International Journal of Drug Policy最新文献

{"title":"Trends in cause-specific mortality among people with hepatitis C virus in New South Wales, Australia","authors":"Shane Tillakeratne ,&nbsp;Heather Valerio ,&nbsp;Maryam Alavi ,&nbsp;Behzad Hajarizadeh ,&nbsp;Marianne Martinello ,&nbsp;Jacob George ,&nbsp;Gail Matthews ,&nbsp;Jason Grebely ,&nbsp;Sallie-Anne Pearson ,&nbsp;Gregory J. Dore","doi":"10.1016/j.drugpo.2025.104790","DOIUrl":"10.1016/j.drugpo.2025.104790","url":null,"abstract":"<div><h3>Background</h3><div>Monitoring of HCV-related morbidity and mortality is crucial to evaluate direct-acting antiviral (DAA) therapy impact and HCV elimination progress. This population-based study examined mortality among individuals with an HCV notification in New South Wales (NSW), Australia, including cause-specific mortality prior to and during the viral hepatitis elimination era (2015–2021).</div></div><div><h3>Methods</h3><div>HCV notifications in NSW, Australia (1995–2021) were linked to hospitalisation records and cause-specific mortality records. Over the period 2002–2021, all-cause and cause-specific mortality rates were examined. Cox proportional hazard models were used to assess factors associated with mortality during the viral hepatitis elimination era.</div></div><div><h3>Results</h3><div>Among people with HCV notifications in 1995–2021, 112,046 were alive during 2002–2021 and contributed to mortality analyses. All-cause mortality per 100,000 population increased from 5.5 in 2002 to 13.4 in 2015 and plateaued at 12.9 in 2021. Liver-related mortality per 100,000 population increased from 2.0 in 2002 to 5.9 in 2015, before declining to 4.6 in 2021. Drug-related mortality per 100,000 population increased from 0.7 in 2002 to 1.8 in 2015, before declining to 1.2 in 2021. Factors associated with increased mortality risk during 2015–2021 included: recent injecting drug use (adjusted Hazard Ratio [aHR] 7.22, 95 % CI 6.84–7.62) and recent alcohol use disorder (aHR 3.17, 95 % CI 2.97–3.37). Recent opioid agonist therapy (aHR 0.47, 95 % CI 0.43–0.51) and recent incarceration (aHR 0.32, 95 % CI 0.23–0.45) were associated with lower mortality risk.</div></div><div><h3>Conclusion</h3><div>During the HCV elimination era, both liver-related and drug-related mortality have declined, suggesting direct and indirect impacts of DAA therapy, respectively. Expanded opioid agonist therapy coverage and enhanced alcohol use disorder management could further reduce mortality.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104790"},"PeriodicalIF":4.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738123","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 Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose","authors":"Brandon del Pozo ,&nbsp;Traci C. Green ,&nbsp;Morgan Godvin ,&nbsp;Bradley Ray","doi":"10.1016/j.drugpo.2025.104789","DOIUrl":"10.1016/j.drugpo.2025.104789","url":null,"abstract":"<div><h3>Context</h3><div>Police seizures of illicit opioids remain a dominant strategy for addressing problematic substance use and overdose in the United States and throughout the world, yet qualitative accounts and quantitative analyses exhibit positive associations between police opioid seizures and ensuing risk of fatal overdose at the local level of individual incidents. Since these associations run counter to the commonly held belief that removing potent illicit substances from the community is protective of overdose, a causal model is needed to demonstrate this association and convey the overdose risks that follow from police opioid seizures.</div></div><div><h3>Methods</h3><div>Leveraging well-established biological and psychological outcomes of opioid use disorder and opioid supply interruption, our analysis presents the Police Opioid Seizure Temporal Risk (POSTeR) Model, an individual-level casual model that begins at the point of opioid dependence, introduces an interruption to an individual's supply of opioids as the result of a police drug seizure, and presents the physical and behavioral outcomes that increase the ensuing temporal risk of fatal overdose.</div></div><div><h3>Results</h3><div>The aftermath of a police opioid seizure can increase a person's risk of fatal overdose. The urgent need to prevent or reduce acute opioid withdrawal symptoms leads people to seek a replacement supply, while reduced opioid tolerance resulting from post-seizure involuntary abstinence combines with the uncertain potency of a replacement supply of illicit opioids to significantly increase the difficulty of administering a safe but effective dose. In the face of these hazards, people in withdrawal often have a reduced aversion to risk, prompting them to consume this uncertain dose in a manner that increases their exposure to overdose.</div></div><div><h3>Conclusions</h3><div>Strategies that emphasize police opioid seizures as an acceptable way to reduce the prevalence of illicit drugs in a community without accounting for the elevated risk of fatal overdose that results can worsen one of the most significant problems they are meant to address.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104789"},"PeriodicalIF":4.