Harm Reduction Journal最新文献

{"title":"Street ketamine use and differential risk of suicidality among adults in Taiwan.","authors":"Yen-Chun Kuo, Sheng-Chang Wang, Chuan-Yu Chen","doi":"10.1186/s12954-025-01308-7","DOIUrl":"10.1186/s12954-025-01308-7","url":null,"abstract":"<p><strong>Introduction: </strong>The misuse of ketamine, a dissociative anesthetic, has surged sharply in popularity across East and Southeast Asia and Oceania. This study aimed to evaluate the association between recent patterns of ketamine use and the risk of suicide in northern Taiwan.</p><p><strong>Methods: </strong>Illicit ketamine users were recruited through network-based sampling from 2015 to 2017, along with a comparison group of individuals who never used ketamine. Data on sociodemographics, drug use history, psychiatric disorders, and suicide risk were collected by trained psychiatric nurses. Participants were categorized into three groups: non- (n = 132), past (no ketamine use for ≥ 1 year; n = 80), and recent users (use in the past year; n = 167). Suicide risk, assessed by six items in the Mini-International Neuropsychiatric Interview, was classified as \"no,\" \"low,\" or \"middle/high.\" Polytomous logistic regression and multivariate analyses were applied for risk estimation.</p><p><strong>Results: </strong>Street ketamine users disproportionately experienced higher mental health disorders (e.g.,major depressive disorder), disadvantaged socioeconomic status, involvement in legal issues, and lifetime suicide attempts (25%). The prevalence of middle to high suicide risk was notably higher among recent (10.8%) and past (5.0%) ketamine users, compared with people who had no ketamine use history. Past-month suicidality was four times higher in recent users (95% CI 1.35-12.27) and 3.4 times higher in past users (95% CI 1.01-11.45). Excess risk associated with recent ketamine use manifested exclusively in suicidal ideation.</p><p><strong>Discussion and conclusions: </strong>Illicit ketamine use is strongly linked to increased suicidality, especially among recent users. Even past users remain at higher risk, highlighting the importance of integrating suicide risk assessments and targeted interventions in community-based alcohol and drug services.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"153"},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191381","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":"'I won't make it without this program': the impact of safer opioid supply program closures in Ontario.","authors":"Farihah Ali, Abigale Sprakes, Jordan Mende-Gibson, Cayley Russell, Andrew Shaw, Matthew Bonn, Andrzej Celinski, Nat Kaminski, Mohammad Karamouzian, Carol Strike, Jürgen Rehm","doi":"10.1186/s12954-025-01298-6","DOIUrl":"10.1186/s12954-025-01298-6","url":null,"abstract":"<p><strong>Background: </strong>Canada is in the midst of a worsening overdose crisis, driven largely by the unregulated drug supply. In response, safer opioid supply (SOS) programs were implemented to provide pharmaceutical-grade opioids alongside critical services. However, in August 2024, Ontario's provincial government introduced restrictions on harm reduction initiatives, coinciding with the expiration of federal funding, forcing many programs to close. In their place, the government announced the implementation of Homelessness and Addiction Recovery Treatment Hubs, which exclude harm reduction programs, including SOS programs. This study explores the experiences of SOS program clients and the anticipated impacts of these program closures on their lives.</p><p><strong>Methods: </strong>A qualitative study design was used, involving semi-structured interviews with people who use drugs who were enrolled in six SOS programs across Ontario. Participants were recruited through convenience and snowball sampling. Eligible participants were current SOS clients (≥ 6 months), aged 18 or older, and English-speaking. Interviews were conducted virtually and explored participants' experiences with SOS programs, anticipated impacts of program closures, and strategies to mitigate risks. Data were thematically analyzed using NVivo.</p><p><strong>Results: </strong>Participants reported that SOS programs reduced their reliance on the unregulated drug supply, decreased their overdose risk, and connected them to wraparound services. The impending closures triggered widespread fear, uncertainty, and anxiety, particularly about returning to the unregulated supply. Participants also expressed concerns over the loss of access to critical health and social services and the potential decline in their quality of life. Many expressed frustration over the lack of meaningful alternatives, difficulties in securing new prescribers, and distress over forced medication tapers.