Honesty above all else? Expectations and perceptions of political conduct in three established democracies

The authors gratefully acknowledge financial support from the ESRC (grant number RES-000-22-3459) and British Academy (grant numbers SG-101785 and SG-52322). They would also like to thank two anonymous reviewers for their helpful comments and suggestions

Mental and Physical Health Needs of Lesbian, Gay, and Bisexual Clients in Substance Abuse Treatment

OBJECTIVE: Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment. METHODS: Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770). RESULTS: LGB individuals were more likely to have mental health diagnoses ((adj)ORs ranging from 1.86–4.00) and current mental health prescription medications ((adj)ORs from 1.79–4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays. DISCUSSION: This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed

Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries

Background: People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Methods: Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Results: Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Discussion: Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.Other UBCNon UBCReviewedFacult