International Journal of Drug Policy最新文献

{"title":"A proportionality approach to the ethics of drug policy","authors":"Mary Jean Walker","doi":"10.1016/j.drugpo.2025.104861","DOIUrl":"10.1016/j.drugpo.2025.104861","url":null,"abstract":"<div><div>This paper applies a proportionality approach to examining the ethics of drug policy. The principle of proportionality states that to be ethically permissible a policy should be likely to impose only burdens that are proportionate to its benefits. I develop an analysis of proportionality judgements as involving two important kinds of ethical reasoning, characterised as consequentialist and deontological, which often interact with each other. I then apply the analysis to examples of drug policies to show how it assists in identifying forms of ethical reasoning potentially informing policy decisions and how they can interact, and identifying normative claims required for the policy to be ethically justifiable. In doing so, the proportionality approach aims to prompt assessment of normative commitments that may affect policy decisions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104861"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139587","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":"Off-label GLP-1 weight-loss medicine use among online bodybuilders: Folk pharmacology, risk and harm reduction","authors":"Luke A. Turnock ,&nbsp;Evelyn Hearne ,&nbsp;Jennifer Germain ,&nbsp;Mikey Hirst ,&nbsp;Honor D. Townshend ,&nbsp;Lambros Lazuras","doi":"10.1016/j.drugpo.2025.104854","DOIUrl":"10.1016/j.drugpo.2025.104854","url":null,"abstract":"<div><h3>Background</h3><div>GLP-1 medicines (e.g. Semaglutide; Tirzepatide) are diabetes medicines that have recently been approved for weight loss purposes. These drugs are increasingly common, with many users accessing these medicines for off-label lifestyle-oriented purposes. While recent research has explored increased interest in these drugs, to date no studies have explored their use in bodybuilding cultures. With bodybuilders often at the forefront of experimental drug use, and diffusing knowledge of drugs to other populations, this research examines bodybuilders’ understandings of use and risk of GLP-1 medicines, and community approaches to harm reduction.</div></div><div><h3>Methods</h3><div>This research adopted a netnographic approach, exploring 12,392 unique posts from 160 threads across two popular bodybuilding forums. Qualitative thematic analysis of posts was undertaken.</div></div><div><h3>Findings</h3><div>Bodybuilders frequently undertook experimental approaches to GLP use, including ‘stacking’ multiple compounds and ‘cycling’ between them, presenting risk. GLPs’ utility for bodybuilding was questioned by some owing to their muscle-wastage effects, but many bodybuilders combined them with anabolic-androgenic steroids (AAS) to off-set these side-effects. In addition to their weight-loss properties, many users discussed the drugs’ anti-ageing properties, and older men appear to be a significant emerging user population. While displacing potentially dangerous fat burners in bodybuilders’ folk pharmacologies, GLPs nonetheless presented risks of hypoglycaemia when combined with AAS, and broader harms. Harm reduction information was frequently shared in forum spaces as part of bodybuilders’ communal folk pharmacology, but some enabling behaviours likely to heighten risk were also identified.</div></div><div><h3>Discussion</h3><div>We examine the likely implications of these findings for public health, with particular reference to the practices of ‘cycling’ and ‘stacking’ GLP medicines and the risk this presents, particularly when combined with drugs such as AAS and far burners. We discuss the need for harm reduction services such as drug testing services, and the need for healthcare professionals to be aware of anti-ageing motivations for use among older men. Continued research into novel GLP use is needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104854"},"PeriodicalIF":4.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131414","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":"Policy reform and the international future of Moroccan Cannabis production","authors":"Pierre-Arnaud Chouvy","doi":"10.1016/j.drugpo.2025.104841","DOIUrl":"10.1016/j.drugpo.2025.104841","url":null,"abstract":"<div><div>In 2023, Morocco produced the first legal <em>Cannabis</em> crop of any illegal hashish-producing country, only three years after it legalised the cultivation of <em>Cannabis</em> for medical and industrial purposes. Nevertheless, as the country continues to amend its regulatory framework and economic policies, numerous questions and uncertainties persist regarding the success of its strategy for the export of <em>Cannabis</em> products and the evolution of its domestic consumer market.