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Sustainability of opioid agonist therapy programmes in Belarus, the Republic of Moldova, Tajikistan and Ukraine in the context of transition from Global Fund support during 2020-2023. 在 2020-2023 年期间从全球基金支助过渡的背景下,白俄罗斯、摩尔多瓦共和国、 塔吉克斯坦和乌克兰类阿片激动剂治疗方案的可持续性。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-16 DOI: 10.1186/s12954-024-01050-6
Raminta Stuikyte, Ivan Varentsov, Naimdzhon Malikov, Sergii Dvoriak, Myroslava Filippovych, Alisher Latypov, Aleksei Kralko, Ala Iatco, Catherine Cook

Background: Most national programmes of opioid agonist therapy (OAT) in Eastern Europe and Central Asia are at a critical juncture for building their sustainability due to decreasing support from the Global Fund and other international HIV funders. Therefore, it is timely to identify the status, trends, opportunities and risk factors of OAT preparedness in the face of donor transition.

Methods: The study assessed the OAT sustainability progress in 4 countries: Belarus, the Republic of Moldova, Tajikistan and Ukraine. The study used a comparative country case study design with qualitative methods and two data points in 2020 and 2022-2023. In total, 363 sources were reviewed and used, 83 interviews with key informants and 13 focus groups were conducted with clients, using a joint methodology and a defined Framework with three dimensions: 'Policy & Governance'; 'Finance & Resources'; and, 'Services'.

Results: All four countries have made improvements to increase OAT sustainability, though it varied. In 2022, Ukraine had a substantial degree of sustainability, followed by Belarus and Moldova with a moderate degree, while Tajikistan's sustainability was at moderate-to-high risk. No country achieved a high degree of OAT sustainability in any of the three dimensions measured. However, a high degree of sustainability was reported for at least one indicator in Belarus, Moldova and Ukraine: 'Medicines'; 'Financial resources'; 'Evidence and information systems'; 'Service Accessibility'; or, 'Service integration & quality'. On average, the greatest improvement between 2020 and 2022 was seen for 'Availability & coverage'; 'Financial resources'; 'Service quality & integration'; and, 'Service accessibility'. The highest risks across the countries, notably in Belarus and Tajikistan, were recorded for the indicator, 'Availability and coverage'. Of concern is that the least progress, or even a decline, was found in 'Human resources'.

Conclusions: OAT sustainability in the 4 analysed countries remains at risk, despite progress in all countries. Managing HIV donor transition can have positive effects in addressing financial sustainability, especially inspired by Ukraine's continued progress despite economic contraction and Russia's invasion. More attention is needed to non-financial aspects of OAT sustainability in donor transition planning. The directions that could have multifaceted positive influence for OAT long-term resilience and scale up for impact on drug problems include decentralisation outside of health settings and broader drug treatment financial and management transformation, together with drug policy reforms. Thus far, viable solutions for sustainability of OAT in conflict areas appear unlikely. Building OAT resilience should remain high on the agenda of national stakeholders, technical partners and donors.

