International Journal of Drug Policy最新文献

{"title":"Emerging new psychoactive ketamine analogues: patterns of use and health risks identified by the French Addictovigilance Network.","authors":"Salim Mezaache, Liselotte Pochard, Hélène Peyrière, Nathalie Fouilhé Sam-Laï, Joëlle Micallef","doi":"10.1016/j.drugpo.2026.105326","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105326","url":null,"abstract":"<p><strong>Background: </strong>Ketamine analogues are emerging dissociative substances structurally related to ketamine and increasingly detected on drug markets worldwide. This study aimed to characterize patterns of use, user profiles, and associated health outcomes in France.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of cases involving ketamine analogues reported to the French Addictovigilance Network up to 31 December 2024. Substances of interest included 2-fluorodeschloroketamine (2-FDCK), deschloroketamine (DCK), N-ethyldeschloroketamine (O-PCE), fluorexetamine (FXE), and hydroxetamine (HXE). Cases were reported by healthcare professionals and reviewed by clinical pharmacologists. Data were extracted from the French National Pharmacovigilance Database and the DRAMES (drug-related deaths) registry.</p><p><strong>Results: </strong>Fifty-six cases were identified from 2017 to 2024, predominantly involving 2-FDCK (52 %) and O-PCE (38 %). Most users were men (93 %), with a mean age of 32.1 years (range: 17-57). Adverse effects were mainly neurological and psychiatric, including dissociation and impaired consciousness. Serious cases accounted for 61 %, including 11 % deaths recorded in the DRAMES registry. Four user profiles were identified through qualitative analysis of case narratives: recreational experimenters, self-medicating individuals, regular users, and individuals unintentionally exposed to adulterated or substituted substances (e.g., sold as synthetic cathinones, cocaine or ketamine). Unintentional exposure, particularly in chemsex contexts, was frequently associated with distressing experiences.</p><p><strong>Conclusions: </strong>Ketamine analogue use is increasing in France, consistent with international trends. These substances pose significant health risks, potentially differing from or exceeding those of ketamine. Strengthened surveillance, improved analytical detection, and targeted harm reduction strategies are needed to mitigate their public health impact.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105326"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844706","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":"Pleasure, shame and harm reduction: A qualitative investigation of poppers and sexualized drug use among men who have sex with men in China.","authors":"Danyang Luo, Qiang Fu, Yunqing Fei, Ligang Yang, Don Operario, M Kumi Smith, Rayner Kay Jin Tan","doi":"10.1016/j.drugpo.2026.105306","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105306","url":null,"abstract":"<p><p>This qualitative study explores the sociocultural meanings and harm-reduction practices surrounding poppers use among men who have sex with men (MSM) in China. Twenty in-depth interviews conducted in Guangzhou reveal that poppers are experienced as both a routine facilitator of sexual pleasure and intimacy, and a source of moral tension. Participants valued the physiological and psychological effects that enhanced receptive anal sex and emotional connection, yet described these benefits often give way to heightened sexual risk, internalized shame, and subsequent guilt. Stigmatizing public health discourses and a restrictive national drug policy context amplified this ambivalence, framing poppers use as deviant and shameful. Despite these challenges, participants demonstrated agency through self-regulation, peer-based harm reduction, and demands for credible, nonjudgemental information. These findings situate poppers use within a complex interplay of pleasure, stigma, and regulation, underscoring the need for culturally grounded, community-led harm reduction that affirms agency and wellbeing.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105306"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844724","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":"Family-centered interventions for people with substance use disorders in low-and middle-income country settings: a scoping review.","authors":"Ashley Sharma, Carol Mita, Kennedy Dozier, Roshni Singh, Anand Chukka, Ramya Ramadas, Sonia Taneja, Abigail Batchelder, Sarah M Bagley, Aishwarya Thakur, Matthew C Sullivan, Satish Kumar Sk, Sunil S Solomon, Kenneth H Mayer, Conall O'Cleirigh, Areej Hassan, Lakshmi Ganapathi","doi":"10.1016/j.drugpo.2026.105298","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105298","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders (SUD) present a significant global health challenge, impacting people who use drugs (PWUD) and their families. While family-centered interventions have shown positive outcomes in high-income countries, their application in low-and middle-income countries (LMICs) remains unexplored. This scoping review sought to synthesize existing research evaluating family-centered interventions for PWUD in LMICs.