International Journal of Drug Policy最新文献

{"title":"A pre-post study of the impact of a multidisciplinary model of care on linkage to hepatitis C care following release from prison: The Beyond Prison Walls study","authors":"Nadine Kronfli ,&nbsp;Andrea Mambro ,&nbsp;Allen O’Brien ,&nbsp;Camille Dussault ,&nbsp;Sylvie Chalifoux ,&nbsp;Lina del Balso ,&nbsp;Apostolia Petropoulos ,&nbsp;Mona Lim ,&nbsp;Alexandros Halavrezos ,&nbsp;Bertrand Lebouche ,&nbsp;Giada Sebastiani ,&nbsp;Marina B. Klein ,&nbsp;Joseph Cox","doi":"10.1016/j.drugpo.2025.104873","DOIUrl":"10.1016/j.drugpo.2025.104873","url":null,"abstract":"<div><h3>Background</h3><div>Many people are released from prison with untreated hepatitis C virus (HCV) and fail to link to care due to competing priorities. We compared linkage to HCV care among individuals who engaged in a multidisciplinary model of care versus in standard of care, and examined factors associated with linkage to care.</div></div><div><h3>Methods</h3><div>We conducted a prospective, quasi-experimental pre-post study in Quebec’s largest provincial prison. Participants in the intervention arm met with a nurse, social worker, and patient navigator and were offered appointment accompaniment post-release. Participants in the control arm received a pre-release discharge appointment. The primary outcome was linkage to HCV care, defined as a documented visit with an HCV care provider within 90 days of release. Bayesian logistic regression was used to determine the impact of the intervention on linkage and to analyze relationships between covariates of interest and linkage. Probability differences and 95 % credible intervals (95 % CrI) were calculated.</div></div><div><h3>Results</h3><div>Overall, 648 participants underwent HCV screening; 19 and 20 had current HCV infection in the control and intervention arms, respectively. Among these, 2 (11 %) and 14 (80 %) were linked to care post-release, respectively. Intervention participants had a + 70 % (45 %, 88 %) difference in linkage to care versus control participants. Among intervention participants, those who were successfully contacted post-release were more likely to be linked to care [+64 % (14 %, 90 %)] than those who were not.</div></div><div><h3>Conclusions</h3><div>A multidisciplinary model of care increased linkage to HCV care among untreated individuals released from prison. Future interventions should support similar models, leveraging social support networks to maximize continuity of care.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104873"},"PeriodicalIF":4.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263724","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":"Speed and smoking kill: A time-varying survival analysis linking methamphetamine use, cigarette smoking, and mortality in sexual minority men","authors":"Grace Yi ,&nbsp;Marjan Javanbakht ,&nbsp;Allison D. Rosen ,&nbsp;Pamina Gorbach ,&nbsp;Jesse Clark ,&nbsp;Steven Shoptaw","doi":"10.1016/j.drugpo.2025.104874","DOIUrl":"10.1016/j.drugpo.2025.104874","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Sexual minority men (SMM) in the US experience high rates of methamphetamine use and are disproportionately affected by HIV. Unlike prior studies among treatment-seeking populations, this study examined associations between methamphetamine use, smoking, and mortality in a community-based cohort of SMM, half of whom have HIV. Using time-varying survival models, we assessed how dynamic patterns of substance use impact mortality risk over time.</div></div><div><h3>Design and Setting</h3><div>This longitudinal cohort study followed <em>N</em> = 541 SMM in Los Angeles from two community-based sites (2014–2023). Substance use and health outcomes data were collected biannually through behavioral surveys and clinical evaluations. Deaths were defined using the Los Angeles Medical Examiner Database or direct reports from participants’ family or friends. We used Cox proportional hazards regression with time-varying covariates to assess the association between methamphetamine use, cigarette smoking, and mortality risk.</div></div><div><h3>Findings</h3><div>There were <em>N</em> = 19 observed deaths in our cohort. Daily methamphetamine use (aHR=4.45, 95 % CI 1.33–14.9), weekly methamphetamine use (aHR=3.32, 95 % CI 1.09–10.1) and smoking more than ½ pack of cigarettes per day (aHR=3.28, 95 % CI 1.07–10.0) were significantly and independently associated with increased risk of mortality, after adjusting for confounders.