Harm Reduction Journal最新文献

{"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}

{"title":"Correction: 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/s12954-025-01290-0","DOIUrl":"10.1186/s12954-025-01290-0","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"142"},"PeriodicalIF":4.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872896","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-based differences in harm reduction practices among people who use drugs in Rhode island: a latent class analysis.","authors":"Leah C Shaw, Anusha Kumar, Carolyn J Park, Yu Li, Catherine A Lenox, Alexandra B Collins, Susan G Sherman, Brandon D L Marshall, Alexandria Macmadu","doi":"10.1186/s12954-025-01295-9","DOIUrl":"10.1186/s12954-025-01295-9","url":null,"abstract":"<p><strong>Background: </strong>Previous research has documented differing drug use patterns and risk behaviors by gender identity and sex at birth, although variations in harm reduction practices by these characteristics have not yet been fully assessed.</p><p><strong>Methods: </strong>We utilized data from the Rhode Island Prescription and Illicit Drug Study (RAPIDS), which enrolled adults who used drugs from 2020 to 2023. Participants were analyzed based on gender identity: men, women, and other (including those identifying as non-binary or something else). Participants reported which harm reduction practices (e.g., use fentanyl test strips, keep naloxone nearby) they typically engaged in to avoid accidental overdose. Latent class analysis (LCA) was used to identify subgroups of harm reduction practice typologies, and a correlation matrix was generated to understand dyads of typical self-reported harm reduction practices.</p><p><strong>Results: </strong>Among 503 eligible participants, 64% were men, 34% were women, and 2% were non-binary or something else (n = 9). Harm reduction practices were comparable between men and women, although men were less likely to keep naloxone nearby (p = 0.02). LCA identified three subgroups of harm reduction practice typologies (no/low, moderate, and high utilization). Group membership in latent classes did not vary by gender identity. However, those belonging to the no/low utilization subgroup were significantly more likely to have ever been incarcerated (p = 0.03) and to be single (p < 0.01). Those belonging to the high utilization group were significantly more likely to have ever witnessed an overdose, performed rescue breathing, and administered naloxone (all p < 0.001). Correlations showed several pairwise relationships, with 'use fentanyl test strips' and 'keeping naloxone nearby' being positively and significantly correlated (r = 0.33, p < 0.05).</p><p><strong>Conclusions: </strong>We found that harm reduction practices and group membership in latent classes were largely comparable between men and women; however, men who use drugs are significantly less likely to keep naloxone nearby. Gender-attentive strategies to increase naloxone carriage and usage among men and enhanced outreach to persons characterized by no or low harm reduction practice utilization, including people who are single and those with a history of incarceration, may be warranted to mitigate overdose risk.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"140"},"PeriodicalIF":4.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872897","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":"A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings.","authors":"Katherine J McLean, Nathan E Kruis, Eric Weintraub, Heather Fitzsimons, Christopher Welsh, Natalie Spicyn, Brook Kearley, William Altekruse, Nicholas Rowland, Annabelle Belcher","doi":"10.1186/s12954-025-01291-z","DOIUrl":"10.1186/s12954-025-01291-z","url":null,"abstract":"<p><strong>Background: </strong>In 2019, the state of Maryland passed legislation requiring local detention centers to offer medications for opioid use disorder (MOUD) to all incarcerated individuals who met criteria for opioid use disorder (OUD). Four years later, many facilities remain out of compliance. Beyond issues of staffing, funding, and technical support, stigma may represent a barrier to MOUD implementation.</p><p><strong>Methods: </strong>Using surveys and interviews among correctional professionals working in Maryland, the current exploratory study sought to identify barriers to MOUD implementation, including measures of provider-based stigma of OUD and support for MOUD.</p><p><strong>Results: </strong>Quantitative and qualitative results revealed moderately high levels of OUD-related stigma and negative attitudes toward MOUD, with multivariable modeling revealing a statistically significant relationship between provider-based stigma of OUD and support for MOUD in correctional settings.