International Journal of Drug Policy最新文献

{"title":"The Impact of Communicating the Benefits and Safety of Psilocybin on Policy Support: a Survey Based Experiment","authors":"K. Hitchins,&nbsp;J.P. Reynolds","doi":"10.1016/j.drugpo.2025.104909","DOIUrl":"10.1016/j.drugpo.2025.104909","url":null,"abstract":"<div><h3><em>Background</em></h3><div>Preliminary evidence suggests psilocybin may have therapeutic value for various mental health conditions; despite this, it is currently illegal in the UK. Less is known about how people form their attitudes towards psilocybin policies.</div></div><div><h3><em>Objectives</em></h3><div>To explore whether beliefs about the benefits and safety of psilocybin influence support for psilocybin policies.</div></div><div><h3><em>Methods</em></h3><div>In an online survey experiment, 804 participants were randomised to receive one of four interventions in a 2 (no information vs evidence for psilocybin benefits) x 2 (no information vs evidence for psilocybin safety) design. Public support for four psilocybin policies and beliefs about the benefits and safety of psilocybin were measured before and after participants were randomised to a group.</div></div><div><h3><em>Results</em></h3><div>In a two-way ANCOVA, the Benefits Intervention significantly increased policy support overall (<em>d</em> = 0.11, <em>p</em> &lt; .001); and for two of four psilocybin policies when analysed separately. Furthermore, the Benefits Intervention significantly strengthened beliefs that psilocybin is beneficial (<em>d</em> = 0.44, <em>p</em> &lt; .001) and safe (<em>d</em> = 0.26, <em>p</em> &lt; .001). The Safety Intervention increased psilocybin policy support overall (<em>d</em> = 0.10, <em>p</em> = .003); and for three of four psilocybin policies when analysed separately. The Safety Intervention also strengthened beliefs that psilocybin is safe (<em>d</em> = 0.28, <em>p</em> &lt; .001) but not that it is beneficial.</div></div><div><h3><em>Conclusions</em></h3><div>Communicating the benefits and safety of psilocybin can increase psilocybin policy support and strengthen beliefs about psilocybin, however further research is needed to explore the longevity of these results.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104909"},"PeriodicalIF":4.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749613","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 decriminalization policy under the microscope in the United States: crime data considerations to inform future research","authors":"Hope M. Smiley-McDonald ,&nbsp;Barrot H. Lambdin ,&nbsp;Pamela K. Lattimore ,&nbsp;Ian A. Silver ,&nbsp;Mark W. Pope ,&nbsp;Sean E. Wire ,&nbsp;Alex H. Kral","doi":"10.1016/j.drugpo.2025.104932","DOIUrl":"10.1016/j.drugpo.2025.104932","url":null,"abstract":"<div><div>When voters passed the 2020 Ballot Measure 110 (M110), the U.S. State of Oregon changed course from a criminal legal system response to a health-centered approach to substance use. M110 was passed with the goal of making health assessment screenings, treatment, and recovery services for substance use disorder available to all who need them and reduce the harms associated with involving the criminal legal system for people who use drugs. Although drug decriminalization was enacted in February 2021, most of M110’s funding streams for substance use disorder treatment, harm reduction, and housing assistance were delayed until August 2022. In the absence of health- or treatment-related data, preliminary studies used pre- and post-crime trend data to show that possession of controlled substances arrests decreased after Oregon implemented drug decriminalization.</div><div>The goal of this methods piece is to inform researchers and governments about the nuances of crime data when these data are often the only means available to assess a new drug policy. Given the multiple factors that occurred immediately before or contemporaneous to enactment of M110 (e.g., the COVID-19 pandemic, Oregon’s acute affordable housing shortage), we consider the methodological issues of prematurely attempting to answer research questions using available crime trend data and associated analytic models to make determinations about whether M110 was meeting its intended goals. Patience and time are needed for ensuring that the necessary and appropriate data are available that correspond to policy goals. We include recommendations for future analyses when more robust data are available to holistically assess the impacts of drug policies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104932"},"PeriodicalIF":4.