</div><div>This current study details and explains how Morocco has advantageously legalised what it calls “licit uses of cannabis”, notably by not referring to hemp, but also by making the strategic decision not to adopt an overall tetrahydrocannabinol (THC) threshold. This study also addresses key agricultural technicalities, such as how higher legal THC levels benefit cannabidiol (CBD) yields and how this directly impacts economic competitiveness, as well as how legal rules and details are structuring a new and rapidly changing global legal cannabinoid market. This study goes beyond the case of Morocco by considering what diverse and evolving international legislations mean for potential future Moroccan exports, depending on how CBD is viewed and regulated in different countries, whether as a pharmaceutical, a wellness product, or a food supplement.</div><div>The study concludes that while the Moroccan authorities have quickly and pragmatically adapted their regulations, both at the production and consumption level, the future of Morocco’s legal <em>Cannabis</em> industry remains largely dependent on local and global environmental and economic factors that will influence its development and viability.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104841"},"PeriodicalIF":4.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124518","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":"Strong increase in the number of intoxications involving psychoactive drugs among adolescents reported to the Dutch Poisons Information Center from 2014–2023","authors":"Ilze MJ Thoonen ,&nbsp;Saskia J Rietjens ,&nbsp;Arjen Koppen ,&nbsp;Dylan W de Lange ,&nbsp;Johanna J Nugteren-van Lonkhuyzen","doi":"10.1016/j.drugpo.2025.104860","DOIUrl":"10.1016/j.drugpo.2025.104860","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of psychoactive drugs has been increasing worldwide, with adolescents and young adults accounting for a large share of people who use drugs. To date, there is limited information on trends of intoxications with psychoactive drugs among adolescents, particularly with regard to New Psychoactive Substances (NPS).</div></div><div><h3>Methods</h3><div>A retrospective study was performed from 2014-2023 to characterize intoxications with psychoactive drugs among adolescents aged 13-17 years, reported to the Dutch Poisons Information Center (DPIC). Data were collected on patient (age and gender) and exposure characteristics (psychoactive drugs involved, day and month of exposure).</div></div><div><h3>Results</h3><div>From 2014-2023 the DPIC was consulted on 978 poisoning events among adolescents involving psychoactive drugs. A significant increase in the number of poisoning events was observed from 2014 to 2023 (RR = 1.14, 95 % CI: 1.11-1.16, <em>p</em> &lt; 0.001). The largest increase was observed in the number of poisoning events with cannabis products (208 % increase, 2014: <em>n</em> = 13 vs. 2023: <em>n</em> = 40) (especially edibles), MDMA (100 % increase, 2014: <em>n</em> = 27 vs. 2023: <em>n</em> = 54) and 3-methylmethcathinone (3-MMC) (2014: <em>n</em> = 0, 2019: <em>n</em> = 2 vs. 2023: <em>n</em> = 24). There was also an increase in the variety of NPS the DPIC was consulted on, with 1 type of NPS reported in 2014 and 13 in 2023.</div></div><div><h3>Conclusions</h3><div>In this study, a strong increase was observed in the number of intoxications with psychoactive drugs among adolescents from 2014-2023. The increase in intoxications with psychoactive drugs among adolescents, as well as the increase in the number of different types of NPS is worrying, since toxicity of especially NPS is often unknown. More education on the potential dangers along with upcoming legislative changes, might reverse this trend.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104860"},"PeriodicalIF":4.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115452","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":"Queering vaping: A qualitative analysis of lesbian, bisexual, and queer women’s E-cigarette use in Australia","authors":"Ruby Grant ,&nbsp;Adrian Farrugia ,&nbsp;Isabel Mudford ,&nbsp;Julie Mooney-Somers ,&nbsp;Jennifer Power ,&nbsp;Ruth McNair ,&nbsp;Amy Pennay ,&nbsp;Adam Bourne","doi":"10.1016/j.drugpo.2025.104853","DOIUrl":"10.1016/j.drugpo.2025.104853","url":null,"abstract":"<div><h3>Background</h3><div>Vaping has emerged as a prominent practice among lesbian, bisexual, and queer (LBQ) women in Australia. Despite its growing prevalence, the socio-cultural dimensions of vaping in LBQ communities remain underexplored. This study examines how vaping functions as a contested site of queer sociability, identity expression, and resistance. Using queer theoretical perspectives, we interrogate the ways LBQ women navigate the aesthetic, social, and political dimensions of vaping within Australia’s unique policy landscape.