Harm Reduction Journal最新文献

{"title":"Effect of collection time and reported cigarettes per day on exhaled carbon monoxide: a retrospective observational study.","authors":"Perry N Willette, Karina C Chen, Tanaia L Botts, David R Botts, Gal Cohen, Jed E Rose","doi":"10.1186/s12954-026-01494-y","DOIUrl":"10.1186/s12954-026-01494-y","url":null,"abstract":"<p><strong>Background: </strong>Research studies that include adults who smoke conventional combustible tobacco cigarettes (cigarettes) commonly use exhaled carbon monoxide (eCO) as a biomarker of cigarette usage. eCO is regularly used as an inclusion or exclusion criterion. Multiple studies have examined the time course of eCO levels after acute use of cigarettes. Published studies have verified the relationship between the reported number of cigarettes smoked per day (CPD) and eCO levels. One article suggested that collection time of day may induce variations in eCO elimination. Researchers can improve recruitment if there is confidence that collection time does not significantly affect eCO.</p><p><strong>Methods: </strong>We analyzed data from eight separate studies conducted between 2019 and 2024 that collected eCO levels from adults who were not abstinent from smoking, after they reported their usual consumption patterns of cigarettes, to determine whether collection time or CPD had a significant effect on eCO levels. Data analyzed included eCO levels, collection times of eCO levels, and reported CPD smoked.</p><p><strong>Results: </strong>In the aggregate data, collection time did not result in significant changes in eCO levels (p = 0.87), as assessed throughout typical clinical hours (08:00 to 18:00). In contrast, and as expected, eCO levels were significantly impacted by CPD (p < 0.001).</p><p><strong>Conclusion: </strong>This finding verifies that screening eCO levels may be obtained throughout the day while minimally impacting eCO levels, allowing for greater flexibility in scheduling individuals for participation in research studies which require evaluation of smoking status.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294180","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":"Recent hydromorphone injection and risk of incident infective endocarditis among people who inject drugs in Toronto, Canada: a cohort study.","authors":"Nicholas Bakewell, Zachary Bouck, Zoë R Greenwald, Katie Upham, Christine M Warren, Marina G Birck, Cristiano S Moura, Sasha Bernatsky, Autumn Neville, Tara Gomes, Daniel Werb","doi":"10.1186/s12954-026-01479-x","DOIUrl":"10.1186/s12954-026-01479-x","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) are at increased risk of infective endocarditis (IE). While opioid injection is a major risk factor for IE, the risk associated with specific prescription opioids, such as hydromorphone, remains unclear and is inconsistently reported, despite a hypothesized pathway whereby the insolubility of controlled-releaseformulations may promote injection equipment reuse and bacterial contamination. Therefore, we estimated and compared the 1-year incidence rates of IE among PWID reporting injection of hydromorphone versus non-hydromorphone opioid medications and versus other opioids/drugs.</p><p><strong>Methods: </strong>Baseline questionnaire data on PWID in the Ontario Integrated Supervised Injection Services cohort (November 2018-March 2020) were linked to health administrative databases. IE incidence was calculated over 1-year post-baseline. Participants were followed until first of IE, death, or 1-year censoring. Exposure was self-reported recent (past 6 months) injection of: hydromorphone, non-hydromorphone opioid medications of interest, or other opioids/drugs. Cox regression estimated associations, adjusting for age, gender, ethnicity, injection drug use, and prior injection-related infections.</p><p><strong>Results: </strong>Among the 514 participants included, 191 reported recent injection of hydromorphone, 32 non-hydromorphone opioid medications of interest, and 291 other opioids/drugs. IE incidence rates were low across groups: 1.6, 3.3, and 1.8 per 100 person-years. Adjusted hazard ratio comparing recent hydromorphone injection versus non-hydromorphone opioid medications of interest was 0.64 (95% confidence interval (CI) 0.06-6.53); versus other opioids/drugs was 0.82 (95% CI 0.19-3.51).</p><p><strong>Conclusions: </strong>In this cohort of PWID, no clear association was found between hydromorphone injection and IE when compared to non-hydromorphone opioid medications or to other opioids/drugs. Due to low event rates and the resulting wide CIs, the findings are limited by low statistical precision. Further research with larger cohorts is warranted to quantify IE risk of specific injected drugs among PWID.