International Journal of Drug Policy最新文献_第8页

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 : 2026-02-01 Epub 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

Reduced risk of overdose among clients of a safer opioid supply program in Southwestern Ontario: A pre-post observational cohort study 在安大略省西南部的一个更安全的阿片类药物供应项目的客户中减少过量的风险：一项前后观察队列研究

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-27 DOI: 10.1016/j.drugpo.2025.105124

Gillian Kolla , Jerri-Lyn Lewis , Adrian Guta , Ashley Schaff , Megan Boyle , Kourteney King , Carol Strike , Mohammad Karamouzian

Introduction

North America faces an ongoing overdose crisis driven by a volatile and toxic drug supply comprised primarily of fentanyl, fentanyl analogues and other adulterants. Safer opioid supply (SOS) programs prescribe pharmaceutical opioids to individuals at high risk of overdose mortality. This study evaluated changes in non-fatal overdose prevalence in the 6 months after SOS program initiation among SOS participants in Kitchener-Waterloo, Canada.

Methods

We analyzed data from a pre-post observational cohort of clients enrolled in a SOS program between July 2021 and October 2023. Baseline surveys were completed upon program entry, with follow-up surveys after 6 months. We compared non-fatal overdose prevalence between baseline and follow-up using McNemar’s test and calculated adjusted odds ratios (aOR) using generalized estimating equation (GEE) models, controlling for potential confounders including homelessness, hospitalization, daily fentanyl use, and incarceration.

Results

Among 100 participants completing follow-up (out of 162 who completed a baseline survey), overdose prevalence decreased significantly from 60 % (95 % Confidence Interval (CI): 50–69) at baseline to 15 % (95 % CI: 9–23) at follow-up (p < 0.001). Overdose incidence rates declined from 48.5 to 3.3 per 100 person-months. After adjusting for confounders, participants had 83 % lower odds of overdose during follow-up (aOR 0.17, 95 % CI: 0.08–0.38).

Discussion

Participants in a SOS program experienced significant reductions in non-fatal overdose during the 6 months following program initiation. SOS clients are a high-risk population with elevated overdose rates at baseline; these results support expanding safer supply programs as part of a comprehensive set of strategies to address the overdose crisis.

北美面临着由主要由芬太尼、芬太尼类似物和其他掺假物组成的挥发性和有毒药物供应所导致的持续过量危机。更安全的阿片类药物供应（SOS）计划向有过量死亡风险的个体开出药物阿片类药物。本研究评估了加拿大基奇纳-滑铁卢地区SOS参与者在SOS项目启动后6个月内非致命性药物过量发生率的变化。方法：我们分析了2021年7月至2023年10月期间参加SOS项目的患者的前后观察队列数据。基线调查在项目开始时完成，6个月后进行随访调查。我们使用McNemar试验比较了基线和随访期间的非致命性药物过量患病率，并使用广义估计方程（GEE）模型计算了调整后的优势比（aOR），控制了潜在的混杂因素，包括无家可归、住院、每日芬太尼使用和监禁。结果在100名完成随访的参与者中（162名完成基线调查的参与者中），药物过量患病率从基线时的60%（95%置信区间（CI）： 50-69）显著下降到随访时的15% (95% CI: 9-23) （p < 0.001）。药物过量发生率从每100人月48.5下降到3.3。在调整混杂因素后，参与者在随访期间服用过量的几率降低了83% （aOR 0.17, 95% CI: 0.08-0.38）。SOS项目的参与者在项目启动后的6个月内经历了非致命性药物过量的显著减少。SOS客户是高危人群，基线时用药过量率升高；这些结果支持扩大更安全的供应计划，作为解决过量危机的综合战略的一部分。

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引用次数: 0

Public attitudes and lifetime home cannabis cultivation – a survey after legalization in Germany 公众态度和终身家庭大麻种植——德国大麻合法化后的一项调查。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1016/j.drugpo.2025.105121