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726110","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":"Current regulations in context: Scraping Australia's online nitrous oxide market","authors":"Samuel Gresham ,&nbsp;Jacques Eugene Raubenheimer","doi":"10.1016/j.drugpo.2025.104773","DOIUrl":"10.1016/j.drugpo.2025.104773","url":null,"abstract":"<div><h3>Background</h3><div>Nitrous oxide is a gas which is often used in the production of whipped cream, but can also be inhaled as a recreational dissociative drug. Usage rates of recreational nitrous oxide appear to be increasing in Australia.</div></div><div><h3>Aims</h3><div>This study aims to characterise the online nitrous oxide marketplace in Australia to understand the efficacy of current legislation and inform future legislative changes.</div></div><div><h3>Methods</h3><div>Google Trends data were used to identify top search terms used to find sites selling nitrous oxide. Sites were then identified from these search terms in Google and Bing, which together hold over 98 % of Australia's search engine market. Each identified site was then screened and scraped for product and other relevant data using custom Python scripts.</div></div><div><h3>Results</h3><div>A total of 93 websites were identified for inclusion, with the top 49 websites fully scraped for products. Overall, 997 products were identified, of which 696 (69.8 %) contained nitrous oxide. Relatively few sites verified the age of users, and many sites provided potentially dangerous bulk pricing incentives. Flavourings were commonly added to nitrous oxide products, potentially attracting younger audiences.</div></div><div><h3>Discussion</h3><div>These data indicate that legislative change is desperately needed in Australia to minimise the availability of rapidly delivered online-derived nitrous oxide. Legislative bodies should consider a range of supply and demand-based regulations to minimise the well understood personal and societal harms related to nitrous oxide use.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104773"},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704426","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":"\"Quick, simple, and friendly\": Understanding the acceptability and accessibility of a nurse and peer-led, mobile model of hepatitis C care adjacent to community corrections in Australia","authors":"Samara Griffin ,&nbsp;Shelley Walker ,&nbsp;Jacinta A Holmes ,&nbsp;Bridget Reid ,&nbsp;Amanda Callus ,&nbsp;Mark Belzer ,&nbsp;Jane Dicka ,&nbsp;Timothy Papaluca ,&nbsp;Anne Craigie ,&nbsp;Sophia Schroeder ,&nbsp;Kari Lancaster ,&nbsp;Margaret Hellard ,&nbsp;Mark Stoové ,&nbsp;Alexander J. Thompson ,&nbsp;Rebecca J Winter","doi":"10.1016/j.drugpo.2025.104785","DOIUrl":"10.1016/j.drugpo.2025.104785","url":null,"abstract":"<div><h3>Background</h3><div>People on community corrections orders are at high-risk for hepatitis C but opportunities for hepatitis C care may be missed due to poor integration of prison-based healthcare. The C No More study is a pilot feasibility study of point-of-care hepatitis C testing and rapid treatment initiation delivered adjacent to community corrections settings in Melbourne, Australia, via a mobile, nurse and peer-led, low-threshold model of care.</div></div><div><h3>Methods</h3><div>We conducted a mixed methods evaluation using Levesque's Conceptual Framework of Access to Health to understand participants’ experiences and perspectives on the accessibility of this model of care. Interviewer-administered surveys were conducted with all participants after enrolment and initial testing, and qualitative in-depth interviews were conducted with a sample of those who completed the survey.</div></div><div><h3>Results</h3><div>500 participants completed the survey, and 20 participants undertook in-depth interviews. Both quantitative and qualitative results indicated that participants found the C No More service approachable and accessible due to the informal outreach setting, the involvement of peer workers, and the convenient location of service delivery. Participants reported feeling comfortable seeking care in the van and found the service appropriate and easy to engage with due to the fingerstick point-of-care testing and individualised support provided by the nurse.</div></div><div><h3>Conclusion</h3><div>Multiple elements of the C No More model increased client-perceived service accessibility, including being located close to government services, point-of-care testing, and the person-centred, peer-based and non-judgemental nurse-led care provided. This study supports the implementation of other peer and nurse-led models of hepatitis C care in similar settings.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104785"},"PeriodicalIF":4.