International Journal of Drug Policy最新文献

{"title":"“Either way, they will use. And so, probably, would you:” A critical discourse analysis of harm reduction portrayal in United States opinion news media","authors":"Hannah A. Carlon,&nbsp;Hanna M. Hebden,&nbsp;Nina C. Christie,&nbsp;Felicia R. Tuchman,&nbsp;David I.K. Moniz-Lewis,&nbsp;Cassandra L. Boness,&nbsp;Katie Witkiewitz,&nbsp;Margo C. Hurlocker","doi":"10.1016/j.drugpo.2025.104801","DOIUrl":"10.1016/j.drugpo.2025.104801","url":null,"abstract":"<div><h3>Background</h3><div>Opioid overdose deaths are declining in the United States for the first time in over five years. These reductions are partially attributed to increasing availability of harm reduction services, but services remain poorly implemented. The framing of issues in news media shapes public sentiment and uptake of services in policy and practice. The aims of this study were to: (1) content analyze United States opinion news media to describe overall attitudes towards and stigmatizing language about harm reduction; and (2) critically analyze discourses underlying articles with respect to stigma and harm reduction support.</div></div><div><h3>Methods</h3><div>Thirty-nine opinion articles across 17 United States newspapers on harm reduction published between May 2023 and April 2024 were included. Targeted analyzed content included attitudes toward harm reduction and stigmatizing language.</div></div><div><h3>Results</h3><div>Most articles had positive attitudes (32/39; 82.1 %), only 5/39 articles (12.8 %) were negative; two were balanced. Over half (22/39; 56.4 %) included stigmatizing language. Critical discourse analysis revealed pro-harm reduction articles were tied together by several threads: harm reduction strategies are evidence-based, do not increase crime, decrease stigma and systemic oppression, and policy change is needed to improve implementation. Among anti-harm reduction articles, discourses included: discriminatory stereotypes to portray opioid use and harm reduction depicted as enabling substance use, equating opioid use with crime, and dismissing systemic injustices influenced by punitive drug policy.</div></div><div><h3>Conclusions</h3><div>Contemporary United States opinion news media predominantly presents pro-harm reduction discourse, but often use stigmatizing language.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104801"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816808","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":"State adult-use cannabis policy effects on law enforcement efforts to disrupt drug markets","authors":"Barrett Wallace Montgomery,&nbsp;Pranav Athimuthu,&nbsp;Nicholas Richardson,&nbsp;Bradley Ray","doi":"10.1016/j.drugpo.2025.104802","DOIUrl":"10.1016/j.drugpo.2025.104802","url":null,"abstract":"<div><h3>Background</h3><div>Legalizing cannabis impacts law enforcement strategies on drug deterrence. While cannabis possession arrests have fallen post-legalization, findings on racial disparities are mixed. No research has yet investigated cannabis legalization effects on police behavior in the form of drug seizures, or how it may influence the enforcement of other drugs. We sought to evaluate the effect of cannabis legalization on drug seizures and their related disparities by race to understand how law enforcement have adjusted to this rapidly shifting legal landscape.</div></div><div><h3>Methods</h3><div>Drug seizure data were collected from the National Incident Based Reporting System (NIBRS) and include state, race, and drug types from 16 states with over 95 % population coverage for 2017–2022. Treatment and control assignments were determined by whether cannabis had been legalized for adult use between 2017 and 2022. Log seizure rates and Black-white risk ratios were calculated using census data. Two-way fixed effects difference-in-differences models robust to multiple treatment periods evaluated the effect of cannabis legalization on seizure rates and Black-white risk ratios.</div></div><div><h3>Results</h3><div>Our findings indicate that cannabis legalization significantly reduced overall drug seizures, particularly those involving cannabis. Of the other seizure types tested, only one non-cannabis drug seizure rate type was significant. We found a moderate yet significant decrease in the Black-white risk ratio for cannabis seizures, though all other racial disparities in seizure rates persisted after the legalization of cannabis.