International Journal of Drug Policy最新文献

{"title":"A comprehensive analysis of jurisdiction-specific laws related to scheduling or required prescription drug monitoring of gabapentin in the United States, 2016–2024","authors":"Katherine Gora Combs ,&nbsp;Rachel Vickers-Smith ,&nbsp;Collin Stewart ,&nbsp;Daniel Wacker ,&nbsp;Juan M. Hincapie-Castillo","doi":"10.1016/j.drugpo.2025.105064","DOIUrl":"10.1016/j.drugpo.2025.105064","url":null,"abstract":"<div><div>Gabapentin prescription use has increased across the United States since the late 2000s. Concerns of potential misuse and growing overdose involvement have led to the passage of jurisdiction-specific policies targeting gabapentin prescribing; however, the current legal landscape of these policies is not well documented or understood. We conducted a comprehensive, longitudinal analysis of policies related to scheduling or required prescription drug monitoring of gabapentin across 51 jurisdictions in the United States from January 2016 through December 2024. Across the study period, 25 jurisdictions (49 %) enacted policies related to gabapentin scheduling or required prescription reporting. Eight (16 %) jurisdictions classified gabapentin as a schedule V controlled substance and mandated reporting of gabapentin prescriptions in the jurisdiction’s prescription drug monitoring program (PDMP) and 17 (33 %) jurisdictions required the reporting of gabapentin prescriptions to the jurisdiction’s PDMP but did not classify gabapentin as a schedule V controlled substance. Both scheduling and mandated reporting policies were largely concentrated between 2016 and 2019. Though policy changes were observed across the entirety of the continental United States, the majority of jurisdictions with policies were concentrated in the Appalachian and Eastern Midwest regions. Our results provide a strong basis for future research on the impact of gabapentin scheduling and prescription drug monitoring policies on prescribing, dispensing, health care utilization, and overdose involvement. Future discussions at the state and federal level can also be informed by this analysis of the current legal landscape of gabapentin prescribing policies in the United States.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105064"},"PeriodicalIF":4.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670243","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":"Population size estimation of people who inject drugs using capture-recapture analysis of multiple respondent-driven sampling rounds: Implications for HIV/HCV burden and harm reduction service planning in Thessaloniki, Greece","authors":"Sotirios Roussos ,&nbsp;Effrosyni Tsirogianni ,&nbsp;Ioannis Goulis ,&nbsp;Georgios Kalamitsis ,&nbsp;Angelos Hatzakis ,&nbsp;Vana Sypsa","doi":"10.1016/j.drugpo.2025.105078","DOIUrl":"10.1016/j.drugpo.2025.105078","url":null,"abstract":"<div><h3>Background</h3><div>Accurate population size estimation of people who inject drugs (PWID) is essential for evidence-based drug policy and service planning, yet it remains challenging. An emerging HIV outbreak in Thessaloniki, Greece's second-largest city, highlighted the urgent need for evidence-based population size estimates.</div></div><div><h3>Methods</h3><div>We applied capture-recapture analysis to five respondent-driven sampling (RDS) rounds conducted during 2019–2021 to estimate PWID population size in Thessaloniki for the 2019–2021 period. These RDS rounds were part of a community-based program aimed at increasing HIV/HCV testing and linkage to care among PWID. We treated each RDS round as a capture source and used log-linear models to estimate PWID population size (past 12 months and past 30 days), accounting for potential dependencies between rounds through interaction terms. We then estimated HIV/HCV disease burden and assessed prevention and harm reduction service coverage against international standards (HIV testing, OAT, NSP).</div></div><div><h3>Results</h3><div>Based on data from 1093 unique participants across five rounds (53.9% currently injecting, 20.3% currently in OAT), capture-recapture analysis estimated 1512 PWID (95% confidence interval (CI): 1345–1741) who had injected drugs in the past 12 months. The estimated prevalence of injecting drug use was 0.22% (95% CI: 0.20–0.25) among adults aged 18–64 years. We estimated 106 people living with HIV (95% uncertainty interval (UI): 83–130) and 945 HCV-antibody–positive individuals (95% UI: 815–1077) among PWID. Needle and syringe program coverage was 36 (95% CI: 31–40) syringes per PWID in 2021.