International Journal of Drug Policy最新文献

{"title":"Opioid overdose and mortality among people who use or inject drugs in Myanmar: A large register-based study","authors":"Carl Fredrik Sjöland ,&nbsp;Ye Htet Kyaw ,&nbsp;Maxim Kan ,&nbsp;Leo Ziegel ,&nbsp;Keshab Deuba ,&nbsp;Thiha Lin ,&nbsp;Susanne Strömdahl ,&nbsp;Fredrik Liljeros ,&nbsp;Anders Hammarberg ,&nbsp;Martin Kåberg ,&nbsp;Aung Yu Naing ,&nbsp;Anna Mia Ekström","doi":"10.1016/j.drugpo.2025.104968","DOIUrl":"10.1016/j.drugpo.2025.104968","url":null,"abstract":"<div><h3>Background</h3><div>Opioid overdose incidence in Myanmar has not been systematically measured. We quantified individual risk factors of overdose, overdose incidence and mortality, and examined predictors of pre‑overdose engagement with harm reduction services.</div></div><div><h3>Methods</h3><div>Electronic registers from 21 Asian Harm Reduction Network–Best Shelter (AHRN–BS) sites in Sagaing, Kachin, and northern Shan (2014–2025) were linked. Incidence and mortality were calculated with the exact Poisson method. A retrospective cohort of 155,875 clients—65,089 people who inject drugs—was analyzed with modified Poisson regression to estimate adjusted prevalence ratios (aPR) for overdose; cases occurring in 2022–2025 were further analyzed for predictors of past‑year service engagement.</div></div><div><h3>Results</h3><div>Registers captured 3472 verified opioid overdoses in 2913 persons. Among people who inject drugs, pooled incidence was 16.8/1000 person‑years (95 % CI 16.2–17.5) and overdose mortality 0.5/1000 person‑years (0.4–0.7). Current injecting without opioid‑agonist therapy (OAT) carried an aPR 8.1 (95 % CI 6.1–10.6) relative to recent non‑injecting use, rising to aPR 10.7 (95 % CI 7.8–14.8) among those who also received OAT. Three‑quarters of overdoses (2598) occurred in persons not enrolled in harm reduction programs; incidence among enrolled clients was 5.7/1000 person-years (95 % CI 5.2–6.2). Migrants were less likely to have accessed services in the year preceding overdose (aPR 0.82, 95 % CI 0.68–0.98). Alcohol was reported in 70.5 % of events and stimulants in 7.2 %.</div></div><div><h3>Discussion</h3><div>Opioid overdose is common and disproportionately affects people outside existing programs. Expanding peer‑led and mobile outreach, tailoring referral pathways for migrants, broadening community naloxone distribution, and securing sustained domestic financing are urgent priorities.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104968"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911829","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":"Discourses of addiction in the construction of people whose drinking affected others in narratives about alcohol harms to others","authors":"Hoang Van Nguyen,&nbsp;Anne-Marie Laslett","doi":"10.1016/j.drugpo.2025.104973","DOIUrl":"10.1016/j.drugpo.2025.104973","url":null,"abstract":"<div><div>While research in alcohol harms to others (AHTO) has described the characteristics of people whose drinking affects others, few studies have investigated the construction of the affecting drinkers from the perspectives of those who have been affected.</div><div>Drawing on data gathered through qualitative interviews with people who reported having been affected by others’ drinking, a discourse analysis was conducted to examine how they constructed the drinkers who affected them in the stories about their experiences.</div><div>The study focuses on stories about AHTO occurrences related to repeated, long-lasting harms that involve people who engaged in ‘problematic’ drinking that affected others, as framed by the affected persons. The discourse analysis showed how participants drew on three dominant discourses about addiction as disease, as choice, and as a social condition, to account for their experiences. Findings demonstrated the multiplicity of discourses in stories of AHTO, which participants conformed, challenged, and negotiated with to (re)construct the people whose drinking affected them as either the ‘perpetrator’, ‘victim’, or both.</div><div>Findings contribute to understanding of the ways in which affected persons make sense of their experiences of AHTO and attribute blame and responsibility. The flexible uses of multiple discourses in context also have implications for clinical settings to encourage agency while destigmatising alcohol use disorder.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104973"},"PeriodicalIF":4.