Mira Lehberger, Anne-Katrin Kleih, Kai Sparke

In 2024, Germany became the most populous European country to legalize home cannabis cultivation. This study provides the first empirical evidence on both public support for and engagement in home cultivation in this new regulatory context. Using survey data from a representative online-panel (n = 1500), we conducted hierarchical regression analyses to examine the factors associated with attitudinal outcomes (support for legalization) and behavioral outcomes (self-reported cultivation in the past or present). Results show that sociodemographic associations with support and cultivation are largely explained by cannabis experience. Among these factors, age and consumption emerged as the most consistent correlates across models. Expectations regarding the consequences of legalization were strongly associated with support but showed little relation to actual cultivation behavior. People who have cultivated expressed substantially higher support and more favorable expectations than those who have not, although participants overall tended to evaluate legalization positively. The only consistently negative expectation shared across groups was that legalization may increase cannabis use in society. Overall, support for legalization appears to be influenced by a broad set of expectations about societal consequences, whereas cultivation behavior is more closely tied to individual experience and personal motivations. While the study is situated in the German context, its insights are relevant beyond national borders: as the largest EU member state to legalize home cultivation, Germany’s experience may provide valuable lessons for other jurisdictions considering similar reforms.

2024年，德国成为将家庭大麻种植合法化的欧洲人口最多的国家。本研究提供了在这种新的监管背景下公众对家庭种植的支持和参与的第一个经验证据。利用代表性在线小组（n = 1500）的调查数据，我们进行了分层回归分析，以检查与态度结果（支持合法化）和行为结果（过去或现在的自我报告培养）相关的因素。结果表明，支持和种植的社会人口学关联在很大程度上可以用大麻经验来解释。在这些因素中，年龄和消费是各模型中最一致的相关性。对大麻合法化后果的预期与支持密切相关，但与实际的大麻种植行为关系不大。尽管参与者总体上倾向于积极评价大麻合法化，但与没有大麻合法化的人相比，大麻合法化的人表达了更高的支持和更有利的期望。各群体唯一一致的负面预期是，大麻合法化可能会增加社会对大麻的使用。总体而言，对大麻合法化的支持似乎受到对社会后果的广泛预期的影响，而大麻种植行为则与个人经历和个人动机更密切相关。虽然这项研究是在德国的背景下进行的，但它的见解超越了国界：作为将家庭种植合法化的最大欧盟成员国，德国的经验可能为其他考虑类似改革的司法管辖区提供宝贵的经验教训。

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引用次数: 0

The health effects of vaping and e-cigarettes: consensus recommendations 电子烟和电子烟对健康的影响：共识建议。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1016/j.drugpo.2025.105117

Erika Kouzoukas , Carolina Navas , Laurie Zawertailo , Chantal Fougere , Simon L Bacon , Nicholas Chadi , William K Evans , Ann McNeill , Osnat Melamed , Theo J. Moraes , Onyenyechukwu Nnorom , Robert Schwartz , Lion Shahab , Miranda Ween , Peter Selby

Objective

To develop evidence-informed recommendations on the health effects of e-cigarettes to guide healthcare practitioners and the public to balance individual and population harm reduction.

Methods

Systematic and umbrella reviews investigating the health effects of e-cigarette use were conducted (September 2017 – January 2024). An international panel of subject matter experts (n = 23) and people in Canada with lived experience (n = 7) participated in a two-day, hybrid meeting, and used a consensus-based approach to develop recommendations. A guidance resource and four accompanying knowledge products were tested for usability with end users.

Results

Consensus was reached on 14 recommendations spanning four health effects: carcinogen exposure, cardiovascular health, respiratory health, and nicotine dependence. Quality of evidence was voted as ranging from high/moderate to moderate/low, and strength of most recommendations was voted as strong.

Conclusions

Guidance has been informed by best available evidence and expertise, providing direction to support decision-making. The use of established methods to evaluate divergent published literature combined with consensus-building methods among a range of stakeholders on vaping is possible. As higher quality evidence continues to emerge, recommendations will require iterative refinement.