</div></div><div><h3>Conclusion</h3><div>Based on this community-based population size estimate, the prevalence of injection was nearly double the official national Greek average. The annual distribution of syringes should increase by 5.6 times to reach the WHO target (≥200 syringes/PWID/year). These findings demonstrate how community-based programs with multiple RDS rounds can also yield population estimates essential for evidence-based drug policy interventions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105078"},"PeriodicalIF":4.4,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624522","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":"Evaluating cannabis substitution for alcohol within the context of a canadian managed alcohol program","authors":"Sybil Goulet-Stock ,&nbsp;Catherine Hacksel ,&nbsp;Beatriz Scandiuzzi ,&nbsp;Rob Boyd ,&nbsp;Bernie Pauly ,&nbsp;Tim Stockwell","doi":"10.1016/j.drugpo.2025.105083","DOIUrl":"10.1016/j.drugpo.2025.105083","url":null,"abstract":"<div><h3>Introduction</h3><div>Managed Alcohol Programs (MAPs) provide beverage alcohol alongside housing and social supports to mitigate alcohol-related harms among individuals experiencing severe alcohol use disorder (AUD) and unstable housing. MAPs have been shown to stabilize alcohol use, reduce alcohol-related harms, improve quality of life, and decrease emergency service utilization. However, concerns about the long-term health risks associated with high levels of alcohol use have driven interest in cannabis substitution as an additional harm reduction strategy. Given the lower harm profile of cannabis, its integration into MAPs offers a promising avenue for further reducing alcohol-related harms. This study evaluates a novel cannabis substitution program within a Canadian MAP, leveraging the unique context of cannabis legalization and harm reduction programming.</div></div><div><h3>Methods</h3><div>Beginning in January 2023, participants (<em>N</em> = 35) were offered the choice of a pre-rolled cannabis joint or their prescribed alcohol dose multiple times per day. Data were drawn from five waves of quantitative surveys (January 2023 to February 2024; <em>n</em> = 20), two years of program records (January 2022 to February 2024; <em>N</em> = 35), and qualitative interviews (<em>n</em> = 14). Hierarchical mixed-effects models were used to predict alcohol use by cannabis use and time. Qualitative data were analyzed using interpretive description methodology.</div></div><div><h3>Results</h3><div>The final model found evidence of a substitution effect: participants who used more cannabis on average also consumed less alcohol overall. Specifically, each additional 0.4-gram joint consumed (approximately 15.2 standard THC units or 76 mg THC) was associated with an estimated 2.43 fewer mean daily standard drinks. Within-person cannabis use was not a significant predictor, indicating that short-term fluctuations in cannabis use were not associated with concurrent changes in alcohol consumption. Alcohol use also declined over time. Qualitative findings provide insights into the dynamic factors shaping drinking and cannabis use patterns.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential for cannabis substitution to meaningfully reduce alcohol-related harms. Implications for program development and future research evaluating changes in health, wellbeing, and harm outcomes are discussed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105083"},"PeriodicalIF":4.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624525","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":"Psychedelics in the age of reproducibility: Reflections on aura, set and setting and the medicalization of mystical-type experiences","authors":"Guy Simon ,&nbsp;Nir Tadmor MD ,&nbsp;Demian Halperin","doi":"10.1016/j.drugpo.2025.105074","DOIUrl":"10.1016/j.drugpo.2025.105074","url":null,"abstract":"<div><div>Psychedelics induce transformative experiences leading to lasting changes in attitudes and behaviour, with outcomes depending on both pharmacological factors and the context of the experience (‘set and setting’), marking a paradigm shift in mental health treatment. As psychedelics transition from traditional contexts to clinical settings, tension emerges between authenticity and standardization. This article uses Walter Benjamin’s concept of “aura” (<em>The Work of Art in the Age of Mechanical Reproduction</em>) to examine what may be lost or gained when psychedelic experiences are removed from original contexts and reproduced in institutional settings. We explore how set and setting contribute to authenticity, analyse medicalization’s implications, examine the roles of ritual and commodification, and propose ways to integrate traditional context with clinical approaches to preserve psychedelics’ transformative potential.