International Journal of Drug Policy最新文献

{"title":"Impact of scaling up harm reduction interventions on injecting risk behaviours, ART outcomes and HIV incidence among people who inject drugs in Kenya","authors":"Josephine G. Walker ,&nbsp;Matthew J. Akiyama ,&nbsp;Adelina Artenie ,&nbsp;Charles M. Cleland ,&nbsp;John A. Lizcano ,&nbsp;Helgar Musyoki ,&nbsp;Mercy Nyakowa ,&nbsp;Peter Cherutich ,&nbsp;Ann E. Kurth ,&nbsp;Peter Vickerman","doi":"10.1016/j.drugpo.2025.104824","DOIUrl":"10.1016/j.drugpo.2025.104824","url":null,"abstract":"<div><h3>Introduction</h3><div>Little data exists on the effectiveness of HIV prevention interventions among people who inject drugs (PWID) in Africa. We used empirical data from Kenya to fill this evidence gap.</div></div><div><h3>Methods</h3><div>Six rounds of bio-behavioural surveys using respondent-driven-sampling were conducted among PWID in Nairobi and Coastal Kenya over 2012–2015. Dried blood spot samples were tested for HIV and HIV viral load, and HIV incidence was estimated through linking participants between rounds. Regression analyses evaluated whether self-reported usage of opioid agonist therapy (OAT) or needle and syringe programmes (NSP) in last year were associated with reduced injecting risk behaviours, increased ART uptake and viral suppression, and reduced risk of HIV acquisition.</div></div><div><h3>Results</h3><div>Overall, 4897 PWID participated in the study, with 3903 participating in &gt;1 round. Over the rounds, coverage increased from zero to 80–86 % for NSP and zero to 10–20 % for OAT. The proportion of people living with HIV (PLHIV) that were virally suppressed increased from 7–14 % to 39–55 %. Accessing NSP and OAT was associated with reduced syringe sharing at last injection (NSP adjusted odds ratio (aOR)=0.31; 95 %CI:0.24–0.40; OAT aOR=0.046; 95 %CI:0.034–0.061) and OAT was associated with reduced injecting frequency (adjusted rate ratio=0.21; 95 %CI:0.12–0.36). Using OAT was associated with increased ART coverage (aOR=2.76; 95 %CI:1.50–5.06) and viral suppression (aOR=2.99; 95 %CI:1.78–5.03) among PLHIV, while NSP was not. HIV incidence decreased from 6.10 (95 %CI:3.56–9.77) to 1.49 (95 %CI:0.79–2.54) per 100 person-years between the first and second half of the study. Accessing NSP was associated with lower HIV incidence (adjusted hazard ratio=0.25; 95 %CI:0.087–0.58).</div></div><div><h3>Conclusions</h3><div>This study provides strong evidence for the benefits of NSP and OAT on varied HIV outcomes among PWID in Africa.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104824"},"PeriodicalIF":4.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in ketamine use among nightclub attendees in New York City, 2017–2024","authors":"Joseph J. Palamar","doi":"10.1016/j.drugpo.2025.104825","DOIUrl":"10.1016/j.drugpo.2025.104825","url":null,"abstract":"<div><h3>Background</h3><div>Ketamine-related poisonings and law enforcement seizures have been increasing in the United States, but population surveys suggest that recreational use has been rare with trends being relatively stable. This study aimed to estimate trends and correlates of use among nightclub attendees—a population known for high prevalence of party drug use.</div></div><div><h3>Methods</h3><div>Adults entering randomly selected nightclubs in New York City were surveyed in 2017 (<em>n</em> = 674), 2018 (<em>n</em> = 724), 2019 (<em>n</em> = 541), 2021 (<em>n</em> = 160), 2022 (<em>n</em> = 322), and 2024 (<em>n</em> = 911) (total <em>N</em> = 3332; 56.3 % male, 52.7 % age ≥26). Trends in lifetime, past-year, and past-month ketamine use were estimated using logistic regression, and correlates and trends in characteristics of people who used in the past month were also estimated.</div></div><div><h3>Results</h3><div>Between 2017 and 2024, lifetime ketamine use increased from 16.6 % to 22.7 % (a 36.7 % increase), past-year use increased from 7.4 % to 14.3 % (a 94.0 % increase), and past-month use increased from 3.1 % to 6.8 % (an 118.1 % increase, Ps&lt;0.001). Past-month use particularly increased among those aged ≥26 (by 222.0 %), females (by 216.6 %), those with a college degree (by 161.0 %), and among people who identify as bisexual or “other” sexuality (by 445.0 %), and among those who used cocaine (by 213.8 %), ecstasy/MDMA (by 94.9 %), and/or LSD (238.2 %) in the past month (Ps&lt;0.01). Identifying as gay/lesbian (aOR=2.03, 95 % CI: 1.19–3.48) and past-month use of cocaine (aOR=8.17, 95 % CI: 4.97–13.43) in particular were associated with increased odds for past-month use.</div></div><div><h3>Conclusions</h3><div>Recreational ketamine use is increasing among this population so an increased focus on both prevention and harm reduction is needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104825"},"PeriodicalIF":4.