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International Journal on Drug Policy

Joshua A Barocas, Jake R Morgan, David A Fiellin, Bruce R Schackman, Golnaz Eftekhari Yazdi, Michael D Stein, Kenneth A Freedberg, Benjamin P Linas
BACKGROUND: Untreated opioid use disorder (OUD) affects the care of HIV/HCV co-infected people who inject opioids. Despite active injection opioid use, there is evidence of increasing engagement in HIV care and adherence to HIV medications among HIV/HCV co-infected persons. However, less than one-half of this population is offered HCV treatment onsite. Treatment for OUD is also rare and largely occurs offsite. Integrating buprenorphine-naloxone (BUP-NX) into onsite care for HIV/HCV co-infected persons may improve outcomes, but the clinical impact and costs are unknown...
May 10, 2019: International Journal on Drug Policy
Jessica F Magidson, John A Joska, Kristen S Regenauer, Emily Satinsky, Lena S Andersen, C J Seitz-Brown, Christina P C Borba, Steven A Safren, Bronwyn Myers
South Africa is home to the largest number of people living with HIV/AIDS in the world. Alongside the HIV/AIDS epidemic, problematic alcohol and other drug (AOD) use is prevalent and associated with poor HIV treatment and secondary HIV prevention outcomes. International guidelines and local policy both support the integration of mental health care and AOD treatment into HIV care, yet barriers exist to implementation. This study aimed to explore patient and provider perspectives on the integration of HIV and AOD treatment services in Cape Town, South Africa...
May 10, 2019: International Journal on Drug Policy
Ruth Praeger, Amanda Roxburgh, Megan Passey, Julie Mooney-Somers
BACKGROUND: In many countries, sexual minority women smoke at higher rates than their heterosexual counterparts. Analyses tend to combine lesbian and bisexual women, preventing an understanding of relevant factors associated with smoking for each group. This analysis used a representative sample of the Australian population to compare tobacco use between heterosexual, lesbian and bisexual women, and examine factors associated with smoking among these groups. METHODS: In a secondary analysis of data from the National Drug Strategy Household Survey (N = 23,855), descriptive statistics were produced for heterosexual (n = 11,776), lesbian (n = 135) and bisexual (n = 167) women...
May 10, 2019: International Journal on Drug Policy
Ian Hamilton, Mark Monaghan
No abstract text is available yet for this article.
May 10, 2019: International Journal on Drug Policy
Meghan Peterson, Josiah Rich, Alexandria Macmadu, Ashley Q Truong, Traci C Green, Leo Beletsky, Kimberly Pognon, Lauren Brinkley-Rubinstein
BACKGROUND: As overdose deaths have increased in the United States, some lawmakers have explored punitive, "supply-side" interventions aimed at reducing the supply of fentanyl. While a rationale of seeking to protect people who use drugs is often given to justify harsh sentences for fentanyl distribution, there is no research to our knowledge on perceptions of the effect of drug-induced homicide laws among people who use drugs. METHODS: We conducted semi-structured, qualitative interviews with 40 people with opioid use disorder (OUD) who were enrolled in a medication for addiction treatment (MAT) program in a unified jail and prison system in Rhode Island on attitudes surrounding increased sentences for distribution of fentanyl, including recently enacted drug-induced homicide laws...
May 9, 2019: International Journal on Drug Policy
Michael Zoorob
BACKGROUND: Rapid increases in drug overdose deaths in the United States since 2014 have been highly regionally stratified, with the largest increases occurring in the eastern and northeastern states. By contrast, many western states saw overdose deaths plateau. This paper shows how the differential influx of fentanyl and fentanyl analogues in the drug supply has reshaped the geography and demography of the overdose crisis in the United States. METHODS: Using all state lab drug seizures obtained by Freedom of Information Act request, I analyze the regionally distinctive presence of fentanyl in the US drug supply with descriptive plots and statistical models...
