Achieving HIV epidemic control through accelerating efforts to expand access to pre-exposure prophylaxis for people who inject drugs.

The world is not on track to reach the majority of the UNAIDS 2025 targets, and people who inject drugs (PWID) continue to be left behind, hindered by counterproductive law enforcement practices, punitive laws, economic distress, and social stigma and discrimination. Poor access to HIV pre-exposure prophylaxis (PrEP) among PWID is nested within the limited access to broader harm reduction services, including needle and syringe programs, opioid overdose management, opioid agonist therapy (also known as medication-assisted treatment), and condoms. Among PWID, women who inject drugs are disproportionately affected and face additional gender-based barriers.

An interrupted time series analysis of fentanyl, naloxone, and opioid-involved deaths in five counties in Eastern Missouri.

Introduction: Rates of opioid overdose deaths (OOD) have increased since the introduction of illicitly manufactured fentanyl in the U.S. drug supply.

Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care.

Background: TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use.

Methods: An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019-November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted.

"They talk about it like it's an overdose crisis when in fact it's basically genocide": The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood.

Indigenous Peoples who use illicit drugs (IPWUID) are disproportionately represented among toxic drug poisoning deaths in Canada. These drug-related harms are framed by the historical and ongoing trauma related to settler colonialism and are acutely visible in Vancouver, Canada's Downtown Eastside - a low-income neighbourhood that is an epicenter of the drug poisoning crisis and characterized by entrenched poverty, substance use, violence, and homelessness. This study was undertaken to examine the experiences and perspectives of IPWUID in the Downtown Eastside regarding the drug poisoning crisis and the responsiveness of harm reduction programs within the context of settler colonialism.

Examining naloxone access and interest in secondary naloxone distribution on an American Indian Reservation in the Northern Midwest of the United States.

Background: Indigenous communities in the United States experience disproportionate rates of overdose morbidity and mortality due to a range of historical traumas and ongoing oppression. Limited health and harm reduction service access on some Tribal lands exacerbate these challenges. To date, little is known about naloxone access on tribal reservation lands.

North Carolina Treatment Courts: Therapeutic Jurisprudence as a Path Toward Recovery and Restoration.

At a time when most of our headlines focus on overdoses and overdose-related deaths, recovery is possible. Treatment courts are providing a path toward recovery and healing.

Lessons From One Physician's Experience With Substance Use Recovery.

I advocate for a "no wrong door" approach, which ensures that no matter where you enter the system-doctor, therapist, family-referral, self-report, jail, hospital, etc. -you get the treatment that gives you the best chance at long-term recovery, even if you don't have M.D.

The Role and Importance of Physician and Health Care Professional Programs.

Physician Health Programs (PHPs) have been support-ing and advocating for health professionals for nearly four decades. Initially developed by state medical societies in the 1980s, PHPs recognized the need for therapeutic alterna-tives to disciplinary measures for physicians facing health issues that could impair their ability to practice safely. Originally focused on substance use disorders, PHPs have since expanded their services to encompass mental health and other co-occurring conditions.

Self-reported drink driving, enforcement, crashes, and crash reporting: A 6-country comparison.

Objective: The objective of this study was to compare drink driving and related road safety issues in 2 urban areas of 6 countries and develop an equation for estimating the rate of crash underreporting to the police in urban areas of countries that lack this information.

Methods: This study is a secondary analysis of 1 to 2 waves of surveys in pairs of matched medium-sized cities in Belgium, Brazil, China, Mexico, South Africa, and Ohio, United States; the surveys supported evaluation of local alcohol harm reduction efforts. Data were from 2017 to 2019 except 2023 for Mexico.

The Opioid Crisis, Preventing and Managing Substance Abuse in India: A Systematic Review.

The opioid crisis has emerged as a significant public health concern globally, with India facing unique challenges in preventing and managing substance abuse. This systematic review aims to analyze the current state of the opioid crisis in India, evaluate existing prevention and management strategies, and propose evidence-based recommendations for addressing this complex issue. A comprehensive literature search was conducted across multiple databases, resulting in the inclusion of 30 studies meeting the predefined criteria.