</p><p><strong>Methods: </strong>A comprehensive search was conducted across 6 databases. From 4838 titles and abstracts initially screened, 101 full texts were examined for eligibility. Data was extracted from 20 studies (14 quantitative, 3 qualitative, and 3 mixed method). For qualitative studies, a codebook was developed, and two coders applied thematic analysis principles to identify key themes.</p><p><strong>Results: </strong>Family-centered interventions were heterogenous in treatment approaches, interventionist training, and duration. Findings revealed improvements in SUD knowledge and outcomes (e.g., increased smoking abstinence, decreased alcohol use and relapse rates). Psychosocial outcomes included improved quality of life, stronger family support, improved communication, and problem-solving skills, as well as reduced depressive symptoms, contributing to PWUD emotional well-being. Qualitative studies corroborated these findings and highlighted multi-level implementation barriers including logistical challenges (transport barriers, competing responsibilities), financial insecurity, mistrust in services, and limited provider capacity.</p><p><strong>Conclusions: </strong>Family-centered interventions show promise in improving substance use and psychosocial outcomes among PWUD in LMICs. However, further research is needed to address challenges in effective implementation including ameliorating barriers to sustained engagement and support for long-term recovery to ensure durable effectiveness.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105298"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844708","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":"Author response to commentary on 'Sustained effects of a community-based intervention targeting illicit drugs in nightlife: A 20-year cross-sectional follow-up of 'Clubs against Drugs''.","authors":"Tobias H Elgán, Johanna Gripenberg","doi":"10.1016/j.drugpo.2026.105319","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105319","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105319"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844679","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":"Anti-Latine bias and drug-induced homicide law support: Evidence from a nationally diverse, randomized survey experiment in the United States.","authors":"Kim Gannon, Gregg Gonsalves, Susan H Busch, Mark J Schlesinger","doi":"10.1016/j.drugpo.2026.105297","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105297","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced homicide laws, which hold people criminally responsible for overdose deaths linked to drugs they distribute, are a prominent feature of modern United States drug policy. Some are concerned that support for these laws is bolstered by racialized assumptions about people who sell drugs. The current study examines whether and how the perceived race-ethnicity of a suspected \"drug dealer\" affects support for drug induced homicide laws.</p><p><strong>Methods: </strong>Participants (n = 2940) recruited from Cint Theorem were randomized to one of four vignettes which varied the race-ethnicity of a suspect who distributed drugs connected to an overdose death (Latine, Black, white, or unidentified race). Participants answered questions about their general support for a drug-induced homicide law as well as several determinants of support: beliefs about deterrence, moral justification, preference for the \"homicide\" charge name, and desire for additional incarceration.</p><p><strong>Results: </strong>Compared to those shown a non-Latine suspect, respondents shown a Latine suspect had significantly greater odds of supporting drug-induced homicide laws, believing they are morally justified, and desiring additional incarceration, but were statistically indistinguishable for beliefs about deterrence and preference for the \"homicide\" charge name. Results were driven by non-Hispanic respondents.</p><p><strong>Conclusion: </strong>This is the first study of its kind to consider the Latine community as a target of punitive drug policy bias. These results suggest that race- and ethnicity-based assumptions continue to influence public opinion about drug policy, echoing the punitive racialization patterns of past \"wars\" on drugs.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105297"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844649","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":"Criminalization of abortion drugs and the politics of governing women's bodies: A biopolitical analysis of abortion regulation and its implications for Indonesia.","authors":"Aga Natalis","doi":"10.1016/j.drugpo.2026.105311","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105311","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105311"},"PeriodicalIF":4.