Pub Date : 2026-01-27DOI: 10.1016/j.drugpo.2026.105152
Corey S. Davis , Michael Abrams , Ashleigh Dennis , Amy Judd Lieberman , Czarina N. Behrends
The United States continues to experience a large amount of drug-related harm, including high rates of both overdose mortality and harms associated with lack of access to new drug use equipment such as syringes and pipes. These harms include the spread of bloodborne disease as well as endocarditis, osteomyelitis, and other skin and soft tissue infections. Laws that prohibit or restrict access to drug use equipment may increase these harms. This manuscript provides a comprehensive legal review of laws that criminalize or otherwise restrict the distribution and possession of equipment for both injecting and inhaling drugs from both syringe services programs and other venues. We also report novel data on the severity of penalties associated with violations of prohibitions on the above activities. We find great heterogeneity in these laws. The free distribution of injection equipment for illicit drug use is permitted in 19 states, and the free distribution of smoking equipment is permitted in 14 states. The possession of injection equipment is permitted in 21 states, and the possession of smoking equipment in 15. Where possession or distribution of drug use equipment is prohibited or restricted, we found large differences in the penalties imposed for violations. There is also wide variation in laws governing the operation of syringe services programs, which are permitted in some form in 40 states but often highly regulated. We suggest that states evaluate and, where indicated, remove legal barriers to these supplies.
{"title":"A comprehensive review of state laws that govern the distribution and possession of drug use equipment in the United States","authors":"Corey S. Davis , Michael Abrams , Ashleigh Dennis , Amy Judd Lieberman , Czarina N. Behrends","doi":"10.1016/j.drugpo.2026.105152","DOIUrl":"10.1016/j.drugpo.2026.105152","url":null,"abstract":"<div><div>The United States continues to experience a large amount of drug-related harm, including high rates of both overdose mortality and harms associated with lack of access to new drug use equipment such as syringes and pipes. These harms include the spread of bloodborne disease as well as endocarditis, osteomyelitis, and other skin and soft tissue infections. Laws that prohibit or restrict access to drug use equipment may increase these harms. This manuscript provides a comprehensive legal review of laws that criminalize or otherwise restrict the distribution and possession of equipment for both injecting and inhaling drugs from both syringe services programs and other venues. We also report novel data on the severity of penalties associated with violations of prohibitions on the above activities. We find great heterogeneity in these laws. The free distribution of injection equipment for illicit drug use is permitted in 19 states, and the free distribution of smoking equipment is permitted in 14 states. The possession of injection equipment is permitted in 21 states, and the possession of smoking equipment in 15. Where possession or distribution of drug use equipment is prohibited or restricted, we found large differences in the penalties imposed for violations. There is also wide variation in laws governing the operation of syringe services programs, which are permitted in some form in 40 states but often highly regulated. We suggest that states evaluate and, where indicated, remove legal barriers to these supplies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105152"},"PeriodicalIF":4.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078483","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}
Pub Date : 2026-01-24DOI: 10.1016/j.drugpo.2026.105156
Catherine M. Comiskey , Ian D. Marder , Melissa Corbally
There is an unresolved tension between the growing emphasis on public health approaches to illicit drug use and to interpersonal violence in some quarters, and the common refrain that drug-related violence is best resolved through law enforcement and criminalisation in others. It is timely, therefore, to analyse these concepts together and through an interdisciplinary lens, exploring how we conceptualise and prevent illicit drug-related interpersonal violence from a public health perspective. This essay explores public health approaches to preventing illicit drug-related interpersonal violence. We situate our analysis in Ireland, where our work is primarily based, and where we feel there is some potential to drive forward public health approaches. We start by outlining some key messages from the empirical literature on the dynamics of illicit drug-related interpersonal violence in Ireland. Next, we seek to map the typology of violence and the World Health Organisation (WHO) ecological model of violence onto evidence-informed approaches to prevention from public health. Finally, we identify some of the approaches which could help Ireland reimagine efforts to prevent at least some forms of drug-related interpersonal violence, while avoiding the harms of criminalisation.
