International Journal of Drug Policy最新文献

{"title":"The Züri Can study: Can regulated cannabis sales promote lower-risk cannabis use? Mini-review and study protocol","authors":"Maximilian Buschner,&nbsp;Nadine Heckel,&nbsp;Patricia Dürler,&nbsp;Etna J․ E. Engeli,&nbsp;Sophie Schneider,&nbsp;Eva M. Havelka,&nbsp;Carlos Nordt,&nbsp;Marcus Herdener","doi":"10.1016/j.drugpo.2024.104610","DOIUrl":"10.1016/j.drugpo.2024.104610","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Recreational use of cannabis is illegal in most countries. Despite this, it is the third most commonly used psychoactive substance worldwide. As a result of this discrepancy, a growing number of countries have begun to reassess their legal approach to cannabis in recent years. While the health risks of cannabis and potential harm reduction measures are increasingly well understood, there are still significant gaps in knowledge about which regulatory and supply models are effective in promoting lower-risk cannabis use.</div><div>In this paper, we outline the Züri Can study, which implements and evaluates a regulatory framework for cannabis sales in the city of Zurich, Switzerland, between 2023 and 2026. In addition, we illustrate how the study addresses current knowledge gaps to provide further insight into the potential future regulation of cannabis in Switzerland.</div><div>To embed the study in the present scientific and political context, we first provide a brief overview of the state of knowledge on cannabis-related health risks and means of reducing them, along with lessons learned from other countries that have implemented varying regulatory systems.</div></div><div><h3>Design and Measurements</h3><div>2,100 participants will be able to legally purchase cannabis either at a pharmacy, a cannabis social club, or the municipal drug information center over a three-year period. As part of this observational study, participants will be evaluated regarding their cannabis use habits and motives, their knowledge of lower-risk use, and their mental and physical health, among other parameters.</div><div>Established harm reduction strategies are implemented as an integral part of the study design.</div></div><div><h3>Comments</h3><div>The study will contribute to a better understanding of the impact of different cannabis distribution models on cannabis use patterns and related health outcomes. The results are expected to assist Swiss and international policy makers in developing evidence-based and public health-oriented regulatory frameworks for cannabis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104610"},"PeriodicalIF":4.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420625","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":"Trends in alcohol expenditure among risky drinkers: A population study in England, 2014–2023","authors":"Sarah Jackson ,&nbsp;Melissa Oldham ,&nbsp;Colin Angus ,&nbsp;Claire Garnett ,&nbsp;Luke Wilson ,&nbsp;John Holmes ,&nbsp;Jamie Brown","doi":"10.1016/j.drugpo.2024.104615","DOIUrl":"10.1016/j.drugpo.2024.104615","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to estimate time trends in alcohol expenditure among risky drinkers in England over the past decade, to understand whether these trends are driven by changes in prices paid or volumes purchased, and to explore differences between population subgroups.</div></div><div><h3>Methods</h3><div>Nationally-representative monthly cross-sectional survey. Participants were 44,382 adults (≥18y) drinking at risky levels (AUDIT-C ≥ 5; ‘risky drinkers’). Linear regression modelled trends between March-2014 and October-2023 in (i) mean weekly inflation-adjusted expenditure on alcohol, (ii) mean weekly alcohol consumption in units, and (iii) mean inflation-adjusted expenditure per unit of alcohol, overall and by age, gender, social grade, region, and smoking status.</div></div><div><h3>Results</h3><div>There was an uncertain decrease in mean weekly expenditure from £18.90 [95 %CI=£18.30-£19.50] in March-2014 to £17.90 [£17.60-£18.30] in May-2016, then an uncertain increase to £18.60 [£18.30-£18.90] between May-2016 and June-2018. This was followed by a further decline to £16.90 [£16.60-£17.30] by April-2021 and subsequent rise to £18.60 [£17.90-£19.40] by October-2023. Changes in weekly alcohol expenditure were more closely mirrored by changes in mean expenditure per unit of alcohol than by changes in mean weekly alcohol consumption in units. Notable subgroup differences included sharp rises in weekly alcohol expenditure since 2021 among younger ages (driven by a rise in expenditure per unit of alcohol) and current smokers (driven by a rise in weekly units of alcohol consumed).