International Journal of Drug Policy最新文献

{"title":"Les ‘Lignes Directrices Pour l'Usage du Cannabis à Moindre Risque (LUCMR)’: RECOMMENDATIONS [The ‘Lower-Risk Cannabis Use Guidelines (LRCUG)’: RECOMMENDATIONS (FRENCH)]","authors":"Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall","doi":"10.1016/j.drugpo.2023.103994","DOIUrl":"10.1016/j.drugpo.2023.103994","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 103994"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9294316","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":"Characterizing non-fatal overdose among people who inject drugs in India: prevalence and risk factor analysis, 2022-2024","authors":"Mihili P. Gunaratne ,&nbsp;Talia A. Loeb ,&nbsp;Allison M. McFall ,&nbsp;Lakshmi Ganapathi ,&nbsp;Jiban J. Baishya ,&nbsp;Ashwini Kedar ,&nbsp;Archit K. Sinha ,&nbsp;Aylur K. Srikrishnan ,&nbsp;Sunil S. Solomon ,&nbsp;Gregory M. Lucas ,&nbsp;Shruti H. Mehta","doi":"10.1016/j.drugpo.2025.105073","DOIUrl":"10.1016/j.drugpo.2025.105073","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal overdose strongly predicts future fatal overdose, yet limited prior work describes the burden among people who inject drugs (PWID) in India. We estimated prevalence and identified correlates of non-fatal overdose among PWID from India.</div></div><div><h3>Methods</h3><div>We conducted respondent-driven sampling (RDS) surveys among PWID across 6 Indian cities (n∼750/site; Amritsar, Bilaspur, Churchandpur, Delhi, Kanpur, and Ludhiana) during 2022–2024. Prevalence of non-fatal overdose in the prior 6 months and non-mutually exclusive events following the overdose were estimated using RDS-weighted descriptive statistics. Correlates (i.e., sociodemographics, HIV and hepatitis C status, substance use in the prior 6 months, and psychosocial symptoms) were assessed using multilevel logistic regression.</div></div><div><h3>Results</h3><div>Prevalence of non-fatal overdose was 8.8% among 4495 PWID. Factors significantly associated with overdose included daily or seasonal employment (vs. monthly or weekly wages), hepatitis C antibody positive status, witnessing a fatal overdose, injecting 3 or more times per day (vs. 1–2 times per day), concurrent use of heroin and stimulants (vs. buprenorphine or other prescription opioids only), hazardous alcohol use, attending a medical facility for addiction or detoxification, and experiencing mild or depressive symptoms (vs. none). Following the overdose, 44.7% reported help from a friend or family member, 25.5% reported nothing happened, 12.9% went to a hospital, and 5.6% were referred to drug treatment or detoxification.</div></div><div><h3>Conclusions</h3><div>We observed a variable burden of non-fatal overdose associated with high injection frequency, combination drug use, alcohol use, attending medical detoxification, and depressive symptoms. Low levels of subsequent linkage to treatment services suggest opportunities to improve overdose prevention and management.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105073"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580413","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"151 ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538167","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":"Population size estimation of people who inject drugs using capture-recapture analysis of multiple respondent-driven sampling rounds: Implications for HIV/HCV burden and harm reduction service planning in Thessaloniki, Greece","authors":"Sotirios Roussos ,&nbsp;Effrosyni Tsirogianni ,&nbsp;Ioannis Goulis ,&nbsp;Georgios Kalamitsis ,&nbsp;Angelos Hatzakis ,&nbsp;Vana Sypsa","doi":"10.1016/j.drugpo.2025.105078","DOIUrl":"10.1016/j.drugpo.2025.105078","url":null,"abstract":"<div><h3>Background</h3><div>Accurate population size estimation of people who inject drugs (PWID) is essential for evidence-based drug policy and service planning, yet it remains challenging. An emerging HIV outbreak in Thessaloniki, Greece's second-largest city, highlighted the urgent need for evidence-based population size estimates.</div></div><div><h3>Methods</h3><div>We applied capture-recapture analysis to five respondent-driven sampling (RDS) rounds conducted during 2019–2021 to estimate PWID population size in Thessaloniki for the 2019–2021 period. These RDS rounds were part of a community-based program aimed at increasing HIV/HCV testing and linkage to care among PWID. We treated each RDS round as a capture source and used log-linear models to estimate PWID population size (past 12 months and past 30 days), accounting for potential dependencies between rounds through interaction terms. We then estimated HIV/HCV disease burden and assessed prevention and harm reduction service coverage against international standards (HIV testing, OAT, NSP).