Harm Reduction Journal最新文献

{"title":"\"Chill packs\" self-administered olanzapine as psychiatric harm reduction for methamphetamine-induced psychosis: a narrative review of the existing evidence base.","authors":"Isabelle Ruedisueli, Carla Marienfeld, Casey Tiefenthaler, Allison Lee, Alicia Harvey-Vera, Steffanie Strathdee, Joseph R Friedman","doi":"10.1186/s12954-026-01475-1","DOIUrl":"10.1186/s12954-026-01475-1","url":null,"abstract":"<p><p>The prevalence of methamphetamine use disorder has risen across the United States and many other countries, which has led to a concomitant rise in methamphetamine-induced psychosis (MIP). A promising and novel approach to address MIP can be found in 'chill packs', a psychiatric harm reduction intervention for people using methamphetamine. Chill packs consist of several low-dose olanzapine tablets (an antipsychotic medication) that can be self-administered in the event of methamphetamine-induced insomnia, anxiety, paranoia, delusions, or other dysphoric symptoms. One recent study assessed the effectiveness of an implementation of chill packs by the San Francisco Department of Health and found that repeat psychiatric emergency visits dropped by 32% after two-months and 13% after six-months from receipt of a chill pack. While these findings are promising, more research is needed to evaluate the efficacy and generalizability of this intervention. Here we provide a narrative review which synthesizes indirect evidence and contextual information relevant to this intervention, including: the epidemiology of MIP, clinical data supporting the use of olanzapine versus other antipsychotics for MIP, evidence for as-needed outpatient antipsychotic use, as well as qualitative and other data describing the potential for misuse of olanzapine and other antipsychotics. Overall, the literature supports that the prevalence of MIP is rising sharply, causing increased psychiatric burden. This is also linked to overdose risk among patients that use illicit fentanyl or other sedatives to \"come down\" after periods of heavy methamphetamine use. Olanzapine has demonstrated comparable efficacy for treating MIP compared to other antipsychotics with enhanced short-term sedative effects, despite a higher burden of long-term metabolic side effects. Olanzapine has very little documented misuse risk, although other agents in its class, especially quetiapine, have higher street value. Qualitative research highlights that some groups already self-administer olanzapine as a 'trip killer' to manage distressing psychiatric side effects from illicit drug use. Overall, we find substantial contextual evidence supporting further trials to evaluate chill packs as a harm-reduction intervention for MIP and provide recommendations for research needed to fill gaps in the evidence for this promising emerging intervention.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162983","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":"Emergence of synthetic drugs in South America: insights from Brazil, Chile, and Colombia.","authors":"Ignacio Bórquez, Bruno Pantaleão, Gabriela Brogim, Ana Paula da Cunha, Noa Krawczyk, Francisco I Bastos","doi":"10.1186/s12954-026-01480-4","DOIUrl":"10.1186/s12954-026-01480-4","url":null,"abstract":"<p><strong>Background: </strong>The illicit drug landscape in South America is going through a major shift. The appearance of Tusi (or \"pink cocaine\"), a mixture often containing ketamine and MDMA, along with the growing presence of synthetic opioids like fentanyl and nitazenes, signals a new chapter in the region's drug use, which has been traditionally dominated by alcohol, cannabis, and cocaine.</p><p><strong>Main body: </strong>Drawing on data on seizures, forensic analyses, warning systems, and surveys from Brazil, Chile, and Colombia, this perspective highlights three movements of the drug supply: non-prescribed and synthetic opioids, ketamine, and Tusi. We also elaborate on their unique public health challenges. Brazil and Chile have seen an increase in non-prescribed opioid use, some of them diverted from healthcare, accompanied by seizures of illicit fentanyl and the discovery of nitazene production in Brazil in May 2025. Colombia, while historically experiencing low opioid use, has documented fentanyl analogs in ketamine and MDMA/Ecstasy samples, mixed with various other contaminants, thus increasing risks among people who use them. Concurrently, ketamine and Tusi use are expanding rapidly across all three countries, particularly among nightclub attendees and youth with criminal-legal involvement. Tusi's unpredictable composition poses heightened overdose risks, especially in settings lacking drug-checking and overdose-prevention education and programs. Furthermore, South America has minimal opioid agonist therapy coverage, limited naloxone access, and underdeveloped harm reduction systems.</p><p><strong>Conclusion: </strong>The emergence of synthetic opioids, ketamine, and Tusi signals a new synthetic drug phase in South America's supply. The convergence of traditional drugs with potent new substances poses important health-related harms. Strengthening regional surveillance, toxicological monitoring, and harm reduction services are urgently needed. Coordinated international research and public health responses will be essential to prevent a drug crisis.