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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 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 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 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 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 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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引用次数: 0
Initiation, cessation and resumption of attendance at the Melbourne supervised injecting room among a cohort of people who inject drugs 一群注射毒品的人开始,停止和恢复出席墨尔本监督注射室
IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2026-01-15 DOI: 10.1016/j.drugpo.2026.105150
Ashleigh C Stewart , Kasun Rathnayake , Adelina Artenie , Matthew Hickman , Jack Stone , Daniel O’Keefe , Thomas Kerr , Paul Agius , Amanda Roxburgh , Peter Higgs , Lisa Maher , Nico Clark , Belinda Bravo , Mark Stoove , Paul M Dietze

Background

Supervised injecting facilities (SIFs) reduce drug-related harms and associated costs, but evidence is limited to a few settings. This study estimates rates of initiation, cessation, and resumption of Melbourne’s Medically Supervised Injecting Room (MSIR) use among a cohort of people who inject drugs.

Methods

Data were drawn from SuperMIX, an ongoing cohort study since 2008. Participants complete baseline and annual surveys, including MSIR use since its opening on 30 June 2018. We reported baseline characteristics and calculated incidence rates (IRs) of MSIR initiation, cessation, and resumption, stratified by recent homelessness and opiate agonist therapy (OAT) use, per 1000 person-years (PY).

Results

Of 1650 eligible participants, 685 (42%) reported MSIR use at baseline. MSIR attenders were slightly older (median 43 vs. 41 years) and less often female (28% vs. 35%) than non-attenders. Most (71%) were infrequent attenders (<50% injections at MSIR). Frequent attenders (n = 202) injected more often (median monthly injections = 50) than infrequent (median = 30) and non-attenders (median = 20). The MSIR initiation rate was 525 per 1000 PY, similar between frequent and infrequent attenders (RR 1.10, 95% CI 0.94–1.28). The cessation rate was 264 per 1000 PY, with no difference between attendance groups (RR 1.11, 95% CI 0.60–2.04). The resumption rate was 250 per 1000 PY, also similar across infrequent and frequent attenders (RR 0.99, 95% CI 0.47–2.09).

Conclusions

We found high MSIR service uptake, relative to cessation. Attendance was higher among men, Aboriginal and/or Torres Strait Islander people, and those recently homeless, with frequent attenders injecting more often and those on OAT less likely to attend frequently.
背景:监督注射设施(SIFs)减少了与毒品相关的危害和相关成本,但证据仅限于少数情况。本研究估计了墨尔本医学监督注射室(MSIR)在注射毒品人群中开始、停止和恢复使用的比率。方法数据来自SuperMIX,这是一项自2008年以来正在进行的队列研究。参与者完成基线和年度调查,包括自2018年6月30日开业以来的MSIR使用情况。我们报告了基线特征并计算了MSIR开始、停止和恢复的发生率(IRs),并根据最近的无家可归和阿片激动剂治疗(OAT)的使用进行了分层,每1000人年(PY)。在1650名符合条件的参与者中,685名(42%)报告在基线时使用了MSIR。MSIR参与者比非参与者年龄稍大(中位43岁对41岁),女性较少(28%对35%)。大多数(71%)是不经常参加(50%在MSIR注射)。频繁参与者(n = 202)比不频繁参与者(n = 30)和非参与者(n = 20)更频繁地注射(每月注射中位数= 50)。MSIR起始率为525 / 1000 PY,在频繁和不频繁的参与者之间相似(RR 1.10, 95% CI 0.94-1.28)。戒烟率为264 / 1000 PY,出勤组之间无差异(RR 1.11, 95% CI 0.60-2.04)。复诊率为250 / 1000 PY,在不经常和经常出席者之间也相似(RR 0.99, 95% CI 0.47-2.09)。结论:我们发现相对于戒烟,MSIR服务的接受程度较高。男性、土著和/或托雷斯海峡岛民以及最近无家可归的人的出勤率更高,经常注射的人更频繁,而服用OAT的人不太可能频繁参加注射。
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引用次数: 0
Between efficacy and ambivalence: Family perceptions of Methadone Maintenance Therapy in Malaysia 在疗效和矛盾心理之间:马来西亚家庭对美沙酮维持治疗的看法
IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2026-01-14 DOI: 10.1016/j.drugpo.2026.105149
Yafizah Yahaya , Fathima Begum Syed Mohideen , Nizam Baharom , Anu Suria Ganason , Nathratul Ayeshah Zulkifli , Norsiah Ali , Nor Hazlin Talib , Engku Aiman Engku Mohd Fauzi , Nor Adam Roslan , Nik Nurshaheedah Nik Mutasim , Junaidi Jais

Background

Opioid dependence remains a major health and social challenge in Malaysia. Methadone Maintenance Therapy (MMT), introduced nationally in 2005, has demonstrated effectiveness in reducing illicit opioid use, HIV transmission, and improving quality of life. This study addresses a critical gap by exploring family members' perceptions of MMT, a crucial yet understudied factor in recovery within Malaysia's collectivist culture.

