Harm Reduction Journal最新文献

{"title":"Transformative justice approaches to domestic, family, and sexual violence: a scoping review.","authors":"Jade Lane, Amy Kirwan, Nina Storey, Georgina Sutherland, Mark Stoove","doi":"10.1186/s12954-026-01447-5","DOIUrl":"10.1186/s12954-026-01447-5","url":null,"abstract":"<p><strong>Background: </strong>Domestic, family, and sexual violence (DFSV) is a widespread public health and human rights issue that disproportionately affects structurally marginalised communities. Mainstream justice responses-focused on policing, criminalisation, and incarceration-frequently do not meet the needs of victim-survivors. Transformative justice (TJ) offers community-led, non-carceral responses that promote harm reduction by seeking to reduce the harms of criminalisation, prevent further violence, promote healing and accountability, and transform the structural conditions that lead to violence. This scoping review maps the characteristics and applications of TJ in the context of DFSV.</p><p><strong>Methods: </strong>Led by victim-survivors of DFSV, this review followed Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR checklist. Peer-reviewed and grey literature published between 2005 and 2025 was sourced from eight databases and Google. Sources were included if they described the characteristics of TJ in non-carceral contexts. Sixty-one sources met the inclusion criteria. Data were extracted using a customised tool and synthesised thematically.</p><p><strong>Results: </strong>Most included sources originated in the United States and were situated outside academic publishing, reflecting TJ's community-based origins. TJ was consistently defined as an abolitionist approach rooted in community accountability, survivor autonomy, and structural transformation. Core principles included anticarceral and feminist commitments, trauma-informed care, and relational accountability. Goals focused on building safety within communities, creating justice processes not reliant on punitive measures, and transforming systemic conditions. Practices included pod mapping, transformative education, and knowledge-building activities such as storytelling and creative expression. The literature highlighted tensions around scalability, consistency, and engagement with state systems.</p><p><strong>Conclusions: </strong>TJ is an evolving field that remains resistant to formal institutionalisation and centres the leadership of those most affected by violence and criminalisation. Its relevance to harm reduction lies in its focus on preventing violence and criminalisation while building community prevention capacities. Research, policy, and practice should prioritise investment in grassroots infrastructures and the leadership of victim-survivors and marginalised communities. The reviewed literature argues that applications of TJ resist being reduced to static models or assimilated into carceral frameworks. Rather, their potential is founded on collective support and sustained political organising, and the long-term work of community transformation.</p><p><strong>Registration: </strong>This review followed a pre-specified protocol developed by the research team in accordance with JBI methodology (Peters M et al. in E. Aromataris (eds) Joanna Briggs Inst","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769804","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 survivors of exploitation who use drugs navigate systems of care: an analysis of survivor insights using the intersectional risk environment.","authors":"Theresa Anasti, Hilary Thibodeau, Nathaniel A Dell, Kathleen Preble, Lauren Grimes, Lindsay B Gezinski","doi":"10.1186/s12954-026-01443-9","DOIUrl":"10.1186/s12954-026-01443-9","url":null,"abstract":"<p><strong>Background: </strong>Drug-related risks such as adverse health outcomes, overdose, and violent victimization vary across populations due to the marginalization of identities, structural inequities, and differing environments. Discrimination and criminalization exacerbate drug-related risks specifically for survivors of sexual exploitation who use drugs. This study aims to understand how survivors who are not currently utilizing intensive treatment services perceive their risk environment, including available resources, and identify possible mechanisms to address health equity. Emphasizing the role of harm reduction and the expertise of lived experience, this paper encourages innovative approaches to supporting survivors.