International Journal of Drug Policy最新文献

{"title":"A step forward or a missed opportunity? Malaysia's recent amendment to the drug dependants (treatment and rehabilitation) 1983 bill","authors":"N.A. Mohd Salleh , Balasingam Vicknasingam","doi":"10.1016/j.drugpo.2025.104806","DOIUrl":"10.1016/j.drugpo.2025.104806","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104806"},"PeriodicalIF":4.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839541","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":"\"I don't know how you can overdose smoking them:\" Perceptions of overdose risks among persons who use illicit fentanyl-laced counterfeit pills","authors":"Raminta Daniulaityte ,&nbsp;Kaylin Sweeney ,&nbsp;Patricia Timmons ,&nbsp;Madeline Hooten ,&nbsp;Elisabeth Williams ,&nbsp;Haley Coles ,&nbsp;Danielle Russell ,&nbsp;Frank LoVecchio","doi":"10.1016/j.drugpo.2025.104808","DOIUrl":"10.1016/j.drugpo.2025.104808","url":null,"abstract":"<div><h3>Aims</h3><div>Illicitly manufactured fentanyl (IMF) remains the primary driver of overdose mortality in the US. Western states saw significant increases in IMF-laced counterfeit pain pills (“blues”). This qualitative study, conducted in Phoenix, Arizona, provides an in-depth understanding of how overdose-related risks are viewed and experienced by people who use “blues.”</div></div><div><h3>Methods</h3><div>Between 11/2022–12/2023, the study recruited 60 individuals who used “blues” using targeted and network-based recruitment. Qualitative interviews were recorded, transcribed, and analyzed using NVivo.</div></div><div><h3>Results</h3><div>The sample included 41.7 % women, and 56.7 % whites. 55.3 % had prior overdose, but most (62.2 %) rated their current risk as none/low. Risk perceptions centered on a multi-level calculus of drug market conditions, individual vulnerabilities, and behavioral factors. Smoking was considered a “normative” way of using “blues”, and most viewed it as protective against overdose in comparison to injection and other routes of use. Drug market conditions and the unpredictability of “blues” were emphasized as important factor of overdose risk. However, some believed that over time, the quality/consistency of “blues” improved, and they became less risky. Many also expressed fears about the emerging local availability of powder fentanyl and its risk. Views about safer dosing, polydrug use, tolerance, and health emphasized personal responsibility and individual vulnerability to overdose risks. Discussions of protective behaviors, including take-home naloxone, varied bases on the perceptions of overdose risks.</div></div><div><h3>Conclusions</h3><div>The findings emphasize the need for close monitoring of local IMF markets and design of comprehensive interventions and risk communication strategies to address perceptions that minimize IMF-laced counterfeit pill risks.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104808"},"PeriodicalIF":4.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839540","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 War on Drugs is a war on women: Louisiana's Abortion Law","authors":"Maryanne Alderson Diaz,&nbsp;Dina Perrone","doi":"10.1016/j.drugpo.2025.104804","DOIUrl":"10.1016/j.drugpo.2025.104804","url":null,"abstract":"<div><div>This commentary explores the criminalization of abortion in Louisiana by arguing that it mirrors the punitive policies of the War on Drugs. We critically analyze the reclassification of abortion-inducing drugs like Mifepristone and Misoprostol as controlled substances to demonstrate how these laws disproportionately impact women, particularly those who are poor and Black and Brown. Drawing on parallels to the racial caste system perpetuated by the War on Drugs, we argue that these policies are less about public health and more about social control, with severe implications for reproductive autonomy and justice. By linking the scheduling of Mifepristone and Misoprostol to the War on Drugs, we show how abortion criminalization and abortion medication criminalization extend the arm of the American legal system to police and punish Black and Brown bodies and communities. We conclude by calling for a reevaluation of these legal frameworks to prevent further marginalization and harm.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104804"},"PeriodicalIF":4.