</div></div><div><h3>Conclusions</h3><div>In England, the average amount adult risky drinkers reported spending on alcohol each week has fluctuated since 2014, with a notable decrease around the start of the COVID-19 pandemic in 2020 and a subsequent rise since restrictions were lifted and since the cost-of-living crisis has led to high rates of inflation. Except for current smokers, this pattern appears to have been driven predominantly by changes in the price paid per unit rather than changes in consumption.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104615"},"PeriodicalIF":4.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401633","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 misuse and symptoms of dependence among people who use gabapentinoids: A qualitative systematic review","authors":"Amy G. McNeilage ,&nbsp;Alison Sim ,&nbsp;Suzanne Nielsen ,&nbsp;Bridin Murnion ,&nbsp;Claire E. Ashton-James","doi":"10.1016/j.drugpo.2024.104605","DOIUrl":"10.1016/j.drugpo.2024.104605","url":null,"abstract":"<div><h3>Background</h3><div>Gabapentinoids are among the most widely prescribed pain medications worldwide. However, there is growing evidence of harms associated with their use. The aim of this study was to systematically review and synthesise qualitative research exploring lived experiences of gabapentinoid (pregabalin and/or gabapentin) misuse and symptoms of dependence.</div></div><div><h3>Methods</h3><div>Six databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, PsycINFO) and grey literature sources were searched from inception to September 2023. The methodological quality of included studies was appraised using a modified 11-item version of the Critical Appraisal Skills Programme qualitative checklist, and higher quality studies were prioritised in the thematic synthesis. Confidence in the overall findings of the review was assessed using the GRADE-CERQual approach. The review was prospectively registered on PROSPERO (CRD42023401832).</div></div><div><h3>Results</h3><div>Twenty-six articles representing 21 original studies were included. The majority used interview methods and were of high methodological quality. Motives for gabapentinoid misuse included getting high, potentiating or offsetting the effects of other drugs, self-medicating for pain, distress, insomnia, or withdrawal symptoms, and substituting for another drug. Symptoms of dependence included the rapid development of tolerance and a severe withdrawal syndrome often involving psychiatric symptoms. Harms including dissociation, loss of consciousness, and overdose were generally reported as a consequence of polysubstance use. Confidence in most of the review findings was moderate with low confidence in one finding.</div></div><div><h3>Conclusion</h3><div>This review provides rich qualitative insights into the potential motives for gabapentinoid misuse as well as the diverse lived experiences of dependence symptomatology. Considering the increasing prescribing of these medications globally, and the potential for public health challenges resulting from misuse, the findings of this review can be used to develop more effective harm reduction strategies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104605"},"PeriodicalIF":4.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401630","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":"Psychomodulatory substances: New legislative framework for control of psychoactive substances in Czechia","authors":"Viktor Mravčík ,&nbsp;Jana Michailidu ,&nbsp;Petr Pleva ,&nbsp;Matyáš Lucký ,&nbsp;Lucia Kiššová ,&nbsp;Jindřich Vobořil","doi":"10.1016/j.drugpo.2024.104603","DOIUrl":"10.1016/j.drugpo.2024.104603","url":null,"abstract":"<div><div>This article challenges drug prohibition advocated by UN conventions as the prevailing regulatory model for psychoactive substances, highlighting its ineffectiveness, harmfulness and outdated nature. At the same time, the conventions exclude some psychoactive substances from international regulation, leaving control to individual countries. Presenting an innovative approach, this article outlines an approach to the legal regulation of psychomodulatory substances (psychoactive substances with low health and societal risk) in non-medical contexts. Acknowledging the potential benefits of such psychoactive substances and balancing them with potential harms, it suggests stringent rules for marketing, safety, and preventing sales to minors. This approach aims to quell illicit markets, safeguard vulnerable populations, and encourage controlled use. Through a case study of the Czech Republicʼs introduction of a new category of psychomodulatory substances, this article showcases a paradigm shift from the prevailing repressive approach to drug regulation. This adaptive model effectively navigates the regulatory void, offering a viable alternative to the UNʼs prohibition framework.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104603"},"PeriodicalIF":4.