</div></div><div><h3>Methods</h3><div>Sixty semi-structured interviews were conducted with LBQ cis and trans women and non-binary individuals aged 18–72 in Australia. A reflexive thematic analysis was employed, informed by queer theory, to explore participants’ accounts of vaping.</div></div><div><h3>Findings</h3><div>Participants framed vaping as a performative practice tied to queer aesthetics, gender expression, and community bonding. While vaping facilitated intimacy and sociability in queer spaces, its association with stigma and youth culture complicated its subversive potential for some. Vaping emerged as a mode of resistance to normative public health narratives, yet also reproduced tensions around deviance and identity.</div></div><div><h3>Conclusion</h3><div>Vaping is a dynamic, contested queer practice, reflecting LBQ women’s negotiations of identity, community, and agency within restrictive policy environments. Policy and public health strategies must consider the queer socio-cultural meanings and community practices that shape vaping, to avoid reinforcing stigma and unintended harms to LGBTQ+ communities.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104853"},"PeriodicalIF":4.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107690","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":"Identifying and responding to policy-related barriers, facilitators, and misunderstandings in the HEALing communities study: A community-driven approach","authors":"Anita Silwal ,&nbsp;Robert Bohler ,&nbsp;Timothy Hunt ,&nbsp;Ramona G. Olvera ,&nbsp;Michelle R. Lofwall ,&nbsp;Christopher D. Cook ,&nbsp;Katherine R. Marks ,&nbsp;Carly Bridden ,&nbsp;Patricia R. Freeman ,&nbsp;Monica Nouvong ,&nbsp;Laura C. Fanucchi ,&nbsp;Nabila El-Bassel ,&nbsp;Lisa A. Frazier ,&nbsp;Sharon L. Walsh ,&nbsp;Jeffery C. Talbert","doi":"10.1016/j.drugpo.2025.104851","DOIUrl":"10.1016/j.drugpo.2025.104851","url":null,"abstract":"<div><h3>Introduction</h3><div>The HEALing (Helping to End Addiction Long-Term®) Communities Study (HCS) aimed to reduce opioid-involved overdose deaths across four states (Kentucky, Massachusetts, New York, and Ohio) via community-engaged implementation of three evidence-based practices (EBPs): (1) opioid overdose education and naloxone distribution, (2) medication for opioid use disorder expansion/linkage/retention, and (3) safer opioid prescribing and dispensing practices. A policy workgroup (PWG) was convened and developed a procedure to identify and address policies potentially impacting EBP implementation.</div></div><div><h3>Methods</h3><div>A five-step method was developed to identify, track, and respond to relevant policies at three of the research sites (Kentucky, Massachusetts, and New York) in collaboration with community partners and stakeholders. Policies possibly impacting EBPs were reported, reviewed, and documented, including any actions taken to address the policy issue. Policies were discussed with local, state, and federal level stakeholders in attempts to resolve barriers, clarify misunderstandings, and disseminate facilitators.</div></div><div><h3>Results</h3><div>A total of 87 (Kentucky = 37; Massachusetts = 19; New York = 31) policies were identified and addressed; 42 were identified as barriers, 24 as facilitators, and 21 as misunderstandings. PWG efforts resolved over 73 % (<em>n</em> = 31) of policy barriers, clarified 90 % (<em>n</em> = 19) of policy misunderstandings, and disseminated 100 % (<em>n</em> = 24) of policy facilitators.</div></div><div><h3>Conclusions</h3><div>A community-driven approach in policy surveillance identified, addressed, and disseminated several different types of policy issues that could impact implementation of EBPs for opioid-involved overdose prevention. Many policy barriers persisted during the HCS study, which may have adversely affected study outcomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104851"},"PeriodicalIF":4.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107623","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 economic factors that determine smoking abstinence: a survival and mediation analysis","authors":"Yanyun He ,&nbsp;Geoffrey T. Fong ,&nbsp;K. Michael Cummings ,&nbsp;Andrew Hyland ,&nbsp;Roberta Freitas-Lemos ,&nbsp;Ce Shang","doi":"10.1016/j.drugpo.2025.104852","DOIUrl":"10.1016/j.drugpo.2025.104852","url":null,"abstract":"<div><h3>Background</h3><div>Higher taxes stimulate quit attempts and higher rates of smoking abstinence. Additionally, taxes on tobacco cigarettes and e-cigarettes (ECs) may influence consumers’ perceptions of the relative costs of these products. Understanding the relationship between cigarette and EC taxes, cost perceptions, and smoking abstinence is therefore crucial.