Pub Date : 2025-11-15DOI: 10.1016/j.drugpo.2025.105059
Holly D Mitchell , India Clancy , Daniela De Angelis , Conor Egan , Ross J Harris , Sharon Hutchinson , Pantelis Samartsidis , Peter Vickerman , Zoe Ward , Alan Yeung , Mounia Zaouche , Matthew Hibbert , Beatrice Emmanouil , Andrew McAuley , Christopher Nugent , Josie Smith , Adelina Artenie , Monica Desai , Matthew Hickman , Viral Hepatitis C Elimination Modelling Working Group
To evidence elimination of hepatitis C virus (HCV), countries need to demonstrate that incidence is ≤2/100 person years in people who inject drugs (PWID). Ongoing prospective cohort studies (gold-standard method) may be too expensive and unsustainable. Here, we first summarise the utility of public health surveillance data, including bio-behavioural surveys, laboratory testing, and treatment registers with additional linkage to administrative data to monitor HCV incidence or related measures. Second, we present five modelling approaches that could be used to generate evidence for assessing progress towards elimination: 1) dynamic deterministic, 2) methods for estimating the force of infection, 3) multi-parameter evidence synthesis (MPES) with back-calculation, 4) Bayesian hierarchical, and 5) cohort multi-state. Some of these approaches can generate modelled incidence estimates based on trends in chronic HCV prevalence, while others focus on related measures such as the decline in chronic HCV prevalence, or the total number of chronic HCV infections that have been diagnosed. We propose that multiple different measures of progress are possible and together, can provide evidence on whether the UK has achieved elimination.
{"title":"Using modelling and public health surveillance data to evidence progress towards the WHO incidence target for hepatitis C elimination in people who inject drugs - a review of complementary approaches in the United Kingdom","authors":"Holly D Mitchell , India Clancy , Daniela De Angelis , Conor Egan , Ross J Harris , Sharon Hutchinson , Pantelis Samartsidis , Peter Vickerman , Zoe Ward , Alan Yeung , Mounia Zaouche , Matthew Hibbert , Beatrice Emmanouil , Andrew McAuley , Christopher Nugent , Josie Smith , Adelina Artenie , Monica Desai , Matthew Hickman , Viral Hepatitis C Elimination Modelling Working Group","doi":"10.1016/j.drugpo.2025.105059","DOIUrl":"10.1016/j.drugpo.2025.105059","url":null,"abstract":"<div><div>To evidence elimination of hepatitis C virus (HCV), countries need to demonstrate that incidence is ≤2/100 person years in people who inject drugs (PWID). Ongoing prospective cohort studies (gold-standard method) may be too expensive and unsustainable. Here, we first summarise the utility of public health surveillance data, including bio-behavioural surveys, laboratory testing, and treatment registers with additional linkage to administrative data to monitor HCV incidence or related measures. Second, we present five modelling approaches that could be used to generate evidence for assessing progress towards elimination: 1) dynamic deterministic, 2) methods for estimating the force of infection, 3) multi-parameter evidence synthesis (MPES) with back-calculation, 4) Bayesian hierarchical, and 5) cohort multi-state. Some of these approaches can generate modelled incidence estimates based on trends in chronic HCV prevalence, while others focus on related measures such as the decline in chronic HCV prevalence, or the total number of chronic HCV infections that have been diagnosed. We propose that multiple different measures of progress are possible and together, can provide evidence on whether the UK has achieved elimination.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105059"},"PeriodicalIF":4.4,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526801","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}
Pub Date : 2025-11-14DOI: 10.1016/j.drugpo.2025.105043
Sandra Gendera , Tim Rhodes , Carla Treloar
There is a tendency to approach the body as if passive, and as acted upon, in medical treatment studies. We undertook a longitudinal qualitative study of monthly buprenorphine depot, with 36 participants (25 men, 11 women; of whom 32 were followed up over three years). Our analysis draws attention to the body as an active actor in the becoming of buprenorphine depot treatment. We trace two scenarios of agency in which bodies participate. The first is discovery and surprise. These are situations in which the body 'speaks', giving feedback in relation to its treatment, and contributing to an iterative process of learning. The second scenario is experimentation. Here, bodily feedbacks inform reasoned actions which give rise to purposeful experimentations in which the body is 'put to the test' or invited into a 'trial' of conjoint learning. Taken together, we show how the body plays a critical role in how buprenorphine treatment 'comes to be known' and how such treatment is made 'workable' in its situation. Our findings emphasize how clinical encounters might better listen to, and learn from, bodies in the implementation of treatments. A priori evidence-based standards and guidelines often shape clinical decisions, but there are other forms of situated and embodied knowing. Bodies are active in shaping what buprenorphine depot treatment comes to be.