背景:由于全球基金和其他国际艾滋病资助者的支持不断减少,东欧和中亚的大多数国家阿片类激动剂治疗(OAT)计划正处于建立其可持续性的关键时刻。因此,在面临捐助方转型的情况下,确定 OAT 准备工作的现状、趋势、机遇和风险因素是非常及时的:本研究评估了 4 个国家的 OAT 可持续性进展情况:方法:本研究评估了白俄罗斯、摩尔多瓦共和国、塔吉克斯坦和乌克兰这 4 个国家的定向 行动可持续性进展情况。研究采用了比较性国家案例研究设计和定性方法,以及 2020 年和 2022-2023 年两个数据点。总共审查和使用了 363 个资料来源,与关键信息提供者进行了 83 次访谈,并与客户进行了 13 次焦点小组讨论,采用了联合方法和具有三个维度的定义框架:结果:结果:所有四个国家都为提高 OAT 的可持续性做出了改进,但改进程度各不相同。2022 年,乌克兰的可持续性达到了相当高的水平,其次是白俄罗斯和摩尔多瓦,达到了中等水平,而塔吉克斯坦的可持续性则处于中等至高风险。在所衡量的三个方面中,没有一个国家实现了 OAT 的高度可持续性。然而,白俄罗斯、摩尔多瓦和乌克兰至少有一项指标达到了高度可持续性:"药品"、"财政资源"、"证据和信息系统"、"服务可及性 "或 "服务整合与质量"。平均而言,"可用性和覆盖范围"、"财政资源"、"服务质量和一体化 "以及 "服务可及性 "在 2020 年至 2022 年期间的改善幅度最大。各国,尤其是白俄罗斯和塔吉克斯坦,在 "可用性和覆盖面 "指标方面的风险最高。令人担忧的是,"人力资源 "方面的进展最小,甚至有所下降:结论:在所分析的 4 个国家中,尽管所有国家都取得了进展,但 OAT 的可持续性仍面临风险。管理艾滋病毒捐助方的过渡可以对解决财务可持续性问题产生积极影响,尤其是乌克兰在经济萎缩和俄罗斯入侵的情况下继续取得进展所带来的启发。在捐助方过渡规划中,需要更多地关注 OAT 可持续性的非财务方面。可对 OAT 的长期适应能力和扩大对毒品问题的影响产生多方面积极影响的方向包括:卫生机构以外的权力下放、更广泛的戒毒治疗财务和管理改革以及毒品政策改革。迄今为止,在冲突地区持续开展 OAT 的可行解决方案似乎不太可能。建设 OAT 的复原力仍应是国家利益相关方、技术合作伙伴和捐助方议程上的优先事项。
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引用次数: 0
COVID-19 vaccination intention among people who use drugs in France in 2021: results from the international community-based research program EPIC. 2021 年法国吸毒者的 COVID-19 疫苗接种意向:国际社区研究计划 EPIC 的结果。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-16 DOI: 10.1186/s12954-024-01096-6
C Lacoux, V Villes, L Riegel, S Coulmain, N Lorente, S Eddine Derras, D Rojas Castro, P Roux, R M Delabre, D Michels

Background: COVID-19 vaccination is crucial to reduce the incidence of severe forms of the disease in the population. However, people who use drugs (PWUD) face structural and individual barriers to vaccination, and little is known about vaccination intention and factors associated with that intention among PWUD. This study aimed to estimate vaccination intention in PWUD and associated factors in the early stage of vaccination campaigns.

Methods: We conducted cross-sectional study in France among PWUD, as part of the international EPIC program, a community-based research study coordinated by Coalition PLUS. It included 166 unvaccinated PWUD attending harm reduction centers. A questionnaire collected data on sociodemographic characteristics, COVID-19 related difficulties, and mental health, among other things. Multivariate logistic regression was used to identify factors associated with low vaccination intention.

Results: Only 19% of participants reported strong intention to get vaccinated against COVID-19. Factors independently associated with low vaccination intention were younger age (aOR = 0.90, 95%CI = 0.85-0.95), lower education level (aOR = 2.67, 95% CI = 0.95-7.55), and unstable housing (aOR = 6.44, 95% CI = 1.59-40.34). The most-cited reasons for low intention were mistrust in COVID-19 vaccines (66.1%), fear of side effects (48.7%), and non-belief in vaccinations in general (25.2%).

Conclusions: This study highlights the need for targeted COVID-19 information and interventions to increase vaccine uptake in PWUD, especially those living in precarity. Community-based interventions and targeted government assistance could play a crucial role in addressing vaccine hesitancy in this population, not only for COVID-19 but for future epidemics.

背景:接种 COVID-19 疫苗对于降低人口中严重形式疾病的发病率至关重要。然而,吸毒者(PWUD)在接种疫苗时面临着结构性和个体障碍,而且人们对吸毒者的接种意愿以及与接种意愿相关的因素知之甚少。本研究旨在估算吸毒人群在疫苗接种活动早期的接种意愿及相关因素:我们在法国对残疾人进行了横断面研究,这是国际 EPIC 计划的一部分,该计划是由 Coalition PLUS 协调的一项以社区为基础的研究。研究对象包括 166 名在减低伤害中心就诊的未接种疫苗的艾滋病感染者。调查问卷收集了有关社会人口特征、COVID-19 相关困难和心理健康等方面的数据。多变量逻辑回归用于确定与疫苗接种意愿低相关的因素:结果:只有 19% 的参与者表示有强烈意愿接种 COVID-19 疫苗。与接种意愿低独立相关的因素有年龄较小(aOR = 0.90,95%CI = 0.85-0.95)、教育水平较低(aOR = 2.67,95%CI = 0.95-7.55)和住房不稳定(aOR = 6.44,95%CI = 1.59-40.34)。接种意愿低的最主要原因是对 COVID-19 疫苗不信任(66.1%)、害怕副作用(48.7%)以及不相信疫苗接种(25.2%):本研究强调了有必要提供有针对性的 COVID-19 信息和干预措施,以提高 PWUD 的疫苗接种率,尤其是那些生活不稳定的人群。以社区为基础的干预措施和有针对性的政府援助可在解决该人群的疫苗接种犹豫方面发挥关键作用,这不仅是为了应对 COVID-19,也是为了应对未来的流行病。
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引用次数: 0
Xylazine awareness and attitudes among people who use drugs in Ohio, 2023-2024. 2023-2024 年俄亥俄州吸毒者对赛拉嗪的认识和态度。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-14 DOI: 10.1186/s12954-024-01097-5
Nichole L Michaels, Saroj Bista, Ashley Short Mejia, Hannah Hays, Gary A Smith