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839542","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":"“It's not just running the test”: Operator experiences of implementing a decentralised hepatitis C point-of-care testing program in Australia","authors":"Grace K. Burton-McKeich ,&nbsp;Lise Lafferty ,&nbsp;Carla Treloar ,&nbsp;Corey Markus ,&nbsp;Susan Matthews ,&nbsp;Tanya L. Applegate ,&nbsp;Louise Causer ,&nbsp;Jason Grebely ,&nbsp;Alison D. Marshall","doi":"10.1016/j.drugpo.2025.104800","DOIUrl":"10.1016/j.drugpo.2025.104800","url":null,"abstract":"<div><h3>Background</h3><div>The decentralisation of hepatitis C virus (HCV) point-of-care testing is a core part of Australia's strategy to meet WHO elimination targets. However, little is known about the experiences of providers implementing these interventions and thus what is needed to improve integration. The study aim was to understand operator experiences, including the challenges and enablers, of implementing point-of-care testing as part of a National Point-of-Care Testing Program.</div></div><div><h3>Methods</h3><div>Providers who were enrolled in the National Program and qualified to perform point-of-care testing were invited to participate in semi-structured qualitative interviews between April and August 2023. Data were analysed according to iterative categorisation and themes were organised according to Service delivery, Resources, and Governance—elements of the Health Systems Dynamics Framework.</div></div><div><h3>Results</h3><div>Of the 31 participants, most were from New South Wales (<em>n</em> = 17), were practicing clinicians (<em>n</em> = 18), worked in outpatient or community health clinics (<em>n</em> = 21), and had no previous experience using a molecular point-of-care testing device (<em>n</em> = 24). Many participants struggled to deliver HCV testing and treatment according to national HCV management guidelines. Some participants avoided using the point-of-care testing device altogether. Others found it challenging to manage the administrative load of delivering the National Program, including planning outreach and following-up clients. These challenges were exacerbated by workforce shortages, difficult-to-navigate IT systems, and a lack of specific implementation advice from Program leadership.</div></div><div><h3>Conclusions</h3><div>This study illustrates several challenges to and enablers of adopting a decentralised HCV point-of-care testing program, highlighting the need to further explore what providers require to effectively implement these interventions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104800"},"PeriodicalIF":4.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839672","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":"“Either way, they will use. And so, probably, would you:” A critical discourse analysis of harm reduction portrayal in United States opinion news media","authors":"Hannah A. Carlon,&nbsp;Hanna M. Hebden,&nbsp;Nina C. Christie,&nbsp;Felicia R. Tuchman,&nbsp;David I.K. Moniz-Lewis,&nbsp;Cassandra L. Boness,&nbsp;Katie Witkiewitz,&nbsp;Margo C. Hurlocker","doi":"10.1016/j.drugpo.2025.104801","DOIUrl":"10.1016/j.drugpo.2025.104801","url":null,"abstract":"<div><h3>Background</h3><div>Opioid overdose deaths are declining in the United States for the first time in over five years. These reductions are partially attributed to increasing availability of harm reduction services, but services remain poorly implemented. The framing of issues in news media shapes public sentiment and uptake of services in policy and practice. The aims of this study were to: (1) content analyze United States opinion news media to describe overall attitudes towards and stigmatizing language about harm reduction; and (2) critically analyze discourses underlying articles with respect to stigma and harm reduction support.</div></div><div><h3>Methods</h3><div>Thirty-nine opinion articles across 17 United States newspapers on harm reduction published between May 2023 and April 2024 were included. Targeted analyzed content included attitudes toward harm reduction and stigmatizing language.</div></div><div><h3>Results</h3><div>Most articles had positive attitudes (32/39; 82.1 %), only 5/39 articles (12.8 %) were negative; two were balanced. Over half (22/39; 56.4 %) included stigmatizing language. Critical discourse analysis revealed pro-harm reduction articles were tied together by several threads: harm reduction strategies are evidence-based, do not increase crime, decrease stigma and systemic oppression, and policy change is needed to improve implementation. Among anti-harm reduction articles, discourses included: discriminatory stereotypes to portray opioid use and harm reduction depicted as enabling substance use, equating opioid use with crime, and dismissing systemic injustices influenced by punitive drug policy.</div></div><div><h3>Conclusions</h3><div>Contemporary United States opinion news media predominantly presents pro-harm reduction discourse, but often use stigmatizing language.