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283675","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":"Pain is associated with reduced adherence to safer injection practices among people who inject opioids.","authors":"O Trent Hall, John A Sturgeon, Jasmin Bradley, Abigail Helm, Johnathan Rausch, Emma Kuloszewski, Megan Deaner, Carlos Malvestutto, Ashley Lipps, Afton Hassett","doi":"10.1186/s12954-026-01490-2","DOIUrl":"10.1186/s12954-026-01490-2","url":null,"abstract":"<p><strong>Background: </strong>Injection opioid use is associated with fatal and non-fatal harms including accidental overdose and infectious diseases. Syringe service programs offer sterile injection equipment and safer injection training to reduce the incidence of injection-related harms. Nevertheless, factors that might reduce adherence to safer injection practices are understudied. This report explores pain as one such factor.</p><p><strong>Methods: </strong>People who inject opioids (n = 130) were recruited from a syringe service program for a cross-sectional survey assessing the relationship between fluctuations in pain severity and adherence to safer injection practices over the past 7 days.</p><p><strong>Results: </strong>A within-subjects Sign Test analysis revealed participants' adherence to safer injection practices fluctuated with changes in pain severity. When their pain was at its worst, participants reported they less often engaged in hand washing (Z -5.63, P < .001), cleaning the injection site (Z -5.29, P  < .001), and waiting until in a clean safe place to inject (Z -3.94, P < .001). Additionally, they more often reused their own injection equipment (Z -2.55, P = .011), and injected faster, or at a higher dose (Z -2.71, P = .007) when in worse pain.</p><p><strong>Conclusions: </strong>This study provides initial evidence that pain is associated with reduced adherence to safer injection practices among people who inject opioids. Although all study participants received training in safer injection practices and cost-free sterile injection equipment, within-subject adherence to safer use practices varied significantly under conditions of best and worst pain.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283658","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":"Navigating an unpredictable supply: lived experiences of xylazine exposure among people who use drugs.","authors":"Raagini Jawa, Margaret Shang, Samia Ismail, Stephen Murray, Cristina Murray-Krezan, Yihao Zheng, Sarah Mackin, Kenny Washington, Pedro Alvarez, Jaime Dillon, Gary McMurtrie, Alexander Y Walley, Jane M Liebschutz","doi":"10.1186/s12954-026-01486-y","DOIUrl":"10.1186/s12954-026-01486-y","url":null,"abstract":"<p><strong>Background: </strong>As xylazine-adulterated opioids become more prevalent in the U.S., people who use drugs (PWUD) face growing risks from sedation, withdrawal, and wounds. This study explores PWUD perceptions on recognizing xylazine exposure including its physical effects and clinical harms and how these factors shape their drug use practices.</p><p><strong>Methods: </strong>In August 2023, we surveyed adult PWUD clients reporting at least one past-year drug use-related wound across three Massachusetts syringe service programs with high xylazine prevalence. We compared demographics, drug use factors, physical effects, and clinical symptoms between those with and without self-reported past-90-day xylazine exposure and conducted content analysis of open-ended responses.</p><p><strong>Results: </strong>Of the 171 respondents, 80% (n = 136) reported past-90-day xylazine exposure. The majority of respondents were male, white, non-Hispanic, and aged 36-45 years, with no significant differences by xylazine exposure. Xylazine-exposed participants commonly reported sedation (77%), loss of consciousness (52%), and wounds (91%). Most participants were afraid and frustrated, seeing xylazine as an unwanted contaminant but were often unable to avoid it due to financial constraints, withdrawal symptoms, and limited alternative options.</p><p><strong>Conclusion: </strong>Syringe service program clients in Massachusetts commonly reported xylazine-adulterated fentanyl exposure, recognized through heavy sedation and skin wounds. Their experiences highlight the urgent need for real-time xylazine detection, safer supply, overdose and sedation risk mitigation, and improved wound prevention and care.