants (n = 100) were recruited from existing National Institute on Drug Abuse (NIDA) projects including a treatment-seeking sample of people recently released from prison (all of whom endorsed recent methamphetamine use) and a sample of people using syringe service programs. In a convergent survey design, participants responded to closed-ended questions regarding recovery outcomes, followed by open-ended items to gain a better understanding of PWUM and their conception of recovery. The importance of non-abstinent outcomes was measured in five categories (substance use, physical health, cognitive functioning, mental health, and financial/social/relationships).</p><p><strong>Results: </strong>Participants were primarily White (88%), male (67%), and an average age of 40. Approximately two-thirds of participants agreed that people need to stop all mood- or mind-altering substances to be in recovery (64%). Nevertheless, participants indicated a variety of desired non-abstinent recovery outcomes, both substance-related (e.g. reductions in methamphetamine use) and non-substance-related (e.g. improved economic stability). Specific non-abstinent outcomes endorsed as \"absolutely essential\" by PWUM included: preventing legal trouble (92%), employment stability (82%), improved quality of life (80%), housing stability (78%), improved coping skills (78%), improved relationships (75%), economic/income stability (74%), ability to think clearly (73%), less impulsivity (73%), less depression (71%), less stress (70%), improved hopefulness (70%), and improved sleep (70%). Open-ended responses emphasized employment stability, economic/income stability, improved coping skills, improved relationships, as well as improved energy, appetite, and sleep.</p><p><strong>Conclusion: </strong>Our findings indicate the importance of non-abstinent recovery outcomes among PWUM, suggesting high acceptability of non-abstinent recovery targets by people with lived experience. Further, the essential importance of non-abstinent outcomes, especially in the financial/social/relationship and mental health domains, were highlighted, providing novel targets for delivering SUD treatment/recovery.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"7"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing medical cannabis use risk among Veterans: A descriptive study.","authors":"Laura M Harris-Lane, Mitchell Sheehy, Courtney A Loveless, Joshua A Rash, David P Storey, Gregory K Tippin, Vikas Parihar, Nick Harris","doi":"10.1186/s12954-024-01149-w","DOIUrl":"10.1186/s12954-024-01149-w","url":null,"abstract":"<p><strong>Background: </strong>Canadian Veterans experiencing chronic pain report concerns about accessing accurate information on the risks associated with medical cannabis (MC) use. The Lower Risk Cannabis Use Guidelines (LRCUG) were developed to equip individuals who use cannabis recreationally with safer-use strategies. Many of the harm reduction recommendations for recreational cannabis use are relevant and important considerations for MC use. The primary objective of our study was to assess Canadian Veterans' awareness of and interest in the LRCUG, and engagement in potential higher-risk MC use behaviours.</p><p><strong>Methods: </strong>Canadian Armed Forces Veterans living with chronic pain (N = 582) were recruited online and through the Chronic Pain Centre of Excellence for Canadian Veterans. Participants completed measures on: cannabis use (never, past, current use), sources of cannabis knowledge, mental health, and awareness of and interest in receiving the LRCUG. Chi-Square and post-hoc analyses characterized the sample and assessed for demographic differences based on cannabis use status and awareness of the LRCUG. Engagement in higher-risk MC use behaviours were aligned to LRCUG recommendations, and detailed descriptively.</p><p><strong>Results: </strong>Veterans who currently use cannabis were more likely to be unemployed (z = 3.62, p < .01), released as a Non-Commissioned Officer (z = -3.83, p < .01), and unable to work due a disability (z = -3.43, p < .01) than Veterans who do not currently use. Less than 30% of Veterans were aware of the LRCUG, with greater awareness among individuals who currently use cannabis (n = 356). Engagement in higher-risk MC use behaviours that contradicted LRCUG recommendations ranged from ~ 9% to ~ 85%. Approximately 9% of Veterans experienced co-morbid mental health concerns, yet their MC use was not for mental health purposes (LRCUG recommendation #7). Additionally, almost 85% of Veterans engaged in daily MC use (LRCUG recommendation #5). The majority of Veterans who currently use cannabis engaged in two or more higher-risk MC use behaviours (60.2%; LRCUG recommendation #12). Almost half of all Veterans received their cannabis information from a healthcare provider or the internet.</p><p><strong>Conclusions: </strong>Our study suggests the importance of safer use guidelines tailored for MC use. Development of lower-risk MC use guidelines can support prescribing practitioners and Veterans with information needed for safer and better-informed MC use decisions, tailored to patients' needs and circumstances.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"9"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}