International Journal of Drug Policy最新文献_第5页

Challenges in managing driving licence legislation when using B-Phosphatidylethanol to identify high levels of alcohol use in primary care patients: A qualitative study 当使用b -磷脂酰乙醇识别初级保健患者的高水平酒精使用时，管理驾驶执照立法的挑战：一项定性研究

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-02 DOI: 10.1016/j.drugpo.2025.105130

Åsa Steensland , Lisa Kastbom , Björn Johnson , Mårten Larsson , Markus Heilig , Anna Segernäs , Andrea Johansson Capusan

Introduction

Swedish physicians have conflicting obligations when managing harmful alcohol use. They are responsible for identification and treatment, while also being legally required to report unfit driving licence holders. B-Phosphatidylethanol (PEth) is a reliable and specific biomarker for alcohol use and a useful tool in the assessment. We explored general practitioners’ experiences of using PEth in the context of their legal obligation to report patients with certain alcohol-related disorders to the Swedish Transport Agency.

Methods

Individual interviews were conducted with physicians (n = 20) from 10 primary healthcare centres with different patterns of PEth utilisation. Interview data were analysed using qualitative content analysis.

Results

Results encompassed three categories: 1. Struggling to implement the regulations: difficulties in assessing driving fitness when PEth test results indicated high alcohol intake; 2. Managing reactions and roles: physicians struggled to balance legal obligation while maintaining a confidential physician-patient relationship; 3. Navigating dilemmas arising from implementing the regulations: regulations were burdensome to apply and diverse strategies emerged, where some physicians refrained from PEth testing and others avoided reporting. Some relied on standardised management approaches or used the obligation to report as a motivating factor for patients to reduce their alcohol use.

Conclusions

The results reveal that difficulties in complying with the legal obligation to report unfit drivers prevent the systematic use of PEth, obstructing the identification of harmful alcohol use and dependence. Clearer guidance on the implementation of the driving licence regulations and the clinical use of PEth are necessary to support physicians in handling this complex issue.

在管理有害酒精使用时，瑞典医生有相互矛盾的义务。他们负责识别和治疗，同时法律也要求他们报告不健康的驾驶执照持有人。b -磷脂酰乙醇（PEth）是一种可靠、特异的酒精使用生物标志物，也是一种有用的评估工具。我们探讨了全科医生在向瑞典运输局报告患有某些酒精相关疾病的患者的法律义务的背景下使用PEth的经验。方法对来自10个不同使用方式的初级卫生保健中心的医生（n = 20）进行个人访谈。访谈资料采用定性内容分析法进行分析。结果结果包括三大类：1.结果；难以实施法规：当PEth测试结果显示酒精摄入量高时，难以评估驾驶健康；2. 管理反应和角色：医生努力平衡法律义务，同时保持保密的医患关系；3. 应对因实施条例而产生的困境：条例的实施负担沉重，出现了各种各样的策略，一些医生避免进行苯二甲酸乙二醇酯检测，另一些医生避免报告。有些依靠标准化的管理方法，或将报告义务作为促使患者减少饮酒的激励因素。结论报告不健康驾驶员的法律义务难以遵守，阻碍了对有害酒精使用和依赖的识别。有必要就驾驶执照条例的实施和临床使用PEth提供更明确的指导，以支持医生处理这一复杂问题。

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引用次数: 0

Initiation, retention, and discontinuation of extended-release buprenorphine (BUP-XR) for opioid dependence: A single-arm multi-site trial in Ukraine 阿片类药物依赖缓释丁丙诺啡（BUP-XR）的开始、保留和停止：乌克兰的一项单臂多地点试验

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-02 DOI: 10.1016/j.drugpo.2025.105107

Sofiia Ohorodnik , Kyle Conroy , Kostyantyn Dumchev , Andrii Ptashchenko , Valeriia Gritsenko , Iryna Ivanchuk , Olga Morozova

Background

Opioid agonist therapy (OAT) is an essential tool for reducing illicit opioid use and mortality. Extended-release formulations of buprenorphine (BUP-XR) show promise in improving adherence and increasing treatment uptake, but real-world studies show mixed results. Previous studies of BUP-XR were conducted in high-income countries. This study aims to evaluate BUP-XR initiation, retention and dropout in the context of Ukraine.

