International Journal of Drug Policy最新文献

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Urban–rural disparities in oral nicotine pouch sales and flavors in the United States 美国口服尼古丁袋装销售和口味的城乡差异
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.drugpo.2026.105178
Lei Xu , Saber Feizy , Megan E Roberts , Ce Shang , Brittney Keller-Hamilton , Darren Mays , Shyanika W Rose , Yanyun He
{"title":"Urban–rural disparities in oral nicotine pouch sales and flavors in the United States","authors":"Lei Xu ,&nbsp;Saber Feizy ,&nbsp;Megan E Roberts ,&nbsp;Ce Shang ,&nbsp;Brittney Keller-Hamilton ,&nbsp;Darren Mays ,&nbsp;Shyanika W Rose ,&nbsp;Yanyun He","doi":"10.1016/j.drugpo.2026.105178","DOIUrl":"10.1016/j.drugpo.2026.105178","url":null,"abstract":"<div><h3>Background</h3><div>As oral nicotine pouches (ONPs) gain popularity in the United States, the extent to which product attributes, such as price and flavor, affect sales remains unclear. Examining urban–rural differences is particularly important given longstanding disparities in smokeless tobacco use and tobacco-related health outcomes across these settings, yet little is known about whether ONP sales and attribute preferences differ between urban and rural areas.</div></div><div><h3>Objectives</h3><div>This study aims to examine how ONP sales are associated with product attributes and sales locations (rural vs. urban), and whether the associations between sales and attributes differ by urban/rural locations.</div></div><div><h3>Methods</h3><div>We linked 2021 NielsenIQ retail sales data with the National Center for Health Statistics county-level urban/rural classifications. Flavors were grouped as implicit (marketed without explicit flavor names), mint/menthol, fruity, or other. Multivariable linear regression models were used by regressing ONP sales on product attributes, rural/urban status, and their interactions.</div></div><div><h3>Results</h3><div>In 2021, 88% of total ONP sales occurred in urban areas, compared with 12% in rural areas. ONP sales per 1000 population were 16% higher in rural than urban areas (<em>p</em> &lt; 0.001). Compared to the sales of implicitly flavored ONPs, sales of mint/menthol, fruit, and other flavors were approximately 23-fold, 4-fold, and 7-fold higher, respectively. These flavor-related differences were less pronounced in rural counties than in urban counties. The price elasticity of demand was –0.66 (<em>p</em> &lt; 0.001) in urban areas and –0.33 (<em>p</em> &lt; 0.001) in rural areas.</div></div><div><h3>Conclusions</h3><div>ONP sales exhibit significant urban–rural disparities, with rural areas showing higher per capita sales overall, but urban areas showing stronger preferences for flavored products and greater price responsiveness. As a result, regulatory measures targeting flavors or pricing may have a greater impact in urban areas compared to rural ones.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105178"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098756","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}
引用次数: 0
Design and development of an automated surveillance system for outbreak detection and individual risk assessment for HIV and viral hepatitis B and C among people who use drugs: The Hippocrates project 设计和开发一个自动监测系统,用于在吸毒者中检测艾滋病毒和病毒性乙型和丙型肝炎的爆发和个人风险评估:希波克拉底项目
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-13 DOI: 10.1016/j.drugpo.2026.105195
Giota Touloumi , Valia Baralou , Nikos Pantazis , Argyro Karakosta , Olga Anagnostou , Dimitris Katsiris , Katerina Micha , Giorgos Pistikos , Christos Danopoulos , Kostas Rouptsos , Athanasios Theocharis