{"title":"The 'knowing' body in the becoming of buprenorphine depot treatment: A qualitative study","authors":"Sandra Gendera , Tim Rhodes , Carla Treloar","doi":"10.1016/j.drugpo.2025.105043","DOIUrl":"10.1016/j.drugpo.2025.105043","url":null,"abstract":"<div><div>There is a tendency to approach the body as if passive, and as acted upon, in medical treatment studies. We undertook a longitudinal qualitative study of monthly buprenorphine depot, with 36 participants (25 men, 11 women; of whom 32 were followed up over three years). Our analysis draws attention to the body as an active actor in the becoming of buprenorphine depot treatment. We trace two scenarios of agency in which bodies participate. The first is <em>discovery</em> and <em>surprise</em>. These are situations in which the body 'speaks', giving feedback in relation to its treatment, and contributing to an iterative process of learning. The second scenario is <em>experimentation</em>. Here, bodily feedbacks inform reasoned actions which give rise to purposeful experimentations in which the body is 'put to the test' or invited into a 'trial' of conjoint learning. Taken together, we show how the body plays a critical role in how buprenorphine treatment 'comes to be known' and how such treatment is made 'workable' in its situation. Our findings emphasize how clinical encounters might better listen to, and learn from, bodies in the implementation of treatments. A priori evidence-based standards and guidelines often shape clinical decisions, but there are other forms of situated and embodied knowing. Bodies are active in shaping what buprenorphine depot treatment comes to be.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105043"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526797","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}
Pub Date : 2025-11-14DOI: 10.1016/j.drugpo.2025.105067
Tereza Dlestikova
This paper proposes a psychedelic theory of desistance, arguing that psychedelic-assisted therapy (PAT) may support the desistance from crime – the cessation of criminal behavior – by promoting identity transformation and personal meaning-making among criminal justice-involved individuals. Drawing from psychedelic science and desistance focused criminological theories, it suggests that, when administered within ethical and therapeutic frameworks, psychedelics can enhance self-reflection, emotional processing, and inner insight – mechanisms known to underlie sustained behavioral change. Because many individuals in the criminal justice system experience trauma, depression and substance dependence, PAT may offer a particularly relevant intervention. The paper contends that community-based, post-release settings are more appropriate and ethically defensible for PAT delivery than correctional institutions. While acknowledging that causal evidence on recidivism outcomes is currently lacking, it outlines the need for carefully designed pilot studies conducted in collaboration with clinicians and reintegration services. Using Czechia as a policy context, it offers a practical roadmap for both future research and practical implementation of PAT in marginalized – justice involved – populations. The central claim is that PAT should function as a complementary component within broader rehabilitation and reintegration strategies, supporting narrative and identity change necessary for long-term desistance from crime.
