International Journal of Drug Policy最新文献

{"title":"Recruiting opioid treatment program administrators for a national survey: Outcomes and lessons learned","authors":"Benjamin R Brady ,&nbsp;Beth E Meyerson ,&nbsp;Alissa Davis ,&nbsp;Greg A Carter ,&nbsp;Sara Najar ,&nbsp;Alexa Martinez ,&nbsp;Caleb Mueller ,&nbsp;Elias O Higbie ,&nbsp;Holden Dal Ponte ,&nbsp;Khino Moneva ,&nbsp;Natalia C Bentz ,&nbsp;Linnea B Linde-Krieger ,&nbsp;Zhanette Coffee ,&nbsp;Arlene N Mahoney ,&nbsp;David Frank ,&nbsp;Richard A Crosby","doi":"10.1016/j.drugpo.2025.104799","DOIUrl":"10.1016/j.drugpo.2025.104799","url":null,"abstract":"<div><h3>Background</h3><div>Globally, access to opioid use disorder treatment remains insufficient. In the US, recent policy changes for opioid use disorder treatment present opportunities to improve patient access to evidence-based methadone treatment. To evaluate the adoption and sustained implementation of these changes, access to a national, representative sample of opioid treatment programs (OTPs, ‘methadone clinics’) is essential. This study reports the outcomes of a recruitment effort for a national sample of OTP administrators.</div></div><div><h3>Methods</h3><div>A stratified random sample of 1000 OTPs was drawn from the US Substance Abuse and Mental Health Services Administration's National Opioid Treatment Program Directory. Stratification was based on state-level OTP regulations and county-level opioid overdose rates. OTPs identified as tribal serving, located in jails or prisons, or requiring corporate approval for research participation were deemed ineligible and excluded from the sample. A team of trained researchers called OTP clinics seeking to speak with administrators and obtain their email addresses for study recruitment.</div></div><div><h3>Results</h3><div>In the sample, 885 OTPs were eligible for study recruitment. We contacted a live person by phone at 73 % of OTPs and an administrator at 23 %. Of the administrators reached, 77 % agreed to receive study information and 22 % completed the survey. Total caller time was 276.5 hours at a cost of $5530.</div></div><div><h3>Conclusion</h3><div>Despite a rigorous sampling frame, and a costly and considerable effort, US OTP recruitment outcomes were suboptimal. Innovative strategies are needed to improve administrator recruitment. Recommendations include updating the SAMHSA directory to include administrator contact information (name, phone, email), using diverse outreach methods, and refining call scripts to improve engagement.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104799"},"PeriodicalIF":4.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of stigmatization among people who use drugs in the initial year of British Columbia's drug decriminalization policy: A qualitative study","authors":"Farihah Ali ,&nbsp;Cayley Russell ,&nbsp;Savannah Torres-Salbach ,&nbsp;Margret Lo ,&nbsp;Matthew Bonn ,&nbsp;Geoff Bardwell ,&nbsp;Juls Budau ,&nbsp;Elaine Hyshka ,&nbsp;Jürgen Rehm","doi":"10.1016/j.drugpo.2025.104791","DOIUrl":"10.1016/j.drugpo.2025.104791","url":null,"abstract":"<div><h3>Background</h3><div>On January 31, 2023, Health Canada approved a three-year pilot decriminalization initiative allowing adults in British Columbia (BC), Canada, to legally possess a cumulative 2.5 g of opioids, cocaine, methamphetamine, or MDMA. The policy aims to reduce the harms associated with drug use, including stigma, which contributes to barriers for people who use drugs in accessing harm reduction and treatment services. Addressing stigma is considered a crucial step in mitigating BC's overdose crisis, by encouraging people who use drugs to feel more comfortable to access and utilize services without fear of judgment. This study examined the impacts of the decriminalization policy on stigma among people who use drugs within the first year of implementation.</div></div><div><h3>Methods</h3><div>From October 2023 to February 2024, 100 semi-structured telephone interviews and brief socio-demographic surveys with people who use drugs from across BC were conducted to explore their experiences of stigmatization post-decriminalization. A qualitative thematic analysis was used to synthesize the data.</div></div><div><h3>Results</h3><div>Findings revealed that societal, structural and self-stigma remain pervasive among people who use drugs post-decriminalization. While most participants reported little change in their experiences of stigma since the policy's implementation, some reported an increase, while others observed a decrease across all forms of stigma. Increased stigma was attributed to perceived heightened visibility of public drug use, which amplified societal stigma. Conversely, decreased stigma was linked to shifting public perceptions of drug use as a public health issue and more humanized interactions with the police. Despite mixed experiences, participants remained optimistic that the policy could contribute to long-term stigma reduction and offered recommendations to support this goal.