Methods

A qualitative study using an interpretive phenomenological approach was conducted. Twenty immediate family members of MMT clients were purposively recruited from two One-Stop Centre for Addictions (OSCA) primary care clinics in Malaysia. In-depth interviews were conducted in Malay or English, audio-recorded, transcribed verbatim, and analysed thematically using NVivo 12.

Results

Participants’ mean age was 39.7 years. Most were spouses (60%), followed by mothers (20%), siblings (15%), and one daughter (5%), with 90% cohabiting with the MMT client. Three key themes emerged: (1) restored functionality and social reintegration, including improved emotional regulation, cessation of violence, and return to employment; (2) familial validation of MMT efficacy, with recognition of reduced cravings, absence of withdrawal symptoms, and behavioural evidence of abstinence; and (3) stigma-experience conflict, where profound ambivalence persisted due to misconceptions, safety fears, and negative social attitudes.

Conclusion

This study provides the first Malaysian evidence on family perceptions of MMT, highlighting its dual role in restoring family stability while facing persistent stigma. Family attitudes prove pivotal to treatment adherence and recovery outcomes, underscoring the urgent need for policy reform toward family-inclusive, stigma-reducing approaches within national harm reduction frameworks.
在马来西亚,类鸦片依赖仍然是一个主要的健康和社会挑战。2005年在全国推行的美沙酮维持疗法(MMT)已证明在减少非法阿片类药物使用、艾滋病毒传播和改善生活质量方面有效。本研究通过探索家庭成员对MMT的看法来解决一个关键的差距,MMT是马来西亚集体主义文化中恢复的一个关键但尚未得到充分研究的因素。方法采用解释现象学方法进行定性研究。有目的地从马来西亚两个一站式成瘾中心(OSCA)初级保健诊所招募MMT客户的20名直系亲属。深入访谈以马来语或英语进行,录音,逐字转录,并使用NVivo 12进行主题分析。结果参与者平均年龄39.7岁。大多数是配偶(60%),其次是母亲(20%),兄弟姐妹(15%)和一个女儿(5%),其中90%与MMT客户同居。出现了三个关键主题:(1)恢复功能和重新融入社会,包括改善情绪调节、停止暴力和重返就业;(2) MMT有效性的家族性验证,识别到渴望减少,没有戒断症状,以及禁欲的行为证据;(3)污名-经验冲突,由于误解、安全恐惧和消极的社会态度,深刻的矛盾心理持续存在。本研究提供了马来西亚首个关于家庭对MMT认知的证据,强调了其在面对持续耻辱的同时恢复家庭稳定的双重作用。家庭态度对治疗依从性和康复结果至关重要,这突出表明迫切需要在国家减少伤害框架内进行政策改革,采取包容家庭、减少污名的方法。
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引用次数: 0
The malleable logics of mandate: analysing uses of the term mandate in the context of a significant policy window 任务期限的延展性逻辑:分析任务期限一词在一个重要政策窗口内的用法
IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2026-01-14 DOI: 10.1016/j.drugpo.2025.105120
Paul Kelaita, Alison Ritter

Background

Mandate is a site of political framing crucial to understanding the potential in a policy window. Yet the multiple uses of the word mandate, by government and advocates, suggests a more complex array of meanings and deployments than presumed on the surface.

Objectives

In this paper we sought to analyse how mandate was variously deployed by multiple policy actors in the lead up to and at a significant drug policy window (the 2024 NSW Drug Summit). We aimed to explore its uses and meanings and how these make possible or constrain policy reform.

Methods

Data were drawn from March 2023 to April 2025, and included political documents, media documents, and material from the drug summit itself. We analysed these data using political theories of election mandates and role mandates.

Results

As a concept, mandate variously referred to the privileges and responsibilities conferred by election results, the range and meaning of election promises, and the processes of policymaking during a term of government. Mandates were operationalised through their being ‘sensed’; defined through pre-election promises that direct, limit, and defer action, and constrain scope; and derived from, variously, votes, collective decision-making, and evidence. At the summit, meanings of election promises were contested: whether the mandate was confined to (merely) holding the summit, or whether the summit could deliver a mandate for future policy reform.