{"title":"Supporting desistance from crime: The promise of psychedelic-assisted therapy in correctional and reentry contexts","authors":"Tereza Dlestikova","doi":"10.1016/j.drugpo.2025.105067","DOIUrl":"10.1016/j.drugpo.2025.105067","url":null,"abstract":"<div><div>This paper proposes a psychedelic theory of desistance, arguing that psychedelic-assisted therapy (PAT) may support the desistance from crime – the cessation of criminal behavior – by promoting identity transformation and personal meaning-making among criminal justice-involved individuals. Drawing from psychedelic science and desistance focused criminological theories, it suggests that, when administered within ethical and therapeutic frameworks, psychedelics can enhance self-reflection, emotional processing, and inner insight – mechanisms known to underlie sustained behavioral change. Because many individuals in the criminal justice system experience trauma, depression and substance dependence, PAT may offer a particularly relevant intervention. The paper contends that community-based, post-release settings are more appropriate and ethically defensible for PAT delivery than correctional institutions. While acknowledging that causal evidence on recidivism outcomes is currently lacking, it outlines the need for carefully designed pilot studies conducted in collaboration with clinicians and reintegration services. Using Czechia as a policy context, it offers a practical roadmap for both future research and practical implementation of PAT in marginalized – justice involved – populations. The central claim is that PAT should function as a complementary component within broader rehabilitation and reintegration strategies, supporting narrative and identity change necessary for long-term desistance from crime.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105067"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526359","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}
Pub Date : 2025-11-14DOI: 10.1016/j.drugpo.2025.105066
Daniel Rosenblum , George Karandinos , Jay Unick , Dennis Cauchon , Daniel Ciccarone
Background
Xylazine is becoming a prevalent fentanyl adulterant in the US. It has been associated with severe wounds and withdrawal symptoms. However, its impact on fatal overdose rates is poorly understood.
Methods
Poisson and ordinary least squares regression analyses are used to estimate the relationship between xylazine prevalence and unintentional overdose death and death rates at the county-month level in Ohio from April through December 2023. Xylazine prevalence is calculated from the Ohio Bureau of Criminal Investigation’s (BCI) Crime Lab Data, and mortality data is from the Ohio Department of Health.
Results
Xylazine prevalence is positively correlated with overdose deaths and death rates in large population counties. Xylazine adulteration is associated with 319 more overdose deaths [95 percent CI: 147–491 deaths], 10 percent of all unintentional overdose deaths in Ohio, over the nine-month period. Our estimates predict that if all fentanyl had been adulterated with xylazine over these nine months, this would have led to an additional 519 deaths.
Discussion
Although the data covers a limited time period, our estimates provide evidence that xylazine-adulterated fentanyl is likely to lead to additional overdose deaths as it continues to spread across the US, blunting the initial signs of a declining trend in overdose deaths. If the findings can be extrapolated to the rest of the country, it is likely that overdose deaths would have fallen more substantially in 2023 if xylazine had not already been so prevalent in large parts of the US.
{"title":"Early evidence of the effects of xylazine-adulterated fentanyl in Ohio","authors":"Daniel Rosenblum , George Karandinos , Jay Unick , Dennis Cauchon , Daniel Ciccarone","doi":"10.1016/j.drugpo.2025.105066","DOIUrl":"10.1016/j.drugpo.2025.105066","url":null,"abstract":"<div><h3>Background</h3><div>Xylazine is becoming a prevalent fentanyl adulterant in the US. It has been associated with severe wounds and withdrawal symptoms. However, its impact on fatal overdose rates is poorly understood.</div></div><div><h3>Methods</h3><div>Poisson and ordinary least squares regression analyses are used to estimate the relationship between xylazine prevalence and unintentional overdose death and death rates at the county-month level in Ohio from April through December 2023. Xylazine prevalence is calculated from the Ohio Bureau of Criminal Investigation’s (BCI) Crime Lab Data, and mortality data is from the Ohio Department of Health.</div></div><div><h3>Results</h3><div>Xylazine prevalence is positively correlated with overdose deaths and death rates in large population counties. Xylazine adulteration is associated with 319 more overdose deaths [95 percent CI: 147–491 deaths], 10 percent of all unintentional overdose deaths in Ohio, over the nine-month period. Our estimates predict that if all fentanyl had been adulterated with xylazine over these nine months, this would have led to an additional 519 deaths.</div></div><div><h3>Discussion</h3><div>Although the data covers a limited time period, our estimates provide evidence that xylazine-adulterated fentanyl is likely to lead to additional overdose deaths as it continues to spread across the US, blunting the initial signs of a declining trend in overdose deaths. If the findings can be extrapolated to the rest of the country, it is likely that overdose deaths would have fallen more substantially in 2023 if xylazine had not already been so prevalent in large parts of the US.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105066"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526358","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}
Pub Date : 2025-11-14DOI: 10.1016/j.drugpo.2025.105068
Erica McAdam , M-J Milloy , Eric C. Sayre , Carmen Verdicchio , Kali-olt Sedgemore , Helena May , Samantha Pranteau , Dyami Corriveau , Drew Friesen , Mathew Fleury , Danya Fast , Kora DeBeck
Background
On January 31, 2023, the province of British Columbia, Canada, implemented a pilot decriminalization of personal possession of certain drugs. This study investigated temporal trends in policing-related barriers to accessing harm reduction services among young people who use drugs (PWUD) in Vancouver before and after decriminalization.
