International Journal of Drug Policy最新文献_第2页

A comprehensive review of state laws that govern the distribution and possession of drug use equipment in the United States 对管理美国毒品使用设备的分配和拥有的州法律的全面审查

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-27 DOI: 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.

美国继续遭受大量与毒品有关的危害，包括过量死亡率高，以及无法获得注射器和管道等新的吸毒设备造成的危害高。这些危害包括血源性疾病的传播以及心内膜炎、骨髓炎和其他皮肤和软组织感染。禁止或限制获得药物使用设备的法律可能会增加这些危害。这份手稿提供了一个全面的法律审查的法律，刑事定罪或以其他方式限制分配和拥有注射器服务项目和其他场所注射和吸入药物的设备。我们还报告了与违反上述活动禁令有关的处罚严重程度的新数据。我们发现这些定律有很大的差异。19个州允许免费分发用于非法药物使用的注射设备，14个州允许免费分发吸烟设备。21个州允许拥有注射设备，15个州允许拥有吸烟设备。在禁止或限制拥有或分发吸毒设备的地方，我们发现对违法行为的处罚有很大差异。管理注射器服务项目运作的法律也存在很大差异，在40个州以某种形式被允许，但往往受到严格监管。我们建议各州评估并在必要时消除这些供应的法律障碍。

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引用次数: 0

Understanding and preventing drug-related interpersonal violence in Ireland through a public health approach 通过公共卫生办法了解和预防爱尔兰与毒品有关的人际暴力。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-24 DOI: 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.

在某些方面，越来越强调用公共卫生方法处理非法药物使用和人际暴力，而在其他方面，人们普遍认为与毒品有关的暴力最好通过执法和定罪来解决，这两者之间存在一种尚未解决的紧张关系。因此，现在是时候通过跨学科的视角一起分析这些概念，从公共卫生的角度探讨我们如何概念化和预防与毒品有关的非法人际暴力。本文探讨了预防与非法毒品有关的人际暴力的公共卫生方法。我们在爱尔兰进行分析，我们的工作主要基于那里，我们认为那里有一些推动公共卫生方法的潜力。我们首先概述了爱尔兰与非法毒品有关的人际暴力动态的实证文献中的一些关键信息。接下来，我们试图将暴力的类型和世界卫生组织（世卫组织）的暴力生态模型映射到公共卫生预防的循证方法上。最后，我们确定了一些方法，这些方法可以帮助爱尔兰重新设想努力防止至少某些形式的与毒品有关的人际暴力，同时避免刑事定罪的危害。

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引用次数: 0

Drug markets and violence in Colombia: Where do we stand, and how do we move forward? 哥伦比亚的毒品市场和暴力：我们的现状如何，我们如何前进？

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-24 DOI: 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.

与毒品市场有关的暴力已从多个角度加以审查。事实上，将一种类型的暴力称为暴力是不准确的，因为暴力表达发生在生产、贩运和商业化的不同阶段，以及与药物使用有关的阶段。虽然哥伦比亚主要是一个生产国，但它也经历了与毒品商业化、当地毒品销售和在其领土上建立犯罪集团有关的其他形式的暴力。本文件的目的是审查文献如何处理拉丁美洲与毒品市场有关的暴力问题，描述哥伦比亚在这方面的现状，并在此分析的基础上提出政策建议。

引用次数: 0

Youth Transitions and the Politics of Risk: Schooling amid Drug-related Violence in Mexico City 青年转型与风险政治：墨西哥城与毒品有关的暴力中的学校教育

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-23 DOI: 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.

墨西哥最近的学者研究了反毒品战争、与毒品有关的暴力和学校教育之间的交集，揭示了对年轻人教育经历的重大影响。我的研究加深了对墨西哥城外围的关注，在那里，毒品市场的扩张和边缘化塑造了社区的日常生活。本研究位于一所主要为工薪阶层家庭服务的社区学校，分析了教师和学校管理人员如何认识学生吸毒和分发毒品的风险，以及学校制定的应对策略。调查结果显示，由于社区环境的原因，教育工作者倾向于将年轻人视为“高危”人群。然而，当学生使用或分发毒品时，教育工作者将他们重新定义为对他人的“风险”。这种转变调动了学校的协议和资源来监督和监督参与此类活动的学生。这些做法与早期的预防和减少伤害倡议并存，这些倡议试图使青少年药物使用污名化。通过讨论风险标签和学生监督的含义，本研究表明为什么青年和教师的经验必须为情境敏感的减少伤害策略的设计提供信息。我的工作通过突出学校在为受毒品相关暴力影响的城市青年推进面向正义的框架方面的作用，为更广泛的毒品政策和毒品教育辩论做出了贡献。