{"title":"Design and development of an automated surveillance system for outbreak detection and individual risk assessment for HIV and viral hepatitis B and C among people who use drugs: The Hippocrates project","authors":"Giota Touloumi ,&nbsp;Valia Baralou ,&nbsp;Nikos Pantazis ,&nbsp;Argyro Karakosta ,&nbsp;Olga Anagnostou ,&nbsp;Dimitris Katsiris ,&nbsp;Katerina Micha ,&nbsp;Giorgos Pistikos ,&nbsp;Christos Danopoulos ,&nbsp;Kostas Rouptsos ,&nbsp;Athanasios Theocharis","doi":"10.1016/j.drugpo.2026.105195","DOIUrl":"10.1016/j.drugpo.2026.105195","url":null,"abstract":"<div><h3>Background</h3><div>People who use drugs (PWUD) are a key population for HIV, HBV and HCV. Recent HIV outbreaks among PWUD, often preceded by undetected HCV outbreaks, highlight the need for timely outbreak detection and identification of high-risk individuals. We aimed to develop an automated system for real-time outbreak detection and individual risk assessment for HIV, HBV and HCV among PWUD.</div></div><div><h3>Methods</h3><div>An integrated information system was developed for data recording and monitoring of PWUD served by Greek Organization against Drugs. The outbreak detection system monitored weekly diagnoses and combined different methods to detect outbreak onset, non-increasing and post-epidemic state. As illustration, their performance was prospectively assessed with sensitivity, specificity and timeliness on a previous HIV outbreak among injecting drug users in Athens, Greece. A Cox model-based risk assessment tool was developed with predictors selected by Random Survival Forest among demographic, socio-economic, behavioural and drug-related data. Performance was evaluated with time-dependent area under curve (AUC).</div></div><div><h3>Results</h3><div>To detect outbreak onset, all methods achieved excellent performance (sensitivity&gt;90%, specificity&gt;94%, no delay in alarm). To detect decline, the best-performing method achieved 58% sensitivity, 91% specificity and 14 weeks timeliness. To detect post-epidemic state, no method yielded satisfactory balance between metrics. The risk assessment tool contained six factors: age, unemployment status, age at initiation of injecting use, syringe sharing, injection as primary mode of use, injecting use in the last month; yielding AUC<em>≅</em>70%.</div></div><div><h3>Conclusion</h3><div>Our automated system efficiently monitors HIV, HBV and HCV among PWUD and identifies high-risk individuals, enabling early interventions to improve outcomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105195"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192154","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}
引用次数: 0
Navigating harm reduction and security mandates: Prison leadership perspectives on implementing prison needle exchange programs in Canada 引导减少伤害和安全任务:加拿大监狱领导对实施监狱针头交换计划的看法
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-13 DOI: 10.1016/j.drugpo.2026.105197
Lise Lafferty , Nashira Popovic , Elise Weiss , Behzad Hajarizadeh , Andrew R. Lloyd , Frederick L. Altice , Nadine Kronfli
{"title":"Navigating harm reduction and security mandates: Prison leadership perspectives on implementing prison needle exchange programs in Canada","authors":"Lise Lafferty ,&nbsp;Nashira Popovic ,&nbsp;Elise Weiss ,&nbsp;Behzad Hajarizadeh ,&nbsp;Andrew R. Lloyd ,&nbsp;Frederick L. Altice ,&nbsp;Nadine Kronfli","doi":"10.1016/j.drugpo.2026.105197","DOIUrl":"10.1016/j.drugpo.2026.105197","url":null,"abstract":"<div><h3>Background</h3><div>Prison needle exchange programs (PNEPs) reduce bloodborne virus transmission among people who inject drugs, yet global implementation remains limited. Canada introduced PNEPs in 2018, but uptake is low, and barriers to implementation persist. While perspectives of correctional officers, healthcare workers, and incarcerated individuals have been examined, little is known about how prison leadership shapes program delivery. Drawing on interviews informed by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, we sought to identify the organisational, system, and structural/policy-level barriers to PNEP implementation from the perspectives of prison administrators.</div></div><div><h3>Methods</h3><div>Between January and March 2025, 27 prison leaders from custodial and medical services from nine Canadian federal prisons with operational PNEPs participated in semi-structured interviews. Data were thematically analysed using the EPIS framework.