</div></div><div><h3>Conclusions</h3><div>Findings confirm that consistent methamphetamine use and cigarette smoking above a threshold frequency of use significantly increase mortality risk among otherwise healthy SMM. Comprehensive interventions including behavioral therapies and risk screening are warranted to mitigate early mortality and improve health outcomes among SMM.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104874"},"PeriodicalIF":4.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263061","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":"Effectiveness of periodic incentives on clinic attendance and hepatitis C testing and treatment for people who inject drugs: A five-year retrospective program evaluation","authors":"Carly Mallise ,&nbsp;Danika Tremain ,&nbsp;Maya Lindsay ,&nbsp;Nathan Ryder ,&nbsp;Kate Fisher ,&nbsp;Benjamin Moran ,&nbsp;Christophe Lecathelinais ,&nbsp;Joanna Mesure ,&nbsp;Jason Grebely ,&nbsp;Alison Marshall ,&nbsp;Adrian Dunlop ,&nbsp;Sally Woodward ,&nbsp;Judith Byaruhanga ,&nbsp;Jodi Tyne ,&nbsp;Annette Slater ,&nbsp;Melanie Kingsland","doi":"10.1016/j.drugpo.2025.104868","DOIUrl":"10.1016/j.drugpo.2025.104868","url":null,"abstract":"<div><h3>Background</h3><div>There is a significant global burden of chronic hepatitis C virus (HCV) infection, with many affected individuals, particularly people who inject drugs (PWID), not receiving testing and treatment. Financial incentives may increase HCV care uptake among PWID, but current evidence is limited. This study evaluated the effectiveness of routine financial incentives for clinic appointment attendance, HCV testing, and HCV treatment among PWID in Newcastle, Australia.</div></div><div><h3>Methods</h3><div>During twice-yearly 4–7-week periods from January 2016 to December 2020, people accessing a needle and syringe program were offered a gift card to attend a clinic appointment at the partnering sexual health service. Clinic records provided data on appointment attendance, HCV testing, and treatment initiation. Poisson regression and chi-square analyses were used to compare outcomes between incentive and non-incentive periods.</div></div><div><h3>Results</h3><div>Among the 1161 PWID who accessed the sexual health service during the study period, there were 4309 appointments attended and 1763 HCV tests undertaken. During the incentive periods, significantly more appointments (IRR 3.01, 95 % CI 2.74–3.31, <em>p</em>&lt;.001) and HCV tests (IRR 5.02, 95 % CI 4.28–5.90, <em>p</em>&lt;.001) occurred per week for PWID compared to the non-incentive periods. However, PWID were more likely to initiate HCV treatment during the non-incentive periods.</div></div><div><h3>Conclusion</h3><div>Integrating financial incentives into routine service delivery may be an effective strategy to increase clinic attendance and HCV testing among PWID. Further research is needed on optimising financial incentives for HCV treatment initiation.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104868"},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241957","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":"Association of fentanyl test strip results and change in drug use behaviors: A multi-state, community-based observational study","authors":"Kitty H. Gelberg ,&nbsp;Nabila El-Bassel ,&nbsp;Denise C. Babineau ,&nbsp;Rachel A. Vickers-Smith ,&nbsp;Laura C. Fanucchi ,&nbsp;Janet E. Childerhose ,&nbsp;Megan E. Hall ,&nbsp;Megan E. Dzurec ,&nbsp;Jennifer Villani ,&nbsp;Mary R. Russo ,&nbsp;Patricia LeBaron ,&nbsp;Katherine R. Marks ,&nbsp;Kathyrn E. Lancaster ,&nbsp;Louisa Gilbert ,&nbsp;James L. David ,&nbsp;Barry S. Eggleston ,&nbsp;Carter A. Roeber ,&nbsp;Emmanuel A. Oga ,&nbsp;Redonna K. Chandler ,&nbsp;Sharon L. Walsh","doi":"10.1016/j.drugpo.2025.104867","DOIUrl":"10.1016/j.drugpo.2025.104867","url":null,"abstract":"<div><h3>Background</h3><div>The Stay Safe Study, conducted between May and December 2023 in the United States, investigated the association between fentanyl test strip (FTS) use and risk reduction behaviors. This paper examines the association between self-reported FTS results and change in drug use behaviors.