The risks for people who inject stimulants differ from those of opioid injectors, mainly because the former tend to inject more times during a day (therefore needle and syringe exchange programmes need to be implemented differently).
Outreach treatment programmes help stimulant injectors to reduce medical problems, such as skin infections
It is not clear if provision of large volumes of sterile injection equipment (in general, stimulant injectors inject more often than opioid users, thus need more syringes), provision of condoms or outreach activities focusing on injecting and risky sexual behaviours can help stimulant injectors
It is not clear if injection kits adapted to local drug use patterns, such as for people that inject home-made stimulants (e.g. distribution of specific paraphernalia for the production of drugs), can help to reduce harms
It is not clear if dissemination of information on how to inject safely, basic hygiene (hand washing, short nails), vein care and simple wound care as well as distribution of antibacterial creams and ointments can help to reduce harms
What doesn't work?
We are not aware of interventions for stimulant injectors that cause harm
Best practice is the best application of available evidence to current activities in the drugs field.
underlying evidence should be relevant to the problems and issues affecting those involved (professionals, policymakers, drug users, their families);
methods should be transparent, reliable and transferable and all appropriate evidence should be considered in the classification process;
experience in implementation, adaptation and training should be systematically collected and made available;
contextual factors should be studied by modelling different prevalence levels so as to assess the impact of an intervention on the population; and
evidence of effectiveness and feasibility of implementation should both be considered for the broader decision-making process.
This definition was agreed by a group of experts including the Chairman of the EMCDDA Management Board João Goulão; members of the EMCDDA Scientific Committee; policymakers and top-level researchers in the areas of treatment, prevention and harm reduction.
Best practice portal
The Best practice portal is a resource for professionals, policymakers and researchers in the drugs field. We provide information on the available evidence on drug-related prevention, treatment and harm reduction, focusing on the European context. The evidence is compiled following an explicit methodological process, and is presented according to client profiles. The client profiles are designed according to the European data on illicit drug users collected at the EMCDDA. Currently, the profiles are organised around the main substance of use. We acknowledge that in reality people often use multiple drugs and the interventions provided might reflect this. We are therefore working on how best to accommodate this aspect in the future. In the portal we also provide an overview of the available quality standards and guidelines in the European Union (EU) Member States.
The portal was developed to respond to the EU drugs action plan (2009–12) and specifically to ‘enhance the quality and effectiveness of drug demand reduction activities, taking account of specific needs of drug users according to gender’. In particular, actions 17 and 19 aimed at exchanging ‘good practice guidelines/quality standards for prevention, treatment, harm reduction and rehabilitation interventions and services’ and ‘to develop an EU consensus on minimum quality standards and benchmarks for prevention, treatment, harm reduction and rehabilitation’.
The portal will be continuously updated as information and research on interventions emerges.
Peer Van der Kreeft
Collaborations and patnerships with external organisations
Below are some of the ongoing collaborations and partnerships involving the EMCDDA's Best practice portal and external organisations.