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844677","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":"Whose wine is it anyway? Examining private label cask wine ownership among Australian alcohol retailers.","authors":"Alexandra Torney, Robin Room, Sarah Callinan, Tina Lam","doi":"10.1016/j.drugpo.2026.105300","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105300","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol pricing policies are recognised as effective strategies for reducing consumption and alcohol-related harms, with their strongest impact concentrated across the lowest-priced products. Across many retail markets, low-cost alcohol is increasingly supplied through retailer-owned (private-label) brands, yet there is little research on how ownership structure relates to pricing at the product level.</p><p><strong>Methods: </strong>Product-level pricing data for cask wine sold by major Australian online alcohol retailers over a month were collected through a commercial web-scraping partnership. Products were classified as retailer-owned or independently owned using trademark records and publicly available ownership information. Prices were standardised to price per standard drink, and analyses were run to compare pricing across ownership types.</p><p><strong>Results: </strong>Retailer-owned products accounted for 42% of all cask wine products listed across major retailers and were consistently and significantly cheaper per standard drink than independently owned products.</p><p><strong>Conclusion: </strong>The lowest-priced cask wine products sold by major retailers were predominately retailer-owned. These findings suggest that pricing-based alcohol policies targeting cheap alcohol in Australia would likely have a larger impact on retailer-owned private-label products rather than independent brands.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105300"},"PeriodicalIF":4.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822422","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":"Re-imagining poppers regulation in Canada: Perspectives from pharmacists, pharmacy students and public health practitioners.","authors":"Timothy Lim, Kristy Scarfone, Jordan Ramnarine, Cameron Schwartz, Alexander Burke, Tyiesha Wright, Alexa Harvey, Tristan Lai, Emmanuel Thibaudeau, Jaris Swidrovich","doi":"10.1016/j.drugpo.2026.105308","DOIUrl":"https://doi.org/10.1016/j.drugpo.2026.105308","url":null,"abstract":"<p><p>Alkyl nitrites, commonly known as poppers, remain widely used in Canada despite regulatory prohibitions that restrict their sale as prescription-only substances. This incongruence between policy and practice has contributed to unregulated supply chains, product contamination, and missed opportunities for harm reduction - particularly among gay, bisexual, and other men who have sex with men, who use poppers at higher rates. This commentary examines the implications of reclassifying poppers as Schedule II drugs, permitting pharmacist-mediated, non-prescription access, drawing on perspectives from pharmacists, pharmacy students, and public health practitioners. It comes at a time where retrenchments in provincial harm reduction efforts, like British Columbia's end of its drug decriminalization and similar reversals in harm reduction programs in Ontario, are occurring. We explore four intersecting domains: public health implications, professional responsibilities, harm reduction, and patient rapport. A regulated pharmacy model could improve product quality, strengthen pharmacovigilance, and support real-world monitoring of adverse events; however, longstanding challenges such as under-reporting, inconsistent documentation of Schedule II products, and operational barriers may limit the robustness of these data. Pharmacists' clinical responsibilities would require careful clinical assessment, while balancing ethical principles and patient autonomy. Within a harm-reduction framework, pharmacists could offer tailored counselling on safer use, sexual health strategies, and polysubstance risks. Yet, meaningful implementation requires addressing stigma, gaps in cultural competency, and variability in pharmacists' comfort discussing sexualized drug use. Ultimately, pharmacist-led provision of poppers has the potential to enhance safety, accessibility, and sexual well-being, but must be accompanied by targeted training, supportive infrastructure, and community-informed approaches to ensure equitable and effective practice.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"153 ","pages":"105308"},"PeriodicalIF":4.