International Journal of Drug Policy最新文献

{"title":"A descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states","authors":"Zongbo Li ,&nbsp;Tanvi V. Chiddawar ,&nbsp;Leah C. Shaw ,&nbsp;Ashleigh Dennis ,&nbsp;Amy Lieberman ,&nbsp;Alexandra Kingsepp ,&nbsp;Andrew J. Trinidad ,&nbsp;Ellenie Tuazon ,&nbsp;Alice E. Welch ,&nbsp;Avik Chatterjee ,&nbsp;Bruce R. Schackman ,&nbsp;Eva A. Enns ,&nbsp;Alexander Y. Walley ,&nbsp;Traci C. Green ,&nbsp;Karla D. Wagner ,&nbsp;Rachel P. Winograd ,&nbsp;Czarina N. Behrends ,&nbsp;Erika L. Crable ,&nbsp;Brandon D.L. Marshall ,&nbsp;Xiao Zang","doi":"10.1016/j.drugpo.2025.105100","DOIUrl":"10.1016/j.drugpo.2025.105100","url":null,"abstract":"<div><h3>Background</h3><div>Since 1999, drug overdose deaths have surged in the United States. There is considerable geographic variability in overdose patterns, state laws, overdose prevention infrastructure, and opioid settlement amounts and investments. To guide localized overdose prevention, it is important to analyze these data and understand heterogeneity.</div></div><div><h3>Methods</h3><div>In this descriptive analysis across six states—Massachusetts, Minnesota, Missouri, Nevada, New York, and Rhode Island, we compared five key domains essential to understanding overdose epidemics, prevention, and policy responses: (1) drug overdose mortality trends by substance and race/ethnicity (2018–2023); (2) state harm reduction laws; (3) availability and coverage of overdose prevention services; (4) opioid settlement funding and spending; and (5) availability and comprehensiveness of publicly available overdose-related data. Data were drawn from publicly available sources and legal information confirmed using Westlaw.</div></div><div><h3>Results</h3><div>All states experienced rising overdose death rates between 2018 and 2023, with significant racial/ethnic disparities. All states have enacted laws to increase access to naloxone. Naloxone distribution rates vary widely, but most states have high availability. Implementation of other harm reduction services differed across states, as well as drug paraphernalia laws. Opioid settlement funding per capita and transparency in spending and planning also differed across states. Some dashboards provided detailed fatal and nonfatal overdose and intervention data stratified by sociodemographics.</div></div><div><h3>Conclusion</h3><div>State-specific differences in overdose patterns, harm reduction laws, prevention infrastructure, and settlement spending underscore the need for localized, tailored strategies. This study’s state-specific profiles lay the groundwork for more advanced decision-support tools to guide effective overdose prevention.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105100"},"PeriodicalIF":4.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693575","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":"Breaking barriers: evaluating access models for harm reduction vending machines","authors":"Ashleigh Herrera ,&nbsp;Bradley Conner ,&nbsp;Presleigh Beshirs ,&nbsp;Ricky Bluthenthal","doi":"10.1016/j.drugpo.2025.105079","DOIUrl":"10.1016/j.drugpo.2025.105079","url":null,"abstract":"<div><div>The opioid epidemic continues to claim lives at alarming rates, disproportionately affecting marginalized communities, with structural barriers preventing equitable access to lifesaving interventions such as naloxone. Harm reduction vending machines (HRVMs) offer a promising solution to this issue, providing low-barrier access to naloxone and other harm reduction supplies. This study examines the impact of different HRVM access models on product utilization, specifically focusing on an outdoor HRVM, Project HOPE, located in Bakersfield, California. Initially, the machine required participant registration and imposed product limits; however, these restrictions were removed in August 2023 to improve access. An interrupted time series analysis of data from June to October 2023 reveal a significant increase in product utilization following the shift to unrestricted access, with increases in demand for naloxone kits, safer injection kits, wound care kits, and other basic needs supplies. The findings suggest that removing barriers to HRVM access, including registration requirements and product limits, can significantly improve the utilization of harm reduction supplies, potentially reducing opioid-related fatalities and promoting health equity. Further research is needed to evaluate the long-term impacts of unrestricted HRVM access models on overdose prevention and other health outcomes.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105079"},"PeriodicalIF":4.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679104","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":"Two methods to estimate the population size of people who inject drugs in the country of Georgia: implications for the EECA region","authors":"George Kamkamidze ,&nbsp;Emeli J. Anderson ,&nbsp;Liana Shengelaia ,&nbsp;Lasha Gulbiani ,&nbsp;Giorgi Kanchelashvili ,&nbsp;Tinatin Abzianidze ,&nbsp;Maia Butsashvili","doi":"10.1016/j.drugpo.2025.105099","DOIUrl":"10.1016/j.drugpo.2025.105099","url":null,"abstract":"<div><h3>Background</h3><div>In the Eastern European country of Georgia, people who inject drugs (PWID) are disproportionately affected by both HIV and hepatitis C virus (HCV) infections. In 2016, it was estimated that over 2 % of adults in Georgia engaged in injection drug use. Updated population size estimates are needed to inform the national public health response to IDU, HIV, and HCV.</div></div><div><h3>Methods</h3><div>Data were from the 2022 Integrated Bio-Behavioral Surveillance Survey of PWID in Georgia. Participants were recruited from seven cities (<em>n</em> = 2005). Two methods were used to estimate the population size of PWID: the Network Scale-Up (NSU) method and the Multiplier Benchmark Method (MBM). The former used social network data from the general population (<em>n</em> = 680) to estimate the proportion of PWID in an individual’s social network. The MBM used external data of PWID and a multiplier estimated from internal data to generate an estimate of the total population size of PWID for each dataset. An anchor multiplier tool was used to combine the results from the two methods.</div></div><div><h3>Results</h3><div>The final estimate resulted in a population size of 54,342 PWID in Georgia, corresponding to a prevalence of 1.4 % among all age groups and 2.4 % among adults aged 18–64.</div></div><div><h3>Conclusion</h3><div>IDU remains a substantial challenge in Georgia, with an estimated 1.5 % of the population engaging in IDU. These findings underscore the need for targeted interventions and improved engagement of PWID in prevention, treatment, and care services across the country.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"147 ","pages":"Article 105099"},"PeriodicalIF":4.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679061","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 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}