{"title":"Understanding and preventing drug-related interpersonal violence in Ireland through a public health approach","authors":"Catherine M. Comiskey , Ian D. Marder , Melissa Corbally","doi":"10.1016/j.drugpo.2026.105156","DOIUrl":"10.1016/j.drugpo.2026.105156","url":null,"abstract":"<div><div>There is an unresolved tension between the growing emphasis on public health approaches to illicit drug use and to interpersonal violence in some quarters, and the common refrain that drug-related violence is best resolved through law enforcement and criminalisation in others. It is timely, therefore, to analyse these concepts together and through an interdisciplinary lens, exploring how we conceptualise and prevent <em>illicit drug-related interpersonal violence</em> from a public health perspective. This essay explores public health approaches to preventing illicit drug-related interpersonal violence. We situate our analysis in Ireland, where our work is primarily based, and where we feel there is some potential to drive forward public health approaches. We start by outlining some key messages from the empirical literature on the dynamics of illicit drug-related interpersonal violence in Ireland. Next, we seek to map the typology of violence and the World Health Organisation (WHO) ecological model of violence onto evidence-informed approaches to prevention from public health. Finally, we identify some of the approaches which could help Ireland reimagine efforts to prevent at least some forms of drug-related interpersonal violence, while avoiding the harms of criminalisation.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105156"},"PeriodicalIF":4.4,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047267","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}
Pub Date : 2026-01-24DOI: 10.1016/j.drugpo.2026.105171
Laura H. Atuesta
Violence linked to drug markets has been examined from multiple perspectives. In fact, referring to a single type of violence is inaccurate, as violent expressions occur across the different phases of production, trafficking, and commercialization, as well as in relation to substance use. Although Colombia is primarily a producer country, it also experiences other forms of violence connected to drug commercialization, local drug sales, and the establishment of criminal groups across its territories. The objective of this document is to review how the literature has addressed the issue of drug market–related violence in Latin America, to describe Colombia’s current situation in this regard, and to provide policy recommendations based on this analysis.
{"title":"Drug markets and violence in Colombia: Where do we stand, and how do we move forward?","authors":"Laura H. Atuesta","doi":"10.1016/j.drugpo.2026.105171","DOIUrl":"10.1016/j.drugpo.2026.105171","url":null,"abstract":"<div><div>Violence linked to drug markets has been examined from multiple perspectives. In fact, referring to a single type of violence is inaccurate, as violent expressions occur across the different phases of production, trafficking, and commercialization, as well as in relation to substance use. Although Colombia is primarily a producer country, it also experiences other forms of violence connected to drug commercialization, local drug sales, and the establishment of criminal groups across its territories. The objective of this document is to review how the literature has addressed the issue of drug market–related violence in Latin America, to describe Colombia’s current situation in this regard, and to provide policy recommendations based on this analysis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105171"},"PeriodicalIF":4.4,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038602","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}
Pub Date : 2026-01-23DOI: 10.1016/j.drugpo.2026.105164
Zaira Magaña-Carbajal
Recent scholarship in Mexico has examined the intersection between the War on Drugs, drug-related violence, and schooling, revealing significant impacts on the educational experiences of young people. My study deepens this focus to the peripheries of Mexico City, where the expansion of the drug market and marginalization shape neighborhoods' everyday life. Situated in a community school that serves primarily working-class families, this study analyzes how teachers and school administrators perceive the risks of student drug use and distribution, as well as the strategies the school enacts to respond. Findings show that educators tend to view young people as an 'at-risk' population due to the neighborhood's context. Yet, when students engage in drug use or distribution, educators reframe them as 'a risk' to others. This transition mobilizes school protocols and resources to surveil and monitor students involved in such activities. These practices coexist with incipient prevention and harm-reduction initiatives that seek to destigmatize youth substance use. By discussing the implications of risk labels and student surveillance, this study shows why youth and teachers' experiences must inform the design of context-sensitive harm-reduction strategies. My work contributes to broader drug policy and drug education debates by foregrounding the role of schools in advancing justice-oriented frameworks for urban youth affected by drug-related violence.
