International Journal of Drug Policy最新文献

{"title":"Drug use patterns and health problems among people who use drugs in Guinea-Bissau (2022): A cross-sectional survey using respondent-driven sampling","authors":"Andrew Scheibe ,&nbsp;Andreia Teixeira ,&nbsp;Mamadu Aliu Djaló ,&nbsp;Miriam Nascimento Pereira ,&nbsp;Kátia Ribeiro Barreto ,&nbsp;Ibrahima Ba ,&nbsp;Lucia Bird ,&nbsp;Jason Eligh","doi":"10.1016/j.drugpo.2024.104648","DOIUrl":"10.1016/j.drugpo.2024.104648","url":null,"abstract":"<div><h3>Background</h3><div>Little data exists on the use of cocaine, methamphetamine, tramadol and heroin or related health conditions in Guinea Bissau. We aimed to estimate drug use practices and the prevalence of selected blood-borne infections, depression and population size estimates of people who use injectable drugs in Guinea-Bissau.</div></div><div><h3>Methods</h3><div>We used respondent-driven sampling to recruit adults who use injectable drugs in this cross sectional survey in three cities (Bissau, Bafatá and Gabú) between July and September 2022. Participants completed an interviewer administered survey enquiring about sociodemographic characteristics, drug use practices and mental health. Rapid diagnostic testing was done for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV). Data was weighted in RDS-Analyst using self-reported network size and Gile's Sequential Sampling Estimator. Population size estimates were generated using the two point capture-recapture method.</div></div><div><h3>Results</h3><div>Overall, 750 participants were recruited. People who use drugs were estimated to be mostly unemployed males aged between 25 and 49 years. Methamphetamine and crack cocaine were most commonly used. Prevalence of ever injecting ranged from 6 % to 44 %. Between 44 % and 52 % of people experience symptoms of depression. Prevalence ranges from 1.9 % to 5.2 % for HIV, and 5.7–8.3 % for HBsAg and 0.42–0.66 % for anti-HCV. The population estimates of people who use injectable drugs were 1637 in Bissau, 1314 in Bafatá and 424 in Gabú.</div></div><div><h3>Conclusion</h3><div>Methamphetamine and crack cocaine are the most commonly used injectable drugs in Guinea-Bissau. Symptoms of depression are common among people who use drugs in the country. Access to evidence-based drug use treatment and harm reduction interventions that integrate mental health care services are needed to improve the health and wellbeing of people who use drugs in Guinea-Bissau.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104648"},"PeriodicalIF":4.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630570","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":"Substance use as a public health issue: A critical review of the Canadian literature, 1896–2020","authors":"Jean-François Crépault ,&nbsp;Brian Emerson ,&nbsp;Elaine Hyshka ,&nbsp;Carol Strike ,&nbsp;Robin Room ,&nbsp;Jürgen Rehm","doi":"10.1016/j.drugpo.2024.104634","DOIUrl":"10.1016/j.drugpo.2024.104634","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The risks associated with substance use can be framed in many ways. In Canada, the consumption of psychoactive substances has at various times been considered a moral, criminal, or medical issue. In the past decade, substance use has increasingly been framed as a public health issue. This study sought to trace the historical development and evolution of the concept of a public health approach to substance use in Canada through a critical review of the academic literature.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Critical review is a method designed to systematically search a body of literature, take stock of its evolution and current state, identify conceptual contributions, and compare schools of thought. Systematic searches were conducted in February and March 2023 in five English-language databases (CINAHL, Medline, PsycInfo, Scopus, Web of Science) and three French-language databases (Cairn.info, Érudit, SDM Repère). Eligible articles were written in English or French by a first author based in Canada, focused primarily on substance use, and published in 2020 or earlier.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;64 articles, published between 1896 and 2020, were synthesized. We found that while public health has been used as a framing for substance use in Canada for at least 120 years, what that means and what it implies for public policy has changed over time. During the first several decades covered in this review, we periodically see the emergence of new conceptualizations of the problem of substance use and its framing as a public health issue. For example, between the 1890s and 1980s, the dominant view of alcohol evolves from that of a social problem, to a disease, to a population health issue. In the 1990s we see the last of these paradigmatic shifts. From that point onwards, the dominant conceptualization is one that prioritizes drug policy harms over drug harms; correspondingly, proposed solutions center on harm reduction, regulation, and policy reform. Beginning in the 2000s, we see detailed proposals for a comprehensive public health framework to substance use, with authors setting out to define the premises, objectives, and components of such a framework.