The public has come to view marijuana reform favorably. However, the “green rush” has faced challenges, including stalled referenda and concerns about the effects of legalization. Given the public’s influence in spurring recreational marijuana reform (RML), it is critical to monitor public attitudes. Given this influence, we first examine to what extent does the public support legalization? Second, given fear of crime arguments, how do perceptions of crime/disorder affect support? Third, because marijuana use has historically been linked to minority groups, to what extent does ethnic threat affect support for RML? Fourth, what additional divides, along socio-demographic dimensions, are evident in regulation support? Drawing on a 2024 wave of the Pew Research Center Poll, this study examines public perceptions toward marijuana reform. Results show that while most Americans support legalization, crime-related concerns, ethnic resentment/threat, and key socio-demographic traits are tied to regulatory attitudes. Implications are discussed.
Criminal legal system (CLS)-involved women who use opioids experience substantial challenges engaging in medications for opioid use disorder (MOUD). This qualitative study examined multilevel determinants of MOUD engagement across carceral, reentry, and community contexts. We conducted a secondary analysis of semi-structured interviews with 12 CLS-involved women with histories of opioid use and MOUD treatment. Reflexive thematic analysis, informed by the social ecological model, identified individual, interpersonal, and institutional/structural determinants. Medication experiences, treatment preferences, recovery motivation, and interpersonal relationships shaped engagement, while institutional/structural determinants included treatment costs, inconsistent jail-based MOUD access, inadequate discharge planning, and availability of low-barrier community services. Notably, jails emerged as sites of both treatment disruption and opportunity. Findings highlight the dynamic, multilevel nature of MOUD engagement and support patient-centered, harm-reduction approaches that preserve treatment choice, facilitate reengagement, and strengthen continuity of care across incarceration, reentry, and community settings.
Evidence on changes in cannabis use (CU) patterns among university students remains limited. This prospective study examined predictors of changes in CU frequency (initiation, maintenance, increase, decrease, and cessation) from baseline to a 12-month follow-up in 3,234 Mexican first-year university students. Bivariate and multivariate logistic regression and repeated-measures linear mixed models were used to identify predictors of CU change frequency, accounting for within-individual effects over time. Among students with lifetime CU (n = 635), initiation and cessation were the most common trajectories. Initiation was associated with stronger high-school peer support (AOR = 1.70), alcohol use disorder symptoms (AOR = 2.83), and no religious affiliation (AOR = 1.46). Cessation was associated with older age (AOR = 2.35) and lifetime cocaine use (AOR = 2.22). Older age, critical/quarrelsome personality, and illicit drug use predicted higher baseline CU frequency but steeper subsequent declines. Findings underscore the first university year as a critical transition period and highlight the time-varying effects of CU risk and protective factors.
Although people who are involved with the U.S. criminal-legal system are at high risk for opioid overdose, access to opioid use disorder (OUD) best practices such as naloxone distribution and medications for OUD (MOUD) remains limited. As part of the HEALing Communities Study landscape analysis, this survey of 19 clinicians employed by one state’s department of corrections explores their reports of the availability, accessibility, and utilization of OUD best practices among their clients on probation and parole. Clinician-reported program practices included consistent OUD screening but minimal provision of overdose education and naloxone to both clients and their families and friends. The most pressing perceived barriers to their clients’ ability to access MOUD identified by clinicians were transportation, the lack of providers, and stigmatizing attitudes among key legal and medical decision-makers. These clinicians’ perspectives underscore persistent gaps in MOUD availability and intervention stigma among criminal-legal system professionals.
Hashish use among youth is a widely documented public health concern in many parts of the world. This study explores the social and contextual meanings that evening hashish use holds for young male users in the newly merged Mohmand district of Khyber Pakhtunkhwa, Pakistan. Using a descriptive qualitative design situated within an interpretive paradigm, we conducted ten semi-structured, in-depth interviews with male hashish users aged 18–30, recruited through purposive sampling at known gathering sites. Data were analyzed using Braun and Clarke’s thematic analysis, supported by MAXQDA 24. Participants associated evening hashish use with the calming quality of twilight, reduced parental and community oversight during that time, peer bonding rituals, and the glorification of evening hashish use in local songs and oral tradition. These findings offer insights of the youth in this locality make sense of and justify their evening hashish use.
