Few Stimulant-Specific Harm Reduction Responses Implemented Globally

"Another major gap globally is the lack of diverse harm reduction services to match the diversity of drugs being used around the world. In Latin America and the Caribbean, for instance, stimulant drugs are more frequently used than opioids. Yet the availability of harm reduction interventions for these substances is insufficient.^114,115,116  Some civil society organisations run peer-led drug-checking initiatives designed for stimulants in Argentina, Brazil, Chile, Uruguay, Peru, Colombia and Mexico,h but these interventions are typically unsanctioned and lack official government support.¹¹⁷ 

"These services have traditionally been aimed at people who use stimulants in the nightlife scene.¹¹⁸  In Western Europe, where drug checking services are available in 12 countries, these services have also produced data and information on the substances available and emerging trends across the region.^119,120,121  In Eurasia, where nine countries have introduced drug checking services to some extent, they all appear to be operating in a legally grey area. An exception is Slovenia, where drug checking services are part of a National Early Warning System on psychoactive substances. In Hungary, Estonia, Czechia, Croatia, Lithuania, Georgia, Ukraine and Poland, drug checking services distribute reagent test kits (mostly in nightlife settings), people perform tests themselves and are invited to come back to discuss the results.¹²² 

"These initiatives could be part of a beneficial package of harm reduction strategies for people who inject drugs, offering alternatives to injecting.¹²⁴ We can report that safer smoking equipment is distributed in at least 25 countries, up from 19 in 2022, with new smoking equipment distribution initiatives reported in Bulgaria, Greece, Ireland, Mexico, Puerto Rico and South Africa. This is an important though limited development. People who smoke drugs are a seriously underserved subpopulation of people who use drugs. For example, in Africa, we can identify only one country that makes safer smoking equipment available (South Africa). Similarly in Asia, we can report availability in only one country (Indonesia).¹²"