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163005","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":"Mapping needles, reducing harm: Findings from a geospatial, community-based needle collection and naloxone training initiative in Saskatchewan, Canada.","authors":"Nelson Pang, Shiny Mary Varghese, Vidya Dhar Reddy, Tashia Acoose, Erin Hidlebaugh, Sandra Kwan, Megan Rowe, Priscilla Medeiros, Paul A Shuper, Francisco Ibáñez-Carrasco, Daniel Grace, Andrew D Eaton","doi":"10.1186/s12954-026-01477-z","DOIUrl":"10.1186/s12954-026-01477-z","url":null,"abstract":"<p><strong>Background: </strong>The opioid crisis is a major public health issue in Canada, with prairie provinces such as Saskatchewan experiencing particularly high rates of opioid-related harms. Factors contributing to this crisis include an unstable drug supply, limited access to harm reduction services, and structural challenges such as poverty and housing instability. The rise of fentanyl has further exacerbated overdose risks, particularly among people who use drugs. Harm reduction programs, such as opioid overdose education and naloxone distribution, have proven effective in reducing overdose fatalities and improving community health. While geospatial analysis has shown promise in identifying areas of high need for targeted harm reduction interventions, its integration into harm reduction strategies remains underexplored.</p><p><strong>Methods: </strong>This study utilized data from 44 participants who completed pop-up naloxone training sessions in Regina, Saskatchewan, between August 2023 and September 2024. Data sources include geospatial information on discarded needles from the ReportNeedles.ca platform and survey responses evaluating opioid overdose and naloxone administration using a modified Opioid Overdose Knowledge Scale. Naloxone training sessions were targeted to areas with a high number of discarded needles determined by the ReportNeedles.ca platform. Geospatial analyses were conducted using ArcGIS to map needle prevalence and assess the accessibility of harm reduction services based on walk-time buffers.</p><p><strong>Results: </strong>Between August 2023 and August 2024, 315 reports on ReportNeedles.ca led to the disposal of 2,836 needles. Geospatial analysis revealed clustering of discarded needles in Regina's city center, with some seasonal variation. Pop-up training sites expanded the accessibility of naloxone services, with 70% of participants reporting living within a 15-minute walk to pop-up Naloxone trainings. However, geospatial analysis revealed gaps in service accessibility specifically in suburban areas. Participants in pop-up naloxone trainings demonstrated strong knowledge of overdose recognition and naloxone administration.</p><p><strong>Conclusions: </strong>This study demonstrates potential benefit in integrating geospatial analysis with harm reduction interventions to address the opioid crisis. By identifying needle prevalence hotspots and utilizing pop-up naloxone training, service providers can improve service accessibility.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162946","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":"Implementation and sustainability of hospital-based harm reduction delivery: a qualitative analysis.","authors":"Leslie W Suen, Leah Fraimow-Wong, Taylor Baisey, Kelly R Knight, Laura Thomas, Ro Giuliano, Oanh Kieu Nguyen, Marlene Martín","doi":"10.1186/s12954-026-01476-0","DOIUrl":"10.1186/s12954-026-01476-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with substance use disorders (SUD) face several challenges when hospitalized, including stigma, undertreated withdrawal and pain, and higher rates of self-directed discharge. Hospital-based harm reduction services can support patients with SUD, increase engagement, build trust, and catalyze culture change. Our hospital's Addiction Consult Team implemented a harm reduction program to provide education and substance use equipment to hospitalized patients whose SUD goals did not include abstinence. We conducted a qualitative evaluation of our harm reduction program to identify implementation and sustainability themes for long-term success.</p><p><strong>Methods: </strong>This qualitative study consisted of semi-structured interviews conducted between October 2022 and March 2023 with hospitalized patients receiving harm reduction services and hospital staff at an urban safety-net hospital in San Francisco, California. Interviews were audio-recorded and transcribed with informed participant consent. Transcripts were deductively and inductively coded through an iterative process, and we used thematic analysis to identify themes.</p><p><strong>Results: </strong>We interviewed 20 patients and 20 staff participants with interviews ranging from 30-45 min. We identified three themes related to implementation and three related to sustainability. Implementation themes were: (1) Operational barriers, including time constraints, lack of clearly defined roles, and competing demands, challenged delivery of harm reduction kits; (2) Tension between generalized versus specialized harm reduction program ownership limited impact; and (3) Educational gaps impeded broader harm reduction uptake and reinforced stigma. Sustainability themes were: (1) Experiential learning reinforced harm reduction practice and culture change; (2) Interprofessional collaboration, especially involving SUD champions, supported the program; and (3) Sharing patient success stories helped overcome stigma and burnout and highlighted harm reduction effectiveness.