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105074"},"PeriodicalIF":4.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624523","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":"COVID-19 vaccination uptake and risk of severe COVID-19 disease among those in, and released from, prison care in Scotland: a national cohort and case-control study","authors":"Maxim Wilkinson ,&nbsp;Alan Yeung ,&nbsp;Jennifer Bishop ,&nbsp;Ciara Gribben ,&nbsp;Bob Taylor ,&nbsp;Claire Cameron ,&nbsp;Diane Stockton ,&nbsp;Norah Palmateer ,&nbsp;Sharon Hutchinson","doi":"10.1016/j.drugpo.2025.105080","DOIUrl":"10.1016/j.drugpo.2025.105080","url":null,"abstract":"<div><h3>Objectives</h3><div>Given the potential higher risk of COVID-19 infection and disease for those incarcerated, we examined uptake of, and factors associated with vaccination, and the risks of severe disease for those in, and released from, prison in Scotland.</div></div><div><h3>Methods</h3><div>During follow-up (01/03/2020 to 13/04/2022), vaccine uptake among ∼15,000 individuals in prison, and following release, was compared with general population matched controls. Conditional logistic regression was used to compare prison status of ∼72,000 individuals admitted or died due to COVID-19 during follow-up to matched controls.</div></div><div><h3>Results</h3><div>By the end of follow-up, similar vaccine uptake was observed among those in prison (dose 1: 73.4 %, dose 2: 64.2 % and dose 3: 43.4 %) compared to matched controls (72.9 %, 67.9 % and 48.7 %). Individuals released (with &lt;14 days incarcerated) were less likely to receive a first dose (aOR: 0.57, CI: 0.52, 0.66) than those who remained in prison. Following first and second doses, those released during the subsequent 12 weeks were less likely to receive their subsequent dose compared to those continuously incarcerated (aORs: 0.48, CI: 0.43, 0.54; 0.35, CI: 0.31, 0.40, respectively). Compared to the wider community outside prison, those incarcerated and recently released were more likely to be admitted or die from COVID-19 (aORs: 3.08, CI: 2.58, 3.69; and 4.53, CI: 3.37, 6.09, respectively).</div></div><div><h3>Conclusions</h3><div>Our findings highlight the important role of prisons in facilitating rapid high coverage of vaccination, involving accelerated schedules where appropriate, to help mitigate the raised risk of severe disease outcomes among both those incarcerated and released into the community.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105080"},"PeriodicalIF":4.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624524","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":"A scoping review and concept analysis to inform Canada’s safe(r) opioid supply research agenda","authors":"Uyen Do ,&nbsp;Sarah Larney ,&nbsp;Matthew Bonn ,&nbsp;Ingrid Matei ,&nbsp;Camille Zolopa ,&nbsp;Amy Bergeron ,&nbsp;Mohammad Karamouzian ,&nbsp;Elaine Hyshka ,&nbsp;Thomas D. Brothers ,&nbsp;Nikki Bozinoff ,&nbsp;Dan Werb ,&nbsp;Didier Jutras-Aswad ,&nbsp;Stine Høj ,&nbsp;Isabelle Boisvert ,&nbsp;Igor Yakovenko ,&nbsp;Julie Bruneau","doi":"10.1016/j.drugpo.2025.105070","DOIUrl":"10.1016/j.drugpo.2025.105070","url":null,"abstract":"<div><h3>Background</h3><div>Providing pharmaceutical opioid medications as alternatives to the unregulated drug market, commonly referred to as safe supply or safer supply (hereafter “safe(r) supply”), has emerged as a harm reduction strategy in Canada, with wide variation in principles and implementation. We aimed to clarify the concept of safe(r) opioid supply across harm-reduction and clinical contexts.</div></div><div><h3>Methods</h3><div>We conducted a scoping review and concept analysis. We systematically searched six major electronic databases and the grey literature to identify articles published between 2010 and 2024. Informed by Walker and Avant’s concept analysis methodology, we extracted definitions and descriptions of programs and interventions, organizing key characteristics into thematic dimensions to develop a framework distinguishing various care approaches.</div></div><div><h3>Results</h3><div>Our review included 95 articles. Safe(r) supply operationalizes under two broad approaches: a medicalized/prescribed approach (‘safer supply’) and a non-medicalized/community-based approach (‘safe supply’). We outlined three illustrative cases that nest within these approaches: (1) Prescribed opioids with opioid agonist therapy (OAT) offered and/or co-prescribed, (2) Prescribed opioids without OAT, (3) Community-based distribution of unregulated drugs with known composition.