Substance use & addiction journal最新文献

{"title":"\"It Eats My Heart\": Identifying Knowledge Gaps in Injection Drug-Related Endocarditis Among Hospitalized Patients.","authors":"Kate E A Roberts, Eunice A Okumu, Bailey McInnes, Bayla Ostrach, Vivian H Chu, Li-Tzy Wu, Carol Golin, David L Rosen, Asher J Schranz","doi":"10.1177/29767342251351759","DOIUrl":"10.1177/29767342251351759","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) rates have risen sharply, spurred by injection drug use (IDU). Public health interventions to prevent infectious complications of IDU have primarily focused on communicable diseases, such as HIV and viral hepatitis. We assessed patients' knowledge of IE in relation to IDU practice.</p><p><strong>Methods: </strong>From 2021 to 2022, we conducted in-person semi-structured interviews (SSIs) with 16 adults hospitalized with IDU-related IE at an academic medical center in North Carolina. SSIs explored participants' knowledge and experience of IE and IDU practices. The SSIs were audio-recorded, transcribed verbatim, and thematically coded.</p><p><strong>Results: </strong>We identified 4 primary themes: limited knowledge of IE; nonspecific IE symptoms; injection behavior and infection prevention; and knowledge of other IDU-related infections, such as hepatitis C virus (HCV) and HIV. Most patients reported little or no knowledge of IE before hospitalization despite previously having soft tissue infections, such as skin abscesses. Presentations were heterogeneous, with many patients not recognizing their symptoms as IE, and often delaying seeking care. In contrast to limited information about IE, all patients reported prior testing for HIV and HCV. While many expressed the importance of not reusing injection equipment, many patients reported reusing injection equipment nonetheless, and several specifically reported that they take no dedicated precautions to prevent infections.</p><p><strong>Conclusion: </strong>Our findings suggest prior to hospitalizations, knowledge of IE, its symptoms, and prevention is limited among persons who inject drugs who acquire IE. Our study indicates an urgent need to disseminate public health messages regarding preventing IDU-related invasive bacterial infections and providing access to sterile equipment to prevent bacterial infections.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251351759"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Naloxone Decline Among African American Kentuckians.","authors":"Rayven L Peterson, Mona Goggins, Destin L Mizelle, Brittany Miller-Roenigk, Candice N Hargons, Danielle Stevens-Watkins","doi":"10.1177/29767342251352271","DOIUrl":"https://doi.org/10.1177/29767342251352271","url":null,"abstract":"<p><strong>Background: </strong>Opioid-involved overdose fatalities among African Americans continue to rise. The current study examines African Americans who reported use of opioids in the past 6 months and declined overdose education and free naloxone.</p><p><strong>Method: </strong>Eligible participants included African American Kentuckians who used opioids in the past 6 months and consented to a larger study examining their opioid use. This paper qualitatively explored their reasons for declining overdose education and naloxone using an adjusted and inductive application of structural tabular thematic analysis.</p><p><strong>Results: </strong>Out of 588 participants, 70 (12%) declined naloxone: the most cited reason for declining naloxone was already possessing the medication. Additional reasons range from not needing or wanting naloxone to no longer using opioids.</p><p><strong>Conclusions: </strong>The findings suggest that African Americans' hesitancy to carry naloxone can be due to pervasive structural issues. Despite these findings, there remain disproportionate drug treatment rates and mortality from overdose among African Americans.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251352271"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-Four Years of Research on Women's Drug Use in Latin America: A Scoping Review (2000-2024).","authors":"Victoria Sánchez Antelo, Cecilia Inés Straw, Vanesa Judith Jeifetz, Jimena Viviana Saavedra, Maria do Perpétuo Socorro Sousa Nóbrega","doi":"10.1177/29767342251347368","DOIUrl":"https://doi.org/10.1177/29767342251347368","url":null,"abstract":"<p><strong>Aim: </strong>To analyze how psychoactive substance (PS) use among Latin American women is addressed between 2000 and 2024, considering theoretical perspectives, dimensions, variables employed, and methodological strategies.