Harm Reduction Journal最新文献

{"title":"Cardiovascular and metabolic changes following 12 weeks of tobacco and nicotine pouch cessation: a Swedish cohort study.","authors":"Peder Af Geijerstam, Annelie Joelsson, Karin Rådholm, Fredrik H Nyström","doi":"10.1186/s12954-025-01195-y","DOIUrl":"https://doi.org/10.1186/s12954-025-01195-y","url":null,"abstract":"<p><strong>Objectives: </strong>Use of snus, including tobacco and nicotine pouches, is increasing in many countries. Nicotine increases blood pressure (BP) acutely, but the long-term effects of quitting the regular use of snus pouches are unknown. The aim was to evaluate the effects of snus cessation on home BP and markers of the metabolic syndrome.</p><p><strong>Methods: </strong>Volunteers aged 18-70 years using snus daily were invited to abruptly end their snus intake and followed using home BP and metabolic measurements before and for 12 weeks after cessation.</p><p><strong>Results: </strong>Fifty volunteers were recruited. Of these, 46 (92%) attempted snus cessation and 37 (74%) did not use snus for at least 3 weeks and were included in the study. Of those included, 33 maintained snus cessation for all 12 weeks. The mean age was 38 (± 10) years and 24 (65%) were men. At week 12, the mean changes in systolic home BP was 3.7 (95% CI 1.5-5.9) mmHg, in body weight was 1.8 (95% CI 1.1-2.4) kg, and in HbA1c was 0.7 (95% CI 0.0-1.6) mmol/mol.</p><p><strong>Conclusions: </strong>Cessation of tobacco and nicotine pouches in individuals who regularly used snus negatively impacted systolic home BP, body weight and HbA1c after 12 weeks. Whether these effects would be reversed by snus re-initiation cannot be determined by this study, but our novel findings suggest that successful cessation of regular snus usage does not immediate improve these cardiovascular risk factors. We call for further research to confirm our findings and evaluate the effects over longer time frames.</p><p><strong>Clinical trial registry number: </strong>NCT06019910, https://clinicaltrials.gov/study/NCT06019910 .</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"54"},"PeriodicalIF":4.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017246","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":"Vernacular and discursive harm reduction: an ethnography of an online drug community.","authors":"Salomé Gilles","doi":"10.1186/s12954-025-01180-5","DOIUrl":"https://doi.org/10.1186/s12954-025-01180-5","url":null,"abstract":"<p><strong>Background: </strong>In the context of online drug communities, the ethos of harm reduction comprises a set of ethical and practical principles that enable drug enthusiasts to shift stigma by normalizing certain behaviors to the detriment of others. The HR ethos is the dominant discourse in drug forums, which may give the impression that it is a natural expression of the online sociability of drug enthusiasts. However, according to the interactionist theory of deviance, there is a process behind the demarcation between deviance and normality; this would suggest that before becoming the dominant discourse, the HR ethos has had to assert itself in drug forums in the face of other attitudes. The study aimed to follow the progression of the HR ethos in an online drug community, in order to identify the process that led to both its generalization by the community's members and their labelling of deviant behavior within the community.</p><p><strong>Methods: </strong>Discord is a recently created social media platform that provides spaces for various online communities called 'servers'. The connective ethnography method was used to select three Discord servers (Blue, Green, and Yellow) for drug enthusiasts. Participant observation was utilized to collect data because it allows us to understand the meaning of interactions between players. Data were collected over a 14-month period using ethnographic field notes. The present article analyzed a 3-month period of identity crisis and resolution on the Blue server using concepts from the sociology of deviance.</p><p><strong>Results: </strong>The process began with the problematic situation: statutory members of the Blue server were exhausted by their own concern that members of the community were being hurt by their drug use. As a solution, members who had already participated in other drug communities, acting as moral entrepreneurs, proposed implementing the HR ethos on the Blue server. The statutory members derived rules from this ethos that created a vernacular HR specifically adapted to the Blue community. In particular, they established rules for discursive HR which enabled them to set boundaries for conversations without judging members' practices. In conclusion, drug enthusiasts in the Blue community took care of each other, and developed a vernacular HR with the aim of ensuring that being part of their community was beneficial for its members.