</div></div><div><h3>Conclusion</h3><div>While decriminalization has the potential to reduce stigma and increase comfort in accessing critical harm reduction and substance use treatment services among people who use drugs, achieving these outcomes requires additional efforts. Public awareness campaigns, targeted anti-stigma education, and broader systemic changes were suggested by participants as essential to address stigmatization in BC. Strengthening these areas could enhance access to and utilization of services, ultimately supporting the broader goals of decriminalization.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104791"},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transnational alcohol corporations in Nigeria as commercial determinants of health: Implications for policy","authors":"Emeka W. Dumbili","doi":"10.1016/j.drugpo.2025.104792","DOIUrl":"10.1016/j.drugpo.2025.104792","url":null,"abstract":"<div><div>Research on commercial determinants of health (CDoH) has burgeoned in the Global North. However, despite the heavy presence of harmful commodity industries in Africa, little scholarly attention has been paid to CDoH. Transnational alcohol corporations (TNACs) in Nigeria deploy well-articulated marketing strategies and practices that negatively impact health in their quest for profit maximisation, wealth extraction and influence. Nevertheless, their tactics and practices are largely unregulated and understudied. This commentary demonstrates how TNACs in Nigeria are a key pervasive and harmful CDoH, highlighting the policy implications of their strategies and practices. Focusing on changing norms that constrain young people's drinking, TNACs promote hazardous drinking practices by using drinking games as a marketing strategy where the winners receive more alcohol and money as prizes. Alcohol corporations also encourage sexual risk-taking and associated harm by marketing <em>alcoholic bitters</em> as aphrodisiacs and sex enhancers. From 2014 to 2016, one TNAC organised the annual Nigerian Beer Symposium, spreading misleading information that beer consumption prevents cancer, reduces kidney stones, and improves women's skin beauty. Furthermore, through partnerships with the government, TNACs appear to use industry-led corporate social responsibility (CSR) initiatives to lobby officials, enhance corporate reputations, sustain pro-drinking framings, disinformation/misinformation and self-regulation, and silence discussions on alcohol policy implementation. While TNACs’ products and practices negatively impact health/equities, decision-makers appear to enable their enormous power. The government should embrace evidence against TNACs as CDoH, implement policies to regulate them and collaborate with civil society organisations/advocates to hold them to account. Relatedly, the government should hold TNACs to account through international mechanisms because most of their practices violate laws in the Global North countries where they are headquartered.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776597","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":"Association of recreational cannabis legalization with changes in medical, illegal, and total cannabis expenditures in Canada","authors":"André J. McDonald ,&nbsp;Alysha Cooper ,&nbsp;Amanda Doggett ,&nbsp;Jillian Halladay ,&nbsp;Kyla Belisario ,&nbsp;James MacKillop","doi":"10.1016/j.drugpo.2025.104793","DOIUrl":"10.1016/j.drugpo.2025.104793","url":null,"abstract":"<div><h3>Background</h3><div>Recreational cannabis legalization (RCL) is being adopted by a growing number of jurisdictions internationally. RCL aims to displace the illegal cannabis market and has the potential to disrupt the medical market, yet few studies have examined these dynamics empirically.</div></div><div><h3>Methods</h3><div>We used interrupted time series analysis to evaluate whether RCL (legislative passage in October 2017/implementation in October 2018) was associated with changes in quarterly national household expenditures on medical cannabis, illegal cannabis, and all cannabis types combined (licensed, illegal, and medical) in Canada from 2001 to 2023, adjusting for price fluctuations.</div></div><div><h3>Results</h3><div>When RCL was passed, medical cannabis represented 11.8 % of the market and illegal cannabis 88.2 %. At five years post-RCL implementation, medical cannabis decreased to 3.7 %, illegal cannabis decreased to 24.3 %, and licensed cannabis took over 72.0 % of the market. The overall cannabis market increased in size by 75 % over these 5 years. Illegal cannabis expenditures increased between RCL passage and implementation but decreased immediately post-implementation and had a significant decreasing trend. Medical cannabis had a significant decreasing trend following RCL passage, and to a lesser extent following RCL implementation. Total cannabis expenditures increased immediately following RCL implementation and showed a significant increasing trend over time. Some caution should be used in interpreting these findings given uncertainty in data quality, particularly for illegal cannabis expenditures (and overall expenditures by extension).