{"title":"Youth Transitions and the Politics of Risk: Schooling amid Drug-related Violence in Mexico City","authors":"Zaira Magaña-Carbajal","doi":"10.1016/j.drugpo.2026.105164","DOIUrl":"10.1016/j.drugpo.2026.105164","url":null,"abstract":"<div><div>Recent scholarship in Mexico has examined the intersection between the War on Drugs, drug-related violence, and schooling, revealing significant impacts on the educational experiences of young people. My study deepens this focus to the peripheries of Mexico City, where the expansion of the drug market and marginalization shape neighborhoods' everyday life. Situated in a community school that serves primarily working-class families, this study analyzes how teachers and school administrators perceive the risks of student drug use and distribution, as well as the strategies the school enacts to respond. Findings show that educators tend to view young people as an 'at-risk' population due to the neighborhood's context. Yet, when students engage in drug use or distribution, educators reframe them as 'a risk' to others. This transition mobilizes school protocols and resources to surveil and monitor students involved in such activities. These practices coexist with incipient prevention and harm-reduction initiatives that seek to destigmatize youth substance use. By discussing the implications of risk labels and student surveillance, this study shows why youth and teachers' experiences must inform the design of context-sensitive harm-reduction strategies. My work contributes to broader drug policy and drug education debates by foregrounding the role of schools in advancing justice-oriented frameworks for urban youth affected by drug-related violence.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105164"},"PeriodicalIF":4.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038601","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}
Pub Date : 2026-01-22DOI: 10.1016/j.drugpo.2026.105170
L. Hondebrink , J.J. Nugteren-van Lonkhuyzen , I.S. van den Hengel-Koot , A.J.H.P. van Riel , P. Jansen , M.H.J.C. Coenraads
Objective
In the Netherlands, a legislative amendment announced on December 9th 2019, banned the production, sale, purchase, and possession of nitrous oxide (N₂O) for recreational use, and became effective January 1st 2023. This study examined the impact of this policy change on the number of nitrous oxide-related health and police incidents.
Methods
We conducted a retrospective analysis of nitrous oxide-related incidents between 2020 and 2025 (up to September), including exposures reported to the Dutch Poisons Information Center and incidents recorded by the Netherlands Police. Interrupted time series analyses were conducted.
Results
In total, 431 exposures and 150,623 police incidents were identified. Exposures and incidents were highest in 2020 (N = 144 and N = 41,644) and declined in 2022 (N = 72 and N = 28,972, p < 0.05), and, more pronounced, in 2023 (N = 23 and N = 9363, p < 0.001). In 2024 and 2025 an increase was observed (p < 0.001), although absolute numbers remained below pre-legislation levels (2024: N = 48 and N = 16,929). The median age of exposed patients was 23 years; 59% were male, 66% reported heavy use, and 39% exhibited signs of peripheral neuropathy. Most police incidents involved public disorder (70%), traffic offences (17%), and possession or trade (8%). Following criminalisation of possession or trade in 2023, police cases rose from N = 452 in 2022 to N = 3,798 (2% versus 22% of all N2O-related incidents) in 2024.
Conclusions
Nitrous oxide-related incidents were declining prior to legislation in 2023 and decreased further in 2023. Although numbers rose again in 2024 and 2025, they remained below 2020-2022 levels. Ongoing monitoring is needed to evaluate long-term effects.