Over the past decade in Sweden, there has been a growing political and media discussion on the expansion of illegal drug markets. Although research has increased, few studies have examined how former drug users perceive the situation. This study explores former drug users perspectives on the illicit drug market in the 21st century. Semi-structured interviews were conducted with 16 former drug users and four main themes were identified: (1) the violent environment, (2) the escalation of organized crime, (3) the ease of access to illegal drugs and (4) diverse perspectives on policy and prevention. There was a consensus among the interviewees that there has been an increase in organized crime and violence in the illegal drug market and that the availability of drugs in Sweden has increased during the 21st century. However, there were diverse opinions regarding drug policy and legislation. More research is needed on lived experience and attitudes to drug policy in Sweden.
This study investigated deficits in social contract reasoning among 78 males with Substance Use Disorder (SUD) and 56 matched healthy controls using eye-tracking. A 2 & times; 2 mixed-design revealed a specific impairment: while both groups showed the classic content effect (better performance on social contract rules), the SUD group was significantly less accurate only on social contract tasks. Eye-tracking analyses further revealed that healthy controls preferentially attended to cost-benefit regions during social-contract trials, whereas the SUD group allocated significantly less attention to these critical areas. This dissociation indicates a deficit not in general logical ability but in the attentional processing of social cost information, which is associated with poorer social contract reasoning. The findings identify an attentional mechanism underlying social dysfunction in addiction and suggest a target for cognitive rehabilitation focused on processing social obligation cues.
The Opioid and Naloxone Education (ONE) Program expanded to correctional facilities in North Dakota to address the impact of opioid misuse among incarcerated individuals. This pilot aimed to evaluate the feasibility and outcomes of implementing comprehensive opioid risk screening, education, and harm reduction interventions in correctional settings. Among 168 individuals who were screened, 65.5% were at risk for opioid-related harm. Unsafe medication storage and disposal were common, and 13% reported diversion behaviors. Nearly 90% accepted naloxone, lockboxes, and disposal tools, demonstrating initial engagement with harm reduction modalities. Seventeen percent have previously received medication for opioid use disorder, and 19% expressed interest in initiating treatment. The findings of this pilot suggest implementing opioid risk screening and harm reduction education within correctional settings is feasible and associated with high engagement. The ONE Program may provide a structured approach to identifying risk and supporting linkage to harm reduction resources.
There is little research in the U.S. on the interactions of people who use opioids (PWUO) with criminal justice personnel, from their perspective. This study reports on the experiences with police and criminal justice personnel of 27 men and women in treatment for substance use disorder. In-depth interviews revealed that many respondents had had aversive experiences with the criminal justice system, including both physical and verbal abuse. Very few report receiving information on treatment from police. The evidence suggests that many police officers do not view opioid use disorder as a medical condition, and instead stigmatize PWUO. This study reveals that PWUO, like members of other marginalized groups, are often targets of police maltreatment. Despite the fact that police may play a lifesaving role in cases of opioid overdose, these findings indicate the problematic nature of police response to overdose and opioid-related offenses.
Alcohol, tobacco and cannabis use remain prevalent among college students. To gain a comprehensive understanding of factors related to problematic use of these substances, we applied the Theory of Triadic Influence (TTI) and nested logistic regression. We used ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) scores from Spring 2023 American College Health Association-National College Health Assessment III participants without a previously diagnosed substance use disorder who had a lifetime history of alcohol, tobacco and cannabis use (N = 18,948 students). The prevalence of moderate-to-high alcohol-, tobacco- and cannabis-risk scores were 27.62%, 47.39%, and 50.23%, respectively. TTI-aligned correlates associated with increased likelihood of moderate-to-high risk use for all three substances included: psychological distress (intrapersonal), financial stress (environmental), and engaging in related behaviors including self-harm, partying, and additional substance use (immediate precursors). Several unique substance-specific correlates were identified as well. Strengths, limitations, and implications are discussed.