</div></div><div><h3>Methods</h3><div>We solicited self-reported drug and FTS use among people who use drugs (PWUD), with a baseline and four weekly surveys over a 28-day observation period in three states (Kentucky, New York and Ohio). For each day participants reported drug use, they were asked types of drugs used, use of FTS, FTS results, and 12 drug use behavior changes because of the result. A generalized estimating equation approach was used to model associations between FTS results and each outcome.</div></div><div><h3>Results</h3><div>These analyses included 541 PWUD who used FTS at least once in the observation period. Positive FTS results were associated with participants taking turns, having naloxone nearby, and using less drugs. There was a four-fold reduction in the amount of drugs used following a positive FTS result (odds ratio (OR)=4.37; 95 % CI, 3.45–5.55). This was modified by self-reported types of drugs tested, with a 20-fold reduction when testing illicit benzodiazepines (OR=19.92; 95 % CI, 8.6–46.27), a 10-fold reduction when testing illicit stimulants (OR=10.04; 95 % CI, 6.49–15.53), and 2-fold reduction in drugs used when testing illicit opioids or other drugs tested (OR=2.11; 95 % CI, 1.14–3.92).</div></div><div><h3>Conclusions</h3><div>These findings suggest that FTS assist PWUD to immediately reduce their risks by changing drug use behaviors, including reducing the amount of drug used.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104867"},"PeriodicalIF":4.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241475","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":"Countering the institutionalization of harm reduction through critical pragmatism","authors":"Andie MacNeil","doi":"10.1016/j.drugpo.2025.104872","DOIUrl":"10.1016/j.drugpo.2025.104872","url":null,"abstract":"<div><div>Although harm reduction practices have been increasingly adopted within health and social service systems globally over the last few decades, this process of institutionalization has not brought conceptual or theoretical clarity to the field of harm reduction. Instead, the growth of harm reduction practices within institutions has revealed the tension between grassroots approaches to harm reduction that focus on social activism and changing the underlying structural harms surrounding substance use, and the depoliticized institutional uses of harm reduction that focus on pragmatically managing individual substance use behaviour. In response to this tension and lack of theoretical clarity, the current paper proposes a critical pragmatist theoretical framework for harm reduction. First, I outline the basic principles of critical theory and pragmatism, and situate various harm reduction movements within these two theoretical foundations. Second, I explain how institutionalization has contributed to pragmatism being positioned as the primary underlying theory of harm reduction and the resulting limitations of this theoretical framing. Finally, I propose a theoretical framework that explicitly integrates both pragmatism and critical theory to help resist this process of institutionalization. I describe the key characteristics of critical pragmatism and outline the epistemological considerations of this pluralist approach as a theoretical framework for harm reduction. To conclude, I reflect on some of the challenges for harm reduction within a shifting political landscape in North America.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104872"},"PeriodicalIF":4.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241955","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":"Necropolitics of the North: A rapid ethnography examining the effects of the closure of one of Northern Ontario’s only supervised consumption sites","authors":"Lucas Tucker ,&nbsp;Francisco Ibanez-Carasco ,&nbsp;Brooke Legault ,&nbsp;Dawn Cameron ,&nbsp;Janett Michaud ,&nbsp;Guy Seguin ,&nbsp;Emily Groot ,&nbsp;Amreetha Jayathilake ,&nbsp;Kaela Pelland ,&nbsp;Amber Fritz ,&nbsp;Heidi Eisenhauer ,&nbsp;Geoff Bardwell","doi":"10.1016/j.drugpo.2025.104869","DOIUrl":"10.1016/j.drugpo.2025.104869","url":null,"abstract":"<div><h3>Background</h3><div>People who use drugs (PWUD) in Northern, rural, and smaller urban Canadian communities are disproportionately affected by drug-related harms and face barriers such as limited resources and heightened stigma. Supervised consumption sites (SCS) are intended to address individual and community harms. In 2024, the only SCS in Sudbury, a small city in Northern Ontario, Canada, closed due to a lack of provincial funding. In this paper, we explore the impact of this closure on PWUD.