Harm Reduction Journal最新文献

{"title":"Correction: Unintentional benzodiazepine use and frequency of drug checking service utilization: a cross-sectional study.","authors":"Lauren Airth, Trevor Goodyear, Brandon D L Marshall, Cameron Grant, Mark Lysyshyn, Susan G Sherman, Evan Wood, Lianping Ti","doi":"10.1186/s12954-026-01497-9","DOIUrl":"10.1186/s12954-026-01497-9","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"23 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404506","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":"Integrating a model of care within a community-based managed alcohol program with indigenous men experiencing homelessness and alcohol use: a retrospective chart review.","authors":"Natalia Gala, Manuela Mbacfou Temgoua, Annie Talbot, Jorge Flores-Aranda, Rossio Motta-Ochoa, Matthew Biddle, Mark Alsop, Stéphanie Marsan","doi":"10.1186/s12954-026-01493-z","DOIUrl":"10.1186/s12954-026-01493-z","url":null,"abstract":"<p><strong>Background: </strong>In Montréal, many members of the Indigenous community are affected by homelessness and substance use, explained in part by the loss of cultural identity. These challenges are compounded by barriers to health and social services, and reduced shelter capacity during the pandemic. In response, an urban Indigenous-led community organization developed a managed alcohol program (MAP) in partnership with a university hospital (UH) addiction medicine team in Montréal, Canada. We describe health outcomes, service access, and substance use among Indigenous men experiencing homelessness and severe alcohol use enrolled in the MAP.</p><p><strong>Methods: </strong>A retrospective medical chart review of residents admitted to the MAP was conducted following its opening in December 2020. Descriptive data were abstracted from the university hospital's electronic medical records and the MAP's medical charts. Pre-admission outcomes were captured for the one-year period prior to the start of the program (December 2019 to December 2020), and post-admission outcomes were collected during each resident's observed follow-up period for up to one year after program entry (December 2020 to December 2021). Descriptive analyses were used to summarize resident characteristics and outcomes.</p><p><strong>Results: </strong>Findings are reported for 12 Indigenous men enrolled in the program during the study period. Residents had a mean age of 51 years, and the majority identified as Inuit (41.7%). The mean duration in the MAP was 208.3 days (range: 32-396 days). Most residents reported an underlying health condition (83.3%), diagnosed psychiatric disorder (75.0%), and substance use disorder other than alcohol (75.0%). During the observed follow-up period, mean alcohol use decreased from 29.1 to 20.0 drinks per day. Decreased use of other substances, including cannabis and tobacco, was also observed. Emergency department (ED) utilization was reportedly lower during follow-up, with 12 residents accessing ED services prior to admission compared to 5 during follow-up.</p><p><strong>Conclusions: </strong>A partnership between an urban Indigenous-led community organization and an addiction medicine team can support harm reduction and access to care. Findings suggest that similar collaborative models may be relevant for supporting care among Indigenous populations experiencing homelessness and severe alcohol use.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404568","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":"National review of state laws on opioid antagonists in Kindergarten-12th grade schools across the United States.","authors":"Monica Kowalczyk, Cathleen Chow, Hannah Huebner, Suzanne Carlberg-Racich, Charles Davis, Christina E Freibott, Nicole Gastala, Ashley A Lowe, Anna Volerman","doi":"10.1186/s12954-026-01504-z","DOIUrl":"10.1186/s12954-026-01504-z","url":null,"abstract":"<p><strong>Background: </strong>Opioid overdoses have surged among United States (US) youth, who face high risk of morbidity and mortality. Opioid antagonists (OAs), like naloxone, are life-saving medications that can reverse overdoses. For youth, schools can be key venues for harm reduction. As states enact laws governing OAs in schools, it is important to understand how states permit schools to manage and respond to emergencies with this medication. This study's objective was to examine statutes on OAs in Kindergarten-12th grade schools to identify and compare key legislative components across states.</p><p><strong>Methods: </strong>This national review analyzed US state laws on OAs in K-12 schools enacted by December 31, 2024. A search of statutes was conducted using Nexis Uni. Team members iteratively reviewed each statute to identify components and extract relevant language. Discrepancies were resolved through discussion. Findings were summarized and reviewed with experts in school health, addiction, and harm reduction for validity.