</div></div><div><h3>Discussion</h3><div>Cannabis legalization was associated with reduced drug seizures overall, driven by a large reduction in cannabis seizures. There was also a significant reduction in the Black-white risk ratio for cannabis seizures, though Black individuals remained at higher risk for all drug seizure types compared to white individuals. While expected to decrease without cannabis smell to prompt seizures, non-cannabis drug seizures were unchanged except for an increase in methamphetamine seizures not involving cannabis, potentially due to shifting enforcement priorities. These results suggest that cannabis policy reform can alleviate law enforcement burdens and may improve racial disparities in drug seizures to a small extent yet highlight the continued necessity for policies addressing systemic biases in drug enforcement.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104802"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816760","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 effectiveness of the communities that HEAL intervention on reducing non-fatal opioid overdoses: A prespecified secondary analysis of a waitlist cluster control randomized controlled trial","authors":"Louisa Gilbert ,&nbsp;Rouba Chahine ,&nbsp;Redonna Chandler ,&nbsp;Daniel J. Feaster ,&nbsp;Erin Kim ,&nbsp;Arnie Aldridge ,&nbsp;Sarah Bagley ,&nbsp;Peter Balvanz ,&nbsp;Soledad Fernandez ,&nbsp;Peter Rock ,&nbsp;Rachel A. Vickers-Smith ,&nbsp;Jennifer Villani ,&nbsp;Tracy Battaglia ,&nbsp;Jennifer Brown ,&nbsp;Heather Bush ,&nbsp;Rachel P. Chase ,&nbsp;Thomas Collins ,&nbsp;Lauren D'Costa ,&nbsp;Carolyn Damato-MacPherson ,&nbsp;James L. David ,&nbsp;Nabila El-Bassel","doi":"10.1016/j.drugpo.2025.104798","DOIUrl":"10.1016/j.drugpo.2025.104798","url":null,"abstract":"<div><h3>Introduction</h3><div>Along with a surge of opioid overdose deaths in the United States, the rates of nonfatal opioid overdose (NFOO) emergency department (ED) visits and hospitalizations have been sharply increasing.</div></div><div><h3>Methods</h3><div>In the HEALing Communities Study (HCS), we conducted a pre-specified secondary analyses to evaluate the effectiveness of the Community that HEALS (CTH) intervention on reducing the count of NFOO ED visits and hospitalizations in a multi-site cluster randomized multi-site, two-arm, parallel, community-level, open, wait list-controlled trial study, Sixty-seven communities in Kentucky, Massachusetts, New York, and Ohio were randomized to the intervention (<em>N</em> = 34) or waitlist control condition (<em>N</em> = 33) stratified by state and balanced by urban/rural classification, fatal opioid overdose rate and population size of communities. We compared the rate of NFOO per 100,000 adults aged ≥18 years between intervention and control communities from July 1, 2021, to June 30, 2022. Rates were calculated in per 100,000 or per 100 adult population measured by inpatient and ED records for intervention community residents with an ICD-10-CM code for opioid poisoning.</div></div><div><h3>Results</h3><div>Compared to control communities, intervention communities had 15 % fewer NFOO per capita (aRR = 0.85; 95 % CI = [0.74,0.96]; p-value=0.013). Effect modifications by state, urban/rural status, sex, age, race and ethnicity were not significant.</div></div><div><h3>Discussion</h3><div>These findings suggest the intervention reduced NFOO ED visits and hospitalizations. The lack of effect modifications suggests that the intervention may be effective in a wide range of communities in the U.S. Further research is needed to identify the mechanisms through which the intervention reduces NFOO.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifier: NCT04111939.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104798"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821492","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":"Patterns of opioid toxicity deaths after the implementation of COVID-19 emergency measures in Ontario, Canada: a weekly interrupted time series","authors":"Valeria Rolle ,&nbsp;Nicholas Bakewell ,&nbsp;Yingbo Na ,&nbsp;Mohammad Karamouzian ,&nbsp;Orville Burke ,&nbsp;Seff Pinch ,&nbsp;Dan Werb ,&nbsp;Sanjana Mitra","doi":"10.1016/j.drugpo.2025.104797","DOIUrl":"10.1016/j.drugpo.2025.104797","url":null,"abstract":"<div><h3>Background</h3><div>In March 2020, Ontario, Canada, implemented COVID-19 public health measures, including school and non-essential business closures, physical distancing, border restrictions, and modified health services. We examined their association with changes in opioid toxicity mortality and assessed variations across age, sex, health region, and drug type.