Harm Reduction Journal最新文献

{"title":"Assessment of harm reduction receipt and infectious diseases outcomes in United States Veterans with opioid use disorder and history of injection drug use.","authors":"Khushbu P Shah, Pronoma Srivastava, Viraj Modi, Audun J Lier","doi":"10.1186/s12954-024-01129-0","DOIUrl":"10.1186/s12954-024-01129-0","url":null,"abstract":"<p><strong>Background: </strong>Injection drug use (IDU) may lead to negative health outcomes and increased healthcare utilization. In US Veterans (USV) with opioid use disorder (OUD), there is sparse information about healthcare utilization, harm reduction prescription, and outcomes associated with IDU, including severe injection-related infections (SIRI). We assessed psychosocial factors, clinical outcomes, and harm reduction receipt in a cohort of USV with OUD, specifically focusing on persons who inject drugs (PWID).</p><p><strong>Methods: </strong>A retrospective cohort study was performed of USV aged ≥ 18 years with a diagnosis of OUD who presented to the Northport Veterans Affairs Medical Center (Long Island, NY) between 2012 and 2022. Demographics, psychosocial factors, history of human immunodeficiency virus (HIV), hepatitis C virus (HCV) infection, and healthcare utilization were compared by IDU status. Prescription of medications for opioid use disorder, naloxone and pre-exposure prophylaxis (PrEP) for HIV were also compared by IDU status. SIRI episodes and associated sequelae were characterized in USV with IDU.</p><p><strong>Results: </strong>A total of 502 USV with OUD were included and 216 (43%) were PWID. Mean age was 52.6 years. PWID were more likely to use multiple stimulants (14.4% PWID vs. 7.3% non-PWID, p < 0.011), be hospitalized with an infection (26.4% PWID vs. 12.2% non-PWID, p < 0.001) and had more frequent inpatient admissions (n = 5.5 PWID vs. n = 3.51 non-PWID, p = 0.003). Among PWID, 134 (62%) had a history of HCV infection, 9 (4.2%) had HIV, and 35 (16.2%) had at least one SIRI episode. PWID had a higher frequency of current (51.9% PWID vs. 38.5% non-PWID, p = 0.003) or previous MOUD use (45.8% PWID vs. 31.1% non-PWID, p < 0.001). Overall PrEP receipt in our cohort (0.46% PWID vs. 1.4% non-PWID, p = 0.4) was low.</p><p><strong>Conclusions: </strong>USV with OUD and a history of IDU had a high prevalence of concurrent stimulant use, HCV, SIRI episodes, and were more likely to be hospitalized than USV with OUD and no history of IDU. Harm reduction strategies such as MOUD or PrEP, can help decrease the risk of infectious diseases, yet PrEP was underutilized in our population regardless of IDU status. USV with OUD would benefit from improved integration of OUD treatment, infectious diseases clinical care and harm reduction interventions.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"211"},"PeriodicalIF":4.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739419","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":"Opportunities to enhance retention on medication for opioid use disorder for adolescents and young adults: results from a qualitative study with medical providers in Philadelphia, PA.","authors":"Maria Christina Herrera, Kaja Darien, Sarah Wood, Scott E Hadland, J Deanna Wilson, Nadia Dowshen","doi":"10.1186/s12954-024-01113-8","DOIUrl":"10.1186/s12954-024-01113-8","url":null,"abstract":"<p><strong>Background: </strong>Medications for opioid use disorder (MOUD) are under-prescribed to adolescents and young adults (AYA). Few published studies have explored challenges to and opportunities to enhance continuous provision of MOUD for AYA. Our report focuses on this emergent theme that was identified as part of a larger qualitative study.</p><p><strong>Methods: </strong>We purposively sampled and enrolled medical providers who prescribed MOUD to AYA. Semi-structured individual interviews using chart-stimulated recall explored barriers and facilitators to MOUD retention. We used modified grounded theory in our qualitative analysis, with double coding of interviews.</p><p><strong>Results: </strong>Barriers to retention on MOUD included patient-level (i.e., return to substance use) and system-level factors (i.e., cost, delayed receipt, pharmacy challenges, and in-person visit requirements). Facilitators included patient-level (i.e., motivation, support networks) and system-level factors (i.e., telehealth access, availability of certified recovery specialists).</p><p><strong>Conclusions: </strong>Our study is the first to look at retention for this key age group, setting it apart from the existing body of literature that looks at medication initiation. Our findings confirm that significant systemic barriers exist to AYA patients' retention on MOUD. Further research is needed to develop interventions that facilitate continuous delivery of high-quality care among this key population.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"210"},"PeriodicalIF":4.