Research News Roundup: June 12, 2025

Journal: Drug and Alcohol Dependence Reports, 2025, doi: 10.1016/j.dadr.2025 .100341.

Authors: Kevin Frederiks, Maxwell Everett, Kristen Gilmore Powell, N. Andrew Peterson, Suzanne Borys, Donald K. Hallcom, & Nina A. Cooperman

Abstract:

The United States opioid epidemic is an enormous public health crisis, claiming over 500,000 lives between 1999 and 2020. However, the increased availability of naloxone has saved many lives and led to the development of community-based naloxone training and distribution programs. We developed a naloxone education and distribution program in New Jersey in 2017. This program provides a 60-minute training for community members in various settings, such as police departments, community centers, etc. Participants were instructed to call the training and distribution program if they used their naloxone kit, and the program would replace it. Callers were asked a short survey about behaviors during the naloxone administration and overdose outcome. From January 2018 through June 2022, 191 calls to report an overdose and request a new kit were received. Overall, 70 (37 %) of the reported naloxone administrations were by police, 38 (20 %) family/friends, and 50 (26 %) strangers. The most common actions taken during the overdose included: 162 (85 %) calling EMS; 161 (84 %) staying with the person who overdosed until EMS arrived; and 131 (69 %) checking the individual who overdosed for signs of breathing. Individuals who helped with an overdose were able to revive the person in 172 (90 %) of the reported overdoses. Our data suggests that participants in these programs will use naloxone for opioid overdoses whether the victim is known to the participant or a stranger. Future research should focus on understanding outcomes of and behaviors during overdose episodes that are not reported to the program.

To read the full text of the article, please visit the publisher’s website.

Journal: Harm Reduction Journal, 2025, doi: 10.1186/s12954-025-01238-4

Authors: Bailey E. Pridgen, Andrew P. Bontemps, Audrey R. Lloyd, William P. Wagner, Emma S. Kay, Ellen F. Eaton, & Karen L. Cropsey

Abstract:

A wealth of research demonstrates that harm reduction interventions for substance use (SU) save lives and reduce risk for serious infectious diseases such as HIV, hepatitis C, and other SU-related health conditions. The U.S. has adopted several harm reduction interventions at federal and state levels to combat SU-related harm. While several policy changes on the federal and state levels decriminalized interventions and further support their use, other policies limit the reach of these interventions by delaying or restricting care, leaving access to life-saving interventions inconsistent across the U.S. Federal and state policies in the U.S. that restrict access to medications for opioid use disorder (MOUD), criminalize possession of drug paraphernalia, prevent syringe service programs and overdose prevention centers from operating, and limit prescribing of pre-exposure prophylaxis (PrEP) pose significant barriers to harm reduction access and implementation. This paper aims to bridge publications and reports on current state and federal harm reduction intervention policies and discuss policy recommendations. Federally, the DEA and SAMHSA should expand certification for methadone dispensing to settings beyond dedicated opioid treatment programs and non-OTP prescribers. Congress can decriminalize items currently categorized as paraphernalia, permit purchasing of syringes and all drug checking equipment using federal funds, amend the Controlled Substances Act to allow for expansion of overdose prevention centers, protect Medicaid coverage of PrEP, and expand Medicaid to cover residential SU treatment. At the state level, states can reduce regulations for prescribing MOUD and PrEP, decriminalize drug paraphernalia, codify Good Samaritan laws, and remove restrictions for syringe service program and overdose prevention center implementation. Lastly, states should expand Medicaid to allow broader access to treatment for SU and oppose Medicaid lock-outs based on current SU. These changes are needed as overdose deaths and serious infectious disease rates from SU continue to climb and impact American lives.

To read the full text of the article, please visit the publisher’s website.

Journal: Substance Use: Research and Treatment, 2025, doi:10.1177/ 29768357 251342749

Authors: Elizabeth Siantz, Leopoldo J. Cabassa, & Adam J. Gordon

Abstract:

People with opioid use disorder (OUD) experience higher prevalence of serious mental illness (e.g., schizophrenia and bipolar disorder) and chronic disease (e.g., diabetes) relative to the general population, less access to high quality health care, and limited access to evidence-based treatments that promote self-management of chronic health conditions. The Chronic Disease Self-Management Program is a widely used patient education intervention that imparts disease knowledge and self-management skills to people with a range of medical conditions. In this Perspective Column, a multidisciplinary team of community-based researchers representing the fields of social work and addiction medicine argue that implementing the Chronic Disease Self-Management Program in a primary care environment is a promising way to build the self-management skills of people with OUD and co-occurring mental illness and chronic disease.

To read the full text of the article, please visit the publisher’s website.

Journal: Harm Reduction Journal, 2025, doi: 10.1186/s12954-025-01249-1

Authors: Aaron Salwan, KariLynn Dowling-McClay, Daniel Greer, Ali AlAli, & Bill Brooks

Abstract:

Background: Xylazine, commonly known as ‘Tranq,’ is a veterinary tranquilizer that is increasingly found in the recreational opioid supply, complicating the user experience. Xylazine-adulterated fentanyl is associated with a withdrawal syndrome that may not respond to usual treatment, and the opioid overdose reversal agent naloxone does not reverse the effect of xylazine.1 While it remains unclear whether xylazine directly increases overdose deaths, its presence in the drug supply likely elevates overall harm and morbidity. Moreover, due to unintended contact, xylazine poses an often unaccounted for danger to people who use drugs, and there is limited understanding of risk perception among people subject to xylazine exposure. The existing research indicates variations in the extent that individuals desire to use or avoid substances that contain xylazine.2, 3 This study aimed to evaluate how people who use drugs perceive their susceptibility to and severity of exposure to xylazine, and to assess how these perceptions impact their engagement in harm reduction behaviors.

Methods: We recruited people receiving treatment for substance use disorders at a community hospital. We used Spearman correlations to evaluate the associations between patient characteristics and perceptions of xylazine exposure are associated with harm reduction behaviors. The survey instrument was informed by the Health Belief Model.

Results: Over half of participants (26/49), estimated that at least some of the drugs that they use contain xylazine, and 73.5% believed that exposure to xylazine increased their risk of overdose. Approximately 65% of respondents reported never trying to obtain xylazine, and only 12.2% agreed or strongly agreed that they were more likely to use a batch of drugs if they knew it contained xylazine. Overall, engagement in harm reduction behaviors was limited, with 57.1%, reporting that they rarely or never carried naloxone when using drugs and 77.6% reported rarely or never testing their drugs before use. There was a positive association between the belief that xylazine increases the risk of overdose and engagement in harm reduction behaviors (Spearman Rho = 0.290, p = 0.043). Participants who identified xylazine in their drugs and modified their behavior as a result are significantly more likely to regularly practice overdose prevention behaviors.

Conclusion: Xylazine is increasingly present in the drug supply, yet susceptibility to exposure does not appear to influence engagement in harm reduction behaviors. Limited use and knowledge of test strips, as well as other overdose prevention behaviors, highlights the need for targeted harm reduction education. Healthcare providers in all practice settings should be aware of the potential risks posed by xylazine exposure and prioritize evidence-based care, including harm reduction.

To read the full text of the article, please visit the publisher’s website.