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697990","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":"Alcohol advertising in disguise: Exposure to zero-alcohol products prompts adolescents to think of alcohol—Reaction time experimental study","authors":"Ashlea Bartram ,&nbsp;Murthy Mittinty ,&nbsp;Md Abdul Ahad ,&nbsp;Svetlana Bogomolova ,&nbsp;Joanne Dono ,&nbsp;Aimee L. Brownbill ,&nbsp;Nathan J. Harrison ,&nbsp;Jacqui Garcia ,&nbsp;Ivana Glavinic ,&nbsp;Mia May ,&nbsp;Jacqueline Bowden","doi":"10.1016/j.drugpo.2025.104753","DOIUrl":"10.1016/j.drugpo.2025.104753","url":null,"abstract":"<div><h3>Background</h3><div>Zero-alcohol drinks (&lt;0.5 % alcohol by volume) appear and taste like alcoholic drinks; they may feature brands from alcoholic drinks (“brand extensions”) or “new-to-world” brands. These drinks are not consistently included within many restrictions aimed at reducing adolescents’ exposure to alcohol products and advertising. This online study examined whether adolescents implicitly categorise images of zero-alcohol drinks as alcoholic beverages.</div></div><div><h3>Methods</h3><div>331 Australian adolescents aged 15–17 years participated in an online within-subjects reaction time experiment. Participants viewed 20 randomly-ordered images of alcohol, zero-alcohol, and soft drink products and were asked to indicate as quickly as possible whether these images made them think of alcohol, with both response time and agreement recorded. Generalised linear mixed effects models were used to examine differences in response time and agreement by drink type, adjusting for clustering of responses within participants, recent consumption, survey device (mobile/computer), and parental presence.</div></div><div><h3>Results</h3><div>Most images of alcoholic (94.4 %), brand extension zero-alcohol (90.7 %), and “new-to-world” zero-alcohol (85.6 %) drinks prompted participants to think of alcohol, compared to 5.2 % of soft drinks. In the mixed effects model, compared to alcoholic drinks, participants on average responded 72 ms slower to brand extension zero-alcohol drinks and 215 ms slower to “new-to-world” brand zero-alcohol drinks.</div></div><div><h3>Conclusions</h3><div>The combination of high levels of agreement and slower reaction times suggest that adolescents categorise zero-alcohol drinks as non-typical alcoholic drinks, rather than soft drinks. Thus, exposure to zero-alcohol drinks had similar effects to exposure to alcoholic drinks. Urgent regulatory action is required to ensure that restrictions on alcohol advertising and availability to minors extend to zero-alcohol drinks.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104753"},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683877","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":"Journey mapping drug seizures among police, public health and local nonprofit professionals, and community members who use drugs","authors":"Bethany Hedden-Clayton ,&nbsp;Erin Comartin ,&nbsp;Jennifer J. Carroll ,&nbsp;Grant Victor ,&nbsp;Brandon del Pozo ,&nbsp;Jessica Best ,&nbsp;Bradley Ray","doi":"10.1016/j.drugpo.2025.104774","DOIUrl":"10.1016/j.drugpo.2025.104774","url":null,"abstract":"<div><h3>Background</h3><div>A growing number of studies suggest that police efforts to disrupt illicit drug markets through the removal of illicit drugs can result in unintended harms to people who use drugs by increasing overdose risks. However, little is understood about the perceptions, expectations, or experiences of those who implement, experience, and/or are impacted by these seizure events.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews (N = 54) with police, public health and local nonprofit professionals engaged in overdose prevention efforts, and people who use drugs (PWUD) in Indianapolis, Indiana—a city where drug seizures have been associated with excess overdose—to examine how each of these groups perceive these events. We use a journey mapping framework to analyze expectations for each of these personas around the shared scenario of drug seizures.</div></div><div><h3>Results</h3><div>Law enforcement drug seizures are routine and are perceived by police as interconnected, longitudinal attempts to dismantle drug supply networks. Public health and local nonprofit professionals described potential harms stemming from drug seizures but reported lacking the shared information and inter-agency collaboration necessary to provide a meaningful response. PWUD reported negative health consequences and increased risk of overdose following drug seizure events. PWUD use multiple strategies to reduce perceived harms from drug seizures.</div></div><div><h3>Conclusion</h3><div>Seizing drugs whenever, wherever, or with whomever they are found has become an accepted policing practice in the United States, ostensibly to reduce risk of drug-related harms. This study offers a new perspective to the growing evidence that this standard practice may result in a myriad of negative public health outcomes for the community. Research, such as this, that engages the lived experiences and perceptions of directly impacted people, is essential for understanding and mitigating these harms. Those most impacted by drug seizures – PWUD – should be at the center of developing, implementing, and evaluating public health and harm reduction efforts to reduce the harms associated with drug seizures.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104774"},"PeriodicalIF":4.