</p><p><strong>Conclusion: </strong>These findings suggest that stigma may be a significant barrier to MOUD implementation in local detention centers, even in the presence of legal mandates. Further, these results reveal the need for educational and anti-stigma campaigns targeted at correctional professionals who are charged with implementing policies that may contradict their previous learning or correctional training.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"141"},"PeriodicalIF":4.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872895","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":"Sterile syringe availability in Georgia pharmacies remained rare, despite policy change permitting sales.","authors":"Courtney R Yarbrough, Nora Jaquemet, Siara I Sitar, Maggie J Mataczynski, Vega Walke, Natalie D Crawford, Henry N Young, Justine W Welsh","doi":"10.1186/s12954-025-01280-2","DOIUrl":"10.1186/s12954-025-01280-2","url":null,"abstract":"<p><strong>Background: </strong>Numerous states, including Georgia in April 2019, have advanced policies designed to increase availability of sterile syringes in pharmacies for people who inject drugs (PWID); however, the extent to which pharmacies are willing to sell syringes to PWID is unclear. We examine sterile syringes sales practices in Georgia pharmacies to PWID following a recent policy change and pharmacists' cited reasons for these practices.</p><p><strong>Methods: </strong>We conducted a telephone survey from October 2020 through May 2021 of one pharmacist (staff or manager) per pharmacy in a sample of Georgia retail pharmacies stratified by urbanicity. The 15-question survey queried respondents about the pharmacy's current practices regarding nonprescription sterile syringe sales and the respondents' perceptions of syringe sales and counseling practices to those purchasing syringes. Pharmacy and pharmacist demographics were collected and correlations between these characteristics were estimated using unadjusted logistic regression models.</p><p><strong>Results: </strong>We obtained responses from 119 pharmacies (response rate = 34%). Most surveyed pharmacies (81%) reported that they did not sell syringes to patients without a prescription for nonmedical uses, including intravenous drug use. There were no differences in whether pharmacies were more or less likely to sell syringes by level of urbanicity, local poverty rate, local racial/ethnic composition, or pharmacy type (i.e., chain vs. independently owned). The most common reasons cited for not selling syringes were security concerns, that syringe sales encourage drug use, and corporate policy. Among pharmacists in pharmacies not currently selling syringes, only 54% of were aware of the state law change allowing sales of syringes without a medical reason.</p><p><strong>Conclusions: </strong>Despite an important policy change advancing harm reduction through sterile syringe access, availability of sterile syringes to PWID in Georgia pharmacies was likely still hampered by lack of dispensing by pharmacies. Implementation efforts following important policy changes-including building awareness of the new policy, encouraging support of harm reduction efforts, and continuing education around substance use disorders-are essential for achieving the intended outcomes of the policy.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"139"},"PeriodicalIF":4.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862196","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":"Switching and substantial reductions in cigarette consumption concurrent with use of a heated tobacco product among adults who smoke in Czechia: an actual use study.","authors":"Christopher Russell, Gabriel Barnard, Venus Marza, Sophie Notley, Thomas Nahde, Martin Fitzpatrick, Layla Malt, Matthew Stevenson, Sarah Weaver, Neil McKeganey","doi":"10.1186/s12954-025-01293-x","DOIUrl":"10.1186/s12954-025-01293-x","url":null,"abstract":"<p><strong>Background: </strong>The potential for heated tobacco products (HTPs) to reduce smoking-related harm depends, in part, on how adults who smoke cigarettes use HTPs in their everyday lives, and the extent to which HTPs come to be used as a replacement for all or most of the cigarettes that a person smokes. This study assessed changes in cigarette smoking behaviour among adults who smoke when using HTPs in near-to-real world settings for six weeks.</p><p><strong>Methods: </strong>Participants were 332 adults aged 19 years and older who smoked between 5 and 30 cigarettes per day, on average, living in Prague or Brno, Czechia, who reported no intention to quit smoking within the next three months but reported a positive likelihood of using the PULZE + iD Heated Tobacco System ('the Study Product') on a regular basis following a brief trial use period. Participants were given a personal prepaid debit card to purchase packs of consumable heated tobacco sticks ('iD Sticks', the Study Sticks) in their choice of 12 commercially available flavours, directly from retailers in the community, to use as desired for six weeks. Participants recorded their daily consumption of cigarettes, Study Sticks, and other tobacco products in an electronic diary for 42 consecutive days. Data were collected between May-November 2023.