Estimating the Cost-Saving Threshold of a Rural Syringe Services Program Before and During the COVID-19 Pandemic.

This study aimed to examine shifts in the cost-savings threshold of a rural syringe services program (SSP) that resulted in the 12-months following the identification of the COVID-19 pandemic. We compared SSP operational costs during the 12-months immediately before and after identification of the COVID-19 pandemic using administrative data from the Cabell-Huntington Harm Reduction Program (CHHRP), which is operated by the Cabell-Huntington Health Department in West Virginia. Data included monthly counts of client encounters, sterile syringe distribution, and HIV testing.

"Smoking weed it gets you over the hump": Cannabis co-use as a facilitator of decreased opioid use among people who inject drugs in Los Angeles, California.

Introduction: Opioid overdose mortality rates have surged dramatically in the last decade due largely to fentanyl in the illicit US drug supply. As of June 2024, 38 states, three territories, namely US Virgin Islands, Guam and the Northern Mariana Islands, and the District of Columbia, allow the medical use of cannabis products. However, there remains limited qualitative community-based evidence on the role of cannabis co-use among opioid using and injecting populations.

'Zombie drugs': Dehumanising news frames and public stigma towards people who use drugs.

Background: News media is an important determinant of public understanding of drug policy topics. Recent media reporting around the use of synthetic drugs such as xylazine makes frequent use of non-human metaphors, including reference to the effects of 'zombie drugs'. We investigated whether presentation of news stories which included such dehumanising frames were associated with i) increased stigmatising attitudes towards people who use drugs; and ii) lower support for relevant harm reduction programmes.

Calorie (energy) labelling for changing selection and consumption of food or alcohol.

Background: Overconsumption of food and consumption of any amount of alcohol increases the risk of non-communicable diseases. Calorie (energy) labelling is advocated as a means to reduce energy intake from food and alcoholic drinks. However, there is continued uncertainty about these potential impacts, with a 2018 Cochrane review identifying only a small body of low-certainty evidence.

Opioid agonist therapy discontinuation in British Columbia: a cross-sectional study of people who access harm reduction services.

Objectives: This study evaluates the prevalence and correlates of opioid agonist therapy (OAT) discontinuation across British Columbia (BC), using a sample of individuals who used substances and accessed harm reduction sites.

Design: This study uses data from the 2019 cross-sectional Harm Reduction Client Survey (HRCS).

Setting: The 2019 survey was administered from October to December at 22 harm reduction supply distribution sites across the 5 Regional Health Authorities of BC.

Aflatoxin B1 impairs the growth and development of chicken PGCs through oxidative stress and mitochondrial dysfunction.

Aflatoxins harm the reproductive system and gamete development in animals. Primordial germ cells (PGCs) in chickens, as ancestral cells of gametes, are essential for genetic transmission, yet the impact and mechanisms of aflatoxins on them remain elusive. This study systematically investigated the effects of aflatoxin B1 (AFB1) on chicken PGCs and their potential mechanisms using an in vitro culture model.

Opioid-related harms and experiences of care among people in justice settings in New South Wales, Australia: evidence from the National Ambulance Surveillance System.

Background: People in justice settings experience higher rates of psychiatric morbidity, including alcohol and drug use disorders, compared with the general population. However, our understanding of opioid-related harms in justice settings is limited. This study used ambulance data to examine opioid-related harms and experiences of care in New South Wales (NSW), Australia, during periods of incarceration or detention.

HIV pre-exposure prophylaxis prescription initiation and maintenance among homeless-experienced people who use drugs.

Background: HIV pre-exposure prophylaxis (PrEP) remains particularly underutilized among homeless-experienced people who use drugs (PWUD).

Setting: Boston Health Care for the Homeless Program, a Federally Qualified Health Center serving homeless-experienced individuals in Boston, Massachusetts.

Methods: To identify determinants of PrEP prescription initiation and continuation, we analyzed electronic medical records and pharmacy data between April 2018-March 2022.

Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

HIV Prevention in Syringe Service Programs Since the Start of COVID-19: Where Do We Go From Here?

Purpose: This narrative review addresses post-2020, specific, complex challenges for use of and adherence to pre-exposure prophylaxis (PrEP) for HIV prevention among out-of-treatment people who use drugs (PWUD) at syringe services programs (SSPs).

Recent Findings: The COVID-19 pandemic and its associated changes to the provision of healthcare have significantly impacted HIV prevention, especially for PWUD. Through a synthesis of literature and clinical experience, we (1) characterize the operational changes imposed by the pandemic on SSPs that shaped the current HIV prevention landscape; (2) describe three levels of current challenges for PWUD, including consumer attitudes, non-medical and medical provider attitudes, and structural and scalability barriers; (3) characterize current models for PrEP in SSPs; and (4) offer practical recommendations for HIV prevention in harm reduction programs.

Adverse childhood experiences, resilience, and syringe services program attendance among persons who inject drugs in Northeast Georgia, USA: A mediation analysis.

Background: Syringe services programs (SSP) are evidence-based venues offering harm reduction services to persons who inject drugs (PWID), such as sterile syringes, STI/HIV testing, and linkage to care to decrease drug use-related morbidities and mortalities. Adverse childhood experiences (ACEs) have been linked with reduced resilience, while increased resilience can help PWID attend SSPs. This study examined the potential mediating role of resilience between ACEs and SSP attendance among PWID.

"New Normal:" Opportunities and Challenges Faced by Syringe Service Programs Following the Effects of the COVID-19 Pandemic.