</p><p><strong>Methods: </strong>This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. An intersectional perspective was employed for the analysis. The literature search included databases such as PubMed and Scielo, covering studies from 2000 to 2024. Eligibility criteria included empirical studies in Spanish, English, or Portuguese. Five researchers evaluated and extracted data. The information was organized in tables and figures.</p><p><strong>Results: </strong>A total of 53 studies were selected out of 556, based on inclusion criteria related to gender, substance use, and regional context. Brazil and Mexico led the academic production, with most studies published between 2004 and 2024, primarily using quantitative descriptive methods. The studies are grouped into 5 themes: prevalence, sociocultural aspects, violence and risks, vulnerable groups, and interventions and treatments. Alcohol and tobacco use were the most studied, followed by marijuana, cocaine, and crack. However, polydrug use and recreational consumption were less explored, as were the experiences of transgender and gender-diverse individuals. Only 4 studies applied an intersectional approach, while most analyses were limited to binary gender perspectives.</p><p><strong>Discussion: </strong>PS use among women reflects complex inequalities tied to gender, race, and class, amplified by structural violence and socioeconomic barriers. Strengthening regional collaboration, adopting intersectional approaches, and diversifying study populations are essential for designing inclusive and effective interventions. Research must overcome current gaps and address underexplored topics like recreational consumption and gender-diverse experiences.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251347368"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic, Socioeconomic, and Clinical Variables Associated With Nonmedical Pharmaceutical Opioid Use and Heroin Use Among US Adults in 2021 to 2022.","authors":"Max L Moss, Michele J Buonora, William C Becker","doi":"10.1177/29767342251348150","DOIUrl":"https://doi.org/10.1177/29767342251348150","url":null,"abstract":"<p><strong>Background: </strong>Recent changes to the US opioid overdose epidemic have been driven by the spread of illicitly manufactured opioids and complex patterns of multisubstance use. Updated analyses of opioid use epidemiology among US adults are needed to guide new research and interventions.</p><p><strong>Methods: </strong>Cross-sectional study of 2021 to 2022 National Survey on Drug Use and Health. Using nationally representative estimates weighted to 255 053 169 adults, multivariable logistic regression models determined odds of mutually exclusive past-year opioid use categories (nonmedical use of pharmaceutical opioids [NMUPO], heroin use, or both) across demographic, socioeconomic, and clinical variables.</p><p><strong>Results: </strong>Prevalence of NMUPO among US adults was 3.0%, heroin use 0.2%, and both 0.2%. Demographic characteristics associated with nonmedical opioid use included middle age groups (e.g., 35-49 years old relative to 18-25 years old, NMUPO: adjusted odds ratio [aOR] 1.61, 95% CI 1.26-2.07) and LGB sexual orientation relative to heterosexual orientation (e.g., NMUPO: aOR 1.33, 95% CI 1.09-1.64). Among socioeconomic variables, the strongest associations were with lower educational attainment (e.g., completing high school relative to completing college, both: aOR 3.84, 95% CI 1.53-9.68). Clinical variables strongly associated with opioid use included nonmedical sedative/tranquilizer use (e.g., NMUPO: aOR 7.48, 95% CI 5.86-9.56), nonmedical stimulant use (e.g., both: aOR 32.42, 95% CI 17.11-61.42), lower self-rated health (e.g., \"poor\" health relative to \"excellent\" health, NMUPO: aOR 1.98, 95% CI 1.34-2.91), and severe mental illness (e.g., both: aOR 3.78, 95% CI 2.05-6.96).</p><p><strong>Conclusions: </strong>Future research and public health efforts should account for heterogeneity in opioid use patterns across US adults, including strong associations with nonopioid substance use.