{"title":"Incidents with recreational nitrous oxide use before and after legislation: poisonings and police incidents in the Netherlands between 2020 and 2025","authors":"L. Hondebrink , J.J. Nugteren-van Lonkhuyzen , I.S. van den Hengel-Koot , A.J.H.P. van Riel , P. Jansen , M.H.J.C. Coenraads","doi":"10.1016/j.drugpo.2026.105170","DOIUrl":"10.1016/j.drugpo.2026.105170","url":null,"abstract":"<div><h3>Objective</h3><div>In the Netherlands, a legislative amendment announced on December 9th 2019, banned the production, sale, purchase, and possession of nitrous oxide (N₂O) for recreational use, and became effective January 1st 2023. This study examined the impact of this policy change on the number of nitrous oxide-related health and police incidents.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of nitrous oxide-related incidents between 2020 and 2025 (up to September), including exposures reported to the Dutch Poisons Information Center and incidents recorded by the Netherlands Police. Interrupted time series analyses were conducted.</div></div><div><h3>Results</h3><div>In total, 431 exposures and 150,623 police incidents were identified. Exposures and incidents were highest in 2020 (<em>N</em> = 144 and <em>N</em> = 41,644) and declined in 2022 (<em>N</em> = 72 and <em>N</em> = 28,972, <em>p</em> < 0.05), and, more pronounced, in 2023 (<em>N</em> = 23 and <em>N</em> = 9363, <em>p</em> < 0.001). In 2024 and 2025 an increase was observed (<em>p</em> < 0.001), although absolute numbers remained below pre-legislation levels (2024: <em>N</em> = 48 and <em>N</em> = 16,929). The median age of exposed patients was 23 years; 59% were male, 66% reported heavy use, and 39% exhibited signs of peripheral neuropathy. Most police incidents involved public disorder (70%), traffic offences (17%), and possession or trade (8%). Following criminalisation of possession or trade in 2023, police cases rose from <em>N</em> = 452 in 2022 to <em>N</em> = 3,798 (2% versus 22% of all N<sub>2</sub>O-related incidents) in 2024.</div></div><div><h3>Conclusions</h3><div>Nitrous oxide-related incidents were declining prior to legislation in 2023 and decreased further in 2023. Although numbers rose again in 2024 and 2025, they remained below 2020-2022 levels. Ongoing monitoring is needed to evaluate long-term effects.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105170"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038603","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}
Pub Date : 2026-01-21DOI: 10.1016/j.drugpo.2026.105155
Tobias Kammersgaard , Charlie Lloyd , Chris Devany , Laura Bainbridge , Kate Brown , Ross Coomber
Background
The link between drugs and violence has been widely studied across a range of academic disciplines, including criminology, sociology, psychology, and social policy. However, much of this scholarship has focused specifically on the United States, and the specific form of competitive violence between rival groups.
Objectives
This paper adds to the literature by focusing on County Lines drug markets in the United Kingdom (UK), which have been linked to increases in violence and the exploitation of young people and vulnerable adults for selling, storing or transporting illicit drugs. We utilise this case, as well as recent literature on harm reduction policing, to expand frameworks for thinking about drug market-related violence.
Methods
The analysis is based on the first national study of the policing of County Lines, which consisted of interviews with senior officers across 44 of the 45 territorial police forces in the UK, as well as additional interviews and observations in three case study areas with front-line officers, partner agencies and people with lived experiences (n=117).
Results
Our findings illustrate how the exploitation of young people and vulnerable adults could be conceptualised as an internal form of violence in County Lines in the UK. Furthermore, we highlight the need to acknowledge enforcement-related violence associated with the policing of drug markets.
Conclusions
Based on our empirical findings, we argue for a conceptual broadening of current understandings of drug market-related violence, as well as further developing harm reduction policing thinking and responses to effectively counteract all forms of violence associated with drug markets and their control.