Background: The prevalence of xylazine, a non-opioid tranquilizer not for human consumption, in illicitly manufactured fentanyl is increasing in the United States. However, little is known about xylazine awareness and attitudes among people who use drugs.

Methods: A cross-sectional survey of people who use drugs in Ohio was conducted from November 2023 - May 2024 to identify xylazine awareness and attitudes in rural and urban counties across the state. Study participants were recruited from naloxone distribution sites, including health departments, syringe service programs, and community-based organizations.

Results: Among 630 people who use drugs in Ohio, more than one-half (53.5%) were unaware of xylazine being in "street drugs," regardless of urbanicity. Among individuals who were aware of xylazine, most (73.0%) indicated they did not want to use the drug and try to avoid it. In addition, 75.8% of this group felt it was "very" or "extremely" important to know if xylazine was in their drugs.

Discussion: This research found that many people who use drugs in Ohio are unaware of xylazine and its risks. An important finding of this study is that most individuals who had heard of xylazine did not want to use it and were concerned about knowing whether xylazine was in their drugs.

背景:在美国,非法制造的芬太尼中含有非人用的非阿片类镇静剂异丙嗪的情况越来越普遍。然而,人们对使用毒品的人对异丙嗪的认识和态度知之甚少:2023 年 11 月至 2024 年 5 月期间,对俄亥俄州的吸毒者进行了一次横断面调查,以确定该州城乡各县对二甲苯嗪的认识和态度。研究参与者是从纳洛酮发放点招募的,包括卫生部门、注射器服务计划和社区组织:在俄亥俄州的 630 名吸毒者中,超过半数(53.5%)的人不知道 "街头毒品 "中含有二甲苯嗪,无论其城市化程度如何。在知道有异丙嗪的人中,大多数(73.0%)表示他们不想使用这种毒品,并尽量避免使用。此外,75.8% 的人认为了解他们的毒品中是否含有甲苯噻嗪 "非常 "或 "极其 "重要:讨论:这项研究发现,俄亥俄州的许多吸毒者并不了解异丙嗪及其风险。本研究的一个重要发现是,大多数听说过二甲肼的人并不想使用它,他们关心的是了解自己的毒品中是否含有二甲肼。
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引用次数: 0
Experiences of harm and mental ill-health among gay, bisexual and other men-who-have-sex-with-men who use methamphetamine or GHB/GBL in different combinations: findings from the COMeT study in Taiwan. 使用甲基苯丙胺或 GHB/GBL 不同组合的男同性恋、双性恋和其他男男性行为者的伤害和精神疾病经历:台湾 COMeT 研究的发现。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-07 DOI: 10.1186/s12954-024-01094-8
Jing-Hao Hsu, Poyao Huang, Chia-Wen Li, Adam Bourne, Carol Strong, Stephane Wen-Wei Ku

Introduction: Polydrug use in the context of chemsex is commonplace among gay, bisexual, and other men-who-have-sex-with-men (GBMSM). This study aimed to examine the differences in experiences of physical, social, and psychological harms, as well as mental ill-health among GBMSM who use different combinations of methamphetamine and gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL) during chemsex.

Method: Adult GBMSM participants who had experience of chemsex in the past 12 months participated in a cross-sectional online survey in Taiwan and self-reported their sociodemographic background, sexual behaviours, mental health, and experiences of harm following a chemsex session. We used univariable and multivariable logistic regression to assess the different experiences of harm and mental ill-health among GBMSM who engaged in chemsex without using methamphetamine, used methamphetamine but not GHB/GBL, and who used both drugs.

Results: Out of 510 participants who completed all items included in the analysis, 24.1% engaged in chemsex without using methamphetamine, 36.9% used methamphetamine but not GHB/GBL, and 39.0% used both drugs. Eighty five percent of men who used both methamphetamine and GHB/GBL reported at least one kind of social harm after a chemsex session, such as missing dates or appointments, or appearing "high" at work, followed by used methamphetamine but not GHB/GBL (69.7%) and those without using methamphetamine (37.4%). After controlling for polydrug and frequency of drug use in the multivariable logistic regression, those who used methamphetamine but not GHB/GBL and those who used both drugs were more likely to report experiencing physical and psychological harms compared to those who did not use methamphetamine (p < 0.003).

