International Journal of Drug Policy最新文献

{"title":"Making sense of drug use and dependence—A scoping review of mass media interventions intended to reduce stigma towards people who use drugs","authors":"Adam Holland ,&nbsp;Tom P Freeman ,&nbsp;James Nicholls ,&nbsp;Chloe Burke ,&nbsp;Joshua Howkins ,&nbsp;Magdalena Harris ,&nbsp;Matthew Hickman ,&nbsp;Angela Attwood ,&nbsp;Vicky Carlisle ,&nbsp;Peter Krykant ,&nbsp;Olivia M Maynard","doi":"10.1016/j.drugpo.2024.104543","DOIUrl":"10.1016/j.drugpo.2024.104543","url":null,"abstract":"<div><h3>Background</h3><p>People who use drugs face entrenched stigma, which fosters shame, restricts service access, and exacerbates inequalities. The use of mass media in anti-stigma interventions offers an opportunity to challenge stigmatising attitudes at scale. There are, however, inconsistencies in messaging approaches used in mass media anti-stigma interventions, and how authors conceptualise and measure ‘stigma’.</p></div><div><h3>Methods</h3><p>This scoping review maps literature on the development and/or evaluation of mass media interventions intended to reduce stigma towards people who use drugs. We systematically searched seven databases for reports about: (i) people who use drugs, (ii) stigma, (iii) mass media. We charted data about intervention (i) subjects and recipients, (ii) format, (iii) authors, (iv) content; and (v) conceptualisation and measurement of stigma. We narratively synthesised findings with qualitative content analyses.</p></div><div><h3>Results</h3><p>From 14,256 records, we included 49 reports about 35 interventions. 25/35 were from the last five years and 19/35 were from the United States. Intended recipients included the public and/or specified sub-populations, often including healthcare workers. Most interventions were intended to reduce stigma towards people with patterns of drug use perceived to be problematic, as opposed to people who use drugs in general. Interventions ranged from single pieces of media to complex multi-format campaigns. People who use(d) drugs contributed to 22/35 interventions. Professionals working in medical disciplines co-authored 29/35 interventions. Intervention content often had a medical focus, describing dependence as a ‘disease’ or medical issue, and emphasised the benefits of recovery. Other interventions, however, criticised medical framings. In some interventions drug use and people who use drugs were described in markedly negative terms. ‘Stigma’ was often under-theorised, and measurement approaches were inconsistent, with 42 instruments used to measure phenomena associated with stigma across 19 quantitative evaluations.</p></div><div><h3>Conclusion</h3><p>We found inconsistencies in approaches to reduce and measure stigma, potentially reflecting different motivations for intervention development. The primary motivation of many interventions was seemingly to promote drug service engagement and recovery.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104543"},"PeriodicalIF":4.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955395924002275/pdfft?md5=b283a9d48ffaf2b2e6f50d6f2d14d285&pid=1-s2.0-S0955395924002275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ‘ban’ for public health that wasn't? Views and impressions on cannabis retail promotion/advertising realities amidst legalization policy in Canada","authors":"","doi":"10.1016/j.drugpo.2023.104294","DOIUrl":"10.1016/j.drugpo.2023.104294","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"131 ","pages":"Article 104294"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589639","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":"Modeling the impact of the COVID-19 pandemic on achieving HCV elimination amongst young and unstably housed people who inject drugs in San Francisco","authors":"","doi":"10.1016/j.drugpo.2024.104452","DOIUrl":"10.1016/j.drugpo.2024.104452","url":null,"abstract":"<div><h3>Background</h3><p>Young adult (18–30 years) people who inject drugs (PWID) face high hepatitis C virus (HCV) prevalence. In San Francisco, where &gt;60% of PWID lack stable housing, barriers hinder HCV treatment access. We assessed progress towards the World Health Organization's (WHO) HCV elimination goal of an 80% reduction in incidence over 2015–2030, focusing on young (YPWID) and unstably housed PWID in San Francisco.</p></div><div><h3>Methods</h3><p>We developed a dynamic HCV transmission model among PWID, parameterized and calibrated using bio-behavioural survey datasets from San Francisco. This included 2018 estimates for the antibody-prevalence among PWID (77%) and care cascade estimates for HCV for YPWID (72% aware of their status and 33% ever initiating treatment). Based on programmatic data, we assumed a 53.8% reduction in testing and 40.7% decrease in treatment from 2020 due to the COVID-19 pandemic, which partially rebounded from April 2021 with testing rates then being 31.1% lower than pre-pandemic rates and treatment numbers being 19.5% lower. We simulated different scenarios of how services changed after the pandemic to project whether elimination goals would be met.