</p><p><strong>Conclusion: </strong>Harm reduction program implementation was challenged by resource constraints, complexity of program ownership, and lack of SUD knowledge. In contrast, experiential learning, interprofessional collaboration, and sharing patient successes sustained harm reduction efforts. Based on these findings, we recommend the following for long-term harm reduction program success: operationalize harm reduction workflow via hospital-wide interprofessional efforts; incorporate continuous, multimodal substance use training with all staff to ensure a baseline knowledge and drive culture change; and create feedback processes to share patient outcomes and narratives with staff.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149288","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: A sea of need: provider accounts of strategies used to manage admission demands to safer opioid supply programs in Ontario.","authors":"Carol Strike, Katherine Rudzinski, Rose A Schmidt, Gillian Kolla, David Kryszajtys, Melissa Perri, Nat Kaminski, Adrian Guta","doi":"10.1186/s12954-026-01473-3","DOIUrl":"10.1186/s12954-026-01473-3","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"23 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137811","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":"Gambling help seeking and self-management in New Zealand and Australia: a cross-sectional survey with quota sampling of priority populations.","authors":"Simone N Rodda, Annie S K Jones, Richard J Siegert, Stephanie S Merkouris, Rimke Bijker, Edmond Fehoko, Damita Schuh, Nicki A Dowling","doi":"10.1186/s12954-026-01472-4","DOIUrl":"10.1186/s12954-026-01472-4","url":null,"abstract":"<p><strong>Background: </strong>Efforts to address gambling harm often rely on narrow definitions of help seeking that focus on professional treatment. This approach overlooks the many other ways people seek support, use tools, or take action to reduce or control their gambling. This study aimed to examine the uptake of a broader range of help seeking and self-management approaches among people who gamble, across priority populations, including Māori, Pacific, Asian and Australian Aboriginal and Torres Strait Islander (ATSI), and among people experiencing different levels of gambling harm.</p><p><strong>Methods: </strong>A 58-item checklist on help seeking options contained three domains: People and Places (n = 33 items), Tools and Resources (n = 12 items) and Self-Help Strategies (n = 13 items). It was administered online to 514 adults in New Zealand and Australia, using quota sampling for ethnicity and gambling severity (75% past or current problems, 25% regular gamblers). Respondents indicated how often they had engaged in each help-seeking behaviour over the past 12 months.</p><p><strong>Results: </strong>Overall, 97% of participants reported using at least one help-seeking option. People and Places were widely used (80.5%) with the most frequently endorsed items being partner, family member, or friend (62.3%), peers in social or cultural groups (44.9%), general practitioners (44.6%) and mental health counsellors (44.4%). Tools and Resources were used by 87.0% and included time-outs (64.8%), reading online information (63.0%), and spending limits (62.5%). Self-Help Strategies were used by 95.5% including lifestyle change (84.2%), setting time or money limits (83.3%), thinking differently about gambling (80.9%), and self-monitoring thoughts, feelings, or behaviours (77.0%). Priority populations had higher uptake of help-seeking options across each of the three domains than non-priority populations. Help seeking increased across levels of gambling severity. Eighty percent of people with no gambling problems reported using any option, compared with 97.9% at low risk and 100% among those with moderate risk or problem gambling.</p><p><strong>Conclusions: </strong>Help seeking extended well beyond specialist gambling services and included family, community and general health settings. This suggests that responses to gambling harm already occur across a wide range of everyday settings and highlights the need to better understand and strengthen these community responses. Future research should examine how different options connect to form pathways of support and how effective these pathways are over time.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005120","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":"Measuring gambling harm in self-reported questionnaires: a scoping review.","authors":"Cong Mou, Sai Abirami Kailasnathan, Eamonn Ferguson, Richard Tunney, Richard James","doi":"10.1186/s12954-025-01352-3","DOIUrl":"10.1186/s12954-025-01352-3","url":null,"abstract":"<p><strong>Objectives: </strong>This review aims to examine how gambling harms are measured by mapping existing self-report measures, analyzing methodologies for scoring gambling harms, and identifying key gaps to inform future research and practice.</p><p><strong>Study design: </strong>Scoping review.</p><p><strong>Methods: </strong>The scoping review coded data from 131 studies, analyzing harm measures, corresponding scoring methods, sample-related variables, and associated measures.</p><p><strong>Results: </strong>(1) This review identified 41 distinct instruments used to measure gambling-related harm over the past two decades, encompassing gambling harm-specific surveys, problem gambling screening tools, custom questionnaires, and questionnaires on harm to affected others. (2) The current landscape reveals that most surveys capture only a subset of harm domains, with dichotomous scoring methods being widely used. (3) Additionally, harm measurement has been largely dominated by a few well-validated instruments, with criterion variables primarily focused on problem gambling severity, gambling engagement, and health-related constructs, and mainly delivered in the global north.