Methods
Data from 2021–2024 were collected from an open prospective cohort of street-involved young PWUD. Logistic regression with generalized estimating equations (GEE) assessed trends in self-reported policing-related barriers to harm reduction services before and after decriminalization, with calendar time and decriminalization (plus their interaction) as primary explanatory variables. A sub-analysis was conducted among participants who identified as being of Indigenous ancestry.
Results
Among 319 participants, the median baseline age was 28.0 years, and 83 (26 %) reported policing-related barriers to harm reduction services at some point during the study period. In multivariable GEE analysis, an increasing trend in reporting police barriers was observed before decriminalization (adjusted per-year odds ratio [AOR]=2.41; 95 % confidence interval [CI]: 1.29–4.51). At the implementation of decriminalization, a significant level drop of 65 % was observed (AOR=0.35; 95 % CI: 0.15–0.82), with no trend observed post-decriminalization (AOR=1.12; 95 % CI: 0.48–2.58 per year). In sub-analysis among Indigenous participants, a significant decreasing trend of 72 % per year in reported policing-related barriers was observed in the post-decriminalization period (AOR = 0.28; 95 % CI: 0.08–0.97).
Implications
Among young PWUD, we observed relative reductions in experiencing policing-related barriers to harm reduction services after the pilot implementation of decriminalization, and this benefit extended to young Indigenous PWUD.
{"title":"Policing and access to harm reduction services among young people who use drugs and young Indigenous people who use drugs before and after the pilot implementation of decriminalization of personal possession","authors":"Erica McAdam , M-J Milloy , Eric C. Sayre , Carmen Verdicchio , Kali-olt Sedgemore , Helena May , Samantha Pranteau , Dyami Corriveau , Drew Friesen , Mathew Fleury , Danya Fast , Kora DeBeck","doi":"10.1016/j.drugpo.2025.105068","DOIUrl":"10.1016/j.drugpo.2025.105068","url":null,"abstract":"<div><h3>Background</h3><div>On January 31, 2023, the province of British Columbia, Canada, implemented a pilot decriminalization of personal possession of certain drugs. This study investigated temporal trends in policing-related barriers to accessing harm reduction services among young people who use drugs (PWUD) in Vancouver before and after decriminalization.</div></div><div><h3>Methods</h3><div>Data from 2021–2024 were collected from an open prospective cohort of street-involved young PWUD. Logistic regression with generalized estimating equations (GEE) assessed trends in self-reported policing-related barriers to harm reduction services before and after decriminalization, with calendar time and decriminalization (plus their interaction) as primary explanatory variables. A sub-analysis was conducted among participants who identified as being of Indigenous ancestry.</div></div><div><h3>Results</h3><div>Among 319 participants, the median baseline age was 28.0 years, and 83 (26 %) reported policing-related barriers to harm reduction services at some point during the study period. In multivariable GEE analysis, an increasing trend in reporting police barriers was observed before decriminalization (adjusted per-year odds ratio [AOR]=2.41; 95 % confidence interval [CI]: 1.29–4.51). At the implementation of decriminalization, a significant level drop of 65 % was observed (AOR=0.35; 95 % CI: 0.15–0.82), with no trend observed post-decriminalization (AOR=1.12; 95 % CI: 0.48–2.58 per year). In sub-analysis among Indigenous participants, a significant decreasing trend of 72 % per year in reported policing-related barriers was observed in the post-decriminalization period (AOR = 0.28; 95 % CI: 0.08–0.97).</div></div><div><h3>Implications</h3><div>Among young PWUD, we observed relative reductions in experiencing policing-related barriers to harm reduction services after the pilot implementation of decriminalization, and this benefit extended to young Indigenous PWUD.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105068"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526800","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}
Pub Date : 2025-11-14DOI: 10.1016/j.drugpo.2025.105065
Vincent Shing Cheng , Serena Yunran Zhang , Wei Jiang , Wing Hong Chui
Faith-based programs are widely used for treating addiction in several countries. Although they are predominantly used in Hong Kong, how they function within the Chinese cultural context remains unknown, particularly for irreligious individuals. Therefore, this study examines how respectability politics are applied within a faith-based drug rehabilitation community in Hong Kong, where religious norms and therapeutic practices shape the residents’ experiences. Based on ethnographic fieldwork and 29 semi-structured interviews, the findings revealed that respectability politics manifests as an interplay among the concern for faith, public image, and therapy, creating a complex dynamic within such a community and offering transformative experiences for some while coercing and excluding those who do not conform. Our insights underscore the need for inclusive therapeutic approaches that respect diverse backgrounds and beliefs and ultimately enhance the effectiveness of faith-based rehabilitation programs. This study highlights the importance of situating respectability politics within specific cultural contexts to understand how marginalized individuals seek dignity during recovery.