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104801"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816808","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":"State adult-use cannabis policy effects on law enforcement efforts to disrupt drug markets","authors":"Barrett Wallace Montgomery,&nbsp;Pranav Athimuthu,&nbsp;Nicholas Richardson,&nbsp;Bradley Ray","doi":"10.1016/j.drugpo.2025.104802","DOIUrl":"10.1016/j.drugpo.2025.104802","url":null,"abstract":"<div><h3>Background</h3><div>Legalizing cannabis impacts law enforcement strategies on drug deterrence. While cannabis possession arrests have fallen post-legalization, findings on racial disparities are mixed. No research has yet investigated cannabis legalization effects on police behavior in the form of drug seizures, or how it may influence the enforcement of other drugs. We sought to evaluate the effect of cannabis legalization on drug seizures and their related disparities by race to understand how law enforcement have adjusted to this rapidly shifting legal landscape.</div></div><div><h3>Methods</h3><div>Drug seizure data were collected from the National Incident Based Reporting System (NIBRS) and include state, race, and drug types from 16 states with over 95 % population coverage for 2017–2022. Treatment and control assignments were determined by whether cannabis had been legalized for adult use between 2017 and 2022. Log seizure rates and Black-white risk ratios were calculated using census data. Two-way fixed effects difference-in-differences models robust to multiple treatment periods evaluated the effect of cannabis legalization on seizure rates and Black-white risk ratios.</div></div><div><h3>Results</h3><div>Our findings indicate that cannabis legalization significantly reduced overall drug seizures, particularly those involving cannabis. Of the other seizure types tested, only one non-cannabis drug seizure rate type was significant. We found a moderate yet significant decrease in the Black-white risk ratio for cannabis seizures, though all other racial disparities in seizure rates persisted after the legalization of cannabis.</div></div><div><h3>Discussion</h3><div>Cannabis legalization was associated with reduced drug seizures overall, driven by a large reduction in cannabis seizures. There was also a significant reduction in the Black-white risk ratio for cannabis seizures, though Black individuals remained at higher risk for all drug seizure types compared to white individuals. While expected to decrease without cannabis smell to prompt seizures, non-cannabis drug seizures were unchanged except for an increase in methamphetamine seizures not involving cannabis, potentially due to shifting enforcement priorities. These results suggest that cannabis policy reform can alleviate law enforcement burdens and may improve racial disparities in drug seizures to a small extent yet highlight the continued necessity for policies addressing systemic biases in drug enforcement.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104802"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816760","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 effectiveness of the communities that HEAL intervention on reducing non-fatal opioid overdoses: A prespecified secondary analysis of a waitlist cluster control randomized controlled trial","authors":"Louisa Gilbert ,&nbsp;Rouba Chahine ,&nbsp;Redonna Chandler ,&nbsp;Daniel J. Feaster ,&nbsp;Erin Kim ,&nbsp;Arnie Aldridge ,&nbsp;Sarah Bagley ,&nbsp;Peter Balvanz ,&nbsp;Soledad Fernandez ,&nbsp;Peter Rock ,&nbsp;Rachel A. Vickers-Smith ,&nbsp;Jennifer Villani ,&nbsp;Tracy Battaglia ,&nbsp;Jennifer Brown ,&nbsp;Heather Bush ,&nbsp;Rachel P. Chase ,&nbsp;Thomas Collins ,&nbsp;Lauren D'Costa ,&nbsp;Carolyn Damato-MacPherson ,&nbsp;James L. David ,&nbsp;Nabila El-Bassel","doi":"10.1016/j.drugpo.2025.104798","DOIUrl":"10.1016/j.drugpo.2025.104798","url":null,"abstract":"<div><h3>Introduction</h3><div>Along with a surge of opioid overdose deaths in the United States, the rates of nonfatal opioid overdose (NFOO) emergency department (ED) visits and hospitalizations have been sharply increasing.</div></div><div><h3>Methods</h3><div>In the HEALing Communities Study (HCS), we conducted a pre-specified secondary analyses to evaluate the effectiveness of the Community that HEALS (CTH) intervention on reducing the count of NFOO ED visits and hospitalizations in a multi-site cluster randomized multi-site, two-arm, parallel, community-level, open, wait list-controlled trial study, Sixty-seven communities in Kentucky, Massachusetts, New York, and Ohio were randomized to the intervention (<em>N</em> = 34) or waitlist control condition (<em>N</em> = 33) stratified by state and balanced by urban/rural classification, fatal opioid overdose rate and population size of communities. We compared the rate of NFOO per 100,000 adults aged ≥18 years between intervention and control communities from July 1, 2021, to June 30, 2022. Rates were calculated in per 100,000 or per 100 adult population measured by inpatient and ED records for intervention community residents with an ICD-10-CM code for opioid poisoning.