International Journal of Drug Policy最新文献

{"title":"Frequency is not enough: Characterizing heterogenous patterns of cannabis use intensity among reservation-area American Indian youth","authors":"Meghan A. Crabtree,&nbsp;Linda R. Stanley,&nbsp;Mark A. Prince,&nbsp;Randall C. Swaim","doi":"10.1016/j.drugpo.2024.104617","DOIUrl":"10.1016/j.drugpo.2024.104617","url":null,"abstract":"<div><h3>Background</h3><div>Reservation-area American Indian (AI) youth use cannabis at significantly higher rates than their national counterparts. This discrepancy is concerning, as cannabis use—particularly heavy use—can negatively impact adolescents’ health. Studies primarily use frequency to classify cannabis use intensity; however, frequency alone may not fully capture heterogenous patterns of use. This study aimed to classify AI adolescents’ cannabis use based on multiple intensity indicators, and to investigate interclass differences in problematic characteristics and outcomes of use.</div></div><div><h3>Methods</h3><div>Participants were 799 reservation-area AI youth (7–12th grade) reporting 12-month cannabis use. Latent Class Analysis (LCA) was used to distinguish cannabis use intensity patterns based on frequency, typical intoxication levels and duration. Auxiliary tests using R3STEP and BCH 3-step procedures were used to assess class predictors (age, initiation age, sex) and interclass differences in simultaneous drug use, stress-motivated use, problems quitting and cannabis-related consequences.</div></div><div><h3>Results</h3><div>Four classes emerged: Light Use (LU; 19 %), Occasional Intoxication (OI; 32 %), Mid-frequency Use(MU; 28 %), and Heavy Use (HU; 21 %). Age and initiation age correlated with membership odds in a heavier use class. Interclass differences in problematic characteristics and outcomes occurred between all classes, particularly for stress-motivated use and cannabis-related consequences—with HU reporting the most problematic characteristics and negative outcomes.</div></div><div><h3>Conclusion</h3><div>These findings suggest that accounting for multiple dimensions of usage intensity may be important in studies examining cannabis use and related problems among AI adolescents. Tailoring intervention programming to address complex cannabis use patterns, with particular focus on stress-coping skills and harm reduction, can ensure AI youth most at risk for cannabis problems gain maximal benefit from prevention efforts.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104617"},"PeriodicalIF":4.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510522","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":"Clinical and public safety risks associated with cannabis legalization and frequency of cannabis use among forensic mental health patients","authors":"Stephanie R. Penney ,&nbsp;Roland M. Jones ,&nbsp;Treena Wilkie ,&nbsp;Cory Gerritsen ,&nbsp;Sumeeta Chatterjee ,&nbsp;Gary A. Chaimowitz ,&nbsp;Alexander I.F. Simpson","doi":"10.1016/j.drugpo.2024.104622","DOIUrl":"10.1016/j.drugpo.2024.104622","url":null,"abstract":"<div><h3>Background</h3><div>There are ongoing concerns regarding the impact of Canada's cannabis legalization and commercialization on vulnerable persons such as those with serious forms of mental illness, including persons with schizophrenia-spectrum disorders and users of forensic mental health services. The primary objective of this study was to investigate the potential harms and mental health-related impacts associated with cannabis legalization on a sample of forensic patients in Ontario (<em>N</em> = 187).</div></div><div><h3>Methods</h3><div>Using a pseudo-prospective design, we investigated the frequency of cannabis use over a four-year period encompassing two years preceding and two years following the legislative change. We recorded clinical and public safety outcomes (i.e., mental health deterioration, length of stay in the forensic system, rates of hospital readmission, victimization and violence) over the same period to test relationships between these variables and rates of cannabis use.</div></div><div><h3>Results</h3><div>We found that one-third of patients either self-reported or were discovered, via urine testing, to have used cannabis over the study period. Frequency of use was lower in the pre-legalization period, and then gradually and significantly increased after legalization. Compared to patients with no cannabis use, those with one or more instances of use were more likely to be readmitted to hospital and had higher rated static risk factors for violence. However, there were no observed differences in the actual rate of violence between patients using and not using cannabis, nor differences in the rate of violence over time. Over half of the patients who used cannabis experienced a worsening of their mental health status in the week following use.</div></div><div><h3>Conclusions</h3><div>Cannabis use among those with SMI is associated with adverse clinical outcomes. Results from this study suggest that the mental health burdens associated with cannabis use have risen in terms of delayed clinical recovery and progress through the forensic system since legalization.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104622"},"PeriodicalIF":4.