</p><p><strong>Methods: </strong>A research team conducted seventeen semi-structured interviews with survivors of exploitation who currently or formerly used drugs in a midwestern US state. This project emerged from a larger study exploring how survivors of exploitation navigated substance use treatment services. The team used Deterding and Waters' twenty-first century flexible coding approach to generate both inductive and deductive codes for data analysis and met weekly to discuss codebook development and code application. The intersectional risk environment framework was used to interpret the findings.</p><p><strong>Results: </strong>Survivors identified characteristics of the physical, social, policy, and economic risk environments that contributed to increased barriers to obtaining long term health and safety. While most participants had previously accessed intensive services for substance use disorder (SUD), restrictions on geographic mobility, poor medical care, and disproportionate criminal-legal involvement were noted as persistent issues faced by survivors upon leaving SUD services, that contributed to ongoing substance use and health inequities. Barriers across risk environments were compounded by the dual stigmatization of drug use and exploitation and further escalated for those with multiple marginalized identities.</p><p><strong>Conclusion: </strong>Increasing access to harm reduction for survivors who use drugs requires a multipronged approach that tackles structural drivers of inequities as well as community and individual level stigma and discrimination. Critical, actionable research that accounts for this complexity is needed to advance health equity for this group.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769832","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":"Syringe service program utilization, behavioral, and experiential factors associated with greater naloxone protection in a longitudinal cohort of people who use illicit opioids in New York city.","authors":"Alex S Bennett, Yuyu Chen, Adrian Harris, David Frank, Saba Rouhani, Alice Cepeda, Alverado Valdez, Jemar R Bather, Melody S Goodman, Luther Elliott","doi":"10.1186/s12954-026-01464-4","DOIUrl":"10.1186/s12954-026-01464-4","url":null,"abstract":"<p><p>BACKGROUND: Despite efforts to blanket high-mortality communities with no-cost naloxone, drug checking technologies, and alternatives to using opioids alone, there remains a considerable lack of knowledge about how exposure to these low-threshold interventions may impact rates of naloxone protection. METHODS: People who used illicit opioids in New York City were surveyed between April 2019 and April 2022. Naloxone protection was defined as the proportion of opioid use events in the past 30 days when opioid use occurred with naloxone present and someone to administer it. Mixed-effect Poisson models examined correlates (syringe service program utilization, behavioral, and experiential factors) of naloxone protection among the overall sample and stratified by gender. RESULTS: Among 428 study participants (mean age 49 years, 64% cisgender male, 35% Black, 41% Latine), several factors were significantly associated with naloxone protection levels. Visiting a syringe service program (SSP) in the last three months was significantly associated with higher naloxone protection in the full sample (IRR = 1.94, 95% CI 1.38–2.74) and among males (IRR = 1.84, 95% CI 1.29–2.64). Significantly lower naloxone protection was also observed among Latine participants compared to White individuals in the full sample (IRR = 0.64, 95% CI 0.44–0.94) and among females aged 57–72 years compared to those aged 20–40 years (IRR = 0.39, 95% CI 0.16–0.95). Participants living with someone who does not use opioids (vs. living with someone who uses opioids) showed significantly lower naloxone protection levels in the full sample (IRR = 0.54, 95% CI 0.37–0.80) and among males (IRR = 0.46, 95% CI 0.29–0.73). Other factors associated with lower naloxone protection in the full sample included any opioid withdrawal in the last 30 days, higher pain severity, and more negative life events. Conversely, receiving social support from another person who uses opioids was significantly associated with higher naloxone protection in the full sample (IRR = 1.14, 95% CI 1.07–1.22) and among females (IRR = 1.30, 95% CI 1.16–1.46). Additional factors associated with greater naloxone protection in the full sample included: concurrent opioid and stimulant use, heroin injection use (1–15 days), fentanyl test strip use, lifetime opioid overdose, and number of lifetime arrests. CONCLUSION: The present findings demonstrate that engagement with syringe service programs and use of harm reduction best practices and interventions are positively associated with naloxone protection, with notable differential associations observed. These results can serve to guide the development of culturally sensitive and tailored outreach programming for individuals at elevated overdose risk.