Methods

A 12-months prospective single-arm, multicenter, open-label trial was conducted among 181 participants switching from sublingual buprenorphine (BUP-SL) to monthly BUP-XR injections (CAM2038/Buvidal^Ⓡ) between February-July 2023 across 10 cities of Ukraine. Correlates of BUP-XR discontinuation due to OAT dropout and switch to BUP-SL were analyzed using competing risks cluster-robust Cox proportional hazards regression models with time-varying covariates.

Results

Despite initial interest, BUP-XR enrollment was low: 273 patients among approximately 2300 eligible agreed to switch to BUP-XR. 80 % received 2 or more, 54 % – 7 or more, and 44 % – 13 or more BUP-XR injections. By the 13th injection, 30 % switched to BUP-SL and 26 % discontinued OAT with distinct set of correlates for the two dropout reasons. 13 % of participants were prescribed supplemental BUP-SL. 74 % of participants starting on the lowest dose (64 mg) had their BUP-XR dose subsequently increased.

Conclusion

BUP-XR uptake and retention in Ukraine were lower than expected in the volatile wartime context. Availability of take-home dosing may reduce the perceived benefits of BUP-XR. Revising clinical guidelines on BUP-XR dosing, dose adjustment, and supplemental BUP-SL prescriptions may reduce the occurrence of opioid withdrawal and improve retention.

背景：类阿片激动剂治疗（OAT）是减少非法阿片类药物使用和死亡率的重要工具。丁丙诺啡缓释制剂（BUP-XR）在改善依从性和增加治疗吸收方面表现出希望，但实际研究显示结果好坏参半。以前对BUP-XR的研究是在高收入国家进行的。本研究旨在评估乌克兰背景下BUP-XR的启动，保留和退出。方法在2023年2月至7月期间，在乌克兰10个城市进行了一项为期12个月的前瞻性单组、多中心、开放标签试验，共有181名参与者从丁丙诺啡（BUP-SL）改为每月注射BUP-XR （CAM2038/BuvidalⓇ）。使用具有时变协变量的竞争风险聚类-鲁棒Cox比例风险回归模型分析了因OAT退出而停用BUP-XR并切换到BUP-SL的相关因素。尽管最初对BUP-XR有兴趣，但BUP-XR的入组率很低：在大约2300名符合条件的患者中，有273名患者同意改用BUP-XR。80%接受2次或以上注射，54% - 7次或以上注射，44% - 13次或以上注射。到第13次注射时，30%的人改用BUP-SL， 26%的人因两种不同的相关原因停用OAT。13%的参与者服用补充性BUP-SL。74%的参与者开始服用最低剂量（64毫克），他们的BUP-XR剂量随后增加。结论在乌克兰动荡的战时环境下，bup - xr的吸收和保留低于预期。可带回家的剂量可能会降低BUP-XR的预期益处。修订BUP-XR给药、剂量调整和补充BUP-SL处方的临床指南可能会减少阿片类药物戒断的发生并改善滞留。

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引用次数: 0

Las ‘Guías para el Uso de Cannabis de Menor Riesgo (GUCMR)’: RECOMENDACIONES [The ‘Lower-Risk Cannabis Use Guidelines (LRCUG)’: RECOMMENDATIONS (SPANISH)] 《低风险大麻使用指南》：建议（西班牙文）

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2023.103996

Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall

引用次数: 0

Exploring THC labelling preferences to communicate the strength of cannabis products: Insights from U.S. consumers 探索四氢大麻酚标签偏好以传达大麻产品的强度：来自美国消费者的见解。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2025.105076

Danielle Dawson , Wayne Hall , Isabella Goodwin , Beatriz H. Carlini , Dan I. Lubman , David Hammond , Tom P Freeman , Valentina Lorenzetti