</div></div><div><h3>Results</h3><div>Based on data from 1093 unique participants across five rounds (53.9% currently injecting, 20.3% currently in OAT), capture-recapture analysis estimated 1512 PWID (95% confidence interval (CI): 1345–1741) who had injected drugs in the past 12 months. The estimated prevalence of injecting drug use was 0.22% (95% CI: 0.20–0.25) among adults aged 18–64 years. We estimated 106 people living with HIV (95% uncertainty interval (UI): 83–130) and 945 HCV-antibody–positive individuals (95% UI: 815–1077) among PWID. Needle and syringe program coverage was 36 (95% CI: 31–40) syringes per PWID in 2021.</div></div><div><h3>Conclusion</h3><div>Based on this community-based population size estimate, the prevalence of injection was nearly double the official national Greek average. The annual distribution of syringes should increase by 5.6 times to reach the WHO target (≥200 syringes/PWID/year). These findings demonstrate how community-based programs with multiple RDS rounds can also yield population estimates essential for evidence-based drug policy interventions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105078"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624522","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":"Scoping review of the characteristics and implementation of routine outcome monitoring and feedback for adults and young people accessing alcohol and other drug use treatment","authors":"Alison K. Beck ,&nbsp;Leanne Hides ,&nbsp;Robert Stirling ,&nbsp;Briony Larance ,&nbsp;Gabrielle Campbell ,&nbsp;Amanda L. Baker ,&nbsp;Suzie Hudson ,&nbsp;John Marsden ,&nbsp;Nina Pocuca ,&nbsp;Jason P. Connor ,&nbsp;Michael Farrell ,&nbsp;Peter J. Kelly","doi":"10.1016/j.drugpo.2025.105071","DOIUrl":"10.1016/j.drugpo.2025.105071","url":null,"abstract":"<div><h3>Background</h3><div>Routinely monitoring therapeutic processes and outcomes is central to evidence-based Alcohol and Other Drug (AOD) use treatment. However, it remains unclear how this routinely captured data is ‘fed back’ to AOD clinicians and clients and used to inform treatment.</div></div><div><h3>Objectives</h3><div>This scoping review examined evaluations of routine outcome monitoring and feedback in young people and adults accessing AOD treatment to describe: a) the nature and extent of evidence; b) the development, characteristics and use of feedback and c) implementation considerations.</div></div><div><h3>Methods</h3><div>A systematic search of 11 online databases produced 796 articles. Independent title/abstract and full-text screening identified 20 evaluations for inclusion. Data extraction was performed independently by two researchers.</div></div><div><h3>Results</h3><div>Evaluations were primarily conducted in the USA (11/20), using non-randomised designs (14/20). Understanding of feedback is complicated by heterogeneity and missing information, but commonalities included technology-assisted outcome assessment to generate immediate, weekly, multi-dimensional feedback comprising a visual representation of change across time. Explicit guidance for using feedback in AOD treatment was rare (1/20). Implementation considerations are discussed across a) fidelity and training practices, b) participant and provider experience and c) barriers and enablers.</div></div><div><h3>Discussion and Conclusions</h3><div>Efforts to examine how best to generate, present and use feedback to inform AOD treatment are needed. Optimising the use of feedback across treatment settings will require examination of the interplay between feedback characteristics and clinician, client and contextual variables. Improved attention to idiographic outcomes, benchmarks, diversity considerations, health literacy, treatment context, training, fidelity and the reporting of evaluations are warranted.