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510508","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":"The role of prescribed controlled substance acquisition as potential triggers of opioid overdose: A case-crossover study","authors":"Allen M. Smith ,&nbsp;Cheng Peng ,&nbsp;Austin Porter ,&nbsp;Bradley C. Martin","doi":"10.1016/j.drugpo.2024.104620","DOIUrl":"10.1016/j.drugpo.2024.104620","url":null,"abstract":"<div><div><em>Background:</em> The role of prescribed opioids and benzodiazepines as risk factors for opioid overdose are well established, however, their role as potential ‘triggers’ of opioid overdose has not been formally investigated. O<em>bjective:</em> The objective of this study was to evaluate the temporal relationship between controlled substance acquisition and opioid overdose utilizing a case-crossover design. <em>Methods:</em> This study utilized Arkansas statewide data between 2014 and 2020. Prescription Drug Monitoring Program (PDMP) data were used to assess controlled substance acquisition and fatal and non-fatal opioid overdose were assessed using linked death certificate, inpatient discharge, and emergency department (ED) data. All persons residing in Arkansas who experienced an opioid overdose or had ≥ 1 Arkansas PDMP prescription fill(s) were included. Controlled substance characteristics were described in the 7 days prior to overdose and compared to the controlled substance characteristics in 11 weekly (7-day) control windows prior to overdose. Binary controlled substance variables indicating presence or absence of: any controlled substance, opioid, benzodiazepine, stimulant, sedative, carisoprodol, opioid and benzodiazepine, and opioid and benzodiazepine and carisoprodol were created. Additionally, total morphine milliequivalents were calculated for each time window. Conditional logistic regression models were estimated and adjusted odds ratios for each controlled substance characteristic after accounting for other controlled substance, and prior overdose, and clinical characteristics derived from ED and inpatient data are reported. <em>Results:</em> A total of 2,818,135 individuals with ≥1 Arkansas PDMP record(s) (45.10 % male; 39.94 mean age) were included, of which 28,670 (1.02 %) experienced ≥1 opioid overdose. There was a significant association between opioid overdose and the acquisition of a controlled substance (OR=1.785; <em>p</em> &lt; 0.001), opioid (OR=1.992; <em>p</em> &lt; 0.001), benzodiazepine (OR=1.379; <em>p</em> &lt; 0.001), carisoprodol (OR=1.744; <em>p</em> &lt; 0.001), opioid and benzodiazepine (OR=2.203; <em>p</em> &lt; 0.001), and opioid and benzodiazepine and carisoprodol (OR=2.503; <em>p</em> &lt; 0.001), in the 7 days prior to an opioid overdose event. <em>Conclusion:</em> Controlled substance prescription acquisition, particularly opioids in combination with carisoprodol and/or benzodiazepines, are potential triggers of opioid overdose.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104620"},"PeriodicalIF":4.4,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478003","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":"Interconnected influence: Unraveling purdue pharmaceutical's role in the global response to the opioid crisis","authors":"Andrea Bowra ,&nbsp;Amaya Perez-Brumer ,&nbsp;Lisa Forman ,&nbsp;Jillian Clare Kohler","doi":"10.1016/j.drugpo.2024.104604","DOIUrl":"10.1016/j.drugpo.2024.104604","url":null,"abstract":"<div><h3>Background</h3><div>The global pharmaceutical industry has a long history of prioritizing profits over public health through widespread practices such as price gouging, deceptive marketing, and fraud. A prominent example of this issue is the mislabeling and mass-marketing of OxyContin by Purdue Pharmaceuticals (Purdue) that catalyzed the opioid crises in and beyond the United States.</div></div><div><h3>Methods</h3><div>Guided by Actor-Network Theory, this case study employs Visual Network Analysis to map the actors-networks involved in responding to the harms caused by Purdue. Data was generated from peer-reviewed and grey literature published between 2007 and 2022 (<em>n</em> = 40) and imported into Gephi visualization software where centrality metrics were applied.</div></div><div><h3>Results</h3><div>A total of 39 actors and 99 relationships were visualized based on the relational thinking that actors who are heavily interconnected with others are rendered important. Centrality measures identified the socio-technical centrality of Purdue in influencing the response to the harms it caused. Purdue exerted influence through various avenues, most prominently through the creation and cooptation of pain advocacy groups, their close ties with United States elected officials, and through embedding pro-opioid messaging in international guidance documents. In doing so, Purdue was able to extend the reach and impact of their opioid promotion, while simultaneously limiting the capacity of regulatory bodies to pursue accountability and implement policies to mitigate opioid-related harms.