</p><p><strong>Conclusions: </strong>This review highlights discrepancies between conceptual frameworks and real-world practices in the measurement of gambling harm, exposing critical gaps in quantification that have implications for policy decisions, clinical assessments, and public health management. It also questions the generalizability of existing measures to non-WEIRD populations. Future research should prioritize rigorous domain selection, refinement of assessment items, and improvements in quantification methods to better serve the needs of policymakers, researchers, and clinicians. Additionally, establishing cross-cultural validity and utility of gambling harm measures outside of WEIRD contexts is also essential.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015236","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":"Too young for medication? prescriber perspectives on how age shapes medication for opioid use disorder prescribing in transition-age adults.","authors":"Diego Renteria, Adetayo Fawole, Jason Alexandre, Haley Allen, Joshua Aleksanyan, Sugy Choi, Edward Liebmann, Sueun Hong, Ashly E Jordan, Megan O' Grady, Vanessa Drury, Sam Kawola, Jamie Del Rosario, Pat Lincourt, Charles J Neighbors","doi":"10.1186/s12954-026-01467-1","DOIUrl":"10.1186/s12954-026-01467-1","url":null,"abstract":"<p><strong>Background: </strong>Transition-age (TA) adults are less likely than adults aged 26 and older to receive medications for opioid use disorder (MOUD), and among those treated, disproportionately receive naltrexone over more effective agonist MOUD (buprenorphine and methadone). Given that prescribers ultimately determine medication selection, understanding how age influences their clinical decisions is essential to addressing these disparities. This study examines how prescribers incorporate age into MOUD prescribing decisions for this developmentally vulnerable population.</p><p><strong>Methods: </strong>Using 2022 New York State Medicaid claims, we identified MOUD prescribers with substantial experience (treating n ≥ 5 TA adults) and conducted semi-structured interviews with 18 outpatient prescribers (MD/DOs, NPs, PAs) from diverse geographic and clinical settings. We applied an inductive thematic analysis approach to explore how prescribers incorporated age and age-related factors into their clinical decision-making around MOUD.</p><p><strong>Results: </strong>Most prescribers did not endorse chronological age as a factor influencing their prescribing patterns, but rather described tailoring treatment based on age-related factors more commonly seen in TA adults. These included developmental characteristics (perceived lack of commitment, peer influence), socioeconomic barriers (e.g., unreliable transportation leading to missed appointments), family influence, and concerns about MOUD dependence. In response to these age-related factors, prescribers implemented harm-reduction principles by adjusting MOUD type prescribing to accommodate TA adults' life-stage realities. In contrast, a small subset of prescribers explicitly cited chronological age as directly influencing MOUD prescribing, expressing hesitations about initiating buprenorphine or referring TA adults for methadone due to long-term dependence concerns.</p><p><strong>Conclusion: </strong>These findings suggest two key mechanisms through which age may influence MOUD prescribing disparities among TA adults: (1) prescribers' responses to age-related life-stage challenges (e.g., developmental and social factors, structural barriers) and (2) explicit prescriber age-based hesitancy about initiating long-term agonist maintenance in younger patients. The first mechanism appeared more influential than explicit hesitancy. These mechanisms may help explain documented disparities in MOUD type prescribed. Addressing these disparities may require multi-level interventions: prescriber education affirming agonist MOUD effectiveness for TA adults, efforts to reduce MOUD misconceptions among patients and families, peer-based approaches that leverage social influence positively, and flexible harm-reduction-oriented clinic policies that accommodate structural barriers while supporting access to evidence-based MOUD.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005245","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":"Acceptability and usability of a respiratory biosensor for drug overdose detection and first responder notification: a qualitative evaluation of perspectives from people who use drugs and wider stakeholders.","authors":"Kristina Hnízdilová, Andrew Radley, Madeleine Caven, Brian Paul Stephens, Christopher J Byrne, Osian Meredith, Bruce Henderson, John Francis Dillon","doi":"10.1186/s12954-026-01452-8","DOIUrl":"10.1186/s12954-026-01452-8","url":null,"abstract":"<p><strong>Background and aims: </strong>Overdose induced by illicit drug use is a significant public health threat in many settings globally. Many such overdoses occur in the context of lone use in private spaces, in the absence of potential first responders. Chest-worn biosensors have the potential to detect respiratory depression which signal overdose and alert first responders, enabling rapid reversal. However, the acceptability of this approach to people who use drugs and other key stakeholders are not known. We aimed to investigate these outcomes in this qualitative sub-study, which is part of a larger trial investigating this intervention.