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restrictive and permissive alcohol policies during the COVID-19 pandemic and their association with alcohol consumption in the United States","authors":"Julia M. Lemp ,&nbsp;Carolin Kilian ,&nbsp;Sophie Bright ,&nbsp;William C. Kerr ,&nbsp;Laura Llamosas-Falcón ,&nbsp;Nina Mulia ,&nbsp;Jürgen Rehm ,&nbsp;Charlotte Probst","doi":"10.1016/j.drugpo.2025.104826","DOIUrl":"10.1016/j.drugpo.2025.104826","url":null,"abstract":"<div><h3>Background</h3><div>Early in the COVID-19 pandemic, alcohol researchers anticipated that psychological distress and changes in alcohol availability would impact alcohol consumption patterns. While psychological distress was expected to increase alcohol use, particularly among vulnerable groups, restrictive alcohol policies might have led to reduced consumption. This study examined the complex relationship between psychological distress, alcohol policies, alcohol consumption, and their interactions with sociodemographic factors during the COVID-19 pandemic in the US.</div></div><div><h3>Methods</h3><div>We used 2020–21 US Behavioral Risk Factor Surveillance System Survey (BRFSS, <em>N</em> = 726,962 adults) data to analyze associations between psychological distress, alcohol policy scores, and alcohol consumption, considering age, sex, education, race and ethnicity, and COVID-19 government response as covariates in a zero-inflated multi-level regression. State-level monthly alcohol policy scores derived from Alcohol Policy Information System data reflect the restrictiveness and permissiveness of alcohol policies implemented during the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>Psychological distress and exposure to restrictive policies increased the likelihood of abstaining from alcohol in the past month, although the observed effects were small. Among past-month drinkers, distress and restrictive policies were associated with slightly higher average daily consumption in pure alcohol grams/day. Younger respondents were more likely to abstain from alcohol when exposed to restrictive policies, while permissive policies correlated with higher drinking prevalence and heavy episodic drinking occurrence among those with higher education.</div></div><div><h3>Conclusion</h3><div>Alcohol policies and psychological distress during the COVID-19 pandemic were linked to both lower and higher alcohol consumption in different population subgroups. Restrictive and permissive policies had diverging associations with consumption patterns across subgroups. While effect sizes were modest, they could translate into meaningful changes in alcohol consumption at the population level, especially during prolonged times of crisis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104826"},"PeriodicalIF":4.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the need for overdose prevention centers in England: A qualitative community-based participatory study on the perspectives of people who use drugs in public and semi-public environments","authors":"Benjamin D. Scher ,&nbsp;Mat Southwell ,&nbsp;Magdalena Harris ,&nbsp;Alex Stevens ,&nbsp;Benjamin W. Chrisinger ,&nbsp;David K. Humphreys ,&nbsp;Gillian W. Shorter","doi":"10.1016/j.drugpo.2025.104816","DOIUrl":"10.1016/j.drugpo.2025.104816","url":null,"abstract":"<div><h3>Background</h3><div>Overdose prevention centres (OPCs) have been implemented as a harm reduction response in around 20 countries; with one just opened in the UK. In a context of rising rates of drug-related deaths, this study aimed to assess the need for an OPC in Sandwell, England, by examining the experiences and perspectives of local people who use drugs.</div></div><div><h3>Methods</h3><div>Qualitative data were collected through three focus groups, 20 street-based interviews with people who use drugs, and observations from four ethnographic field sessions. This was a community-based participatory project and included community consultation during study design and peer researcher participation during data collection, analysis and dissemination.</div></div><div><h3>Results</h3><div>Findings evidence how the threat of public and police interaction in semi-public drug use spaces leads to rushed injection practice, hampers poor venous access management, and increases risk of injection-related harms. Participants were enthusiastic about the concept of an OPC and its potential to reduce injecting-related risks, drug-related death, provide safety, and prevent traumatic experiences with police. Participants also highlighted concerns about negative public perceptions of their community, viewing an OPC as a potential solution to improving community relations by reducing drug-related litter.</div></div><div><h3>Conclusions</h3><div>There is an urgent need for OPC implementation, given current risks from rushed injection practices, the lack of safe spaces, and the increasing presence of nitazenes and other unexpected contaminants in the UK drug supply. The assertion from local people who drugs that an OPC would be an appropriate and effective intervention requires prioritisation by policymakers.