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683878","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":"Facilitating access to direct-acting antivirals in a community-based point-of-diagnosis model for hepatitis C treatment: The role of the pharmacy team in the no one waits (NOW) study","authors":"Colleen A. McGourty ,&nbsp;Diana Ung ,&nbsp;Mackenzie Clark ,&nbsp;Jennifer Nguyen ,&nbsp;Claire McDonell ,&nbsp;Annie Luetkemeyer ,&nbsp;Jeff McKinney ,&nbsp;Jennifer C. Price ,&nbsp;Meghan D. Morris","doi":"10.1016/j.drugpo.2025.104768","DOIUrl":"10.1016/j.drugpo.2025.104768","url":null,"abstract":"<div><h3>Background</h3><div>Despite simplified hepatitis C virus (HCV) treatment algorithms, insurance-related barriers prevent same-day HCV treatment upon diagnosis in the US. We assessed how direct partnerships with a pharmacy team facilitated HCV treatment initiation among socially marginalized populations in a community setting.</div></div><div><h3>Methods</h3><div>The No One Waits (NOW) Study, a single-arm trial conducted between July 1, 2020, and October 31, 2021, in San Francisco, CA, targeted individuals experiencing homelessness, injecting drugs, and eligible for simplified HCV treatment. Upon positive HCV RNA results, participants were enrolled in same-day treatment and given a 2-week sofosbuvir/velpatasvir (SOF/VEL) starter pack. Additional insurance-provided SOF/VEL was requested for 12 weeks of treatment. If insurance-provided medication was unavailable, SOF/VEL was provided using the study supply. We describe the sustained partnership with a specialty pharmacy team that was necessary for the NOW model's success.</div></div><div><h3>Results</h3><div>Eighty-seven participants started treatment at diagnosis. Most were unsheltered (61 %), actively injecting drugs (80 %), and had incomes below the federal poverty line (97 %). 90 % transitioned to insurance-covered treatment before completion, with pharmacy members assisting participants in navigating insurance authorization, medication transport, and financial assistance.</div></div><div><h3>Conclusion</h3><div>A sustained partnership with a specialty pharmacy team was critical in transitioning participants to insurance-covered treatment quickly and overcoming barriers, while the study-provided 2-week starter pack facilitated same-day treatment at the point of diagnosis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104768"},"PeriodicalIF":4.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619451","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 relationship between patient-centred care for substance use disorders and patient outcomes: A scoping review","authors":"Bronwyn Myers ,&nbsp;Nicholas Da Silva ,&nbsp;Stella McLaughlin ,&nbsp;Jessika Purnomo ,&nbsp;Daria Shumskaya ,&nbsp;Kaori Koume ,&nbsp;Sanita Suhartono ,&nbsp;Giovanna Campello ,&nbsp;Anja Busse","doi":"10.1016/j.drugpo.2025.104770","DOIUrl":"10.1016/j.drugpo.2025.104770","url":null,"abstract":"<div><h3>Background</h3><div>Patient-centred care (PCC) is considered crucial for high-quality substance use disorder (SUD) treatment and care, but it is unclear whether PCC is associated with enhanced outcomes. This review aimed to map available evidence of the relationship between PCC and outcomes across the SUD treatment continuum.</div></div><div><h3>Methods</h3><div>We conducted a scoping review of the literature on the relationship between PCC for SUD and service outcomes in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Six electronic databases were searched for peer-reviewed articles published in English between January 1994 and June 2024. After screening 5268 titles and abstracts and 186 full texts in duplicate, data were extracted from 135 articles and narratively synthesized according to six PCC dimensions (therapeutic alliance, shared decision-making, personalised supports, integrated care for co-occurring disorders, trauma-informed and culturally-informed care).</div></div><div><h3>Results</h3><div>The findings from this review suggest largely positive associations between these PCC components and the outcomes of generalist and specialist SUD services. Few studies (&lt;1 %) assessed more than one PCC dimension. The therapeutic alliance was the most frequently assessed dimension (35.6 %, 48/135 articles), followed by shared decision-making (16.3 %, 22/135 articles), trauma-informed care (14.8 %, 20/135 articles), integrated care (13.3 %, 18/135 articles), and personalised services (13.3 %, 18/135 articles). PCC in generalist services was associated with greater SUD treatment utilization and fewer adverse events. PCC in specialist SUD treatment was largely associated with better SUD outcomes.</div></div><div><h3>Conclusions</h3><div>This review highlighted evidence gaps on the relationship between PCC and SUD service outcomes, with literature scant for some PCC dimensions and studies typically examining a single dimension of PCC. More research is needed to understand the relative importance of each PCC dimension for predicting SUD service outcomes, how these dimensions interact to influence outcomes, and to develop and evaluate interventions for enhancing PCC.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104770"},"PeriodicalIF":4.