{"title":"The role of Christianity in residential drug rehabilitation in Hong Kong: A lens of respectability politics","authors":"Vincent Shing Cheng , Serena Yunran Zhang , Wei Jiang , Wing Hong Chui","doi":"10.1016/j.drugpo.2025.105065","DOIUrl":"10.1016/j.drugpo.2025.105065","url":null,"abstract":"<div><div>Faith-based programs are widely used for treating addiction in several countries. Although they are predominantly used in Hong Kong, how they function within the Chinese cultural context remains unknown, particularly for irreligious individuals. Therefore, this study examines how respectability politics are applied within a faith-based drug rehabilitation community in Hong Kong, where religious norms and therapeutic practices shape the residents’ experiences. Based on ethnographic fieldwork and 29 semi-structured interviews, the findings revealed that respectability politics manifests as an interplay among the concern for faith, public image, and therapy, creating a complex dynamic within such a community and offering transformative experiences for some while coercing and excluding those who do not conform. Our insights underscore the need for inclusive therapeutic approaches that respect diverse backgrounds and beliefs and ultimately enhance the effectiveness of faith-based rehabilitation programs. This study highlights the importance of situating respectability politics within specific cultural contexts to understand how marginalized individuals seek dignity during recovery.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105065"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526357","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}
Pub Date : 2025-11-13DOI: 10.1016/j.drugpo.2025.105060
Codey J. Carr , Peter Reuter , Greg Midgette
Objectives
To provide an analysis of state-level variation in how alcohol and adult-use cannabis regulatory agencies articulate their involvement in, and pursuit of, public health goals.
Methods
An important slogan in state-level campaigns to legalize adult-use cannabis was to regulate cannabis “like alcohol.” We conducted a content analysis of annual reports produced by state cannabis and alcohol regulatory agencies in the United States where adult-use cannabis has been legalized to compare the reported public health orientations of each agency. Our coding domains capture references to (1) stated public health goals, (2) data collaboration with public health agencies, (3) public health efforts, and (4) law enforcement efforts.
Results
Adult-use cannabis regulatory agencies reported all public health indicators more often, while alcohol regulatory agencies reported engaging in law enforcement efforts more often than cannabis regulators. Compared to states that legalized adult-use cannabis through ballot initiatives, states that legalized through their legislatures reported more public health indicators for both cannabis and alcohol regulators. We find a positive correlation within states between the public health engagement of alcohol and cannabis regulators.
Conclusions
Cannabis regulatory agencies largely outperform alcohol regulatory agencies in terms of their articulated public health goals, activities, and policies. US states adopting adult-use cannabis legalization more recently, have predominantly legalized through their state legislatures and have cannabis regulators that report on a greater number of cannabis-related public health issues. More research is needed to assess whether public health-related actions reported by cannabis agencies translate into tangible public health benefits among cannabis using and affected populations.