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104816"},"PeriodicalIF":4.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction notice to “The impact of medically supervised injection centres on drug-related harms: A meta-analysis” [International Journal of Drug Policy Volume 59 (2018) 98-107]","authors":"Tom May,&nbsp;Trevor Bennett,&nbsp;Katy Holloway","doi":"10.1016/j.drugpo.2025.104829","DOIUrl":"10.1016/j.drugpo.2025.104829","url":null,"abstract":"<div><div>This article has been retracted: please see Elsevier Policy on Article Withdrawal (<span><span>https://www.elsevier.com/locate/withdrawalpolicy</span><svg><path></path></svg></span>).</div><div>This article has been retracted at the request of the Editor-in-Chief.</div><div>In light of two critical reviews received by the journal after publication (available on request), and additional commissioned independent assessments, the Journal has retracted the following paper from publication: May, T., Bennett, T. and Holloway, K. (2018) The impact of medically supervised injection centres on drug-related harms: A meta-analysis, 59: 98-107.</div><div>This action is supported by the authors’ acknowledgement of methodological weaknesses linked to the pooling of diverse outcomes into a single composite measure (authors’ response to critical reviews also available on request from the Editor). The authors have acknowledged that these analyses should not have been undertaken in this way and resulted from honest human error in the use of methods. Accordingly, the authors acknowledge that the combined effect size reported in the original paper should be discounted. Given that the composite measure was a key finding reported by the original paper, the decision to retract the paper from publication had been made, including with the consent of the authors. The journal acknowledges that the peer review process did not pick up on the specific methodological weaknesses identified post publication. The journal takes its peer review process extremely seriously. It is for this reason that the journal commissioned an independent assessment of the original paper in addition to the original peer review reports in order to assess whether to retract the paper.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104829"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Help-seeking among pregnant and parenting women who use drugs: Mitigating stigma through relationships","authors":"Emily Nichol ,&nbsp;Bernie Pauly ,&nbsp;Karen Milligan ,&nbsp;Karen Urbanoski","doi":"10.1016/j.drugpo.2025.104818","DOIUrl":"10.1016/j.drugpo.2025.104818","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant and parenting women who use drugs experience high rates of stigma when navigating the health care system, due to the gendered impacts of punitive drug policies and assumptions that conflate substance use with an inability to parent. There is a lack of research examining how stigma uniquely impacts pregnant and parenting women who use drugs, particularly with regards to self-efficacy and motivations to access health and social services, and other personal experiences of help-seeking processes. This study explores how stigma is internalized, anticipated, and embodied in the context of help-seeking, among pregnant and parenting women who use drugs.</div></div><div><h3>Methods</h3><div>Semi-structured telephone interviews were conducted from October 2020-February 2021 with current and past clients of integrated treatment programs in Ontario, designed for women who are pregnant and parenting young children (n = 24). Participants were asked to reflect upon their service experiences prior to COVID-19.</div></div><div><h3>Results</h3><div>Applying an interpretive description approach, the following themes emerged: (1) stigma and avoidance of help-seeking (2) stigma at the structural level: barriers to care and (3) mitigating stigma to enhance help-seeking: facilitating recovery through relationships.</div></div><div><h3>Conclusion</h3><div>Expressions of judgement have negative impacts on self-esteem and can foster internalized stigma, while disclosure of substance use in motherhood can threaten to damage interpersonal relationships. At the same time, supportive relationships can buffer against stigma-related harms. Service invisibility and implicit bias within the medical community further deter help-seeking, with negative past experiences compounding mistrust of the system. To promote conditions that are supportive of help-seeking and healthy outcomes for this population, compassion and empathy are critical.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104818"},"PeriodicalIF":4.