</p><p><strong>Results: </strong>Thirty-eight states have laws on OAs in K-12 schools. Nine states (24%) mandate a supply of OAs to be available in schools, while eight states (21%) require policies to be adopted for school systems to have OAs. State laws vary in terms of components. State laws commonly define OA (n = 24, 63%) and specify school types and/or levels (n = 35, 92%). Most states detail individual(s) who may administer OAs in school settings (n = 34, 89%) and training on OAs (n = 25, 66%). More than half of states detail acquisition (n = 22, 58%) and inventory logistics (n = 21, 55%). Few state laws include incident response post-administration (n = 9, 24%), reporting of administration (n = 8, 21%), and parental involvement (n = 5, 13%). Lastly, most states include immunity (n = 32, 84%) protecting school systems and/or individuals who provide or administer OAs.</p><p><strong>Conclusion: </strong>This study found most states have laws on OAs in K-12 schools with variation in specific language. Such variability in state legislation contributes to varied implementation in school, which may affect accessibility to OAs and response to overdose emergencies in schools. If implemented effectively, such legislation has potential to promote harm reduction and reduce opioid overdoses among youth.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396544","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":"Patterns, motivations, and healthcare experiences of medical cannabis use among gender and sexuality diverse people in Australia: findings from the Cannabis as Medicine Survey 2022 (CAMS-22).","authors":"Benjamin T Trevitt, Sasha Bailey, Llewelyn Mills, Thomas Arkell, Iain S McGregor, Nicholas Lintzeris","doi":"10.1186/s12954-026-01489-9","DOIUrl":"10.1186/s12954-026-01489-9","url":null,"abstract":"<p><strong>Introduction: </strong>LGBTQA+ people are at greater risk of using cannabis at earlier ages, in greater frequencies and quantities and over longer periods of time compared with their cisgendered, heterosexual peers. Prescribed medicinal cannabis is becoming increasingly commonly utilised in Australia to treat a variety of conditions including pain, mental health diagnoses and sleep. There is currently little research looking into the motivations and experiences of LGBTQA+ people accessing medical cannabis (MC) through healthcare providers.</p><p><strong>Objectives: </strong>To explore differences in patterns, reasons for using, and experiences of accessing medicinal cannabis between LGBTQA+ people and their cisgender, heterosexual peers.</p><p><strong>Methods: </strong>We utilised data collected from an online anonymous cross-sectional survey of individuals (CAMS-22 survey), consisting of adult Australians who had utilised cannabis to treat a medical condition in the previous year. Participants were asked questions about their gender and sexuality, demographic characteristics, patterns and characteristics of MC use, conditions treated, and accessibility to and satisfaction of treatment.</p><p><strong>Results: </strong>Of the 3107 respondents included in these analyses, 2332 (77.3%) self-identified as heterosexual and 686 (22.7%) as sexually diverse. Over 95% of participants identified as cisgender (n = 2932), with only 148 (4.8%) identifying as trans. Sexually diverse participants commenced regular MC use at an earlier age, were more likely to identify a mental health condition and less likely to identify pain as their primary reason for MC consumption, and reported less satisfaction with treatment compared to heterosexuals-primarily around provision of information. Trans participants commenced MC use at an earlier age; were more likely to identify a mental health condition or sleep as their primary reason for MC use; and also reported less satisfaction with treatment than their cisgender counterparts for more interpersonal reasons.</p><p><strong>Conclusion: </strong>LGBTQA+ people use cannabis for medical purposes at significantly earlier ages and primarily to address mental health and substance use concerns. Future research should explore ways in which prescribers can specifically tailor support to meet all physical and mental health needs of LGBTQA+ people, (beyond simply prescribing MC), not only through treatments that they offer, but also through adjunct and complementary services.