Conclusion: GBMSM who used both methamphetamine and GHB/GBL in a chemsex context were more likely to report experience of harms than those who only used a single chemsex drug or engaged in chemsex without methamphetamine or GHB/GBL. Harm reduction should focus on both preventing HIV and STI transmission and on minimising psychosocial harm to GBMSM, with varying impacts depending on drug use.

导言:在男同性恋、双性恋和其他男男性行为者(GBMSM)中,在化学性行为背景下使用多种药物的现象十分普遍。本研究旨在探讨在药交过程中使用甲基苯丙胺和γ-羟丁酸/γ-丁内酯(GHB/GBL)不同组合的男同性恋、双性恋和其他男男性行为者(GBMSM)在身体、社会和心理伤害以及精神疾病方面的体验差异:在过去12个月中有过化性经历的GBMSM成年参与者参与了一项在台湾进行的横断面在线调查,并自我报告了他们的社会人口背景、性行为、心理健康以及化性后的伤害经历。我们使用单变量和多变量逻辑回归法评估了未吸食甲基苯丙胺、吸食甲基苯丙胺但未吸食伽马--羟丁酸(GHB/GBL)以及同时吸食这两种毒品的GBMSM的不同伤害经历和心理健康状况:在完成所有分析项目的510名参与者中,24.1%的人在不使用甲基苯丙胺的情况下进行了性交易,36.9%的人使用了甲基苯丙胺但未使用伽马--羟丁酸/吉贝丁酯,39.0%的人同时使用了这两种毒品。85%既吸食甲基苯丙胺又吸食伽马--羟丁酸/吉贝丁酯的男性报告说,他们在药交后至少受到了一种社会伤害,如错过约会或约会时间,或在工作中显得 "兴奋",其次是吸食甲基苯丙胺但未吸食伽马--羟丁酸/吉贝丁酯的男性(69.7%)和未吸食甲基苯丙胺的男性(37.4%)。在多变量逻辑回归中对多种毒品和吸毒频率进行控制后,与不吸食甲基苯丙胺的人相比,吸食甲基苯丙胺但不吸食伽马--羟丁酸/丁二酸的人和同时吸食这两种毒品的人更有可能报告遭受身体和心理伤害(p 结论:吸食甲基苯丙胺但不吸食伽马--羟丁酸/丁二酸的人和同时吸食伽马--羟丁酸/丁二酸的人更有可能报告遭受身体和心理伤害):在化学性性行为中同时使用甲基苯丙胺和伽马--羟丁酸/吉丁酸的女性同性恋、双性恋和变性者比只使用一种化学性性行为药物或不使用甲基苯丙胺或伽马--羟丁酸/吉丁酸的女性同性恋、双性恋和变性者更有可能报告受到伤害。减少伤害应侧重于预防艾滋病毒和性传播感染的传播,以及最大限度地减少对基于性别的性传播疾病和性病的社会心理伤害,不同的药物使用会产生不同的影响。
{"title":"Experiences of harm and mental ill-health among gay, bisexual and other men-who-have-sex-with-men who use methamphetamine or GHB/GBL in different combinations: findings from the COMeT study in Taiwan.","authors":"Jing-Hao Hsu, Poyao Huang, Chia-Wen Li, Adam Bourne, Carol Strong, Stephane Wen-Wei Ku","doi":"10.1186/s12954-024-01094-8","DOIUrl":"https://doi.org/10.1186/s12954-024-01094-8","url":null,"abstract":"<p><strong>Introduction: </strong>Polydrug use in the context of chemsex is commonplace among gay, bisexual, and other men-who-have-sex-with-men (GBMSM). This study aimed to examine the differences in experiences of physical, social, and psychological harms, as well as mental ill-health among GBMSM who use different combinations of methamphetamine and gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL) during chemsex.</p><p><strong>Method: </strong>Adult GBMSM participants who had experience of chemsex in the past 12 months participated in a cross-sectional online survey in Taiwan and self-reported their sociodemographic background, sexual behaviours, mental health, and experiences of harm following a chemsex session. We used univariable and multivariable logistic regression to assess the different experiences of harm and mental ill-health among GBMSM who engaged in chemsex without using methamphetamine, used methamphetamine but not GHB/GBL, and who used both drugs.</p><p><strong>Results: </strong>Out of 510 participants who completed all items included in the analysis, 24.1% engaged in chemsex without using methamphetamine, 36.9% used methamphetamine but not GHB/GBL, and 39.0% used both drugs. Eighty five percent of men who used both methamphetamine and GHB/GBL reported at least one kind of social harm after a chemsex session, such as missing dates or appointments, or appearing \"high\" at work, followed by used methamphetamine but not GHB/GBL (69.7%) and those without using methamphetamine (37.4%). After controlling for polydrug and frequency of drug use in the multivariable logistic regression, those who used methamphetamine but not GHB/GBL and those who used both drugs were more likely to report experiencing physical and psychological harms compared to those who did not use methamphetamine (p < 0.003).</p><p><strong>Conclusion: </strong>GBMSM who used both methamphetamine and GHB/GBL in a chemsex context were more likely to report experience of harms than those who only used a single chemsex drug or engaged in chemsex without methamphetamine or GHB/GBL. Harm reduction should focus on both preventing HIV and STI transmission and on minimising psychosocial harm to GBMSM, with varying impacts depending on drug use.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"21 1","pages":"181"},"PeriodicalIF":4.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How post overdose response efforts can address social determinants of health among people who use drugs: perspectives from the New York State Department of Health (NYSDOH) Post Overdose Response Team (PORT). 用药过量后应对工作如何解决吸毒者健康的社会决定因素:纽约州卫生部 (NYSDOH) 用药过量后应对小组 (PORT) 的观点。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-03 DOI: 10.1186/s12954-024-01081-z
Danielle Lloyd, Nerissa George, Donald Grove, Rebecca Goldberg, Allan Clear