</div></div><div><h3>Conclusions</h3><div>Recreational cannabis legalization in Canada appears to be achieving one of its primary goals by displacing the illegal cannabis market, and medical users also appear to be transitioning to the recreational market. However, overall cannabis expenditures have also grown substantially since legalization, which could have adverse implications for public health.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104793"},"PeriodicalIF":4.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777446","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":"Impact of Delta-8-THC warning labels on perceived intoxication, harm, and susceptibility among adolescents","authors":"Alyssa F. Harlow ,&nbsp;Adam M. Leventhal ,&nbsp;Jessica L. Barrington-Trimis","doi":"10.1016/j.drugpo.2025.104781","DOIUrl":"10.1016/j.drugpo.2025.104781","url":null,"abstract":"<div><h3>Background</h3><div>Youth use of hemp-derived cannabis products containing psychoactive Δ8-tetrahydrocannabinol (delta-8-THC) is prevalent in the United States (US). Delta-8-THC is intoxicating, however delta-8-THC products are not subject to warning labeling requirements in many US states. This experiment determined effects of hypothetical cannabis warning labels on perception of delta-8-THC gummies and vape products.</div></div><div><h3>Methods</h3><div>A mixed within-between-subject experiment was embedded into a 2023 survey of 3,647 Southern California adolescents. Participants were randomized to view photos of delta-8-THC edible and vape products under one of three conditions (control [unmodified] vs. standard size warning label [universal cannabis warning symbol, government warning text, instructions for use, and text stating it was cannabis-infused] vs. larger warning label [same as standard label with larger cannabis warning symbol]). After image exposure, we measured anticipated intoxication, perceived harm, and susceptibility to use the respective delta-8-THC products. Moderation by product type and cannabis use status were assessed.</div></div><div><h3>Results</h3><div>Youth who viewed delta-8-THC products with larger warning labels (vs. control) reported greater anticipated intoxication (Mean Difference[MD]==2.50, 95 %CI=0.85–4.14 on 100-point scale), and higher likelihood that delta-8-THC products are bad for their health (Risk Ratio[RR]=1.07, 95 %CI=1.02–1.12), pose at least some risk (RR=1.03, 95 %CI: 1.01–1.05), and are the same or more harmful than marijuana (RR=1.04, 95 %CI=1.01–1.07). There were no warning label effects on susceptibility and minimal differences across outcomes between larger versus standard warning labels. Warning label effects on perceived harm were stronger for delta-8-THC gummies (vs. vape) and for never vs. ever cannabis-using youth (interaction p-values &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Requiring delta-8-THC products to conform to labeling requirements for cannabis products may increase understanding of their intoxicating effects and harm among cannabis-naïve youth. In lieu of federal regulations, states should consider implementation of delta-8-THC regulations such as labeling requirements that promote safety and reduce potential harm to youth.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104781"},"PeriodicalIF":4.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769005","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":"Structural and healthcare predictors of substance use-related death following release from incarceration: A retrospective cohort study in Rhode Island, 2018–2020","authors":"Lauren Brinkley-Rubinstein ,&nbsp;Katherine LeMasters ,&nbsp;Justin Berk ,&nbsp;Sara N. Levintow ,&nbsp;Sarah Martino ,&nbsp;Rahul Vanjani","doi":"10.1016/j.drugpo.2025.104783","DOIUrl":"10.1016/j.drugpo.2025.104783","url":null,"abstract":"<div><h3>Background</h3><div>Incarcerated individuals are at a high risk of substance use-related death after release. While prior research has demonstrated that this is partially due to loss of tolerance during incarceration and return to use after release, structural and healthcare use factors that may also impact overdose risk have been underexplored. We assessed the relationship between structural factors (e.g., housing services received) and health care use (e.g., emergency department use) and overdose risk at 12-months post-incarceration in Rhode Island in the United States.