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251348150"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Asynchronous Training on Student's Confidence and Attitudes Regarding Patients With Opioid Use Disorders.","authors":"Daniel J Mullin, Amber Cahill, Daniel P Alford, Nicholas Bergeron, Phoebe A Cushman, Gerardo Gonzalez, Stephen A Martin, Alyssa F Peterkin, Emmanuel N Pothos, Marya Pulaski, Jill M Terrien, Melissa A Fischer","doi":"10.1177/29767342251347358","DOIUrl":"https://doi.org/10.1177/29767342251347358","url":null,"abstract":"<p><strong>Background: </strong>The American opioid use disorder (OUD) and overdose epidemic require physicians and advanced care providers to be prepared to care for patients with this life-threatening condition. Learning to identify, engage, and treat patients with OUD with medications is an essential skill for providers, as is developing requisite confidence and therapeutic attitudes regarding the care of patients with OUD (CP-OUD). To address the need for improved OUD treatment education, our team built and implemented a 12-module asynchronous course entitled, \"Care of Patients with Opioid Use Disorder\", in 3 Doctor of Medicine (MD) programs and a Graduate School of Nursing (GSN) program.</p><p><strong>Methods: </strong>Students self-reported their attitudes and confidence regarding the CP-OUD before and after each module. Twelve questions assessed confidence, and 12 questions assessed attitude. Students' change in confidence and attitudes before and after training was calculated.</p><p><strong>Results: </strong>Responses were collected between January 2021 and November 2024. The number of students completing each module ranged from 552 to 967 MD students and 81 to 149 GSN students. Students reported improved confidence after completing each of the 12 modules (<0.0001). Students reported improved attitudes after completing 10 of the 12 modules (<0.0001). Differences ranging from small to medium size were observed between MD and GSN student's baseline confidence for 4 modules, and baseline attitudes for 6 modules.</p><p><strong>Conclusions: </strong>Asynchronous learning modules can be effectively implemented in medical and nursing education to improve confidence and attitudes regarding the CP-OUD. The use of asynchronous training modules allows for flexible deployment, as evidenced by their use in 3 MD programs and a GSN program. Future research should investigate whether improved confidence and attitudes during medical and nursing education result in more graduates caring for patients with OUD post-training.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251347358"},"PeriodicalIF":0.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Patients With and Without Chronic Pain Seeking Behavioral Health Treatment for Co-Occurring Opioid Use and Mental Health Disorders.","authors":"Abigail Helm, Eleni Kachadoorian, Paige M Shaffer, Orman Trent Hall, David Smelson","doi":"10.1177/29767342251351127","DOIUrl":"https://doi.org/10.1177/29767342251351127","url":null,"abstract":"<p><strong>Background: </strong>Among patients with chronic pain (CP; pain persisting for 3+ months) and opioid use disorder (OUD), ~3 in 4 report co-occurring mental health conditions, which may exacerbate difficulties accessing and engaging in behavioral health treatment. Beyond rates of co-occurring diagnoses, little is known about the differences in specific behavioral health needs of individuals with CP versus those without CP when they seek behavioral health treatment for OUD and co-occurring mental health disorders.</p><p><strong>Methods: </strong>These secondary analyses utilized data from a randomized controlled trial. Patients (n = 396) were individuals with (n = 281) and without CP (n = 115) seeking behavioral health treatment for OUD and co-occurring mental health disorders. Analyses focused on intake assessment data from validated patient-reported outcome measures for CP, OUD, and mental health: (1) pain intensity and interference (ie, impact on daily activities), (2) mental health symptoms and functioning, (3) current substance use, (4) quality of life, (5) sleep disturbance, (6) physical function, and (7) cognitive function.</p><p><strong>Results: </strong>Seventy-one percent of patients reported current CP at intake, and these patients reported high pain intensity and interference. Compared to those without CP, patients with CP reported significantly more depression, anxiety, and trauma symptoms; more difficulty with mental health functioning; lower quality of life; more sleep disturbance; and worse physical function. There were no significant differences in self-reported substance use or cognitive function.</p><p><strong>Conclusions: </strong>This study suggests that individuals with CP as well as OUD and co-occurring mental health disorders may have worse mental health, quality of life, sleep, and physical functioning upon entering treatment compared to those without CP. Thus, behavioral health treatment providers should assess broad mental and physical health needs in addition to screening for CP to address any issues, which may interfere with successful behavioral health treatment.