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"53"},"PeriodicalIF":4.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999844","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":"The impact of psychostimulant use on office based buprenorphine treatment retention.","authors":"Ryan Edgerton, Peter Rebeiro, Sam MacMaster, Lisa Bell, Parul Patel, Loren Ginn, Kyra Beach, Veeraj Shah, R Lyle Cooper","doi":"10.1186/s12954-025-01201-3","DOIUrl":"https://doi.org/10.1186/s12954-025-01201-3","url":null,"abstract":"<p><strong>Background: </strong>Over a million people have died from overdose since 1999, over 600,000. of which involved opioids. Treatment options that focus on overdose prevention are desperately needed and buprenorphine treatment is a form of opioid prevention if provided in a harm reduction setting. Co-morbid opioid and stimulant use disorders have increased at a higher rate than other co-morbid combinations between 2011 and 2019. The objective of this study was to identify the effects of psychostimulant use on buprenorphine treatment retention.</p><p><strong>Methods: </strong>We conducted an analysis of a cohort of 143 individuals with opioid use disorder that initiated treatment in a low-threshold, urban office based opioid treatment (OBOT) clinic located in Nashville Tennessee between 2018 and 2020. Retention was measured at 1, 3, and 6-months. Logistic regression was used to identify differences between people who tested positive for stimulants and people who did not.</p><p><strong>Results: </strong>The majority of the patients were white (83%), male (64%), unhoused (59%) and uninsured (70%). There was moderate psychostimulant use in the sample with 19% testing positive for cocaine and 13% testing positive for methamphetamine at baseline. Patients testing positive for cocaine prior to their six month retention point had 0.279 lower odds of being retained in treatment. Further, testing positive for either cocaine or methamphetamine resulted in 0.284 and 0.258 odds of retention at 3 and 6-months respectively.</p><p><strong>Conclusion: </strong>This study examined the impact of stimulant use on retention in buprenorphine treatment within a low-threshold OBOT clinic. Our findings differ from previous research that reported significant decreases in retention among methamphetamine users. Instead, results suggest that patients using psychostimulants can be effectively retained in care within a low-resource, low-threshold setting, though increased clinical engagement may be beneficial for those testing positive for cocaine or methamphetamine. Given the limited access to buprenorphine treatment, these findings underscore the urgent need for expanded, accessible treatment models that can effectively serve individuals with co-occurring stimulant use.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"51"},"PeriodicalIF":4.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006476","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":"Drug use and harm reduction practices of applicants to a public health vending machine service in Clark County, NV, 2021-2023.","authors":"Rachel Q Bryant, Kathleen Reich, Jessica A Johnson, Brandon Delise, Ying Zhang, Cassius Lockett, Sean T Allen","doi":"10.1186/s12954-025-01207-x","DOIUrl":"https://doi.org/10.1186/s12954-025-01207-x","url":null,"abstract":"<p><strong>Background: </strong>In 2017, Clark County, NV, implemented Public Health Vending Machines (PHVMs), an innovative approach to the dispensation of harm reduction supplies to persons who inject drugs (PWID), including sterile equipment and naloxone. Administrative data associated with PHVM operations can be valuable for understanding drug use behaviors among PWID. The current study examines the demographics and drug use profiles of PHVM registrants who completed the harm reduction survey between January 2021 to June 2023 with comparison to nation-wide trends.</p><p><strong>Methods: </strong>All registration forms for PHVM services in Clark County, NV, between 1/1/2021-6/30/2022 with a completed harm reduction survey were included for analysis. Descriptive statistics were used to characterize differences in applicant demographics as well as self-reported injection and non-injection drug use, risk behaviors, and interest in harm reduction services. Logistic regression models tested the association between types of injection drug use and overdose and risk behaviors.