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105071"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850631","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":"Evaluating cannabis substitution for alcohol within the context of a canadian managed alcohol program","authors":"Sybil Goulet-Stock ,&nbsp;Catherine Hacksel ,&nbsp;Beatriz Scandiuzzi ,&nbsp;Rob Boyd ,&nbsp;Bernie Pauly ,&nbsp;Tim Stockwell","doi":"10.1016/j.drugpo.2025.105083","DOIUrl":"10.1016/j.drugpo.2025.105083","url":null,"abstract":"<div><h3>Introduction</h3><div>Managed Alcohol Programs (MAPs) provide beverage alcohol alongside housing and social supports to mitigate alcohol-related harms among individuals experiencing severe alcohol use disorder (AUD) and unstable housing. MAPs have been shown to stabilize alcohol use, reduce alcohol-related harms, improve quality of life, and decrease emergency service utilization. However, concerns about the long-term health risks associated with high levels of alcohol use have driven interest in cannabis substitution as an additional harm reduction strategy. Given the lower harm profile of cannabis, its integration into MAPs offers a promising avenue for further reducing alcohol-related harms. This study evaluates a novel cannabis substitution program within a Canadian MAP, leveraging the unique context of cannabis legalization and harm reduction programming.</div></div><div><h3>Methods</h3><div>Beginning in January 2023, participants (<em>N</em> = 35) were offered the choice of a pre-rolled cannabis joint or their prescribed alcohol dose multiple times per day. Data were drawn from five waves of quantitative surveys (January 2023 to February 2024; <em>n</em> = 20), two years of program records (January 2022 to February 2024; <em>N</em> = 35), and qualitative interviews (<em>n</em> = 14). Hierarchical mixed-effects models were used to predict alcohol use by cannabis use and time. Qualitative data were analyzed using interpretive description methodology.</div></div><div><h3>Results</h3><div>The final model found evidence of a substitution effect: participants who used more cannabis on average also consumed less alcohol overall. Specifically, each additional 0.4-gram joint consumed (approximately 15.2 standard THC units or 76 mg THC) was associated with an estimated 2.43 fewer mean daily standard drinks. Within-person cannabis use was not a significant predictor, indicating that short-term fluctuations in cannabis use were not associated with concurrent changes in alcohol consumption. Alcohol use also declined over time. Qualitative findings provide insights into the dynamic factors shaping drinking and cannabis use patterns.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential for cannabis substitution to meaningfully reduce alcohol-related harms. Implications for program development and future research evaluating changes in health, wellbeing, and harm outcomes are discussed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105083"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624525","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 descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states","authors":"Zongbo Li ,&nbsp;Tanvi V. Chiddawar ,&nbsp;Leah C. Shaw ,&nbsp;Ashleigh Dennis ,&nbsp;Amy Lieberman ,&nbsp;Alexandra Kingsepp ,&nbsp;Andrew J. Trinidad ,&nbsp;Ellenie Tuazon ,&nbsp;Alice E. Welch ,&nbsp;Avik Chatterjee ,&nbsp;Bruce R. Schackman ,&nbsp;Eva A. Enns ,&nbsp;Alexander Y. Walley ,&nbsp;Traci C. Green ,&nbsp;Karla D. Wagner ,&nbsp;Rachel P. Winograd ,&nbsp;Czarina N. Behrends ,&nbsp;Erika L. Crable ,&nbsp;Brandon D.L. Marshall ,&nbsp;Xiao Zang","doi":"10.1016/j.drugpo.2025.105100","DOIUrl":"10.1016/j.drugpo.2025.105100","url":null,"abstract":"<div><h3>Background</h3><div>Since 1999, drug overdose deaths have surged in the United States. There is considerable geographic variability in overdose patterns, state laws, overdose prevention infrastructure, and opioid settlement amounts and investments. To guide localized overdose prevention, it is important to analyze these data and understand heterogeneity.</div></div><div><h3>Methods</h3><div>In this descriptive analysis across six states—Massachusetts, Minnesota, Missouri, Nevada, New York, and Rhode Island, we compared five key domains essential to understanding overdose epidemics, prevention, and policy responses: (1) drug overdose mortality trends by substance and race/ethnicity (2018–2023); (2) state harm reduction laws; (3) availability and coverage of overdose prevention services; (4) opioid settlement funding and spending; and (5) availability and comprehensiveness of publicly available overdose-related data. Data were drawn from publicly available sources and legal information confirmed using Westlaw.