Evidence suggests that individuals affected by problematic heroin use can desist at various points in their drug-using career. Drawing on a doctoral study that developed a non-linear four-stage model of desistance from heroin careers within the Maltese context, this paper focuses on exploring the contingencies that are in place during the initial pre-desistance stage. The study adopted an evolved grounded theory methodology. Semi-structured interviews were conducted with twenty-two participants, fourteen identifying as male and eight as female, who had desisted from heroin careers for a minimum of five years. Findings show that a series of setbacks encountered after committing to a heroin career can create profound ambivalence, leading to pivotal reckoning moments that prompt individuals to consider change. Importantly, the emergence of hope that desistance is possible appears to play an instrumental role in initiating the desistance process.
Youth illegal drug use causes severe medical and economic harm to individuals and society. This study explores virtual reality (VR) as a promising approach to drug prevention among adolescents. We developed a VR-based program and evaluated its effectiveness in improving their drug resistance skills, normality perception, and competence attitude using a quasi-experimental research design with 60 high school students in Las Vegas, Nevada. Results from the Wilcoxon signed-rank test indicated that the VR program significantly improved participants’ drug avoidance personalities. Multiple regression analysis further showed significant improvements in resistance skills and competence attitudes. Findings from an additional post-intervention survey indicated that participants perceived the VR program as effective in increasing awareness of drug-related risks and supporting drug-use prevention efforts. Overall, these results suggest that VR-based interventions represent a promising approach to youth drug prevention.
This prospective multicenter cohort study examined changes in patient-reported outcome measures (PROMs) among 161 men and women entering residential substance use disorder (SUD) treatment in Belgium and explored how treatment setting and sociodemographic factors influence outcomes. PROMs were assessed at baseline and after 45, 90, and 180 days using the PROMIS-GH (general health), WHOQoL-BREF (quality of life), and SURE-NL (recovery). Linear mixed models showed significant improvements in mental and physical health, and in all quality of life (QoL) domains except for social relationships. Psychological and physical health improvements plateaued, while perceived QoL and environmental domains improved linearly. Males scored higher in psychological health whereas treatment modalities differed in psychological health and social relationships. Recovery scores remained consistently high, possibly due to ceiling effects, underscoring the importance of the timing and context of PROM assessment. Integrating PROMs into routine care has the potential to support patient-centered practices and enhance treatment outcomes in SUD services.
Illicit drug use poses a particularly high risk among certain subgroups of society, including trauma-exposed occupations like police officers. Nevertheless, very little is known about the prevalence and types of illicit drug abuse among police personnel. This study aimed to examine the prevalence and patterns of illicit drug use among young police recruits (i.e., police cadets) in Hungary using a cross-sectional questionnaire-based online survey. Our results show that 16.9% of police cadets have ever tried illicit drugs. Drug experimentation was more prevalent among males than females, but the difference was not statistically significant. It was also found that perceived environmental drug use was the most important factor in explaining cadets' drug experimentation. Drug abuse can significantly impact job performance among officers, and negatively affects the community's trust for police. Therefore, drug abuse among police students and officers should be addressed as organizational and community-level issues requiring a holistic approach.
Perinatal opioid use disorder contributes significantly to the U.S. maternal health crisis. Medication for opioid use disorder (MOUD) improves maternal and neonatal outcomes, yet stigma remains a barrier to care for pregnant patients. This qualitative study examined stigma experienced by perinatal patients on MOUD and its impact on healthcare engagement using the Health Stigma and Discrimination Framework. Semi-structured interviews were conducted with 15 patients receiving integrated perinatal and addiction care in Philadelphia, Pennsylvania, between October 2023 and April 2025. Participants were aged 24-40 years; 47% identified as Black and 53% as White. Thematic analysis identified key drivers of stigma including societal judgments of parental fitness, fear of state involvement, and provider knowledge gaps regarding MOUD. Stigma manifested as inadequate pain management, fear of custody loss, and reduced care-seeking behaviors. Findings underscore the need for provider education and policy reform to reduce punitive responses to MOUD use in pregnancy.
This mixed-methods study, guided by the health belief model (HBM), explored how cognitive appraisals, stigma, and social context shape marijuana use among Bangladeshi university students. Quantitative data were collected through snowball sampling (n = 352). Recurrent use was operationalised as usage occurring at least once per month during the preceding three months. Qualitative data were generated through in-depth interviews (n = 33) and were analysed thematically. Recurrent users reported greater perceived benefits, more influential peer and media cues to action, and lower perceived susceptibility, barriers, and stigma compared to occasional users. Qualitative themes indicated marijuana use became normalised through peer culture, stress-coping narratives, evolving moral frameworks, informal access networks, and the management of dual identities. Collectively, the findings indicate marijuana use among Bangladeshi university students is associated more with socially reinforced benefit appraisals and culturally negotiated justifications than with ignorance of harm.