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907558","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":"Appearance of 2-MMC and 3-MMC on the illicit drug market in the Netherlands: A systematic narrative review of the prevalence and risks","authors":"Jan van Amsterdam ,&nbsp;Ton Nabben ,&nbsp;Wim van den Brink","doi":"10.1016/j.drugpo.2025.104971","DOIUrl":"10.1016/j.drugpo.2025.104971","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Use of the synthetic methylmethcathinones 2-MMC and 3-MMC (2/3-MMC) is emerging, especially among young people, but their health risks remain unclear.</div></div><div><h3>Method</h3><div>A systematic narrative review was conducted on studies describing the availability, pharmaco-toxicological profile, and user characteristics of 2/3-MMC, with a focus on the situation in The Netherlands.</div></div><div><h3>Results</h3><div>Among nightlife youth (16–35 yrs.) in The Netherlands, reported past-year 3-MMC use increased almost four-fold within two years,and in 2022 became the third most commonly used substance (33.7 %), after cannabis and MDMA. 2/3-MMC appears to have a pharmaco-toxicological profile similar to 4-MMC (mephedrone), with similar dopaminergic but less serotonergic activity. Their shorter duration of action may lead to increased craving and more frequent re-dosing compared to 4-MMC. Low price, high availability and positive recommendations on social media have attracted (very) young (aged 14–17), who are often particularly vulnerable. Despite a legal ban on 3-MMC in 2021, the number of individuals seeking treatment for problematic 3-MMC use in the Netherlands rose from 33 in 2021 to 330 in 2023. Most cases involved polydrug users.</div></div><div><h3>Conclusions</h3><div>In general, 2/3-MMC appear to be less toxic and harmful than other illicit substances though their use may result in more craving, more frequent re-dosing and, thus, to more dependence than 4-MMC. The number of treatment seeking problematic 3-MMC users is increasing. Drug regulation may help prevent a further rise in 2/3-MMC use, although a shift to other cathinones cannot be ruled out. Mental health organisations should therefore remain vigilant to monitor problematic 2/3-MMC use, especially among vulnerable (very) young users.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104971"},"PeriodicalIF":4.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907557","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":"5F-AKB48: A synthetic cannabinoid presenting an emerging public health concern in France","authors":"Clément Harmel ,&nbsp;Weniko Caré ,&nbsp;Hervé Laborde-Casterot ,&nbsp;Marc Liautard ,&nbsp;Jérôme Langrand ,&nbsp;Laurène Dufayet","doi":"10.1016/j.drugpo.2025.104972","DOIUrl":"10.1016/j.drugpo.2025.104972","url":null,"abstract":"<div><h3>Introduction</h3><div>5F-AKB48 is a potent synthetic cannabinoid with psychoactive effects. This study aimed to describe the sociodemographic and clinical characteristics of 5F-AKB48 exposures reported to French Poison Control Centers (PCCs).</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of all acute 5F-AKB48 exposure cases reported to French PCCs from 2017 to 2024. Collected data included patient demographics, symptoms, and outcomes. Poisoning severity was assessed using the Poison Severity Score (PSS).</div></div><div><h3>Results</h3><div>A total of 304 cases were identified, mostly in adolescent males (median age: 16.5 years; sex ratio: 4.4). Most exposures occurred in northern France. 5F-AKB48 was used alone in 91 % of cases. Of these, 59 % presented with mild symptoms, 35 % with moderate symptoms, and 4 % with severe symptoms (including seizures, coma, and agitation). More severe outcomes were observed in cases involving multiple substances. No fatalities were reported, though the outcome was unknown in 36 % of cases.</div></div><div><h3>Conclusion</h3><div>5F-AKB48 appears to be an emerging recreational drug among adolescents in France, probably due to its discreet use in liquid forms compatible with e-cigarette. While most cases were mild to moderate, the potential for serious toxicity, particularly with co-exposure, should not be overlooked. The associated risks call for stronger public health measures, including stricter e-cigarettes regulation and drug education initiatives in educational settings.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104972"},"PeriodicalIF":4.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904488","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":"Pre-implementation findings on the barriers and potential solutions to initiate same-day antiretroviral therapy among people who inject drugs in Malaysia","authors":"David Oliveros ,&nbsp;Grazele Jenarun ,&nbsp;N.A. Mohd Salleh ,&nbsp;Rumana Saifi ,&nbsp;Valerie A. Earnshaw ,&nbsp;Lynn M. Madden ,&nbsp;Daniel J. Bromberg ,&nbsp;Ryan A. Sutherland ,&nbsp;Benjamin M. Nikitin ,&nbsp;Adeeba Kamarulzaman ,&nbsp;Frederick L. Altice","doi":"10.1016/j.drugpo.2025.104967","DOIUrl":"10.1016/j.drugpo.2025.104967","url":null,"abstract":"<div><h3>Background</h3><div>Rapid-start antiretroviral therapy (RS-ART), including same-day ART (SD-ART), effectively improves individual and public health by speeding up treatment initiation but is underutilized among people who inject drugs (PWID). As a pre-implementation activity, we assessed barriers and facilitators to SD-ART for PWID in Malaysia using insights from multiple stakeholders.