Individuals who have survived an overdose often have myriad needs that extend far beyond their drug use. The social determinants of health (SDOH) framework has been underutilized throughout the opioid overdose crisis, despite widespread acknowledgment that SDOH are contributors to the majority of health outcomes. Post Overdose Response Teams (PORTs) engage with individuals who have experienced 1 or more nonfatal overdoses and bear witness to the many ways in which overdose survivors experience instability with healthcare, housing, employment, and family structure. Employing a harm reduction model, PORTs are well-positioned to reach people who use drugs (PWUD) and to address gaps in basic needs on an individualized basis, including providing social support and a sense of personal connection during a period of heightened vulnerability. The New York State Department of Health (NYSDOH) PORT program is a harm reduction initiative that utilizes law enforcement data and several public databases to obtain accurate referral information and has been active since 2019 in NYC. This PORT program offers various services from overdose prevention education and resources, referrals to health and treatment services, and support services to overdose survivors and individuals within their social network. This perspective paper provides an in-depth overview of the program and shares quantitative and qualitative findings from the pilot phase and Year 1 of the program collected via client referral data, interviews, and case note reviews. It also examines the barriers and successes the program encountered during the pilot phase and Year 1. The team's approach to addressing complex needs is centered around human connection and working toward addressing SDOH one individualized solution at a time. Application of the NYSDOH PORT model as outlined has the potential to create significant positive impacts on the lives of PWUD, while potentially becoming a new avenue to reduce SDOH-related issues among PWUD.

在用药过量中幸存下来的人往往有无数的需求,这些需求远远超出了他们使用药物的范围。在整个阿片类药物过量危机中,健康的社会决定因素(SDOH)框架一直未得到充分利用,尽管人们普遍认为健康的社会决定因素是造成大多数健康后果的因素。用药过量后应对小组(PORTs)与经历过一次或多次非致命性用药过量的个人接触,并见证了用药过量幸存者在医疗保健、住房、就业和家庭结构等方面的诸多不稳定因素。PORTs 采用减低伤害模式,能够很好地帮助吸毒者 (PWUD),并在个性化的基础上解决基本需求方面的差距,包括在他们最脆弱的时期提供社会支持和个人联系感。纽约州卫生部(NYSDOH)的 PORT 计划是一项减少伤害的举措,它利用执法数据和多个公共数据库来获取准确的转介信息,自 2019 年以来一直活跃在纽约市。该 PORT 计划为用药过量幸存者及其社交网络中的个人提供各种服务,包括用药过量预防教育和资源、健康和治疗服务转介以及支持服务。本视角论文对该计划进行了深入概述,并分享了试点阶段和计划第一年通过客户转介数据、访谈和病例回顾收集到的定量和定性研究结果。报告还探讨了该计划在试点阶段和第一年遇到的障碍和取得的成功。该团队解决复杂需求的方法是以人与人之间的联系为中心,致力于一次解决一个个性化的 SDOH 问题。所概述的纽约州卫生部 PORT 模式的应用有可能对残疾人的生活产生重大的积极影响,同时有可能成为减少残疾人中与 SDOH 相关问题的新途径。
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引用次数: 0
Facilitators of and obstacles to practitioners' adoption of harm reduction in cannabis use: a scoping review. 从业人员采用减少大麻使用危害的促进因素和障碍:范围界定审查。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-01 DOI: 10.1186/s12954-024-01093-9
Roula Haddad, Christian Dagenais, Jean-Sébastien Fallu, Christophe Huỳnh, Laurence D'Arcy, Aurélie Hot