{"title":"Policing and drug market-related violence: competitive, internal and enforcement-related violence in UK County Lines","authors":"Tobias Kammersgaard , Charlie Lloyd , Chris Devany , Laura Bainbridge , Kate Brown , Ross Coomber","doi":"10.1016/j.drugpo.2026.105155","DOIUrl":"10.1016/j.drugpo.2026.105155","url":null,"abstract":"<div><h3>Background</h3><div>The link between drugs and violence has been widely studied across a range of academic disciplines, including criminology, sociology, psychology, and social policy. However, much of this scholarship has focused specifically on the United States, and the specific form of competitive violence between rival groups.</div></div><div><h3>Objectives</h3><div>This paper adds to the literature by focusing on County Lines drug markets in the United Kingdom (UK), which have been linked to increases in violence and the exploitation of young people and vulnerable adults for selling, storing or transporting illicit drugs. We utilise this case, as well as recent literature on harm reduction policing, to expand frameworks for thinking about drug market-related violence.</div></div><div><h3>Methods</h3><div>The analysis is based on the first national study of the policing of County Lines, which consisted of interviews with senior officers across 44 of the 45 territorial police forces in the UK, as well as additional interviews and observations in three case study areas with front-line officers, partner agencies and people with lived experiences (n=117).</div></div><div><h3>Results</h3><div>Our findings illustrate how the exploitation of young people and vulnerable adults could be conceptualised as an internal form of violence in County Lines in the UK. Furthermore, we highlight the need to acknowledge enforcement-related violence associated with the policing of drug markets.</div></div><div><h3>Conclusions</h3><div>Based on our empirical findings, we argue for a conceptual broadening of current understandings of drug market-related violence, as well as further developing harm reduction policing thinking and responses to effectively counteract all forms of violence associated with drug markets and their control.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105155"},"PeriodicalIF":4.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031289","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}
Pub Date : 2026-01-20DOI: 10.1016/j.drugpo.2025.105127
K. Foley , B. Lunnay , C. Kevin , PR. Ward
Alcohol companies invest heavily in marketing to shape consumer perceptions of what drinking means in social contexts. An international literature documents the way gendered expectations and associations are used in marketing campaigns to encourage women to drink alcohol. Our paper contributes new insight about gendered marketing on takeaway products in alcohol retail outlets with a particular focus on gendered affective (feeling) expectations and fills a knowledge gap regarding the Australian context.
We applied semiotics to explore strategies used to ‘feminise’ alcohol marketing, by photographing takeaway products for sale in retail outlets (10 department and boutique liquor outlets). After removing duplicate products (n = 54); text, images and features were reviewed for icons or symbols of stereotypical femininity (n = 145 excluded). The remaining products (n = 473) were coded and analysed using feminist literature on affect to facilitate interpretations of what alcohol was signified to ‘stand in for’ in women’s lives amidst shared gendered expectations.
Strategies used to feminise alcohol products included ‘pinking' them (i.e. a hibiscus sour called ‘the pinkening’), making them purple, glittery or floral, and including women’s names and bodies or gendered social roles (e.g. cooking) and symbols (e.g. engagement ring). Affective significations discernible on feminised products were that alcohol could enable feelings of wellness and balance; cultivate strength, resilience and confidence; and blur temporal boundaries to facilitate ‘drift’ away from everyday life and associated pressures.
Our work contributes a theory-informed exploration of how women’s gendered experiences are used as an opening to market alcohol to women for its affective potential amidst gendered oppressions, values, and priorities. We draw from semiotics to make recommendations towards gender-responsive regulation of alcohol marketing in Australia, that restricts how gendered affective expectations can be used as architecture to nudge consumer choices towards drinking.