</div></div><div><h3>Methods</h3><div>We conducted an interrupted time series using opioid toxicity death records (March 2019 to February 2021) from the Office of the Chief Coroner for Ontario. Using a generalized linear model (Poisson or negative binomial), we estimated changes in weekly death counts following the first (March 17th to May 19th, 2020) and second (November 23rd, 2020, to February 14th, 2021) lockdowns, as well as the entire post-COVID-19 period, modelling interventions as level shifts in opioid toxicity deaths.</div></div><div><h3>Results</h3><div>Of 3844 individuals who died within the study period, 74.4 % were male, and the median age was 40 (interquartile range: 31 to 51). Weekly deaths ranged from 9 to 72. Following the province-wide state of emergency and first lockdown, there was a step increase in the number of deaths, with an estimated Rate Ratio (RR) of 1.21 (95 % CI 1.02 to 1.52). Over the duration of the post-COVID-19 period, an overall sustained increase in the number of opioid toxicity deaths (RR 1.11 [95 % CI 1.02 to 1.41]) was observed across the province.</div></div><div><h3>Implications</h3><div>The period after initial COVID-19 measures was associated with increases in opioid toxicity mortality. Future responses to public health emergencies must proactively mitigate the potential unintended consequence of toxic drug-related harms among substance-using populations.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104797"},"PeriodicalIF":4.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799674","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":"Recruiting opioid treatment program administrators for a national survey: Outcomes and lessons learned","authors":"Benjamin R Brady ,&nbsp;Beth E Meyerson ,&nbsp;Alissa Davis ,&nbsp;Greg A Carter ,&nbsp;Sara Najar ,&nbsp;Alexa Martinez ,&nbsp;Caleb Mueller ,&nbsp;Elias O Higbie ,&nbsp;Holden Dal Ponte ,&nbsp;Khino Moneva ,&nbsp;Natalia C Bentz ,&nbsp;Linnea B Linde-Krieger ,&nbsp;Zhanette Coffee ,&nbsp;Arlene N Mahoney ,&nbsp;David Frank ,&nbsp;Richard A Crosby","doi":"10.1016/j.drugpo.2025.104799","DOIUrl":"10.1016/j.drugpo.2025.104799","url":null,"abstract":"<div><h3>Background</h3><div>Globally, access to opioid use disorder treatment remains insufficient. In the US, recent policy changes for opioid use disorder treatment present opportunities to improve patient access to evidence-based methadone treatment. To evaluate the adoption and sustained implementation of these changes, access to a national, representative sample of opioid treatment programs (OTPs, ‘methadone clinics’) is essential. This study reports the outcomes of a recruitment effort for a national sample of OTP administrators.</div></div><div><h3>Methods</h3><div>A stratified random sample of 1000 OTPs was drawn from the US Substance Abuse and Mental Health Services Administration's National Opioid Treatment Program Directory. Stratification was based on state-level OTP regulations and county-level opioid overdose rates. OTPs identified as tribal serving, located in jails or prisons, or requiring corporate approval for research participation were deemed ineligible and excluded from the sample. A team of trained researchers called OTP clinics seeking to speak with administrators and obtain their email addresses for study recruitment.</div></div><div><h3>Results</h3><div>In the sample, 885 OTPs were eligible for study recruitment. We contacted a live person by phone at 73 % of OTPs and an administrator at 23 %. Of the administrators reached, 77 % agreed to receive study information and 22 % completed the survey. Total caller time was 276.5 hours at a cost of $5530.</div></div><div><h3>Conclusion</h3><div>Despite a rigorous sampling frame, and a costly and considerable effort, US OTP recruitment outcomes were suboptimal. Innovative strategies are needed to improve administrator recruitment. Recommendations include updating the SAMHSA directory to include administrator contact information (name, phone, email), using diverse outreach methods, and refining call scripts to improve engagement.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104799"},"PeriodicalIF":4.