{"title":"Public health orientation of Cannabis and alcohol regulators: An analysis of state-level variation in the United States","authors":"Codey J. Carr , Peter Reuter , Greg Midgette","doi":"10.1016/j.drugpo.2025.105060","DOIUrl":"10.1016/j.drugpo.2025.105060","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide an analysis of state-level variation in how alcohol and adult-use cannabis regulatory agencies articulate their involvement in, and pursuit of, public health goals.</div></div><div><h3>Methods</h3><div>An important slogan in state-level campaigns to legalize adult-use cannabis was to regulate cannabis “like alcohol.” We conducted a content analysis of annual reports produced by state cannabis and alcohol regulatory agencies in the United States where adult-use cannabis has been legalized to compare the reported public health orientations of each agency. Our coding domains capture references to (1) stated public health goals, (2) data collaboration with public health agencies, (3) public health efforts, and (4) law enforcement efforts.</div></div><div><h3>Results</h3><div>Adult-use cannabis regulatory agencies reported all public health indicators more often, while alcohol regulatory agencies reported engaging in law enforcement efforts more often than cannabis regulators. Compared to states that legalized adult-use cannabis through ballot initiatives, states that legalized through their legislatures reported more public health indicators for both cannabis and alcohol regulators. We find a positive correlation within states between the public health engagement of alcohol and cannabis regulators.</div></div><div><h3>Conclusions</h3><div>Cannabis regulatory agencies largely outperform alcohol regulatory agencies in terms of their articulated public health goals, activities, and policies. US states adopting adult-use cannabis legalization more recently, have predominantly legalized through their state legislatures and have cannabis regulators that report on a greater number of cannabis-related public health issues. More research is needed to assess whether public health-related actions reported by cannabis agencies translate into tangible public health benefits among cannabis using and affected populations.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105060"},"PeriodicalIF":4.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524598","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}
Pub Date : 2025-11-12DOI: 10.1016/j.drugpo.2025.105063
Alexander G. Kuzma-Hunt, Jinhui Zhao, Karen Urbanoski, Jaime Arredondo Sanchez Lira, Timothy Naimi
Background
In 2023, British Columbia (BC), Canada implemented a three-year pilot policy to decriminalize personal possession of a cumulative total of 2.5 g or less of opioids, cocaine, methamphetamine, and MDMA. Under this exemption, individuals found within the threshold are not subject to criminal charges, though possession above 2.5 g, possession in excluded locations (e.g., schools, airports), and trafficking remain criminal offences. This study evaluates the impact of this policy on police-reported drug-related offences, charges, and seizures in Victoria, BC.
Methods
Interrupted time-series analysis used police administrative data from the Victoria Police Department between January 2020 and December 2023. Monthly rates of drug-related offences, charges and seizures per 100,000 adults aged 15+ were analyzed across three policy phases: pre-announcement (run-in), policy awareness, and post-implementation. Autoregressive integrated moving average and mixed linear regression models were used to adjust for trend, seasonality and repeated measures.
Results
Offences and charges declined during the period prior to the implementation of decriminalization, but not during the decriminalization pilot. The mean weight of drugs seized per incident increased significantly post-implementation, but rates and proportions of seizures with cumulative drug weights <4.5 grams declined.
Conclusion
Enforcement shifts preceded formal decriminalization, possibly reflecting anticipatory changes in policing practices. The post-implementation increases in seizure weights, alongside declining low-weight seizures, may indicate a reallocation of enforcement away from personal possession. To strengthen the impact of decriminalization, future efforts should prioritize clear policy communication, implementation training, and alignment between enforcement practices and public health goals.