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709072","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":"Joint smoking-vaping prevalence rates among American youth and young adults 2011-2022.","authors":"Brad Rodu, Nantaporn Plurphanswat","doi":"10.1186/s12954-024-01125-4","DOIUrl":"10.1186/s12954-024-01125-4","url":null,"abstract":"<p><p>The Center for Disease Control and Prevention (CDC) annually tracks American youth and adult smoking prevalence using data from the National Youth Tobacco Survey (NYTS) and the National Health Interview Survey (NHIS). The NYTS and the NHIS began collecting information on vaping in 2011 and 2014 respectively. However, since those years the CDC has only reported smoking and vaping rates separately, which presents a long-term and important information gap, given the decade-long debate about whether e-cigarettes help people who smoke reduce or quit, and whether they are a gateway to youth smoking. This short report provides joint smoking and vaping prevalence rates for American high school students from 2011 to 2022 from the NYTS, and rates for American adults 18-44 years old over the same period from the NHIS. The results show that cigarette smoking declined sharply, especially in high schoolers and emerging young adults (18-20 years) while vaping increased substantially. In addition, the prevalence of vaping among people who formerly smoked also increased. The importance of these trends is highlighted by sharp increases in quit ratios among emerging and junior (21-24 years) young adults, who had historically low levels of quitting.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"209"},"PeriodicalIF":4.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710068","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":"Exploring and describing alcohol harm reduction interventions: a scoping review of literature from the past decade in the western world.","authors":"Sarah Perrin, Amandine Fillol, Sarah Moriceau, Lysiane Le Tirant, Axel Allache, Fuschia Serre, Nolwenn Stevens, Marc Auriacombe, Linda Cambon, Judith Martin-Fernandez","doi":"10.1186/s12954-024-01105-8","DOIUrl":"10.1186/s12954-024-01105-8","url":null,"abstract":"<p><strong>Context: </strong>Regular alcohol use is a predominant risk factor for disease, injury, and social harm. While robust evidence is advocating for implementing interventions to reduce the harms of illegal substance use, less literature is dedicated to identifying and understanding interventions aiming at reducing the various harms associated with alcohol.</p><p><strong>Objectives: </strong>This review describes how alcohol harm reduction (AHR) interventions are currently conducted and analyzes the facilitators and barriers identified by the studies on their efficacy.</p><p><strong>Method: </strong>This scoping review with evidence appraisal included articles published between 2011 and 2022, addressing one or more AHR interventions for population of at least 18 years (including alcohol user who have an addiction but also alcohol user with harmful drinking), conducted in North industrialized countries (Europe, Nort America, Australia).</p><p><strong>Results: </strong>Among the 61 articles selected, we identified several forms of support (face-to-face or remote, support in residential settings, structural interventions, and interventions created upon spontaneous initiatives), and strategies of intervention were also analyzed (the ones based upon learning and skill development, the ones based upon psychological support, the ones focusing upon socio-economic conditions, strategies focusing on the coordination and adaptation of the care system, and those strategies based on peer support). The facilitators linked to fundamental characteristics of the interventions were the promotion of empowerment and autonomy of beneficiaries, setting objectives tailored to individual needs, professionals harmonizing their values, evidence-based interventions taking into account cultural contexts, and comprehensive and holistic support. Practical facilitators from the intervention process consist of increasing the number of sessions, involvement, and formation of members of staff, disposing of the necessary resources, and using technological tools.</p><p><strong>Discussion: </strong>The sheer variety of AHR interventions demonstrates that this is a fertile field in terms of intervention design and innovation. This work illustrates the importance of designing effective, adapted harm reduction interventions, prioritizing interventions that make support more accessible to more people. This also prompts us to consider the potential benefits of invoking proportionate universalism in the design of AHR interventions in order to operationalize alcohol harm reduction philosophy. accessible to more people.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"207"},"PeriodicalIF":4.