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381955","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":"\"That would be such a game changer\": a qualitative study of the acceptability and feasibility of a digital harm reduction support tool among people who use drugs.","authors":"David Frank, Raagini Jawa, Corona Zhang, Kelly Thompson, Thomas Pointer, Jennifer Muggeo, Tamar Krishnamurti, Scout LoPriore, Jess Tilley, Paul J Joudrey","doi":"10.1186/s12954-026-01492-0","DOIUrl":"10.1186/s12954-026-01492-0","url":null,"abstract":"<p><strong>Introduction: </strong>People who use drugs (PWUD) in the U.S. often face barriers to accessing harm reduction, social, and medical services, including fragmented systems and limited access to locally relevant, usable information. A digital harm reduction support tool (DHRST) that identifies clients' needs and matches them to available community resources may help address these barriers. We examined the feasibility and acceptability of a DHRST among PWUD, as well as its potential role in supporting safer practices and improving engagement with services.</p><p><strong>Methods: </strong>We recruited a convenience sample of 37 clients from a community-based harm reduction organization to participate in semi-structured interviews. Participants were ≥ 18 years old, English-speaking, and able to provide informed consent. Interviews explored perceptions of the feasibility, acceptability, and potential uses of a DHRST. Data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Four primary themes emerged from our data: (1) participants viewed a DHRST as a valuable tool for navigating fragmented and locally specific information about harm reduction, social, and healthcare services; (2) participants perceived the tool as a means of enhancing safety in an increasingly unpredictable drug supply through access to real-time, peer-generated information and alerts; (3) participants expressed concerns about privacy, surveillance, and the potential unintended consequences of sharing sensitive information; and (4) participants emphasized that feasibility would depend on accessibility, including device access, digital literacy, and the availability of multiple platforms for engagement. Overall, participants expressed strong enthusiasm for the potential value of a DHRST despite concerns regarding implementation and information security.</p><p><strong>Conclusions: </strong>Findings suggest that a DHRST is both acceptable and potentially valuable for supporting harm reduction among PWUD, particularly as a means of improving access to locally relevant information. However, its effectiveness will depend on careful attention to structural constraints, privacy and data governance, and the broader risk environment in which information-sharing occurs. These findings support continued development of DHRSTs while emphasizing the need for user-centered and context-sensitive design.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360517","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: Barriers and facilitators to initiating and adhering to harm reduction services among people who inject drugs in the United States: a systematic review.","authors":"Carrie L Nacht, Britt Skaathun, Kristen Ogarrio, Reanna Durbin-Matrone, Laura Laura Wright, Rick Reich, Kat Reich, Kristefer Stojanovski","doi":"10.1186/s12954-026-01495-x","DOIUrl":"10.1186/s12954-026-01495-x","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"23 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360446","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":"\"People are going to do drugs:\" harm reduction as a strategy for survivors of sex trafficking who use substances.","authors":"Lindsay B Gezinski, Ariel M S Richer, Aundrea Dilanchian, Theresa Anasti, Nathaniel A Dell, Cassandra Price","doi":"10.1186/s12954-026-01471-5","DOIUrl":"10.1186/s12954-026-01471-5","url":null,"abstract":"<p><strong>Background: </strong>Survivors of sex trafficking often experience co-occurring substance use and face significant barriers to accessing care. Harm reduction offers a nonjudgmental, survivor-centered approach to mitigating health risks associated with substance use and commercial sex. However, limited research has explored how harm reduction is understood and implemented by service providers working with this population. This study aimed to examine service providers' perspectives on the role, impact, and challenges of harm reduction in supporting survivors of sex trafficking who use substances.</p><p><strong>Methods: </strong>This qualitative study employed purposive and snowball sampling to recruit 21 service providers from human trafficking, domestic violence, and other agencies across the southwestern US who serve survivors of sex trafficking. Semi-structured interviews were conducted to explore participants' experiences with harm reduction strategies, perceived barriers, and relational dynamics in service provision. Interviews were transcribed verbatim and analyzed using thematic analysis, following Braun and Clarke's six-step process. A constant comparative method was used to refine codes and identify emergent themes.