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769795","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":"\"We're here, and we're non-judgmental, we're here to save lives\": stressors and fulfillment among overdose response hotline operators in Canada.","authors":"William Rioux, Dylan Viste, Iain Sander, Sarah Wilson, Stephanie Jones, Pamela Taplay, S Monty Ghosh","doi":"10.1186/s12954-026-01462-6","DOIUrl":"10.1186/s12954-026-01462-6","url":null,"abstract":"<p><strong>Background: </strong>The toxic drug supply and overdose epidemic in North America has led to deaths, reduced quality of life, and emotional burdens, especially for harm reduction workers who experience stress from grief and trauma. This study aims to evaluate the benefits and harms of working in overdose prevention hotlines and to identify strategies to reduce stress and trauma for lived-experience operators in these settings.</p><p><strong>Methods: </strong>We conducted a sequential mixed-methods study comprising 11 qualitative interviews and a survey with 15 operators and volunteers with Canada's National Overdose Response Service (NORS). The study explored operator challenges, compassion fatigue, and quality of life with previously validated quality of life surveys (ProQOL), while also assessing the perceived effectiveness of the hotline in reducing overdose deaths, mental health impacts, and emergency medical service call-outs.</p><p><strong>Results: </strong>From our qualitative interviews, 3 major themes emerged including (1) The duality of remote overdose response work including: tension between flexibility, accessibility, and supportive team dynamics, with ethical challenges, lack of physical presence, and complex client interactions. (2) Emotional burden and stress in a remote context and: (3) Meaning, purpose, and peer connection as drivers of fulfilment. Overall, most participants ranked their burnout levels as low (13/15 (86.6%)), compassion satisfaction as high (13/15 (86.6%)), and secondary traumatic stress as low (14/15 (93.3%)).</p><p><strong>Conclusion: </strong>This study reveals that work with overdose prevention hotlines is both rewarding and sustainable, with operators experiencing low burnout, low secondary traumatic stress, and high compassion satisfaction. The flexibility, strong team support, and inclusive approach of NORS make remote harm reduction a viable model for aiding marginalized individuals effectively in the overdose crisis.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769664","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 novel model of care; Telemedicine and peer support for HCV care among HIV-infected people who inject drugs in remote Myanmar: a retrospective study.","authors":"Ni Ni Tun, Frank Smithuis, Nyan Lynn Tun, Myo Min Min Hteik, Lutgarde Lynen, Christopher P Conlon, Tinne Gils, Josefien van Olmen, Tom Decroo","doi":"10.1186/s12954-026-01463-5","DOIUrl":"10.1186/s12954-026-01463-5","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) are at increased risk of co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Uncontrolled HCV infection contributes to ongoing transmission among PWID, underscoring the urgent need to expand access to treatment as a public health priority. Despite the availability of highly effective direct-acting antiviral therapy, access remains limited, particularly in remote areas where stigma and structural barriers complicate care delivery. Implementing integrated and differentiated HCV care models in these settings may help address this gap. This study evaluated a novel care model in remote areas in which general practitioners delivered integrated HCV and HIV care, supported by specialist telemonitoring, community health workers, and peer educators. We assessed treatment outcomes and associated predictors.</p><p><strong>Methods: </strong>Routine program data from the HCV treatment register were used to assess treatment completion and sustained viral response (SVR) among PWID. SVR12 was defined as an undetectable HCV viral load at 12 weeks after treatment completion. Patients who achieved SVR12 were invited for retesting at one year to calculate the one-year SVR rate (SVR64). Logistic regression analyses were performed to identify predictors of both SVR12 and SVR64.