</p></div><div><h3>Results</h3><p>Continuing post-pandemic rates of testing and treatment, the model projects an 83.3% (95% credibility interval [95% CrI]:60.6–96.9%) decrease in incidence among PWID over 2015–2030 to 1.5/100pyrs (95% CrI:0.3–4.4) in 2030. The probability of achieving the elimination goal by 2030 is 62.0%. Among YPWID and unstably housed PWID, the probability of achieving the elimination goal by 2030 is 54.8 and 67.6%, respectively. Importantly, further increasing testing and treatment rates to pre-pandemic levels by 2025 only results in a small increase in the probability (67.5%) of the elimination goal being achieved among all PWID by 2030, while increased coverage of medication for opioid use disorder among YPWID and/or housing interventions results in the probability of achieving elimination increasing to over 75%.</p></div><div><h3>Conclusion</h3><p>The COVID-19 pandemic impeded progress toward achieving HCV elimination. Our findings indicate that existing partial rebounds in HCV testing and treatment may achieve the elimination goal by 2030, with an additional scale-up of interventions aimed at YPWID or unstably housed PWID ensuring San Francisco is likely to achieve elimination by 2030.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"131 ","pages":"Article 104452"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955395924001373/pdfft?md5=21e193cb6f06a6fe636e5b356942e27b&pid=1-s2.0-S0955395924001373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443571","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":"National increase in the community supply of take‐home naloxone associated with a mass media campaign in Scotland: a segmented time series analysis","authors":"","doi":"10.1016/j.drugpo.2023.104106","DOIUrl":"10.1016/j.drugpo.2023.104106","url":null,"abstract":"<div><h3>Background</h3><p>Take-home naloxone (THN) programmes have been associated with reductions in opioid-related mortality. In response to high rates of drug-related deaths in Scotland, the Scottish Government commissioned the ‘How to save a life’ (HTSAL) mass media campaign to: (1) increase awareness of drug-related deaths and how to respond to an overdose, and (2) increase the supply of THN. The aim of this study was to assess the effect of the campaign on the supply of THN.</p></div><div><h3>Methods</h3><p>We used an interrupted time series design to assess the effect of the HTSAL mass media campaign on the national community supply of THN. The study time period was August 2020–December 2021. We modelled two key dates: the start of the campaign (week beginning (w/b) 30th of August 2021) and after the end of the main campaign (w/b 25th of October 2021).</p></div><div><h3>Results</h3><p>The total number of THN kits distributed in the community in Scotland during the study period was 27,064. The mean number of THN kits distributed per week (relative to the pre-campaign period), increased by 126% during the campaign and 57% post-campaign. In segmented regression analyses, the pre-campaign trend in the number of THN kits supplied was increasing by an average of 1% each week (RR=1.01, 95% CI 1.01 to 1.01, <em>p</em>&lt;0.001). Once the campaign started, a significant change in level was observed, and the number of kits increased by 75% (RR=1.75, 95% CI 1.29 to 2.40, <em>p</em>&lt;0.001). The trend during the campaign was stable (i.e. not increasing or decreasing) but a significant change in level was observed when the campaign ended, and the number of THN kits supplied decreased by 32% (RR=0.68, 95% CI 0.46 to 0.98, <em>p</em> = 0.042). The trend during the post-campaign period was stable.</p></div><div><h3>Conclusions</h3><p>The HTSAL campaign had a short term, but large and significant impact, on the community supply of THN in Scotland. Mass media campaigns could be combined with other interventions and strategies to maintain the increased uptake of THN outside of campaign periods.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"131 ","pages":"Article 104106"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964745","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":"How to save a life: Public awareness of a national mass media take home naloxone campaign, and effects of exposure to campaign components on overdose knowledge and responses.","authors":"","doi":"10.1016/j.drugpo.2023.104111","DOIUrl":"10.1016/j.drugpo.2023.104111","url":null,"abstract":"<div><h3>Background</h3><p>Take home naloxone (THN) programmes are effective at reducing opioid related mortality, but require high levels of distribution, including to the general public. Mass media campaigns can be effective in improving public understanding of a topic and encouraging behavior change. Whilst mass media campaigns focusing on naloxone have been developed internationally, there is a lack of research on their potential impact. We investigated the effects of components of a recent national mass media campaign (Scotland, UK) designed to improve public awareness of drug related deaths, and readiness to intervene.