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401631","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 use of health utility in cost-utility analysis: A systematic review in substance use disorders","authors":"Anh Dam Tran ,&nbsp;Xin Zhan ,&nbsp;Annaëlle Vinzent ,&nbsp;Lorelie Flood ,&nbsp;Tian Bai ,&nbsp;Erinn Gallagher ,&nbsp;Gregory S. Zaric","doi":"10.1016/j.drugpo.2024.104570","DOIUrl":"10.1016/j.drugpo.2024.104570","url":null,"abstract":"<div><h3>Background and aim</h3><div>We aim to identify within-trial and modelled Cost-Utility Analysis (CUA) in substance use disorders (SUD) and review the applicability assessment associated with health utility used in modelled CUA.</div></div><div><h3>Study design and methods</h3><div>We searched Medline, Embase, EconLit and the Pharmaceutical Benefits Advisory Committee (PBAC) databases. A global systematic literature search was undertaken to determine the CUA of SUD interventions. Key characteristics of the studies and use of health utility were described. The applicability assessment associated with health utility used in modelled CUA was reviewed using The Health Utility Application Tool (HAT).</div></div><div><h3>Results</h3><div>The final review retrieved 49 CUA (14 within-trial and 35 modelled CUA). Three major health utility measurements were used - standard gamble, EQ-5D-5L and SF-6D. EQ-5D-5L was mainly used in within-trial CUA, whereas standard gamble, EQ-5D-5L and SF-6D were equally cited in modelled CUA and within-trial CUA. Twenty-nine articles using modelled CUA citing health utilities from published literature were assessed. Only half and one-third of CUA studies described the type of quality-of-life measure and value sets used in health utility studies, respectively. Only two-thirds showed the authors addressed questions about the similarities in clinical conditions, and health state description between health utility studies and economic evaluation studies.</div></div><div><h3>Conclusion</h3><div>Justifications for chosen health utilities in modelled CUA studies were mostly absent in SUD. We suggested health economists use the HAT to make judgements when assessing health utility from published estimates. The use of this tool will increase the reliability of economic evaluation carried out to assist government and policymakers in making informed decisions around health topics.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104570"},"PeriodicalIF":4.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401632","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":"Access and care for people with opioid use disorder in U.S. skilled nursing facilities: A policy commentary","authors":"Shivani Nishar ,&nbsp;Jon Soske ,&nbsp;Rahul Vanjani ,&nbsp;Simeon D. Kimmel ,&nbsp;Corinne Roma ,&nbsp;Patience M. Dow","doi":"10.1016/j.drugpo.2024.104607","DOIUrl":"10.1016/j.drugpo.2024.104607","url":null,"abstract":"<div><div>Referrals for people with opioid use disorder (OUD) to skilled nursing facilities (SNFs) are increasing in the United States (U.S.). Further, legal guidance from the U.S. Department of Justice states that people with OUD cannot be discriminated against by health care institutions because of OUD or treatment with medications for OUD (MOUD). As such, SNFs are an important touchpoint for initiating or continuing MOUD, particularly amid rising drug-related overdose deaths among older adults and because people with OUD experience frailty and other geriatric syndromes at younger chronological ages. Informed by research, clinical expertise, and lived experience, this commentary describes policy and practice opportunities to help address challenges faced by people with OUD in gaining access to care and MOUD in SNFs. We propose opportunities to intervene against barriers that impede SNF placement and access to MOUD for people with OUD, including further revisions to 42 CFR Part 8 regulations to extend waivers for certification as opioid treatment programs (OTPs) to SNFs, allowing them to administer and dispense methadone in the same way as hospitals. If passed, proposed federal changes under the Modernizing Opioid Treatment Act would eliminate the requirement for methadone to be dispensed through OTPs, offering another opportunity to improve access to methadone for SNF residents. Also, we propose national and state-level investment in mobile substance use disorder services and partnerships with OTPs and hospital-based addiction consult services. We also recognize the need for more compassionate attitudes toward people with OUD in healthcare settings and discuss opportunities to address stigma. Although people with OUD are referred to SNFs for skilled care needs and not specifically for OUD care, it is essential for SNFs to be prepared to continue MOUD. It is both legally mandated and imperative that people with OUD have access to high quality and equitable SNF care.