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Overall we found a gradual convergence towards a potential Canadian model for a public health approach to substance use: a model based on principles including human rights and equity, in which psychoactive substances are neither criminalized nor commercialized, but rather strictly regulated, proportionately to the risks they pose, in a manner that optimizes the health of the population. At present, governments across Canada appear to be moving in the opposite direction: drug policy is leaning further into criminalization for already illicit substances and further into commercialization for legal ones. Treating psychoactive substances as either the objects of criminal law or as harmless commodities are both associated with","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104634"},"PeriodicalIF":4.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630593","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":"Creating a robust coordinated data and policy framework for addressing substance use issues in the United States","authors":"Qiushi Chen ,&nbsp;Glenn Sterner ,&nbsp;Danielle Rhubart ,&nbsp;Robert Newton ,&nbsp;Bethany Shaw ,&nbsp;Dennis Scanlon","doi":"10.1016/j.drugpo.2024.104629","DOIUrl":"10.1016/j.drugpo.2024.104629","url":null,"abstract":"<div><div>The ongoing opioid epidemic has been met with the inadequate use of data-informed approaches to respond to the crisis. Although data relevant to opioid and substance use do exist and have been utilized for research in the literature and practice, they have not been prepared for cross-sector coordination and for providing practical intelligence to inform policy planning directly. In this article, we share our views on how data can better serve the purposes of informing policy and planning to maximize population health and safety benefits. Based on our experience in advising state policymakers on developing settlement allocation strategies based on empirical data, we discuss several issues in the data, including coverage, specificity in drug types, time relevance, geographic units, and access, which may hinder data-informed policymaking. Following these discussions, we envision a coordinated data and policy framework as an ideal case to ensure access to meaningful and timely data and harness the full potential of the data to inform policy to combat the continuing epidemic.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104629"},"PeriodicalIF":4.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593159","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":"Uncorking the ‘wine mum’: Exploring the complexity of Australian women's everyday lives and drinking practices","authors":"Gabriel Caluzzi ,&nbsp;Megan Cook ,&nbsp;Maree Patsouras ,&nbsp;Cassandra J.C. Wright ,&nbsp;Emmanuel Kuntsche ,&nbsp;Sandra Kuntsche","doi":"10.1016/j.drugpo.2024.104637","DOIUrl":"10.1016/j.drugpo.2024.104637","url":null,"abstract":"<div><h3>Background</h3><div>With greater attention given to midlife women's drinking in research and in media representations of ‘wine mums’, we suggest that focusing on static gender roles (e.g., women as mothers) risks overlooking complex and dynamic features of women's lives. We draw on the concept of thick intersectionality to explore how everyday experiences of women's lives and multiple identities shape their drinking practices.</div></div><div><h3>Methods</h3><div>This study draws on interviews with Australian women in their forties and fifties who were employed, had school-aged children and drank alcohol. We present four detailed accounts as interpreted narratives.</div></div><div><h3>Results</h3><div>Close analysis of the stories of four women highlights important features of women's lives. Drinking practices were often intertwined with gendered labour, power inequalities and managing stresses borne from these. Gender, class, relationality, life course transitions, affect and various aspects of labour dynamics (temporality, autonomy and unseen labour) were prominent in the accounts. Alongside this health, geography, life histories and culture interacted in women's narratives and the various identities and roles they moved between, co-producing drinking practices in different ways.</div></div><div><h3>Conclusion</h3><div>By juxtaposing women's stories with ‘wine mum’ stereotypes, and the broader feminisation of drinking, we highlight how women's drinking practices are influenced not only by static identities, but the complex interplay between gender, a myriad of fluid social categories, and day-to-day life. We suggest that attending to context and women's everyday experiences is crucial for generating a nuanced understanding of drinking beyond women's traditional gender roles.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104637"},"PeriodicalIF":4.