</p><p><strong>Methods: </strong>Semi-structured interviews and focus groups were conducted with participants who completed the study protocol (n = 20), partially completed the study protocol (n = 1) and stakeholder groups (n = 8) about device acceptability. Verbatim transcripts were analysed using reflexive thematic analysis. Factors influencing device acceptability for PWUD were interpreted using the concepts of the COM-B behaviour model. Discussions around implementation with stakeholder groups utilised Normalisation Process Theory to further appraise the intervention and its integration into existing services.</p><p><strong>Results: </strong>Experiences with overdose or drug-related deaths (DRD) were identified within qualitative data as motivating factors for device wear. First responder groups stressed the importance of patient choice and device accuracy. The accelerometer sensor was found to be acceptable to people who use drugs (PWUD) and was utilised to monitor respiratory patterns. Stakeholders recognised the potential of these devices to play a part in the management of overdose and identified necessary requirements to ensure successful implementation of the device, such as funding allocation, potential barriers and integration into existing services.</p><p><strong>Conclusions: </strong>The chest-worn biosensor was acceptable to PWUD, driven by personal experiences with overdose risks, and were viewed by stakeholders as a promising tool for overdose management. Successful implementation will require ensuring device accuracy, respecting patient choice, securing funding, and integrating the technology into existing services.</p><p><strong>Clinical trials registration: </strong>Researchregistry7351.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987194","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 coalition's diversity and targeted overdose prevention strategies designed to reach special populations.","authors":"Dawn Goddard-Eckrich, Rouba A Chahine, LaShawn Glasgow, Emmanuel Oga, Jennifer Miles, JaNae Holloway, Megan E Hall, Sarah M Bagley, Erin Kim, Alissa Davis, Deborah Chassler, Nishita Dsouza, Stephanie Mack, Jill Davis, Judith Harness, Charles H Lea, Carly Bridden, Nicole Herron, Elizabeth Larimore, Katherine Calver, Pamela Salsberry","doi":"10.1186/s12954-026-01458-2","DOIUrl":"10.1186/s12954-026-01458-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite significant efforts to address the opioid crisis, there are critical inequities among populations disproportionately burdened by overdose deaths. Community-level adoption of evidence-based practices (EBPs), including opioid education, naloxone distribution (OEND) and medication treatment for opioid use disorder (MOUD), hold promise for addressing the opioid crisis. Community coalitions are key agents for increasing community-level adoption of EBPs, and diversity and cultural sensitivity among coalition members are essential for advancing work that reaches populations experiencing inequities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This analysis leverages data from 445 community coalition members from 33 communities across four states participating in the HEALing Communities Study (HCS). We explore associations between HCS community coalition members' perceived need for tailored OEND and MOUD strategies and the coalitions' selection and implementation of strategies explicitly designed to reach special populations, defined in HCS as people experiencing homelessness, people who are non-English speakers or immigrants, people involved in transactional sex, women who are pregnant and post-partum, racial and ethnic minoritized people, and veterans. We also explore the association between the proportion of coalition members identifying as racially and ethnically minoritized and the selection and implementation of OEND and MOUD strategies designed to reach racial and ethnic minoritized people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We found a significant association between the proportion of coalition members identifying as racially or ethnically minoritized and the number of selected OEND strategies explicitly designed to reach racial and ethnic minoritized people (Adjusted Change [AC] = 1.88, CI:1.37, 2.59, p &lt; 0.001). A similar significant association was found between the proportion of coalition members identifying as racially and ethnically minoritized and the number of implemented OEND strategies designed to reach racial and ethnic minoritized people (AC = 1.76, CI: 1.27, 2.44, p &lt; 0.001). No significant association was found between coalition diversity and the selection or implementation of MOUD strategies designed to reach racial and ethnic minoritized people. We also did not find a significant association between coalition members' perceived need for tailored strategies and selection or implementation of OEND and MOUD strategies designed to reach special populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study underscores the importance of community coalitions in addressing the opioid crisis through EBPs that are tailored to reach special populations. Enhancing coalition diversity and providing adequate support for community coalitions can help improve community-level adoption of EBPs and promote tailoring of OEND and MOUD strategies to reach special populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;(ClinicalTrial","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971739","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}