International Journal of Drug Policy最新文献

{"title":"Prevalence and correlates of multiple injections per injection episode among people who inject drugs in rural U.S. communities","authors":"L. Sarah Mixson ,&nbsp;William Zule ,&nbsp;Stephanie A. Ruderman ,&nbsp;Judith Feinberg ,&nbsp;Thomas J. Stopka ,&nbsp;Adams L. Sibley ,&nbsp;Suzan M. Walters ,&nbsp;Georgiy Bobashev ,&nbsp;Ryan Cook ,&nbsp;Karli R. Hochstatter ,&nbsp;Carolyn A. Fahey ,&nbsp;Lawrence J Ouellet ,&nbsp;Rob Fredericksen ,&nbsp;Hannah L.F. Cooper ,&nbsp;April M. Young ,&nbsp;Jon Zibbell ,&nbsp;Dalia Khoury ,&nbsp;Peter D. Friedmann ,&nbsp;William C. Miller ,&nbsp;P. Todd Korthuis ,&nbsp;Joseph Delaney","doi":"10.1016/j.drugpo.2025.104837","DOIUrl":"10.1016/j.drugpo.2025.104837","url":null,"abstract":"<div><h3>Background</h3><div>Multiple injections per injection episode (MIPIE) is increasingly common among people who inject drugs (PWID). While MIPIE may lower overdose risk, it could elevate infectious disease risk. This study examined the prevalence of MIPIE among rural PWID in the United States and its associations with injection behaviors associated with disease transmission (e.g., syringe mediated drug sharing, receptive supply sharing) and health outcomes (e.g., hepatitis C virus (HCV) status, naloxone possession, and overdose).</div></div><div><h3>Methods</h3><div>The Rural Opioid Initiative includes eight research cohorts of rural people who use drugs from across the U.S., recruited from 01/2018 to 03/2020. MIPIE was dichotomized as any vs. none using the question: “How many times in the past 30 days did you inject more than one time in one sitting?” We employed a fixed effects meta-analytic approach to examine cross-sectional associations through adjusted regression analyses.</div></div><div><h3>Results</h3><div>Among 2441 PWID, most reported MIPIE (71% [n=1729]). In adjusted analyses, MIPIE was associated with a higher prevalence of past 30-day receptive syringe sharing (Prevalence Ratio (PR)=2.02; 95% confidence interval (CI)=1.74–2.34), syringe-mediated drug sharing (PR=1.92; 95%CI=1.69–2.18), receptive supply sharing (PR=1.99; 95%CI=1.75–2.26), distributive supply sharing (PR=2.30; 95%CI=1.99–2.65), HCV (PR=1.26; 95%CI=1.11–1.44), naloxone possession (PR=1.32; 95%CI=1.17–1.50), overdose ever (PR=1.42; 95%CI=1.25-1.57), and overdose in the prior 90 days (PR=2.09; 95%CI=1.52–2.87).</div></div><div><h3>Conclusions</h3><div>MIPIE is a common practice among rural PWID and is associated with injection behaviors associated with disease transmission, HCV, and overdose. Intervention studies should develop harm reduction strategies that address both overdose prevention and infectious disease mitigation related to MIPIE.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104837"},"PeriodicalIF":4.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178410","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":"Heroin injection to fentanyl smoking: Examining temporal trends in substance type and route of administration among people who inject drugs in Los Angeles, CA and Denver, CO, USA between 2021–2022","authors":"Siddhi S. Ganesh ,&nbsp;Rebecca P. Smeltzer ,&nbsp;Jesse Lloyd Goldshear ,&nbsp;Pooja Shah ,&nbsp;Karen Corsi ,&nbsp;Jimi Huh ,&nbsp;Ricky N. Bluthenthal","doi":"10.1016/j.drugpo.2025.104864","DOIUrl":"10.1016/j.drugpo.2025.104864","url":null,"abstract":"<div><h3>Introduction</h3><div>In the US, fentanyl is replacing heroin in illicit drug markets. We examined temporal effects of changing substance use patterns and self-reported skin abscesses among people who inject drugs (PWID).</div></div><div><h3>Methods</h3><div>We surveyed 472 PWID in Los Angeles, CA and Denver, CO during 2021/22. Survey items covered demographics, drug use patterns (type, frequency, and route of administration), injection-related risk behaviors, and self-reported skin abscesses over the last 3 months.</div></div><div><h3>Analysis</h3><div>We used baseline data to determine if heroin and fentanyl use patterns and health outcomes changed over time. We reclassified the sample into three – 6-month participant recruitment periods (Period 1: Apr to Sep 2021 [<em>n</em> = 256/54 %]; Period 2: Oct to Mar 2021/22 [<em>n</em> = 129/27 %]; Period 3: Apr to Sep 2022[<em>n</em> = 87/18 %]). We used bivariable analyses to determine factors associated with daily injection of any drug, daily non-injection fentanyl use, and abscesses. Regression analyses were conducted to determine factors associated with these changing substance use patterns and abscesses.</div></div><div><h3>Results</h3><div>We observed statistically significant changes in the following: daily injection (78 % in Period 1 to 56 % in Period 3; <em>p</em> &lt; 0.001), daily heroin use (46 % in P1 to 28 % in P3;), daily fentanyl smoking (18 % in Period 1 to 33 % in Period 3) and abscesses (43 % in P1 to 32 % in). In multivariable robust Poisson regression models, participants recruited in later periods with lower risk of daily injection and abscesses and higher risk of daily non-injection fentanyl use.