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251351127"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Missing Dose: Integrating Harm Reduction into Pharmacy Curriculums.","authors":"Tessa Rife-Pennington, Beth Dinges, Thao Thanh Vu, Michael P Douglas, David L Pennington","doi":"10.1177/29767342251351753","DOIUrl":"https://doi.org/10.1177/29767342251351753","url":null,"abstract":"<p><p>Pharmacists are uniquely poised for harm reduction work due to their accessibility, medication expertise, and direct patient interaction. They can provide non-prescription syringes, dispense naloxone and medication for opioid use disorder, offer human immunodeficiency virus and hepatitis C virus testing, administer vaccines for hepatitis B virus and human papillomavirus, and prescribe pre- and post-exposure prophylaxis. Despite these advancements, ongoing barriers such as restrictive pharmacy policies and stigma persist, and gaps in education contribute to the problem. Currently, harm reduction education is underrepresented in the Doctor of Pharmacy curriculum. This commentary highlights existing gaps in pharmacist training, emerging pilot programs, and makes practical recommendations for integration of harm reduction education, including minimal competencies, curricular mapping, and implementation strategies to facilitate uptake.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251351753"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Use Disorder and Harm Reduction Curriculum in United States and Canadian Undergraduate Medical Education: An Online Survey.","authors":"Tucker Avra, Andrew Nelson, Joseph Friedman, Willow Limbach, Mary Sarkisian, Tamiko Nesley, Tiffany Chu, Kyla Truman, Brandon Moghanian, Joshua Yazditabar, Tamanna Ahluwalia, Chelsea Shover, David Goodman-Meza","doi":"10.1177/29767342251313595","DOIUrl":"10.1177/29767342251313595","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders (SUD) are a significant public health challenge, necessitating that clinicians are trained in SUD treatment and harm reduction (HR) strategies. Despite this, no studies have assessed the extent of SUD and HR training across all medical schools. This study assesses the current state of SUD and HR curriculum among medical students in the United States and Canada.</p><p><strong>Methods: </strong>From May to July 2023, we conducted an anonymous online survey via email invitation to student affairs' offices of all 220 accredited US and Canadian medical schools. The survey assessed the curricula students were exposed to related to SUD treatment, HR, and stigmatizing attitudes.</p><p><strong>Results: </strong>A sample of 568 students from 52 medical schools (23.6% of all US and Canadian medical schools) completed the survey. Participants reported that in their medical school they were taught about: recognition of an opioid overdose (80.0%), identifying and treating opioid withdrawal (68.2%), principles and practices of HR (60.6%), administering naloxone (56.6%), the importance of syringe service programs (51.8%), prescribing methadone and/or buprenorphine (29.5%), and counseling patients on safe injection practices (11.4%). In addition, participants reported that they were taught: how to identify drug-seeking behavior (36.4%), that people who use heroin are \"drug abusers\" (24.4%), to withhold opioid pain medication from patients who are known or suspected to use drugs (15.9%), and that medication for opioid use disorder is another form of addiction (12.6%).</p><p><strong>Discussion: </strong>We found large curricular gaps related to the administration of medications for opioid use disorder and treating opioid overdose and withdrawal, as well as a significant prevalence of stigmatizing attitudes. Renewed efforts are needed to implement comprehensive and destigmatizing SUD curricula. The study is limited by response bias and is expected to overestimate the extent of HR related curriculum, indicating the true gap is likely higher than reported.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"704-710"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preamble to Prevention of Adolescent Substance Use: Pediatric Resident Screening for Caregiver Substance Use.","authors":"Jessica B Calihan, Samara Jinks-Chang, Tiffany Mark, Rachel Alinsky, Hoover Adger, Pamela A Matson","doi":"10.1177/29767342251313856","DOIUrl":"10.1177/29767342251313856","url":null,"abstract":"<p><strong>Background: </strong>Caregiver problematic substance use (SU) is a common adverse childhood experience that is associated with the development of SU disorders in adolescence and poor health outcomes. Most pediatricians do not currently screen for caregiver SU, missing an opportunity to provide targeted prevention counseling to at-risk youth and their families. The objective of this study was to assess whether pediatric residents' screening-related competencies, beliefs, and training were associated with current screening practices and/or preparedness to screen in the future.