目的：就电子烟对健康的影响提出循证建议，以指导医疗从业人员和公众平衡减少个人和群体危害。方法：从2017年9月至2024年1月，对电子烟使用对健康的影响进行了系统和全面的综述。一个由主题专家组成的国际小组（n = 23）和加拿大有实际经验的人（n = 7）参加了为期两天的混合会议，并采用基于共识的方法提出建议。对一个指导资源和四个附带的知识产品进行了最终用户可用性测试。结果：就14项建议达成共识，涉及4种健康影响：致癌物质暴露、心血管健康、呼吸系统健康和尼古丁依赖。证据质量从高/中等到中/低，大多数建议的强度被评为强。结论：可获得的最佳证据和专业知识为指导提供了信息，为支持决策提供了方向。使用既定的方法来评估不同的已发表文献，并结合在一系列利益相关者之间建立共识的方法，是可能的。随着更高质量的证据不断出现，建议将需要反复改进。

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引用次数: 0

The effect of a police crackdown on online drug sales: on the importance of targeting vendors’ reputation? 警方打击网络毒品销售的影响：打击商家声誉的重要性？

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-20 DOI: 10.1016/j.drugpo.2025.105113

Etienne Blais , David Décary-Hétu , William Arbour , Camille Gagné , Roxane Perrin-Plouffe , Arielle Chaîné

Objectives

This article evaluates the effect of a police crackdown on cannabis vendors operating in cryptomarkets. The police seized >100 cannabis parcels in transit and arrested one runner during this crackdown.

Methods

An automated web crawler was used to download, and structure content found on 30 cryptomarkets between 1 January 2015 and 26 June 2017. Data were then aggregated on a weekly basis. The synthetic difference-and-difference (SDiD) approach and its extension for event-study analysis were used to estimate the effect of the police crackdown on the number of cannabis transactions and vendors.

Results

Estimates from the SDiD models suggest that the crackdown was associated with a significant decline in cannabis transactions. The event-study analysis indicates that the effect was delayed and for a short time. Estimates from the SDiD show that the overall effect of the crackdown on vendors was not significant. The event-study analysis shows that a significant effect was observed for several time units; the effect can be characterized as abrupt and lasted for several weeks after the intervention.

Conclusions

Results suggest that police crackdowns can effectively disrupt for cryptomarkets. Seizing parcels negatively affected vendors’ reputation and compromised the trust system on which cryptomarkets are built.

目的：本文评估了警方打击在加密市场经营的大麻供应商的影响。警方在这次打击行动中，检获100个运输中的大麻包裹，并拘捕一名走私犯。方法：使用自动网络爬虫下载并构建2015年1月1日至2017年6月26日期间在30个加密市场上发现的内容。然后每周汇总数据。综合差异与差异（SDiD）方法及其对事件研究分析的扩展用于估计警方打击大麻交易和供应商数量的影响。结果：SDiD模型的估计表明，打击行动与大麻交易的显著下降有关。事件研究分析表明，影响是延迟的，持续时间短。SDiD的估计显示，打击商贩的总体效果并不显著。事件研究分析表明，在几个时间单位内观察到显著的影响；这种效果是突然的，并在干预后持续数周。结论：结果表明，警方打击可以有效地扰乱加密市场。没收包裹对供应商的声誉产生了负面影响，并损害了加密市场赖以建立的信任体系。

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引用次数: 0

What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles “多物质”到底是什么意思？比较疾病预防控制中心记录的与毒品有关的死亡人数与洛杉矶法医的详细数据。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-30 DOI: 10.1016/j.drugpo.2025.105129

Joseph R. Friedman , Ruby Romero , Arthur Funnell , David Goodman-Meza , Chelsea L. Shover

Introduction

Complex polysubstance use is increasing in the United States. However, most epidemiological literature relies on traditional data sources, especially CDC WONDER, which is limited to employing two ICD-10 codes concurrently. We leverage complete medical examiner records from Los Angeles County to examine the limitations of CDC WONDER data for detecting polysubstance drug deaths.