</div></div><div><h3>Results</h3><div>Implementation was shaped by structural tensions between harm reduction goals and “zero tolerance” custodial mandates. Outer context factors, especially union resistance, lack of policy clarity, and federal directives, created misalignment and ambiguity in program ownership. Prison climate, staff turnover, and leadership engagement influenced shifts in attitudes toward PNEPs over time. Healthcare personnel, though central to delivery, were often tasked with communicating custodial decisions, undermining trust. Intervention fit was shaped by security classification and perceived drug use patterns, with PNEPs viewed as ill-suited for minimum-security settings. Sites that streamlined approval processes and designated leadership roles were better positioned to support program uptake. Time, experiential exposure, and tailored education were key facilitators of cultural change and implementation readiness.</div></div><div><h3>Conclusion</h3><div>Addressing outer context barriers and clarifying responsibilities between health and corrections are critical to PNEP sustainability. Leadership engagement is essential to enabling system-wide adoption.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105197"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192155","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}
引用次数: 0
A nationally representative repeated cross-sectional study of 10-year substance use trends among culturally and linguistically diverse Australians 一项具有全国代表性的重复横断面研究,研究了文化和语言多样化的澳大利亚人10年来的物质使用趋势。
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-11 DOI: 10.1016/j.drugpo.2026.105179
Yan Yee Lee , Tianze Sun , Jason P. Connor , Coral Gartner , Germaine Lai , Heena Akbar , Carmen C.W. Lim
{"title":"A nationally representative repeated cross-sectional study of 10-year substance use trends among culturally and linguistically diverse Australians","authors":"Yan Yee Lee ,&nbsp;Tianze Sun ,&nbsp;Jason P. Connor ,&nbsp;Coral Gartner ,&nbsp;Germaine Lai ,&nbsp;Heena Akbar ,&nbsp;Carmen C.W. Lim","doi":"10.1016/j.drugpo.2026.105179","DOIUrl":"10.1016/j.drugpo.2026.105179","url":null,"abstract":"<div><h3>Aim</h3><div>To estimate the absolute and relative changes in prevalence of tobacco, e-cigarette, alcohol, and illicit substance use over the past decade among Culturally and Linguistically Diverse (CALD) and non-CALD populations in Australia from 2013 to 2022/23.</div></div><div><h3>Method</h3><div>Data were drawn from four waves of the National Drug Strategy Household Survey (NDSHS), comprising of 91, 282 respondents (2013: <em>n</em> = 23, 855; 2016: <em>n</em> = 23, 749; 2019: <em>n</em> = 22, 015; 2022/23: <em>n</em> = 21, 663). CALD status (22.5% of weighted sample) was defined as being born outside Australia/New Zealand/United Kingdom and/or speaking a language other than English at home. Analyses calculated weighted prevalence estimates and absolute and relative changes in prevalence between 2013 and 2022/23 with 99% CI.</div></div><div><h3>Findings</h3><div>Between 2013 and 2022/2023, any tobacco product use declined significantly for both CALD (14.4% to 8.5%, 99%CI:8.0%, -3.7%) and non-CALD respondents (18.0% to 9.6%, 99%CI:9.6%, -7.3%). E-cigarette use (measured from 2016) increased in both populations, with CALD showing a 5-fold increase (0.8% to 4.8%; 99%CI: 2.7%, 5.2%) and non-CALD showing a 4.8-fold increase (1.3% to 7.5%; 99%CI: 5.5%, 7.0%). Risky alcohol use declined among CALD (23.2% to 13.1%, 99%CI:12.7%, -7.6%) and non-CALD respondents (43.2% to 33.9%, 99%CI:10.9%, -7.6%). Any illicit substance use remained stable among CALD respondents (10.3% to 9.0%; 99%CI: −3.2%, 0.8%) but increased among non-CALD respondents (16.0% to 18.4%; 99%CI: 1.2%, 3.8%).</div></div><div><h3>Conclusions</h3><div>In Australia, CALD individuals had lower prevalence of use of most tobacco products, e-cigarettes, alcohol, and illicit drugs than non-CALD individuals. Between 2013 and 2022/23, roll-your-own cigarette and waterpipe use remained stable among CALD individuals despite significant declines in non-CALD individuals. Both groups experienced steep rises in e-cigarette use between 2016 and 2022/23.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105179"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182840","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}