</div></div><div><h3>Discussion</h3><div>Changes in the illicit opioid market have resulted in decreased injection and increased non-injection fentanyl use. Lower injection drug use may be leading to lower risk for abscesses among PWID.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104864"},"PeriodicalIF":4.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178402","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":"Willingness and contextual considerations for supervised consumption sites: a mixed-methods study among people who inject drugs in Stockholm","authors":"Elin Holmén ,&nbsp;Martin Kåberg ,&nbsp;Elin Lundeberg ,&nbsp;Jessica Storbjörk ,&nbsp;Anders Hammarberg","doi":"10.1016/j.drugpo.2025.104866","DOIUrl":"10.1016/j.drugpo.2025.104866","url":null,"abstract":"<div><h3>Background</h3><div>Sweden faces high rates of overdose mortality, but supervised consumption sites (SCSs), where people can use drugs under healthcare supervision, have not been adopted. No studies have assessed the willingness of Swedish people who inject drugs to use a future SCS or their views on potential rules.</div></div><div><h3>Methods</h3><div>This mixed-methods study applied a risk-environment approach and collected data from people who inject drugs in Stockholm using a 28-item survey and qualitative interviews.</div></div><div><h3>Results</h3><div>Most of the 219 survey respondents reported significant risk factors, including unstable housing, previous opioid overdose, and public drug use. Among participants, 158 (72.1 %) were willing to use an SCS, while 61 (27.9 %) were unsure or unwilling. In multivariate analysis, opioid use (AOR 3.24; CI 1.31–8.02), public injection (AOR 5.22; CI 2.35–11.56), and overdose within the past year (AOR 6.89; CI 1.66–28.56) predicted willingness to use an SCS. The most common reason was “I want to avoid stress” (82.2 %). For the 61 participants unwilling or unsure, the main reason was “already having a safe place for drug use” (78.75 %). Certain rules, like bans on groin/neck injection and assisted injection, were less accepted among both survey and interview respondents. Qualitative data revealed reluctance to inject in front of SCS staff due to privacy concerns.</div></div><div><h3>Conclusion</h3><div>Our results suggest high SCS acceptability among a marginalised cohort of people who inject drugs in Stockholm. Results confirm and extend prior research by illuminating their perceptions, including important preferences to consider when designing a future SCS in Sweden.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104866"},"PeriodicalIF":4.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178401","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":"System dynamics modeling to inform implementation of evidence-based prevention of opioid overdose and fatality: A state-level model from the New York HEALing Communities Study","authors":"Nasim S. Sabounchi ,&nbsp;Rachel L. Thompson ,&nbsp;Matthew R. Lootens ,&nbsp;David W. Lounsbury ,&nbsp;Gary Hirsch ,&nbsp;Derek Blevins ,&nbsp;Turner C. Canty ,&nbsp;Nabila El-Bassel ,&nbsp;Louisa Gilbert ,&nbsp;Pedro Mateu-Gelabert ,&nbsp;Daniel J. Feaster ,&nbsp;Bruce D. Rapkin ,&nbsp;Terry T.-K. Huang","doi":"10.1016/j.drugpo.2025.104843","DOIUrl":"10.1016/j.drugpo.2025.104843","url":null,"abstract":"<div><h3>Background</h3><div>As part of the New York HEALing Communities Study, we modeled the opioid epidemic in New York State (NYS) to help coalition members understand short- and long-term capacity-building needs and trade-offs in choosing the optimal mix of harm reduction, treatment, and prevention strategies.</div></div><div><h3>Methods</h3><div>We built and validated a system dynamics simulation model of the interdependent effects of exposure to opioids, opioid supply and overdose risk, community awareness of overdose risk, naloxone supply and use, and treatment for opioid use disorder (OUD). We simulated overdose and fatality rates, OUD prevalence, and related measures from 2012 to 2032 for the NYS population aged ≥12 and tested policy scenarios for reducing future overdose deaths.</div></div><div><h3>Results</h3><div>Increasing naloxone distribution by 50 % led to a 10 % decrease in overdose deaths, but only minimally reduced OUD prevalence (1 %) by 2032. Enhancing by 50 % medications for OUD (MOUD) initiations and prevention efforts each led to substantial decreases in deaths (29 % and 25 %, respectively) and OUD prevalence (27 % and 6 %) by 2032. Simultaneously increasing naloxone distribution and MOUD initiations by 50 % resulted in 38 % fewer deaths, while adding prevention efforts alongside resulted in 56 % fewer fatalities. Sensitivity analyses of the models’ feedback loops demonstrated similar relative impacts.