Methods

Drug-involved deaths occurring in Los Angeles County were described using the CDC WONDER system and Los Angeles County Medical Examiner data. Annual single-drug involvement rates were compared between the two data sources. The average number of drugs, and the proportion of polysubstance deaths involving 3 or more substances was summarized by year. UpSet plot visualization was employed for complex set analysis.

Results

Overall concordance in single-substance death counts between CDC WONDER and medical examiner records was high among n = 6 substances assessed. The average number of drugs reported per death had a skewed distribution and increased from 1.72 in 2012 to 2.29 in 2023. The percentage of polysubstance deaths with 3+ drugs increased from 51% in 2012 to 74% in 2023. The number of unique polysubstance combinations with 3+ substances increased from 11 in 2012 to 57 in 2023.

Discussion

Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis grows increasingly polysubstance in nature, improving the epidemiological tracking of deaths involving multiple drugs, and drugs not captured by ICD-10 codes currently, is of paramount importance.

在美国，复合多物质的使用正在增加。然而，大多数流行病学文献依赖于传统的数据来源，特别是CDC WONDER，它仅限于同时使用两个ICD-10代码。我们利用洛杉矶县完整的法医记录来检验CDC WONDER数据在检测多物质药物死亡方面的局限性。方法：使用CDC WONDER系统和洛杉矶县法医数据描述洛杉矶县发生的与药物有关的死亡。比较两种数据来源的年度单一药物受累率。按年汇总药物的平均数量和涉及3种及3种以上药物的多物质死亡比例。复集分析采用颠覆图可视化。结果：在评估的n = 6种物质中，CDC WONDER单物质死亡计数与法医记录之间的总体一致性很高。每例死亡报告的平均药物数量分布不均匀，从2012年的1.72种增加到2023年的2.29种。使用3种以上药物的多物质死亡比例从2012年的51%增加到2023年的74%。具有3种以上物质的独特多物质组合从2012年的11种增加到2023年的57种。讨论：虽然单一药物介入率的一致性很高，但CDC WONDER未能充分捕获大多数多药物死亡，因为大约四分之三的这些死亡使用其2种药物限制不完整地描述。随着平均死亡人数越来越多地涉及更多的药物，这种限制变得更加严重。我们说明了在法医死亡中可以看到的各种各样的多物质组合。由于过量危机的性质越来越多，因此，改善对涉及多种药物以及目前未被《国际疾病分类-10》代码所涵盖的药物的死亡的流行病学追踪至关重要。

{"title":"What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles","authors":"Joseph R. Friedman , Ruby Romero , Arthur Funnell , David Goodman-Meza , Chelsea L. Shover","doi":"10.1016/j.drugpo.2025.105129","DOIUrl":"10.1016/j.drugpo.2025.105129","url":null,"abstract":"<div><h3>Introduction</h3><div>Complex polysubstance use is increasing in the United States. However, most epidemiological literature relies on traditional data sources, especially CDC WONDER, which is limited to employing two ICD-10 codes concurrently. We leverage complete medical examiner records from Los Angeles County to examine the limitations of CDC WONDER data for detecting polysubstance drug deaths.</div></div><div><h3>Methods</h3><div>Drug-involved deaths occurring in Los Angeles County were described using the CDC WONDER system and Los Angeles County Medical Examiner data. Annual single-drug involvement rates were compared between the two data sources. The average number of drugs, and the proportion of polysubstance deaths involving 3 or more substances was summarized by year. UpSet plot visualization was employed for complex set analysis.</div></div><div><h3>Results</h3><div>Overall concordance in single-substance death counts between CDC WONDER and medical examiner records was high among <em>n</em> = 6 substances assessed. The average number of drugs reported per death had a skewed distribution and increased from 1.72 in 2012 to 2.29 in 2023. The percentage of polysubstance deaths with 3+ drugs increased from 51% in 2012 to 74% in 2023. The number of unique polysubstance combinations with 3+ substances increased from 11 in 2012 to 57 in 2023.</div></div><div><h3>Discussion</h3><div>Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis grows increasingly polysubstance in nature, improving the epidemiological tracking of deaths involving multiple drugs, and drugs not captured by ICD-10 codes currently, is of paramount importance.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"148 ","pages":"Article 105129"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865317","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