</p><p><strong>Results: </strong>A total of 637 PHVM applications with completed survey data were included for analysis. Respondents were an average of 36.1 ± 10.2 years old, 56.3% male sex, and 63.6% non-Hispanic White with 85.1% reporting injection drug use (IDU). Notably, greater proportions of respondents with histories of IDU also indicated non-injection drug administration, such as smoking and snorting. In the 3 months prior to registration, the majority of IDU respondents reported high risk drug use behaviors, including daily use, multiple injections per day, and opioid and stimulant co-use. Fentanyl was suspected in 62.1% of overdoses in the last 3 months. Compared to PWID using stimulants only, respondents with opioid and stimulant co-use had a higher likelihood of overdose (aOR 4.51; 95% CI 2.05, 11.1; p < 0.001) and re-using injection supplies (aOR 2.14; 95% CI 1.33, 3.48; p = 0.002). More opioid and stimulant co-use respondents were interested in treatment/detox and obtaining naloxone than those without co-use.</p><p><strong>Conclusions: </strong>The demographics and drug use behaviors of the PHVM PWID are consistent with contemporaneous county and nation-wide. As the overdose crisis evolves, PHVM could be pivotal tools in the early detection of new risks to facilitate timely adaptation of harm reduction strategies to improve morbidity and mortality.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"52"},"PeriodicalIF":4.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008587","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":"The gender factor in meeting the needs of women who use drugs in Senegal.","authors":"Rose André Y Faye, Alice Desclaux, Aïda Diagne","doi":"10.1186/s12954-025-01186-z","DOIUrl":"https://doi.org/10.1186/s12954-025-01186-z","url":null,"abstract":"<p><p>Harm reduction (HR) services are developing in Africa. In Senegal, the overall HR service coverage ratio is one WUD for every 10 men. By analysing gender-specific initiatives developed by HR stakeholders and evaluating their limitations, we explored HR in Senegal through a gender lens to better understand how to meet the specific needs of WWUD. The data for this study were collected through interviews, observations, and the researchers' direct presence in drug use settings, as part of a social anthropology research project on the trajectories of WWUD in Senegal. The study reveals that in Senegal, two approaches (broadly integrating HR) are employed to address the specific health and psychosocial needs of WWUD: care exclusively dedicated to WWUD (e.g., gynaecological consultations, women-only days, HIV testing, discussion groups) and support focused on capacity building (e.g., community empowerment, training peer workers). However, this dual approach has limitations. It primarily targets WWUD who inject drugs such as cocaine and heroin, neglecting the needs of those using non-injectable substances (e.g., tramadol, alcohol, cannabis). Additionally, it does not account for the diverse social profiles of WWUD and their varying needs. Despite HR actors' best efforts to provide tailored services, they face funding challenges. Moreover, the stigma surrounding drug use hinders WWUD's participation in proposed activities. To address the limitations and challenges of the current HR offer, WWUD employ adaptive and resilience strategies through community empowerment initiatives. Addressing these gaps requires the development of HR services tailored to the specific needs of non-injecting WWUD, conducting in-depth research to better adapt interventions for this target population, and mobilising funding to implement innovative and effective approaches to improve their access to care.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"50"},"PeriodicalIF":4.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016241","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":"Engagement in hepatitis C virus cascade of care and factors associated with testing among people who inject drugs in Iran.","authors":"Mehrdad Khezri, Fatemeh Tavakoli, Soheil Mehmandoost, Heidar Sharafi, Omid Zamani, Maliheh Sadat Bazrafshani, Naser Nasiri, Hossein Mirzaei, Hossein Moameri, Ali Akbar Haghdoost, Courtney McKnight, Don Des Jarlais, Mohammad Karamouzian, Hamid Sharifi","doi":"10.1186/s12954-025-01162-7","DOIUrl":"10.1186/s12954-025-01162-7","url":null,"abstract":"<p><strong>Background: </strong>Understanding the hepatitis C virus (HCV) cascade of care (CoC) and factors associated with engagement is crucial for designing interventions for achieving HCV elimination. However, data on engagement in the HCV CoC among people who inject drugs (PWID) in the Middle East and North Africa remains limited. We examined the HCV CoC and factors associated with testing among Iranian PWID.