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harms associated with injecting in public spaces: a global systematic review and meta-analysis","authors":"Mehrdad Khezri ,&nbsp;Sarah Kimball ,&nbsp;Courtney McKnight ,&nbsp;Saba Rouhani ,&nbsp;Amanda M. Bunting ,&nbsp;Mohammad Karamouzian ,&nbsp;Danielle C. Ompad ,&nbsp;Don Des Jarlais","doi":"10.1016/j.drugpo.2025.104819","DOIUrl":"10.1016/j.drugpo.2025.104819","url":null,"abstract":"<div><h3>Background</h3><div>Despite increasing backlash against harm reduction efforts and the need to understand the risk environments encountered by people who inject drugs (PWID), a quantitative systematic review on public injecting and associated health and drug-related outcomes is lacking. We aimed to summarize the global evidence on the prevalence and harms associated with injecting in public spaces.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Global Health, and Web of Science from inception to March 21, 2024. We pooled data from included studies using random-effects meta-analyses to quantify the associations between recent (i.e., current or within the last year) public injecting and associated outcomes. Public injecting was defined as injecting in public or semi-public spaces, including streets, parks, and abandoned buildings. Risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tool.</div></div><div><h3>Results</h3><div>Of the 6144 initial records, 84 studies were eligible for inclusion. The pooled prevalence of recent public injecting was 48.85 % (95 % confidence intervals [CI] 43.87, 53.85). Public injecting was associated with increased odds of recent non-fatal overdose (odds ratio [OR] 2.51, 95 % CI 2.01, 3.13), HCV infection (OR 1.55, 95 % CI 1.18, 2.02), recent needle/syringe sharing (OR 2.41, 95 % CI 1.97, 2.94), recent sex work (OR 1.75, 95 % CI 1.03, 2.97), recent incarceration (OR 2.10, 95 % CI 1.78, 2.47), and recent unstable housing/homelessness (OR 4.23, 95 % CI 3.17, 5.65). Public injecting showed a statistically non-significant association with HIV infection (OR 1.41, 95 % CI 0.80, 2.46). Public injecting was also associated with a higher willingness to use supervised injection facilities (OR 2.66, 95 % CI 1.86, 3.80).</div></div><div><h3>Conclusion</h3><div>Public injecting is prevalent among PWID and associated with various adverse drug- and health-related outcomes, highlighting the need for increased access to safe injection spaces. Findings support developing interventions to reduce harms from public injecting, such as addressing structural risks from law enforcement, expanding naloxone programs, and establishing overdose prevention centers. Housing interventions, in particular, could serve as an effective upstream strategy to reduce public injecting and related harms.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104819"},"PeriodicalIF":4.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of fentanyl in a stimulant landscape: Un/intentional use, social relations, and developing communities of care","authors":"Jennifer Syvertsen ,&nbsp;Alejandra Cabral ,&nbsp;Elijah Knaap ,&nbsp;Sergio Rey ,&nbsp;Robin A. Pollini","doi":"10.1016/j.drugpo.2025.104807","DOIUrl":"10.1016/j.drugpo.2025.104807","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of fentanyl into the unregulated drug supply has drastically altered drug landscapes across the United States and increasingly contributed to overdose. As part of a larger study about opioid overdose, we assessed how the emergence of fentanyl has shaped health outcomes and social relations in an underserved region of California.</div></div><div><h3>Methods</h3><div>From 2022–2024, we engaged in ethnographic fieldwork, surveys, and qualitative interviews with people 18+ years old and reporting opioid or stimulant use in the prior three months. We generated descriptive statistics and examined un/intentional fentanyl use among people using opioids (regardless of stimulant use) compared to those exclusively using stimulants. Qualitative interviews were thematically coded to lend insight into the social contexts of fentanyl use.</div></div><div><h3>Results</h3><div>Of 195 survey participants, 31 % were women, and 60 % identified as racialized groups, with an average age of 43; the qualitative sub-sample (<em>n</em> = 53 interviews) was similar. People using opioids were often initially unintentionally exposed to fentanyl through the heroin supply or prescription pills, but shifted to intentional use. People using stimulants attributed unintentional fentanyl use to adulterated methamphetamine, mistaking fentanyl for other drugs, and sharing smoking tools. Socially, fentanyl heightened overdose risk and fueled community stigma, while paradoxically instantiating forms of community care (i.e., overdose response, warning those experimenting with fentanyl).