Author response to commentary on 'Cannabis consumption and motor vehicle collision: A systematic review and meta-analysis of observational studies' 作者对“大麻消费和机动车碰撞：观察性研究的系统回顾和荟萃分析”评论的回应

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI: 10.1016/j.drugpo.2025.105112

Andrew Jin , Jason W. Busse , Behnam Sadeghirad

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 : 2026-02-01 Epub 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 Epub Date: 2023-04-11 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

Organized criminal violence and leadership decapitation in Latin America’s drug wars 拉丁美洲毒品战争中的有组织犯罪暴力和领导层斩首。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.drugpo.2025.105103

Patrick J. Burke

Purpose

This study examines the effects of arresting or killing leaders of organized criminal groups (OCGs) on drug market violence in six Latin American countries. It is the first cross-national study of leadership decapitations, and the first to include both state-perpetrated and OCG-perpetrated decapitations as independent variables.

Method

Leadership removals and drug market violence were identified using the Armed Conflict Location and Event Dataset (ACLED). The three outcome variables are: (1) inter-OCG battle deaths, (2) battle deaths from armed confrontations between state forces and OCGs, and (3) a combined measure of the two. I estimate the effects of leadership decapitations using a series of linear regressions with two-way fixed effects. The panel dataset includes Mexican, Venezuelan, and Brazilian states, and departments in El Salvador, Honduras, and Guatemala (N = 136), measured monthly between 2022 and 2024.

Results

The main models and several robustness checks show that state-perpetrated decapitations are most consistently associated with an increase in state-OCG battle deaths. In contrast, OCG-perpetrated decapitations are associated with an increase in inter-OCG battle deaths. In both cases, effects tend to diminish within a few months of the decapitation.

Conclusion

OCG-perpetrated decapitations likely trigger violent contestation over the drug trade between and within OCGs. However, state decapitations likely trigger violence through other mechanisms, including the state’s intent to incapacitate target OCGs, and the latter attempting to send costly signals of strength to rivals by attacking state forces. Implications for policy and future research are discussed.

目的：本研究考察了逮捕或杀害有组织犯罪集团（ocg）领导人对六个拉丁美洲国家毒品市场暴力的影响。这是第一次对领导层斩首的跨国研究，也是第一次将国家实施的斩首和ocg实施的斩首作为独立变量。方法：使用武装冲突地点和事件数据集（ACLED）识别领导层撤职和毒品市场暴力。三个结果变量是：(1)ocg之间的战斗死亡人数，(2)国家部队与ocg之间的武装对抗造成的战斗死亡人数，以及(3)两者的综合衡量。我使用一系列具有双向固定效应的线性回归来估计领导层斩首的影响。面板数据集包括墨西哥、委内瑞拉和巴西各州，以及萨尔瓦多、洪都拉斯和危地马拉的部门（N = 136），在2022年至2024年间每月测量一次。结果：主要模型和几个稳健性检查表明，国家实施的斩首与国家ocg战斗死亡人数的增加最为一致。相反，ocg实施的斩首与ocg间战斗死亡人数的增加有关。在这两种情况下，效果往往在斩首后的几个月内减弱。结论：ocg实施的斩首可能引发ocg之间和内部对毒品交易的暴力争论。然而，国家斩首可能通过其他机制引发暴力，包括国家意图使目标ocg丧失能力，后者试图通过攻击国家部队向对手发出代价高昂的实力信号。对政策和未来研究的影响进行了讨论。

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引用次数: 0