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750188","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":"Gender, coca, and the Colombian Peace Agreement: The overlooked gendered dynamics in policy implementation","authors":"Alejandra Zuluaga Duque ,&nbsp;Kate Seear ,&nbsp;Renae Fomiatti","doi":"10.1016/j.drugpo.2025.104926","DOIUrl":"10.1016/j.drugpo.2025.104926","url":null,"abstract":"<div><div>Established in 2016, the Colombian Peace Agreement aimed to resolve longstanding conflict in the country. One of its commitments was to address the ‘War on Drugs’ including through gender-based approaches. The Agreement includes provisions aimed at supporting those cultivating coca, such as an enrolment process in a coca substitution program aimed at supporting the economic livelihoods of coca growers. In this article, we examine why women coca growers may be overlooked in this process and what assumptions key stakeholders in charge of implementing the Agreement make about gender and coca growing. We contrast such assumptions with the lived experiences of women coca growers to demonstrate how data collection practices in policy and research constitute a version of the coca economy predominantly ignorant to women’s priorities and concerns. Using Fraser’s (2020) framework on ontopolitically-oriented research and Bacchi’s (2009) What’s the Problem Represented to Be Approach, we illustrate how stakeholder assumptions about women’s roles in the coca growing economy shape the legitimate recipients and beneficiaries of drug policy interventions. Our analysis offers novel insights into how gendered dynamics become concealed <em>through</em> drug policies designed for coca growing contexts, as well as explain the scarcity of research focused on women and coca-growing. We argue that the enrolment process in the coca substitution program has undermined women’s economic autonomy through their exclusion as domestic counterparts, while their security concerns have been treated as unrelated to coca substitution programs.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104926"},"PeriodicalIF":4.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738287","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":"Temporary and sustained changes in alcoholic and alcohol-free or low-alcohol drinks sales during January? A time series analysis of seasonal patterning in Great Britain","authors":"Aisha Moolla ,&nbsp;John Holmes ,&nbsp;Luke Wilson ,&nbsp;Jamie Brown ,&nbsp;Inge Kersbergen ,&nbsp;Abigail Stevely","doi":"10.1016/j.drugpo.2025.104939","DOIUrl":"10.1016/j.drugpo.2025.104939","url":null,"abstract":"<div><h3>Introduction</h3><div>Sales of alcohol-free and low-alcohol (no/lo) drinks are increasing rapidly but the drivers of this trend remain unclear. Reductions in alcohol consumption during January, including through temporary abstinence campaigns like Dry January, are one potential driver. This study estimates the immediate and long-term impact of changes made in January on sales of standard alcoholic and no/lo drinks in Great Britain.</div></div><div><h3>Methods</h3><div>Population-level sales data for standard alcoholic and no/lo drinks were analysed using ARIMAX time series models for the on-trade (e.g. bars; June 2014 to January 2024), off-trade (i.e. shops; January 2020 to December 2023), and overall market (January 2020 to December 2023). Outcome measures were sales volumes of standard alcoholic and no/lo drinks in servings and the percentage of total servings that were no/lo drinks.</div></div><div><h3>Results</h3><div>In the overall market, alcoholic drink sales were lower in January than other months and highest in December (β=+263,074,000 servings; 95 %CI 230,629,000––295,520,000), while no/lo drink sales were higher in January compared to February, March, and the autumn months (lowest in November; β=-1081,000 servings; 95 %CI -1965,000 ––-196,000). The percentage of servings that were no/lo drinks peaked in January. There was uncertain evidence of large reductions in alcoholic drink sales each January driving long-term reductions in the off-trade (β=-48,383,000 servings; 95 %CI -106,104––9338,000) but there did not appear to be substantial impacts on other long-term trends.</div></div><div><h3>Conclusions</h3><div>There are short-term decreases in standard alcoholic drink sales and increases in no/lo drink sales in January but there appeared to be no substantial sustained changes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104939"},"PeriodicalIF":4.