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.

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.

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.

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.

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.

In Denmark, rising concern over young people's non-prescribed use of opioids such as tramadol and oxycodone has fueled media narratives invoking predatory suppliers and vulnerable youth, with a key emphasis on kiosks and social media as venues that make opioids immediately accessible to young people. To inform effective policy responses, more nuanced, empirically grounded understandings of youth opioid sourcing are needed.

Regulatory approaches to alcohol availability vary widely, yet policies that control the number or location of alcohol retail outlets remain under-documented. This study aimed to identify and describe these approaches across jurisdictions in the USA and Canada.

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.

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.

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.

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.

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.

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.

As the global cannabis policy landscape shifts in some places from prohibition to decriminalization to different forms of regulated markets, there is a unique opportunity to explore how the experiences of women cultivators may vary along with such policy change. This study aims to advance our knowledge of women's participation in cannabis cultivation in a time when the legal status of cannabis is becoming more diversified globally.

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.

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.

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" (The Work of Art in the Age of Mechanical Reproduction) 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.

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.

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.