</div></div><div><h3>Results</h3><div>Compared to control communities, intervention communities had 15 % fewer NFOO per capita (aRR = 0.85; 95 % CI = [0.74,0.96]; p-value=0.013). Effect modifications by state, urban/rural status, sex, age, race and ethnicity were not significant.</div></div><div><h3>Discussion</h3><div>These findings suggest the intervention reduced NFOO ED visits and hospitalizations. The lack of effect modifications suggests that the intervention may be effective in a wide range of communities in the U.S. Further research is needed to identify the mechanisms through which the intervention reduces NFOO.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifier: NCT04111939.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"140 ","pages":"Article 104798"},"PeriodicalIF":4.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821492","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":"Patterns of opioid toxicity deaths after the implementation of COVID-19 emergency measures in Ontario, Canada: a weekly interrupted time series","authors":"Valeria Rolle ,&nbsp;Nicholas Bakewell ,&nbsp;Yingbo Na ,&nbsp;Mohammad Karamouzian ,&nbsp;Orville Burke ,&nbsp;Seff Pinch ,&nbsp;Dan Werb ,&nbsp;Sanjana Mitra","doi":"10.1016/j.drugpo.2025.104797","DOIUrl":"10.1016/j.drugpo.2025.104797","url":null,"abstract":"<div><h3>Background</h3><div>In March 2020, Ontario, Canada, implemented COVID-19 public health measures, including school and non-essential business closures, physical distancing, border restrictions, and modified health services. We examined their association with changes in opioid toxicity mortality and assessed variations across age, sex, health region, and drug type.</div></div><div><h3>Methods</h3><div>We conducted an interrupted time series using opioid toxicity death records (March 2019 to February 2021) from the Office of the Chief Coroner for Ontario. Using a generalized linear model (Poisson or negative binomial), we estimated changes in weekly death counts following the first (March 17th to May 19th, 2020) and second (November 23rd, 2020, to February 14th, 2021) lockdowns, as well as the entire post-COVID-19 period, modelling interventions as level shifts in opioid toxicity deaths.</div></div><div><h3>Results</h3><div>Of 3844 individuals who died within the study period, 74.4 % were male, and the median age was 40 (interquartile range: 31 to 51). Weekly deaths ranged from 9 to 72. Following the province-wide state of emergency and first lockdown, there was a step increase in the number of deaths, with an estimated Rate Ratio (RR) of 1.21 (95 % CI 1.02 to 1.52). Over the duration of the post-COVID-19 period, an overall sustained increase in the number of opioid toxicity deaths (RR 1.11 [95 % CI 1.02 to 1.41]) was observed across the province.</div></div><div><h3>Implications</h3><div>The period after initial COVID-19 measures was associated with increases in opioid toxicity mortality. Future responses to public health emergencies must proactively mitigate the potential unintended consequence of toxic drug-related harms among substance-using populations.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104797"},"PeriodicalIF":4.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799674","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":"Recruiting opioid treatment program administrators for a national survey: Outcomes and lessons learned","authors":"Benjamin R Brady ,&nbsp;Beth E Meyerson ,&nbsp;Alissa Davis ,&nbsp;Greg A Carter ,&nbsp;Sara Najar ,&nbsp;Alexa Martinez ,&nbsp;Caleb Mueller ,&nbsp;Elias O Higbie ,&nbsp;Holden Dal Ponte ,&nbsp;Khino Moneva ,&nbsp;Natalia C Bentz ,&nbsp;Linnea B Linde-Krieger ,&nbsp;Zhanette Coffee ,&nbsp;Arlene N Mahoney ,&nbsp;David Frank ,&nbsp;Richard A Crosby","doi":"10.1016/j.drugpo.2025.104799","DOIUrl":"10.1016/j.drugpo.2025.104799","url":null,"abstract":"<div><h3>Background</h3><div>Globally, access to opioid use disorder treatment remains insufficient. In the US, recent policy changes for opioid use disorder treatment present opportunities to improve patient access to evidence-based methadone treatment. To evaluate the adoption and sustained implementation of these changes, access to a national, representative sample of opioid treatment programs (OTPs, ‘methadone clinics’) is essential. This study reports the outcomes of a recruitment effort for a national sample of OTP administrators.