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695375","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":"Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities.","authors":"Aline Pouille, Clara De Ruysscher, Lena van Selm, Jan van Amsterdam, Wim van den Brink, Machteld Busz, Roberto Perez Gayo, Marios Atzemis, Wouter Vanderplasschen","doi":"10.1186/s12954-024-01110-x","DOIUrl":"10.1186/s12954-024-01110-x","url":null,"abstract":"<p><strong>Background: </strong>Persons who migrate for economic reasons, along with asylum seekers and refugees, face multiple personal experiences and societal inequalities that increase the risk of mental health problems and substance dependency, compounded by intersectional social and economic vulnerabilities. The precarious situation and limited access to care of persons with a migration background who use drugs (PMWUD) in Europe raises concern. Therefore, this qualitative study explores the challenges and support needs of a sample of PMWUD in vulnerable situations living in Amsterdam, Athens, Berlin and Paris.</p><p><strong>Methods: </strong>This study employed a community-based participatory approach. Through semi-structured interviews with PMWUD (n = 99), we identified  (service) needs of a diversity of PMWUD in Europe. Participants were recruited through a combination of community gatekeepers, venue-based sampling, and snowball sampling. Trained community researchers conducted the interviews, which focused on participants' living situation, substance use, physical and mental health, and employment opportunities.</p><p><strong>Results: </strong>Despite substantial heterogeneity among the PMWUD, several common themes emerged across all groups. Participants frequently mentioned early childhood adversity, limited social networks leading to loneliness, medical, psychological, and substance use issues, histories of personal violence or poverty, homelessness, lack of necessary documents for health care, social security, and employment, and encounters with the criminal justice system. These intertwined and mutually reinforcing factors simultaneously functioned as barriers to care and support, alongside other barriers such as linguistic and cultural differences, and stigma and discrimination. Due to social exclusion, migration, and substance dependence, participants had limited reliable social networks. Therefore, they often had to rely on accessible and low-threshold services. Harm reduction services played a significant role in providing support to PMWUD. Most PMWUD indicated that basic needs for hygiene and food were met thanks to local organizations. Differences in housing opportunities and access to harm reduction services were identified in each city.</p><p><strong>Conclusion: </strong>Structural barriers toward treatment and care, often related to administrative requirements, stand in the way of appropriate care for PMWUD. Linguistically and culturally sensitive outreach activities with limited practical requirements could break down social and treatment barriers.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"208"},"PeriodicalIF":4.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695333","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":"Community alcohol sales and opioid poisoning deaths: Alcohol serving space as a harm reduction opportunity.","authors":"Cory M Morton, Kristen Gilmore Powell, Michael Routhier, N Andrew Peterson","doi":"10.1186/s12954-024-01123-6","DOIUrl":"10.1186/s12954-024-01123-6","url":null,"abstract":"<p><p>The concurrent use of opioids and alcohol is particularly dangerous for individuals. Alcohol is commonly seen in opioid overdose death toxicology reports and, concurrent use of alcohol and opioids is often reported by individuals across a diverse range of opioid use profiles. This study investigates whether there is a community-level relationship between alcohol sales and opioid-related overdose deaths to inform the situating of harm reduction efforts in spaces most likely to reduce substance-related harms. Using an ecological design, zip code-level data for New Hampshire were combined from the US Census Bureau's American Community Survey (sociodemographics), the National Alcohol Beverage Control Association (alcohol retail sales), and the NH Office of the Chief Medical Examiner (zip code level opioid poisoning deaths) to investigate the relationship between alcohol sales and opioid-related poisoning deaths at a community level in a state with the third highest rate of opioid poisoning deaths for the year the current study represents. Using a spatial error regression model approach, opioid-related poisoning deaths were higher in zip codes with greater population density and on-premise alcohol sales and were lower in zip codes with greater off-premise alcohol sales and area disadvantage. The findings here co-locate higher levels of on-premise alcohol sales and opioid-related poisoning deaths at a community-level, mirroring individual-level findings on the danger of mixing these two substances. Results inform harm reduction approaches by identifying substance use spaces where overdose prevention messaging or policy change may be most effective.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"206"},"PeriodicalIF":4.