</p><p><strong>Results: </strong>Among 314 HIV-HCV co-infected PWID who initiated HCV treatment, 69.7% (219 of 314) achieved SVR12, and after one year, 57.5% (126 of 219) achieved SVR64, based on intention-to-treat analysis. Participants aged ≥ 25 years were significantly more likely to achieve both SVR12 and SVR64. Methadone maintenance therapy (aOR: 2.6; 95% CI: 1.5-4.4), not being an active PWID (aOR: 1.5; 95% CI: 1.0-2.5), and advanced liver disease: fibrosis (aOR: 2.3; 95% CI: 1.2-4.2) and cirrhosis (aOR: 2.9; 95% CI: 1.3-6.3), were independently associated with SVR64 (p ≤ 0.05).</p><p><strong>Conclusion: </strong>A novel care model involving general practitioners, specialist telemonitoring, and support from community health workers and peer educators demonstrated effectiveness in achieving SVR among HIV-HCV co-infected PWID in remote settings. Further qualitative research is warranted to better understand the factors influencing HCV treatment outcomes.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769712","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":"Cannabis products and risk perceptions among people who consume and do not consume cannabis in the UK: findings from the International Cannabis Policy Study.","authors":"Elle Wadsworth, Lindsey A Hines, David Hammond, Tom P Freeman","doi":"10.1186/s12954-026-01456-4","DOIUrl":"10.1186/s12954-026-01456-4","url":null,"abstract":"<p><strong>Background: </strong>Population data on cannabis use-beyond prevalence and frequency of use-in the UK is lacking, yet needed to inform harm reduction messaging about cannabis. This study examined (a) recreational and medical cannabis use; (b) cannabis product use; (c) cannabis risk perceptions via three different routes of administration; (d) how product use and risk perceptions vary by reasons for use and higher risk use.</p><p><strong>Methods: </strong>Data were from UK respondents of the 2023 International Cannabis Policy Study. National surveys included 3444 UK residents and 1590 people who consumed cannabis in the past year aged 16-65. Weighted logistic regression examined associations between product use, risk perceptions and reasons for use.</p><p><strong>Results: </strong>50.9% of people who reported consuming cannabis reported doing so for recreational reasons only, 12.1% for medical reasons only, and 31.3% for both reasons. Dried flower was the most consumed product both in the past year (68%). Edibles (38.9%), vape oils (30.5%) and hash (27.5%) were the next commonly consumed products. People who consumed cannabis in the past year that screened positive for higher risk use were more likely to report consuming non-flower products (AOR 3.15, 95% CI 2.17, 4.58) than only dried flower. There were a higher percentage of respondents-regardless of whether they consumed cannabis or not-that reported perceiving consuming edibles daily as low or very low risk than smoking or vaping cannabis daily.</p><p><strong>Conclusions: </strong>There is diversity in the UK cannabis market in terms of the reasons for use and the products consumed. Understanding product use beyond just 'cannabis' and risk perceptions across different routes of administration is important for informing harm reduction messaging and evaluating policies to minimise harm and maximise benefit from both recreational and medical cannabis.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769747","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":"Willingness to use a mobile syringe service program among people who inject drugs in rural Appalachia.","authors":"Alex Elswick, Amanda Fallin-Bennett, Tasfia Jahangir, Susan Westneat, April M Young","doi":"10.1186/s12954-026-01461-7","DOIUrl":"10.1186/s12954-026-01461-7","url":null,"abstract":"<p><strong>Background: </strong>Rural people who use drugs face a litany of structural and psychosocial barriers to SSP utilization (e.g., unreliable transportation, stigma). Mobile SSPs may mitigate some barriers, but little is known about acceptability among rural people who use drugs and their preferences for mobile SSP design. This study examines (1) factors associated with willingness to use a mobile SSP among rural people who use drugs, and (2) their desired attributes and services.</p><p><strong>Methods: </strong>Data were collected from 259 participants who inject drugs that were recruited through outreach and respondent-driven sampling (RDS) in Appalachian Kentucky. In addition to descriptive analyses, independent variables' associations with the outcome (i.e., being willing to use a mobile SSP) were estimated using generalized estimating equations. All models controlled for lifetime use of a fixed-site SSP.