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822479","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":"It's Your Right - implementation and outcomes of a co-designed national Australian hepatitis C health promotion campaign.","authors":"Louisa Walsh, Shannon Christensen, Troy Combo, Jacqui A Richmond, Chris Gough, John Gobeil, Jane Dicka, Carol Holly, Peter Sidaway, Joseph S Doyle, Margaret Hellard, Emily Adamson, Alisa Pedrana","doi":"10.1016/j.drugpo.2026.105245","DOIUrl":"10.1016/j.drugpo.2026.105245","url":null,"abstract":"<p><strong>Background: </strong>In 2022, an estimated 74,400 people in Australia were living with hepatitis C. Despite an initial rapid uptake of direct acting antiviral treatment after their approval for use in Australia in 2016, national hepatitis C testing and treatment rates have declined since 2019. In response, It's Your Right, a national health promotion campaign co-designed with and for people with lived-living experience of injecting drug use and/or hepatitis C, was implemented in all Australian states and territories in 2022. This article presents outcomes of the campaign.</p><p><strong>Methods: </strong>A mixed methods evaluation was co-designed with peer workers from peer-led drug user organisations and community-based hepatitis organisations. Campaign outcomes included analysis of social marketing reach data, hepatitis C testing and treatment data, and client survey.</p><p><strong>Results: </strong>It's Your Right demonstrated wide reach with >8.9 million people seeing the campaign. The campaign was memorable - 53 % of clients from the implementing organisations who were surveyed demonstrated unprompted campaign recall, while 72 % remembered the campaign when prompted. Implementing organisations documented 2595 conversations about hepatitis C with clients, conducted 1343 hepatitis C tests, referred 151 people for treatment, and utilised 1254 incentives to engage clients in hepatitis C care during the campaign period. Thirty-eight percent of survey participants spoke to a peer worker, and 31 % accessed testing, due to seeing the campaign.</p><p><strong>Conclusion: </strong>It's Your Right was highly valued by implementing organisations and reached people in the community who inject drugs. The campaign inspired people to seek out support from peer workers and take up hepatitis C testing.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"151 ","pages":"105245"},"PeriodicalIF":4.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500309","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":"Emergence of xylazine in accidental overdose deaths, impaired drivers, sexual assaults, and public intoxications within San Francisco","authors":"Tyler Devincenzi ,&nbsp;Luke N. Rodda","doi":"10.1016/j.drugpo.2026.105184","DOIUrl":"10.1016/j.drugpo.2026.105184","url":null,"abstract":"<div><h3>Background</h3><div>Xylazine, a veterinary sedative and alpha-2 adrenergic receptor agonist not approved for human use, has emerged as a significant adulterant in the illicit fentanyl supply across the United States. While its presence has been well documented on the East Coast, systematic reporting from California remains limited.</div></div><div><h3>Objective</h3><div>This study characterizes the emergence, prevalence, and concentration trends of xylazine in forensic casework in San Francisco from 2022 January to 2024 December, and describes polysubstance patterns associated with its use.</div></div><div><h3>Design</h3><div>We retrospectively analyzed up to thirty-six (36) months of routine comprehensive toxicological testing for over 200 drugs/metabolites performed on all xylazine-positive accidental overdose deaths (AOD), driving under the influence of drugs (DUID), drug-facilitated sexual assault (DFSA), and public intoxication (PI) cases within the City and County of San Francisco, totaling 314 cases.</div></div><div><h3>Results</h3><div>Xylazine detections increased across all case types from 2023 to 2024 and rose steadily in AOD cases from 2022 through 2024. The majority of xylazine-positive cases were AOD. Mean and peak xylazine concentrations demonstrated year-to-year increases, with peak AOD blood and urine concentrations observed up to 31 and 2100 ng/mL, respectively. All xylazine-positive cases co-occurred with fentanyl, a fentanyl precursor or metabolite, or a fentanyl analog. Additionally, 71% of these cases involved five to eight additional drug classes.</div></div><div><h3>Discussion</h3><div>Xylazine has rapidly infiltrated the San Francisco illicit fentanyl supply and is frequently present in polysubstance use patterns. Rising prevalence and increasing concentrations indicate evolving market dynamics, with implications for overdose risk and forensic and public health surveillance.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105184"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192068","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}