</div></div><div><h3>Results</h3><div>All states experienced rising overdose death rates between 2018 and 2023, with significant racial/ethnic disparities. All states have enacted laws to increase access to naloxone. Naloxone distribution rates vary widely, but most states have high availability. Implementation of other harm reduction services differed across states, as well as drug paraphernalia laws. Opioid settlement funding per capita and transparency in spending and planning also differed across states. Some dashboards provided detailed fatal and nonfatal overdose and intervention data stratified by sociodemographics.</div></div><div><h3>Conclusion</h3><div>State-specific differences in overdose patterns, harm reduction laws, prevention infrastructure, and settlement spending underscore the need for localized, tailored strategies. This study’s state-specific profiles lay the groundwork for more advanced decision-support tools to guide effective overdose prevention.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105100"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693575","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":"Incorporating experiential reports provided by people who use drugs into drug-related early warning systems: benefits, risks principles and approaches","authors":"Jack Freestone ,&nbsp;Cilla Zhou ,&nbsp;Stassi Kypri ,&nbsp;Molly Howes ,&nbsp;Emily Ebdon ,&nbsp;Laura Purcell ,&nbsp;Paul Dessauer ,&nbsp;Clancy Beckers ,&nbsp;Brittany Chapman ,&nbsp;Sonya Weith ,&nbsp;Mitch Lamb ,&nbsp;Brendan Clifford ,&nbsp;Krista J Siefried ,&nbsp;Monica J Barratt ,&nbsp;Amy Peacock ,&nbsp;Rachel Sutherland ,&nbsp;Jess Doumany ,&nbsp;Peta Gava ,&nbsp;Megan Standfield ,&nbsp;Rebecca Kavanagh ,&nbsp;Nadine Ezard","doi":"10.1016/j.drugpo.2025.105098","DOIUrl":"10.1016/j.drugpo.2025.105098","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug-related early warning systems (EWS) comprise interdisciplinary networks that interpret data to detect and mitigate drug-related harms. The cross-disciplinary literature on EWS highlights the need for EWS to integrate community, scientific, and technical knowledges. Internationally, certain drug-related EWS collect incidental reports of noteworthy drug events provided by people who use drugs (PWUD). This qualitative study explored the potential benefits, risks, principles and approaches associated with implementing systematic mechanisms for community drug reporting, to inform the development of a nation-wide reporting system in Australia.</div></div><div><h3>Methods</h3><div>Data were drawn from 20 semi-structured interviews with Australian EWS practitioners plus three advisory meetings engaging 14 staff from community-based and peer-led organisations representing PWUD. Discussions focused on the prospect of collecting, analysing and sharing community data to support drug-related EWS. Thematic analysis was conducted on interview transcripts and advisory meeting minutes.</div></div><div><h3>Results</h3><div>Benefits ascribed to collecting incidental drug reports from communities included the faster detection of concerns and providing context for analytically verified data. Concerns were raised about data privacy and criminalisation, difficulty verifying community reports and spreading misinformation. It was suggested that community reporting initiatives should be led by PWUD; prioritise community engagement; be open to reports of benefits and harms, be underpinned by robust moderation, with data used to inform diverse harm reduction communications.</div></div><div><h3>Conclusions</h3><div>The systematic collection of and response to experiential reports provided by PWUD has potential to improve drug-related EWS. Such systems must be underpinned by strong governance, remain open to collecting reports of benefits plus harms and be led by communities.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105098"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716351","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":"COVID-19 vaccination uptake and risk of severe COVID-19 disease among those in, and released from, prison care in Scotland: a national cohort and case-control study","authors":"Maxim Wilkinson ,&nbsp;Alan Yeung ,&nbsp;Jennifer Bishop ,&nbsp;Ciara Gribben ,&nbsp;Bob Taylor ,&nbsp;Claire Cameron ,&nbsp;Diane Stockton ,&nbsp;Norah Palmateer ,&nbsp;Sharon Hutchinson","doi":"10.1016/j.drugpo.2025.105080","DOIUrl":"10.1016/j.drugpo.2025.105080","url":null,"abstract":"<div><h3>Objectives</h3><div>Given the potential higher risk of COVID-19 infection and disease for those incarcerated, we examined uptake of, and factors associated with vaccination, and the risks of severe disease for those in, and released from, prison in Scotland.