</div></div><div><h3>Conclusion</h3><div>This study advances understandings of the complex interplay between transnational pharmaceutical companies, global health systems, regulatory bodies, and public health. In doing so, we underscore the need for stronger regulation and increased transparency surrounding the interactions between pharma, patient groups, governments, and international organizations to better address and prevent future harms.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104604"},"PeriodicalIF":4.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478000","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":"2S/LGBTQ+ youth substance use and pathways to homelessness: A photovoice study","authors":"Trevor Goodyear ,&nbsp;Emily Jenkins ,&nbsp;John L. Oliffe ,&nbsp;Danya Fast ,&nbsp;Hannah Kia ,&nbsp;Rod Knight","doi":"10.1016/j.drugpo.2024.104621","DOIUrl":"10.1016/j.drugpo.2024.104621","url":null,"abstract":"<div><h3>Background</h3><div>Studies have posited that substance use is associated with, or contributes to, homelessness for 2S/LGBTQ+ youth. However, interconnections between these issues are poorly articulated.</div></div><div><h3>Methods</h3><div>This community-based photovoice study describes the narratives used by 2S/LGBTQ+ youth about how substance use featured in their pathways to homelessness. Employing constructionist narrative analysis, two storylines were inductively derived from participant-produced photographs and photovoice interviews with 32 2S/LGBTQ+ youth in Vancouver, Canada.</div></div><div><h3>Results</h3><div><em>Taking refuge</em> narratives centered on 2S/LGBTQ+ youths’ use of substances to cope with intersecting hardships and minority stressors they had faced growing up, and when transitioning to homelessness. <em>From playing into precarity</em> narratives focused on the shifting possibilities and tensions of what sexualized crystal methamphetamine use can surface for 2S/LGBTQ+ youth in terms of facilitating connection and release and simultaneously invoking discomforts, including eviction from their family home.</div></div><div><h3>Conclusions</h3><div>These narratives can usefully be anticipated and recognized to better understand and address the social contexts in which 2S/LGBTQ+ youth experience substance use and associated harms, especially homelessness. They affirm the need for tailored supports for 2S/LGBTQ+ youth who use drugs in the lead-up to and after becoming homeless, including the provision of care that better recognizes youths’ pursuits of becoming and belonging in the context of marginalization, and that takes a harm reduction approach to addressing the role of substance use in these pursuits.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104621"},"PeriodicalIF":4.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477999","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":"Publics in local media reporting on harm reduction: Rightfully worried local witnesses or uneducated obstacles to change","authors":"Katarina Winter ,&nbsp;Josefin Månsson","doi":"10.1016/j.drugpo.2024.104619","DOIUrl":"10.1016/j.drugpo.2024.104619","url":null,"abstract":"<div><h3>Background</h3><div>In 2018, the planned opening of a second Needle and Syringe Exchange Program (NSP) unit in Stockholm, Sweden, was stopped with reference to protests from the public. Local Stockholm media cited stakeholders who claimed that the initiative was led by politicians with “zero knowledge about what makes citizens upset” and referred to reported public concern over a preschool located near the planned NSP unit. This case highlights the significant role of the public – and the idea of public opinion – in relation to political and medial aspects of alcohol and other drug (AOD) issues. Our aim is to scrutinize how “the public” is produced in local print media reports on harm reduction measures such as the NSP, to illuminate how these representations operate and what reality/ies they co-produce.</div></div><div><h3>Methods</h3><div>We analyzed 171 articles reporting on harm reduction in local Stockholm print media from 2012 to 2023. The themes identified in the analysis emerged from a combination of data-driven empirical observations and a theory-driven approach grounded in the influential literature on publics and counterpublics by Michael Warner and Nancy Fraser.</div></div><div><h3>Results</h3><div>The overarching articulation in the material is that of a singular and homogeneous public. Public opinion regarding local experiences of individual drug use and harm reduction is depicted as being driven by fear and worry over living alongside “messy others”, thereby producing a public of worried local community witnesses. This production of the public takes on two different meanings depending on the narrative of the articles: 1) as righteous and entitled, 2) as ignorant and irrational. As a result, the public comes to operate as either a consulted public deserving consideration in the implementation of harm reduction policies or as an uneducated political obstacle to change. Consequently, the public is assigned both a counterpublic and a dominant public identity.