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引用次数: 0

Incidents with recreational nitrous oxide use before and after legislation: poisonings and police incidents in the Netherlands between 2020 and 2025 立法前后娱乐性使用一氧化二氮的事件：2020年至2025年间荷兰的中毒和警察事件

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-22 DOI: 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.

荷兰于2019年12月9日宣布了一项立法修正案，禁止生产、销售、购买和持有娱乐用途的一氧化二氮（N₂O），并于2023年1月1日生效。这项研究审查了这一政策变化对与一氧化二氮有关的健康和警察事件数量的影响。方法：我们对2020年至2025年（截至9月）期间与一氧化二氮相关的事件进行了回顾性分析，包括向荷兰毒物信息中心报告的暴露情况和荷兰警方记录的事件。进行中断时间序列分析。结果共发现431起暴露事件和150,623起警察事件。暴露和事件在2020年最高（N = 144和N = 41,644），在2022年下降（N = 72和N = 28,972, p < 0.05），在2023年更明显（N = 23和N = 9363, p < 0.001）。在2024年和2025年观察到增加（p < 0.001），尽管绝对数字仍低于立法前的水平（2024年：N = 48和N = 16,929）。暴露患者的中位年龄为23岁；59%为男性，66%重度使用，39%表现出周围神经病变的迹象。大多数警察案件涉及扰乱公共秩序（70%）、交通违章（17%）和非法持有或交易（8%）。在2023年将持有或交易定为刑事犯罪之后，警方案件从2022年的N = 452上升到2024年的N = 3798（占所有n20相关事件的2%，而占22%）。结论2023年立法前与氧化亚氮相关的事故呈下降趋势，并在2023年进一步下降。尽管这一数字在2024年和2025年再次上升，但仍低于2020-2022年的水平。需要持续监测以评估长期影响。

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引用次数: 0

Policing and drug market-related violence: competitive, internal and enforcement-related violence in UK County Lines 警务和与毒品市场有关的暴力：英国郡线的竞争性、内部和执法相关的暴力。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-21 DOI: 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.

背景：毒品与暴力之间的联系已在一系列学科中得到广泛研究，包括犯罪学、社会学、心理学和社会政策。然而，这些学术研究大多集中在美国，以及敌对团体之间竞争暴力的具体形式。目的：本文通过关注英国的县际毒品市场来补充文献，这些市场与暴力事件的增加以及对年轻人和弱势成年人进行销售、储存或运输非法毒品的剥削有关。我们利用这个案例，以及最近关于减少伤害的警务的文献，来扩展思考与毒品市场有关的暴力的框架。方法：该分析基于对郡线警务的首次全国研究，该研究包括对英国45个地区警察部队中的44个地区的高级警官的访谈，以及对前线官员、合作机构和有生活经验的人在三个案例研究领域的额外访谈和观察（n=117）。结果：我们的研究结果说明了对年轻人和弱势成年人的剥削如何被概念化为英国县域内暴力的一种内部形式。此外，我们强调有必要承认与毒品市场警务有关的执法暴力。结论：根据我们的实证研究结果，我们主张从概念上拓宽目前对毒品市场相关暴力的理解，并进一步发展减少伤害的警务思维和对策，以有效抵制与毒品市场及其控制相关的一切形式的暴力。

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引用次数: 0

Gendered marketing on takeaway alcohol products in Australia: A semiotic analysis of advertising to women 澳大利亚外卖酒类产品的性别营销：对女性广告的符号学分析

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-20 DOI: 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.

