Harm Reduction Journal最新文献

{"title":"Qualitative insights into drug use safety strategies and social support among sexual minority women who inject drugs in Baltimore, Maryland.","authors":"Jennifer L Glick, Leanne Zhang, Aimee Huang, Megan Nguyen, Danielle German","doi":"10.1186/s12954-025-01257-1","DOIUrl":"10.1186/s12954-025-01257-1","url":null,"abstract":"<p><strong>Background: </strong>Sexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID's strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies.</p><p><strong>Methods: </strong>We conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants' sexual orientation and gender identities, social networks and support systems, drug use behaviors and HIV risk, and experiences accessing services. Using an inductive thematic analysis approach, we examined emergent themes related to drug use, social support, safety, and HIV and identified key safety strategies and social support experiences for SMWWID.</p><p><strong>Results: </strong>SMWWID employed various strategies to \"stay safe,\" which they primarily interpreted as ensuring overdose safety (i.e., using drugs in the presence of others, carrying Naloxone, purchasing strategies), and additionally as infectious disease safety (i.e., avoiding syringe sharing, using sterile syringes) and avoiding threats of violence (i.e., maintaining situational awareness while using drugs). Romantic or sexual partners, family and friends, and the wider community were sources of social support for overdose safety, and family and friends also provided material support (e.g., financial, housing). Syringe sharing with romantic partners and threats of violence from people in the community detracted from SMWWID's safety.</p><p><strong>Conclusion: </strong>SMWWID in this sample reported strong safety prioritization while using drugs, often facilitated by their social support systems. Harm reduction interventions that consider SMWWID's relationships, including those that aim to improve social connectedness, may better meet the needs of SMWWID, thereby enhancing safety.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"118"},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600173","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":"Drug use and sexual behaviors among women who inject drugs and use a syringe services program; Miami, Florida.","authors":"Belén Hervera, Teresa A Chueng, Joy Scheidell, Katrina Ciraldo, Sabrina Soto Sugar, Marina Plesons, Hansel E Tookes, David P Serota, Raymond R Balise, Noby Nakamuro, Shelby Meaders, David W Forrest, Tyler S Bartholomew","doi":"10.1186/s12954-025-01266-0","DOIUrl":"10.1186/s12954-025-01266-0","url":null,"abstract":"<p><strong>Background: </strong>Women who inject drugs (WWID) face disproportionately higher risks of infectious diseases, reproductive health challenges, and gendered social and structural vulnerabilities compared to men. Despite these elevated risks, most harm reduction programs do not tailor their services to meet the needs of WWID. In Florida, where syringe service programs are relatively new and implemented at the county-level, access remains limited. These gaps are especially pronounced for WWID, who face additional barriers due to restrictive reproductive policies and limited access to gender-responsive care. This study examined gender-related risks among people who inject drugs (PWID) accessing a SSP in Miami, Florida to inform harm reduction service delivery and intervention needs.</p><p><strong>Methods: </strong>This study analyzed enrollment data from the first legal SSP in Florida collected from its December 2016 inception through July 2022 (N = 1660). In bivariate analyses, we used chi-square tests to describe differences in sociodemographic, injection drug use (IDU) and sexual behaviors, and infectious disease prevalence between men and women. We used multivariable logistic regression models to estimate associations between gender and IDU behaviors, sexual behaviors, and HIV/HCV prevalence, adjusting for age, race/ethnicity, housing status, and enrollment year.</p><p><strong>Results: </strong>Our sample included 1660 participants (26% women). Compared to men, WWID had significantly higher odds of sharing syringes (adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI], 1.23-2.10), injecting over five times per day (aOR = 1.33, CI 95%, 1.05-1.70), injecting opioids only (aOR = 1.79, 95% CI 1.35-2.38), and opioid/stimulant co-injection versus stimulant-only injection use (aOR = 1.46, CI 95%, 1.03-2.6). WWID also had higher odds of engaging in recent sexual activity (aOR = 1.75, 95% CI, 1.25-2.45), exchanging sex for money/resources (aOR = 6.60, 95% CI, 4.12-10.57), and testing reactive for HCV antibody at time of enrollment (aOR = 1.41, 95% CI, 1.10-1.80).