Implications

The use of mandate by politicians reveals the conditions that get set around policy change. The use of mandate by advocates suggests that expectations of policy events are different to those of government. Appreciating how mandate is multiply used and comes to have effects opens avenues for maximising the opportunity in policy windows.
任务授权是一个政治框架,对于理解政策窗口期的潜力至关重要。然而,政府和支持者对“授权”一词的多次使用表明,它的含义和部署比表面上想象的要复杂得多。在本文中,我们试图分析在一个重要的毒品政策窗口(2024年新南威尔士州毒品峰会)之前和期间,多个政策参与者是如何以不同的方式部署任务的。我们的目的是探讨它的用途和意义,以及它们如何促进或制约政策改革。方法数据采集时间为2023年3月至2025年4月,包括政治文件、媒体文件和毒品峰会本身的资料。我们使用选举授权和角色授权的政治理论分析了这些数据。作为一个概念,授权指的是选举结果赋予的特权和责任、选举承诺的范围和意义,以及政府任期内的决策过程。任务是通过“感知”来实施的;通过选举前的承诺来定义,这些承诺指导、限制和推迟行动,并限制范围;并从不同的投票、集体决策和证据中得出结论。在峰会上,人们对选举承诺的含义进行了争论:授权是否仅限于(仅仅)举行峰会,或者峰会是否可以为未来的政策改革提供授权。政治家使用授权揭示了围绕政策变化所设定的条件。倡导者使用授权表明,对政策事件的期望与政府的期望不同。了解授权是如何被多重使用并产生效果的,为最大限度地利用政策窗口期的机会开辟了途径。
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引用次数: 0
Reproductive health consequences of criminal legal involvement for women who use drugs in Taiwan 台湾吸毒妇女的刑事法律介入对生殖健康的影响。
IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2026-01-13 DOI: 10.1016/j.drugpo.2025.105135
Tan-Wen Hsieh , Wenmay Rei , Rosetta Siew , Sheng-Chang Wang , Chuan-Yu Chen

Background

Criminal legal responses to drug use may carry unintended consequences for women’s reproductive health, particularly in systems where punitive and health-oriented approaches coexist. This study explores how criminal legal involvement—both past contact and intervention stages—affects reproductive outcomes for young women who use drugs in Taiwan.

Methods

We conducted a retrospective cohort study of 4601 women aged 18–29 arrested for Schedule II drug use (predominantly meth/amphetamine) between 2011 and 2015. National police, health insurance, birth registration, and drug intervention datasets were linked to assess three outcomes: time to post-arrest pregnancy, pregnancy loss, and delayed initiation of prenatal care. Time-dependent Cox proportional hazard models and logistic regressions were used to estimate the associations.

Results

Over a three-year follow-up, nearly one-third of young women became pregnant after arrest. Among first post-arrest pregnancies (n = 1367), one-third ended in loss, and 9.2 % of live births lacked timely first-trimester care. Women without prior drug offenses were more likely to conceive soon after arrest (aHR = 1.25, 95 % CI: 1.10–1.43), while pregnancy hazard declined during deferred prosecution (aHR = 0.73, 95 % CI: 0.61–0.88). The incident offense was associated with a 28 % higher risk of pregnancy loss, despite reducing the odds of delayed prenatal care (aOR = 0.48, 95 % CI: 0.28–0.81).

Discussion

These findings reveal how the criminal legal system's involvement shapes reproductive health outcomes among women who use drugs. Early prosecutorial stages represent a pivotal window to integrate reproductive healthcare, reduce maternal risks, and support recovery.
背景:对吸毒的刑事法律反应可能对妇女生殖健康产生意想不到的后果,特别是在惩罚和以健康为导向的方法并存的系统中。本研究探讨刑事法律介入(包括过往接触及介入阶段)如何影响台湾年轻吸毒女性的生殖结果。方法:我们对4601名年龄在18-29岁的女性进行了一项回顾性队列研究,这些女性在2011年至2015年间因使用附表II药物(主要是冰毒/安非他明)而被捕。将国家警察、医疗保险、出生登记和药物干预数据集联系起来,以评估三个结果:停止妊娠后的时间、妊娠丢失和延迟开始产前护理。使用时间相关的Cox比例风险模型和逻辑回归来估计相关性。结果:在三年的随访中,近三分之一的年轻女性在被捕后怀孕。在首次停搏后妊娠(n = 1367)中,三分之一以流产告终,9.2%的活产缺乏及时的妊娠早期护理。无毒品前科的妇女在被捕后更容易怀孕(aHR = 1.25, 95% CI: 1.10 ~ 1.43),而延迟起诉期间怀孕风险下降(aHR = 0.73, 95% CI: 0.61 ~ 0.88)。尽管延迟产前护理的几率降低,但事件性犯罪与流产风险增加28%相关(aOR = 0.48, 95% CI: 0.28-0.81)。讨论:这些发现揭示了刑事司法系统的介入如何影响吸毒妇女的生殖健康结果。早期起诉阶段是整合生殖保健、减少产妇风险和支持康复的关键窗口。
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引用次数: 0
Drug policy and culture: A cross-national comparative study using Hofstede’s index 毒品政策与文化:利用Hofstede指数的跨国比较研究
IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2026-01-08 DOI: 10.1016/j.drugpo.2025.105132
Shazib Altaf , Jusung Lee , Sugy Choi , Sujeong Park