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586462","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":"High hepatitis C virus reinfection in a community-based sample of people who inject drugs in Imphal, India","authors":"Mihili P. Gunaratne ,&nbsp;Ashwini Kedar ,&nbsp;Allison M. McFall ,&nbsp;Aylur K. Srikrishnan ,&nbsp;Shanta Chingtham ,&nbsp;Pradeep Amrose ,&nbsp;Jiban J. Baishya ,&nbsp;Archit K. Sinha ,&nbsp;Shruti H. Mehta ,&nbsp;Sunil S. Solomon","doi":"10.1016/j.drugpo.2024.104635","DOIUrl":"10.1016/j.drugpo.2024.104635","url":null,"abstract":"<div><h3>Background</h3><div>Reinfection with hepatitis C virus (HCV) following successful treatment with direct-acting antivirals (DAAs) is a threat to achieving the World Health Organization viral hepatitis elimination goals. Given the limited data among people who inject drugs (PWID) from low-and-middle-income countries (LMICs), we characterized HCV reinfection among PWID in Imphal, India.</div></div><div><h3>Methods</h3><div>Our study population included PWID who achieved a sustained virologic response (SVR) after DAA treatment at community-based treatment programs located in harm reduction centers. Reinfection rates per 100 person-years (PY) were calculated overall and by select characteristics. Poisson regression was used to estimate incidence rate ratios and correlates of reinfection.</div></div><div><h3>Results</h3><div>Among 1267 PWID who achieved SVR and were screened for this study, 315 instances of reinfection were documented over 2395 PY of follow-up with an incidence rate (IR) of 13.2 per 100 PY (95 % CI: 11.8, 14.7). The incidence of reinfection was highest among those 18–24 years old (20.0 per 100 PY, 95 % CI: 16.9, 23.8) and in multivariable analysis, age remained independently associated with reinfection risk. Those 18–24 years old had the highest incidence (adjusted incidence rate ratio (aIRR) compared to 45–54 years: 4.94 [95 % CI: 2.59, 9.42]). The use of medication for opioid use disorder (MOUD) was also associated with reinfection in those reporting recent injection (aIRR: 1.57 [95 % CI: 1.19, 2.09]).</div></div><div><h3>Conclusions</h3><div>The high reinfection rate among PWID in Imphal, a setting with comprehensive harm reduction programs, highlights the need to integrate and innovate models of HCV care and harm reduction service delivery with a particular emphasis on young PWID.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104635"},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577888","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":"Cannabis legalization and changes in cannabis and tobacco/nicotine use and co-use in a national cohort of U.S. adults during 2017–2021","authors":"Vira Pravosud ,&nbsp;Stanton Glantz ,&nbsp;Salomeh Keyhani ,&nbsp;Pamela M. Ling ,&nbsp;Lauren K. Lempert ,&nbsp;Katherine J. Hoggatt ,&nbsp;Deborah Hasin ,&nbsp;Nhung Nguyen ,&nbsp;Francis Julian L. Graham ,&nbsp;Beth E. Cohen","doi":"10.1016/j.drugpo.2024.104618","DOIUrl":"10.1016/j.drugpo.2024.104618","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about whether cannabis legalization impacts cannabis use uptake or has spillover effects on co-use of cannabis and tobacco/nicotine (using both in the past 30 days). We determined associations of cannabis legalization with self-reported (1) current (past 30-day) cannabis use; (2) current (“now”) tobacco/nicotine use (smoking or electronic cigarette use); and (3) current co-use of cannabis and tobacco/nicotine and how prevalence is changing over time.</div></div><div><h3>Methods</h3><div>In this longitudinal study, a web-based survey was administered to a nationally representative, population-based panel of US adults in 2017, 2020, and 2021. We used weighted unadjusted binomial logistic GEE models to assess changes in prevalence of cannabis, tobacco/nicotine use and co-use and weighted, adjusted binary logistic GEE models to assess associations of cannabis legalization with cannabis, tobacco/nicotine use and co-use.</div></div><div><h3>Results</h3><div>A total of 9003 participants (age range = 18–94, mean age = 47.9 [±17.4 SD] years; 4696 females [weighted 52.0 %]) completed the survey in 2017; 5979/8529 (70.1 %) in 2020 and 5420/7305 (74.2 %) in 2021 from the original cohort who remained available. Current cannabis use significantly increased +3.3 % between 2017 and 2021, while tobacco/nicotine use significantly declined (−1.9 %); co-use of cannabis and tobacco/nicotine did not change significantly (+0.2 %). Both <em>medical</em> and <em>recreational</em> cannabis legalization was associated with increased current cannabis use; the independent effect of recreational cannabis legalization was 1.13 times larger than medical. There were no statistically significant differences in tobacco/nicotine use and co-use prevalence by legalization status.</div></div><div><h3>Conclusion</h3><div>Cannabis legalization increases cannabis use but is not associated with changes in tobacco/nicotine use or co-use. Legalization should be coupled with public health efforts.