</div></div><div><h3>Methods</h3><div>During follow-up (01/03/2020 to 13/04/2022), vaccine uptake among ∼15,000 individuals in prison, and following release, was compared with general population matched controls. Conditional logistic regression was used to compare prison status of ∼72,000 individuals admitted or died due to COVID-19 during follow-up to matched controls.</div></div><div><h3>Results</h3><div>By the end of follow-up, similar vaccine uptake was observed among those in prison (dose 1: 73.4 %, dose 2: 64.2 % and dose 3: 43.4 %) compared to matched controls (72.9 %, 67.9 % and 48.7 %). Individuals released (with &lt;14 days incarcerated) were less likely to receive a first dose (aOR: 0.57, CI: 0.52, 0.66) than those who remained in prison. Following first and second doses, those released during the subsequent 12 weeks were less likely to receive their subsequent dose compared to those continuously incarcerated (aORs: 0.48, CI: 0.43, 0.54; 0.35, CI: 0.31, 0.40, respectively). Compared to the wider community outside prison, those incarcerated and recently released were more likely to be admitted or die from COVID-19 (aORs: 3.08, CI: 2.58, 3.69; and 4.53, CI: 3.37, 6.09, respectively).</div></div><div><h3>Conclusions</h3><div>Our findings highlight the important role of prisons in facilitating rapid high coverage of vaccination, involving accelerated schedules where appropriate, to help mitigate the raised risk of severe disease outcomes among both those incarcerated and released into the community.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105080"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624524","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":"Impact of increased criminal penalties for fentanyl possession on initiation and retention on medications for opioid use disorder in Colorado","authors":"Xiaoyu Guan ,&nbsp;Cole Jurecka ,&nbsp;Pranav Padmanabhan ,&nbsp;Kristina Yamkovoy ,&nbsp;Paul J. Christine ,&nbsp;Ingrid A. Binswanger ,&nbsp;Jason M. Glanz ,&nbsp;Danielle M. Kline ,&nbsp;Joshua A. Barocas","doi":"10.1016/j.drugpo.2025.105037","DOIUrl":"10.1016/j.drugpo.2025.105037","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the impact of HB 22-1326, a state law increasing criminal penalties for fentanyl possession, on buprenorphine and methadone initiation and retention.</div></div><div><h3>Design</h3><div>Interrupted time series without control</div></div><div><h3>Setting</h3><div>The state of Colorado</div></div><div><h3>Participants</h3><div>We analyzed Colorado buprenorphine and methadone dispensing data for individuals aged 18–64 years from January 2018 to December 2023.</div></div><div><h3>Intervention</h3><div>Colorado House Bill 1326 (HB-1326), which increased criminal penalties for fentanyl possession in July 2022.</div></div><div><h3>Measurements</h3><div>Monthly initiation and 180-day retention rates for buprenorphine and methadone pre- and post-HB 22-1326.</div></div><div><h3>Findings</h3><div>For buprenorphine initiation rates, there were no statistically significant post-implementation level or slope changes, relative to an increasing pre-implementation trend. Methadone initiation rates showed similarly no statistically significant post-implementation changes, following an increasing pre-implementation trend. For buprenorphine retention rates, there were no statistically significant post-implementation level or slope changes, relative to a flat pre-implementation trend. For methadone retention rates, the post-implementation trend showed a statistically significant slope decrease (5.3% per month; 95% CI = -7.2%, -3.4%), relative to a decreasing pre-implementation trend. However, this finding was not robust in the sensitivity analysis that applied alternative assumptions for missing discharge dates.</div></div><div><h3>Conclusions</h3><div>Increased criminal penalties for fentanyl possession may not yield meaningful changes in MOUD initiation or retention.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105037"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340936","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}