</p><p><strong>Results: </strong>During Week-6 of ad libitum use of the Study Product, 16.0% of participants had completely switched from cigarettes to the Study Product (i.e., past 7-day use of the Study Product and zero cigarettes smoked) and 33.7% had reduced their daily cigarette consumption by 50-99% while continuing to use the Study Product. On average, weekly cigarette consumption reduced by 35.6% (1.9 fewer packs per participant) during Week-1 and 45.2% (2.4 fewer packs per participant) during Week-6, compared to the pre-study baseline week. Most Study Sticks consumed during the Observational Phase were flavoured to taste like fruit (40.1%), followed by tobacco (38.4%) and menthol/mint (21.5%). At Week-24, 63.6% continued to purchase Study Sticks with their own money and 50.9% were using the Study Product as a complete or majority replacement for cigarettes.</p><p><strong>Conclusions: </strong>The Study Product has potential to help adults who smoke to completely switch away from cigarettes or substantially reduce cigarette consumption in the short- to medium-term in real-world settings.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"138"},"PeriodicalIF":4.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855096","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":"Evaluation of nitazene immunoassay test strips for rapid in-situ detection of nitazene and nitazene analogs in illicit drug samples.","authors":"Victoria Marland, Lorna Nisbet, Niamh Nic Daéid","doi":"10.1186/s12954-025-01287-9","DOIUrl":"10.1186/s12954-025-01287-9","url":null,"abstract":"<p><strong>Background: </strong>The detection of nitazene compounds in the United Kingdom has raised concerns among healthcare professionals, public health authorities, and law enforcement due to the increased risk of fatal overdose, particularly among opioid users. In response, nitazene testing strips have been distributed to help users identify these substances in drugs they may consume. However, to date, limited testing has been conducted on the effectiveness of these strips.</p><p><strong>Methods: </strong>This study assesses the sensitivity and selectivity of a widely distributed nitazene immunoassay drug testing strip. The limit of detection and selectivity was examined for 36 nitazene analogs and 93 other drugs and cutting agents commonly encountered in illicit samples. The effectiveness of the test strips for the detection of metonitazene in the presence of other drugs was examined using a series of concentrations in solution in combination with other drugs. Testing of the strips was also carried out using authentic seized heroin samples.</p><p><strong>Results: </strong>The strips detected 28 out of 36 nitazene compounds (78%) with detection limits ranging from 250 ng/mL to 100 µg/mL. The strips did not provide positive results for 93 other drugs and cutting agents at a concentration of 100 µg/mL. However, false positives were observed when testing seized heroin samples, caused by caffeine concentrations over 300 µg/mL. False negatives were also seen for eight nitazene compounds.</p><p><strong>Conclusion: </strong>Caution should be exercised when deploying these nitazene test strips as frontline presumptive tests in both criminal justice and public health contexts due to the observed false negative and false positive results. While the strips successfully detected a majority of nitazene compounds, their inability to identify certain analogs poses a risk of not detecting the presence of these potent opioids in the drug supply. Additionally, the occurrence of false positives, due to the presence of caffeine-a common adulterant in illicit substances-raises concerns about their suitability for use as a harm reduction method.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"137"},"PeriodicalIF":4.