引用次数: 0
Online marketing for alcohol home delivery and alcohol purchasing behaviour: A mixed-methods study 酒精送货上门和酒精购买行为的在线营销:一项混合方法研究
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-14 DOI: 10.1016/j.drugpo.2026.105202
Kerri Coomber , Kira Button , Emma Masiero , Florentine Martino , Adyya Gupta , Ryan Baldwin , Peter G Miller , Kathryn Backholer , Julia Stafford
{"title":"Online marketing for alcohol home delivery and alcohol purchasing behaviour: A mixed-methods study","authors":"Kerri Coomber ,&nbsp;Kira Button ,&nbsp;Emma Masiero ,&nbsp;Florentine Martino ,&nbsp;Adyya Gupta ,&nbsp;Ryan Baldwin ,&nbsp;Peter G Miller ,&nbsp;Kathryn Backholer ,&nbsp;Julia Stafford","doi":"10.1016/j.drugpo.2026.105202","DOIUrl":"10.1016/j.drugpo.2026.105202","url":null,"abstract":"<div><h3>Background and aims</h3><div>Alcohol home delivery is associated with increased alcohol consumption, with online marketing (including advertisements and promotions) potentially driving increased online purchases. This study aimed to understand consumers’ exposure to online advertising and promotions for alcohol home delivery and its association with alcohol purchase patterns.</div></div><div><h3>Methods</h3><div>Both quantitative (Study 1) and qualitative (Study 2) data were collected. Study 1 sampled 702 adult (≥18 years) Australian high-risk drinkers (AUDIT-10 score ≥8) to examine associations between purchase modality (in-store only, occasional online, and predominantly online) and exposure to, and influence of, online alcohol advertising. Study 2 collected screen recordings of online alcohol purchases from 30 Australian adult drinkers (15 low-risk and 15 high-risk drinkers), with a follow-up interview.</div></div><div><h3>Results</h3><div>Study 1 participants in both online purchase groups had higher odds of reporting exposure to online alcohol advertising compared to those who purchase in-store only, with predominant purchasers also more likely to see advertising daily compared to the two other groups. App notifications and virtual cart reminders were more likely to prompt predominant purchasers to complete their alcohol purchase compared to occasional purchasers. Study 2 found frequent appearance of in-platform, time-sensitive promotions, such as limited time discounts. Participants reported promotions influenced their purchasing behaviour to take advantage of special pricing. Participants also reported general exposure to online alcohol marketing sometimes leads them to make a purchase.</div></div><div><h3>Conclusion</h3><div>These findings show current marketing strategies encourage drinkers to purchase more alcohol. Strengthened policy initiatives are needed to help reduce alcohol-related harms due to marketing practices.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105202"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192156","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}
引用次数: 0
Outcomes and implications of British Columbia’s ‘drug decriminalization initiative’ for health-oriented drug policymaking 不列颠哥伦比亚省“药物非刑事化倡议”对面向健康的药物决策的结果和影响。
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-06 DOI: 10.1016/j.drugpo.2026.105181
Benedikt Fischer , Didier Jutras-Aswad , Bernard Le Foll , Daniel T. Myran
{"title":"Outcomes and implications of British Columbia’s ‘drug decriminalization initiative’ for health-oriented drug policymaking","authors":"Benedikt Fischer ,&nbsp;Didier Jutras-Aswad ,&nbsp;Bernard Le Foll ,&nbsp;Daniel T. Myran","doi":"10.1016/j.drugpo.2026.105181","DOIUrl":"10.1016/j.drugpo.2026.105181","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105181"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137928","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}
引用次数: 0
Temporal and regional associations between fentanyl concentrations in the unregulated drug supply and drug-related mortality in British Columbia, Canada 加拿大不列颠哥伦比亚省不受管制药物供应中芬太尼浓度与药物相关死亡率之间的时间和区域关联
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-14 DOI: 10.1016/j.drugpo.2026.105200