</div></div><div><h3>Methods</h3><div>This study utilized longitudinal data from the US arm of the 2016–2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) Surveys and implemented a survival analysis to explore the impact of cigarette and EC taxes on smoking abstinence. A mediation analysis was also performed to test whether the effects of taxes are influenced by individuals’ perceptions about the relative cost differences between ECs and cigarettes.</div></div><div><h3>Results</h3><div>A 10 % increase in cigarette taxes was associated with an 11.1 % increase in smoking abstinence. EC taxes were not associated with smoking abstinence among the overall sample. However, higher EC taxes were associated with greater odds of smoking abstinence among individuals over 40 and lower odds of smoking abstinence among individuals under 40. Relative cost perception did not mediate the effect of taxes on smoking abstinence. Additionally, the odds of quitting were higher among individuals in the high-income group and those who used ECs daily, and lower among individuals in older age groups.</div></div><div><h3>Conclusions</h3><div>Cigarette taxes have a direct impact on smoking abstinence, independent of cost perceptions. To enhance cessation rates, policymakers should implement targeted strategies such as increasing access to cessation programs, providing financial incentives for quitting, and tailoring tax policies to better support older individuals and those with lower incomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104852"},"PeriodicalIF":4.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107622","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 opioid crisis in Poland? Insights from online forum data","authors":"Piotr Siuda ,&nbsp;Paweł Matuszewski","doi":"10.1016/j.drugpo.2025.104844","DOIUrl":"10.1016/j.drugpo.2025.104844","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, Polish media have raised alarms about the growing opioid threat. However, the latest research challenges these concerns, indicating a lack of factual evidence about the rise in the treatment and consumption of opioids. The present research contributes to this debate by analyzing online discussion trends on the Hyperreal—the most significant Polish forum for debating psychoactive substances. The aim is to verify whether online user discussions reflect—or contradict—concerns about an emerging opioid crisis in Poland, and how such discussions may complement other forms of data.</div></div><div><h3>Methods</h3><div>The study is based on 1,174,816 Hyperreal posts from its start in 2005 to 2023, of which 208,768 were related to opioids. Text data were cleaned and lemmatized. We conducted a time series analysis to track changes in posts, mentions, user numbers, and the proportion of opioid-related posts relative to overall forum content.</div></div><div><h3>Results</h3><div>Our analysis showed that codeine was the most popular opioid on the forum, while fentanyl and oxycodone—reported by the media as spreading in Poland—did not garner much attention. Overall, throughout the 20 years, the discussions on opioids remained at a stable level, with a decline in posts and users since 2021, and other topics becoming more frequent.</div></div><div><h3>Conclusion</h3><div>The findings suggest that media narratives may be exaggerated and offer additional support for the view that Poland is currently not experiencing the early stages of a crisis. Nonetheless, we emphasize the need for further research on actual opioid consumption patterns.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104844"},"PeriodicalIF":4.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089776","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":"Implications of the fragility of opioid agonist treatment continuity on hepatitis C re-exposure concerns among people in prison: a qualitative study","authors":"Lise Lafferty ,&nbsp;Tracey Brown ,&nbsp;Colette McGrath ,&nbsp;Thomas Wright ,&nbsp;Charles Henderson ,&nbsp;Andrew R Lloyd ,&nbsp;Jason Grebely ,&nbsp;Carla Treloar","doi":"10.1016/j.drugpo.2025.104831","DOIUrl":"10.1016/j.drugpo.2025.104831","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis C virus (HCV) is prevalent among people who are incarcerated. Provision of opioid agonist treatment (OAT) has been shown to reduce risk of HCV transmission in the community. Little is known about the navigation of HCV (re-)exposure in prisons, and people’s experiences and utilisation of OAT as a risk reduction strategy while incarcerated.