As most harm reduction interventions are funded under the umbrella of HIV, most of the research and project funding also goes to analyse the effectiveness of HIV/AIDS strategies. This means that both programmes and the evidence focus on those drug users who inject their drug and they leave out those who smoke, snort or swallow. The people who can benefit from harm reduction interventions are most often injecting opioid users, and harm reduction often becomes associated with heroin use alone. At the same time, people using stimulants may face somewhat different problems, regarding health as well as psychosocial and legal circumstances. As this leaves many marginalised stimulant users underserviced, there is a need for the harm reduction field to broaden the scope and to structurally include stimulant users.

With the support of the Global Partnership on Drug Policies and Development (GPDPD), a project implemented by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, a team of three Mainline researchers conducted a study into effective harm reduction interventions for stimulant users. The study includes a review of the evidence for different harm reduction strategies for stimulants and a detailed description of seven good practices in different world regions.





What we know

The body of available research conducted on effective harm reduction for stimulant users provides some basic insights. We understand the chemical structures of stimulants and how they stimulate the central nervous system. We can categorise stimulants into cocaine, amphetamines, meth-amphetamines, methcathinones and cathinones. There is abundant information about the attributes and effects of stimulants:

They increase wakefulness, focus and confidence; they can elevate someone’s mood and provide feelings of power; they decrease fatigue and appetite. They can also produce nervousness 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 don’t know enough yet is which harm reduction strategies have been developed worldwide for different contexts and types of stimulants user, and which of those strategies are being positively evaluated. The harm reduction field would greatly benefit from more practical guidance to establish interventions for stimulant users in specific contexts. This study aims to fill that need.