</div></div><div><h3>Conclusion</h3><div>Safe(r) supply encompasses prescribed opioid alternatives interventions (safer supply) and non-medicalized (safe supply) approaches with shared antecedents but distinct attributes and consequences. This study highlights the need to better define and standardize the parameters of safer supply approaches, including population, dosing, and intended objectives, to enable a more precise assessment of their potential benefits and risks. This nuanced understanding is crucial for developing evidence-based strategies in response to Canada’s drug poisoning crisis.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105070"},"PeriodicalIF":4.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606914","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":"Characterizing non-fatal overdose among people who inject drugs in India: prevalence and risk factor analysis, 2022-2024","authors":"Mihili P. Gunaratne ,&nbsp;Talia A. Loeb ,&nbsp;Allison M. McFall ,&nbsp;Lakshmi Ganapathi ,&nbsp;Jiban J. Baishya ,&nbsp;Ashwini Kedar ,&nbsp;Archit K. Sinha ,&nbsp;Aylur K. Srikrishnan ,&nbsp;Sunil S. Solomon ,&nbsp;Gregory M. Lucas ,&nbsp;Shruti H. Mehta","doi":"10.1016/j.drugpo.2025.105073","DOIUrl":"10.1016/j.drugpo.2025.105073","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal overdose strongly predicts future fatal overdose, yet limited prior work describes the burden among people who inject drugs (PWID) in India. We estimated prevalence and identified correlates of non-fatal overdose among PWID from India.</div></div><div><h3>Methods</h3><div>We conducted respondent-driven sampling (RDS) surveys among PWID across 6 Indian cities (n∼750/site; Amritsar, Bilaspur, Churchandpur, Delhi, Kanpur, and Ludhiana) during 2022–2024. Prevalence of non-fatal overdose in the prior 6 months and non-mutually exclusive events following the overdose were estimated using RDS-weighted descriptive statistics. Correlates (i.e., sociodemographics, HIV and hepatitis C status, substance use in the prior 6 months, and psychosocial symptoms) were assessed using multilevel logistic regression.</div></div><div><h3>Results</h3><div>Prevalence of non-fatal overdose was 8.8% among 4495 PWID. Factors significantly associated with overdose included daily or seasonal employment (vs. monthly or weekly wages), hepatitis C antibody positive status, witnessing a fatal overdose, injecting 3 or more times per day (vs. 1–2 times per day), concurrent use of heroin and stimulants (vs. buprenorphine or other prescription opioids only), hazardous alcohol use, attending a medical facility for addiction or detoxification, and experiencing mild or depressive symptoms (vs. none). Following the overdose, 44.7% reported help from a friend or family member, 25.5% reported nothing happened, 12.9% went to a hospital, and 5.6% were referred to drug treatment or detoxification.</div></div><div><h3>Conclusions</h3><div>We observed a variable burden of non-fatal overdose associated with high injection frequency, combination drug use, alcohol use, attending medical detoxification, and depressive symptoms. Low levels of subsequent linkage to treatment services suggest opportunities to improve overdose prevention and management.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105073"},"PeriodicalIF":4.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580413","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":"A response to Weatherburn et al. (2025) ‘Risky alcohol use and violence against women: cause or consequence?’","authors":"Megan Cook,&nbsp;Amy Pennay,&nbsp;Sarah Callinan","doi":"10.1016/j.drugpo.2025.105077","DOIUrl":"10.1016/j.drugpo.2025.105077","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105077"},"PeriodicalIF":4.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580412","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":"Quantitative controls on the number and/or location of alcohol retail outlets: an overview of approaches in the USA and Canada","authors":"Robyn Burton ,&nbsp;Pamela Trangenstein ,&nbsp;Megan Cook ,&nbsp;Niamh Fitzgerald ,&nbsp;James Nicholls","doi":"10.1016/j.drugpo.2025.105075","DOIUrl":"10.1016/j.drugpo.2025.105075","url":null,"abstract":"<div><h3>Background</h3><div>Regulatory approaches to alcohol availability vary widely, yet policies that control the number or location of alcohol retail outlets remain under-documented. This study aimed to identify and describe these approaches across jurisdictions in the USA and Canada.