</p><p><strong>Conclusion: </strong>Drawing on real-world programmatic data from routine SSP intake, this study highlights the. elevated injection and sexual health risks faced by WWID accessing a SSP. Findings support the need for gender-responsive harm reduction strategies, including bundled, trauma-informed services that integrate safer injection supplies, overdose prevention, reproductive and sexual healthcare, and peer-led education initiatives that also address the social and structural determinants of health-such as trauma, poverty, housing instability, stigma, criminalization, and relational dynamics. These findings directly informed the development of a women-centered harm reduction clinic at the IDEA Miami SSP. This model may inform responsive service design in similar settings.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"117"},"PeriodicalIF":4.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583765","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":"Anabolic-androgenic steroid testing as a tool for consumer engagement and harm reduction: a sequential explanatory mixed-method study.","authors":"Timothy Piatkowski, Ross Coomber, Cameron Francis, Emma Kill, Geoff Davey, Sarah Cresswell, Alan White, Madeline Harding, Karen Blakey, Steph Reeve, Brooke Walters, Cheneal Puljević, Jason Ferris, Monica J Barratt","doi":"10.1186/s12954-025-01270-4","DOIUrl":"10.1186/s12954-025-01270-4","url":null,"abstract":"<p><strong>Introduction: </strong>Anabolic-androgenic steroid (AAS) use is widespread, yet regulation remains limited, exposing consumers to misidentified and contaminated products. This study expands AAS testing by enhancing purity analysis, identifying branding inconsistencies, and examining consumer responses. It aims to evaluate the impact of enhanced testing and feedback on consumer behaviour and harm reduction.</p><p><strong>Methods: </strong>This is a sequential explanatory mixed-methods study incorporating chemical analysis of community-submitted AAS samples and interviews with participants. Interviews used semi-structured formats, focusing on participants' understanding of the testing results, and how it influenced their AAS usage decisions. We sampled from community harm reduction organisations across two drug checking sites in Queensland, Australia.</p><p><strong>Results: </strong>Between April 19 and August 16, 2024, 58 AAS samples were submitted. Chemical analysis was conducted using Radian-ASAP direct mass spectrometry and Orbitrap Liquid Chromatography Mass Spectrometry to verify the identity and dosage of the submitted AAS. Of the 46 analysable samples, 9 exhibited presence issues (i.e., the compound differed from expectations), while 15 demonstrated purity issues (i.e., the concentration was either too low or too high). Twenty-five AAS consumers were interviewed, with follow-up interviews conducted with 15 participants to assess their behaviour changes. Interviews (N = 40) indicated that consumers' trust in the substances they used was reduced, leading to more cautious approaches and reconsideration of usage practices.</p><p><strong>Conclusion: </strong>This study demonstrates that chemical analysis can be a powerful tool in influencing AAS consumers' practices, highlighting the need for further research on how testing, coupled with harm reduction interventions, can improve consumer safety and decision-making.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"114"},"PeriodicalIF":4.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564660","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":"Understanding drug-related harms as risk-amplifying loops among people who inject drugs in Sweden.","authors":"Jessica Storbjörk, Eva Samuelsson, Josefin Månsson, Jukka Törrönen","doi":"10.1186/s12954-025-01267-z","DOIUrl":"10.1186/s12954-025-01267-z","url":null,"abstract":"<p><strong>Background: </strong>Reducing risks and harms among people who inject drugs by, for example, Needle and Syringe exchange Programs (NSP) may be impeded in practice by, for example, policy restrictions, particularly in settings like Sweden where a zero-tolerance drug strategy prevails. In practice, risks and harms are produced through an interplay of multiple mutually reinforcing factors. Moreover, risk management strategies may constitute risks per se and generate new risks, potentially intensifying overall harm. This study aimed to increase our understanding of how such risks are generated in the lives of people who inject drugs.</p><p><strong>Methods: </strong>In 2022-2023, we interviewed 32 purposively selected research participants, primarily recruited through the Stockholm NSP. Drawing on actor-network theory, we analyzed the interviews to identify factors-constituent human and non-human actors-that constitute and generate risk and harm. These dynamics were conceptualized as risk-amplifying loops, in which harms are contingently enacted, may multiply, and the effects of policy and practice may become unintentional and unpredictable.