{"title":"Evaluation of decriminalizing small amounts of illicit drugs in Victoria, BC: A seasonally adjusted interrupted time-series analysis of police data","authors":"Alexander G. Kuzma-Hunt, Jinhui Zhao, Karen Urbanoski, Jaime Arredondo Sanchez Lira, Timothy Naimi","doi":"10.1016/j.drugpo.2025.105063","DOIUrl":"10.1016/j.drugpo.2025.105063","url":null,"abstract":"<div><h3>Background</h3><div>In 2023, British Columbia (BC), Canada implemented a three-year pilot policy to decriminalize personal possession of a cumulative total of 2.5 g or less of opioids, cocaine, methamphetamine, and MDMA. Under this exemption, individuals found within the threshold are not subject to criminal charges, though possession above 2.5 g, possession in excluded locations (e.g., schools, airports), and trafficking remain criminal offences. This study evaluates the impact of this policy on police-reported drug-related offences, charges, and seizures in Victoria, BC.</div></div><div><h3>Methods</h3><div>Interrupted time-series analysis used police administrative data from the Victoria Police Department between January 2020 and December 2023. Monthly rates of drug-related offences, charges and seizures per 100,000 adults aged 15+ were analyzed across three policy phases: pre-announcement (run-in), policy awareness, and post-implementation. Autoregressive integrated moving average and mixed linear regression models were used to adjust for trend, seasonality and repeated measures.</div></div><div><h3>Results</h3><div>Offences and charges declined during the period prior to the implementation of decriminalization, but not during the decriminalization pilot. The mean weight of drugs seized per incident increased significantly post-implementation, but rates and proportions of seizures with cumulative drug weights <4.5 grams declined.</div></div><div><h3>Conclusion</h3><div>Enforcement shifts preceded formal decriminalization, possibly reflecting anticipatory changes in policing practices. The post-implementation increases in seizure weights, alongside declining low-weight seizures, may indicate a reallocation of enforcement away from personal possession. To strengthen the impact of decriminalization, future efforts should prioritize clear policy communication, implementation training, and alignment between enforcement practices and public health goals.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"146 ","pages":"Article 105063"},"PeriodicalIF":4.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514513","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}
Pub Date : 2025-11-08DOI: 10.1016/j.drugpo.2025.105042
Adrienne Gaudreault , Maya Gibb , Robert Talarico , Benedikt Fischerf , Wayne Hall , Daniel T. Myran
Background
In August 2020, the Government of Canada advised federal prosecutors to divert simple drug cases from the criminal justice system, and on January 31, 2023, the province of British Columbia (B.C.) initiated a temporary decriminalization policy for drug possession. It remains unclear whether decriminalization has reduced social and public health outcomes of the drug crisis.
Methods
A population-based cross-sectional study examining data on police-recorded drug crime incidents in Canada from January 1st 2016, to December 31st 2023. A controlled interrupted time-series design was used to assess changes in incidents and charges for drug possession and trafficking, within the first year after implementation of drug decriminalization policies.
Results
Between 2016 and 2023, Canada recorded 204,817 police-recorded drug possession incidents. Before the Federal Prosecutor Directive in 2020, possession and trafficking incident rates were increasing by 0.39 % and 0.78 % respectively each month. In the three years after the Federal Directive, possession incidents declined by 46 % (RR: 0.54, 95 % CI: 0.47–0.62) and trafficking by 43 % (RR: 0.57, 95 % CI: 0.47–0.70). B.C.’s 2023 decriminalization led to a further 52 % drop in police-recorded possession incidents in B.C., while possession rates remained stable in the rest of Canada (Relative Difference: 0.41, 95 % CI: 0.28–0.62). Changes in police-recorded trafficking incidents in B.C., which were not decriminalized, did not differ from the rest of Canada (Relative Difference: 1.00, 95 % CI: 0.53–1.90).
Interpretation
The 2020 Federal Directive and the first year of B.C.’s 2023 decriminalization significantly reduced the burden of enforced drug possession incidents which may have reduced some individual and social harms related to user-criminalization.
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Pub Date : 2025-11-08DOI: 10.1016/j.drugpo.2025.105053
Candan Turkkan
A central tenet of the drug control literature is that the prohibition of drug crops (opium poppy, coca, cannabis) generates a “prohibition premium” that strengthens illicit supply chains and provides a lucrative alternative to legal agriculture. This paper complicates this view by examining a puzzling counter-case: Turkey’s transition to a fully licit opiates fully licit supply chain. Analyzing the post-1974 control regime, I argue that two interventions were critical: the switch to poppy straw process, and the Grain Board’s (TMO) price stabilization policies. While the former removed opium from the supply chain and thus minimized opportunities for diversion at the farm level, latter provided stability for smallholders amidst the fluctuations generated by liberalization of the economy. The case thus demonstrates that states can successfully manage a licit opiate supply chain with minimal diversions and illicit cultivation by removing opportunities and stabilizing agrarian livelihoods through public interventions.
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