Background: As cannabis policies have become more liberalized internationally, cannabis products have become increasingly accessible, diversified and potent as indicated by the amount of delta-9-tetrahydrocannabinol (THC) they contain. The THC content of cannabis products is often inconsistently reported, limiting opportunities to inform consumers about health risks and safer consumption practices. We explored consumers’ preferences on the type of THC information (i.e., standard units, concentration, total content) that should be displayed on cannabis products in legal markets. Methods: A convenience sample of 575 adults from various U.S. states who reported cannabis use within the past 12 months was recruited via Amazon Mechanical Turk. Respondents completed a survey assessing cannabis use and related attitudes, which included a subsection focused on potential metrics that could be used to report THC content. Descriptive and inferential statistical analyses were conducted. Results: Majority of respondents considered it important for cannabis products to include information on Standard THC Units (e.g., 5 milligrams of THC), THC concentration (%), or the total content of THC on cannabis product labels. When comparing Standard THC Units, THC concentration or both options, Standard THC Units were the preferred metric, p<.001. Consumer preferences for these three metrics did not signficantly differ across U.S. state cannabis policy environments, sex, and frequency of cannabis use when compared using multinomial logistic regression. Conclusions: These exploratory findings preliminarily support the potential value of standardized THC dose labelling, particularly in the form of a standardized metric such as the Standard THC Unit, as a tool to better inform consumer decision-making and promote safer patterns of use. The findings require replication in more representative samples using additional THC metrics, including but not limited to, THC milligrams as a response option.

背景：随着大麻政策在国际上变得更加自由化，大麻产品变得越来越容易获得、多样化和有效，其所含的德尔塔-9-四氢大麻酚（THC）的含量表明了这一点。大麻产品中四氢大麻酚含量的报告往往不一致，限制了向消费者通报健康风险和更安全消费做法的机会。我们探讨了消费者对合法市场上大麻产品上应该显示的四氢大麻酚信息类型（即标准单位、浓度、总含量）的偏好。方法：通过亚马逊土耳其机器人招募了来自美国各州的575名报告在过去12个月内使用大麻的成年人作为方便样本。受访者完成了一项评估大麻使用情况和相关态度的调查，其中包括一项侧重于可用于报告四氢大麻酚含量的潜在指标的分节。进行描述性和推断性统计分析。结果：大多数答复者认为大麻产品必须在大麻产品标签上包括四氢大麻酚标准单位（例如，五毫克四氢大麻酚）、四氢大麻酚浓度（%）或四氢大麻酚总含量的信息。在比较标准四氢大麻酚单位、四氢大麻酚浓度或两者的选择时，标准四氢大麻酚单位是首选的度量单位。结论：这些探索性发现初步支持了标准化四氢大麻酚剂量标签的潜在价值，特别是以标准四氢大麻酚单位等标准化度量单位的形式，作为更好地告知消费者决策和促进更安全使用模式的工具。研究结果需要在更有代表性的样本中使用额外的四氢大麻酚指标进行复制，包括但不限于四氢大麻酚毫克作为响应选项。

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引用次数: 0

Second-wave mutual-help groups: Examining effectiveness for individuals with alcohol use disorders in the longitudinal, U.S. national PAL Study cohorts 第二波互助小组：在美国国家PAL纵向研究队列中检查酒精使用障碍个体的有效性。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2025.104921

Sarah E. Zemore , Camillia K. Lui , Amy A. Mericle , Libo Li , Priscilla Martinez , Christine Timko

Background

Second-wave mutual-help groups (MHGs) for addiction (e.g., SMART Recovery) are prevalent and promising, but limited studies have examined their effectiveness. We examined 1) the comparative effectiveness of second-wave MHGs for supporting alcohol use disorder recovery and 2) correlates of MHG involvement.

Methods

Data were pooled from the Peer ALternatives for Addiction (PAL) Study 2015 and 2021 Cohorts (N = 1152), which recruited adults via collaboration with MHG directors and recovery-related organizations. Eligibility criteria included U.S. residence, lifetime alcohol use disorder, and past-30-day in-person/online attendance at Women for Sobriety, LifeRing, SMART, and/or a 12-step group. Surveys were administered at baseline, 6 months, and 12 months (response rates=81–88 %), and assessed MHG choice (defined using attendance), MHG involvement (5-item scale; e.g., regular/home group, volunteering/service) and alcohol outcomes (below).