</div></div><div><h3>Methods</h3><div>We conducted a community-based rapid ethnography inclusive of naturalistic observations and qualitative semi-structured interviews (<em>n</em> = 27). Data were analyzed thematically using a participatory analytic approach and analysis was informed by theories of necropolitics and structural violence.</div></div><div><h3>Results</h3><div>Following the closure of the SCS site, participants perceived a reduction in access to harm reduction services, as well as negative impacts on personal well-being. Participants reported that the SCS’s closure forced local PWUD to begin unsafe consumption practices, resulting in increased overdose risk, physical health issues, and social stigma. The closure negatively affected safety, social connectedness, availability, and ease of access to harm reduction supplies.</div></div><div><h3>Conclusions</h3><div>The SCS closure has exacerbated already limited support for PWUD in Sudbury and increased their exposure to a variety of risks and harms. Necropolitics of the state deem PWUD as unworthy of living, resulting in structural violence and the creation of death worlds for PWUD.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104869"},"PeriodicalIF":4.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241588","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":"Like birds of a feather? A multi-case study on the connections between cannabis, tobacco, alcohol and pharmaceutical companies in legalized cannabis markets","authors":"Marthe Ongenaert,&nbsp;Tom Decorte","doi":"10.1016/j.drugpo.2025.104863","DOIUrl":"10.1016/j.drugpo.2025.104863","url":null,"abstract":"<div><h3>Background</h3><div>As of 2024, cannabis legalization in Northern American countries has spurred industry growth, intersecting with alcohol, tobacco, and pharmaceuticals. This study examines the investments and employee movement between five cannabis companies and alcohol, tobacco and pharmaceutical companies in order to explore the connections between the industries. While these relationships may bolster cannabis businesses, they also pose risks such as profit-driven practices that could undermine public health protections.</div></div><div><h3>Method</h3><div>An exploratory and descriptive approach was used to analyze business investments and employee flow between five cannabis companies (Canopy Growth, Aurora Cannabis, Tilray, Cronos Group, and Organigram) and alcohol, tobacco, and pharmaceutical companies. Data was collected through Nexis Uni, corporate reports, press releases, and LinkedIn, documenting financial transactions and management transitions.</div></div><div><h3>Results</h3><div>The results reveal investment relationships between the five cannabis companies and companies from the alcohol, tobacco, and pharmaceutical sectors. Some cannabis companies have secured substantial investments from alcohol and tobacco firms, which view cannabis as both a competitor and an opportunity for market expansion. These investments often come with influence, allowing industries to shape the cannabis market. Additionally, employee flows indicate cross-industry expertise transfer, particularly in management, finance, and strategy. This suggests that traditional companies are strategically positioning themselves within the cannabis sector, while cannabis companies are leveraging expertise form other sectors to drive innovation.</div></div><div><h3>Conclusion</h3><div>The connections between cannabis and traditional industries raise concerns over market dynamics and public health risks by importing profit-driven tactics that weaken regulations and public safety. By drawing on lessons from established industries, future studies can help navigate the balance between industry growth and societal well-being, ensuring that cannabis commercialization does not come at the expense of consumer health.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104863"},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223165","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":"Negotiating the divide: Science, politics, and institutional boundaries in Swiss cannabis regulation","authors":"Sharon R. Sznitman ,&nbsp;Reto Auer ,&nbsp;Jonathan Christopher Havinga ,&nbsp;Alessandro Casalini ,&nbsp;Barbara Broers","doi":"10.1016/j.drugpo.2025.104865","DOIUrl":"10.1016/j.drugpo.2025.104865","url":null,"abstract":"<div><h3>Aim</h3><div>Cannabis policy developments worldwide typically follow separate tracks for medical and non-medical use, even in jurisdictions pursuing both forms of legalization. As these parallel regulatory frameworks evolve, understanding how stakeholders negotiate and maintain boundaries between these domains become crucial for effective policy development. Using Swiss cannabis policies as a case study, this study examines how stakeholders engage in boundary work related to medical and non-medical cannabis regulation.