Policy
Title:
Objectives: This study tested associations of criminal justice referral status with 1) treatment completion and 2) reduced substance use among individuals at discharge who were pregnant and referred to outpatient treatment from the criminal justice system.
Methods: Data were obtained from the 2015–2021 Treatment Episode Dataset-Discharges (TEDS-D). The sample consisted of 7881 justice-involved outpatient discharges who were pregnant. The independent variable was the type of criminal justice referral: court or diversionary program, probation or parole, or other. Outcome variables included treatment completion and reduced substance use. Multivariable logistic regression models were used to measure associations of referral type with treatment outcomes, adjusting for covariates.
Results: Referrals from court or diversionary programs had higher odds of treatment completion than referrals from probation or parole (AOR = 1.40, 95% CI = 1.23–1.60). Among individuals at discharge who reported daily use prior to admission, those referred through court or diversionary programs had higher odds of reduced substance use at discharge compared to those referred through probation or parole (AOR = 1.85, 95% CI = 1.23–2.79).
Conclusions: Overall, better outcomes were observed among those referred through courts or diversionary programs compared to those referred through probation or parole.
Notes from Duarne McBride: These findings demonstrate the potential utility of drug courts and diversionary programs in facilitating positive treatment outcomes while also preventing exposure to more punitive forms of criminal justice system involvement. This article references IPA research.
Title:
Citation: Giommoni L, Stuart Jepsen K, Murray S. Does regulating drug precursors affect illicit drug markets? An expanded and updated systematic review. Drug Alcohol Depend. 2025 Sep 20;276:112900. doi: 10.1016/j.drugalcdep.2025.112900. Epub ahead of print. PMID: 41037997.
Background: Many countries are placing greater emphasis on regulating precursor chemicals used in illicit drug production. However, the latest review on this topic is 14 years old and limited to North American methamphetamine regulations. This review updates and expands on past work by assessing how precursor regulations affect illicit drug markets.
Method: We conducted a systematic review following PRISMA guidelines, searching 13 databases and relevant organizational websites for grey literature. Eligible studies quantitatively assessed precursor regulations' impact on drug supply, demand, or related harms. Due to intervention variability, we used narrative synthesis. Bias risk was evaluated with the EPOC Risk of Bias Tool.
Results:
1. Twenty-six studies met the inclusion criteria, published between 2003 and 2023, focusing
methamphetamine (n = 23), cocaine (n = 3), and heroin (n = 1). Most were from the USA
(n = 20), with others from Canada (n = 1), Mexico (n = 1), Australia (n = 3), and the
Czech Republic (n = 1).
2. The studies assessed 12 outcomes across 37 interventions, 14 of which were effective and
23 ineffective.
3. Effective interventions led to impacts such as a 100 % price increase, a 40 % purity
reduction, and a 43 % drop in past-month drug use, lasting from months to seven years.
4. Ineffective interventions shared three issues: targeting unused chemicals, focusing on
small-scale operations, or failing as suppliers adapted to new sources or routes.
Conclusions: Precursor regulations can reduce the supply, use, and harms of heroin, cocaine, and methamphetamine. However, they are not a one-size-fits-all solution. Their effectiveness depends on how they are designed and the context in which they are implemented. Overall, the data suggest that regulatory policies can significantly reduce drug use. This article cited IPA research supported by the National Institute of Justice.
Title:
Citation: Mannes ZL, Wall MM, Alschuler DM, et al. Cannabis Legalization and Opioid Use Disorder in Veterans Health Administration Patients. JAMA Health Forum. 2025;6(6):e251369. doi:10.1001/jamahealthforum.2025.1369
Question: Were medical cannabis laws (MCLs) or recreational cannabis laws (RCLs) associated with opioid use disorder (OUD) in Veterans Health Administration patients?
Findings:
1. In this cohort study of Veterans Affairs Administration patients, from 2005 to 2022, OUD
decreased from 1.12%to 1.06%in states without cannabis laws,
2. Increased from 1.13% to 1.19% in states that enacted MCL, and
3. Remained stable in states that also enacted RCL.
4. MCL/RCL enactment as associated with greater OUD prevalence, with more substantial
increases in OUD among middle-aged and older adults and those with chronic pain.
Notes from Duane McBride: The study results suggest that MCL/RCL enactment was associated with increased OUD, suggesting that cannabis legalization is not an effective intervention to reduce the burden of OUD. These data suggest that legalizing medical and recreational marijuana did not reduce substance use disorders in this population but rather was related to slightly higher rates of opiated use disorders.’