</p><p><strong>Conclusion: </strong>This study highlights participants' concerns that SOS program closures may force them back into an increasingly dangerous unregulated market, ultimately putting their lives at risk, along with reversing the many benefits SOS programs provided, such as connections to essential health and social services. By replacing harm reduction programs with treatment services, the government is not reducing the demand for opioid use; instead, it forces a return to the unregulated drug market, ultimately putting individuals at risk of overdose.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"151"},"PeriodicalIF":4.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137212","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: Muslims perceptions of safe alcohol use: a qualitative study in the Gulf Council Cooperation countries.","authors":"Samah Alageel, Noura Alomair","doi":"10.1186/s12954-025-01297-7","DOIUrl":"10.1186/s12954-025-01297-7","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"150"},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069412","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 'selves' in doping and its psychosocial mechanisms: harmonised multi-country evidence from high-performing athletes in the UK, US, and China.","authors":"Shuge Zhang, Ian Boardley, Jingdong Liu, Jules Woolf","doi":"10.1186/s12954-025-01304-x","DOIUrl":"10.1186/s12954-025-01304-x","url":null,"abstract":"<p><strong>Background: </strong>Doping remains an ongoing threat to clean competition. To date, global preventive initiatives have not addressed critical psychosocial antecedents of doping thoroughly due to the scarcity of knowledge regarding its psychosocial mechanisms from a harmonised cross-country perspective. We, therefore, conducted a multi-country investigation testing the interplay of two important yet overlooked attributes, namely narcissism and self-compassion, and examined their psychosocial mechanisms underpinning doping.</p><p><strong>Methods: </strong>Using a sample of 499 high-performing athletes (80% competing at national level or above) from the UK, US, and China, we performed a series of multi-variate multi-group moderation models to test the narcissism × compassion interaction on doping and examined potential psychosocial mechanisms underlying such effects. In all analyses, we applied cluster control to adjust for coach-/team-level confounds and compared fixed vs. random effects models for cross-country comparisons.</p><p><strong>Results: </strong>We found an identical interaction across study countries showing self-compassion alleviates narcissism-related doping willingness (especially that vulnerable narcissism drives). Grandiose narcissism's protective effect on vulnerable narcissism-related doping moral disengagement was invariant across countries. Resilient coping appears to be a consistent mechanism across study countries that explains narcissism-related risk and compassion-related protection. Fear of failure manifested varied mechanistic effects in different study countries, inferring potential cross-cultural differences.</p><p><strong>Conclusion: </strong>Vulnerable narcissism is a critical person-level correlate of doping. Grandiose narcissism, in the presence of self-compassion, can alleviate such risk thanks to enhanced resilient coping. Future education and interventions should tackle these important person-level attributes for anti-doping.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"149"},"PeriodicalIF":4.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951403","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":"Predictors of perceived HIV stigma among people who inject drugs in the United States.","authors":"Itunu Sokale, Paige Wermuth, Johnny Wilkerson, Folefac Atem, Salma Khuwaja, Catherine Troisi","doi":"10.1186/s12954-025-01285-x","DOIUrl":"https://doi.org/10.1186/s12954-025-01285-x","url":null,"abstract":"<p><strong>Background: </strong>HIV stigma is a huge impediment to ending the HIV epidemic. To develop effective HIV interventions, we must determine factors associated with HIV stigma, particularly among high-risk groups like people who inject drugs (PWID). We aimed to identify predictors of perceived HIV stigma (PHS) among a sample of PWID from 23 U.S. cities.</p><p><strong>Methods: </strong>We analyzed the 2018 National HIV Behavioral Surveillance data on PWID aged ≥ 18 years. PHS was assessed using a validated survey that measured four PHS constructs: perceived unfriendliness, perceived discrimination, perceived punishment, and perceived support. We created a composite PHS index score by summing each participant's four measures of PHS and categorizing participants based on whether their score was above or below the mean PHS index score. Adjusted prevalence ratios (aPR) and 95% CI were calculated using the generalized linear model Poisson regression log-link function to assess the predictors of PHS.