Results

In lagged, multivariate generalized estimating equations, greater MHG involvement strongly predicted higher odds of alcohol abstinence (OR=2.62, p<.001), lower odds of alcohol problems (OR=0.39, p<.01), and fewer drinking days (IRR=0.12, p<.001) at follow-ups. MHG choice was unrelated to outcomes either alone or in interaction with MHG involvement, suggesting comparable effectiveness for all second-wave MHGs (vs. 12-step). Predictors of greater MHG involvement included older age, a total abstinence (vs. other) goal, and 2015 (vs. 2021) Cohort.

Conclusions

Findings suggest comparable effectiveness for the targeted second-wave alternatives (vs. 12-step) among community members attending MHGs, indicating that alcohol service providers, courts, and policymakers should consider referring to and supporting these alternatives. Still, variation in SMART’s program across time and geography suggests caution in interpreting the results for SMART.

背景：针对成瘾的第二波互助小组（MHGs）（例如SMART Recovery）很普遍，也很有前景，但对其有效性的研究有限。我们检验了1)第二波MHG在支持酒精使用障碍康复方面的相对有效性和2)MHG参与的相关关系。方法：数据汇集自2015年和2021年同伴替代成瘾研究（PAL）队列（N = 1152），该队列通过与MHG主管和康复相关组织合作招募成年人。入选标准包括居住在美国，终生酒精使用障碍，过去30天亲自或在线参加妇女戒酒、生活、SMART和/或12步小组。调查在基线、6个月和12个月进行（应答率=81- 88%），并评估MHG选择（使用出勤率定义）、MHG参与(5项量表；例如，常规/家庭小组，志愿服务/服务)和酒精结果（见下文）。结果：在滞后的多变量广义估计方程中，更大的MHG参与强烈预测了更高的戒酒几率（OR=2.62）。结论：研究结果表明，在参加MHG的社区成员中，有针对性的第二波替代方案（与12步替代方案相比）具有相当的有效性，这表明酒精服务提供者、法院和政策制定者应考虑参考和支持这些替代方案。尽管如此，SMART项目在时间和地域上的差异表明，在解释SMART的结果时要谨慎。

{"title":"Second-wave mutual-help groups: Examining effectiveness for individuals with alcohol use disorders in the longitudinal, U.S. national PAL Study cohorts","authors":"Sarah E. Zemore , Camillia K. Lui , Amy A. Mericle , Libo Li , Priscilla Martinez , Christine Timko","doi":"10.1016/j.drugpo.2025.104921","DOIUrl":"10.1016/j.drugpo.2025.104921","url":null,"abstract":"<div><h3>Background</h3><div>Second-wave mutual-help groups (MHGs) for addiction (e.g., SMART Recovery) are prevalent and promising, but limited studies have examined their effectiveness. We examined 1) the comparative effectiveness of second-wave MHGs for supporting alcohol use disorder recovery and 2) correlates of MHG involvement.</div></div><div><h3>Methods</h3><div>Data were pooled from the Peer ALternatives for Addiction (PAL) Study 2015 and 2021 Cohorts (<em>N</em> = 1152), which recruited adults via collaboration with MHG directors and recovery-related organizations. Eligibility criteria included U.S. residence, lifetime alcohol use disorder, and past-30-day in-person/online attendance at Women for Sobriety, LifeRing, SMART, and/or a 12-step group. Surveys were administered at baseline, 6 months, and 12 months (response rates=81–88 %), and assessed MHG choice (defined using attendance), MHG involvement (5-item scale; e.g., regular/home group, volunteering/service) and alcohol outcomes (below).</div></div><div><h3>Results</h3><div>In lagged, multivariate generalized estimating equations, greater MHG involvement strongly predicted higher odds of alcohol abstinence (OR=2.62, <em>p</em><.001), lower odds of alcohol problems (OR=0.39, <em>p</em><.01), and fewer drinking days (IRR=0.12, <em>p</em><.001) at follow-ups. MHG choice was unrelated to outcomes either alone or in interaction with MHG involvement, suggesting comparable effectiveness for all second-wave MHGs (vs. 12-step). Predictors of greater MHG involvement included older age, a total abstinence (vs. other) goal, and 2015 (vs. 2021) Cohort.</div></div><div><h3>Conclusions</h3><div>Findings suggest comparable effectiveness for the targeted second-wave alternatives (vs. 12-step) among community members attending MHGs, indicating that alcohol service providers, courts, and policymakers should consider referring to and supporting these alternatives. Still, variation in SMART’s program across time and geography suggests caution in interpreting the results for SMART.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 104921"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765644","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}