</p><p><strong>Results: </strong>Overall, 59.9% (n = 155) endorsed mobile SSPs as a program they would be willing to use. People with lower income, had less reliable access to transportation, were using methamphetamine, were engaging in syringe sharing and reuse, and who had experienced more overdoses in their lifetime were more willing to use a mobile SSP than were their counterparts. Those who experienced more shame around their drug use were less likely to use a mobile SSP than those who experienced no shame. Participants were receptive to a variety of locations, unit sizes, and staffing models, but the most desired staffing and locations were clinical in nature and most preferred hours of operation were afternoon hours.</p><p><strong>Discussion: </strong>Findings suggest moderate willingness to engage in mobile SSP services among this population, particularly for people who use drugs who have challenges with transportation and who are engaging in behaviors that increase risk for HIV and HCV. Mobile SSPs may increase accessibility, acceptability, and ultimately, the utilization of critical harm reduction services in Appalachia.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769831","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":"Substance use and mental health before versus during COVID-19 pandemic among persons who inject drugs with HCV infection history-the HERO study.","authors":"Snehal S Lopes, Irene Pericot-Valverde, Paula J Lum, Lynn E Taylor, Shruti H Mehta, Judith I Tsui, Judith Feinberg, Arthur Y Kim, Brianna L Norton, Kimberly Page, Cristina Murray-Krezan, Jessica Anderson, Alison Karasz, Julia Arnsten, Phillip Moschella, Moonseong Heo, Alain H Litwin","doi":"10.1186/s12954-026-01445-7","DOIUrl":"10.1186/s12954-026-01445-7","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic adversely impacted mental health and substance use-related outcomes in the general population. However, few studies have compared specific substance use patterns and behaviors and mental health outcomes between the COVID-19 and pre-COVID-19 periods among persons who inject drugs with HCV infection.</p><p><strong>Methods: </strong>This study included a secondary trend analysis using data from the HERO study. The pre-COVID-19 and the COVID-19 periods within the HERO study timeframe were compared on substance use and mental health outcomes, which were measured at multiple timepoints per participant. Substance use behaviors included the use, reuse, and sharing of drug injection equipment; the type of substance used; and mental health outcomes included depression and anxiety. Generalized linear mixed models were used to test changes in the study outcomes between the pre-COVID-19 and the COVID-19 periods.</p><p><strong>Results: </strong>Compared to the pre-COVID-19 period, the COVID-19 period was associated with higher likelihoods of injecting drugs [aOR = 1.64; 95% CI (1.23, 2.17); p = 0.001], reusing one's injection equipment [aOR = 3.14; 95% CI (2.28, 4.32); p < 0.001], using benzodiazepines [aOR = 4.16; 95% CI (2.02, 8.58); p < 0.001] and other opiates/pills/painkillers [aOR = 1.72; 95% CI (1.01, 2.93); p = 0.047], and higher depression [estimated mean difference = 0.97; 95% CI (0.09, 1.85); p = 0.030]. There were no significant differences in sharing of drug injection equipment and anxiety between the pre-COVID-19 and COVID-19 periods.</p><p><strong>Conclusions: </strong>Compared to pre-COVID-19 period, injection drug use and reuse of drug injection equipment increased during the COVID-19 period. There was an increase in the use of certain drug types (benzodiazepines and opiates/pills/painkillers) and a rise in depression levels during COVID-19. Ensuring continuity of access to healthcare, including harm reduction services, treatment for substance use and mental health during health crisis times, is important for catering to the special healthcare needs of PWID.</p><p><strong>Clinical trial: </strong>This research is a secondary analysis study based on data from the parent trial, the HERO study (Litwin et al., 2019; Litwin et al., 2022) registered at ClinicalTrials.gov (NCT02824640, 07/01/2016).</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769782","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 comparison of opioid overdose risk behaviors by race and ethnicity among overdose survivors in Boston, MA, and San Francisco, CA.","authors":"Gabriela E Reed, Vanessa M McMahan, Yi-Shin Grace Chang, Natrina L Johnson, Alexander Y Walley, Phillip O Coffin, Miriam T H Harris","doi":"10.1186/s12954-026-01451-9","DOIUrl":"10.1186/s12954-026-01451-9","url":null,"abstract":"<p><strong>Background: </strong>Black and Latino people are at high risk for overdose mortality. Interventions focused on overdose risk behaviors may offer opportunities to reduce overdose, but little research has addressed racial and ethnic differences in risk behaviors. We explored differences in risk behaviors among Black, Latino, and White individuals who used opioids and had a history of prior overdose.