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692917","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":"How far are we? Assessing progress in hepatitis C response towards the WHO 2030 elimination goals by the civil society monitoring in 25 European countries, period 2020 to 2023.","authors":"Mojca Maticic, J Cernosa, C Loboda, J Tamse, R Rigoni, E Duffell, I Indave, R Zimmermann, L Darragh, J Moura, A Leicht, T Windelinckx, M Jauffret-Roustide, K Schiffer, T Tammi","doi":"10.1186/s12954-024-01115-6","DOIUrl":"10.1186/s12954-024-01115-6","url":null,"abstract":"<p><strong>Background: </strong>With the advent of direct acting antivirals (DAAs) the World Health Organisation (WHO) adopted global strategy to eliminate hepatitis C virus (HCV) infection by 2030. In Europe, people who inject drugs (PWID) account for the majority of new cases, however testing and treatment remain suboptimal. The aim was to monitor progress in HCV policy and cascade-of-care for PWID, led by the civil society organisations (CSO) that provide harm reduction services for PWID across Europe.</p><p><strong>Methods: </strong>In period 2020-2023, CSOs representing focal points of Correlation-European Harm Reduction Network were annually invited to complete online questionnaire on use/impact of HCV test-and-treat guidelines for PWID, availability/functioning of continuum-of-care, and role/limitations of harm reduction services for PWID. A retrospective longitudinal analysis of responses to questions answered each year by the same respondents was performed, and a comparison among the studied years was made.</p><p><strong>Results: </strong>Twenty-five CSOs from cities in 25 European countries were included and responded to 25 questions. Between 2020 and 2023, there was positive trend in number of HCV treatment guidelines, separate guidelines for PWID, and their positive impact on acess to testing/treatment (24/25, 5/25, and 16/25 in 2023, respectively). DAAs were available in all countries, predominantly prescribed by specialist physicians only (slight increase at primary care), with restrictions including active drug use, stage of liver fibrosis or/and reimbursement policies (2/25, 4/25, and 3/25 in 2023, respectively). A decrease in HCV testing sites was noted. Treatment was consistently most common at clinical settings, however an increase outside the specialist settings was detected, particularly in prisons (12/25 and 15/25 in 2020-2021, respectively). Comparing 2022-2023, number of HCV-testing services increased in many cities with positive dynamic in nearly all the settings; increase in treatment at harm reduction services/community centres was noted (6/25 to 8/25, respectively). Between 2020 and 2023 the frequency of various limitations to CSOs addressing HCV was oscillating, presenting an increase between 2022 and 2023 (9/25 to 14/25, respectively).</p><p><strong>Conclusion: </strong>The overall progress towards WHO HCV elimination goals across Europe remains insufficient, most probably also due to the influence of Covid-19 pandemic. Further improvements are needed, also by including CSOs for PWID in continuum-of-care services, and in monitoring progress.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"203"},"PeriodicalIF":4.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675374","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":"Experiences of the changing illicit drug supply among racial and ethnic minoritized people in three US states: a qualitative study.","authors":"Brendan Saloner, Olivia K Sugarman, Lauren Byrne, Samantha Harris, Molly C Reid, Hridika Shah, Eric Hulsey, Adrienne Hurst, Lindsey Kerins, Dionna King, Susan Sherman, Emily Kaner, Daliah Heller, Sachini Bandara","doi":"10.1186/s12954-024-01126-3","DOIUrl":"10.1186/s12954-024-01126-3","url":null,"abstract":"<p><strong>Background: </strong>Amidst a national surge in overdose deaths among racial and ethnic minoritized people and people who use stimulants (cocaine or methamphetamines), our objective was to understand how these groups are adapting to a rapidly changing illicit drug supply.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 64 people who use drugs and who self-identified as Black, Hispanic, Multiracial, or other Non-White race in three states (Michigan, New Jersey, and Wisconsin). Transcribed interviews were coded thematically.</p><p><strong>Results: </strong>Most respondents used stimulants alone or in combination with opioids. Respondents perceived that the drug supply had become more unpredictable and dangerous but differed in their personal perception of risk and their adaptations. For example, respondents had very mixed perceptions of their own risk of being harmed by fentanyl, and differing opinions about whether fentanyl test strips would be useful. Xylazine, a novel adulterant in the opioid drug supply that has received public health and media attention, was not well known within the sample.</p><p><strong>Conclusion: </strong>Our study highlights the challenges experienced by minoritized people who use drugs in responding to a changing drug supply, underscoring the limits of public health approaches focused solely on individual behavioral change.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"205"},"PeriodicalIF":4.