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104607"},"PeriodicalIF":4.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394240","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":"Historical and theoretical roots of the big events framework","authors":"Samuel R. Friedman ,&nbsp;Diana Rossi ,&nbsp;David C. Perlman","doi":"10.1016/j.drugpo.2024.104606","DOIUrl":"10.1016/j.drugpo.2024.104606","url":null,"abstract":"<div><div>This article traces the evolution of the Big Events framework since it began as an attempt to understand why sociopolitical transitions in the Former Soviet Union, South Africa, and Indonesia were followed by HIV outbreaks. Big Events frameworks have evolved over time, but all versions try to concretize how macrosocial changes lead to social, personal and environmental changes that shape risk environments and drug use or other behavioral patterns in ways that may lead to epidemics. Important stages in the evolution of the Big Events framework included understanding that the sequelae of Big Events were contingent rather than deterministic, and the development of new survey measures to understand pathways through which Big Events affect social and epidemiologic outcomes. On a broader level, the Big Events framework is a useful crystallization and application of more abstract sociological, social epidemiologic and Marxist frameworks about upstream/downstream relationships and how major social changes are related to epidemics. As such, they raise issues of how to conduct research on dialectical interaction processes. On another level, this article traces the Big Events “style of thought” as Mannheim (Mannheim, 1971) termed it, within the historical context of changes in public health and social science theory, particularly during and after the 1960s.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104606"},"PeriodicalIF":4.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394241","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":"Looking beyond drugs: A scoping review of recovery in the context of illicit substance use among adolescents and young adults","authors":"Cameron R. Eekhoudt ,&nbsp;Monique Sandhu ,&nbsp;Caroline Mniszak ,&nbsp;Trevor Goodyear ,&nbsp;Roxanne Turuba ,&nbsp;Kirsten Marchand ,&nbsp;Skye Barbic ,&nbsp;Danya Fast","doi":"10.1016/j.drugpo.2024.104598","DOIUrl":"10.1016/j.drugpo.2024.104598","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive literature exploring the harms associated with illicit substance use among young people who use drugs (YPWUD), the concept of “recovery” among this population has received significantly less attention. Addressing this literature gap can inform efforts to better support YPWUD as they pursue their goals.</div></div><div><h3>Objective</h3><div>To examine the qualitative literature on how young people (&lt; 30 years of age) understand and navigate substance use recovery and healing in the context of illicit substance use, including how interventions and caregivers are implicated in these processes.</div></div><div><h3>Methods</h3><div>The design for this scoping review was guided by Arksey and O'Malley's framework and informed by Levac et al. refinements. We surveyed five bibliographic databases for English, peer-reviewed, empirical studies published between 1999 and 2023. Studies were independently reviewed by two reviewers. We charted, synthesized, and assessed studies for common themes.</div></div><div><h3>Findings</h3><div>A total of 28 articles met the inclusion criteria for this scoping review. Studies show varied definitions and enactments of recovery as part of a continuum of substance use care, frequently extending beyond the notion of recovery as abstinence. Caregivers providing emotional, material, and social support are crucial to recovery; however, the challenges of supporting a young person's recovery are manifold, including misaligned expectations about recovery definitions and processes.</div></div><div><h3>Conclusion</h3><div>Findings underscore the need for recovery-oriented care that aligns with young people's diverse and shifting needs, goals, and contexts. Recovery programs must range from harm reduction to abstinence-based approaches across institutional and non-institutional settings and actively engage YPWUD and caregivers.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104598"},"PeriodicalIF":4.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394242","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":"Repurposing prescribed hydromorphone: Alternative uses of safer supply and tablet-injectable opioid agonist treatment to meet unaddressed health needs","authors":"Andrew Ivsins ,&nbsp;Jeanette M. Bowles ,&nbsp;Manal Mansoor ,&nbsp;Thomas Kerr ,&nbsp;Geoff Bardwell","doi":"10.1016/j.drugpo.2024.104601","DOIUrl":"10.1016/j.drugpo.2024.104601","url":null,"abstract":"<div><h3>Background</h3><div>In response to the ongoing overdose crisis in Canada, a number of opioid agonist treatment and safer supply programs provide people at high overdose risk with daily-dispensed tablet hydromorphone, with some requiring witnessed ingestion and others providing take-away doses. While these programs are intended to reduce overdose events by limiting people's use of the contaminated drug supply, the experiences of people receiving hydromorphone vary. In this article we explore the ways people repurpose hydromorphone to address unmet needs.