</p><p><strong>Results: </strong>A total of 10,925 (10,229 HIV-negative, 179 HIV-positive-unaware, and 517 HIV-positive-aware) PWID were assessed. PHS prevalence was similar (52.6%, 53.4%, 53.6%) across groups, but the predictors differed by HIV status. For HIV-negative group, PHS predictors were older age (≥ 50 years: aPR 1:10, 95% confidence interval (CI): 1.01-1.19), female sex (aPR 1.07, 95% CI: 1.03-1.10), Hispanic (aPR 1.11, 95% CI: 1.06-1.16) and Other (aPR 1.08, 95% CI: 1.02-1.14) race/ethnicity, homelessness (aPR 1.07, 95% CI: 1.03-1.10), receptive syringe sharing (aPR 1.09, 95% CI: 1.05-1.13), participation in drug use treatment (aPR 0.96, 95% CI: 0.93-0.99), syringe service program (SSP) (aPR 0.94, 95% CI: 0.91-0.97), and no HIV testing (aPR 1.07, 95% CI: 1.03-1.10) within 12 month before the interview. For HIV-positive-unaware PWID, past-year homelessness (aPR 2.23, 95% CI: 1.46-1.3.40) and incarceration (aPR 0.71, 95% CI: 0.57-0.89) were linked with PHS. Among HIV-positive-aware PWID, PHS predictors included younger age (30-39 years: (aPR 1.28, 95% CI: 1.01-1.62), female sex (aPR 1.28, 95% CI: 1.05-1.55), Hispanic race/ethnicity (aPR 1.52, 95% CI: 1.23-1.89), incarceration (aPR 1.32, 95% CI: 1.10-1.56), and past-year SSP participation (aPR 0.84, 95% CI: 0.74-0.96).</p><p><strong>Conclusions: </strong>PHS predictors differed by HIV status. The current findings highlight the importance of leveraging SSP and drug use treatment to combat HIV stigma effectively.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"148"},"PeriodicalIF":4.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951840","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":"Gender differences regarding interest in opioid agonist treatment with hydromorphone: a cross-sectional study of syringe service program participants.","authors":"Vitaliy Lasiychuk, Megan Ghiroli, Teresa López-Castro, Aaron D Fox","doi":"10.1186/s12954-025-01300-1","DOIUrl":"https://doi.org/10.1186/s12954-025-01300-1","url":null,"abstract":"<p><strong>Background: </strong>In the United States, only 15-20% of people with opioid use disorder (OUD) receive medications for OUD annually. Injectable opioid agonist treatment with hydromorphone (iOAT-H) is a novel approach that reduces non-prescribed opioid use. However, interest in iOAT-H among women, who face unique challenges in OUD treatment, may be different than men. This study evaluates women's attitudes toward iOAT-H, and gender disparities in OUD-related risks, exploring potential gender-specific treatment needs. We hypothesized that women would be less interested in iOAT-H than men given the disproportionate stigma women face in accessing OUD treatment.</p><p><strong>Methods: </strong>This is a secondary analysis of a cross-sectional study of urban syringe service program participants. Participants self-reported interest in iOAT-H, which was assessed on a 4-point scale with 3 or 4 considered \"interested.\" Participants also provided self-reported data on preferences for OUD treatment and their OUD-related risks, including frequency of drug use and injection practices. Descriptive statistics and comparative analyses were employed to explore gender differences.</p><p><strong>Results: </strong>Of 108 participants, 31% were women and 69% were men with a mean age of 43.0 (SD ± 10.8). Almost all participants had severe OUD (98.1%) and had prior OUD care (96.3%). Most women (68%) and men (64%) reported interest in iOAT-H. For OUD treatment preferences, most women chose iOAT-H (56%), while men most commonly endorsed methadone treatment (42%) as their preferred option. Women had more OUD-related risks than men including injecting more times per day (5 vs. 3, p > 0.01) and injecting in public more often (24 vs. 7, p = 0.05) in the past 30 days.</p><p><strong>Conclusion: </strong>Interest in iOAT-H was high among women and men, but we found gender differences in OUD-related risks. This may reflect unmet needs among women who would potentially enter treatment with iOAT-H, but additional work is necessary to examine specific risks such as mental health, trauma exposure, and creating safe treatment spaces for women. Nonetheless, iOAT-H appeared acceptable to women in our sample, and many treatment-experienced people who inject drugs would prefer iOAT-H to other available OUD treatments.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"147"},"PeriodicalIF":4.