{"title":"Gendered marketing on takeaway alcohol products in Australia: A semiotic analysis of advertising to women","authors":"K. Foley , B. Lunnay , C. Kevin , PR. Ward","doi":"10.1016/j.drugpo.2025.105127","DOIUrl":"10.1016/j.drugpo.2025.105127","url":null,"abstract":"<div><div>Alcohol companies invest heavily in marketing to shape consumer perceptions of what drinking means in social contexts. An international literature documents the way gendered expectations and associations are used in marketing campaigns to encourage women to drink alcohol. Our paper contributes new insight about gendered marketing on takeaway products in alcohol retail outlets with a particular focus on gendered affective (feeling) expectations and fills a knowledge gap regarding the Australian context.</div><div>We applied semiotics to explore strategies used to ‘feminise’ alcohol marketing, by photographing takeaway products for sale in retail outlets (10 department and boutique liquor outlets). After removing duplicate products (<em>n</em> = 54); text, images and features were reviewed for icons or symbols of stereotypical femininity (<em>n</em> = 145 excluded). The remaining products (<em>n</em> = 473) were coded and analysed using feminist literature on affect to facilitate interpretations of what alcohol was signified to ‘stand in for’ in women’s lives amidst shared gendered expectations.</div><div>Strategies used to feminise alcohol products included ‘pinking' them (i.e. a hibiscus sour called ‘the pinkening’), making them purple, glittery or floral, and including women’s names and bodies or gendered social roles (e.g. cooking) and symbols (e.g. engagement ring). Affective significations discernible on feminised products were that alcohol could enable feelings of wellness and balance; cultivate strength, resilience and confidence; and blur temporal boundaries to facilitate ‘drift’ away from everyday life and associated pressures.</div><div>Our work contributes a theory-informed exploration of how women’s gendered experiences are used as an opening to market alcohol to women for its affective potential amidst gendered oppressions, values, and priorities. We draw from semiotics to make recommendations towards gender-responsive regulation of alcohol marketing in Australia, that restricts how gendered affective expectations can be used as architecture to nudge consumer choices towards drinking.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105127"},"PeriodicalIF":4.4,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020273","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}
Substance use, including cannabis (marijuana/dagga), is a major global public health concern. In South Africa, the Cannabis for Private Purposes Bill decriminalised, the use, possession, and cultivation of cannabis by adults in private for personal use, but it remains illegal for those under 18. This study aimed to determine the impact of the cannabis decriminalisation bill on treatment demand among South African adolescents and young adults for cannabis use. A secondary aim was to examine trends in cannabis-related admissions post-legislation.
Methods
We used retrospective, inpatient and outpatient treatment demand data to assess time trends for cannabis t admissions among South African adolescents aged ≤18 years and young adults aged 19–25 years for the period 2015 to 2023. Basic descriptive statistics and logistic regression were employed to assess changes in cannabis-related admissions over time (2015–2023), adjusting for various sociodemographic and treatment-specific variables. Adjusted odds ratios (ORs) were reported at a 95% confidence interval and significance p-value of<0.05.
Results
The results do not support an immediate increase in treatment demand for cannabis-related problems among adolescents and young adults following the 2018 decriminalisation ruling. Instead, a significant increase in admissions was observed after 2021 onwards, with significantly higher odds observed in 2022 (AOR=1.50, 1.38–1.63, p < 0.001) and 2023 (AOR=1.48, 1.37–1.59, p < 0.001) compared to 2019. Treatment demand also varied by age category, gender, and educational attainment, with higher odds among adolescents, males, and those with primary or secondary education.
Conclusion
The decriminalisation of cannabis for private use has impacted treatment demand for cannabis use and the need for specialist substance use treatment among adolescents in South Africa. Legislation and amendments thereof must consider the specific vulnerabilities associated with this population, and the recent decriminalisation of cannabis should also be further explored.