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were completed with n=25 men incarcerated in an urban reception (intake) and remand (awaiting sentencing) prison in New South Wales, Australia. De-identified transcripts were coded deductively and analysed thematically, informed by a fragile treatment environment lens focused on OAT treatment as a risk mitigation strategy for HCV (re-)exposure.</div></div><div><h3>Results</h3><div>Overall, 25 men were included (all had previously been diagnosed with HCV, 13 were receiving long-acting injectable buprenorphine). Participants viewed risk of HCV (re-)exposure as part of injecting drug use in prison. Participants who were prescribed long-acting injectable buprenorphine described the treatment as supporting reduced injection drug use while incarcerated. However, OAT dosage was not always experienced as ‘adequate’, with some participants reporting supplementing with ‘the yard program’ (injecting drug use in the yard/cells) as the prescribed OAT dose lacked effectiveness to sustain until the next dose. Continuity of care was tenuous as people cycled from prison to community to prison, with people being removed from their OAT program after missing a scheduled dose in the community often due to a participant being ‘on the run’.</div></div><div><h3>Conclusion</h3><div>Continuity of OAT and HCV care remains a fragile experience for people who cycle in and out of incarceration. People who miss their OAT appointment in the community might wait several months upon re-incarceration to re-enter the OAT program. This leaves people vulnerable to injection sharing in custody and, subsequently, increased risk of HCV (re-)exposure while waiting to recommence OAT or to return to the optimal dosing level.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104831"},"PeriodicalIF":4.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089778","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":"Getting “The whole picture”: A review of international research on the outcomes of regulated cannabis supply","authors":"Vendula Belackova ,&nbsp;Benjamin Petruzelka ,&nbsp;Jakub Cihak ,&nbsp;Jana Michailidu ,&nbsp;Viktor Mravcik","doi":"10.1016/j.drugpo.2025.104796","DOIUrl":"10.1016/j.drugpo.2025.104796","url":null,"abstract":"<div><h3>Background</h3><div>Several jurisdictions have pursued reforms that regulate cannabis production and/or sale for adult (non-medical) use. Looking at outcomes of such reforms across multiple jurisdictions may help to identify outcomes that are inherent to non-criminal cannabis supply, as well as provide insight into the outcomes of specific regulation models.</div></div><div><h3>Methods</h3><div>We identified nine indicators of cannabis policy outcomes and aggregated them into three domains (social outcomes, outcomes in cannabis use, health-related outcomes). We assessed these outcomes across five jurisdictions with different models of regulating cannabis supply (Netherlands, Spain, U.S. states that legalized cannabis, Uruguay, and Canada). We used a three-level systematic literature review, prioritising studies with quasi-experimental design (i.e. comparative and longitudinal). We categorised the studies according to their design and the type of outcome (increase, decrease, or no outcome).</div></div><div><h3>Results</h3><div>Across long-standing as well as recent cannabis supply regimes, and across different models of cannabis supply<em>,</em> our review identified common outcomes: a decrease in cannabis-related arrests, an increase in adult (but not adolescent) cannabis use, and increase in healthcare utilization (not traffic-related). Negative health-related outcomes were most consistently found for the U.S. states that legalised cannabis for adult non-medicinal use (there were limitations to nuancing cannabis supply models across U.S. states). In the remaining jurisdictions (the Netherlands, Spain, Canada, Uruguay), the design or time-frame of the identified studies was limited, and studies on certain outcomes were lacking.</div></div><div><h3>Conclusions</h3><div>Regulating cannabis supply may be associated with benefits in the social area and with potential harms regarding public health; there may though be trade-offs depending on the choice of a cannabis regulation model. Jurisdictions may attempt to mix and match the present models of cannabis regulation to achieve the best ratio of benefits and harms. More research into the specific parameters influencing cannabis policy outcomes is needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"142 ","pages":"Article 104796"},"PeriodicalIF":4.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089779","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}