May 9, 2019: International Journal on Drug Policy
Anna Olsen, Belinda Lawton, Robyn Dwyer, Meng-Wong Taing, Ka Lai Joyce Chun, Samantha Hollingworth, Suzanne Nielsen
BACKGROUND: Opioid overdose is a significant public health issue among people who use pharmaceutical opioids and/or heroin. One response to reducing overdose deaths is to expand public access to naloxone. The Australian Therapeutic Goods Administration down-scheduled naloxone from prescription only (S4) to pharmacist only over-the-counter (OTC, schedule 3) in February 2016. There is little research examining pharmacists' perspectives or experiences of this change. METHODS: Thirty-seven semi-structured interviews with Australian community pharmacists were conducted in 2016-2017 to investigate pharmacists' attitudes to and experiences of OTC naloxone...
May 9, 2019: International Journal on Drug Policy
Alexandra B Collins, Geoff Bardwell, Ryan McNeil, Jade Boyd
No abstract text is available yet for this article.
May 9, 2019: International Journal on Drug Policy
Megan Webb, Heith Copes, Peter S Hendricks
BACKGROUND: Microdosing involves ingesting a small dose of a classic psychedelic (e.g., LSD and psilocybin) at regular intervals for prolonged periods. The practice is said to reduce anxiety, improve mood, and offer several creative and practical benefits to users. Using the narrative identity theoretical framework, our aim was to explore the experiences of those who microdosed classic psychedelics. Specifically, we sought to understand how and why they began microdosing and how they made sense of their actions in the context of their conventional lives...
May 6, 2019: International Journal on Drug Policy
Christopher M Jones
BACKGROUND: Syringe Services Programs (SSPs) have been proposed as a key intervention to address increasing rates of opioid injection, overdose, and infectious disease transmission in the U.S. In recent years, multiple states and jurisdictions have enacted laws and policies to enable implementation of SSPs. These statutory and regulatory changes have resulted in the expansion of SSPs in a short period of time under a patchwork of different regulations and policies. Understanding how SSPs are responding to this evolving policy environment in the midst of a worsening opioid crisis can inform the development of strategies to maximize the role SSPs play in the response to the opioid crisis...
May 3, 2019: International Journal on Drug Policy
Sébastien Tutenges, Frederik Bøhling
Using ethnographic data, this paper investigates the techniques used inside pubs, bars and nightclubs to solicit and sustain alcohol consumption among patrons. Focus is on venues with the majority of patrons belonging to the age group of approximately 15-35 years. The paper identifies a number of techniques, both overt and covert, including: alcohol advertising; special offers (e.g. 'Happy Hours' and 'all you can drink' specials); bartenders' use of strategic intimacy, flirtation, and encouragements to buy more; speed drinking devices (e...
May 2, 2019: International Journal on Drug Policy
Gaurav Jyani, Shankar Prinja, Atul Ambekar, Pankaj Bahuguna, Rajesh Kumar
BACKGROUND: The health and economic consequences of alcohol consumption have been assessed mainly in developed countries. This study aims to estimate health impact and economic burden attributable to alcohol use in India. METHODS: A combination of decision tree and mathematical markov model was parameterized to assess the health effects and economic cost attributable to alcohol consumption. Health effect of alcohol was modelled for a time period of 2011 to 2050 on three sets of conditions - liver disease, cancers and road traffic accidents...
May 2, 2019: International Journal on Drug Policy
Gerrit Kamphausen, Bernd Werse
INTRODUCTION: This article analyses the factors of trust, logistics, and conflict on darknet markets (DNMs) and forums that are dedicated to selling illicit drugs. The analysis is conducted by utilising Elias (1978) theoretical concept of 'figuration,' which refers to the communicative constellations that eventuate between actors. METHODS: A qualitative content analysis was applied to a sample collected from darknet forums related to darknet markets, independent forums with trade sections, and separate vendor shops...
