Amphetamine-type stimulant use: global and European trends in the harm reduction response

Background:

It has been estimated that between 13.9 and 54.8 million people use amphetamine-type stimulants (ATS) worldwide; the second most commonly used drug after cannabis. There has been a marked increase in ATS use in the EU, East Asia, parts of Africa, the U.S., and Latin America in recent years. This presentation will review recent developments in the harm reduction response to stimulant use, with a special focus on their relevance in Europe.

Methods:

Using information from civil society and harm reduction networks, international scientific and grey literature, reports from multilateral agencies, international non-governmental organisations, and expert consultation with key academics, HRI has compiled information on stimulant use and harm reduction programmes from around the world though its Global State of Harm Reduction 2018 report, which have sought to respond to ATS-related harms, and the novel ways in which harm reduction services can adapt to this growing need. A survey was also sent out to civil society and harm reduction networks to obtain national and regional information on key developments.

Results:

The academic literature on ATS-related harms is relatively small compared to other areas of harm reduction. There are however, nascent harm reduction responses targeted towards people who use ATS that have illustrated promising results. These programmes include adaptations for people who use ATS of traditional harm reduction services, such as needle and syringe programmes and drug consumption rooms. Newer innovations include drug-checking, tailored informational services, provision of safer sniffing and smoking equipment, and interventions based on housing and social integration. There is little documented evidence relating to pharmacological treatment for ATS use. Patterns of ATS use vary considerably between and within geographic regions, however useful examples and lessons relevant to Europe can be drawn from around the world.

Conclusion:

Although there has been slow but steady progress in the acceptance of harm reduction as it relates to ATS use, there remains an urgent necessity to significantly increase research in this area. There is a need not only to evaluate current programmes but to develop guidance on other effective interventions, and to increase the availability of funding for these essential harm reduction services.