Substance Misuse

March 18, 2024 | Fact Sheets, Novel Psychoactive Substances, Opioids, Public Safety, Stimulants, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet,  examines xylazine, a powerful veterinary sedative increasingly appearing as an adulterant in heroin and fentanyl mixtures in the U.S., particularly since 2020. Xylazine has a chemical structure similar to compounds called phenothiazines and operates by decreasing the release of norepinephrine and dopamine in the central nervous system, resulting in analgesia, sedation, and muscle relaxation. Xylazine intoxication can result in central nervous system depression, low blood pressure, and slow heart rate. Respiratory depression can also occur, which increases the risk of overdose when combined with opioid-induced respiratory depression. ...

January 16, 2024 | Controlled Substances, Harm Reduction, Reports & Studies, Stimulants, Substance Misuse, Treatments

Total abstinence has historically been the goal of treatment for substance use disorders; however, there is a growing recognition of the health benefits associated with reduced use as a harm reduction measure in stimulant use disorders treatment. The researchers and authors of this report aimed to assess the validity of reduced stimulant use as an outcome measure in randomized controlled trials of pharmacological interventions for stimulant use disorder....

November 15, 2023 | Criminal Justice, Fact Sheets, Stimulants, Substance Misuse

This fact sheet examines the racial disparities and stigma surrounding crack cocaine, established in the late 1980s, that continue to this day. The Fair Sentencing Act has helped to lessen the sentencing disparity between crack and powder cocaine, yet gaps remain. Passage of certain legislation, like the EQUAL Act, which was introduced in the 118th Congress in 2023, would eliminate both the sentencing and racial disparity in cocaine sentencing still seen today in U.S. courts....

October 31, 2023 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet examines bromazolam, a novel benzodiazepine that is structurally related to alprazolam (Xanax), which has been a Schedule IV controlled substance in the U.S. since November 1981. Bromazolam is typically found in tablet or powder form and sold mainly via online drug markets under its own name or as “XLI-268.” It has been found mixed with opioids, including fentanyl, and in counterfeit Xanax pills. There is not much information about the illicit use of bromazolam and its effects on the human body in scientific literature, so most of the information currently available about the substance is anecdotal. ...

October 30, 2023 | Controlled Substances, Fact Sheets, Recovery, Substance Misuse, Treatments

This fact sheet summarizes a recent increase in the use of contingency management, a behavioral therapy that reinforces or rewards positive behavioral change. Often, mental health professionals use contingency management alongside other methods of treatment. In the context of substance use disorder treatment, patients typically receive something of monetary value to incentivize abstinence from drug use. Contingency management is a well-studied and effective method for treating substance use disorder, but until recently, received little support....

September 18, 2023 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet examines nitazenes, a group of synthetic opioids more powerful than fentanyl. Scientists developed nitazenes in the 1950s as analgesics, but the U.S. Food and Drug Administration never approved the compounds for therapeutic use....