</div></div><div><h3>Methods</h3><div>A stratified random sample of 1000 OTPs was drawn from the US Substance Abuse and Mental Health Services Administration's National Opioid Treatment Program Directory. Stratification was based on state-level OTP regulations and county-level opioid overdose rates. OTPs identified as tribal serving, located in jails or prisons, or requiring corporate approval for research participation were deemed ineligible and excluded from the sample. A team of trained researchers called OTP clinics seeking to speak with administrators and obtain their email addresses for study recruitment.</div></div><div><h3>Results</h3><div>In the sample, 885 OTPs were eligible for study recruitment. We contacted a live person by phone at 73 % of OTPs and an administrator at 23 %. Of the administrators reached, 77 % agreed to receive study information and 22 % completed the survey. Total caller time was 276.5 hours at a cost of $5530.</div></div><div><h3>Conclusion</h3><div>Despite a rigorous sampling frame, and a costly and considerable effort, US OTP recruitment outcomes were suboptimal. Innovative strategies are needed to improve administrator recruitment. Recommendations include updating the SAMHSA directory to include administrator contact information (name, phone, email), using diverse outreach methods, and refining call scripts to improve engagement.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104799"},"PeriodicalIF":4.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784003","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":"Experiences of stigmatization among people who use drugs in the initial year of British Columbia's drug decriminalization policy: A qualitative study","authors":"Farihah Ali ,&nbsp;Cayley Russell ,&nbsp;Savannah Torres-Salbach ,&nbsp;Margret Lo ,&nbsp;Matthew Bonn ,&nbsp;Geoff Bardwell ,&nbsp;Juls Budau ,&nbsp;Elaine Hyshka ,&nbsp;Jürgen Rehm","doi":"10.1016/j.drugpo.2025.104791","DOIUrl":"10.1016/j.drugpo.2025.104791","url":null,"abstract":"<div><h3>Background</h3><div>On January 31, 2023, Health Canada approved a three-year pilot decriminalization initiative allowing adults in British Columbia (BC), Canada, to legally possess a cumulative 2.5 g of opioids, cocaine, methamphetamine, or MDMA. The policy aims to reduce the harms associated with drug use, including stigma, which contributes to barriers for people who use drugs in accessing harm reduction and treatment services. Addressing stigma is considered a crucial step in mitigating BC's overdose crisis, by encouraging people who use drugs to feel more comfortable to access and utilize services without fear of judgment. This study examined the impacts of the decriminalization policy on stigma among people who use drugs within the first year of implementation.</div></div><div><h3>Methods</h3><div>From October 2023 to February 2024, 100 semi-structured telephone interviews and brief socio-demographic surveys with people who use drugs from across BC were conducted to explore their experiences of stigmatization post-decriminalization. A qualitative thematic analysis was used to synthesize the data.</div></div><div><h3>Results</h3><div>Findings revealed that societal, structural and self-stigma remain pervasive among people who use drugs post-decriminalization. While most participants reported little change in their experiences of stigma since the policy's implementation, some reported an increase, while others observed a decrease across all forms of stigma. Increased stigma was attributed to perceived heightened visibility of public drug use, which amplified societal stigma. Conversely, decreased stigma was linked to shifting public perceptions of drug use as a public health issue and more humanized interactions with the police. Despite mixed experiences, participants remained optimistic that the policy could contribute to long-term stigma reduction and offered recommendations to support this goal.</div></div><div><h3>Conclusion</h3><div>While decriminalization has the potential to reduce stigma and increase comfort in accessing critical harm reduction and substance use treatment services among people who use drugs, achieving these outcomes requires additional efforts. Public awareness campaigns, targeted anti-stigma education, and broader systemic changes were suggested by participants as essential to address stigmatization in BC. Strengthening these areas could enhance access to and utilization of services, ultimately supporting the broader goals of decriminalization.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104791"},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777445","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}