Samuel Tobias , Joshua Bird , Sara M. Guzman , Heather Palis , Alexis Crabtree , Jason E. Hein , Evan Wood , Lianping Ti
{"title":"Temporal and regional associations between fentanyl concentrations in the unregulated drug supply and drug-related mortality in British Columbia, Canada","authors":"Samuel Tobias ,&nbsp;Joshua Bird ,&nbsp;Sara M. Guzman ,&nbsp;Heather Palis ,&nbsp;Alexis Crabtree ,&nbsp;Jason E. Hein ,&nbsp;Evan Wood ,&nbsp;Lianping Ti","doi":"10.1016/j.drugpo.2026.105200","DOIUrl":"10.1016/j.drugpo.2026.105200","url":null,"abstract":"<div><h3>Background</h3><div>British Columbia (BC), Canada, continues to experience persistently high rates of unregulated drug toxicity. While the presence of fentanyl in the drug supply is well-established, less is known about how fluctuations in its concentration may influence mortality at the population level. This study describes geographic variation and temporal trends in fentanyl concentrations across BC and assesses if they are associated with unregulated drug toxicity rates.</div></div><div><h3>Methods</h3><div>Using a validated machine learning model that quantifies fentanyl and fluorofentanyl concentrations in unregulated opioid samples, we estimated concentrations in samples submitted to BC drug checking services from October 2018 to June 2025. We derived monthly median concentrations by geographic health service delivery area to determine historic monthly typical fentanyl strength. We then examined the relationship between fentanyl concentrations and unregulated drug toxicity mortality rates using a generalized additive mixed model (GAMM), accounting for regional heterogeneity, temporal trends, and autocorrelation.</div></div><div><h3>Results</h3><div>Median fentanyl concentrations varied geographically and temporally across the province, peaking provincially at 11.0% in mid-2023 before declining to 5.1% in early 2025. The GAMM estimated that, on average, each 1-percentage point increase in median fentanyl concentration was associated with a 0.072 increase in the monthly drug-related mortality rate per 100,000 population (<em>p</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>Quantifying fentanyl concentrations from point-of-care drug checking data enables detection of geographic and temporal patterns in the unregulated drug supply and their associations with drug-related mortality. This approach offers a tool for harm reduction, drug supply monitoring, and policy response during the ongoing drug toxicity crisis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105200"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192230","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}
引用次数: 0
Governance and trade: Mafias’ multifunctional violence in Italian drug markets 治理与贸易:黑手党在意大利毒品市场的多功能暴力
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-12 DOI: 10.1016/j.drugpo.2026.105183
Alberto Aziani , Francesco Calderoni
{"title":"Governance and trade: Mafias’ multifunctional violence in Italian drug markets","authors":"Alberto Aziani ,&nbsp;Francesco Calderoni","doi":"10.1016/j.drugpo.2026.105183","DOIUrl":"10.1016/j.drugpo.2026.105183","url":null,"abstract":"<div><div>Systemic violence is a structural feature of drug economies and a key spillover of prohibitionist drug policies. Despite its centrality, the concept is often applied in ways that obscure its distinct purposes, market levels, and organizational contexts. To address this gap, the study examines violence at the intersection of mafia activity and drug markets, focusing on its distribution across market levels (retail, national wholesale, transnational), organizational functions (governance and trade), and rivalry configurations (inter-, intra-, and extra-clan). It draws on a press-based dataset of mafia-related homicides in Italy (2014–2024) to code and analyze these dynamics. Results show that more than half of all mafia homicides are drug-related, mainly tied to governance activities and concentrated at the retail level of the market. This pattern marks a qualitative shift in mafia violence: increasingly selective, embedded in market dynamics, confined to criminal circuits. Statistical analyses reveal significant associations between activity type, market level, and rivalry configuration, indicating that coercion concentrates where regulatory control and market participation intersect. This pattern underscores the multifunctional nature of Italian mafias, which govern markets from within while actively engaging in trade. By grounding this overlap empirically, the study advances theoretical debates on organized crime’s role in shaping illicit economies. It also offers a replicable framework for analyzing drug-related violence in the absence of official statistics.