引用次数: 0

Building standards of psychedelic care: Qualitative examination of expert perspectives on safety, inclusion, and accountability 迷幻药治疗标准的建立：安全性、包容性和问责制专家观点的定性检验。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2025.104938

Christina Chwyl , Adrianne R. Wilson-Poe , Kim A. Hoffman , Alissa Bazinet , Kellie Pertl , Jason B. Luoma , Don des Jarlais , Sarann Bielavitz , P. Todd Korthuis

There remain significant gaps in knowledge about best practices for facilitated psychedelic care and psychedelic-assisted therapy. To inform the development of service models that support safe and beneficial experiences, this qualitative study explored expert perspectives on current and ideal standards of care, including key practices (e.g., screening, adapting care to diverse contexts) and regulatory and research challenges that influence service delivery. Online focus groups (n = 8) were conducted with a purposive U.S. sample of people with psychedelic content knowledge expertise, including providers (psychiatrists, clinical psychologists, addiction medicine experts, and licensed/unlicensed practitioners) and harm reduction specialists. Transcripts were analyzed through Thematic Analysis team-based coding using a combined inductive-deductive approach within a semantic framework. Participants (N = 38, mean age 47 (SD = 10) years, 53 % women, 84 % white) had an average of 10 years of psychedelic service experience (SD = 11) across diverse settings, including festivals/events, service centers, and clinical, research, ceremonial, community and ‘underground’ contexts. Five key themes emerged: (1) ‘Strengthening Safety through Credibility and Accountability’; (2) ‘Advancing Culturally Responsive and Inclusive Psychedelic Care’; (3) ‘Healing in Community: The Crucial Role of Ongoing Support and Integration’; (4) ‘Ensuring Safe Psychedelic Use: Preparation, Screening, Vulnerability, and Medication Management’; and (5) ‘Providing Informed Guidance and Navigating Legal and Informational Gray Areas.’ Overall, results underscore the need for stronger provider accountability structures, culturally inclusive practices, accessible and integrated community support, robust safety and screening protocols, and clearer guidelines to help providers navigate legal complexities, ensure safety, and optimize outcomes across diverse populations.

在促进致幻剂护理和致幻剂辅助治疗的最佳实践方面，仍存在显著的知识差距。为了为支持安全和有益体验的服务模式的发展提供信息，本定性研究探讨了专家对当前和理想护理标准的看法，包括关键实践（例如，筛查、使护理适应不同情况）以及影响服务提供的监管和研究挑战。在线焦点小组（n = 8）由具有致幻剂内容知识专业知识的美国人组成，包括提供者（精神科医生、临床心理学家、成瘾医学专家和有执照/无执照的从业者）和减少危害专家。通过基于主题分析团队的编码，在语义框架内使用组合的归纳-演绎方法分析转录本。参与者（N = 38，平均年龄47 （SD = 10）岁，53%的女性，84%的白人）平均有10年的迷幻药服务经历（SD = 11），包括节日/活动、服务中心、临床、研究、仪式、社区和“地下”环境。出现了五个关键主题：(1)“以诚信和问责加强安全”；(2)“促进文化响应和包容性迷幻药护理”；(3)“社区治疗：持续支持和融合的关键作用”；(4)确保安全使用致幻剂：制备、筛选、脆弱性和药物管理；和(5)“提供明智的指导，穿越法律和信息的灰色地带。”总体而言，结果强调需要建立更强大的提供者问责结构、文化包容性实践、可获得和综合的社区支持、健全的安全和筛查协议，以及更明确的指导方针，以帮助提供者应对法律复杂性、确保安全并优化不同人群的结果。