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271171","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":"Stigma toward individuals with cannabis use disorder across age groups: associations with familiarity and sociodemographic characteristics.","authors":"Lukas Andreas Basedow, Elisa Wandinger, Antonia Brindle, Michael Kölch, Olaf Reis","doi":"10.1186/s12954-026-01491-1","DOIUrl":"10.1186/s12954-026-01491-1","url":null,"abstract":"<p><strong>Background: </strong>Stigma experienced by individuals with cannabis use disorder (CUD) has been identified as a significant impediment to their engagement with treatment programs. Therefore, this study aims to investigate the effect of sociodemographic factors and familiarity with cannabis on stigmatizing attributions towards adolescent and adult case vignettes of people affected by CUD.</p><p><strong>Method: </strong>A quota sampling web survey in Germany conducted by a professional survey institute including two case vignettes of people with a CUD, applying a 2 × 2 × 2 (age of vignette* age of participant*familiarity with cannabis/CUD) within-subject design. Sociodemographic information, questions about participants' cannabis use experience, a measure of stigmatizing attitudes, and a short version of the attribution questionnaire.</p><p><strong>Results: </strong>A total sample of n = 1603 (50.1% female) participants was recruited, with n = 501 being adolescent participants. Subjective social standing of the whole sample was slightly elevated (Mean social rank (SD) = 5.74 (1.8)). The adolescent case with a CUD was more stigmatized compared to an adult case (F(1, 3196) = 12.77; p < 0.001). Individuals who were more familiar with cannabis use (F(1,3196) = 19.65; p < 0.001) and/or CUD (F(1,3196) = 6.00; p =0 .014) reported fewer stigmatizing attributions. This effect of familiarity was more pronounced for adolescents compared to adults.</p><p><strong>Conclusions: </strong>Adults with CUD seem to receive less stigma compared to adolescents with CUD, while stigmatizing attributions are produced less often when people have more contact with cannabis use and CUD. Future studies should aim to systematically test the influence of different characteristics of stigmatizing persons on stigma production in order to offer tailored interventions.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264224","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":"Influence of sponsorship on betting intentions: from linear to deep learning models.","authors":"Manuel Alonso Dos Santos, Rodrigo Fuentes-Solis, Ana María Gómez-Tafalla, Eduardo Torres-Moraga","doi":"10.1186/s12954-026-01485-z","DOIUrl":"10.1186/s12954-026-01485-z","url":null,"abstract":"<p><p>Sports sponsorship by commercial betting providers is an essential source of income for sports entities worldwide. This study examines the formation of betting behavior in sporting events using predictor variables, namely, self-congruence, perceived exposure, subjective norms, goodwill, and involvement, to predict betting intention and actual gambling behavior, comparing linear (PLS-SEM) and nonlinear (artificial neural networks-ANN) methods. Data from 661 Spanish subjects were analyzed. The results of the PLS-SEM model identified subjective norms and self-congruence as the main predictors of betting intention, whereas goodwill showed limited effects. However, the ANN analysis revealed complex patterns not detected by linear methods, where variables such as goodwill acquire greater relative importance when considering complex interactions between variables. The research contributes theoretically by highlighting the need to adopt conceptual frameworks that consider the complex interaction between psychosocial variables, overcoming traditional models that analyze the determinants of gambling behavior in isolation. Additionally, it provides new knowledge about the differentiated and complementary influence of self-congruence, perceived exposure, goodwill, and involvement in predicting gambling behavior, constructs that had not been systematically integrated into a joint predictive model. Methodologically, it contributes by demonstrating that the integration of SEM and ANN approaches improves the robustness and validity of the analysis, offering a more complete view of the factors that influence the intention to gamble. The findings have practical implications for the design of more effective problem gambling prevention strategies and regulations.