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738295","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":"Characterising benzodiazepine use and the association with non-fatal overdose among people who inject opioids in England, Wales and Northern Ireland","authors":"Megan Minett-Smith ,&nbsp;Holly D Mitchell ,&nbsp;Eleanor Clarke ,&nbsp;Peter Vickerman ,&nbsp;Matthew Hickman ,&nbsp;Jack Stone ,&nbsp;Josephine Walker ,&nbsp;Joshua Dawe ,&nbsp;Adelina Artenie","doi":"10.1016/j.drugpo.2025.104927","DOIUrl":"10.1016/j.drugpo.2025.104927","url":null,"abstract":"<div><h3>Introduction</h3><div>In Scotland, co-use of opioids and benzodiazepines has been strongly linked to rising drug-related deaths, but little similar information is available for the rest of the UK. We compared characteristics of people who inject opioids (PWIO) by benzodiazepine use and examined its association with non-fatal overdose in England, Wales and Northern Ireland.</div></div><div><h3>Methods</h3><div>PWIO in England, Wales and Northern Ireland were recruited through specialist drug services in 2022 as part of the Unlinked Anonymous Monitoring Survey. Participants self-reported socio-demographic, behavioural, and health-related information. PWIO with and without past-month benzodiazepine use were compared on sociodemographic characteristics, drug use patterns, use of harm-reduction services, markers of vulnerability, quality of life and mental health. Poisson regression was used to estimate bivariable and multivariable associations between past-month benzodiazepine use and non-fatal overdose in the past year.</div></div><div><h3>Results</h3><div>Of 1333 PWIO included, 29.3 % reported past-month benzodiazepine use, and 21.8 % reported past-year non-fatal overdose. PWIO who used benzodiazepines were more likely to report using other drugs—both injected and non-injected—greater social vulnerabilities such as homelessness, incarceration, and engagement in sex work, and poorer mental health. For example, they more frequently injected speed (19.0 % vs. 9.5 %) and cocaine (46.4 % vs. 29.2 %), smoked cannabis (62.3 % vs. 31.7 %) and used pregabalin/gabapentin (60.8% vs. 10.1 %). Differences in sociodemographic characteristics, use of harm-reduction services and most quality-of-life domains were minimal. After adjusting for potential confounders, benzodiazepine use remained associated with higher prevalence of non-fatal overdose (adjusted prevalence ratio: 1.43; 95 %CI: 1.13–1.82).</div></div><div><h3>Discussion</h3><div>Benzodiazepine use is common among PWIO in England, Wales, and Northern Ireland, and is associated with higher prevalence of non-fatal overdose. These findings underscore the need to strengthen overdose prevention and harm reduction efforts addressing benzodiazepine use across the UK.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104927"},"PeriodicalIF":4.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722654","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":"Pregabalin and gabapentin use in France from 2012 to 2023, impact of prescription restrictions, a time series analysis","authors":"Alexandre Michel ,&nbsp;Michel Prade ,&nbsp;David De Bandt","doi":"10.1016/j.drugpo.2025.104929","DOIUrl":"10.1016/j.drugpo.2025.104929","url":null,"abstract":"<div><h3>Introduction</h3><div>Gabapentinoids use is accompanied by increased misuse, particularly for pregabalin. In May 2021, France introduced secure prescription requirements for pregabalin. This paper aims to analyse variations in gabapentinoid dispensing, with a focus on changes in prescription rules.</div></div><div><h3>Materiel and method</h3><div>We performed an ecological study using the French national health insurance database from January 2012 to December 2023. We analysed pregabalin and gabapentin doses sold by city pharmacies expressed in monthly defined daily dose per thousand inhabitant a day (DDD/TID) between January 2012 and December 2023. Dose sales trends before and after May 2021 were compared using segmented analysis of Autoregressive Integrated Moving Average models. Descriptive analysis was performed to analyse associated expenses expressed in euros.</div></div><div><h3>Results</h3><div>Between 2012 and 2020, pregabalin doses sold rose from 3.228 DDD/TID to 4.908 DDD/TID. After the reform, they declined to 3.923 DDD/TID in 2023. Gabapentin doses sold increased from 1.042 DDD/TID to 1.257 DDD/TID between 2012 and 2020, then rose further post-reform, reaching 1.705 DDD/TID. Costs related to the pregabalin doses sold decreased from €132.47 to €51.36 million from 2012 to 2023. Costs related to gabapentin decrease from €32.31 to €26.84 million between 2012 and 2021, then increase to €37.70 million in 2023.