</div></div><div><h3>Methods</h3><div>Thematic content analysis was conducted on qualitative interview data from 18 stakeholders involved in Swiss cannabis policy.</div></div><div><h3>Results</h3><div>Two distinct forms of boundary work emerged. <em>Conceptual boundary work</em> involved using discursive methods to legitimize medical cannabis as scientific while positioning non-medical cannabis in the social/political domain. <em>Structural boundary work</em> manifested through institutional mechanisms, particularly health insurance reimbursement and pharmacy distribution. Insurance reimbursement served as a key structural element distinguishing medical from non-medical cannabis. However, using pharmacies as distribution points in non-medical cannabis regulatory pilot projects was identified as problematic, potentially undermining intended boundaries between domains.</div></div><div><h3>Conclusions</h3><div>The study reveals that stakeholders engage in boundary work as a strategic tool to navigate the complexity of maintaining boundaries between medical and non-medical cannabis systems. Relying on scientific discourse to legitimize medical cannabis while keeping non-medical cannabis in the social/political sphere may create artificial distinctions that do not reflect the complex reality of cannabis use. Policymakers aiming to reduce blurred boundaries should carefully consider how policy elements may undermine intended separations between domains.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104865"},"PeriodicalIF":4.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223164","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":"Beyond the label: analyzing the presence and information behind the QR codes on alcohol containers in 13 European countries","authors":"","doi":"10.1016/j.drugpo.2025.104862","DOIUrl":"10.1016/j.drugpo.2025.104862","url":null,"abstract":"<div><h3>Introduction</h3><div>Digital labelling through quick-response (QR) codes is increasingly proposed by the alcohol producers to inform consumers without significantly modifying their original labels. Current alcohol labelling policy discourse in Europe often revolves around the advantages and disadvantages of digital labelling, yet evidence on actual practices and the information provided through QR codes is lacking. This study aimed to assess the presence of QR codes on alcohol labels in 13 European countries, as well as the accessibility and content of the information behind those.</div></div><div><h3>Methods</h3><div>The study methodology was developed with the EVID-ACTION Youth Network, with members sampling stores and products based on a co-developed mapping protocol. Thirty-four stores in 25 cities across 13 European countries were visited between April and August 2024. Descriptive analysis was conducted by beverage type and country.</div></div><div><h3>Results</h3><div>Of 1815 products examined, 31 % contained QR codes (23 % beers, 37 % wines, 30 % spirits). Most QR codes (84 %) were positioned on the back of containers, and 61 % had no explanatory text about their purpose. Most accessed websites were in local languages (75 %), with 36 % requiring age information to enter. Websites most commonly contained brand/drink information (46 %), followed by nutritional information (42 %), health information (42 %), and ingredient information (41 %).</div></div><div><h3>Discussion</h3><div>Almost a third of alcoholic beverages in 13 European countries contained QR code. However, most labels did not specify the purpose of the code. Furthermore, given the website content, there is concern that they serve as a promotional tool rather than providing access to nutritional and risk information.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104862"},"PeriodicalIF":4.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185751","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":"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}