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251258","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":"Take-home naloxone (THN) ownership among a community-based cohort of sex workers who use drugs in metro vancouver: longitudinal trends and structural determinants (2017-2024).","authors":"Sarah Moreheart, Kate Shannon, Andrea Krüsi, Wiebke Bartels, Haoxuan Zhou, Kanna Hayashi, Emily Luba, Colette Merrison, Shira Miriam Goldenberg","doi":"10.1186/s12954-026-01483-1","DOIUrl":"10.1186/s12954-026-01483-1","url":null,"abstract":"<p><strong>Background: </strong>Sex workers who use drugs face disproportionately high overdose burden, driven by drug toxicity and intersecting structural factors in sex work and drug use environments. Given limited evidence regarding sex workers' use of overdose prevention tools, including take-home naloxone (THN), we examined period prevalence, time trends, and structural factors longitudinally associated with THN ownership among sex workers over 7 years.</p><p><strong>Methods: </strong>Data derived from An Evaluation of Sex Workers' Health Access, a prospective, community-based cohort of sex workers in Vancouver, Canada (March 2017-March 2024). Generalized linear mixed-effects modeling (GLMM) examined structural factors associated with THN ownership.</p><p><strong>Results: </strong>Among 506 participants, 90.3% (N = 457) ever owned THN. Period prevalence of THN ownership remained high across semi-annual visits( 72.6-88.8%). In multivariable GLMM modeling, THN ownership was associated with injection drug use (Adjusted Odds Ratio [AOR] 1.70, 95% Confidence Interval [CI] 1.35-2.14), enrollment in opioid agonist therapy (AOR 1.60, 95% CI 1.29-1.98), and drug use with sex work clients (AOR 1.27, 95% CI 1.02-1.59); whereas recent homelessness was associated with lower odds of THN ownership (AOR 0.52, 95% CI 0.37-0.73). Having used sex work-specific programs was marginally associated with higher odds of THN ownership.</p><p><strong>Conclusion: </strong>The majority of sex workers in this study owned THN, with high prevalence sustained over time. Ownership was particularly associated with enrollment in opioid agonist therapy and drug use with clients. However, recent homelessness was a barrier to THN ownership. Findings highlight the importance of integrating THN distribution and training into sex work-specific programs, with a focus on enhancing access to treatment and addressing structural factors that impact both safety and overdose prevention. Ensuring sex workers' right to health via strengthening THN access and equity-driven harm reduction strategies that prioritize the most marginalized sex workers is recommended.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224528","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":"Support from New York City's office of chief medical examiner for people bereaved by drug poisoning: development and implementation of the family support program.","authors":"Karli R Hochstatter, Hannah Johnson, Megan Brown, Jan Gryczynski, Talia Nadel, Jason Graham","doi":"10.1186/s12954-026-01482-2","DOIUrl":"10.1186/s12954-026-01482-2","url":null,"abstract":"<p><p>Bereavement from loss related to drug poisoning, the leading cause of injury-related death in the United States, is associated with elevated risk for prolonged grief disorder, substance use, and poor mental health outcomes. Despite this, few interventions specifically target survivors of overdose loss. The Family Support Program (FSP) is a novel, social worker-delivered bereavement support service provided by the Drug Intelligence and Intervention Group of the New York City Office of Chief Medical Examiner for family, friends, and other close social network members bereaved by drug poisoning. The FSP integrates evidence-based components including motivational interviewing, psychoeducation, social support, and linkage to care to reduce grief-related distress and improve psychosocial functioning. This paper describes the development, implementation, and pilot-phase adaptations of the FSP, including program design, staffing strategies, data infrastructure, and lessons learned. This paper can guide medical examiner and coroner offices in developing responsive, trauma-informed services for individuals affected by drug poisoning loss.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204686","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":"Participant perspectives on a safe supply program in Vancouver, Canada: impacts, satisfaction and improvement priorities.","authors":"Zia Mawani, Mary Clare Kennedy, Elizabeth Holliday, Christy Sutherland, Thomas Kerr","doi":"10.1186/s12954-026-01481-3","DOIUrl":"10.1186/s12954-026-01481-3","url":null,"abstract":"<p><strong>Objectives: </strong>The ongoing toxic drug crisis in Canada, driven largely by fentanyl proliferation, has led to ever-escalating overdose rates. The Safer Alternatives for Emergency Response (SAFER) program was launched in Vancouver, British Columbia (BC) in 2021 to reduce overdose risk by offering prescribed pharmaceutical alternatives, including fentanyl medications. This study aimed to evaluate satisfaction and the program's perceived impact on health and social outcomes among SAFER participants.