</div></div><div><h3>Methods</h3><div>We used a retrospective cohort study design. Rhode Island Department of Corrections (RIDOC) data were linked with individual-level data across state agencies. Cumulative incidence of substance use-related death was estimated as a function of structural and healthcare factors using hazard ratios from cause-specific cox landmark models for dynamic predictions.</div></div><div><h3>Results</h3><div>There were 9696 individuals in the analytic sample. Most deaths that occurred within 12 months post-release involved substance use (<em>N</em> = 96). People who had more previous incarcerations had a higher risk of substance use-related death. Reporting taxable wages (aHR: 0.52; 95 % CI: 0.25, 1.09) was weakly associated with in a lower risk of substance use-related death while being admitted to the hospital (aHR: 1.79; 95 % CI: 0.91, 3.53) was weakly associated with a slightly higher risk of substance use-related death 12-months post-release.</div></div><div><h3>Conclusion</h3><div>Structural factors were weakly associated with reduced risk of substance use-related death post-release from incarceration. Conducting needs assessments (e.g., identifying employment needs) and interventions (e.g., employment training programs) prior to or at release that address these structural factors are critical for reducing this risk. Further, these findings contribute to the evidence that decarceration should be used a public health tool given the high risk of substance use-related death post-release.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104783"},"PeriodicalIF":4.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769004","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":"Prioritising research on marketing and consumption of No and Low (NoLo) alcoholic beverages in Ireland","authors":"Emeka W. Dumbili ,&nbsp;Paula Leonard ,&nbsp;James Larkin ,&nbsp;Frank Houghton","doi":"10.1016/j.drugpo.2025.104794","DOIUrl":"10.1016/j.drugpo.2025.104794","url":null,"abstract":"<div><div>Advertising of zero/no and low-strength (NoLo) alcohol brands is becoming increasingly common in Ireland, but empirical research to determine their impact is lacking. Although the Public Health (Alcohol) Act (2018) prohibits advertising alcohol on or within 200 m of buses, trains, schools and playgrounds, the alcohol industry advertises NoLo products in these spaces using similar iconography and brand identifiers of parent brands. This article highlights evidence regarding the industry's roles in the frequent promotion of NoLo brands in Ireland, recommending areas for future research. While NoLo products and advertisements are becoming common in Ireland, recently, the alcohol industry invested €30 million to double NoLo's production capacity. Given the available evidence elsewhere, we argue that doubling the production capacity serves the alcohol industry's interests, not public health interests, as it misleadingly claims because it will increase alcogenic environments and exposure to more marketing campaigns and normalise alcohol consumption. We urge the Minister of Health to take responsibility for effectively interpreting and implementing the Public Health Act to ban NoLo advertising in spaces where full-strength beverage advertisements are prohibited. We conclude by recommending key areas for urgent research focusing on, but not limited to, the perceptions and consumption of NoLo among different populations, including those who drink harmfully or are in recovery and the impact of marketing and availability of NoLo on alcohol initiation and consumption among young people. This will help generate robust evidence to inform the public, improve public health, and implement policies that curtail alcohol corporations’ health-damaging activities in Ireland.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104794"},"PeriodicalIF":4.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761045","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":"Standard THC units: A tool to benchmark cannabis-related driving risks","authors":"Valentina Lorenzetti ,&nbsp;Tom P Freeman ,&nbsp;Amie Hayley","doi":"10.1016/j.drugpo.2025.104788","DOIUrl":"10.1016/j.drugpo.2025.104788","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104788"},"PeriodicalIF":4.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761046","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":"Community-administered naloxone for overdose reversal: The role of sex worker-led programming and occupational violence in a community-based cohort (2018–2024)","authors":"Sarah Moreheart ,&nbsp;Kate Shannon ,&nbsp;Kanna Hayashi ,&nbsp;Wiebke Bartels ,&nbsp;Andrea Krüsi ,&nbsp;Shira Miriam Goldenberg","doi":"10.1016/j.drugpo.2025.104784","DOIUrl":"10.1016/j.drugpo.2025.104784","url":null,"abstract":"<div><h3>Background</h3><div>Amidst the ongoing toxic drug crisis, sex workers who use drugs face high overdose risk alongside structural barriers to harm reduction services. Previous work has noted that occupational violence and peer-led programs can influence health outcomes for sex workers. Given the potential for community-administered take-home naloxone (THN) to reduce overdose-related harm, we evaluated longitudinal trends and uptake of THN administration, and the associations between exposure to sex work-specific programs and occupational violence and harassment with THN administration over 5.5-years (2018–2024).