Background: Cannabis use can generate potential avoidable harms, hence the need for effective preventive measures and treatment. Studies show the efficacy of harm reduction (HR) in minimizing undesirable consequences associated with this use. Despite its proven efficacy, HR in cannabis use remains poorly applied by many health and social services (HSS) practitioners, especially with young people. However, knowledge regarding the underlying reasons for this is limited. To fill this gap, we aimed to identify facilitators of and obstacles to HSS practitioners' adoption of HR in cannabis use across OECD countries.

Methods: We conducted a scoping review, guided by Arksey and O'Malley's model. The search strategy, executed on health databases and in the grey literature, captured 1804 studies, of which 35 were retained. Data from these studies were extracted in summary sheets for qualitative and numerical analysis.

Results: Facilitators and obstacles were grouped into four themes: stakeholders' characteristics (e.g., education, practice experience); clients' characteristics (e.g., personal, medical); factors related to HR (e.g., perceived efficacy, misconceptions); factors related to the workplace (e.g., type of workplace). Data were also extracted to describe the populations recruited in the selected studies: type of population, clientele, workplace.

Conclusion: Several factors might facilitate or hinder HSS practitioners' adoption of HR in cannabis use. Taking these into consideration when translating knowledge about HR can improve its acceptability and applicability. Future research and action should focus on this when addressing practitioners' adoption of HR.

背景:吸食大麻会产生潜在的、可避免的危害,因此需要采取有效的预防措施和治疗方法。研究表明,减少危害(HR)在最大限度地减少与吸食大麻有关的不良后果方面非常有效。尽管其功效已得到证实,但许多健康和社会服务(HSS)从业人员对大麻使用中的减害措施的应用仍然很少,尤其是对年轻人。然而,有关造成这种情况的根本原因的知识却很有限。为了填补这一空白,我们旨在确定经合组织国家卫生和社会服务从业人员在大麻使用中采用 HR 的促进因素和障碍:我们在 Arksey 和 O'Malley 模型的指导下进行了范围界定研究。我们在健康数据库和灰色文献中执行了搜索策略,共搜索到 1804 项研究,其中 35 项被保留下来。这些研究的数据被提取到摘要表中,用于定性和数字分析:促进因素和障碍分为四个主题:利益相关者的特征(如教育、实践经验);客户的特征(如个人、医疗);与人力资源相关的因素(如感知功效、误解);与工作场所相关的因素(如工作场所类型)。还提取了一些数据,以描述所选研究中招募的人群:人群类型、客户、工作场所:有几个因素可能会促进或阻碍人力资源和社会保障从业人员采用大麻使用方面的人力资源。在翻译有关人力资源的知识时考虑到这些因素,可以提高其可接受性和适用性。在解决从业人员采用人力资源的问题时,未来的研究和行动应重点关注这一点。
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引用次数: 0
Correction: Non-injection drug use among incarcerated people in Iran: Findings from three consecutive national bio-behavioral surveys. 更正:伊朗被监禁者使用非注射毒品的情况:连续三次全国生物行为调查的结果。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-10-01 DOI: 10.1186/s12954-024-01086-8
Mahkameh Rafiee, Mohammad Karamouzian, Mohammad Sharifi, Ali Mirzazadeh, Mehrdad Khezri, Ali Akbar Haghdoost, Soheil Mehmandoost, Hamid Sharifi
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引用次数: 0
If there had been no snus in Sweden: the impact of snus on mortality attributable to smoking. 如果瑞典没有鼻烟:鼻烟对吸烟死亡率的影响。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-09-26 DOI: 10.1186/s12954-024-01095-7
Lars M Ramstrom

In Sweden, there has been a massive transition from cigarette smoking to snus, the Swedish kind of low-toxicity oral tobacco. This product poses very little health risk compared to cigarettes, as illustrated by the fact that males in Sweden have Europe's lowest level of mortality attributable to smoking. The current investigation estimates how high the smoking-attributable mortality in Sweden would have been if there had been no snus in Sweden. It is made up by comparisons between observed Swedish data and two scenarios without snus: a group of comparable countries, and, a hypothetical Sweden with no snus use. Both comparisons suggest that around 3000 lives per year have been saved by the use of snus in Sweden.