Developing STEP-SE: A Qualitative Usability Study of a Novel Patient-Reported Outcomes Tool for Managing Side Effects in Shared Decision-Making for Schizophrenia Spectrum Disorder Care.

Background: Schizophrenia treatment with antipsychotics often results in side effects that impact adherence and quality of life. Managing these effects remains challenging, as it requires balancing efficacy and tolerability. The Schizophrenia Technological Evaluation of Patient Side Effects (STEP-SE) app aims to aid side effects monitoring and management through shared decision-making (SDM).

Effects of E-Cigarettes on Combustible Cigarette Smoking Among Adults with Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial.

Introduction: People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.

Naloxone Coprescribing and the Prevention of Opioid Overdoses: Quasi-Experimental Metacognitive Assessment of a Novel Education Initiative.

Background: Critical evaluation of naloxone coprescription academic detailing programs has been positive, but little research has focused on how participant thinking changes during academic detailing.

Objective: The dual purposes of this study were to (1) present a metacognitive evaluation of a naloxone coprescription academic detailing intervention and (2) describe the application of a metacognitive evaluation for future medical education interventions.

Methods: Data were obtained from a pre-post knowledge assessment of a web-based, self-paced intervention designed to increase knowledge of clinical and organizational best practices for the coprescription of naloxone.

Tobacco use disorder in patients with other mental disorders: a dual disorder perspective from clinical neuroscience.

Tobacco smoking is the leading cause of disability and preventable deaths worldwide, but it should be differentiated from tobacco use disorder, which is, according to the Diagnostic and Statistical Manual of Mental Disorders, a mental disorder. The rapid delivery of nicotine to the brain activates acetylcholine receptors and stimulates the release of dopamine, both systems implicated in other mental disorders. Rates of tobacco use disorder are much higher among people suffering from other mental disorders and these patients find it more difficult to quit.

[The effectiveness of compulsory treatment for substance use disorder].

Background: In a minority of patients with substance use disorders, there is both unwillingness to treat and serious harm or damage to the patient or society. In these situations, compulsory treatment may be considered. However, it is unclear whether compulsory care is effective in reduction of substance use.

Phytochemical Analysis and Antioxidant, Antimicrobial, and Antibiofilm Effects of a New Himalayan Lichen Usman and Khalid Growing in Pakistan.

Phytochemical composition and antimicrobial, antibiofilm, and antioxidant effects of a newly described Himalayan lichen Usman and Khalid growing in Pakistan were investigated. HPLC-DAD methods were used for identification of secondary metabolites in acetone and methanol extracts. The total phenolics content was measured using a spectrophotometric method.

Predictors of treatment outcomes for Hepatitis C infection in a nationwide elimination program in Iceland: The treatment as prevention for Hepatitis C (TraP HepC) study.

Background: Limited data exists about treatment outcomes in nationwide hepatitis C virus (HCV) elimination programs where injection drug use (IDU) is the main mode of transmission. In 2016 Iceland initiated the HCV elimination program known as Treatment as Prevention for Hepatitis C (TraP HepC). Factors associated with HCV cure in this population are examined.

"We're Not Gonna Aid You in Shooting Up": Stigma's Relationship to Harm Reduction in People Who Inject Drugs.

Background: Harm reduction, when applied to drug use, prioritizes improving patient-centered health outcomes and reducing drug-related harm. In order for harm reduction strategies to be adopted by people who inject drugs (PWID), they need to be promoted, accessible, and accepted in that population and the community-at-large. While PWID face stigma at multiple levels, less is known about how stigma influences uptake and acceptance of harm reduction services and strategies among PWID.

Frequency is not enough: Characterizing heterogenous patterns of cannabis use intensity among reservation-area American Indian youth.

Background: Reservation-area American Indian (AI) youth use cannabis at significantly higher rates than their national counterparts. This discrepancy is concerning, as cannabis use-particularly heavy use-can negatively impact adolescents' health. Studies primarily use frequency to classify cannabis use intensity; however, frequency alone may not fully capture heterogenous patterns of use.