</div></div><div><h3>Methods</h3><div>This article draws on in-depth qualitative interviews from two studies evaluating hydromorphone tablet distribution programs in British Columbia, Canada. We used thematic analysis to identify themes related to repurposing hydromorphone. We compared themes across the two studies to identify any similarities or differences in relation to the ways study participants discussed repurposing hydromorphone tablets. We utilize vignettes – snapshots of participant experiences – to analyse and represent the data.</div></div><div><h3>Results</h3><div>Four vignettes demonstrate how hydromorphone tablets are often being used to address and resolve unmet needs of people who use drugs. While most participants reported reducing their use of illicit drugs, a variety of instrumental uses of tablet hydromorphone were also discussed, including reducing anxiety, addressing sleep issues, withdrawal management, and managing chronic pain.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate how people who use drugs are maximizing the benefits of tablet hydromorphone distribution to address unmet needs. Hydromorphone distribution programs represent a public health and harm reduction intervention that is usefully addressing experiences related to structural vulnerabilities (such as inadequate pain management), which are often overlooked amongst stigmatized groups.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104601"},"PeriodicalIF":4.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394243","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":"The intersection of substance use stigma and anti-Black racial stigma: A scoping review","authors":"Rashmi Ghonasgi ,&nbsp;Maria E. Paschke ,&nbsp;Rachel P. Winograd ,&nbsp;Catherine Wright ,&nbsp;Eva Selph ,&nbsp;Devin E. Banks","doi":"10.1016/j.drugpo.2024.104612","DOIUrl":"10.1016/j.drugpo.2024.104612","url":null,"abstract":"<div><h3>Background</h3><div>Substance use stigma poses a barrier to treatment and recovery from substance use disorder. Stigma is amplified when intersecting with other stigmatized identities, particularly Black racial identity. Despite increasing attention to the intersecting roles of racial and substance use stigma, it is unknown how these stigmas interact to impact treatment and health outcomes among Black people who use drugs. This scoping review examines empirical research documenting differential impacts of race and racism on substance use stigma.</div></div><div><h3>Methods</h3><div>We systematically searched PsychInfo and PubMed databases. Eligible studies were conducted in the U.S.; examined a Black sample, subsample, or experimental condition/variable (i.e., in a vignette); and measured substance use stigma (excluding alcohol or nicotine). Qualitative studies describing a theme related to substance use stigma were also included.</div></div><div><h3>Results</h3><div>Of 1431 unique results, 22 articles met inclusion criteria. The most measured substance use stigma type was interpersonal (e.g., discrimination). Most quantitative findings (<em>n</em> = 15) suggested that Black members of the general public endorse less substance use stigma and Black people who use drugs face less substance use stigma relative to their White counterparts. Qualitative studies (<em>n</em> = 7) suggested stigma was a more common and pernicious substance use treatment barrier for Black people compared to White. Across methods, racial prejudice was associated with substance use stigma, supporting hegemonic ideas that substance use is stereotypically characteristic of Black people.</div></div><div><h3>Conclusions</h3><div>The interaction between substance use stigma and race is complex and varies by in-group and out-group raters as a function of racial identity and identity as a person who uses drugs. Contradictory findings reflect methodological differences, emphasizing the need for more unified measurement of substance use stigma. More research is needed among Black people who use drugs to improve understanding of the impact of these intersecting stigmas on racial inequities in substance use treatment, morbidity, and mortality.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104612"},"PeriodicalIF":4.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382023","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}