背景:物质使用,包括大麻(大麻/dagga),是一个主要的全球公共卫生问题。在南非,《私人用途大麻法案》将成年人私人使用、拥有和种植大麻合法化,但对于18岁以下的人来说,这仍然是非法的。本研究旨在确定大麻非刑事化法案对南非青少年和年轻人使用大麻的治疗需求的影响。第二个目的是研究立法后与大麻有关的入院趋势。方法:我们使用回顾性、住院和门诊治疗需求数据来评估2015年至2023年期间南非年龄≤18岁的青少年和19-25岁的年轻人大麻入院的时间趋势。采用基本描述性统计和逻辑回归来评估大麻相关入院人数随时间(2015-2023)的变化,调整各种社会人口统计学和治疗特定变量。调整后的优势比(or)以95%的置信区间和显著性p值报告结果:结果不支持在2018年合法化裁决后青少年和年轻人对大麻相关问题的治疗需求立即增加。相反,2021年以后的入学率显著增加,与2019年相比,2022年(AOR=1.50, 1.38-1.63, p < 0.001)和2023年(AOR=1.48, 1.37-1.59, p < 0.001)的入学率显著增加。治疗需求也因年龄、性别和受教育程度而异,在青少年、男性和接受过小学或中学教育的人群中发病率较高。结论:私人使用大麻的非刑事化影响了南非青少年对大麻使用的治疗需求和对专门药物使用治疗的需求。立法及其修正案必须考虑到与这一人群有关的具体脆弱性,还应进一步探讨最近将大麻非刑事化的问题。
{"title":"From courtroom to clinic: How legal rulings shape cannabis use among adolescents and young adults in South Africa","authors":"Nadine Harker , Nancy Hornsby , Mukhethwa Londani , Charles Parry , Tara Carney","doi":"10.1016/j.drugpo.2026.105151","DOIUrl":"10.1016/j.drugpo.2026.105151","url":null,"abstract":"<div><h3>Background</h3><div>Substance use, including cannabis (marijuana/dagga), is a major global public health concern. In South Africa, the Cannabis for Private Purposes Bill decriminalised, the use, possession, and cultivation of cannabis by adults in private for personal use, but it remains illegal for those under 18. This study aimed to determine the impact of the cannabis decriminalisation bill on treatment demand among South African adolescents and young adults for cannabis use. A secondary aim was to examine trends in cannabis-related admissions post-legislation.</div></div><div><h3>Methods</h3><div>We used retrospective, inpatient and outpatient treatment demand data to assess time trends for cannabis t admissions among South African adolescents aged ≤18 years and young adults aged 19–25 years for the period 2015 to 2023. Basic descriptive statistics and logistic regression were employed to assess changes in cannabis-related admissions over time (2015–2023), adjusting for various sociodemographic and treatment-specific variables. Adjusted odds ratios (ORs) were reported at a 95% confidence interval and significance p-value of<0.05.</div></div><div><h3>Results</h3><div>The results do not support an immediate increase in treatment demand for cannabis-related problems among adolescents and young adults following the 2018 decriminalisation ruling. Instead, a significant increase in admissions was observed after 2021 onwards, with significantly higher odds observed in 2022 (AOR=1.50, 1.38–1.63, <em>p</em> < 0.001) and 2023 (AOR=1.48, 1.37–1.59, <em>p</em> < 0.001) compared to 2019. Treatment demand also varied by age category, gender, and educational attainment, with higher odds among adolescents, males, and those with primary or secondary education.</div></div><div><h3>Conclusion</h3><div>The decriminalisation of cannabis for private use has impacted treatment demand for cannabis use and the need for specialist substance use treatment among adolescents in South Africa. Legislation and amendments thereof must consider the specific vulnerabilities associated with this population, and the recent decriminalisation of cannabis should also be further explored.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105151"},"PeriodicalIF":4.4,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012997","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}
Pub Date : 2026-01-19DOI: 10.1016/j.drugpo.2026.105154
Lyu Azbel , Mary Tate , Viktoria Akerø , Frederick L. Altice , Sergii Dvoriak
Eastern Europe and Central Asia (EECA) face a dual crisis in addiction treatment. On one side, Russian imperial legacies persist through punitive “narcology,” now weaponized amid ongoing aggression. On the other, Western retrenchment, marked by abrupt aid suspensions and dwindling harm-reduction budgets, has weakened the evidence-based counterweight that once challenged authoritarian approaches. The result is a convergence of punitive logics that marginalizes people who use drugs, whether through active repression, such as the closure of methadone programs in Crimea, or sudden neglect, such as the withdrawal of donor funding for opioid agonist therapy in Tajikistan. We call for a decolonial, community-driven response grounded in non-reformist reform and transformative discomfort—one that reduces harm while dismantling punitive systems and embraces the tensions of shared authority and care. Drawing on the case of self-run addiction treatment in Kyrgyz prisons, we call for resourcing user-led infrastructures as models for decolonial directions in global health amid a splintering global health world order.