</div></div><div><h3>Conclusion</h3><div>Our research calls for evidence-based education about fentanyl, expanded access to harm reduction services, including community drug checking and safer smoking supplies, and low-barrier drug treatment as part of broader efforts to promote community care.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104807"},"PeriodicalIF":4.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From rejection to recognition: Human rights, morality, and the future of Marijuana policy in Indonesia","authors":"Aga Natalis ,&nbsp;Adventi Ferawati Sembiring ,&nbsp;Emy Handayani","doi":"10.1016/j.drugpo.2025.104817","DOIUrl":"10.1016/j.drugpo.2025.104817","url":null,"abstract":"<div><div>Historical evidence suggests that cannabis has been integrated into Indonesian cultural practices since the 14th century, particularly in Aceh, where it was used for medicinal, ceremonial, and agricultural purposes. Over time, public perception of cannabis has shifted significantly—from acceptance to prohibition. The cases of Fidelis Ari Sudarwoto and Santi Warastuti have reignited national discourse on the legalization of medical cannabis as a means of alleviating human suffering. This essay explores the moral and human rights dimensions of Indonesia’s cannabis policy and proposes an alternative moral framework. The transformation of societal attitudes toward cannabis is influenced by increasingly restrictive legal structures rooted in the colonial era, alongside the role of religious values in shaping policy decisions. The Constitutional Court’s rulings—specifically decisions No 106/PUU-XVIII/2020 and No 13/PUU-XXII/2024—highlight the complex interplay between legal regulations, cultural practices, and ethical considerations. A reformative approach grounded in human rights, legal ethics, and scientific evidence is crucial for an objective assessment of the potential social benefits of cannabis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104817"},"PeriodicalIF":4.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in cannabis attitudes and perceptions in the five years following recreational legalization in Canada: Findings from an observational cohort study of community adults","authors":"Amanda Doggett ,&nbsp;Kyla L. Belisario ,&nbsp;André J. McDonald ,&nbsp;Jane De Jesus ,&nbsp;Emily Vandehei ,&nbsp;Jessica Gillard ,&nbsp;Laura Lee ,&nbsp;James MacKillop","doi":"10.1016/j.drugpo.2025.104782","DOIUrl":"10.1016/j.drugpo.2025.104782","url":null,"abstract":"<div><h3>Background</h3><div>Social acceptability and perceived risks/benefits are key attitudinal factors that influence substance use, and a major concern about cannabis legalization is an increase in more favourable attitudes ultimately leading to greater cannabis misuse. This study investigated perceptions of cannabis acceptability and risks/benefits over the 5 years following legalization in Canada, the first G7 nation to have legalized cannabis nationally, in a longitudinal observational cohort of community adults.</div></div><div><h3>Methods</h3><div>Participants (60 % female, median age = 29, 48% reporting cannabis use pre-legalization) were non-clinical adults from the general community who were assessed up to 11 times from September 2018 to October 2023 (mean waves = 9.9). Overall temporal attitudinal changes and whether changes were moderated by pre-legalization cannabis use status were examined.</div></div><div><h3>Results</h3><div>Significant increases over time were present for social acceptability of any recreational cannabis use (OR [95% CI]: 1.06 [1.05, 1.07]) and trying cannabis (1.02 [1.01, 1.03]), while acceptability of medical cannabis use decreased (0.95 [0.94, 0.96]). Meanwhile, regular cannabis use was perceived as riskier (0.97 [0.96, 0.98]) and addiction potential was perceived as greater (0.94 [0.93, 0.95]) over time. Perceived health-related benefits of cannabis were significantly less likely to be endorsed over time, while there were significant increases in perceived risks, including exacerbating stress, anxiety, and depression; exacerbating existing medical conditions; and disrupting sleep. Moderator analyses found participants not using cannabis pre-legalization showed significantly steeper increases towards greater social acceptability of occasional and regular use, and less steep increases in endorsement of cannabis-related risks.</div></div><div><h3>Conclusions</h3><div>Shifting social acceptability of cannabis post-legalization in Canada is paralleled by increases in perceived health-related risks and decreases in perceived benefits. Continued surveillance of attitudinal changes following legalization in Canada is warranted to inform the impacts in the largest national legal cannabis jurisdiction as well as other jurisdictions considering regulatory reform.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104782"},"PeriodicalIF":4.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}