</div></div><div><h3>Methods</h3><div>A two-stage document analysis was conducted for all 50 states, 10 Canadian provinces, and three Canadian territories (jurisdictions). Relevant legislative documents were identified and reviewed, with data extracted on policies establishing quantitative thresholds on either total outlet numbers (including outright prohibition), outlets numbers per population, distances between alcohol retail outlets, or distances between alcohol retail outlets and sensitive locations such as schools. Data collection took place between March and May 2024.</div></div><div><h3>Results</h3><div>Among 63 jurisdictions, 56 (88.9 %) used at least one approach to limiting the number and/or location of alcohol retail outlets, with 39 (61.9 %) using two or more. The most common approach (63.5 % of jurisdictions) was limiting minimum distances between outlets and specific locations, such as schools or places-of-worship. Population-based limits on outlet density were used by 44.4 % of jurisdictions, but thresholds varied substantially, (e.g. from 1.36 to 200 outlets per 100,000 population for on-sales, and 5.00 to 200 per 100,000 population for off-sales). Nearly half of all jurisdictions (47.6 %) had at least one dry county or area, while a smaller proportion (17.5 %) set minimum distances between outlets to prevent clustering. Fixed caps on the absolute number of outlets, regardless of population size, were least common (12.7 %).</div></div><div><h3>Conclusion</h3><div>Quantitative controls on the number and/or location of alcohol retail outlets are widely used across the USA and Canada but vary significantly in structure and stringency. While some jurisdictions impose multiple controls, others apply none. Understanding these policy approaches provides insight into regulatory frameworks but does not indicate enforcement levels or public health impact. Further research could examine how these measures are implemented and whether different models influence alcohol availability.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105075"},"PeriodicalIF":4.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574729","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":"Young adults’ sourcing and supply of opioids in a changing drug market","authors":"Maj Nygaard-Christensen ,&nbsp;Thomas Friis Søgaard ,&nbsp;Esben Houborg ,&nbsp;Birgitte Thylstrup","doi":"10.1016/j.drugpo.2025.105072","DOIUrl":"10.1016/j.drugpo.2025.105072","url":null,"abstract":"<div><h3>Background</h3><div>In Denmark, rising concern over young people’s non-prescribed use of opioids such as tramadol and oxycodone has fueled media narratives invoking predatory suppliers and vulnerable youth, with a key emphasis on kiosks and social media as venues that make opioids immediately accessible to young people. To inform effective policy responses, more nuanced, empirically grounded understandings of youth opioid sourcing are needed.</div></div><div><h3>Methods</h3><div>The article draws on qualitative data from a Danish study on non-prescribed use of tramadol and oxycodone among treatment-enrolled young adults and stakeholders in prevention and treatment. We analyze interviews with 30 young adults (20 male, 10 female, aged 18–32, median age 24.2) enrolled in municipal opioid agonist treatment (OAT) across eight municipalities. Interviews explored pathways into use, treatment experiences, and sourcing practices. This analysis centers on data related to acquisition, with attention to the role of social networks in facilitating access to non-prescribed opioids.</div></div><div><h3>Results</h3><div>Participants were predominantly young adults with prior experience of illegal drug use, often involving early initiation and poly-drug experimentation. The majority were introduced to opioids by friends or acquaintances and continued sourcing opioids through social networks, in addition to kiosks, online platforms, and prescriptions. Several participants had also engaged in small-scale sales or smuggling, often through existing relationships or to support their own use. Fluid boundaries between use and supply were common.</div></div><div><h3>Conclusion</h3><div>The study shows that young adults access opioids from a variety of sources that often start with sourcing opioids through social networks, especially during the early stages of use. These insights call for nuanced prevention strategies that move beyond individual consumer models and address the complex social dynamics of non-prescribed opioid access and use.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105072"},"PeriodicalIF":4.4,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528056","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}