{"title":"Decolonizing addiction treatment in Eastern Europe and Central Asia: Confronting Russian narcology and Western retreat","authors":"Lyu Azbel , Mary Tate , Viktoria Akerø , Frederick L. Altice , Sergii Dvoriak","doi":"10.1016/j.drugpo.2026.105154","DOIUrl":"10.1016/j.drugpo.2026.105154","url":null,"abstract":"<div><div>Eastern Europe and Central Asia (EECA) face a dual crisis in addiction treatment. On one side, Russian imperial legacies persist through punitive “narcology,” now weaponized amid ongoing aggression. On the other, Western retrenchment, marked by abrupt aid suspensions and dwindling harm-reduction budgets, has weakened the evidence-based counterweight that once challenged authoritarian approaches. The result is a convergence of punitive logics that marginalizes people who use drugs, whether through active repression, such as the closure of methadone programs in Crimea, or sudden neglect, such as the withdrawal of donor funding for opioid agonist therapy in Tajikistan. We call for a decolonial, community-driven response grounded in non-reformist reform and transformative discomfort—one that reduces harm while dismantling punitive systems and embraces the tensions of shared authority and care. Drawing on the case of self-run addiction treatment in Kyrgyz prisons, we call for resourcing user-led infrastructures as models for decolonial directions in global health amid a splintering global health world order.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105154"},"PeriodicalIF":4.4,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012910","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}
Pub Date : 2026-01-15DOI: 10.1016/j.drugpo.2026.105153
Peter Kelly, Catherine Comiskey, Barry Mc Brien, Adam R. Winstock, Philip James
Globally, opioid agonist treatment (OAT) is recognised as a cornerstone of evidence-based responses to opioid dependence. Many countries have expanded access by enabling nurses to prescribe methadone and buprenorphine, with consistent evidence of safety, effectiveness, and improved equity of access. Despite this precedent, Ireland has not introduced nurse prescribing of OAT. Drawing on policy reviews, communications, national strategy documents, legislation, parliamentary debates, international literature and media reports, this commentary positions this issue as an important initiative which has been excluded from Irish drug-policy.
This commentary highlights a clinical and regulatory paradox: Irish nurses may prescribe controlled opioids for pain and palliative care for a person who is dependent on opioids, but are legally prohibited from prescribing the same medications for OAT. Independent reviews and government policy have recommended exploring nurse prescribing to address persistent workforce shortages. This commentary identifies how governance structures have marginalised nursing perspectives and mobilised evidence selectively, contributing to inaction. The authors propose that this case illustrates how existing approaches, varying accountability, and political framing shape policy decisions. With a new national drugs strategy in development, Ireland faces a choice: continue with non-inclusive, traditional governance or adopt inclusive, evidence-informed reform that aligns with international best practice.
{"title":"Nurse prescribing of opioid agonist treatment in Ireland: Evidence, governance, and the politics of drug policy decision-making","authors":"Peter Kelly, Catherine Comiskey, Barry Mc Brien, Adam R. Winstock, Philip James","doi":"10.1016/j.drugpo.2026.105153","DOIUrl":"10.1016/j.drugpo.2026.105153","url":null,"abstract":"<div><div>Globally, opioid agonist treatment (OAT) is recognised as a cornerstone of evidence-based responses to opioid dependence. Many countries have expanded access by enabling nurses to prescribe methadone and buprenorphine, with consistent evidence of safety, effectiveness, and improved equity of access. Despite this precedent, Ireland has not introduced nurse prescribing of OAT. Drawing on policy reviews, communications, national strategy documents, legislation, parliamentary debates, international literature and media reports, this commentary positions this issue as an important initiative which has been excluded from Irish drug-policy.</div><div>This commentary highlights a clinical and regulatory paradox: Irish nurses may prescribe controlled opioids for pain and palliative care for a person who is dependent on opioids, but are legally prohibited from prescribing the same medications for OAT. Independent reviews and government policy have recommended exploring nurse prescribing to address persistent workforce shortages. This commentary identifies how governance structures have marginalised nursing perspectives and mobilised evidence selectively, contributing to inaction. The authors propose that this case illustrates how existing approaches, varying accountability, and political framing shape policy decisions. With a new national drugs strategy in development, Ireland faces a choice: continue with non-inclusive, traditional governance or adopt inclusive, evidence-informed reform that aligns with international best practice.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"149 ","pages":"Article 105153"},"PeriodicalIF":4.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979897","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}