在瑞典,人们已经从吸食香烟大量过渡到吸食 snus(瑞典的一种低毒口服烟草)。与香烟相比,这种产品对健康的危害很小,瑞典男性因吸烟导致的死亡率是欧洲最低的就说明了这一点。目前的调查估计,如果瑞典没有鼻烟,吸烟导致的死亡率会有多高。它是通过比较瑞典的观察数据和两种没有鼻烟的情况而得出的:一组可比国家和一个没有使用鼻烟的假想瑞典。这两项比较结果表明,瑞典每年因使用鼻烟而挽救的生命约为 3000 条。
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引用次数: 0
"Give me the reigns of taking care of myself with a home": Healing environments in an Indigenous-led alcohol harm reduction program. "给我一个家,让我自己照顾自己":土著人主导的减少酒精伤害计划中的康复环境。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-09-26 DOI: 10.1186/s12954-024-01090-y
Meaghan Brown, Fran Hunt-Jinnouchi, Jennifer Robinson, Nancy Clark, Christopher Mushquash, Katrina Milaney, Bernie Pauly

Background: Distinct from western Managed Alcohol Programs (MAPs), Indigenous-led alcohol harm reduction programs can be defined by both 'culture as healing' and decolonized harm reduction philosophies. We sought to explore experiences of Indigenous 'family members' (participants) in an Indigenous-led alcohol harm reduction program and culturally supportive housing to identify appropriate supports according to family member perspectives, and to inform delivery of the program.

Methods: Situated within an Indigenous-western research partnership, we completed semi-structured interviews with seven family members of an Indigenous-led alcohol harm reduction and culturally supportive housing program. Community-guided protocols informed relational knowledge gathering practices including semi-structured in-depth interviews, qualitative thematic analysis, collaborative interpretation of findings, and development of knowledge products.

Results: Family members highlighted the importance of tailored Indigenous-led alcohol harm reduction in shifting their relationships to alcohol from survival to having choice and control of their drinking (It's a choice I'm making right now). The provision of varied and incremental culture-based opportunities (Multiple pathways for connecting to culture) facilitated engagement with culture as healing. Policies that honour respect and autonomy were identified as supportive to healing and harm reduction, countering family members' experiences in western spaces (Give me the reigns of taking care of myself with a home).

Conclusions: An Indigenous-led alcohol harm reduction program within a model of culture as healing facilitated shifts in relationships to alcohol, providing a space where family members could explore long term goals of healing and connection to culture. Family members' experiences and recommendations offer key considerations for the design of Indigenous-led harm reduction and culture as healing models. Recommendations emphasize the provision of tailored alcohol harm reduction plans in parallel to multiple and accessible opportunities for connection to culture as healing in order to meet diverse participant goals and relationships to alcohol and culture.

背景:与西方的酗酒管理项目(MAPs)不同,土著人主导的减少酒精伤害项目可以用 "文化即治疗 "和非殖民化的减少伤害理念来定义。我们试图探索原住民 "家庭成员"(参与者)在原住民主导的减少酒精伤害项目和文化支持性住房中的经验,以根据家庭成员的观点确定适当的支持,并为项目的实施提供信息:在原住民-西方研究合作项目中,我们对原住民主导的减少酒精伤害和文化支持性住房项目中的七名家庭成员进行了半结构化访谈。社区指导协议为关系知识收集实践提供了信息,包括半结构式深度访谈、定性主题分析、合作解释研究结果以及开发知识产品:结果:家庭成员强调了由土著人主导的量身定制的减少酒精伤害活动在将他们与酒精的关系从生存转变为对饮酒的选择和控制(这是我现在做出的选择)方面的重要性。提供以文化为基础的各种渐进式机会(与文化联系的多种途径)有助于将文化作为治疗手段。尊重尊重和自主的政策被认为是对治疗和减少伤害的支持,与家庭成员在西方空间的经历形成了反差(给我一个家,让我自己照顾自己):由原住民主导的减少酒精伤害计划以文化作为治疗模式,促进了与酒精关系的转变,为家庭成员提供了一个可以探索治疗和与文化联系的长期目标的空间。家庭成员的经验和建议为设计由土著人主导的减低伤害和文化治疗模式提供了关键的考虑因素。这些建议强调,在提供量身定制的减少酒精伤害计划的同时,也要提供多种与作为治疗的文化相联系的机会,以满足不同参与者的目标以及与酒精和文化的关系。
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引用次数: 0
Assessing stigma: Health and social worker regard towards working with people using illicit drugs in Athens, Greece. 评估耻辱感:希腊雅典卫生和社会工作者对与吸毒者合作的看法。
IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Pub Date : 2024-09-26 DOI: 10.1186/s12954-024-01091-x
Cristina Temenos, Aliki Koutlou, Sotiria Kyriakidou, Sofia Galanaki