Background

National drug policies vary widely across countries, shaped by historical, institutional, economic, and social factors. However, the role of cultural values in shaping drug policies remains underexplored. This study applies Hofstede’s cultural dimensions index to assess associations between national cultural norms and Global Drug Policy Index (GDPI) scores.

Methods

We conducted a cross-national comparative analysis using data from 25 countries with both GDPI scores and Hofstede’s cultural dimension scores in 2021. The dependent variable was the GDPI overall score and four sub-indices: Absence of Extreme Sentencing, Proportionality of the Criminal Justice Response, Health and Harm Reduction, and Access to Controlled Medicines. Independent variables included four Hofstede dimensions: Power Distance, Individualism, Masculinity, and Uncertainty Avoidance. Control variables included GDP per capita (log), cannabis prevalence, continent dummies, and opium/coca production status. Ordinary least squares (OLS) regressions with robust standard errors were used.

Results

Higher Power Distance was associated with lower overall GDPI scores (β = -0.296, p = 0.015), as well as with the Absence of Extreme Sentencing, and Access to Controlled Medicines indicators, suggesting that hierarchical societies tend to adopt more punitive and restrictive drug policies. Uncertainty Avoidance was positively associated with Access to Controlled Medicines (β = 0.234, p = 0.051). Higher cannabis prevalence showed consistent positive associations with progressive policy outcomes, while regional variation was evident, particularly in Europe and the Americas.

Conclusion

This study highlights the role of cultural values in shaping national approaches to drug policy, with power distance and uncertainty avoidance emerging as significant factors. Higher cannabis prevalence, a reflection of the epidemiological context, was also associated with more progressive policy outcomes. Policymakers should consider cultural and public health factors when designing drug strategies, particularly in hierarchical societies, where specific reforms may be needed to limit punitive laws and expand access to essential treatments.
受历史、体制、经济和社会因素的影响,各国的国家毒品政策差别很大。然而,文化价值观在制定毒品政策方面的作用仍未得到充分探讨。本研究采用Hofstede的文化维度指数来评估国家文化规范与全球毒品政策指数(GDPI)得分之间的关系。方法我们使用来自25个国家的数据进行了跨国比较分析,这些数据包括2021年的gdp得分和Hofstede文化维度得分。因变量是国内生产总值总体得分和四个子指数:没有极端判决,刑事司法反应的比例性,健康和减少伤害,以及获得管制药物。自变量包括四个Hofstede维度:权力距离、个人主义、男子气概和不确定性规避。控制变量包括人均国内生产总值(log)、大麻流行率、大陆假体和鸦片/古柯生产状况。采用具有稳健标准误差的普通最小二乘(OLS)回归。结果较高的权力距离与较低的总体gdp得分相关(β = -0.296, p = 0.015),并且与缺乏极端判决和获取管制药物指标相关,表明等级社会倾向于采取更具惩罚性和限制性的药物政策。不确定性规避与管制药物可及性呈正相关(β = 0.234, p = 0.051)。较高的大麻流行率与渐进式政策结果显示出一致的积极关联,而区域差异很明显,特别是在欧洲和美洲。结论本研究强调了文化价值观在制定国家毒品政策方面的作用,其中权力距离和不确定性规避成为重要因素。大麻流行率较高,反映了流行病学背景,也与更进步的政策成果有关。决策者在制定药物战略时应考虑文化和公共卫生因素,特别是在等级社会中,在那里可能需要进行具体改革,以限制惩罚性法律和扩大获得基本治疗的机会。
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引用次数: 0
期刊
International Journal of Drug Policy
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