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104618"},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577886","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":"“They talk about it like it's an overdose crisis when in fact it's basically genocide”: The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood","authors":"Jennifer Lavalley ,&nbsp;Linda Steinhauer ,&nbsp;Dino (Boomer) Bundy ,&nbsp;Thomas Kerr ,&nbsp;Ryan McNeil","doi":"10.1016/j.drugpo.2024.104631","DOIUrl":"10.1016/j.drugpo.2024.104631","url":null,"abstract":"<div><div>Indigenous Peoples who use illicit drugs (IPWUID) are disproportionately represented among toxic drug poisoning deaths in Canada. These drug-related harms are framed by the historical and ongoing trauma related to settler colonialism and are acutely visible in Vancouver, Canada's Downtown Eastside - a low-income neighbourhood that is an epicenter of the drug poisoning crisis and characterized by entrenched poverty, substance use, violence, and homelessness. This study was undertaken to examine the experiences and perspectives of IPWUID in the Downtown Eastside regarding the drug poisoning crisis and the responsiveness of harm reduction programs within the context of settler colonialism. Indigenous-led qualitative interviews were conducted with 16 IPWUID recruited by Indigenous peer researchers. Indigenous ways of knowing were embedded throughout the entire research design to ensure research was culturally congruent. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence and racial capitalism. Our analysis reviewed three key themes that centered the experiences of IPWUID in Vancouver's Downtown Eastside in relation to the drug poisoning crisis: (1) that the drug poisoning crisis is understood as a form of genocide toward Indigenous Peoples; (2) that the crisis is experienced within the context of pervasive distrust and adversarial relationships with police rooted in structurally racist experiences of place-based policing practices; and (3) that there is a desire for culturally-safe harm reduction care with Indigenous representation, cultural integration, and that addresses inequities and injustice stemming from colonialism and structural racism. Findings demonstrate how responses to the drug poisoning crisis among IPWUID need to respond to social and materials conditions perpetuated by colonialism and racial capitalism, while also centering IPWUID through the development and implementation of Indigenous-led and culturally safe harm reduction approaches.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104631"},"PeriodicalIF":4.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577887","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":"Bridging the gap: Exploring consumer experiences and motivations for transitioning between illicit and regulated cannabis markets","authors":"Jennifer R. Donnan ,&nbsp;Rachel Howells ,&nbsp;Sylvia Farooq ,&nbsp;Myles Maillet ,&nbsp;Laura M. Harris-Lane","doi":"10.1016/j.drugpo.2024.104644","DOIUrl":"10.1016/j.drugpo.2024.104644","url":null,"abstract":"<div><h3>Background</h3><div>Canada pioneered the non-medical legalization of cannabis production and sales, witnessing substantial growth in the regulated market over the last five years, post-legalization. However, persistent barriers hinder many consumers from transitioning to the legal market, necessitating a nuanced understanding of their behaviors for targeted policy interventions. This study aims to improve understanding of cannabis consumers’ unregulated purchase decisions in British Columbia (B.C.), and to explore motivational factors for transitioning to the legal market.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with cannabis consumers in B.C., who were at least 19 years old and purchased some or all of their cannabis through unregulated sources. Interviews were transcribed and an inductive thematic analysis was conducted using NVivo. Through coding iterations, we moved from descriptive to analytic codes, and finally mapped the codes to themes aligned with the <em>Five Stages of Consumer Decision Making</em> model.</div></div><div><h3>Results</h3><div>Participants (<em>N</em> = 31) represented a broad range of demographic characteristics (i.e., gender, age, education, income). Four themes were identified: seeking information, evaluation of alternatives, purchase decision, and post purchase evaluation. Despite purchasing all or some of their cannabis from the unregulated market, most participants were supportive of legalization and felt that legal cannabis is safe, accessible, and of reasonable quality. However, several barriers prevent consumers from regularly accessing the regulated market, including: price, lack of sales and promotions, potency, limited product variety, and inadequate product interaction.</div></div><div><h3>Conclusion</h3><div>This study delineates barriers that obstruct consumers' transition to the regulated market. These findings, aligned with considerations for public health and safety, offer valuable insights to inform cannabis policy and promote a more effective and consumer-oriented regulatory framework.