Harm Reduction Journal最新文献

{"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}

{"title":"\"Anything can happen\": experiences of people using opioids in a xylazine market.","authors":"Megan K Reed, Karla Martin González, Traci C Green, Tracy Esteves Camacho, Rose Laurano, Frida Clark-García, Catalyst Geraci, Ava Kane, Kristin L Rising","doi":"10.1186/s12954-025-01275-z","DOIUrl":"10.1186/s12954-025-01275-z","url":null,"abstract":"<p><strong>Background: </strong>Xylazine is associated with a number of negative health outcomes, such as severe wounds and withdrawal. As xylazine increasingly emerges in drug markets across the United States, there is an urgent need for a national response to reduce related harm. As such, healthcare systems, harm reduction organizations, and community members continue to work to identify and develop the best approaches for harm reduction interventions to address xylazine challenges. This study engaged people who use opioids (PWUO) in Philadelphia to explore current experiences with and responses to xylazine adulteration.</p><p><strong>Methods: </strong>From January to February 2024, we conducted semi-structured interviews with PWUO in the Kensington neighborhood of Philadelphia to explore their perceptions of and experiences with xylazine. We used a Community-Based Participatory Research (CBPR) framework to include people with living experiences of xylazine use in the research process. The interviews were audio-recorded, transcribed, and coded using content analysis to identify themes.</p><p><strong>Results: </strong>Among 40 participants, 50% were male, 55% White, 32% Latino, half completed high school and 40% were unhoused. Ages ranged from 25 to 57 years old. All reported using xylazine and fentanyl, and a majority (75%) had experienced an overdose in their lifetime. More than half (57.5%) reported injecting as a preferred method for mode of administration. Participants reported profound impacts from xylazine on themselves and the broader community of PWUO in Philadelphia. Conversations primarily centered on four domains of concern: wounds, withdrawal, safety concerns from unconscious sedation, and safety concerns from mobile sedation.</p><p><strong>Conclusions: </strong>Xylazine had many negative impacts on PWUO, including severe wounds, withdrawal, and sedation, with sedation resulting in increased risk of robbery, physical or sexual assault, or accidents while sedated but mobile. Individual attempts to reduce these xylazine-related harms are insubstantial when placed against structural factors driving these risks. Increased investment in wound care supplies and streetside wound care nursing by trauma-informed clinicians who will not further stigmatize people in need of care may be beneficial. In addition, higher-level policy and programmatic changes, i.e., updating clinical procedures to treat withdrawal, access to housing, and lower barrier treatment facilities, are needed to reduce the harms associated with xylazine use most effectively.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"134"},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759965","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 to eliminate hepatitis C between people who inject drugs in community services and prisons in Catalonia.","authors":"Elena Yela, Daniel G Abiétar, Rafael Clua-García","doi":"10.1186/s12954-025-01286-w","DOIUrl":"10.1186/s12954-025-01286-w","url":null,"abstract":"<p><strong>Background: </strong>The Spanish National Health System, with devolved powers to autonomous communities such as Catalonia, faces significant challenges in controlling viral infections like hepatitis C (HCV) among vulnerable groups, particularly people who inject drugs (PWID), where prisons serve as crucial intervention sites. Catalonia's health authorities have implemented strategies to combat HCV, including direct-acting antiviral (DAA) treatments and harm reduction programmes within both community and penitentiary settings. However, substantial barriers persist in achieving full treatment uptake and clearance among PWID subpopulations.</p><p><strong>Main body: </strong>This review aims to discuss the Catalonia's current HCV programmes and explores intervention proposals needed to achieve WHO elimination targets. Catalonia has implemented a comprehensive HCV plan, particularly targeting PWID, that has proven effective through enhanced screening, universal treatment access, and harm reduction, though structural and social barriers remain due to fragmented health and social systems.</p><p><strong>Conclusion: </strong>Advancing towards HCV elimination requires strengthened inter-organisational coordination, integrated social and health services, simplified care pathways, enhanced screening, professional training, targeted research, measurable goals, culturally appropriate and participatory prevention strategies, and a comprehensive, people-centred approach. This is particularly important in prisons, where universal screening, adapted caring processes, harm reduction, and opioid substitution treatments (OST) are essential. Considering the social determinants of health perspective, it is essential that policies and programs are structured to reduce structural inequities and vulnerabilities, thereby promoting equity in both access to prevention, care, treatment, and health benefits across all population groups, particularly those most affected.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"133"},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759966","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":"Innovations at the intersection of homelessness and substance use during the COVID-19 pandemic: a scoping review.","authors":"Hannah Passmore, Sam Craft, Rachel Krieger, Sunny Tang, Sofia Sacerdote, Emily Lumbis, Stephanie Blaufarb, Kelly M Doran","doi":"10.1186/s12954-025-01235-7","DOIUrl":"10.1186/s12954-025-01235-7","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to disruptions in substance use and harm reduction services for people experiencing homelessness (PEH) as well as opportunities to innovate. Pandemic-era innovations may offer insights on more effective approaches to the intertwined issues of homelessness and substance use beyond the pandemic. We present findings from a scoping literature review of articles describing interventions related to substance use and homelessness that emerged during the pandemic.</p><p><strong>Methods: </strong>We conducted a scoping literature review to identify articles on pandemic-era innovations related to substance use and homelessness. We completed a comprehensive search for articles in nine academic and grey literature databases in November 2022, and a second database search in September 2023. We screened titles, abstracts, and full text using predefined inclusion and exclusion criteria. We extracted data on study design, location, participants, and outcomes.</p><p><strong>Results: </strong>Database searches yielded 812 unique articles; 68 met inclusion criteria. Most articles discussed interventions addressing opioid use (n = 60). Commonly described interventions included telemedicine-based prescribing of medications for opioid use disorder (MOUD), homeless services site-based MOUD provision, managed alcohol programs, supervised consumption services, and safer supply prescribing. Articles reported few intervention-related adverse effects, though study designs (e.g., non-experimental, observational studies lacking comparison groups) presented limitations to effectiveness outcome assessment. Surmountable challenges associated with interventions included inequitable access to technology for PEH.