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of stigmatization among people who use drugs in the initial year of British Columbia's drug decriminalization policy: A qualitative study","authors":"Farihah Ali ,&nbsp;Cayley Russell ,&nbsp;Savannah Torres-Salbach ,&nbsp;Margret Lo ,&nbsp;Matthew Bonn ,&nbsp;Geoff Bardwell ,&nbsp;Juls Budau ,&nbsp;Elaine Hyshka ,&nbsp;Jürgen Rehm","doi":"10.1016/j.drugpo.2025.104791","DOIUrl":"10.1016/j.drugpo.2025.104791","url":null,"abstract":"<div><h3>Background</h3><div>On January 31, 2023, Health Canada approved a three-year pilot decriminalization initiative allowing adults in British Columbia (BC), Canada, to legally possess a cumulative 2.5 g of opioids, cocaine, methamphetamine, or MDMA. The policy aims to reduce the harms associated with drug use, including stigma, which contributes to barriers for people who use drugs in accessing harm reduction and treatment services. Addressing stigma is considered a crucial step in mitigating BC's overdose crisis, by encouraging people who use drugs to feel more comfortable to access and utilize services without fear of judgment. This study examined the impacts of the decriminalization policy on stigma among people who use drugs within the first year of implementation.</div></div><div><h3>Methods</h3><div>From October 2023 to February 2024, 100 semi-structured telephone interviews and brief socio-demographic surveys with people who use drugs from across BC were conducted to explore their experiences of stigmatization post-decriminalization. A qualitative thematic analysis was used to synthesize the data.</div></div><div><h3>Results</h3><div>Findings revealed that societal, structural and self-stigma remain pervasive among people who use drugs post-decriminalization. While most participants reported little change in their experiences of stigma since the policy's implementation, some reported an increase, while others observed a decrease across all forms of stigma. Increased stigma was attributed to perceived heightened visibility of public drug use, which amplified societal stigma. Conversely, decreased stigma was linked to shifting public perceptions of drug use as a public health issue and more humanized interactions with the police. Despite mixed experiences, participants remained optimistic that the policy could contribute to long-term stigma reduction and offered recommendations to support this goal.</div></div><div><h3>Conclusion</h3><div>While decriminalization has the potential to reduce stigma and increase comfort in accessing critical harm reduction and substance use treatment services among people who use drugs, achieving these outcomes requires additional efforts. Public awareness campaigns, targeted anti-stigma education, and broader systemic changes were suggested by participants as essential to address stigmatization in BC. Strengthening these areas could enhance access to and utilization of services, ultimately supporting the broader goals of decriminalization.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104791"},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transnational alcohol corporations in Nigeria as commercial determinants of health: Implications for policy","authors":"Emeka W. Dumbili","doi":"10.1016/j.drugpo.2025.104792","DOIUrl":"10.1016/j.drugpo.2025.104792","url":null,"abstract":"<div><div>Research on commercial determinants of health (CDoH) has burgeoned in the Global North. However, despite the heavy presence of harmful commodity industries in Africa, little scholarly attention has been paid to CDoH. Transnational alcohol corporations (TNACs) in Nigeria deploy well-articulated marketing strategies and practices that negatively impact health in their quest for profit maximisation, wealth extraction and influence. Nevertheless, their tactics and practices are largely unregulated and understudied. This commentary demonstrates how TNACs in Nigeria are a key pervasive and harmful CDoH, highlighting the policy implications of their strategies and practices. Focusing on changing norms that constrain young people's drinking, TNACs promote hazardous drinking practices by using drinking games as a marketing strategy where the winners receive more alcohol and money as prizes. Alcohol corporations also encourage sexual risk-taking and associated harm by marketing <em>alcoholic bitters</em> as aphrodisiacs and sex enhancers. From 2014 to 2016, one TNAC organised the annual Nigerian Beer Symposium, spreading misleading information that beer consumption prevents cancer, reduces kidney stones, and improves women's skin beauty. Furthermore, through partnerships with the government, TNACs