</div></div><div><h3>Discussion</h3><div>These data suggest that the May 2021 reform has reduced pregabalin consumption and induced an increase of gabapentin use. Cost implications remain of difficult interpretation due to multiple confounding factors. Further research could clarify these trends and be used to optimize prescription practices.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 104929"},"PeriodicalIF":4.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722653","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":"Re: Retention and dropout from sublingual and extended-release buprenorphine treatment: A comparative analysis of data from a nationally representative sample of commercially-insured people with opioid use disorder in the United States","authors":"Angela M DeVeaugh-Geiss ,&nbsp;Howard D Chilcoat","doi":"10.1016/j.drugpo.2025.104933","DOIUrl":"10.1016/j.drugpo.2025.104933","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104933"},"PeriodicalIF":4.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703222","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":"Second-wave mutual-help groups: Examining effectiveness for individuals with alcohol use disorders in the longitudinal, U.S. national PAL Study cohorts.","authors":"Sarah E Zemore, Camillia K Lui, Amy A Mericle, Libo Li, Priscilla Martinez, Christine Timko","doi":"10.1016/j.drugpo.2025.104921","DOIUrl":"10.1016/j.drugpo.2025.104921","url":null,"abstract":"<p><strong>Background: </strong>Second-wave mutual-help groups (MHGs) for addiction (e.g., SMART Recovery) are prevalent and promising, but limited studies have examined their effectiveness. We examined 1) the comparative effectiveness of second-wave MHGs for supporting alcohol use disorder recovery and 2) correlates of MHG involvement.</p><p><strong>Methods: </strong>Data were pooled from the Peer ALternatives for Addiction (PAL) Study 2015 and 2021 Cohorts (N = 1152), which recruited adults via collaboration with MHG directors and recovery-related organizations. Eligibility criteria included U.S. residence, lifetime alcohol use disorder, and past-30-day in-person/online attendance at Women for Sobriety, LifeRing, SMART, and/or a 12-step group. Surveys were administered at baseline, 6 months, and 12 months (response rates=81-88 %), and assessed MHG choice (defined using attendance), MHG involvement (5-item scale; e.g., regular/home group, volunteering/service) and alcohol outcomes (below).</p><p><strong>Results: </strong>In lagged, multivariate generalized estimating equations, greater MHG involvement strongly predicted higher odds of alcohol abstinence (OR=2.62, p<.001), lower odds of alcohol problems (OR=0.39, p<.01), and fewer drinking days (IRR=0.12, p<.001) at follow-ups. MHG choice was unrelated to outcomes either alone or in interaction with MHG involvement, suggesting comparable effectiveness for all second-wave MHGs (vs. 12-step). Predictors of greater MHG involvement included older age, a total abstinence (vs. other) goal, and 2015 (vs. 2021) Cohort.</p><p><strong>Conclusions: </strong>Findings suggest comparable effectiveness for the targeted second-wave alternatives (vs. 12-step) among community members attending MHGs, indicating that alcohol service providers, courts, and policymakers should consider referring to and supporting these alternatives. Still, variation in SMART's program across time and geography suggests caution in interpreting the results for SMART.</p>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":" ","pages":"104921"},"PeriodicalIF":4.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765644","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":"Modeling the impact of changing drug markets and structural determinants on HCV and/or HIV transmission among people who inject drugs in the United States: A rural and urban comparison","authors":"Natasha K. Martin ,&nbsp;Daniela Abramovitz ,&nbsp;William H. Eger ,&nbsp;Joseph R. Friedman ,&nbsp;Annick Borquez ,&nbsp;Jaskaran S. Cheema ,&nbsp;Tara Stamos-Beusig ,&nbsp;Jack Stone ,&nbsp;Peter Vickerman ,&nbsp;Heather Bradley ,&nbsp;Ryan P. Westergaard ,&nbsp;Steffanie A. Strathdee","doi":"10.1016/j.drugpo.2025.104925","DOIUrl":"10.1016/j.drugpo.2025.104925","url":null,"abstract":"<div><h3>Background</h3><div>The impact of changing drug use patterns on hepatitis C virus (HCV) and HIV incidence among people who inject drugs (PWID) in the US is understudied.