{"title":"Building standards of psychedelic care: Qualitative examination of expert perspectives on safety, inclusion, and accountability","authors":"Christina Chwyl , Adrianne R. Wilson-Poe , Kim A. Hoffman , Alissa Bazinet , Kellie Pertl , Jason B. Luoma , Don des Jarlais , Sarann Bielavitz , P. Todd Korthuis","doi":"10.1016/j.drugpo.2025.104938","DOIUrl":"10.1016/j.drugpo.2025.104938","url":null,"abstract":"<div><div>There remain significant gaps in knowledge about best practices for facilitated psychedelic care and psychedelic-assisted therapy. To inform the development of service models that support safe and beneficial experiences, this qualitative study explored expert perspectives on current and ideal standards of care, including key practices (e.g., screening, adapting care to diverse contexts) and regulatory and research challenges that influence service delivery. Online focus groups (<em>n</em> = 8) were conducted with a purposive U.S. sample of people with psychedelic content knowledge expertise, including providers (psychiatrists, clinical psychologists, addiction medicine experts, and licensed/unlicensed practitioners) and harm reduction specialists. Transcripts were analyzed through Thematic Analysis team-based coding using a combined inductive-deductive approach within a semantic framework. Participants (<em>N</em> = 38, mean age 47 (<em>SD =</em> 10) years, 53 % women, 84 % white) had an average of 10 years of psychedelic service experience (<em>SD</em> = 11) across diverse settings, including festivals/events, service centers, and clinical, research, ceremonial, community and ‘underground’ contexts. Five key themes emerged: (1) ‘<em>Strengthening Safety through Credibility and Accountability’</em>; (2) ‘<em>Advancing Culturally Responsive and Inclusive Psychedelic Care</em><strong>’</strong>; (3) ‘<em>Healing in Community: The Crucial Role of Ongoing Support and Integration</em>’; (4) <strong>‘</strong><em>Ensuring Safe Psychedelic Use: Preparation, Screening, Vulnerability, and Medication Management’</em>; and (5) <em>‘Providing Informed Guidance and Navigating Legal and Informational Gray Areas.’</em> Overall, results underscore the need for stronger provider accountability structures, culturally inclusive practices, accessible and integrated community support, robust safety and screening protocols, and clearer guidelines to help providers navigate legal complexities, ensure safety, and optimize outcomes across diverse populations.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 104938"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849407","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}

引用次数: 0

Die ‘Richtlinien für die Risiko-Reduzierung beim Cannabiskonsum (RRRCK)’: EMPFEHLUNGEN “降低大麻使用风险指南（RRCK）”。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2023.103995

Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall

引用次数: 0

Les ‘Lignes Directrices Pour l'Usage du Cannabis à Moindre Risque (LUCMR)’: RECOMMENDATIONS [The ‘Lower-Risk Cannabis Use Guidelines (LRCUG)’: RECOMMENDATIONS (FRENCH)] 《低风险大麻使用指南》（LRCUG）：建议（法国）

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2023.103994

Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall

引用次数: 0

Scoping review of the characteristics and implementation of routine outcome monitoring and feedback for adults and young people accessing alcohol and other drug use treatment 审查成年人和年轻人接受酒精和其他药物使用治疗的特点和实施常规结果监测和反馈的范围。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2025.105071

Alison K. Beck , Leanne Hides , Robert Stirling , Briony Larance , Gabrielle Campbell , Amanda L. Baker , Suzie Hudson , John Marsden , Nina Pocuca , Jason P. Connor , Michael Farrell , Peter J. Kelly

Background

Routinely monitoring therapeutic processes and outcomes is central to evidence-based Alcohol and Other Drug (AOD) use treatment. However, it remains unclear how this routinely captured data is ‘fed back’ to AOD clinicians and clients and used to inform treatment.

Objectives

This scoping review examined evaluations of routine outcome monitoring and feedback in young people and adults accessing AOD treatment to describe: a) the nature and extent of evidence; b) the development, characteristics and use of feedback and c) implementation considerations.