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105183"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192153","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}
引用次数: 0
Risk behaviors and prevalence of hepatitis B and C among people who inject drugs in Georgia: integrated bio-behavioral survey (IBBS) 格鲁吉亚注射吸毒者中乙型和丙型肝炎的危险行为和流行:综合生物行为调查(IBBS)
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-12 DOI: 10.1016/j.drugpo.2026.105177
Kanchelashvili Giorgi , Butsashvili Maia , Kochlamazashvili Marika , Gulbiani Lasha , Abashidze Giga , Kamkamidze Tina , Abzianidze Tinatin , Adamia Sopio , Chelidze Nikoloz , Stvilia Ketevan , Kamkamidze George
{"title":"Risk behaviors and prevalence of hepatitis B and C among people who inject drugs in Georgia: integrated bio-behavioral survey (IBBS)","authors":"Kanchelashvili Giorgi ,&nbsp;Butsashvili Maia ,&nbsp;Kochlamazashvili Marika ,&nbsp;Gulbiani Lasha ,&nbsp;Abashidze Giga ,&nbsp;Kamkamidze Tina ,&nbsp;Abzianidze Tinatin ,&nbsp;Adamia Sopio ,&nbsp;Chelidze Nikoloz ,&nbsp;Stvilia Ketevan ,&nbsp;Kamkamidze George","doi":"10.1016/j.drugpo.2026.105177","DOIUrl":"10.1016/j.drugpo.2026.105177","url":null,"abstract":"<div><h3>Introduction</h3><div>Injection drug use (IDU) poses significant public health risks, including the transmission of blood-borne infections such as hepatitis B (HBV) and hepatitis C (HCV). This study aims to evaluate the prevalence of risk behaviors associated with IDU and the prevalence of HBV and HCV among people who inject drugs (PWID) in Georgia.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in seven cities of Georgia in 2022, involving 2005 PWID aged ≥18 years. Participants were recruited using respondent-driven sampling. Data were collected through face-to-face interviews and blood samples were collected for HCV/HBV testing.</div></div><div><h3>Results</h3><div>The majority of study participants (98.6%) were males, 63.2% were older than 40 years, and 51.3% had a history of imprisonment. 24.4% reported using a needle/syringe previously used by someone else. HCV seropositivity was found in 58.1% of respondents, with 32.1% of anti-HCV positive individuals testing positive for HCV RNA. HBV surface antigen was detected in 2.5%. Only 7.5% reported being vaccinated for hepatitis B and 27.8% expressed willingness to be vaccinated. 33.9% had HCV treatment history. HCV prevalence was significantly higher among males, older PWID, those with a history of incarceration and history of sharing needles used by others.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the high prevalence of HCV and low HBV vaccination rates among PWID in Georgia, emphasizing the need for strengthened harm reduction strategies. Expanding sterile injection access, integrating HBV vaccination, and removing structural barriers are key to improving prevention and testing efforts and linkage to care.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"150 ","pages":"Article 105177"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192229","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}
引用次数: 0
Breaking the cycle: addressing the evolving dynamic of violence associated with the European drug market 打破循环:处理与欧洲毒品市场有关的不断演变的暴力动态。
IF 4.4 2区 医学
International Journal of Drug Policy Pub Date : 2026-04-01 Epub Date: 2026-02-11 DOI: 10.1016/j.drugpo.2026.105182
Teodora Groshkova, Alexander Söderholm, Marieke Liem, Kim Moeller, Seán Redmond, Paul Griffiths, Karin Svanberg, Célia Bobet, Liesbeth Vandam, Marica Ferri, Andrew Cunningham
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