appear to use industry-led corporate social responsibility (CSR) initiatives to lobby officials, enhance corporate reputations, sustain pro-drinking framings, disinformation/misinformation and self-regulation, and silence discussions on alcohol policy implementation. While TNACs’ products and practices negatively impact health/equities, decision-makers appear to enable their enormous power. The government should embrace evidence against TNACs as CDoH, implement policies to regulate them and collaborate with civil society organisations/advocates to hold them to account. Relatedly, the government should hold TNACs to account through international mechanisms because most of their practices violate laws in the Global North countries where they are headquartered.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776597","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":"Association of recreational cannabis legalization with changes in medical, illegal, and total cannabis expenditures in Canada","authors":"André J. McDonald ,&nbsp;Alysha Cooper ,&nbsp;Amanda Doggett ,&nbsp;Jillian Halladay ,&nbsp;Kyla Belisario ,&nbsp;James MacKillop","doi":"10.1016/j.drugpo.2025.104793","DOIUrl":"10.1016/j.drugpo.2025.104793","url":null,"abstract":"<div><h3>Background</h3><div>Recreational cannabis legalization (RCL) is being adopted by a growing number of jurisdictions internationally. RCL aims to displace the illegal cannabis market and has the potential to disrupt the medical market, yet few studies have examined these dynamics empirically.</div></div><div><h3>Methods</h3><div>We used interrupted time series analysis to evaluate whether RCL (legislative passage in October 2017/implementation in October 2018) was associated with changes in quarterly national household expenditures on medical cannabis, illegal cannabis, and all cannabis types combined (licensed, illegal, and medical) in Canada from 2001 to 2023, adjusting for price fluctuations.</div></div><div><h3>Results</h3><div>When RCL was passed, medical cannabis represented 11.8 % of the market and illegal cannabis 88.2 %. At five years post-RCL implementation, medical cannabis decreased to 3.7 %, illegal cannabis decreased to 24.3 %, and licensed cannabis took over 72.0 % of the market. The overall cannabis market increased in size by 75 % over these 5 years. Illegal cannabis expenditures increased between RCL passage and implementation but decreased immediately post-implementation and had a significant decreasing trend. Medical cannabis had a significant decreasing trend following RCL passage, and to a lesser extent following RCL implementation. Total cannabis expenditures increased immediately following RCL implementation and showed a significant increasing trend over time. Some caution should be used in interpreting these findings given uncertainty in data quality, particularly for illegal cannabis expenditures (and overall expenditures by extension).</div></div><div><h3>Conclusions</h3><div>Recreational cannabis legalization in Canada appears to be achieving one of its primary goals by displacing the illegal cannabis market, and medical users also appear to be transitioning to the recreational market. However, overall cannabis expenditures have also grown substantially since legalization, which could have adverse implications for public health.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104793"},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Delta-8-THC warning labels on perceived intoxication, harm, and susceptibility among adolescents","authors":"Alyssa F. Harlow ,&nbsp;Adam M. Leventhal ,&nbsp;Jessica L. Barrington-Trimis","doi":"10.1016/j.drugpo.2025.104781","DOIUrl":"10.1016/j.drugpo.2025.104781","url":null,"abstract":"<div><h3>Background</h3><div>Youth use of hemp-derived cannabis products containing psychoactive Δ8-tetrahydrocannabinol (delta-8-THC) is prevalent in the United States (US). Delta-8-THC is intoxicating, however delta-8-THC products are not subject to warning labeling requirements in many US states. This experiment determined effects of hypothetical cannabis warning labels on perception of delta-8-THC gummies and vape products.