</div></div><div><h3>Methods</h3><div>An HCV and HIV transmission model was calibrated to urban and rural area data (San Diego, CA and Central/Northern Wisconsin). Fentanyl use among PWID was assumed to increase mortality and injecting-related risk of HIV and HCV based on San Diego data. We predicted HCV/HIV incidence with recent trends (in fentanyl use, transition from injecting to smoking drugs, opiate agonist treatment (OAT) and incarceration), and scenarios with no trend changes since 2020. We calculated the population attributable fraction of fentanyl on incidence, comparing to a no fentanyl counterfactual from 2015 to 2025.</div></div><div><h3>Results</h3><div>High and increasing self-reported fentanyl use among PWID was observed in Central/Northern Wisconsin (20 % in 2018 to 45 % in 2021) and San Diego (51 % in 2021 to 66 % in 2023). Between 2015–2025, modeling suggests fentanyl use contributed to 18 % (95 %CI 9–25) and 34 % (95 %CI 26–45) of new HCV infections among PWID in Central/Northern Wisconsin and San Diego, respectively. Fentanyl contributed to 10 % (95 %CI 1–26) of HIV infections in San Diego; no HIV was observed among Central/Northern Wisconsin PWID. Fentanyl-associated risk was mitigated by increased OAT, reduced incarceration (Wisconsin), and shifts from injecting to smoking drugs (San Diego).</div></div><div><h3>Conclusions</h3><div>Fentanyl use increased HCV and/or HIV in an urban and rural area, suggesting expanded access to harm reduction, alongside interventions to reduce blood-borne virus transmission risk among PWID who use fentanyl are urgently needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104925"},"PeriodicalIF":4.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685970","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":"Exploring models of safer supply provision: A qualitative study on the preferences of people who access the unregulated drug market","authors":"Abby Hutchison ,&nbsp;Phoenix Beck  McGreevy ,&nbsp;Benjamin Enns ,&nbsp;Brenda Carolina Guerra-Alejos ,&nbsp;Nancy Henderson ,&nbsp;Karen Urbanoski ,&nbsp;Erin Howley ,&nbsp;Donald MacPherson ,&nbsp;Jessica C Xavier ,&nbsp;Jane A Buxton ,&nbsp;Bernie Pauly","doi":"10.1016/j.drugpo.2025.104920","DOIUrl":"10.1016/j.drugpo.2025.104920","url":null,"abstract":"<div><h3>Background</h3><div>People who use drugs and other experts have long advocated for a supply of regulated drugs of known quality and composition as an alternative to the toxic and unregulated drug supply that is causing unprecedented rates of death and injury in Canada and internationally. Prescription based safer supply programs often fail to meet the diverse needs of people who access the unregulated market. This study explores a range of possible models to enhance implementation of prescription and non-prescription safer supply based on preferences and goals of people who use drugs.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of three qualitative data sets from studies that explored various practical and theoretical elements of safer supply from the perspectives of people who use drugs. Our analysis included 175 responses from the perspectives of individuals who access the unregulated drug supply, receive prescribed alternatives to the unregulated supply, and/or work in front line harm reduction. We conducted a thematic analysis, using the insights to describe a range of possible safer supply models spanning both prescription and non-prescription models.</div></div><div><h3>Results</h3><div>Five possible safer supply models were identified: team based prescribed safer supply, buyers’ club, compassion club, events space distribution, and dispensary. The range of models reflects participants diverse goals, preferences, and desired outcomes for safer supply.</div></div><div><h3>Conclusion</h3><div>Our findings emphasize the importance of a range of models implemented concurrently to address a population level crisis. Importantly, models outside of a prescriber-based model were often preferred for their orientation towards community care and the ability to move beyond the inherent limitations of medical models of prescribed safer supply.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104920"},"PeriodicalIF":4.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662155","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}