</div></div><div><h3>Methods</h3><div>We conducted focus groups (<em>n</em> = 4) using nominal group technique (NGT), a mixed-methods research strategy, with PWID, HIV specialists, and community health workers (CHWs) in Greater Kuala Lumpur, Malaysia. This method involved open questions, round-robin listing of ideas, and participant voting to derive a rank-ordered consensus on major implementation barriers and facilitators, organized according to the socioecological model.</div></div><div><h3>Results</h3><div>Among PWID (<em>n</em> = 5: 15 votes), the highest-ranking barriers included fear of police (40 %), procedural complexity (30 %), and discomfort with HIV providers (27 %). HIV specialists (<em>n</em> = 12: 36 votes) ranked readiness for treatment (27 %), risk of opportunistic infections (20 %), and incarceration concerns (13 %) as key barriers. CHWs (<em>n</em> = 7: 21 votes) pointed to complex appointment systems (33 %), delays in confirmatory testing (19 %), and stigma-reinforcing interactions with clinicians (19 %) as obstacles. Facilitators for PWID included initiating ART before reviewing results (27 %) and same-day counseling (27 %). For HIV specialists, essential strategies were enhancing NGO partnerships (33 %) and expanding ART options like dolutegravir (20 %). CHWs recommended simplifying treatment processes (33 %) and creating a dedicated clinic for HIV services (29 %).</div></div><div><h3>Conclusion</h3><div>Despite available harm reduction and HIV treatment services, structural and interpersonal stigma significantly hinder SD-ART initiation among PWID in Malaysia. Addressing stigma through tailored ART initiation strategies is crucial for closing this implementation gap.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104967"},"PeriodicalIF":4.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904490","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":"Novel psychoactive substances in Australian emergency departments: implications for public health practice from multi-centre prospective toxicosurveillance across five states, 2022–2023","authors":"Jennifer L. Smith ,&nbsp;Courtney C. Weber ,&nbsp;Jennifer L. Schumann ,&nbsp;Nadine Ezard ,&nbsp;Daniel M. Fatovich ,&nbsp;David McCutcheon ,&nbsp;Katherine Z. Isoardi ,&nbsp;Andrew H. Dawson ,&nbsp;Rebekka Syrjanen ,&nbsp;Keith Harris ,&nbsp;Peter Stockham ,&nbsp;Emma Partridge ,&nbsp;Sam Alfred ,&nbsp;Viet Tran ,&nbsp;Ellie M. Kotkis ,&nbsp;Paul Sakrajda ,&nbsp;Melissa Trujillo ,&nbsp;Shaun L. Greene ,&nbsp;EDNA and EDNAV investigator teams","doi":"10.1016/j.drugpo.2025.104969","DOIUrl":"10.1016/j.drugpo.2025.104969","url":null,"abstract":"<div><h3>Background</h3><div>Comprehensive toxicology testing of emergency department (ED) presentations has become a prominent data source on novel psychoactive substances (NPS) in Australia. We describe the type and frequency of analytically confirmed NPS across five Australian states and 28 EDs between 2022 and 2023.</div></div><div><h3>Methods</h3><div>This is a prospective series of ED presentations with at least one confirmed NPS detection identified by the Emerging Drugs Network of Australia (EDNA) and Emerging Drugs Network of Australia Victoria (EDNAV). De-identified demographic and toxicology data were extracted for analysis.</div></div><div><h3>Results</h3><div>At least one NPS was detected in 646 ED presentations. Total detections was 1044 across 59 different compounds. The median age was 26 years (range 16–90 years) and 464 (71.8 %) were male. Benzodiazepine-type NPS comprised over three-quarters of all NPS positive cases (526, 81.4 %), bromazolam being most frequent (290, 44.9 % total cases). Twenty-four different novel stimulants were detected across 88 (13.6 %) presentations, N,N-dimethylpentylone (52, 8.0 % total cases) the most common. Novel opioids, dissociatives and synthetic cannabinoid receptor agonists made up a small proportion of total NPS positive cases. These findings directly informed nine public health harm reduction communications by multiple state government authorities warning of high-risk NPS detections. Traditional illicit drug co-detections were common (520, 80.5 %), in particular methylamphetamine (404, 62.5 %).</div></div><div><h3>Conclusion</h3><div>Drug intelligence data generated in an acute harm setting such as the ED can provide early warning of drugs of concern circulating in the community, including NPS. This facilitates rapid community responses to reduce harm and inform subsequent public health responses.