</p><p><strong>Results: </strong>Four risk-amplifying loops were inductively elucidated: the Service deficit, Perpetrator-victim, Deprivation, and Solitude loops. In each, two actors-the drug and the person who injects drugs-were constituted differently. Furthermore, the loops were interlinked and more fully understood in relation to one another, forming a network that reflected the broader environment of injection drug use (IDU) in Sweden. Each loop was shaped and co-constituted by the prohibitionist framing of Swedish drug policy influencing access to services, the drug market, and the position of people who use drugs.</p><p><strong>Conclusions: </strong>Understanding drug-related harms as risk-amplifying loops highlights the emergent effects of the multiple and unfolding risks in the lives of people who inject drugs. This perspective facilitates discussion of impediments to effective harm reduction practices and points to potential sites for countermeasures and policy reform.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"115"},"PeriodicalIF":4.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564670","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 and facilitators to injectable opioid agonist treatment engagement within a structural vulnerability context: a qualitative study of patient experiences in Vancouver, Canada.","authors":"Samara Mayer, Nadia Fairbairn, Al Fowler, Jade Boyd, Thomas Kerr, Ryan McNeil","doi":"10.1186/s12954-025-01262-4","DOIUrl":"10.1186/s12954-025-01262-4","url":null,"abstract":"<p><strong>Background: </strong>Amidst a sustained drug poisoning crisis, there is growing recognition in Canada of the need to expand injectable opioid agonist treatment (iOAT). iOAT is an intensive treatment that involves the daily self-administration of hydromorphone or diacetylmorphine under healthcare provider supervision, typically accompanied by other health and social services. While this treatment has demonstrated effectiveness in reducing drug use-related risks, high threshold characteristics may also create barriers to engagement. This study examined patients' experiences of barriers and facilitators to iOAT with attention to how social and structural factors (e.g., housing vulnerability, poverty) shape program engagement.</p><p><strong>Methods: </strong>This study draws on qualitative interviews and fieldwork observations with people accessing four iOAT programs in Vancouver's Downtown Eastside neighbourhood from May 2018 to November 2019. Data included baseline and follow-up interviews and approximately 50 h of observational fieldwork. Analysis leveraged a structural vulnerability lens to examine how social and structural factors shape people's engagement with iOAT.</p><p><strong>Results: </strong>Participants highlighted how improved access to health and social services, compassionate and relational care, and flexible and individualized approaches to treatment delivery that addresses and accounts for the structural vulnerabilities facilitated engagement in treatment. However, dosing supervision, operational capacity and medication formulation were experienced as barriers to treatment. These barriers were magnified by structural vulnerabilities such as housing instability and mobility challenges.</p><p><strong>Conclusions: </strong>Study findings highlight how people navigate the barriers and facilitators to iOAT engagement in light of the structural vulnerabilities they experience. Adaptations to and ongoing support for iOAT programs may help to facilitate engagement and should focus on equity-oriented and patient- centered treatment models that includes the integration of social supports, support for relational care and treatment planning that supports patient autonomy.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"116"},"PeriodicalIF":4.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564669","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":"The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders.","authors":"Martine Skumlien, Sam Craft, Luke Russell, Navyaa Toshniwal, Christopher Pudney, Tom P Freeman, Jenny Scott","doi":"10.1186/s12954-025-01227-7","DOIUrl":"10.1186/s12954-025-01227-7","url":null,"abstract":"<p><strong>Background: </strong>Synthetic cannabinoids (SCs) are prevalent in prisons and among people who experience homelessness in the UK and can cause serious harms to people who use them. While it is currently not possible to test for SCs at the point of care (POC), a new method for doing so using fluorescence spectral fingerprinting has recently been developed. In this study, we aimed to outline the potential utility of POC SC testing in settings where SCs and SC use occur.</p><p><strong>Methods: </strong>This is a mixed-methods study. Professional stakeholders (n = 449) working or volunteering in healthcare, homeless, police, or prison services were invited to give their views on POC SC testing in an online survey with both quantitative and qualitative (free text) questions. Follow-up interviews were conducted with 35 survey participants and additionally with 25 people who use synthetic cannabinoids (PWUSC). Quantitative survey responses on the overall view of saliva- or drug-based detection of SCs were compared between the four groups using Kruskal-Wallis tests. Qualitative survey responses were analysed using content analysis and interviews were analysed using thematic analysis.