</p><p><strong>Methods: </strong>Baseline surveys from a quality improvement initiative to increase screening for household SU in pediatric primary care were e-mailed to all pediatric residents at an academic medical center. Surveys assessed residents' current screening practices, preparedness to screen in the future, screening-related competencies, receipt of SU training, beliefs about screening, perceived caregiver acceptability of screening, and stigma about caregiver SU.</p><p><strong>Results: </strong>Residents agreed screening for household SU is a pediatrician's responsibility and beneficial for patients and families, yet only 5% universally screened. Preparedness to screen in the future was positively associated with reported screening-related competencies and receipt of training on SU screening during residency.</p><p><strong>Conclusions: </strong>Most residents did not universally screen for household SU, thereby missing opportunities for targeted secondary prevention of adolescent SU. Trained residents who reported competence in addressing families' concerns were more likely to feel prepared to screen in the future, suggesting education that addresses caring for affected families, reviews available resources, and improves pediatrician confidence may be particularly impactful.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"711-717"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Community Harm Reduction Strategies for Maternal and Fetal Opioid Impacts: Implications for Policy.","authors":"Maren Wright Voss, Marcela C Smid, Julie C Herrick, Aarica Cleveland, Amelia Van Komen, Joli Johanson, Matthew Huntington","doi":"10.1177/29767342241312486","DOIUrl":"10.1177/29767342241312486","url":null,"abstract":"<p><strong>Background: </strong>Community-based harm reduction for opioid use may be crucial for mitigating maternal and fetal harms by reducing information bias, fostering trust, and connecting individuals to essential treatment and services. This scoping review examines community-based harm reduction strategies and policies addressing maternal opioid use occurring in nonclinical settings, including stigma reduction, public health education, service access, and integration. The objectives of this scoping review are to 1) delineate community-based harm reduction approaches; 2) contextualize findings; 3) identify policy gaps; and 4) synthesize insights for policy.</p><p><strong>Methods: </strong>A systematic selection of articles was conducted using predefined inclusion and exclusion criteria. Three search domains (mother-child dyad, opioid misuse, and harm reduction) were used from PubMed, PsychINFO, and Scopus databases from 2013 onward. Articles were screened using title and abstract review, full-text analysis, and cross-referencing to ensure relevance. Articles focusing on policy related to community-based harm reduction strategies for pregnant individuals experiencing opioid misuse were included in the final review.</p><p><strong>Results: </strong>Initial search yielded 548 articles with 45 articles identified as domain relevant. After full-text review, 26 articles were included in final scoping review. Number of publications increased over time (2013-2017, <i>n</i> = 6; 2018-2021, <i>n</i> = 20). Twenty articles (77%) addressed multisystem level interventions, defined as coordinated strategies across multiple sectors (e.g., healthcare, education, and social services) and favored supportive (over punitive) harm reduction methods. Identified needs included addressing socioeconomic disparities and ensuring equitable access to care. Literature gaps highlight an oversimplification of outcomes such as narrow definitions of neonatal abstinence syndrome that do not account for overall harm reduction.</p><p><strong>Conclusions: </strong>Policy review favored systemic interventions over individual-level criminalization or remediation. Community-based, comprehensive, integrated, and supportive care received less attention than medication-based treatment. These results underscore urgent need for consideration of evidence-based community-level harm reduction strategies to effectively address maternal opioid use and its associated challenges.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"722-734"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}