</div></div><div><h3>Conclusions</h3><div>A combination of evidence-based strategies while also promoting prevention should be prioritized to reduce overdose fatality. Sustained community awareness and prevention efforts are needed even as overdoses and deaths decline due to the significant effects of the community awareness feedback loop on the epidemic trends.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104843"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146908","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":"A proportionality approach to the ethics of drug policy","authors":"Mary Jean Walker","doi":"10.1016/j.drugpo.2025.104861","DOIUrl":"10.1016/j.drugpo.2025.104861","url":null,"abstract":"<div><div>This paper applies a proportionality approach to examining the ethics of drug policy. The principle of proportionality states that to be ethically permissible a policy should be likely to impose only burdens that are proportionate to its benefits. I develop an analysis of proportionality judgements as involving two important kinds of ethical reasoning, characterised as consequentialist and deontological, which often interact with each other. I then apply the analysis to examples of drug policies to show how it assists in identifying forms of ethical reasoning potentially informing policy decisions and how they can interact, and identifying normative claims required for the policy to be ethically justifiable. In doing so, the proportionality approach aims to prompt assessment of normative commitments that may affect policy decisions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104861"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139587","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":"Off-label GLP-1 weight-loss medicine use among online bodybuilders: Folk pharmacology, risk and harm reduction","authors":"Luke A. Turnock ,&nbsp;Evelyn Hearne ,&nbsp;Jennifer Germain ,&nbsp;Mikey Hirst ,&nbsp;Honor D. Townshend ,&nbsp;Lambros Lazuras","doi":"10.1016/j.drugpo.2025.104854","DOIUrl":"10.1016/j.drugpo.2025.104854","url":null,"abstract":"<div><h3>Background</h3><div>GLP-1 medicines (e.g. Semaglutide; Tirzepatide) are diabetes medicines that have recently been approved for weight loss purposes. These drugs are increasingly common, with many users accessing these medicines for off-label lifestyle-oriented purposes. While recent research has explored increased interest in these drugs, to date no studies have explored their use in bodybuilding cultures. With bodybuilders often at the forefront of experimental drug use, and diffusing knowledge of drugs to other populations, this research examines bodybuilders’ understandings of use and risk of GLP-1 medicines, and community approaches to harm reduction.</div></div><div><h3>Methods</h3><div>This research adopted a netnographic approach, exploring 12,392 unique posts from 160 threads across two popular bodybuilding forums. Qualitative thematic analysis of posts was undertaken.</div></div><div><h3>Findings</h3><div>Bodybuilders frequently undertook experimental approaches to GLP use, including ‘stacking’ multiple compounds and ‘cycling’ between them, presenting risk. GLPs’ utility for bodybuilding was questioned by some owing to their muscle-wastage effects, but many bodybuilders combined them with anabolic-androgenic steroids (AAS) to off-set these side-effects. In addition to their weight-loss properties, many users discussed the drugs’ anti-ageing properties, and older men appear to be a significant emerging user population. While displacing potentially dangerous fat burners in bodybuilders’ folk pharmacologies, GLPs nonetheless presented risks of hypoglycaemia when combined with AAS, and broader harms. Harm reduction information was frequently shared in forum spaces as part of bodybuilders’ communal folk pharmacology, but some enabling behaviours likely to heighten risk were also identified.</div></div><div><h3>Discussion</h3><div>We examine the likely implications of these findings for public health, with particular reference to the practices of ‘cycling’ and ‘stacking’ GLP medicines and the risk this presents, particularly when combined with drugs such as AAS and far burners. We discuss the need for harm reduction services such as drug testing services, and the need for healthcare professionals to be aware of anti-ageing motivations for use among older men. Continued research into novel GLP use is needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104854"},"PeriodicalIF":4.