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104969"},"PeriodicalIF":4.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885666","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":"Using nominal group technique (NGT) to identify barriers and facilitators to implement rapid-start direct-acting antiviral (DAA) for people who use drugs living with hepatitis C in Malaysia","authors":"N. Adi Azahar ,&nbsp;D. Devi ,&nbsp;S. Rampal ,&nbsp;A. Kamarulzaman ,&nbsp;NA. Mohd Salleh","doi":"10.1016/j.drugpo.2025.104966","DOIUrl":"10.1016/j.drugpo.2025.104966","url":null,"abstract":"<div><h3>Introduction</h3><div>The uptake of direct-acting antiviral (DAA) is suboptimal among people who use drugs (PWUD) living with hepatitis C virus (HCV). However, innovative methods such as Rapid-Start DAA (RS-DAA) can expedite treatment initiation. We sought to explore the perspectives of HCV service providers, policy experts and PWUD to guide the development of an RS-DAA strategy in Malaysia.</div></div><div><h3>Methods</h3><div>Three separate focus groups were conducted in Klang Valley, Malaysia, using the Nominal Group Technique with HCV service providers, policy experts, and PWUD. These sessions included open questions, silent idea generation and individual round-robin feedback. Discussions were guided by Høj’s framework on access to HCV care, and concluded with a structured voting process, through which participants generated a rank-ordered list of ideas to systematically inform the RS-DAA strategy.</div></div><div><h3>Results</h3><div>A total of 23 participants were recruited: HCV service providers (<em>n</em> = 10, working in primary and tertiary healthcare settings), policy experts (<em>n</em> = 5, from public health organizations), and PWUD (<em>n</em> = 8, with varied HCV treatment experiences). Service providers identified delays in receiving HCV RNA results as the top barrier. Policy experts emphasized limited testing capacity and concerns about outreach team’s capabilities. PWUD cited time constraints due to work and family responsibilities. Potential solutions included enabling remote registration of new clients, improved laboratory coordination, and enhanced community awareness on HCV.</div></div><div><h3>Conclusion</h3><div>Addressing logistical challenges, fostering collaboration, and optimizing processes are essential for RS-DAA. The next step will involve revising the proposed protocol based on stakeholder feedback and moving towards its implementation.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104966"},"PeriodicalIF":4.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The shifting riskscape: Changes in geographic accessibility to alcohol, cannabis, and tobacco in Ontario, Canada from 2019 to 2022","authors":"Shiran Zhong ,&nbsp;Alexander Wray ,&nbsp;Jamie Seabrook ,&nbsp;Jason A Gilliland","doi":"10.1016/j.drugpo.2025.104965","DOIUrl":"10.1016/j.drugpo.2025.104965","url":null,"abstract":"<div><h3>Background</h3><div>Geographic accessibility to alcohol, cannabis, and tobacco has changed in Ontario, Canada between 2019 and 2022 due to regulatory changes.</div></div><div><h3>Aim</h3><div>We conceptualize geographic accessibility to these substances as a ‘riskscape’ and investigate how these recent regulatory changes have altered the substance riskscape in Ontario, Canada in relation to neighborhood socioeconomic factors.</div></div><div><h3>Design</h3><div>We use an interrupted time series design to calculate the shortest distance between the centroid of each dissemination block and the nearest alcohol, cannabis, and tobacco outlet in 2019 and 2022. The geographic accessibility to substance outlets is further evaluated in relation to neighborhood disadvantage.</div></div><div><h3>Findings</h3><div>Accessibility to alcohol and cannabis increased substantially across the province, while there were minimal reductions in accessibility to tobacco during the same time period. Neighborhoods with a higher prevalence of lone parenthood, low educational attainment, and government transfer recipients exhibited a higher exposure to risky substances compared to the general population. The regulatory changes further exacerbated potential vulnerability among these populations to varying degrees.</div></div><div><h3>Conclusions</h3><div>The substantial changes in accessibility to alcohol, cannabis, and tobacco warrant further investigation, particularly focusing on how these shifting riskscapes influence consumption patterns, disparities in harm, and long-term health outcomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104965"},"PeriodicalIF":4.