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104644"},"PeriodicalIF":4.4,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569833","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 place-based spatial analysis of racial inequities in overdose in St. Louis County Missouri, United States","authors":"Phillip L. Marotta ,&nbsp;Benjamin CB Leach ,&nbsp;William D. Hutson ,&nbsp;Joel M. Caplan ,&nbsp;Brenna Lohmann ,&nbsp;Charlin Hughes ,&nbsp;Devin Banks ,&nbsp;Stephen Roll ,&nbsp;Yung Chun ,&nbsp;Jason Jabbari ,&nbsp;Rachel Ancona ,&nbsp;Kristen Mueller ,&nbsp;Ben Cooper ,&nbsp;Theresa Anasti ,&nbsp;Nathaniel Dell ,&nbsp;Rachel Winograd ,&nbsp;Robert Heimer","doi":"10.1016/j.drugpo.2024.104611","DOIUrl":"10.1016/j.drugpo.2024.104611","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to identify place features associated with increased risk of drug-involved fatalities and generate a composite score measuring risk based on the combined effects of features of the built environment.</div></div><div><h3>Methods</h3><div>We conducted a geospatial analysis of overdose data from 2022 to 2023 provided by the St. Louis County Medical Examiner's Office to test whether drug-involved deaths were more likely to occur near 54 different place features using Risk Terrain Modeling (RTM). RTM was used to identify features of the built environment that create settings of heightened overdose risk. Risk was estimated using Relative Risk Values (RRVs) and a composite score measuring Relative Risk Scores (RRS) across the county was produced for drugs, opioids, and stimulants, as well as by Black and White decedents.</div></div><div><h3>Results</h3><div>In the model including all drugs, deaths were more likely to occur in close proximity to hotels/motels (RRV=39.65, SE=0.34, t-value=10.81 <em>p</em>&lt;.001), foreclosures (RRV=4.42, SE=0.12, t-value = 12.80, <em>p</em>&lt;.001), police departments (RRV=3.13, SE=0.24, t-score=4.86, <em>p</em>&lt;.001), and restaurants (RRV=2.33, SE=0.12, t-value=7.16, <em>p</em>&lt;.001). For Black decedents, deaths were more likely to occur near foreclosures (RRV=9.01, SE=0.18, t-value =11.92, <em>p</em>&lt;.001), and places of worship (RRV= 2.51, SE=0.18, t-value = 11.92, <em>p</em>&lt;.001). For White decedents, deaths were more likely to occur in close proximity to hotels/motels (RRV=38.97, SE=0.39, t-value=9.30, <em>p</em>&lt;.001) foreclosures (RRV=2.57, SE=0.16, t-value =5.84, <em>p</em>&lt;.001), restaurants (RRV=2.52, SE=0.17, t-value=5.33, <em>p</em>&lt;.001) and, auto painting/repair shops (RRV=0.04, SE=0.18, t-value =3.39, <em>p</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>These findings suggest that places of worship, the hospitality industry, and housing authorities may be physical features of the environment that reflect social conditions that are conducive to overdose. The scaling up of harm reduction strategies could be enhanced by targeting places where features are co-located.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104611"},"PeriodicalIF":4.4,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569892","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":"Examining the association between trenbolone, psychological distress, and aggression among males who use anabolic-androgenic steroids","authors":"Timothy Piatkowski ,&nbsp;Dominique De Andrade ,&nbsp;David Neumann ,&nbsp;Calvert Tisdale ,&nbsp;Matthew Dunn","doi":"10.1016/j.drugpo.2024.104636","DOIUrl":"10.1016/j.drugpo.2024.104636","url":null,"abstract":"<div><div><em>Introduction:</em> The link between anabolic-androgenic steroid (AAS) use and psychosocial effects such as aggression and violence is contentious. Few studies differentiate between types of AAS. This study focuses on trenbolone to assess its psychological risks and effects on aggression compared to other AAS. We hypothesised that there would be a positive relationship between trenbolone dosage and both psychological distress and aggression among people who use AAS. <em>Methods:</em> Using purposive and snowball sampling of people using AAS, we conducted an online survey to investigate the relationship between trenbolone use and other AAS use. Participants completed sections on demographics, trenbolone and other illicit drug use, the Kessler Psychological Distress Scale, and the Buss and Perry Aggression Questionnaire. Data were analysed using multinominal and multivariable regression. <em>Results:</em> The study included 282 males using AAS. Over 33% (<em>n</em>=93) reported currently using trenbolone, with 55.3% (<em>n</em>=156) of participants reporting having used trenbolone in the past, and 11.7% (<em>n</em>=33) reporting having never used trenbolone. Those who had never used trenbolone were not significantly different on age, height, weight, and BMI compared to those who had<em>.</em> After controlling for age and BMI, dose of trenbolone was significantly (<em>p</em>=0.045) associated with higher levels of verbal aggression. <em>Conclusion:</em> The study highlights trenbolone's association with increased verbal aggression among males using AAS, particularly at higher doses. Further research should continue to differentiate between AAS types and the accompanying health harms.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"134 ","pages":"Article 104636"},"PeriodicalIF":4.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560770","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}