</p><p><strong>Methods: </strong>Data were collected from 78 SAFER participants through baseline interviewer-administered questionnaires. The primary outcome was self-reported changes in drug use, health status and social outcomes. Descriptive statistics summarized participant characteristics and outcomes.</p><p><strong>Results: </strong>Among 78 participants, with 22 (28%) identifying as women or gender diverse, 76% reported reduced drug use, while 71% experienced reductions in drug cravings/withdrawal and overdose risk, respectively. Safer drug-use behaviours were also reported: 56% reported that they were more likely to use sterile equipment, 37% said they were more likely to check their drugs, and 35% said they were more likely to carry naloxone. Improvements in overall physical health (58%), mental health (63%), financial stability (55%), and social connections (49%) were also noted. High satisfaction with services was reported (78%), although 71% suggested improvements, including extended hours, easier access to carry doses, and expanded medication options.</p><p><strong>Discussion: </strong>These findings indicate that the SAFER program is perceived as effective in reducing overdose risk and improving health and social outcomes. However, barriers such as service accessibility and limited medication options remain. Addressing these concerns could enhance program outcomes. Further large-scale research is recommended to confirm these results and explore long-term impacts.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198661","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":"Leveraging lived experience: a qualitative study on the impact of formerly incarcerated consultants in public policy making to improve safety net services.","authors":"Jazmin Candelario, Diana Zúñiga, Diamond Lee, Califia Abwoon, Sandy Arevalo, María Casillas Gonzalez, Jason Garcia, Sergio Garcia, Lami Glenn, Gilbert Johnson, Jack Morris, Tue Huynh, Yusef Wiley, Arleen F Brown, Savanna L Carson","doi":"10.1186/s12954-026-01484-0","DOIUrl":"10.1186/s12954-026-01484-0","url":null,"abstract":"<p><strong>Background: </strong>Los Angeles County-wide criminal justice reform and policy decision-making focused on reentry and diversion from incarceration usually include only the voices of law enforcement and other public-sector employees, with little input from impacted community members. The Reentry Health Advisory Collaborative (RHAC), founded in 2020 with grant funding, was established to engage formerly incarcerated individuals and their communities in county safety-net health systems. We aimed to assess the impact of RHAC and the importance of formerly incarcerated community input in safety-net programs and policymaking.</p><p><strong>Methods: </strong>In 2022, following 3 years of RHAC implementation, online qualitative surveys were conducted with RHAC members and reentry service collaborators, including agency staff, nonprofits, and policymakers, to understand RHAC's influence and how lived experiences inform justice and health systems.</p><p><strong>Results: </strong>Thirty replies from collaborators (59%) and eight from members (100%) resulted in thematic findings that highlighted benefits of involving formerly incarcerated persons in program and policy decisions-such as their firsthand experiences, focus on root causes, and community and socioeconomic tailoring approaches-and challenges like limited political power, varying receptiveness to ideas and inclusion, and a lack of sustainable funding. Members shared outcomes like motivation, peer support, leadership skills, and advocacy training needs. Recommendations for future inclusion emphasized promoting awareness and strategies for relationships with public-serving institutions, early inclusion for impacting pivotal decision-making, and continued engagement with the community through on-the-ground grassroots efforts. Barriers to reentry included basic needs, access issues, lack of support, and discrimination.</p><p><strong>Conclusions: </strong>Compensating lived experience in health and justice services promotes inclusive, equitable policies that reflect community needs.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194621","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}