"Increasing the Substantial Gains That Took Place During the Pandemic

"Continuing Decreases for Three Most Common Drugs Used by Students in 2024

"Our study has several limitations. First, cannabis exposure was poorly reported in the included studies, which prevented our meta-analysis from assessing it. Second, a significant portion of included studies was at moderate to high risk of bias, primarily due to a lack of information regarding missing data. Concerns were also raised about the risk of misclassification of exposure, particularly in studies from medical databases, which have a low sensitivity for non-medical drug use.

"Main findings

"24 studies evaluated the occurrence of MACE in the context of exposure to cannabis, including one to medical cannabis and none to other cannabinoids. The quantitative analysis suggests a positive association between cannabis use and MACE. Findings from the sensitivity analysis restricted to cohort studies were consistent with the primary analysis.

"In this population-based study, individuals newly prescribed SOS typically had more comorbidities than people receiving methadone, with higher rates of alcohol use disorder, HIV, hepatitis C, opioid toxicity, infections, and recent engagement in OAT. After matching, we found reduced rates of clinical and health systems outcomes over time among individuals commencing SOS or methadone. In comparative analyses, people receiving SOS had higher rates of opioid toxicities, emergency department visits, inpatient hospitalisations, and incident infections compared with methadone recipients.

"Opioid toxicities are a public health crisis in North America that has been amplified in severity by the COVID-19 pandemic.

"After rapid expansion between 2009 and 2018, the number of distinct NPS found on global drug markets has now stabilized at around 550, i.e. at around half the number of NPS ever identified on drug markets. In 2020, Member States reported 548 NPS on the market, of which 77 were identified for the first time.

"This work adds to a growing body of literature on how increased criminal penalties for drug possession and distribution affect health. Prior work has documented that the criminal legal system can be a stigmatizing revolving door that people often struggle to escape (Jones & Sawyer, 2019; LeMasters et al., 2023a).

"The opioid overdose epidemic continues to evolve in the United States (US). While the epidemic began with prescription opioids in the 1990’s, it evolved to consist largely of heroin by 2010, and synthetic opioids by 2013, driven by high-potency illicitly manufactured fentanyl and fentanyl analogs (Centers for Disease Control and Prevention, 2023).

"Across a unique field survey of authorities in targeted regions, a large-scale field survey of the same regions, and an experiment conducted online, results consistently showed that higher perceived governmental support for comprehensive drug policies inclusive of harm reduction measures would lead to increased public trust in local government. This medium-sized effect was evident in both the assessments of local authorities and the self-reported perception of community residents.