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Speed Limits: harm reduction for stimulants

Mainline investigated best practices in different countries in the field of harm reduction interventions for people who use stimulants.

stimulants and interventions

Most harm reduction interventions are currently financed from funds for HIV control. In practice, this means that harm reduction focuses primarily on users who inject. People who smoke, snort or swallow are mostly excluded from healthcare or harm-reduction projects. Harm reduction is often associated with people who use heroin. But people who use stimulants also encounter problems, both psychologically, physically, socially and legally. Stimulant users, like heroin users, can become marginalised and do not always have good access to care and support. It is high time for the harm reduction field to broaden its scope and structurally include stimulant users in projects and interventions.

what we know about the use of Stimulants

The available research on the short- and long-term effects of stimulant use provides us with some basic insights. We understand the chemical structures of stimulants and how they affect the central nervous system. Stimulants can be categorized into cocaine, amphetamines, methamphetamines, methcathinones, and cathinones. There is an abundance of information regarding the properties and effects of these stimulants.

They increase alertness, focus, and self-confidence; they can improve a person’s mood and feelings of power; they reduce fatigue and appetite. They can also cause irritability or anxiety and, in some cases, psychosis and suicidal thoughts.
e.g. Holman, 1994; EMCDDA, 2007; Hildrey et al., 2009; Pates and Riley, 2009

What we do not yet know enough about is which harm reduction strategies have been developed worldwide for different contexts and stimulant users, and which of these strategies are effective. The harm reduction field would greatly benefit from more practical guidance on setting up interventions for stimulant users in diverse contexts. With this study, Mainline is taking a first, but important, step towards meeting this need.

our research into stimulant use

The research:

Conducts a systematic and global literature review on harm reduction activities for stimulant users;
Documents, describes and analyses 8 ‘best practices’ of harm reduction interventions for stimulant users in different regions of the world;
It promotes the vision that harm reduction is more than just HIV prevention. The project contributes to a vision of harm reduction from a human rights perspective and focuses on improving the quality of life for all people who use substances, including stimulant users.

The study began on September 1, 2017 and was completed in August 2018.