Methods

A systematic search of 11 online databases produced 796 articles. Independent title/abstract and full-text screening identified 20 evaluations for inclusion. Data extraction was performed independently by two researchers.

Results

Evaluations were primarily conducted in the USA (11/20), using non-randomised designs (14/20). Understanding of feedback is complicated by heterogeneity and missing information, but commonalities included technology-assisted outcome assessment to generate immediate, weekly, multi-dimensional feedback comprising a visual representation of change across time. Explicit guidance for using feedback in AOD treatment was rare (1/20). Implementation considerations are discussed across a) fidelity and training practices, b) participant and provider experience and c) barriers and enablers.

Discussion and Conclusions

Efforts to examine how best to generate, present and use feedback to inform AOD treatment are needed. Optimising the use of feedback across treatment settings will require examination of the interplay between feedback characteristics and clinician, client and contextual variables. Improved attention to idiographic outcomes, benchmarks, diversity considerations, health literacy, treatment context, training, fidelity and the reporting of evaluations are warranted.

背景：常规监测治疗过程和结果是循证酒精和其他药物（AOD）使用治疗的核心。然而，目前尚不清楚如何将这些常规捕获的数据“反馈”给AOD临床医生和客户，并用于指导治疗。目的：本范围审查审查了获得AOD治疗的年轻人和成年人的常规结果监测和反馈评估，以描述：a)证据的性质和范围；B)反馈的发展、特点和使用；c)实施时的考虑。方法：系统检索11个在线数据库，得到796篇文献。独立的标题/摘要和全文筛选确定了20个评价纳入。数据提取由两位研究者独立完成。结果：评估主要在美国进行（11/20），采用非随机设计（14/20）。对反馈的理解因异质性和信息缺失而变得复杂，但共性包括技术辅助的结果评估，以生成即时的、每周的、多维的反馈，包括对时间变化的可视化表示。在AOD治疗中使用反馈的明确指导很少（1/20）。本文从以下几个方面讨论了实现方面的考虑：a)保真度和培训实践；b)参与者和提供者经验；c)障碍和促成因素。讨论和结论：需要努力研究如何最好地产生、呈现和使用反馈来指导AOD治疗。在治疗设置中优化反馈的使用将需要检查反馈特征与临床医生、客户和环境变量之间的相互作用。有必要更多地关注具体结果、基准、多样性考虑、保健知识、治疗背景、培训、忠诚和评估报告。

{"title":"Scoping review of the characteristics and implementation of routine outcome monitoring and feedback for adults and young people accessing alcohol and other drug use treatment","authors":"Alison K. Beck , Leanne Hides , Robert Stirling , Briony Larance , Gabrielle Campbell , Amanda L. Baker , Suzie Hudson , John Marsden , Nina Pocuca , Jason P. Connor , Michael Farrell , Peter J. Kelly","doi":"10.1016/j.drugpo.2025.105071","DOIUrl":"10.1016/j.drugpo.2025.105071","url":null,"abstract":"<div><h3>Background</h3><div>Routinely monitoring therapeutic processes and outcomes is central to evidence-based Alcohol and Other Drug (AOD) use treatment. However, it remains unclear how this routinely captured data is ‘fed back’ to AOD clinicians and clients and used to inform treatment.</div></div><div><h3>Objectives</h3><div>This scoping review examined evaluations of routine outcome monitoring and feedback in young people and adults accessing AOD treatment to describe: a) the nature and extent of evidence; b) the development, characteristics and use of feedback and c) implementation considerations.</div></div><div><h3>Methods</h3><div>A systematic search of 11 online databases produced 796 articles. Independent title/abstract and full-text screening identified 20 evaluations for inclusion. Data extraction was performed independently by two researchers.</div></div><div><h3>Results</h3><div>Evaluations were primarily conducted in the USA (11/20), using non-randomised designs (14/20). Understanding of feedback is complicated by heterogeneity and missing information, but commonalities included technology-assisted outcome assessment to generate immediate, weekly, multi-dimensional feedback comprising a visual representation of change across time. Explicit guidance for using feedback in AOD treatment was rare (1/20). Implementation considerations are discussed across a) fidelity and training practices, b) participant and provider experience and c) barriers and enablers.</div></div><div><h3>Discussion and Conclusions</h3><div>Efforts to examine how best to generate, present and use feedback to inform AOD treatment are needed. Optimising the use of feedback across treatment settings will require examination of the interplay between feedback characteristics and clinician, client and contextual variables. Improved attention to idiographic outcomes, benchmarks, diversity considerations, health literacy, treatment context, training, fidelity and the reporting of evaluations are warranted.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105071"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850631","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}