</p><p><strong>Methods: </strong>We recruited PWID in 14 cities using respondent-driven sampling. PWID completed structured interviews capturing measures on socio-demographics, behaviors, and HCV CoC. We examined the self-reported numbers and proportions of individuals who ever tested for HCV, tested positive for HCV antibody, were diagnosed with HCV, initiated HCV treatment, and achieved sustained virologic response (SVR). Multivariable logistic regression models were built to assess factors associated with HCV antibody testing.</p><p><strong>Results: </strong>Of 2308 PWID, 23.1% had ever received an HCV antibody test, 13.9% received the HCV antibody test in the last year, 3.4% had tested positive for HCV antibodies, and 2.5% had received an HCV diagnosis. Of those diagnosed, 54.4% reported initiating treatment, and 31.6% had achieved SVR. HCV antibody testing was significantly associated with having knowledge about HCV transmission through sharing needle/syringe (adjusted odds ratio [aOR] 8.09; 95% confidence intervals [CI] 5.25, 12.48), living with HIV (aOR 4.15; 1.58, 10.92), no previous history of homelessness (aOR 1.89; 1.31, 2.72), history of arrest/incarceration (aOR 1.83; 1.26, 2.64), history of being diagnosed with any mental health problems (aOR 2.88; 1.79, 4.61), history of non-fatal overdose (aOR 1.51; 1.08, 2.10), receiving needle exchange programs in the last 12 months (aOR 6.20; 3.86, 9.93), opioid agonist treatment in the last six months (aOR 2.10; 1.39, 3.18), and having ever received HBV vaccine (aOR 2.31; 1.59, 3.35).</p><p><strong>Conclusions: </strong>We found a considerably low engagement in HCV CoC among PWID in Iran. Enhancing access to testing services for PWID, especially those with limited awareness of HCV transmission and those encountering structural challenges, is essential as the initial step in the HCV CoC. This improvement is vital for strengthening HCV elimination efforts in Iran.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"49"},"PeriodicalIF":4.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811312","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":"Desirable treatment or a problematic drug scene? - An interview study of patients' and professionals' views on the risks and benefits of liberalized opioid agonist treatment.","authors":"Johan Nordgren, Torkel Richert","doi":"10.1186/s12954-025-01197-w","DOIUrl":"10.1186/s12954-025-01197-w","url":null,"abstract":"<p><strong>Background: </strong>Opioid agonist treatment (OAT) is a highly effective treatment option for people with opioid use disorder. The potent medications used create dilemmas regarding low or high thresholds to access treatment, patient autonomy and regulations. OAT in Scania County in the south of Sweden has seen the implementation of regulatory changes resulting in liberalization through a patient choice model and increased access to treatment. In this setting, in which OAT has developed from high threshold to low threshold because of policy changes at both national and local levels, we aimed to analyze how patients and staff view the risks and benefits of OAT.</p><p><strong>Methods: </strong>We conducted qualitative interviews with 32 OAT patients and 15 OAT staff in Malmö, Sweden. We analyzed the data with a thematic analysis approach.</p><p><strong>Results: </strong>Patients reported that OAT helped them to \"stabilize\" their lives although many felt a sense of being locked into treatment, which acted as a barrier to normalization. A significant risk was being offered illicit drugs by patients and dealers when visiting the clinic. Patients who had enrolled in OAT before liberalization found current guidelines too lenient and expressed worry that persons being enrolled were too young. Staff viewed liberalization with some ambivalence, with a positive view of increased access to OAT, although they had worries about the enrollment of young patients and difficulties supporting patients with ongoing drug use. Staff also viewed the sale of drugs in and outside of clinics as a significant problem. Some staff viewed medicines as the most important aspect of OAT, while others positioned the social support as most important.