</p></div><div><h3>Methods</h3><p>We undertook a cross-sectional online experimental study with a randomized design, conducted with a nationally representative sample. Participants (N = 1551; 52.6% female; age 46.1±16.5 years) were assessed on overdose knowledge and readiness to intervene after presentation of eight combinations of campaign components.</p></div><div><h3>Results</h3><p>Compared to a basic campaign description, exposure to all types of campaign component were associated with higher overdose knowledge (<em>p</em> &lt; .001), but not knowledge of what to do in response to an overdose (<em>p</em> = .374), or readiness to intervene (<em>p</em>= .286). The greatest effects were associated with a media rich audio-visual resource (animated video with a popular song on the soundtrack, and narrated by a well-known actor).</p></div><div><h3>Conclusion</h3><p>Our data suggest that harm reduction is an appropriate topic for large-scale mass media campaigns. However, effects may be limited to knowledge and awareness raising in the general public, and may be related to the types of media used. Audience segmentation is important and more general messaging about drug related deaths may be more appropriate for the majority of audiences.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"131 ","pages":"Article 104111"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955395923001585/pdfft?md5=db1f094331ced35d4fcc141c6d8d56c7&pid=1-s2.0-S0955395923001585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of an unsanctioned compassion club on non-fatal overdose","authors":"","doi":"10.1016/j.drugpo.2024.104330","DOIUrl":"10.1016/j.drugpo.2024.104330","url":null,"abstract":"<div><h3>Objectives</h3><p>In 2022, the Drug User Liberation Front opened an unsanctioned compassion club in Vancouver where members could purchase illicit drugs that had been rigorously tested to ensure quality and a lack of potentially fatal contaminants. We sought to evaluate the impact of access to this novel safer supply intervention on non-fatal overdose.</p></div><div><h3>Methods</h3><p>Data were obtained from 47 club members via surveys completed at 3-month intervals between August 2022 and October 2023. We conducted multivariable generalized estimating equations (GEE) analyses to examine the association between club enrolment and the outcomes of: (1) any non-fatal overdose; and (2) any non-fatal overdose involving naloxone administration.</p></div><div><h3>Results</h3><p>The final sample, including 47 study participants, contributed a total of 225 observations and 44.4 person-years of follow-up during the study, and a median follow-up duration of 12.2 months (quartile 1 - 3: 10.4 – 14.7) per participant. In multivariable GEE analyses, enrolment in the compassion club was associated with reduced likelihood of non-fatal overdose (Adjusted Odds Ratio [AOR] = 0.51, 95% Confidence Interval (CI): 0.26 – 0.99) and non-fatal overdose involving naloxone administration (AOR = 0.37, 95% CI: 0.16 – 0.84) after adjusting for potential confounders.</p></div><div><h3>Discussion</h3><p>In this study, enrolment in an unsanctioned compassion club was found to be associated with reductions in any type of non-fatal overdose and non-fatal overdose involving naloxone administration. These findings highlight the need for ongoing research on safer supply interventions, as well as the potential of non-medicalized compassion clubs to complement existing safer supply programming and reduce overdose events.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"131 ","pages":"Article 104330"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S095539592400015X/pdfft?md5=3d284c228eb4b905349747f412860569&pid=1-s2.0-S095539592400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940965","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":"Pilot model of hepatitis C virus micro-elimination in high-risk populations in Hong Kong: Barriers and facilitators","authors":"Lung-Yi Mak ,&nbsp;Wai-Pan To ,&nbsp;Vivien Tsui ,&nbsp;Matthew Shing-Hin Chung ,&nbsp;Ka-Yin Hui ,&nbsp;Trevor Kwan-Hung Wu ,&nbsp;Anthony Kwok ,&nbsp;Kwan-Lung Ko ,&nbsp;Danny Ka-Ho Wong ,&nbsp;Siu-Yin Wong ,&nbsp;Kevin Sze-Hang Liu ,&nbsp;Wai-Kay Seto ,&nbsp;Man-Fung Yuen","doi":"10.1016/j.drugpo.2024.104568","DOIUrl":"10.1016/j.drugpo.2024.104568","url":null,"abstract":"<div><h3>Background</h3><p>Although the general seroprevalence of hepatitis C virus (HCV) infection in Hong Kong is &lt;0.5 %, Hong Kong is still striving for HCV elimination owing to barriers in care cascade encompassing linkage-to-care (LTC), treatment initiation and adherence. We aimed to evaluate the feasibility of a pilot model of micro-elimination to strengthen the HCV care cascade for high-risk groups in Hong Kong.