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131414","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":"Policy reform and the international future of Moroccan Cannabis production","authors":"Pierre-Arnaud Chouvy","doi":"10.1016/j.drugpo.2025.104841","DOIUrl":"10.1016/j.drugpo.2025.104841","url":null,"abstract":"<div><div>In 2023, Morocco produced the first legal <em>Cannabis</em> crop of any illegal hashish-producing country, only three years after it legalised the cultivation of <em>Cannabis</em> for medical and industrial purposes. Nevertheless, as the country continues to amend its regulatory framework and economic policies, numerous questions and uncertainties persist regarding the success of its strategy for the export of <em>Cannabis</em> products and the evolution of its domestic consumer market.</div><div>This current study details and explains how Morocco has advantageously legalised what it calls “licit uses of cannabis”, notably by not referring to hemp, but also by making the strategic decision not to adopt an overall tetrahydrocannabinol (THC) threshold. This study also addresses key agricultural technicalities, such as how higher legal THC levels benefit cannabidiol (CBD) yields and how this directly impacts economic competitiveness, as well as how legal rules and details are structuring a new and rapidly changing global legal cannabinoid market. This study goes beyond the case of Morocco by considering what diverse and evolving international legislations mean for potential future Moroccan exports, depending on how CBD is viewed and regulated in different countries, whether as a pharmaceutical, a wellness product, or a food supplement.</div><div>The study concludes that while the Moroccan authorities have quickly and pragmatically adapted their regulations, both at the production and consumption level, the future of Morocco’s legal <em>Cannabis</em> industry remains largely dependent on local and global environmental and economic factors that will influence its development and viability.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104841"},"PeriodicalIF":4.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124518","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":"Strong increase in the number of intoxications involving psychoactive drugs among adolescents reported to the Dutch Poisons Information Center from 2014–2023","authors":"Ilze MJ Thoonen ,&nbsp;Saskia J Rietjens ,&nbsp;Arjen Koppen ,&nbsp;Dylan W de Lange ,&nbsp;Johanna J Nugteren-van Lonkhuyzen","doi":"10.1016/j.drugpo.2025.104860","DOIUrl":"10.1016/j.drugpo.2025.104860","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of psychoactive drugs has been increasing worldwide, with adolescents and young adults accounting for a large share of people who use drugs. To date, there is limited information on trends of intoxications with psychoactive drugs among adolescents, particularly with regard to New Psychoactive Substances (NPS).</div></div><div><h3>Methods</h3><div>A retrospective study was performed from 2014-2023 to characterize intoxications with psychoactive drugs among adolescents aged 13-17 years, reported to the Dutch Poisons Information Center (DPIC). Data were collected on patient (age and gender) and exposure characteristics (psychoactive drugs involved, day and month of exposure).</div></div><div><h3>Results</h3><div>From 2014-2023 the DPIC was consulted on 978 poisoning events among adolescents involving psychoactive drugs. A significant increase in the number of poisoning events was observed from 2014 to 2023 (RR = 1.14, 95 % CI: 1.11-1.16, <em>p</em> &lt; 0.001). The largest increase was observed in the number of poisoning events with cannabis products (208 % increase, 2014: <em>n</em> = 13 vs. 2023: <em>n</em> = 40) (especially edibles), MDMA (100 % increase, 2014: <em>n</em> = 27 vs. 2023: <em>n</em> = 54) and 3-methylmethcathinone (3-MMC) (2014: <em>n</em> = 0, 2019: <em>n</em> = 2 vs. 2023: <em>n</em> = 24). There was also an increase in the variety of NPS the DPIC was consulted on, with 1 type of NPS reported in 2014 and 13 in 2023.</div></div><div><h3>Conclusions</h3><div>In this study, a strong increase was observed in the number of intoxications with psychoactive drugs among adolescents from 2014-2023. The increase in intoxications with psychoactive drugs among adolescents, as well as the increase in the number of different types of NPS is worrying, since toxicity of especially NPS is often unknown. More education on the potential dangers along with upcoming legislative changes, might reverse this trend.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104860"},"PeriodicalIF":4.