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    Harm Reduction Strategies: Stimulants

    Stimulants, which include cocaine and amphetamines, speed up the body’s system, which increases blood pressure and heart rate. This can result in serious health issues, and they are often involved in overdoses. Some stimulants are legal with a medical prescription, like medications prescribed for ADHD (such as Adderall and Vyvanse). You might be concerned about your loved one’s stimulant use, even if legally prescribed. While you may wish they do not use them at all, here are some strategies you can share with them to reduce their risk of illness and death.

    Safe smoking kits

    Safe smoking kits include clean smoking supplies like: 

    • New glass stems and pipes 
    • Alcohol wipes to clean hands, injection sites and used products 
    • Plastic mouth pieces to prevent burning from a pipe or other smoking device 
    • ChapStick or Vaseline to soothe lips and prevent chapping and open sores

    Provide oxygen

    When someone is overdosing on opioids, they require oxygen. Learn how to do rescue breathing and chest compressions in the event of an overdose.

    It is also possible to purchase cans of oxygen over-the-counter (product examples include Boost Oxygen, which can be purchased at drugstores). This can help provide someone with additional oxygen in the immediate aftermath of an overdose.

    Go slow

    It is always best to test one’s reaction to a substance before using more of it, especially given many substances are filled with worrisome cutting agents or other chemicals. Using a smaller amount of stimulants at a slower pace is always safer than doing them in large quantities. It is also good to use it less after periods of not using it or when feeling sick.

    Use clean and sterile needles

    Using clean needles and syringes when using intravenous (IV) stimulants can help prevent infection and the spread of diseases like HIV. Most states have legal or locally permitted needle exchange sites where people can trade in their old needles for clean ones.

    Safe consumption sites

    There is a service in New York City where people can use the substances they bring under the safety and support of trained personnel. They also offer other services that can improve a loved one’s wellbeing.  Many people are advocating to offer these services in other parts of the country.

    Don’t use alone

    Using substances with others is always better than being alone in the event of an overdose. Encourage your loved one to be with individuals they trust whenever possible. If using substances alone, support apps like the Brave App or Canary can virtually alert another person if help is needed. There is also a free service called  Never Use Alone that a loved one can call and their volunteers will stay on the call as long as needed to ensure safety.

    Additionally, if using stimulants in a group, try to stagger use so that there is always someone sober enough to recognize signs of overdose.

    Don’t mix substances

    Mixing stimulants with other substances can cause an overdose, which can lead to serious illness and even death. This is especially important when it comes to depressants like alcohol and prescribed medications like benzodiazepines (e.g., Xanax, Valium, Klonopin). Encourage your loved one to check with a healthcare provider to learn about negative drug interactions.

    Use PrEP

    HIV can be easily contracted through the use of shared needles and other products. PrEP is a highly effective prevention medication for people at risk of getting HIV. 

    Fentanyl test strips

    Fentanyl test strips are paper strips used to detect the presence of fentanyl, a deadly synthetic opioid, in injectable substances, powders and pills. Fentanyl can often be found in stimulants like cocaine. The strips are used by dipping a strip into a mix of water and the substance and will indicate whether fentanyl is present or not.

    Xylazine test strips

    Xylazine, also known as “tranq,” is a deadly animal sedative that has been found in opioids and illegal stimulants. These work in the same way as fentanyl test strips and can detect if there is any xylazine in a stimulant.  

    Carry naloxone (e.g., Narcan)

    Naloxone, usually known by its brand name Narcan, can reverse an opioid overdose. While it is not designed to reverse an overdose caused by stimulants, it may work in a situation where opioids and stimulants are both involved. Encourage your loved one and everyone around them to carry it. It is available over the counter and for free from many community organizations. Click here to learn how to administer it. 

    Safeguard medications

     If you are medically prescribed a stimulant, be sure to keep it out of sight and safely secured. When you are done, you can safely dispose of them. Keep tabs on your loved one’s prescription stimulant use. 

    Maintain good dental habits:

    People who use stimulants often are at risk of developing problems with their dental health. Encourage your loved one to take good care of their teeth and see a dentist regularly.

    Keep a healthy diet

    Stimulants can reduce your loved one’s appetite. This can cause malnutrition and serious vitamin deficiencies. Help your loved one maintain a healthy diet and consider encouraging them to see a doctor and/or dietician.

    See health professionals regularly

    Because stimulant use can lead to heart problems and other health disorders, it is important to make sure your loved one’s doctor and other health professionals are aware of their use. They may want to conduct related tests more often.

    Medications to reduce use

    There are no FDA- approved medications for the treatment of Stimulant Use Disorder.  That said, there are some medications have been used off-label to help reduce usage.  These include topiramate, bupropion  (commonly used for smoking cessation) and naltrexone. If interested. your loved one needs to talk to their healthcare provider to see if they are a good candidate for the medication.

    Moderation strategies

    Many people who use stimulants may not have an interest in stopping completely but might be willing to cut back. It’s possible they might be open to stopping cocaine use, for example, but may continue to use substances with a far reduced overdose risk like marijuana.

    Remember that any step to reduce the risks of stimulant use is a step in the right direction.