</p></div><div><h3>Methods</h3><p>We initiated the pilot <u>C</u>onquering <u>H</u>epatitis v<u>I</u>a <u>M</u>icro-<u>E</u>limination (CHIME) program which adopts an integrated care approach involving outreach visits to halfway house or drug rehabilitation centers run by non-governmental organizations. Participants with history of injection drug use (PWID), recreational drug use, or imprisonment were included. We performed point-of-care test for anti-HCV with reflex HCV RNA testing. LTC with government-subsidized direct acting antiviral was provided to viremic participants. We compared the impact on the care cascade with a cohort of HCV patients (17.8 % PWID) under usual care.</p></div><div><h3>Results</h3><p>396 participants (62.9 % PWID) were screened and 187 (47.2 %) were viremic, of which 29.8 % had cirrhosis. Proportion with LTC, treatment initiation and adherence were 76.5 % and 63.7 %, 90.9 % and 85.8 %, and 90.0 % and 92.2 %, for the CHIME program and usual care, respectively. The CHIME program was significantly associated with higher odds of LTC (OR 1.797, 95 % CI 1.221–2.644). Non-engagement in care (affecting 37.9 % participants with HCV viremia) was associated with unemployment (OR 2.165, 95 % CI 1.118–4.190).</p></div><div><h3>Conclusion</h3><p>The pilot CHIME program demonstrated feasibility of an integrated approach to consolidate the HCV care cascade in high-risk populations in Hong Kong.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104568"},"PeriodicalIF":4.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095199","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":"Opportunities and challenges for implementing drug checking services in British Columbia, Canada: A qualitative study","authors":"Koharu Loulou Chayama ,&nbsp;Lianping Ti ,&nbsp;Jaime Arredondo Sanchez Lira ,&nbsp;Pierre-julien Coulaud ,&nbsp;Geoff Bardwell ,&nbsp;Rod Knight","doi":"10.1016/j.drugpo.2024.104560","DOIUrl":"10.1016/j.drugpo.2024.104560","url":null,"abstract":"<div><h3>Background</h3><p>Amidst the ongoing drug poisoning crisis across North America, drug checking services (DCS) are increasingly being implemented as an intervention intended to reduce drug-related harms. This study sought to identify key opportunities and challenges influencing the implementation of DCS in British Columbia (BC), Canada.</p></div><div><h3>Methods</h3><p>Between January 2020 and July 2021, semi-structured, in-depth interviews were conducted with 21 individuals involved in the implementation of DCS across BC (i.e., policymakers, health authority personnel, community organization representatives and service providers). The Consolidated Framework for Implementation Research (CFIR) was used to guide coding and analysis of the interviews.</p></div><div><h3>Results</h3><p>By bringing in a wealth of knowledge about community needs and concerns, in addition to a passion and energy for social justice and health equity, community members and organizations with a dedication for harm reduction played a critical role in the successful implementation of DCS in BC. Other significant facilitators to implementation included the preventive benefits of DCS that made the intervention compelling to policy influencers and decision makers, the provincial public health emergency regarding overdose that shifted the regulatory environment of DCS, the adaptability of DCS to meet concerns and needs in various contexts, including via ongoing processes of reflection and evaluation. Barriers to implementation included criminalization and stigmatization of drug use and people who use drugs and lack of funding for community-led implementation actions.</p></div><div><h3>Conclusions</h3><p>Alongside structural reforms that address the underlying contextual factors that influence implementation (e.g., decriminalization of drugs, increased funding for DCS), centering community expertise throughout implementation is critical to the success of DCS. Our findings provide important insights into how BC can successfully implement systems-level harm reduction interventions and offer insights for other jurisdictions in their implementation of DCS.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104560"},"PeriodicalIF":4.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955395924002445/pdfft?md5=9a8c6ec95c9dacc6b2eb8a355bbe3ef9&pid=1-s2.0-S0955395924002445-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095197","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 a supervised consumption site on HIV and HCV transmission among people who inject drugs in three counties in California, USA","authors":"J.A. Killion ,&nbsp;O.S. Jegede ,&nbsp;D. Werb ,&nbsp;P.J. Davidson ,&nbsp;L.R. Smith ,&nbsp;T. Gaines ,&nbsp;J. Graff Zivin ,&nbsp;M.L. Zúñiga ,&nbsp;H.A. Pines ,&nbsp;R.S. Garfein ,&nbsp;S.A. Strathdee ,&nbsp;C. Rivera Saldana ,&nbsp;N.K. Martin","doi":"10.1016/j.drugpo.2024.104557","DOIUrl":"10.1016/j.drugpo.2024.104557","url":null,"abstract":"<div><h3>Background</h3><p>Supervised consumption sites (SCS) have been shown to reduce receptive syringe sharing among people who inject drugs (PWID) in the United States and elsewhere, which can prevent HIV and hepatitis C virus (HCV) transmission. PWID are at risk of disease transmission and may benefit from SCS, however legislation has yet to support their implementation. This study aims to determine the potential impact of SCS implementation on HIV and HCV incidence among PWID in three California counties.