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951855","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":"Prospective cohort study of fentanyl test strip use and distribution in three states: the stay safe study protocol and implementation recommendations for researchers.","authors":"Janet E Childerhose, Kitty Gelberg, Rachel Vickers-Smith, Megan E Dzurec, Emmanuel Oga, Mallory Harris, Rachel Caspar, Denise C Babineau, Megan E Hall, Beth S Linas, Katherine E Marks, Amanda Fallin-Bennett, Laura C Fanucchi, Louisa Gilbert, James L David, Mary Russo, Kathryn E Lancaster, Soledad Fernandez, Michael Konstan, Redonna K Chandler, Carter Roeber, Jennifer Villani, Rebecca D Jackson, Bridget Freisthler, Sharon L Walsh, Nabila El-Bassel","doi":"10.1186/s12954-025-01277-x","DOIUrl":"https://doi.org/10.1186/s12954-025-01277-x","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"146"},"PeriodicalIF":4.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951447","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":"\"They won't prosecute, but they will though:\" the continuing struggle between criminalization and harm reduction within the criminal justice system in the context of an opioid overdose crisis.","authors":"Julia Dickson-Gomez, Sarah Krechel, Jessica Ohlrich, Jennifer Hernandez-Meier, Constance Kostelac","doi":"10.1186/s12954-025-01284-y","DOIUrl":"https://doi.org/10.1186/s12954-025-01284-y","url":null,"abstract":"<p><p>People who use drugs (PWUD) come into frequent contact with the police including after calling for emergency medical services when witnessing an opioid overdose. Good Samaritan laws have been passed in many jurisdictions to protect people from prosecution if they call for emergency services. Other interventions have used police to connect people to harm reduction and drug treatment services. In contrast, more traditional policing practices that criminalize drug use persist, potentially increasing overdose risk and decreasing the likelihood that PWUD will call 911 in the case of an overdose. Little research has examined how all these different and contradictory policies have been implemented in practice. This paper presents data from in-depth interviews with 66 PWUD about their overdose experiences. Interviews explored the context in which overdose occurred; what actions participants took when witnessing an overdose, including whether they administered naloxone or called 911; and if they called 911, what law enforcement and emergency medical services (EMS) offered or did upon arrival (e.g. offer naloxone, refer to treatment, arrest, or confiscate drugs). Participants reported frequently being arrested following overdoses as there were many exceptions to the Good Samaritan Law. While in prison or jail, participants were not provided MOUD or naloxone and many experienced an overdose while in custody or shortly upon release. Few participants reported receiving referrals to drug treatment or ham reduction, and many described law enforcement officers' engaging in practices that discourage PWUD from calling 911.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"145"},"PeriodicalIF":4.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951842","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 measures in a recreational gym user with anabolic androgenic steroid dependence: a case report in the context of current best clinical practice.","authors":"Raphael Magnolini, Sofia Laura Bottoni, Helena Hammer, Joël Capraro, Philip Bruggmann, Oliver Senn","doi":"10.1186/s12954-025-01294-w","DOIUrl":"https://doi.org/10.1186/s12954-025-01294-w","url":null,"abstract":"<p><strong>Introduction: </strong>The non-medical use of androgens among recreational gym users has become a global substance use concern. Complications from use particularly appear to affect the cardiovascular system, including the development of cardiovascular events, as well as anabolic steroid-induced cardiomyopathy (ASIC). Furthermore, the development of substance dependence with a specific withdrawal syndrome appears to be common and is contributed by the development of endocrine dysfunction related to anabolic steroid-induced hypogonadism. A 38-year-old male law enforcement officer and recreational bodybuilder presented with multiple health complaints following years of supraphysiologic androgen use and polypharmacy. Key symptoms included new-onset subacute dyspnea, dizziness, palpitations, headaches, and recurrent failed attempts at androgen cessation. Clinical findings showed abnormal blood pressure, testicular atrophy, plethoric appearance, and laboratory evidence of progressive polycythemia (hematocrit: 56.9%; normal < 49%), elevated testosterone, and suppressed luteinizing and