This paper aims to examine the challenges and implications of the Village and Commune Safety Policy (VCSP) on harm-reduction programs and describe lessons learned from a harm-reduction program within the context of the VCSP in Cambodia. Data were collected from a monitoring and evaluation database and reports of a drop-in center that provides a wide range of harm-reduction services. In addition, qualitative data were collected through key informant interviews and focus group discussions with 38 participants including people who use drugs (PWUD) and people who inject drugs (PWID). Desk reviews and consultative meetings with key stakeholders were also conducted. In total, 496 PWUD were registered into the program between 2010 and 2012, of which 22.4% were PWID, and 15.0% were women. The mean age of participants was 26 years old. HIV prevalence among PWUD was 1.0% compared to 16.2% among PWID. Remarkable achievements were observed such as high uptake of services by PWUD and PWID with active referrals to methadone maintenance treatment (MMT) and voluntary HIV confidential counseling and testing (VCCT). However, distribution of clean needles and syringes in communities was limited. Also, the newly initiated needle and syringe program (NSP) based in pharmacies failed to reach PWUD and PWID. Appropriate coordination and collaboration with law enforcement and authorities were observed given the complexity of the VCSP. However, the implementation of the VCSP poses challenges including NSP and accessibility to harm reduction services. For future successes of harm-reduction programs, it is important to maintain close coordination and collaboration between program implementers and local authorities with mutual understanding and flexibility. Show less

Introduction and aims Previous research has focused primarily on the severity of the alcohol hangover. Much less is known about the duration of the alcohol hangover. The objective of this analysis was to examine the average duration of the alcohol hangover. Design and Methods N=811 Dutch students, aged 18-30 years old, completed a survey on alcohol consumption and their latest alcohol hangover. Overall hangover severity was reported for every two hours after waking up (starting 4am until midnight). Hangover duration was calculated from the moment of stopping alcohol consumption until the first time hangover severity scores reached zero. Results During the drinking session that resulted in their latest hangover they consumed a mean (SD) of 5.9 (6.2) alcoholic drinks, followed by 6.5 (2.0) hours of sleep. The start of the alcohol hangover was not assessed, as it can be assumed that BAC approached zero while participants were sleeping. From the moment of stopping alcohol consumption, the average duration of the alcohol hangover was 18.4 (3.8) hours. For the majority of drinkers, hangover duration ranged from 14 to 23 hours. Alternatively, the hangover lasts approximately 12 hours from the time of waking up. Hangover duration correlated significantly with hangover severity and total sleep time, but no significant association was found with the number of alcoholic drinks that were consumed. Discussion and Conclusions The duration of the alcohol hangover ranged from 14 to 23 hours, with an average of 18.4 hours after stopping drinking, or alternatively, about 12 hours after waking up. Show less