The use of illegal stimulants such as methamphetamine is on the rise, as indicated by their presence in at least half of all opioid-related deaths in Canada in 2022.
In response, a growing body of evidence suggests that prescribing psychostimulant medications could help to reduce the consumption of illegal stimulants, according to a commentary in the CMAJ (Canadian Medical Association Journal).
Recent clinical trials conducted in Australia, Europe, and the United States have prompted physicians and nurse practitioners in Canada and other nations to increasingly prescribe psychostimulants as a form of harm reduction for individuals suffering from stimulant use disorder.
Dr. Heather Palis from the University of British Columbia and Dr. Scott MacDonald from Providence Health Care, Vancouver, BC, explain,
“This emerging evidence can support prescribers’ level of confidence in off-label prescribing of psychostimulants to patients with stimulant use disorder (and particularly for patients with attention-deficit/hyperactivity disorder and stimulant use disorder).”
In 2020, the Federal Minister of Health in Canada issued a letter encouraging provinces and territories to expand access to safer pharmaceutical-grade alternatives to harmful, contaminated illegal drugs.
So far, only British Columbia has offered guidance on prescribing psychostimulants to individuals at risk of overdose.
The authors propose that, in order to successfully integrate prescribed psychostimulants into Canada’s health system, clinical practice guidance should be updated based on new evidence.
They also suggest that substance use treatment programs and clinics should establish protocols for including psychostimulants in their range of interventions.
They conclude: “Broader implementation of prescribed psychostimulants as an effective option in the continuum of care for stimulant use disorder is needed in Canada;
this practice would help the growing number of patients seeking to reduce their reliance on the illegal stimulant supply during the ongoing unregulated drug poisoning crisis.”
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The study was published in Canadian Medical Association Journal.
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