This study examines the burden of psychostimulant use disorder among consumers in Ogun State, Nigeria, using three domains: health, public safety/crime, and productivity, from a cross-section of 216 users. It was found that depressants accounted for 66.67%, and sedative-hypnotics accounted for 59.26% of the psychostimulant use among the consumers. Sleep and psychiatric disorder accounted for 16.38 and 15.7% of the total prevalent illness episodes, confirming that mental and behavioural disorders are the major psychostimulant disorders experienced. The highest (14.45%) contributors to the disorder are direct costs, such as inpatient admissions and the cost of medicines. Also, 34.26% of the selected psychostimulant consumers are willing to quit the consumption. The Logit regression shows that the awareness of the risk associated with substance use and early initiation increases the likelihood of their willingness to quit the psychostimulant use. By addressing the socioeconomic and psychosocial drivers of continued use, these measures can significantly increase willingness to quit psychostimulant use.
Substance Use Disorder (SUD) represents a pattern of alcohol or drug use that causes significant impairment and distress, acting as a risk factor for suicide, trafficking, and poverty. This cross-sectional study investigated demographic and situational determinants of SUD among English- and Polish-speaking online addiction-related forum users (N = 385). Data analyzed in JASP revealed a predominantly male sample (57%, mean age 33). Polysubstance use was prevalent, averaging three substances per participant; depressants (34%), cannabinoids (23%), and opioids (21%) were most frequent. Younger age (r = 0.231, p < .001) and male gender (r = 0.643, p = .005) predisposed to cannabis use, while female gender correlated with opioid use (r = 0.603, p = .012). Older age predicted higher alcohol consumption (r = 0.187, p < .001). Family history of SUD increased treatment likelihood (r = 0.338, p < .001) and number (r = 0.162, p = .001). Notably, females without a family history reported the highest average number of substances used. These findings emphasize non-uniform addiction pathways, necessitating personalized, inclusive, and culturally aware clinical interventions.
Fibroblast growth factors are a family of proteins that have recently been implicated in neuroplasticity, and their association with psychiatric disorders has attracted growing interest. We aimed to compare Fibroblast Growth Factor-2 (FGF-2) and FGF-9 levels in opioid use disorder (OUD) patients in remission with healthy controls. This cross-sectional study included 45 patients with OUD in remission receiving buprenorphine/naloxone (B/N) maintenance therapy and 45 healthy controls. Peripheral blood samples were collected from all participants. FGF-2 and FGF-9 serum levels were similar in the OUD group and healthy controls (p = 0.665, p = 0.090, respectively). A positive correlation was also found between FGF-2 and FGF-9 (r = 0.496, p = 0.001). Neuroplasticity in OUD patients in remission receiving B/N treatment appears to be comparable to that of healthy controls. These findings underscore the importance of long-term treatment strategies in OUD.
Cross-cultural simultaneous tests of the effects of social bonding, differential association/social learning, and strain theories on adolescent alcohol use are very rare worldwide. The present study examined the effects of social bonding, differential association/social learning, and general strain theories on adolescent alcohol use using a sample of 1,710 high school students from central Ankara, the capital of T & uuml;rkiye, in 2001. In the simultaneous test of the three theories, attachment to teachers and school involvement (i.e., social bonding variables) reduced the likelihood of adolescent alcohol use, whereas close friends' alcohol use, father's alcohol use, delinquent peers, criminal family members, and definitions favorable to alcohol use (i.e., differential association/social learning variables) increased it. However, the gap between educational aspiration and educational expectation and the gap between monetary aspiration and educational expectation (i.e., general strain theory variables) decreased the likelihood of adolescent alcohol use. Overall, the three theories are largely associated with alcohol use in the theoretically expected direction, except for some strain theory variables, which deviated from expectations only in the simultaneous test. Differential association/social learning theory plays the most important role in explaining adolescent alcohol use, followed by social bonding theory and general strain theory.