May 1, 2019: International Journal on Drug Policy
Michala Kowalski, Claire Hooker, Monica J Barratt
INTRODUCTION: Why aren't cryptomarkets more widely used? Researchers from a wide array of fields have attempted to answer this question by studying the size of drug cryptomarkets, the substances trafficked, and their structure. In this paper we address the potential acceptance of drug cryptomarkets by studying their perceived ease of use. METHODS: This paper draws on observational data collected over 350 h of unstructured observation during an ethnographic study conducted in April-September 2016 of the two most prominent drug cryptomarkets at the time, in addition to seven face-to-face semi-structured qualitative interviews...
May 1, 2019: International Journal on Drug Policy
Hannah K Knudsen, Michelle R Lofwall, Sharon L Walsh, Jennifer R Havens
BACKGROUND: Health insurance improves health and reduces mortality. Expanding insurance is a central feature of the Affordable Care Act (ACA). Persons who use drugs (PWUDs) have historically been at high risk of being uninsured. It is unknown if Appalachian PWUDs, who live in an extremely economically distressed region, are more likely to be insured since implementation of the ACA. METHODS: Data from a cohort of 503 PWUDs from eastern Appalachian Kentucky, who were interviewed at seven time-points between 2008 and 2017, were analysed using mixed effects regression models...
May 1, 2019: International Journal on Drug Policy
Brian Vandenberg, Heng Jiang, Michael Livingston
BACKGROUND: In 1988, the Australian government introduced a single nominal rate of tax on all beer products calculated on alcohol content. However, in 2000/01, varying nominal rates of tax were introduced for beer products according to three alcohol content levels (low-/mid-/high-strength) and container type (on-/off-premises). Little is known about the effect of the different tax policies on alcohol consumption and government revenue. METHODS: We undertake time series analysis over 1989-2016 to examine the effect of beer tax policies in two sub-periods (before/after 2000/01) on category-level beer consumption per capita and government revenue...
May 1, 2019: International Journal on Drug Policy
Silje Anderdal Bakken, Jakob Johan Demant
INTRODUCTION: From the early use of pagers and cellular phones to the darknet and smartphones, technological developments have facilitated drug deals in various ways, especially by altering time and space boundaries. Traditional drug market literature theorises about how physical markets, within which sellers act according to their risk perceptions and motivation, are led by supply, demand, and enforcement. However, there is an almost absolute research gap in understanding how this relates to digital markets and social media markets in particular...
May 1, 2019: International Journal on Drug Policy
Jakob Manthey
In this contribution, I summarize recent trends of cannabis use in Europe and their public health implications. The first trend refers to an increase of treatment demand for cannabis problems by 76% while prevalence of cannabis use remained largely stable in the same period, based on available data. There are good reasons to assume that this trend reflects increases in the prevalence of cannabis use disorders, however, data to support this claim are not available. Potential drivers for a rising prevalence of cannabis use disorders comprise changes in consumption patterns and increasing levels of THC in available cannabis products...
April 25, 2019: International Journal on Drug Policy
Michelle Olding, Dan Werb, Andy Guise, Will Small, Ryan McNeil
Despite the proliferation of fentanyl and fentanyl-adulterated opioids in North America, the impacts of this drug market change on injection initiation processes have not been examined. With the aim of informing structural interventions to address injection initiation and related harms, we explore how people who inject drugs (PWID) in Vancouver, Canada understand and navigate social norms of initiating others into injecting within the context of an overdose crisis. In-depth qualitative interviews were conducted with 19 PWID who reported helping someone inject for the first time...
April 25, 2019: International Journal on Drug Policy
Carl A Latkin, Rachel E Gicquelais, Catie Clyde, Lauren Dayton, Melissa Davey-Rothwell, Danielle German, Seun Falade-Nwulia, Haneefa Saleem, Michael Fingerhood, Karin Tobin
BACKGROUND: Fatalities from opioid overdose quadrupled during the last 15 years as illicit opioid use increased. This study assesses how stigma and drug use settings are associated with non-fatal overdose to identify targets for overdose risk reduction interventions and inform overdose education and naloxone distribution programs. METHODS: We surveyed 444 people who used drugs in Baltimore, Maryland, USA, from 2009 to 2013 as part of a randomized clinical trial of a harm reduction intervention...
April 23, 2019: International Journal on Drug Policy
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