</div></div><div><h3>Methods</h3><div>A mixed within-between-subject experiment was embedded into a 2023 survey of 3,647 Southern California adolescents. Participants were randomized to view photos of delta-8-THC edible and vape products under one of three conditions (control [unmodified] vs. standard size warning label [universal cannabis warning symbol, government warning text, instructions for use, and text stating it was cannabis-infused] vs. larger warning label [same as standard label with larger cannabis warning symbol]). After image exposure, we measured anticipated intoxication, perceived harm, and susceptibility to use the respective delta-8-THC products. Moderation by product type and cannabis use status were assessed.</div></div><div><h3>Results</h3><div>Youth who viewed delta-8-THC products with larger warning labels (vs. control) reported greater anticipated intoxication (Mean Difference[MD]==2.50, 95 %CI=0.85–4.14 on 100-point scale), and higher likelihood that delta-8-THC products are bad for their health (Risk Ratio[RR]=1.07, 95 %CI=1.02–1.12), pose at least some risk (RR=1.03, 95 %CI: 1.01–1.05), and are the same or more harmful than marijuana (RR=1.04, 95 %CI=1.01–1.07). There were no warning label effects on susceptibility and minimal differences across outcomes between larger versus standard warning labels. Warning label effects on perceived harm were stronger for delta-8-THC gummies (vs. vape) and for never vs. ever cannabis-using youth (interaction p-values &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Requiring delta-8-THC products to conform to labeling requirements for cannabis products may increase understanding of their intoxicating effects and harm among cannabis-naïve youth. In lieu of federal regulations, states should consider implementation of delta-8-THC regulations such as labeling requirements that promote safety and reduce potential harm to youth.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104781"},"PeriodicalIF":4.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769005","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":"Structural and healthcare predictors of substance use-related death following release from incarceration: A retrospective cohort study in Rhode Island, 2018–2020","authors":"Lauren Brinkley-Rubinstein ,&nbsp;Katherine LeMasters ,&nbsp;Justin Berk ,&nbsp;Sara N. Levintow ,&nbsp;Sarah Martino ,&nbsp;Rahul Vanjani","doi":"10.1016/j.drugpo.2025.104783","DOIUrl":"10.1016/j.drugpo.2025.104783","url":null,"abstract":"<div><h3>Background</h3><div>Incarcerated individuals are at a high risk of substance use-related death after release. While prior research has demonstrated that this is partially due to loss of tolerance during incarceration and return to use after release, structural and healthcare use factors that may also impact overdose risk have been underexplored. We assessed the relationship between structural factors (e.g., housing services received) and health care use (e.g., emergency department use) and overdose risk at 12-months post-incarceration in Rhode Island in the United States.</div></div><div><h3>Methods</h3><div>We used a retrospective cohort study design. Rhode Island Department of Corrections (RIDOC) data were linked with individual-level data across state agencies. Cumulative incidence of substance use-related death was estimated as a function of structural and healthcare factors using hazard ratios from cause-specific cox landmark models for dynamic predictions.</div></div><div><h3>Results</h3><div>There were 9696 individuals in the analytic sample. Most deaths that occurred within 12 months post-release involved substance use (<em>N</em> = 96). People who had more previous incarcerations had a higher risk of substance use-related death. Reporting taxable wages (aHR: 0.52; 95 % CI: 0.25, 1.09) was weakly associated with in a lower risk of substance use-related death while being admitted to the hospital (aHR: 1.79; 95 % CI: 0.91, 3.53) was weakly associated with a slightly higher risk of substance use-related death 12-months post-release.</div></div><div><h3>Conclusion</h3><div>Structural factors were weakly associated with reduced risk of substance use-related death post-release from incarceration. Conducting needs assessments (e.g., identifying employment needs) and interventions (e.g., employment training programs) prior to or at release that address these structural factors are critical for reducing this risk. Further, these findings contribute to the evidence that decarceration should be used a public health tool given the high risk of substance use-related death post-release.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104783"},"PeriodicalIF":4.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769004","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}