The Current State of Psychostimulants Use and Harms in Canada

Abstract

Psychostimulant use in Canada-similar to recent data trends from the United States-has been showing signs of increase over the past decade, while with patterns of use varying across the country. Changes in drug use preferences from opioids to psychostimulants have been noted in several provinces, for example, Alberta. Similarly, reports from British Columbia highlight a shift from opioids to psychostimulants with methamphetamine use representing the most commonly used drug. Further, the greatest amount of methamphetamine was seized in Quebec. Harms of psychostimulants include but are not limited to cardiovascular events, violence, paranoia/psychosis, increase in crime, and risky behaviors. Overall, physical and mental morbidity is associated with psychostimulant use in addition to elevated risk of contracting HIV and Hepatitis C Virus (HCV). There are increasing trends of the co-use of psycho-stimulants with opioids, resulting in heightened risk for acute adverse outcomes (eg, poisoning mortality). Populations involved in the use of psychostimulants across Canada are often socio-economically marginalized and vulnerable, or include men who have sex with men communities as well as post-secondary students. These populations warrant concerted efforts towards reducing the harms associated with psychostimulants; however, current interventions are limited. Interventions to be considered include safer psychostimulant paraphernalia distribution, psychosocial and pharmacotherapeutic interventions, supervised consumption services, and possible "safer supply" interventions. Studies suggest the need for tailored interventions for psychosti-mulants, prioritizing population-specific needs, better prevention, and further research. Overall, concerted effort to decrease psychostimulant-related use and harms, especially amongst youth, marginalized populations, and men who have sex with men communities, are warranted across Canada.