</p><p><strong>Results: </strong>SCs were perceived as prevalent in UK prisons and homeless communities, but stakeholders felt poorly equipped to tackle SC use and harms. The quantitative analyses revealed that all groups rated both saliva- and drug-based detection positively, but police and prison services were more positive towards both types of testing than healthcare and homeless services (all p's < 0.001). The thematic and content analyses outlined several potential benefits of POC SC testing across all four settings, with the strongest support for use in prisons, particularly to reduce the ingress of SCs. Both PWUSC and professional stakeholders raised concerns that testing would be used in a punitive manner and highlighted the lack of treatment options for SC dependence and overdose as a major barrier to reducing harms.</p><p><strong>Conclusions: </strong>POC SC testing has the potential to support healthcare, homeless, police, and prison services in reducing the prevalence of SCs and improving the care of PWUSC. However, ethical application of the technology must be carefully considered to avoid causing undue harm to PWUSC, such as criminalisation and stigma.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"113"},"PeriodicalIF":4.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527683","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":"Correction: Study assessing the effectiveness of overdose prevention centers through evaluation research (SAFER): an overview of the study protocol.","authors":"Magdalena Cerdá, Bennett L Allen, Alexandra B Collins, Czarina N Behrends, Michele Santacatterina, Victoria Jent, Brandon D L Marshall","doi":"10.1186/s12954-025-01258-0","DOIUrl":"10.1186/s12954-025-01258-0","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"112"},"PeriodicalIF":4.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511743","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":"Primary care physician characteristics associated with becoming opioid agonist treatment prescribers in British Columbia: a retrospective case-control study.","authors":"Dimitra Panagiotoglou, Sandra Peterson, M Ruth Lavergne, Tara Gomes, Rashmi Chadha, Cheyenne Johnson, Rita McCracken","doi":"10.1186/s12954-025-01261-5","DOIUrl":"10.1186/s12954-025-01261-5","url":null,"abstract":"<p><strong>Background: </strong>Opioid agonist treatment (OAT) is the gold standard of care for patients living with opioid use disorder. Since 2016, efforts to expand OAT access have focused on primary care physicians. This study aimed to understand how OAT-prescribing-naïve primary care physicians who began prescribing OAT differed from their peers who did not.</p><p><strong>Methods: </strong>We used administrative health data to identify all patients eligible for OAT initiation between 1 January 2016 and 31 December 2019. We matched primary care visits that resulted in an OAT dispensation with visits that did not. We conducted logistic regression with generalized estimating equations to identify physician demographics and practice characteristics associated with becoming an OAT prescriber.</p><p><strong>Results: </strong>Of the 4253 primary care physicians who were OAT-prescribing-naïve before 2016, 2183 (51.3%) began prescribing OAT. Physicians who practiced in rural settings (aOR = 1.78, 95% CI: 1.32, 2.40) or saw fewer than 16 patients a day (aOR = 1.46, 95% CI: 1.21, 1.75) were more likely to become OAT prescribers. The likelihood of becoming an OAT prescriber declined with the proportion of visits delivered out of office (aOR = 0.20, 95% CI: 0.16, 0.26) and years since graduation (e.g., physicians who graduated between 2000-2009 were 20% less likely to initiate (aOR = 0.80, 95% CI: 0.64, 0.99) compared with peers who graduated since 2010).</p><p><strong>Conclusions: </strong>Physicians who saw fewer patients and worked across fewer settings were more likely to become OAT prescribers. However, physicians in rural settings are stepping in to address unmet demand despite resource and time constraints. Understanding the differences between physicians who become OAT prescribers and peers who do not is critical to effectively target interventions to improve OAT access in the future.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"111"},"PeriodicalIF":4.