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115452","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":"Queering vaping: A qualitative analysis of lesbian, bisexual, and queer women’s E-cigarette use in Australia","authors":"Ruby Grant ,&nbsp;Adrian Farrugia ,&nbsp;Isabel Mudford ,&nbsp;Julie Mooney-Somers ,&nbsp;Jennifer Power ,&nbsp;Ruth McNair ,&nbsp;Amy Pennay ,&nbsp;Adam Bourne","doi":"10.1016/j.drugpo.2025.104853","DOIUrl":"10.1016/j.drugpo.2025.104853","url":null,"abstract":"<div><h3>Background</h3><div>Vaping has emerged as a prominent practice among lesbian, bisexual, and queer (LBQ) women in Australia. Despite its growing prevalence, the socio-cultural dimensions of vaping in LBQ communities remain underexplored. This study examines how vaping functions as a contested site of queer sociability, identity expression, and resistance. Using queer theoretical perspectives, we interrogate the ways LBQ women navigate the aesthetic, social, and political dimensions of vaping within Australia’s unique policy landscape.</div></div><div><h3>Methods</h3><div>Sixty semi-structured interviews were conducted with LBQ cis and trans women and non-binary individuals aged 18–72 in Australia. A reflexive thematic analysis was employed, informed by queer theory, to explore participants’ accounts of vaping.</div></div><div><h3>Findings</h3><div>Participants framed vaping as a performative practice tied to queer aesthetics, gender expression, and community bonding. While vaping facilitated intimacy and sociability in queer spaces, its association with stigma and youth culture complicated its subversive potential for some. Vaping emerged as a mode of resistance to normative public health narratives, yet also reproduced tensions around deviance and identity.</div></div><div><h3>Conclusion</h3><div>Vaping is a dynamic, contested queer practice, reflecting LBQ women’s negotiations of identity, community, and agency within restrictive policy environments. Policy and public health strategies must consider the queer socio-cultural meanings and community practices that shape vaping, to avoid reinforcing stigma and unintended harms to LGBTQ+ communities.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104853"},"PeriodicalIF":4.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107690","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":"Identifying and responding to policy-related barriers, facilitators, and misunderstandings in the HEALing communities study: A community-driven approach","authors":"Anita Silwal ,&nbsp;Robert Bohler ,&nbsp;Timothy Hunt ,&nbsp;Ramona G. Olvera ,&nbsp;Michelle R. Lofwall ,&nbsp;Christopher D. Cook ,&nbsp;Katherine R. Marks ,&nbsp;Carly Bridden ,&nbsp;Patricia R. Freeman ,&nbsp;Monica Nouvong ,&nbsp;Laura C. Fanucchi ,&nbsp;Nabila El-Bassel ,&nbsp;Lisa A. Frazier ,&nbsp;Sharon L. Walsh ,&nbsp;Jeffery C. Talbert","doi":"10.1016/j.drugpo.2025.104851","DOIUrl":"10.1016/j.drugpo.2025.104851","url":null,"abstract":"<div><h3>Introduction</h3><div>The HEALing (Helping to End Addiction Long-Term®) Communities Study (HCS) aimed to reduce opioid-involved overdose deaths across four states (Kentucky, Massachusetts, New York, and Ohio) via community-engaged implementation of three evidence-based practices (EBPs): (1) opioid overdose education and naloxone distribution, (2) medication for opioid use disorder expansion/linkage/retention, and (3) safer opioid prescribing and dispensing practices. A policy workgroup (PWG) was convened and developed a procedure to identify and address policies potentially impacting EBP implementation.</div></div><div><h3>Methods</h3><div>A five-step method was developed to identify, track, and respond to relevant policies at three of the research sites (Kentucky, Massachusetts, and New York) in collaboration with community partners and stakeholders. Policies possibly impacting EBPs were reported, reviewed, and documented, including any actions taken to address the policy issue. Policies were discussed with local, state, and federal level stakeholders in attempts to resolve barriers, clarify misunderstandings, and disseminate facilitators.</div></div><div><h3>Results</h3><div>A total of 87 (Kentucky = 37; Massachusetts = 19; New York = 31) policies were identified and addressed; 42 were identified as barriers, 24 as facilitators, and 21 as misunderstandings. PWG efforts resolved over 73 % (<em>n</em> = 31) of policy barriers, clarified 90 % (<em>n</em> = 19) of policy misunderstandings, and disseminated 100 % (<em>n</em> = 24) of policy facilitators.</div></div><div><h3>Conclusions</h3><div>A community-driven approach in policy surveillance identified, addressed, and disseminated several different types of policy issues that could impact implementation of EBPs for opioid-involved overdose prevention. Many policy barriers persisted during the HCS study, which may have adversely affected study outcomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104851"},"PeriodicalIF":4.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107623","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}