</p><p><strong>Conclusions: </strong>Patient and staff perspectives were relatively congruent as they highlighted substantial risks regarding drug dealing at OAT clinics and were ambivalent toward the liberalization of OAT guidelines and the increased access to OAT. Liberalization impacted both patients and staff in their everyday lives and in professional practice, in a setting where OAT is both a desirable treatment and sometimes the basis of a problematic drug scene.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"47"},"PeriodicalIF":4.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788292","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":"Quantifying the size and characteristics of a population of people who use drugs on the reservation lands of a tribal nation in the southern plains (USA).","authors":"Sean T Allen, Molly C Reid, Kristin E Schneider, Allison O'Rourke, Brady A Garrett, Maisie Conrad, Coleman Cox, Kendra Lewis, Sierra Lewis, Lisa Wilson, Melissa Walls","doi":"10.1186/s12954-025-01194-z","DOIUrl":"10.1186/s12954-025-01194-z","url":null,"abstract":"<p><strong>Background: </strong>Reversing trends in substance use-related health inequities among Indigenous Peoples requires investments in epidemiological research anchored in community-based participatory research (CBPR) methodologies. There is scarce literature that describes how to implement population estimation methods on American Indian reservation lands.</p><p><strong>Objective: </strong>This research describes how we leveraged CBPR throughout the implementation of a population estimation study conducted in collaboration with a Tribal Nation in the southern plains to quantify the size and characteristics of persons with histories of illicit substance use on reservation lands.</p><p><strong>Methods: </strong>We used the capture and recapture population estimation methodology in April-May 2023 to estimate the size of the population of people who used illicit substances in the past six months in a county within the collaborating tribe's jurisdiction. Participant recruitment occurred in areas where people who use drugs were known to congregate. Participants completed a survey that included measures pertaining to sociodemographics, substance use, harm reduction, overdose, sexual health, and cultural factors.</p><p><strong>Results: </strong>In total, N = 501 surveys were completed by unique persons who had used illicit substances in their lifetime. A large proportion had injected drugs in the past six months or greater than six months ago (19.6% and 31.7%, respectively). There were N = 210 persons who reported having used illicit substances by at least one route of administration within the last six months. We estimated that there were 419 (95% confidence interval = 277, 562) adults who had recently used an illicit substance in the county where the study occurred.</p><p><strong>Conclusions: </strong>This study demonstrates that population estimation methodologies can be integrated with community-based participatory research approaches to quantify the size of populations of people who use drugs. Future work should be conducted to understand the degree to which population-level needs evolve over time and in response to local initiatives.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"48"},"PeriodicalIF":4.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788278","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":"Use of reagent test kits and fentanyl test strips among electronic music festival attendees in Colorado: prevalence, barriers, and behavior in response to drug checking.","authors":"Cianna J Piercey, Thomas E Schlechter, Devin Henry, Mikayla Allen-Collins, Riley Ahern, Joseph Cameron, Bradley T Conner, Jeffrey G Snodgrass, Hollis C Karoly","doi":"10.1186/s12954-025-01181-4","DOIUrl":"10.1186/s12954-025-01181-4","url":null,"abstract":"<p><strong>Background: </strong>Polysubstance use is common at electronic dance music (EDM) events and hazards associated with polysubstance use may be exacerbated when people who use drugs are unaware of the contents of their drug sample. Reagent test kits (RTK) and fentanyl test strips (FTS) are two efficacious drug checking tools that people who use drugs might use to protect themselves from risks associated with contamination, adulteration, and misrepresentation of unregulated substances. In the current study, we aimed to (1) characterize the use of RTK and FTS among attendees of a 4-day music festival in Colorado and (2) qualitatively capture perceived barriers to using RTK and FTS within festival settings.</p><p><strong>Methods: </strong>We surveyed 227 music festival attendees on their use of drug checking tools (i.e., RTK and FTS) and behavior in response to drug checking. We also collected qualitative data on perceived barriers of using RTK and FTS within a festival setting using survey-based open-ended text response questions.