</div></div><div><h3>Methods</h3><div>Data was derived from An Evaluation of Sex Workers’ Health Access, a prospective, community-based cohort of sex workers in Vancouver, Canada from September 2018-March 2024. We plotted semi-annual trends of THN administration (Aim 1) and used bivariate logistic regression with generalized estimating equations (GEE) to characterize uptake of THN administration (Aim 2). Lastly, we employed bivariate and multivariable GEE to evaluate the association between exposure to sex-work specific programs and occupational violence and harassment with THN administration (Aim 3).</div></div><div><h3>Results</h3><div>Among 427 participants, 57.9 % (N = 247) reported administering THN at least once. Exposure to sex work-specific programs was strongly associated with THN administration (Adjusted Odds Ratio [AOR] 1.26, 95 % Confidence Interval [CI] 1.02–1.55), as was exposure to violence from clients (AOR 1.72, 95 %CI 1.22–2.41) and community (AOR 1.76, 95 %CI 1.25–2.46), and police harassment (AOR 1.54, 95 %CI 1.07–2.21).</div></div><div><h3>Conclusion</h3><div>Over 5.5 years, over half of participants administered THN, which was associated with exposure to sex work-specific programs and occupational violence. Violence from clients, community members, and police independently increased the likelihood of THN administration. Findings suggest that marginalized sex workers, particularly those who use drugs in occupational settings, are uniquely positioned to respond to overdoses. This supports the feasibility of implementing sex worker-specific overdose interventions and highlights the need to expand community-based, sex worker-led safety, violence prevention, and care interventions to strengthen overdose prevention efforts and improve naloxone cascade metrics.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104784"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746561","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":"Trends in cause-specific mortality among people with hepatitis C virus in New South Wales, Australia","authors":"Shane Tillakeratne ,&nbsp;Heather Valerio ,&nbsp;Maryam Alavi ,&nbsp;Behzad Hajarizadeh ,&nbsp;Marianne Martinello ,&nbsp;Jacob George ,&nbsp;Gail Matthews ,&nbsp;Jason Grebely ,&nbsp;Sallie-Anne Pearson ,&nbsp;Gregory J. Dore","doi":"10.1016/j.drugpo.2025.104790","DOIUrl":"10.1016/j.drugpo.2025.104790","url":null,"abstract":"<div><h3>Background</h3><div>Monitoring of HCV-related morbidity and mortality is crucial to evaluate direct-acting antiviral (DAA) therapy impact and HCV elimination progress. This population-based study examined mortality among individuals with an HCV notification in New South Wales (NSW), Australia, including cause-specific mortality prior to and during the viral hepatitis elimination era (2015–2021).</div></div><div><h3>Methods</h3><div>HCV notifications in NSW, Australia (1995–2021) were linked to hospitalisation records and cause-specific mortality records. Over the period 2002–2021, all-cause and cause-specific mortality rates were examined. Cox proportional hazard models were used to assess factors associated with mortality during the viral hepatitis elimination era.</div></div><div><h3>Results</h3><div>Among people with HCV notifications in 1995–2021, 112,046 were alive during 2002–2021 and contributed to mortality analyses. All-cause mortality per 100,000 population increased from 5.5 in 2002 to 13.4 in 2015 and plateaued at 12.9 in 2021. Liver-related mortality per 100,000 population increased from 2.0 in 2002 to 5.9 in 2015, before declining to 4.6 in 2021. Drug-related mortality per 100,000 population increased from 0.7 in 2002 to 1.8 in 2015, before declining to 1.2 in 2021. Factors associated with increased mortality risk during 2015–2021 included: recent injecting drug use (adjusted Hazard Ratio [aHR] 7.22, 95 % CI 6.84–7.62) and recent alcohol use disorder (aHR 3.17, 95 % CI 2.97–3.37). Recent opioid agonist therapy (aHR 0.47, 95 % CI 0.43–0.51) and recent incarceration (aHR 0.32, 95 % CI 0.23–0.45) were associated with lower mortality risk.</div></div><div><h3>Conclusion</h3><div>During the HCV elimination era, both liver-related and drug-related mortality have declined, suggesting direct and indirect impacts of DAA therapy, respectively. Expanded opioid agonist therapy coverage and enhanced alcohol use disorder management could further reduce mortality.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"139 ","pages":"Article 104790"},"PeriodicalIF":4.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738123","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}