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619374","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 association between social capital and drug overdose mortality in the United States","authors":"Tarfa Verinumbe MD, MPH ,&nbsp;Andrea N. Ponce MPH ,&nbsp;Grace Y. Lee BSc ,&nbsp;Unique Kumtap MPH ,&nbsp;Catherine R. Lesko PhD ,&nbsp;Malik Burnett MD, MPH ,&nbsp;Carl Latkin PhD ,&nbsp;Oluwaseun Falade-Nwulia MD, MPH","doi":"10.1016/j.drugpo.2025.104766","DOIUrl":"10.1016/j.drugpo.2025.104766","url":null,"abstract":"<div><h3>Background</h3><div>Drug-related death is a significant public health challenge in the United States (U.S.). While social capital has emerged as a macro-social construct of interest in understanding the predictors of drug overdose, most research has examined this construct at the individual and neighborhood-level. This ecological study aims to investigate the association between county-level social capital and drug overdose mortality across 50 U.S. states and the District of Columbia.</div></div><div><h3>Methods</h3><div>County-level social capital, as measured by a social capital index (SCI), was obtained from the U.S. Congress’ Social Capital Project. The SCI incorporates indicators related to family structure stability, confidence and trust in institutions, community cohesion, social network structure and volunteerism. County drug overdose mortality data from 2017 to 2019 were obtained from the National Vital Statistics System restricted-use data files. The association between county-level social capital and drug overdose mortality was assessed by multi-level negative-binomial regression models.</div></div><div><h3>Results</h3><div>In a sample of 2,992 counties, SCI ranged from -4.32 standard deviation below to 2.97 standard deviation above the average SCI across counties. After adjusting for covariates, a one standard deviation increase in SCI was associated with a 24 % decrease in drug overdose death rate (adjusted IRR: 0.76; 95 % CI: 0.71, 0.81).</div></div><div><h3>Conclusion</h3><div>In this study, counties with high social capital had significantly lower rates of drug overdose deaths than counties with low social capital. Policymakers may consider interventions aimed at promoting factors that mediate the effects of social capital on drug overdose mortality, as a way to tackle this public health challenge.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104766"},"PeriodicalIF":4.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619367","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 the potential of wastewater-based epidemiology to estimate the retail illicit drug market size in Europe: A case study","authors":"Maarten Quireyns ,&nbsp;Natan Van Wichelen ,&nbsp;Tim Boogaerts ,&nbsp;Tim Surmont ,&nbsp;Andrew Cunningham ,&nbsp;João Matias ,&nbsp;Celine Gys ,&nbsp;Adrian Covaci ,&nbsp;Alexander L.N. van Nuijs","doi":"10.1016/j.drugpo.2025.104771","DOIUrl":"10.1016/j.drugpo.2025.104771","url":null,"abstract":"<div><h3>Background and aims</h3><div>Estimating the retail drug market size is complex due to its clandestine nature, yet useful for intervention and policy planning. Wastewater-based epidemiology (WBE) offers an alternative strategy to estimate population-wide consumption trends by analysing influent wastewater, avoiding self-reporting biases associated with other estimation techniques, e.g., consumption or expenditure-based models. This study evaluates the applicability of WBE for drug market size estimation.</div></div><div><h3>Methods</h3><div>Using WBE data the drug market situation of amphetamine, cocaine, MDMA, and methamphetamine is estimated in European cities (<em>n</em>=75) through combination with price/purity information (Statistical Bulletin) published by the European Union Drugs Agency. Market sizes were estimated at three levels: (L1) pure drug quantities, (L2) adulterated retail drugs quantities, and (L3) market value. Furthermore, yearly consumption estimates from the commonly applied consecutive seven-day sampling is compared to a randomised stratified sampling approach in Brussels, Belgium.</div></div><div><h3>Results</h3><div>Challenges include the availability and accuracy of price and purity data, which complicates cross-country comparisons and hinders the higher-levels calculations. Due to missing data, the market value (L3) could only be calculated for a limited number of cities, i.e., 39% (amphetamine), 39% (cocaine), 1% (MDMA), and 23% (methamphetamine). Furthermore, statistically significant differences were shown for amphetamine (up to 139% measurement error) and methamphetamine (up to 58% measurement error) between both sampling approaches.</div></div><div><h3>Conclusions</h3><div>Particularly at city level, WBE can complement traditional market size estimations, but significant uncertainties remain. Future research should expand one-week consecutive sampling to a randomised stratified sampling approach tailored to drug and location.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104771"},"PeriodicalIF":4.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610667","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}