</p><p><strong>Conclusions: </strong>Innovations in programs that provide substance use treatment and harm reduction services to PEH were observed during the COVID-19 pandemic. Further evidence is needed to determine which COVID-19 pandemic-related innovations were most impactful and how they should be prioritized and continued post-pandemic.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"132"},"PeriodicalIF":4.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742024","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":"Does a take-home dose program result in better patient adherence to methadone? Evidence from Vietnam.","authors":"Thuong Nong, Dominic Hodgkin, Nguyen Bich Diep, Victor Capoccia, Constance Horgan, Hoang Dinh Canh, Giang Le","doi":"10.1186/s12954-025-01279-9","DOIUrl":"10.1186/s12954-025-01279-9","url":null,"abstract":"<p><strong>Background: </strong>Methadone maintenance treatment (MMT) is an effective treatment for opioid use disorders, yet patient adherence and retention remain challenges in many countries. To address this, Vietnam piloted a take-home methadone program in 21 clinics across three northern provinces.</p><p><strong>Methods: </strong>Using a stepped-wedge design, the study evaluated the impact of this take-home program on treatment adherence among 500 MMT patients who were eligible for take-home methadone in 12 pilot clinics. We used T-tests and Poisson regression models to compare patients' treatment adherence between take-home and in-person dosing periods, and conducted sensitivity analyses to assess the robustness of the results.</p><p><strong>Results: </strong>The results indicated a significant improvement in adherence during take-home months. Joining the take-home program is associated with a reduction in methadone doses missed in a month by approximately 60%. Each additional month in the program is associated with a further 11% decrease in missed doses. Sensitivity analysis supports this finding. Each additional month in the program is also associated with a reduction in the number of times missing five consecutive doses in a month by 12.3%, but no association was found between take-home and the outcome. The sensitivity analysis found a significant negative association between the likelihood of missing five consecutive doses and the patient's continued participation in the take-home program until the last month of data collection.</p><p><strong>Conclusion: </strong>The findings underscore the effectiveness of the take-home methadone policy in enhancing patient adherence, with greater benefits observed over extended participation.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"131"},"PeriodicalIF":4.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm reduction self-efficacy and motivations for contactless supply access among a sample of syringe services program participants.","authors":"Rachel A Hoopsick, Benjamin M Campbell, R Andrew Yockey","doi":"10.1186/s12954-025-01288-8","DOIUrl":"10.1186/s12954-025-01288-8","url":null,"abstract":"<p><strong>Background: </strong>Contactless harm reduction supply methods (e.g., vending machines, mail order, mobile delivery) have become prevalent in the United States. However, this approach has faced some criticisms, including the notion that, unlike staffed syringe services programs, contactless methods do not provide face-to-face support, education, or referrals to treatment, potentially limiting their overall impact.</p><p><strong>Methods: </strong>We collected self-reported data from a sample of people who inject drugs who accessed a syringe services program (N = 50), including their demographics, harm reduction self-efficacy (i.e., confidence to employ specific health-preserving coping skills in high-risk drug using situations), and motivations for contactless harm reduction supply access via vending machine. We explored differences in the participants' demographics and harm reduction self-efficacy by usual method of harm reduction supply access (in-person vs. vending machine).</p><p><strong>Results: </strong>Participants accessed the harm reduction supply vending machine primarily out of convenience (66%) and limited syringe services program hours (56%). Fear of being seen by someone they knew (28%), law enforcement (34%), and social services (22%) were also motivators. Overall, harm reduction self-efficacy was highest for safer injection practices but lowest for reducing drug use. We did not find any significant differences in participants' demographics or harm reduction self-efficacy by access method.</p><p><strong>Conclusions: </strong>People who access harm reduction supplies in person and through contactless methods may not meaningfully differ in terms of their demographics and harm reduction self-efficacy, and contactless harm reduction supply methods are more convenient than in-person services. Findings support continued reductions to barriers of harm reduction services.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"130"},"PeriodicalIF":4.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729907","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":"Managing risks and harms associated with the use of anabolic steroids: a qualitative study.","authors":"J M X Amaral, A Kimergård, P Deluca","doi":"10.1186/s12954-025-01269-x","DOIUrl":"10.1186/s12954-025-01269-x","url":null,"abstract":"<p><strong>Background: </strong>People using anabolic steroids adopt different strategies to manage risks and harms associated with the use of these substances. We investigated how users learn, develop and incorporate risk-management strategies, as well as the events triggering changes in their health-related behaviour.</p><p><strong>Methods: </strong>Twenty semi-structured interviews were conducted with anabolic steroid users living in the UK to discuss their risk-management strategies (19 males, 1 female; median age = 35.5 years; median time of anabolic steroid use = 9 years). Online interviews were transcribed verbatim and qualitative data was analysed via iterative categorisation.</p><p><strong>Results: </strong>The use of risk-management strategies was characterised as a continuous cycle of identification, prevention and control of risks and harms. Preventative strategies were more commonly adopted after many years of anabolic steroid use. Changes in life circumstances and adverse health conditions were described as common triggers for changes in behaviour, including the cessation of anabolic steroid use.</p><p><strong>Conclusion: </strong>Our findings can inform interventions aimed at increasing awareness and promoting healthier behaviours among people who use anabolic steroids. Further research is needed to evaluate the effectiveness and safety of the risk-management strategies employed by this population.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"129"},"PeriodicalIF":4.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729908","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}