Background: After the 2008 Global Financial Crisis and resulting economic austerity, the rise in illicit drug use engendered an increased need for people who use drugs (PWUD) to access medical care, compounded by the COVID-19 pandemic. Research shows that perceptions of medical staff towards PWUD facilitate or act as a barrier to accessing health care. This study provides a better understanding of health and social work professionals' perceptions by assessing stigma levels towards PWUD in Athens, Greece.

Methods: This is a mixed-method study. It calculates the stigma score for professionals (n = 60) and the stigma score associated with specific drugs based on the Medical Condition Regard Scale through a quantitative analysis of responses to a semi-structured online survey about attitudes of health and social work professionals towards PWUD. It draws on the qualitative analysis of 12 semi-structured interviews with 16 service managers, providers, and health services advocates working in the charity sector to determine whether perceptions of PWUD affect writing and implementing policy and protocols for services.

Results: Stigma towards PWUD exists amongst health and social work professionals in Athens. Professionals who have worked with PWUD for longer periods of time, professionals who have had specific training on working with PWUD, and professionals who feel that they have the necessary training to work with PWUD all demonstrated a higher stigma score than those reporting the opposite. Cannabis and opioids were associated with lower stigma scores while shisha had the highest level of stigma associated with it. Finally, professional environments are not conducive to alleviating stigma as the lack of training specific to stigma, the lack of professional supervision, and worker burn-out are key barriers faced by professionals in their everyday practice.

Conclusions: Reducing and eliminating stigma towards PWUD among health and social workers requires immediate action. Measures to be taken include: introducing training programs focused on stigma towards PWUD to healthcare providers, social workers, lawyers, police, the media; increasing professional supervision on field work for health and social workers; introducing low barrier health care and specialist units. Peers and field-focused organisations should meaningfully participate in drug and alcohol policymaking, program development, and implementation.

背景:2008 年全球金融危机和由此导致的经济紧缩之后,非法药物使用的增加导致吸毒者(PWUD)对医疗服务的需求增加,COVID-19 的流行更是雪上加霜。研究表明,医务人员对吸毒者的看法会促进或阻碍他们获得医疗服务。本研究通过评估希腊雅典的医务人员和社会工作专业人员对 PWUD 的成见程度,更好地了解他们的看法:这是一项混合方法研究。方法:这是一项混合方法研究,通过对卫生和社会工作专业人员对艾滋病毒/艾滋病感染者态度的半结构化在线调查的回复进行定量分析,计算出专业人员(n = 60)的污名化得分,并根据医疗条件关注量表计算出与特定药物相关的污名化得分。报告还借鉴了对 16 名服务管理人员、提供者和慈善机构健康服务倡导者进行的 12 次半结构式访谈的定性分析,以确定对 PWUD 的看法是否会影响服务政策和协议的制定与实施:雅典的卫生和社会工作专业人员对残疾人存在偏见。与艾滋病毒/艾滋病感染者共事时间较长的专业人员、接受过与艾滋病毒/艾滋病感染者共事的专门培训的专业人员以及认为自己接受过与艾滋病毒/艾滋病感染者共事的必要培训的专业人员的耻辱感得分均高于那些报告相反情况的专业人员。大麻和阿片类药物的耻辱感得分较低,而水烟的耻辱感得分最高。最后,专业环境不利于减轻污名化,因为缺乏专门针对污名化的培训、缺乏专业监督以及工作人员倦怠是专业人员在日常工作中面临的主要障碍:减少和消除卫生和社会工作者对残疾人的成见需要立即采取行动。应采取的措施包括:为医疗服务提供者、社会工作者、律师、警察和媒体提供以污名化为重点的培训计划;加强对医疗工作者和社会工作者现场工作的专业监督;引入低障碍医疗保健和专科部门。同龄人和以实地工作为重点的组织应切实参与毒品和酗酒问题的决策、计划制定和实施。
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引用次数: 0
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Harm Reduction Journal
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