</p><p><strong>Results: </strong>The percentage of participants having ever used RTK and FTS was 75.3% and 66.5% respectively. When asked how often participants ensure their drugs are tested prior to consumption, participants responding \"always\" or \"most of the time\" was 54.4% for use of RTK and 59.4% for use of FTS. Additionally, 60.8% of participants reported that they had never consumed a drug that reagent tested differently than expected and 87.9% of participants reported that they had never consumed a drug that tested positive for fentanyl. Perceived barriers to using RTK and FTS within a festival setting encompassed the following themes: (1) accessing testing materials (2) environmental or ecological barriers (3) legal concerns (4) social dynamics (5) lack of education/training and (6) limits of individual drug checking tools.</p><p><strong>Conclusions: </strong>RTK and FTS appear to empower festival attendees in the U.S. to make informed decisions related to their substance use. However, there is a critical need to reduce barriers associated with drug checking for this at-risk population.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"46"},"PeriodicalIF":4.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772223","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":"Estimating lung cancer risk from e-cigarettes and heated tobacco products: applications of a tool based on biomarkers of exposure and of potential harm.","authors":"Peter N Lee, Katharine J Coombs, John S Fry","doi":"10.1186/s12954-025-01188-x","DOIUrl":"10.1186/s12954-025-01188-x","url":null,"abstract":"<p><strong>Background: </strong>Reliable epidemiological data are limited on the lung cancer risk of groups using e-cigarettes (ECIGs) and groups using heated tobacco products (HTPs).</p><p><strong>Aim: </strong>We describe a methodology to estimate the lung cancer risk of these groups according to their levels of biomarkers of exposure (BOEs) and of potential harm (BOPHs).</p><p><strong>Methods: </strong>Using 28 search terms for BOEs and 82 for BOPHs we sought publications reporting biomarker-specific data from North America and Europe comparing individuals who smoke cigarettes and individuals who use other established products (ETPs; cigars, pipes, smokeless tobacco (ST) and/or snuff/snus). Publications were selected using defined inclusion/exclusion criteria. Additionally using lung cancer relative risk (RR) estimates for users of specific ETPs derived from recent meta-analyses of epidemiological studies in these regions, we derived a regression model predicting the lung cancer RR by level of each specific biomarker. Separately for groups using ECIGs and using HTPs the lung cancer risk was then estimated by combining RR estimates for selected biomarkers. Our primary estimates only considered biomarkers statistically significantly (p < 0.01) related to lung cancer risk which showed no significant (p < 0.01) misfit to the RR of 1.0 for non-users-those with no use of ETPs, ECIGs or HTPs.</p><p><strong>Results: </strong>Based on 38 available publications, we extracted biomarker-specific data for ETPs for 56 BOEs within 21 of the 28 search terms considered and for 54 BOPHs within 29 of the 82. The regression slope fitted to the lung cancer risk was significant (p < 0.01) for 22 BOEs and six BOPHs. However, the predicted RR for non-users significantly (p < 0.01) differed from 1.0 for 16 of these biomarkers. We estimated the lung cancer RR for using ECIGs, derived from 30 estimates for 10 biomarkers, as 1.88 (95% CI 1.60-2.22), the excess risk (ER = RR - 1) being 6.8% of that for smokers of cigarettes. The RR estimate varied little in most sensitivity analyses conducted, but increased markedly after removing the restriction to significant model fit. We estimated the lung cancer RR for using HTPs, combining estimates for four BOEs, as 1.44 (0.41-5.08), the ER being 3.4% of that for smokers of cigarettes.</p><p><strong>Conclusions: </strong>Despite some methodological limitations, our approach estimates risk when reliable epidemiological data are unavailable. Using the biomarkers considered here, the model indicates that the lung cancer risk for individuals using ECIGs is much lower than for smokers of cigarettes, and suggests that the risk for those using HTPs is also low. Research using additional data could add precision to these findings.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"45"},"PeriodicalIF":4.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752391","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}