酒类公司在营销上投入巨资，以塑造消费者对饮酒在社会环境中意味着什么的认知。一份国际文献记录了在鼓励妇女饮酒的营销活动中如何利用性别期望和联系。我们的论文为酒类零售网点外卖产品的性别营销提供了新的见解，特别关注性别情感（感觉）期望，并填补了澳大利亚背景下的知识空白。我们运用符号学来探索用于“女性化”酒类营销的策略，通过拍摄在零售店（10家百货公司和精品酒类店）销售的外卖产品。去除重复产品后（n = 54）；审查文本、图像和特征，寻找典型女性气质的图标或符号（n = 145除外）。剩余的产品（n = 473）被编码和分析，使用女权主义的影响文献，以促进对酒精在女性生活中“代表”的意义的解释，因为女性有着共同的性别期望。让酒精产品女性化的策略包括将其“粉红化”（即一种名为“粉红化”的木槿酸），使其呈紫色、闪闪发光或花香，并包括女性的名字、身体或性别社会角色（如烹饪）和符号（如订婚戒指）。在女性化产品上可以看出的情感意义是，酒精可以使人感到健康和平衡；培养力量、韧性和信心；模糊时间界限，以方便“漂移”远离日常生活和相关压力。我们的工作有助于从理论上探索女性的性别经历如何被用作向女性推销酒精的一个突破口，因为它在性别压迫、价值观和优先事项中具有情感潜力。我们从符号学中吸取教训，对澳大利亚酒类营销的性别敏感监管提出建议，这限制了性别情感期望如何被用作推动消费者选择饮酒的架构。

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引用次数: 0

From courtroom to clinic: How legal rulings shape cannabis use among adolescents and young adults in South Africa 从法庭到诊所：法律裁决如何影响南非青少年和年轻人的大麻使用。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-19 DOI: 10.1016/j.drugpo.2026.105151

Nadine Harker , Nancy Hornsby , Mukhethwa Londani , Charles Parry , Tara Carney

Background

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。

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引用次数: 0

Decolonizing addiction treatment in Eastern Europe and Central Asia: Confronting Russian narcology and Western retreat 东欧和中亚的非殖民化成瘾治疗：面对俄罗斯麻醉学和西方撤退。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-19 DOI: 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.

东欧和中亚（EECA）在成瘾治疗方面面临双重危机。一方面，俄罗斯帝国的遗产通过惩罚性的“毒品治疗法”得以延续，如今在不断的侵略中被武器化。另一方面，西方的紧缩，以突然中止援助和减少伤害预算为标志，削弱了曾经挑战威权方法的循证平衡。其结果是惩罚性逻辑趋同，将吸毒者边缘化，无论是通过积极的压制（如克里米亚关闭美沙酮项目），还是突然忽视（如塔吉克斯坦取消阿片类药物激动剂治疗的捐赠资金）。我们呼吁以非改革主义的改革和变革的不安为基础，采取一种非殖民化的、社区驱动的应对措施——在拆除惩罚性制度的同时减少伤害，并接受共享权力和照顾的紧张关系。根据吉尔吉斯斯坦监狱自营戒毒的情况，我们呼吁为用户主导的基础设施提供资源，在全球卫生世界秩序分裂的情况下，将其作为全球卫生非殖民化方向的典范。

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引用次数: 0

Nurse prescribing of opioid agonist treatment in Ireland: Evidence, governance, and the politics of drug policy decision-making 护士处方阿片类激动剂治疗在爱尔兰：证据，治理和药物政策决策的政治

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-15 DOI: 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.

在全球范围内，阿片类药物激动剂治疗（OAT）被认为是阿片类药物依赖的循证反应的基石。许多国家通过允许护士开美沙酮和丁丙诺啡来扩大可及性，并有一致的证据证明其安全性和有效性，并改善了可及性的公平性。尽管有这样的先例，爱尔兰还没有引入护士开处方的OAT。根据政策审查、来文、国家战略文件、立法、议会辩论、国际文献和媒体报道，本评论将这一问题定位为一项被排除在爱尔兰毒品政策之外的重要倡议。这篇评论强调了临床和监管方面的一个悖论：爱尔兰护士可能会为依赖阿片类药物的人开出受控制的阿片类药物来治疗疼痛和缓和治疗，但法律禁止为OAT开出相同的药物。独立审查和政府政策建议探索护士处方，以解决持续的劳动力短缺问题。本评论指出，治理结构如何将护理观点边缘化，并有选择地动员证据，从而导致不作为。作者提出，这个案例说明了现有的方法、不同的问责制和政治框架如何影响政策决定。随着新的国家药物战略的制定，爱尔兰面临着一个选择：继续采用非包容性的传统治理，还是采用与国际最佳实践相一致的包容性的、循证的改革。

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