follicle-stimulating hormones. He was at risk for muscle dysmorphia and met criteria for androgen dependence. Diagnosis confirmed ASIC. Treatment consisted of recurrent bloodletting for polycythemia, guideline-based cardiac management, and a structured endocrine regimen (tapered transdermal testosterone, oral Tamoxifen, subcutaneous human chorionic gonadotropin) to support androgen discontinuation and hormonal recovery. At 4 months, ASIC had normalized, and he was asymptomatic. However, after 6 months, he developed laboratory-confirmed idiopathic primary hypogonadism and began guideline-directed testosterone replacement. Despite more than a year of abstinence from non-medical androgen use and normalization of cardiac function, the patient died from a cardiovascular event, highlighting the possibly persistent risks of prior androgen use.</p><p><strong>Conclusion: </strong>Non-medical androgen use is a growing global issue among recreational gym-goers. The intersection of severe health risks and substance dependence highlights the urgent need for an integrated, medical and harm-reduction approach-ideally delivered in specialized primary care settings. Early detection of cardiovascular risk factors is crucial for mitigating the often-overlooked yet potentially reversible complications. A reassessment of legal and clinical measures is warranted to optimize harm reduction and provision of care. Despite best practices and a year of abstinence from non-medical androgen use, the patient's fatal outcome underscores the critical need for further research, heightened awareness, and more robust prevention and harm reduction strategies for those affected by non-medical androgen use.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"144"},"PeriodicalIF":4.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951874","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":"Tribally-affiliated syringe services programs in the United States: a brief report.","authors":"Sean T Allen, Edmund Keane, Clinton Alexander, Sharon Day, Philomena Kebec, Andrea Medley, Frank Johnson, Pam Hughes, Brooklynn Barney, Melissa Walls","doi":"10.1186/s12954-025-01296-8","DOIUrl":"10.1186/s12954-025-01296-8","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined the implementation of syringe services programs (SSPs) that serve Indigenous people who inject drugs in the United States (US). There are 574 Federally-recognized tribes in the US, each characterized by unique traditions, values, and customs. Given the diversity of tribes, better understanding SSP implementation in Native contexts first requires examining the degree to which tribes in the US implemented these programs.</p><p><strong>Objective: </strong>This research describes the number of SSPs that are affiliated with Federally-recognized tribes in the US.</p><p><strong>Methods: </strong>From July to September 2022, we conducted an online search of all 574 Federally-recognized tribes to determine how many had affiliated SSPs. We downloaded a list of Federally-recognized tribes from the Bureau of Indian Affairs (BIA) and conducted Boolean searches on Google for the name of each tribe and SSPs. Our searches included several synonyms for SSPs, including \"needle exchange,\" \"syringe exchange,\" and \"harm reduction.\" In instances where \"harm reduction programs\" were identified, we reviewed website contents to determine if the program was inclusive of a SSP. We considered SSPs to be affiliated with Federally-recognized tribe(s) if they were housed in a tribal health clinic or tribal organization, or via an explicit partnership with a Federally-recognized tribe.</p><p><strong>Results: </strong>We identified 21 SSPs that were affiliated with Federally-recognized tribes. The majority (85.7%) of SSPs were affiliated with a single tribe. Eight of the SSPs also offered medications for opioid use disorder (MOUD) on-site (e.g., the SSPs operated out of health clinics that offered MOUD).</p><p><strong>Conclusions: </strong>The results of this study demonstrate that there are at least 21 SSPs that are affiliated with Federally-recognized tribes in the US, with some serving multiple tribes. This research makes a noteworthy contribution to the public health literature given that no systematic exploration of the number of SSPs affiliated with tribes has been conducted. The scale of substance use inequities among Indigenous people underscores the critical importance of communities implementing and managing their own comprehensive harm reduction programs.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"143"},"PeriodicalIF":4.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872898","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}