</p><p><strong>Methods: </strong>We used cross-sectional baseline data from REBOOT 2.0 (the REpeated dose Behavioral intervention to reduce Opioid Overdose Trial) based in Boston, MA, and San Francisco, CA, which enrolled people with opioid use disorder and a history of opioid overdose. We used the Andersen behavioral model to inform covariate selection for a multivariable logistic regression analysis examining associations between race/ethnicity (Black, Latino, and White) and three individual overdose risk behaviors (using opioids alone, not using a tester dose, and using alcohol and/or benzodiazepines on the same day as opioids).</p><p><strong>Results: </strong>Of 247 participants, 19% were Black, 16% were Latino and 66% were White. More than 20% in each group reported each risk behavior. In unadjusted analyses, Black participants had higher odds of using alone (OR = 2.17, 95% CI 1.08-4.36) and lower odds of not using a tester dose (OR = 0.48, 95% CI 0.24-0.93), indicating greater tester dose use. After adjusting for age, gender and structural determinants of health (e.g., housing, incarceration, education, opioid use disorder treatment) the adjusted odds of Black participants using alone (aOR = 2.05, 95% CI 0.99-4.26) and a tester dose (aOR = 0.56, 95% CI 0.28-1.13) were no longer statistically significant.</p><p><strong>Conclusions: </strong>Overdose risk behaviors were common among Black, Latino, and White overdose survivors in San Francisco and Boston. Overdose risk behaviors were not significantly different for Black or Latino compared to White overdose survivors after adjusting for age, gender, and structural determinants of health. For individuals at the highest risk of overdose, individual prevention efforts remain necessary but are not sufficient. Interventions should also address the social-structural factors shaping overdose risk, including housing, criminalization, and access to treatment.</p><p><strong>Trial registration: </strong>Details found at clinicaltrials.gov, NCT02093559.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728892","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":"Lessons from COVID-19 for improving delivery of medications for opioid use disorder in future pandemic events: results from a Puerto Rico Delphi consensus panel.","authors":"Roberto Abadie, Celia Fisher","doi":"10.1186/s12954-026-01454-6","DOIUrl":"10.1186/s12954-026-01454-6","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 severely disrupted the provision of medications for opioid use disorder (MOUD) everywhere. Yet, while MOUD has proven to reduce mortality and other drug-related harms, no comprehensive guidelines exist to deliver treatment during a future pandemic.</p><p><strong>Methods: </strong>From June to November 2023, (N = 12) stakeholders with professional backgrounds in MOUD delivery and policy, including one patient located in San Juan, Puerto Rico, were recruited to deliver policy recommendations on pandemic preparedness. A Delphi consensus approach was employed in three rounds of consultations utilizing an anonymous Qualtrics survey format that included informed consent information. Panelists responded to an initial set of 26 statements across four domains: providing treatment, testing and vaccination, overdose prevention, and emergency preparedness which were revised based on ratings and narrative responses from each round.</p><p><strong>Results: </strong>Consensus was reached on 22 statements, and panelists produced five majority recommendations. Panelists produced comprehensive guidance on policies to provide MOUD in a future pandemic, including recommendations that clinics provide testing and vaccination sites as soon as these resources become available and staff should receive training in emergency preparedness, including trauma-informed care and ventilator use. No consensus was reached regarding unsupervised take-home dosing or the mandatory requirement of testing and vaccination for patients and staff.</p><p><strong>Conclusion: </strong>The global prevalence of opioid use disorders and the urgent need for MOUD suggest that pandemic preparation policies for MOUD could benefit from a more coordinated international approach that avoids disruption of services especially for vulnerable patients living in poverty.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722199","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}