</p><p><strong>Results: </strong>Five major themes were identified: (1) comprehensive harm reduction as a lifesaving strategy, (2) education and health literacy as critical intervention tools, (3) navigating barriers to harm reduction, (4) relational foundations of harm reduction, and (5) ambivalence toward harm reduction as a standalone strategy. Participants described harm reduction as essential to preventing overdose, reducing disease transmission, and fostering engagement through nonjudgmental care. They emphasized the importance of peer-led outreach, trauma-informed education, and holistic support that includes meeting basic needs. However, providers also reported legal and institutional constraints, funding challenges, and public misconceptions that hindered implementation. A minority of participants expressed ambivalence about harm reduction, reflecting ongoing tensions between abstinence-based and non-abstinence approaches.</p><p><strong>Conclusions: </strong>Harm reduction is viewed by providers as a vital, relational, and flexible approach to supporting survivors of sex trafficking who use substances. Findings highlight the need for policy reform, increased investment in peer-led and trauma-informed models, and broader cultural shifts to reduce stigma. Future research should include survivor perspectives and explore harm reduction strategies across diverse geographic and demographic contexts.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351741","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 alternative is they're not getting care at all\": a qualitative interview study of opioid use disorder treatment providers' perspectives on quality and appropriateness of telehealth for buprenorphine access.","authors":"Naomi Zucker, Emilio Flores, David Mandell, Justin Clapp, Shoshana V Aronowitz","doi":"10.1186/s12954-026-01474-2","DOIUrl":"10.1186/s12954-026-01474-2","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) is a major source of morbidity and mortality in the United States. While substantial evidence supports the effectiveness of medications for opioid disorder (MOUD), 80% of people with OUD receive no treatment, and of those who do, less than half receive MOUD. Since the Covid-19 pandemic, there has been a substantial increase in the use of telehealth to deliver MOUD care. While telehealth has shown promise for increasing access and improving retention in treatment, its ongoing uptake and provision will depend on its acceptance and implementation by providers. This qualitative, interview-based study aims to explore how providers understand, experience, and assess telehealth for MOUD in the wake of its rapid expansion.</p><p><strong>Methods: </strong>We conducted 25 in-depth, semi-structured interviews with MOUD providers in Southeastern Pennsylvania, including prescribing clinicians, clinic staff, mental health counselors, program administrators/leadership and pharmacists. We recruited from diverse substance use disorder treatment settings, using purposive and snowball sampling. Interviews were conducted over Zoom, transcribed, and coded and analyzed using iterative thematic coding.</p><p><strong>Results: </strong>While most providers hold largely positive views of telehealth for MOUD due to its ability to improve access, they differed in their assessments of how such care compares to in-person MOUD treatment and for whom it is most appropriate and effective. Our findings show that debates over telehealth center on perceived quality of care and the \"stability\" of patients. Despite these disagreements, providers largely agree that telehealth is \"better than nothing.\"</p><p><strong>Conclusions: </strong>While most providers hold largely positive views of telehealth for MOUD, hesitation towards telehealth is linked to assumptions about the broader empirical state of in-person MOUD treatment and about patient needs, preferences, and capacities to engage in care. Understanding when and why providers may oppose the use of telehealth for MOUD is critical to improving care for patients and reducing barriers to a form of treatment that can increase access to much-needed care for the most vulnerable patients.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307923","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":"\"You've involved us knowing that we don't think about the law like you\": a qualitative study on Supersavers' perspective of overdose engagement in Skåne county, South Sweden.","authors":"Katja Troberg, Pernilla Isendahl","doi":"10.1186/s12954-026-01487-x","DOIUrl":"10.1186/s12954-026-01487-x","url":null,"abstract":"<p><strong>Background: </strong>People with illicit opioid use have a high risk of overdose related morbidity and mortality. A small group of Supersavers (i.e., individuals who have administered naloxone on three or more overdose occasions) carries a substantial burden by managing a high proportion of overdose reversals. Despite their critical role, little is known about how Supersavers' experiences of repeated overdose reversals, their own overdose risks and its mitigation, or the support needed to sustain their engagement. This study examines Supersavers' contextual experiences, their views on risks, responsibility, and overdose engagement, and their need for healthcare support.