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681540","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":"Analysis of different populations accessing online overdose response training and harm reduction supplies (ADORES).","authors":"Michaela Pacheco, Abiodun Ologunowa, Anita Jacobson","doi":"10.1186/s12954-024-01118-3","DOIUrl":"10.1186/s12954-024-01118-3","url":null,"abstract":"<p><strong>Background: </strong>An online mail order naloxone and harm reduction supply program was created by an interdisciplinary team at the University of Rhode Island College of Pharmacy and hosted on the university website (UNIV). The program was subsequently funded by the Rhode Island Department of Health (DOH) and added to the DOH website. This study compares demographic characteristics of the two populations submitting requests through the program's distinct access points, UNIV and DOH, to those of populations at-risk for overdose.</p><p><strong>Methods: </strong>This is a retrospective comparative analysis using voluntarily provided information from mail order request forms submitted through two websites from June 2020 through October 2023. The primary objective was to compare demographic characteristics of requesters through the two access points to those of individuals at-risk for experiencing or responding to an overdose. Descriptive statistics were used to characterize the two distinct populations. Chi-square tests were performed to determine if statistically significant differences in population demographics existed between access points. Odds ratios were estimated using a simple logistic regression model to assess the relationship between access point and demographic characteristic to determine if either access point had a greater likelihood of reaching individuals with at-risk demographics.</p><p><strong>Results: </strong>A total of 5,783 (UNIV = 1662; DOH = 4121) mail order request forms were included in the analysis. Participants who completed requests through UNIV were more likely to be 44 years old or younger and/or reside in rural areas. Participants who submitted requests through DOH were more likely to reside in non-rural and/or low-income areas, and/or identify as gender minorities. Additionally, UNIV respondents were more likely to be first-time naloxone requesters while DOH respondents were more likely to have obtained and used naloxone before.</p><p><strong>Conclusions: </strong>Results establish that different access points can reach different at-risk population subsets and support the use of multiple access points and advertising strategies to expand the reach of online mail order harm reduction programs.</p><p><strong>Study registration: </strong>The study was retrospectively approved by the University of Rhode Island Institutional Review Board (IRB reference #2124391-2).</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"202"},"PeriodicalIF":4.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675366","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":"How we understand fully the supply, demand, and harm reduction in drugs policy in Vietnam?","authors":"Hai Thanh Luong","doi":"10.1186/s12954-024-01103-w","DOIUrl":"10.1186/s12954-024-01103-w","url":null,"abstract":"<p><p>Since the 1990s, Vietnam has begun prioritising preventing and combating drug-related crimes (supply reduction) and rehabilitating drug users (demand reduction). In the 2000s, harm reduction approaches in relation to drug control began to be recognised as one of Vietnam's opiate substitution therapy methods before embarking on greater drug policy reform in the early 2010s. In implementing the ideology of the Communist Party of Vietnam, the anti-narcotic police forces often apply a zero-tolerance approach to drug traffickers and identify drug users as a priority applies a zero-tolerance approach to drug traffickers and identifies drug users as a priority to send them to prison or compulsory detention centres rather than apply harm reduction as the international standard model to promote health conditions for them without detention. This study conducted a qualitative content analysis of documents by collecting and analysing grey literature on drug policy resources, combined with qualitative interviews with experts and drug policy professionals. Although Vietnam (re)states its commitment to balance the three pillars of harm minimisation in its drug policy reform, my research demonstrates that unclear provisions and blurred policies remain, and the challenges associated with scaling these approaches equally may not be feasible in reality. To do this, this study briefly explains (1) why Vietnam dominates the use of supply reduction-driven measures with 'hard strikes' for drug-related crimes, including the death penalty; (2) why Vietnam continues to use compulsory detention facilities for drug users as the main component of its demand reduction policy; and (3) why Vietnam still struggles to apply harm reduction, including in relation to policing practices. Some specific recommendations are called for further consideration to support harm reduction in policing.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"204"},"PeriodicalIF":4.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675380","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}