</p></div><div><h3>Methods</h3><p>A dynamic HIV and HCV joint transmission model among PWID (sexual and injecting transmission of HIV, injecting transmission of HCV) was calibrated to epidemiological data for three counties: San Francisco, Los Angeles, and San Diego. The model incorporated HIV and HCV disease stages and HIV and HCV treatment. Based on United States data, we assumed access to SCS reduced receptive syringe sharing by a relative risk of 0.17 (95 % CI: 0.04–1.03). This model examined scaling-up SCS coverage from 0 % to 20 % of the PWID population within the respective counties and assessed its impact on HIV and HCV incidence rates after 10 years.</p></div><div><h3>Results</h3><p>By increasing SCS from 0 % to 20 % coverage among PWID, 21.8 % (95 % CI: −1.2–32.9 %) of new HIV infections and 28.3 % (95 % CI: −2.0–34.5 %) of new HCV infections among PWID in San Francisco County, 17.7 % (95 % CI: −1.0–30.8 %) of new HIV infections and 29.8 % (95 % CI: −2.1–36.1 %) of new HCV infections in Los Angeles County, and 32.1 % (95 % CI: −2.8–41.5 %) of new HIV infections and 24.3 % (95 % CI: −1.6–29.0 %) of new HCV infections in San Diego County could be prevented over ten years.</p></div><div><h3>Conclusion</h3><p>Our models suggest that SCS is an important intervention to enable HCV elimination and could help end the HIV epidemic among PWID in California. It could also have additional benefits such facilitating pathways into drug treatment programs and preventing fatal overdose.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104557"},"PeriodicalIF":4.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S095539592400241X/pdfft?md5=bbc6661d69dc245629a6f9646bd14b33&pid=1-s2.0-S095539592400241X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095198","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":"Putting tendencies and trajectories to work: useful tools for engaging with accounts of change and recovery?","authors":"Katrin Oliver ,&nbsp;Michael Savic","doi":"10.1016/j.drugpo.2024.104563","DOIUrl":"10.1016/j.drugpo.2024.104563","url":null,"abstract":"<div><p>Dominant understandings of recovery emphasise personal responsibility for initiating and sustaining changes in people's subjectivities and relationships to alcohol and other drugs. However, this potentially obscures the complexities and temporalities of change processes and the range of socio-material elements involved. Addressing this gap, critical drug studies scholars have productively employed the concepts of tendencies and trajectories to analyse how past events of drug consumption flow into current and future consumption events. Critiquing notions of personal responsibility within recovery processes, we apply the concepts of tendencies and trajectories to help explain recovery's emergence and continuities. Doing so helps decentre the individual as the agent responsible for improved capacity by broadening the perspective of developing health and wellbeing. In this paper, we provide a qualitative analysis of interviews with fourteen people with lived recovery experiences within an urban-rural setting in Melbourne, Australia. This analysis illustrates how recovery tendencies and trajectories are cultivated through repeated actions, habits, and practices over time. Applying the concept of trajectories to change narratives reveals how accumulated moments precede and follow turning points, supporting shifts in consumption patterns. These moments are not necessarily connected but, when considered collectively, contribute to a recovery trajectory and assemblage of health. In reflecting on the affordances of thinking, researching and doing with recovery tendencies and trajectories, we argue that analysing tendencies and trajectories illuminate opportunities where change lies within an endless combination of human and non-human forces. Applying these concepts to recovery research, practice, and policy engages with temporal and socio-material elements of recovery, offering a more emancipatory approach than is currently provided by common recovery theories and approaches that assume individuals are personally responsible for change.</p></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"132 ","pages":"Article 104563"},"PeriodicalIF":4.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955395924002470/pdfft?md5=27666046347ea6df0d860ba4857592d6&pid=1-s2.0-S0955395924002470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087399","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}