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811972","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":"A portrait of online gambling: a look at a transformation amid a pandemic.","authors":"Sylvia Kairouz, Annie-Claude Savard, W Spencer Murch, Melanie Rose Dixon, Nadine Blanchette Martin, Magaly Brodeur, Sophie Dauphinais, Francine Ferland, Denis Hamel, Magali Dufour, Martin French, Eva Monson, Valérie Van Mourik, Adèle Morvannou","doi":"10.1186/s12954-025-01265-1","DOIUrl":"10.1186/s12954-025-01265-1","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic brought about an extraordinary societal context in which the gambling offer was modified to meet public health measures intended to curb viral transmission. With many land-based gambling venues being forced to close, gambling opportunities were left almost exclusively to the online domain, thus possibly instigating changes in the population's online gambling habits. Using a sequential mixed methods design, this study aimed to (1) investigate the self-reported changes in gambling habits of adults in the province of Québec (Canada) following the declaration of the COVID-19 pandemic and ensuing public health responses, and (2) report on their lived experiences of these changes during the first year of the pandemic.</p><p><strong>Method: </strong>A population survey was conducted with a representative sample of 4,676 online gamblers residing in the province of Québec, which was selected through random digit dialing for telephone interviews and from a web panel. From the initial sample, 96 online gamblers were recruited for in-depth semi-structured interviews inquiring about their gambling experiences during the first year of the pandemic.</p><p><strong>Results: </strong>The prevalence of online gambling was estimated at 15.6-20.3% of Québec's population in 2021, among which 5.6% gambled online for the first time during the pandemic, which represented a substantial addition to the 14.7% of people who gambled online both before and during the pandemic. Only 1.4% of people quit online gambling during the pandemic. The impact of the pandemic was similar for frequency, expenditure, and time spent on various online gambling activities, with day trading having increased most during the pandemic. Seeking to earn money was one of several motivations endorsed by participants who had begun or increased online gambling practices during the first year of the pandemic.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic clearly revealed a significant increase in online gambling practices when changes in the gambling landscape and in daily life occurred due to the health crisis. This calls for a greater attention to the need for comprehensive regulatory measures and a support system for online gambling in a context of a steadily increasing lucrative market.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"136"},"PeriodicalIF":4.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794224","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":"Expanding buprenorphine prescribing in primary care: a qualitative study of the experiences of primary care providers and nurse care managers participating in the New York City buprenorphine nurse care manager initiative.","authors":"Elodie C Warren, Nisha Beharie, Marissa Kaplan-Dobbs, Asmara Tesfaye Rogoza, Alex Harocopos","doi":"10.1186/s12954-025-01271-3","DOIUrl":"10.1186/s12954-025-01271-3","url":null,"abstract":"<p><strong>Background: </strong>Improving access to and retention in evidence-based treatment for opioid use disorder, including buprenorphine, is a critical response to the opioid overdose crisis. To increase the availability of buprenorphine treatment in primary care settings, the New York City Department of Health and Mental Hygiene implemented the Buprenorphine Nurse Care Manager Initiative in safety-net primary care clinics. The initiative funds nurse care managers to coordinate ongoing buprenorphine care and provides clinical support and technical assistance for implementation.</p><p><strong>Methods: </strong>As part of a process evaluation of the initiative, we conducted in-depth interviews with 18 primary care providers new to prescribing buprenorphine and five nurse care managers across six organizations in New York City that participated in the Buprenorphine Nurse Care Manager Initiative between 2017 and 2019. We aimed to understand participating providers' views on the successes and challenges of the initiative. Thematic and trajectory analytic approaches were used to capture major themes and changes over time.</p><p><strong>Results: </strong>Findings show that participating providers valued many aspects of the initiative, suggesting that integrating buprenorphine treatment with the support of a nurse care manager into safety-net primary care clinics can effectively expand access to buprenorphine and quality of care for people with opioid use disorder in New York City.</p><p><strong>Conclusions: </strong>Findings from this process evaluation can inform future primary care-based buprenorphine treatment initiatives. Recommendations include ensuring ample nurse care manager support for primary care providers, robust mentorship structures, and organizational buy-in for initiative sustainability.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"135"},"PeriodicalIF":4.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788907","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}