</div></div><div><h3>Conclusions</h3><div>When the representation of the worried public is repeatedly echoed by the media, it becomes hard to ignore in policy-making processes. The implications of such media representations are significant, as they risk disguising the complex nature of publics as a diverse group of individuals while reproducing taken-for-granted ideas about local communities opposing harm reduction measures. In addition, the appropriation of a counterpublic identity narrows the discursive space for action. Taken together, the repetition of a singular worried public and the appropriation of the counterpublic position make it nearly impossible to imagine alternative public responses to harm reduction. As a consequence, this can limit well-needed policy responses to AOD issues.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104619"},"PeriodicalIF":4.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478002","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":"Perceived patient navigator services and characteristics to address barriers to linkage to hepatitis C care among people released from provincial prison in Quebec, Canada","authors":"Nadine Kronfli ,&nbsp;Andrea Mambro ,&nbsp;Lindsey R. Riback ,&nbsp;David Ortiz-Paredes ,&nbsp;Camille Dussault ,&nbsp;Sylvie Chalifoux ,&nbsp;Lina del Balso ,&nbsp;Apostolia Petropoulos ,&nbsp;Mona Lim ,&nbsp;Alexandros Halavrezos ,&nbsp;Giada Sebastiani ,&nbsp;Marina B. Klein ,&nbsp;Bertrand Lebouche ,&nbsp;Joseph Cox ,&nbsp;Matthew J. Akiyama","doi":"10.1016/j.drugpo.2024.104624","DOIUrl":"10.1016/j.drugpo.2024.104624","url":null,"abstract":"<div><h3>Background</h3><div>Patient navigation increases linkage to hepatitis C virus (HCV) care following release from prison; however, little is known about the services patient navigators should provide to maximize linkage to care. We aimed to identify perceived barriers and facilitators to linkage to HCV care post-release, and to determine patient navigator services and characteristics best suited to address barriers to linkage to care among people released from prison.</div></div><div><h3>Methods</h3><div>Ten semi-structured interviews were conducted with adult (age ≥18 years) men living with chronic HCV, released from the largest Quebec provincial prison, and linked to HCV care by a patient navigator. Interviews were guided by the Socio-Ecological Model (SEM) and aimed to explore the multi-level barriers and facilitators to linkage to HCV care post-release. Interviews were audio-recorded, transcribed, and analyzed using a deductive, thematic approach.</div></div><div><h3>Results</h3><div>The median age of participants was 54 years. Barriers to linkage to HCV care included competing priorities post-release (e.g., substance use, mental health issues, unstable housing), stigma (related to HCV, injection drug use, and incarceration), and lack of transportation. Facilitators included social support, established relationships with existing healthcare providers, prior cure with direct-acting antivirals, and HCV-related health literacy and knowledge. Perceived essential patient navigator services to enhance linkage included pre-release discharge appointments, housing assistance, and facilitated transportation to HCV appointments. Ensuring a consistent, non-judgemental, and empathetic patient navigator were considered important characteristics; lived experiences of incarceration and/or HCV were not felt to be essential for a patient navigator.</div></div><div><h3>Conclusions</h3><div>Interventions that seek to improve linkage to HCV care for people following release from prison should address many levels (individual, interpersonal, and policy) of the SEM. While people experience several competing priorities post-release, having an empathetic and consistent patient navigator, regardless of their lived experiences of HCV and/or incarceration, may improve linkage to HCV care post-release.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104624"},"PeriodicalIF":4.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478001","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":"Slamsex as slow edgework: Sexualized drug use and harm reduction in post-AIDS Taiwan","authors":"Poyao Huang","doi":"10.1016/j.drugpo.2024.104613","DOIUrl":"10.1016/j.drugpo.2024.104613","url":null,"abstract":"<div><h3>Background</h3><div>Since the mid-2010s, slamsex—sexualized drug use involving intravenously injecting meth—has rapidly emerged in metropolitan gay communities as a sociosexual practice necessitating harm reduction interventions. However, its impact on gay men's sociosexual lives and HIV technologies is not well understood. This paper addresses this gap by investigating two intertwined temporal dimensions of slamsex, viewing it as a form of <em>slow edgework</em> in post-AIDS Taiwan.</div></div><div><h3>Methods</h3><div>Ethnographic research was conducted in Taiwan between 2022 and 2024, involving 30 interviews with gay men who practice slamsex and 7 HIV/AIDS NGO representatives. Semi-structured interviews focused on slamming events, covering their edge, transition, and healthcare network.</div></div><div><h3>Results</h3><div>Findings reveal paradoxes within edgework, demonstrating that slamsex can be both extreme and risky, as well as slow and mundane. Participants navigated state surveillance and the materiality of syringes through meticulous risk calculations and digital-savvy strategies for acquiring clean syringes. The practice involved risk and a networked economy of care services provided by other injectors. In response to HIV technologies (PrEP and viral load disclosure), gay men in this study normalized HIV/AIDS while developing a sense of vulnerability to their own infection.