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with thirteen Supersavers recruited from Malmö needle and syringe program. Thematic analysis was conducted whereupon analysis was guided by Bourdieu's theories on habitus, capital and field and Rhode's 'risk environment' framework.</p><p><strong>Results: </strong>Supersavers were deeply committed to helping others and widely recognized for their skills, often having managed multiple overdoses prior to naloxone availability. This responsibility functioned as an embodied readiness to act, reflecting a habitus shaped through repeated exposure and supported by experiential (\"street\") capital, including technical skills and peer trust. Access to training and naloxone strengthened this capacity, increasing perceived safety and reducing the physical and emotional burden of overdose reversals. While repeated exposure to overdose contributed to normalization, it also involved cumulative emotional strain, and most participants had not sought professional support despite experiencing multiple traumas.</p><p><strong>Conclusion: </strong>These findings show how Supersavers' practices emerge through the interplay of habitus, capital, and risk environment, where engagement is sustained by responsibility yet shaped by structural constraints. Strengthening harm reduction responses requires not only continued access to naloxone and training, but also accessible, context-sensitive healthcare support that addresses both Supersavers' own overdose risk and the emotional burden associated with repeated reversals.</p><p><strong>Trial registration: </strong>NCT03570099, registered on 26 June 2018.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307919","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":"Centering the voices of young people who use opioids and youth harm reduction practitioners: insights from an international Youth RISE cohort.","authors":"Atika Juristia, Vincentius Azvian, Carolina Arredondo, Rebeca Calzada, Alfonso Chávez Rivera, Susan Wambui, Walter Osigai Etepesit, Trevor Goodyear","doi":"10.1186/s12954-026-01449-3","DOIUrl":"10.1186/s12954-026-01449-3","url":null,"abstract":"<p><p>Young people across the world use opioids and experience drug-related harms yet remain excluded from many opioid-related harm reduction policies and services. In this commentary, we trace our collective advocacy as young people who use opioids and youth harm reduction workers from Canada, Indonesia, Kenya, Mexico, Uganda, and the United States. Specifically, we describe the creation of our Youth RISE cohort in 2023 and our community engagement to strengthen access to harm reduction for young people globally. Over a two-month period, we held weekly online meetings where we exchanged perspectives and experiences with three set thematic discussion topics-needs, challenges, and recommendations-related to youth opioid use and harm reduction within our respective countries. Our work reflects the challenges we have faced confronting entrenched prohibitionist policies and navigating services that stigmatize and control young people who use opioids. Despite these challenges, we share a commitment to advance person-centered harm reduction and push for structural reforms to improve the health and rights of young people who use opioids and other drugs. Recommendations from our work together converge on the need to move beyond punitive approaches toward comprehensive, youth-tailored harm reduction grounded in evidence, equity, and human rights. Specifically, we call for investment in youth-tailored harm reduction programs (e.g., drug-checking, supervised consumption spaces, naloxone), prescribed alternatives, comprehensive drug education, and systemic action to address the stigma and surveillance that come with abstinence-focused approaches to youth opioid use. Beyond this, we argue that meaningful youth engagement is essential to genuinely resourcing youth harm reduction and ensuring that it effectively responds to young people's diverse and evolving realities of opioid use amid the harms of criminalization and prohibitionist-based drug policies.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"23 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301315","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}