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495890","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":"Harm reduction in photovoice knowledge mobilization with 2S/LGBTQ+ youth who use(d) drugs: A community showcase.","authors":"Trevor Goodyear, Christian Barborini, Reid Gilmore, Apollo Collin-Gray, Mazal Jensen, Lee Young, Alec Hossain, En He","doi":"10.1186/s12954-025-01263-3","DOIUrl":"10.1186/s12954-025-01263-3","url":null,"abstract":"<p><p>Photovoice, a participatory photography approach, is an action-oriented research methodology that is increasingly being taken up in research with equity-owed populations and related to sensitive topics. This includes scholarship and activism with people who use(d) drugs, for which there are important ethical and pragmatic considerations. Among these is the challenge of drawing attention to substance use-related inequities yet not causing harm in (mis)representing communities, above all when sharing participant-produced photography with wider public audiences, including via photovoice exhibits. In this commentary, we draw from our recent photovoice research with 2S/LGBTQ+ youth who use(d) drugs to recount our process of planning and hosting a community photovoice exhibit, with the aim of highlighting implications for harm reduction-oriented and youth-engaged knowledge mobilization. We begin by introducing our Youth Action Committee, comprised of nine transgender, non-binary, and gender non-conforming youth who use(d) drugs, while briefly tracing our group's history of collaboration leading up the 'Queer Eyes, Queer Lives' photovoice exhibit, with Vancouver's 2024 Queer Arts Festival. Next, we discuss our participatory and intentional approach to planning this community event, including the steps we took to increase accessibility and turnout (e.g., venue selection, strategic partnerships) and make the exhibit youth-friendly and engaging (e.g., hiring a DJ, providing food, enlisting Youth Action Committee members as speakers). We then detail our approach to promoting youth choice in selecting generative and non-harmful photographs for the exhibit, such as by using photo-rating and photo-release processes during study data collection and deliberating with the Youth Action Committee to choose exhibit photographs that could most appropriately and respectfully represent research participant's multiple lived realities. We couch this practical discussion within a broader conversation about resisting damage- and deficit-focused narratives in substance use research, highlighting our group's active efforts to shift such narratives by showcasing photography reflecting community resiliencies, strengths, joys, and politicalities. The parts and sum of this commentary provide direction for other activist-scholars seeking to create, share, and mobilize art in substance use research and community intervention, and we end the paper by encouraging others to reinterpret and build on our approach through their own work.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"109"},"PeriodicalIF":4.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474961","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":"Highlighting variability in fentanyl test strip instructions using thematic content analysis.","authors":"Cianna J Piercey, Claire L Pince, Hollis C Karoly","doi":"10.1186/s12954-025-01252-6","DOIUrl":"10.1186/s12954-025-01252-6","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl test strips (FTS) are a harm reduction tool used by individuals seeking to avoid unintentional fentanyl exposure while consuming other illicit substances (e.g., heroin, cocaine). While evidence speaks to the efficacy and acceptability of FTS, there are currently no standardized instructions for the use of FTS as a drug checking tool, and little is known about potential variability across instructions.</p><p><strong>Methods: </strong>We sought to investigate variability in content across FTS instructions (N = 16) through conducting a thematic content analysis of instructions listed in the first three pages of a Google search. The search was conducted in May of 2024, with \"fentanyl test strip instructions\" entered as the search term. To be included in the present analysis, the information listed in the search result must have contained explicit instructions for how to use FTS and have been printed in English.</p><p><strong>Results: </strong>Thematic content analysis of FTS instructions yielded 26 codes and 4 themes. Themes included (1) Information about FTS (2) Testing Methods (3) Test Results and (4) Additional Resources. Overall, results indicated considerable variability across the 16 instructions examined, with the greatest variability observed within the testing methods theme.</p><p><strong>Conclusion: </strong>Inconsistencies in online FTS instructions, such as those identified in the current study, could lead to distrust among people who use drugs and disengagement with this drug checking practice. Standardized and accessible instructions are critical to optimizing the efficacy of FTS as a harm reduction tool and reducing accidental fentanyl exposure.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"110"},"PeriodicalIF":4.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474971","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}