引用次数: 0

Hepatitis C treatment in a jail setting: A retrospective cohort analysis of low-barrier initiation of direct acting antivirals 监狱环境中的丙型肝炎治疗：直接作用抗病毒药物低屏障起始的回顾性队列分析

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 DOI: 10.1016/j.drugpo.2025.105125

Justin Berk, Matthew J Akiyama, Nicole Schachman, Reed Junkin, Aprotim Bhowmik, Deborah Davis, Saengnapha Williams, Josiah Rich, Matthew Murphy

Introduction

A significant proportion of individuals with hepatitis C virus (HCV) experience incarceration. Jails house individuals who are pre-trial or for short sentences and represent a critical setting to expand HCV treatment access. Low-barrier treatment models may help overcome implementation barriers to initiating treatment in jail settings. In 2021, the Rhode Island Department of Corrections began implementing low-barrier HCV treatment including take-home medications for those released before completing therapy in both a jail (pre-trial) and prison (sentenced) setting. This study aimed to evaluate response to therapy for HCV infection between individuals who initiated treatment in jail versus those who initiated in prison.

Methods

This study was an observational cohort of people receiving low-barrier HCV treatment initiation between January 2021 and September 2023 at the Rhode Island Department of Corrections. Logistic regression compared individuals who initiated therapy in jail to those initiating in prison. The primary outcome sustained virological response 12 weeks after treatment completion (SVR12).

Results

Of 160 individuals who initiated treatment during incarceration, 84 initiated in jail and 76 in prison. SVR12 was similar between individuals who initiated HCV treatment in jail (85%) and those who initiated in prison (86%). There was no statistical difference in likelihood of SVR12 between those initiating in a jail versus a prison in unadjusted bivariate analysis or an adjusted model. Individuals completing treatment in-facility were more likely to achieve SVR12.

Conclusion

Jail-based HCV treatment initiation is feasible. However, individuals released with medication face challenges in linkage to care. Improved discharge planning and community linkage are critical to post-release treatment success.

相当大比例的丙型肝炎病毒（HCV）感染者经历过监禁。监狱关押审前或刑期较短的个人，是扩大丙型肝炎病毒治疗可及性的关键场所。低障碍治疗模式可能有助于克服在监狱环境中开始治疗的实施障碍。2021年，罗德岛惩教局开始实施低屏障丙型肝炎治疗，包括为那些在监狱（审前）和监狱（判刑）环境中完成治疗前获释的人提供带回家的药物。本研究旨在评估在监狱中开始治疗的个体与在监狱中开始治疗的个体对HCV感染治疗的反应。该研究是一项观察性队列研究，研究对象是2021年1月至2023年9月在罗德岛惩教局接受低屏障丙型肝炎治疗的患者。Logistic回归比较了在监狱中开始治疗的个体和在监狱中开始治疗的个体。主要结局是在治疗完成后12周持续出现病毒学应答（SVR12）。结果160人在监禁期间开始治疗，84人在监狱开始治疗，76人在监狱开始治疗。在监狱中开始HCV治疗的个体（85%）和在监狱中开始治疗的个体（86%）之间的SVR12相似。在未调整的双变量分析或调整的模型中，在监狱中与在监狱中开始的人之间，SVR12的可能性没有统计学差异。在机构内完成治疗的个体更有可能达到SVR12。结论基于监狱启动HCV治疗是可行的。然而，药物释放的个人面临着与护理联系的挑战。改善出院计划和社区联系对释放后治疗的成功至关重要。

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引用次数: 0