</div></div><div><h3>Conclusion</h3><div>In the era of HIV/AIDS normalization, slamsex as slow edgework underscores the need for temporally and spatially nuanced discussions on drug policy. This study highlights the importance of culturally tailored interventions that consider slow, networked interactions to provide harm reduction for men on the chemsex scene, as well as the needs for more evidence-based, non-discriminatory research on queer sexual health and drug studies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104613"},"PeriodicalIF":4.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445042","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":"Historic and current achievements of the temperance movement in the control of alcohol and its adverse health consequences","authors":"David Dunt ,&nbsp;Heng Jiang ,&nbsp;Robin Room","doi":"10.1016/j.drugpo.2024.104608","DOIUrl":"10.1016/j.drugpo.2024.104608","url":null,"abstract":"<div><h3>Setting</h3><div>The study aims to assess firstly, the historical (pre-2000) achievements in the control of alcohol and its adverse health consequences in the nine developed countries with mass temperance movements. Currently (post-2000), it looks at achievements in developed countries more generally, including these nine countries.</div></div><div><h3>Methods</h3><div>The study is a policy analysis conducted within an historical timeframe. This principally involves the historical impacts on government schemes regulating alcohol as well as individual alcohol consumption and its consequences. Trends since 2000 in alcohol consumption in young people in high-income temperance cultures are also examined.</div></div><div><h3>Results and conclusion</h3><div>Substantial alcohol-related public health impacts have occurred in almost all of the nine countries, either on relevant government schemes and/or individual alcohol consumption. Regarding government schemes, five of the nine temperance countries, and in part a sixth (the US), retain government store monopoly systems, offering heavily-taxed spirits with limits on their accessibility. Impacts on individual consumption in these countries, where studied, were positive. Consumption in young people since 2000 in high income countries is lower in temperance than non-temperance countries.</div><div>It is concluded that temperance culture has had substantial and enduring governmental and individual public health impacts relating to alcohol consumption.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":"Article 104608"},"PeriodicalIF":4.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432614","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":"How do relational practices co-constitute care for people who use drugs? The social and political dimensions of peer-led harm reduction","authors":"Timothy Piatkowski ,&nbsp;Kate Seear ,&nbsp;Steph Reeve ,&nbsp;Emma Kill","doi":"10.1016/j.drugpo.2024.104614","DOIUrl":"10.1016/j.drugpo.2024.104614","url":null,"abstract":"<div><h3>Introduction</h3><div>People who use drugs have a long history of mobilising to reduce harm within their communities, significantly influencing harm reduction efforts globally. Peers with lived experience contribute through needle exchange programs, harm reduction education, and community-based research. Despite facing stigma, their initiatives have generated multiple benefits for communities. Collaborations between peers and researchers are increasingly recognised, emphasising meaningful participation in decisions affecting their lives. This paper focuses on the role of peers in mitigating drug-related risks and harms through community care.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 30 people who use drugs, exploring peer support and harm reduction. Data were analysed by the lead author and a coding framework was developed in which key theme-categories were organised. Theoretical framing from science and technology studies informed analysis, recognising the political dimensions of research.</div></div><div><h3>Results</h3><div>Peers play a crucial role in bridging gaps in formal services, offering stigma-free, relational care spaces. These spaces, both physical and social, affirm dignity and solidarity, countering marginalisation. Participants highlight the importance of peer involvement in driving change, promoting safer use practices, and advocating for a holistic harm reduction approach that considers systemic factors.</div></div><div><h3>Conclusions</h3><div>Our data highlight the vital role of peer connections and peer-led harm reduction practices in fostering safety, solidarity, and connection among communities of people who use drugs. Future research should continue to explore peer-led initiatives within evolving healthcare contexts, considering broader social dynamics and employing innovative conceptual frameworks to promote equitable peer-led harm reduction strategies.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"133 ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420626","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}