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to healthcare among managed alcohol program participants: A mixed methods study","authors":"Alexa Davis ,&nbsp;Bernie Pauly ,&nbsp;Sherry H. Stewart ,&nbsp;Tim Stockwell ,&nbsp;Mark Asbridge","doi":"10.1016/j.drugpo.2025.104950","DOIUrl":"10.1016/j.drugpo.2025.104950","url":null,"abstract":"<div><div>Managed alcohol programs (MAPs) offer safe and regulated doses of alcohol to individuals with high-risk drinking behaviours unresponsive to other treatments. These harm reduction programs aim to reduce alcohol-related harms and increase access to housing, health, and social services. In our study we aimed to understand the impacts of MAP participation on access to healthcare. Using a mixed methods design, we analyzed data collected in six Canadian cities between 2014 and 2017. Data sources included surveys from MAP participants (<em>n</em> = 188) and locally recruited and matched control participants (<em>n</em> = 198), and semi-structured interviews with MAP participants (<em>n</em> = 56). In the quantitative cross-sectional analysis, MAP participants were more likely to report regular (OR 1.77 [1.02 – 3.07]) and satisfactory (OR 2.02 [1.04 – 3.91]) access to healthcare compared to controls. We identified variable findings in access to healthcare between a subset of MAP (<em>n</em> = 82) and control (<em>n</em> = 116) participants with 12-month longitudinal follow-up data; however, when MAP participants were on the program, they had an increased likelihood of reporting regular (OR 2.16 [1.04 – 4.48]) and satisfactory (OR 3.23 [1.09 – 9.54]) access to healthcare compared to when they were off the program. Themes generated from the qualitative analysis illustrated the services offered within and alongside MAPs, the impacts of the MAP environment on access to healthcare, and the time needed to develop trusting relationships and address complex needs. These findings highlight the importance of long-term supportive care to improve access to healthcare among those experiencing homelessness and alcohol use disorders.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104950"},"PeriodicalIF":4.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867526","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":"Drug-free nation: Reconstructing the ‘official drug narratives’ in Singapore and the Philippines","authors":"Gideon Lasco","doi":"10.1016/j.drugpo.2025.104947","DOIUrl":"10.1016/j.drugpo.2025.104947","url":null,"abstract":"<div><h3>Background</h3><div>This paper reconstructs and analyses the “official drug narratives” in Singapore and the Philippines as recounted by its drug enforcement agencies and government officials. Drawing inspiration from narrative analyses and works that have explored official and institutional narratives, it defines such narratives as government accounts of how drugs figured in its country’s history and how it responded to the challenges posed by drugs to society. It then identifies common elements in these narratives, namely plot, settings, characters, and moral of the story.</div></div><div><h3>Methods</h3><div>Documents and other material from drug-policy and-enforcement related institutions, primarily the Central Narcotics Bureau (CNB) and the Ministry of Home Affairs (MHA) for Singapore, and the Dangerous Drugs Board (DDB) and Philippine Drug Enforcement Agency (PDEA) for the Philippines, from 2015 to 2024, with particularly attention to drug policy-related anniversaries and official commemorations.</div></div><div><h3>Findings</h3><div>In both countries, official drug narratives highlight the national(list) character of their drug policies and cast their longstanding campaigns in existential terms, relying on the language of statistics and expertise, as well as a curation of the past, to legitimise the righteousness of their initiatives. While people involved with drugs were the expected ‘villains’ and the citizenry, especially the youth, the expected victims, notable was the characterisation of drug enforcers as underdogs pit against powerful enemies.</div></div><div><h3>Conclusion</h3><div>Analysing official drug narratives offers a way to examine a country’s policy trajectories and overall paradigms and call attention to aspects that may be overlooked because they are not directly related to policy. By reconstructing the narrative content and structure of governments’ discourses on drugs, official drug narratives can contribute towards a better understanding not just of the making of national drug policies, but on the stories on which they stand.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104947"},"PeriodicalIF":4.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860418","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}