Syringe services programs (SSPs) provide critical evidence-based public health services that decrease harms from drug use for people who use drugs (PWUD). Many SSPs have experienced significant and evolving COVID-19-related disruptions. We aimed to characterize the impacts of COVID-19 on SSP operations in the United States approximately two years into the pandemic.

Content analysis of perceptions of combined pharmacobehavioral treatment for American Indian people with opioid use disorder.

Objective: Both opioid misuse and overdose mortality have disproportionately impacted the American Indian population. Although medications for opioid use disorder, such as buprenorphine (BUP-NX), are highly effective in reducing overdose mortality, questions have been raised about the cultural acceptability of Western medical approaches in this population. Understanding patients' desired recovery pathways can lead to more culturally appropriate, patient-centered, and effective approaches to opioid use disorder (OUD) treatment.

Approaches, Barriers, and Facilitators in Statewide Initiative to Combat Opioid Overdose: A Narrative Review of Ohio's Experiences During the HEALing Communities Study.

Objectives: Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).

Patient experience of an abstinence-based Indigenous residential treatment program in Northern Ontario: a descriptive qualitative study.

Background: Indigenous peoples with substance use disorders (SUD) and intergenerational trauma (IGT) face complex healthcare needs. Therefore understanding Indigenous patient experiences is crucial for enhancing care delivery, fostering engagement, and achieving optimal outcomes, yet few studies explore the motivations for seeking, staying in, and utilizing treatment from an Indigenous perspective. The goal of this study was to understand the patient experience with an abstinence-based treatment model in a residential treatment setting.

Medicare Part D: Major Shifts With the Inflation Reduction Act and a Way Forward.

The Inflation Reduction Act (IRA) of 2022 introduced major changes in the Part D benefit that aim to improve medication access and correct several of the financial misalignments in the current Part D benefit. The changes address financial obligations of Medicare beneficiaries, the federal government, Part D plan sponsors (i.e.

Perceptions of access to harm reduction services during the COVID-19 pandemic among people who inject drugs in metropolitan Chicago.

Background: The COVID-19 pandemic amplified the risk environment for people who inject drugs (PWID), making continued access to harm reduction services imperative. Research has shown that some harm reduction service providers were able to continue to provide services throughout the pandemic. Most of these studies, however, focused on staff perspectives, not those of PWID.

Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies.

In 2020, the in the county of San Diego (COSD) was launched, a private-public joint endeavor between the COSD and the American Liver Foundation. We use epidemic modeling to assess whether the COSD is on track to reach its elimination targets (80% reduction in incidence, 65% reduction in hepatitis C virus (HCV)-related mortality by 2030 compared to 2015) and what intervention scale-up may be required. We adapted a previously developed dynamic, deterministic model of HCV transmission and disease progression among adults in the COSD, stratified by risk, age, gender, and human immunodeficiency virus (HIV) status.

A Qualitative Study to Describe the Nature and Scope of Street Medicine Programs in the United States.

Street medicine is a health delivery model designed to provide direct patient care to people experiencing unsheltered homelessness where they are physically located, whether that be on the streets or in encampments. The model has developed in response to the barriers people experiencing homelessness (PEH) encounter when accessing care through traditional points of access such as primary care clinics. Street medicine programs are rapidly emerging across the United States (U.

The impact of Covid-19 on harm reduction policies in Iran: an interrupted time series analysis.

Background: The global emergence of the Covid-19 pandemic in 2019 posed unprecedented challenges to healthcare systems, disrupting routine services and necessitating swift adaptations. Harm reduction programs, vital for addressing substance use-related health risks, faced unique challenges during the pandemic, impacting vulnerable populations. This study focuses on the repercussions of Covid-19 on harm reduction policies in Iran, specifically examining the distribution of condoms, syringes, and methadone to high-risk individuals attending Triangle Centers.

Implementing recycling in the operating room: a single-center experience.

Background: Climate change poses significant challenges to global health, exacerbated by healthcare systems' carbon footprint and waste generation. Surgical activities contribute to these impacts, necessitating sustainable practices to mitigate environmental harm. This study aims to assess the feasibility and effectiveness of a recycling program in reducing waste, carbon emissions, and disposal costs in the operating rooms (ORs).

A Cross-Sectional Evaluation of Opioid Dispensing Competencies in Final-Year Pharm-D Students: A Multicenter Study from Punjab, Pakistan.

Background: The opioid crisis continues to be a public health concern worldwide due to the high rates of misuse and associated mortality. Opioid dispensing competencies are critical for pharmacy graduates to promote the rational use of opioids.

Purpose: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.

Evaluating client functioning in a harm reduction program in South Africa: insights from a tool derived from the International Classification of Functioning, Disability and Health.

South Africa faces the detrimental effects of problematic substance use. The Community Oriented Substance Use Program (COSUP) is a research-based, community-situated harm-reduction program. The International Classification of Functioning, Disability and Health (ICF) was used as the framework to develop a unique tool to determine the functioning of COSUP clients.

Impact of diagnosis-related group payment on medical expenditure and treatment efficiency on people with drug-resistant tuberculosis: a quasi-experimental study design.

Background: The severe health challenge and financial burden of drug-resistant tuberculosis (DR-TB) continues to be an impediment in China and worldwide. This study aimed to explore the impact of Diagnosis-related group (DRG) payment on medical expenditure and treatment efficiency among DR-TB patients.

Methods: This retrospective cohort study included all DR-TB patients from the digitized Hospital Information System (HIS) of Wuhan Pulmonary Hospital and the TB Information Management System (TBIMS) with completed full course of National Tuberculosis Program (NTP) standard treatment in Wuhan from January 2016 to December 2022, excluding patients whose treatment spanned both before and after the DRG timepoint.