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Treatment
Harm Reduction
Harm Reduction Education
84. For patients who engage in risky stimulant use, clinicians should:
a. offer basic harm reduction education about safer stimulant use (L-S),
b. tailor harm reduction education to the patient's patterns of substance use (eg,
context of use, route of administration, type of preparation; L-S),
c. refer to relevant local harm reduction services as indicated based on the
patient's clinical assessment (L-S),
d. offer harm reduction education on overdose prevention and reversal (H-S), and
e. offer harm reduction education regarding safer sexual practices (H-S).
Overdose Prevention and Reversal
85. For patients who use stimulants from nonmedical sources or are
socially engaged with others who do, clinicians should prescribe
or distribute overdose reversal medications (eg, naloxone) or refer
patients to locations where they can obtain these medications in the
community (H-S).
Note: There is an increased concern regarding fentanyl contamination and as a result,
opioid-related overdose.
86. Clinicians should recommend that patients perform comprehensive
drug checking, including using fentanyl test strips, every time they
obtain a new batch of stimulants from nonmedical sources and
review the technique for using fentanyl test strips when permitted by
state law (M-C).
87. Clinicians should consider referring individuals to local supervised
consumption sites (SCS) when available (M-S).
Safer Sexual Practices and Contraception
88. For patients who engage in risky sexual behaviors, clinicians should:
a. offer or refer for STI testing at least every 3 to 6 months or more frequently
depending on the individual patient's risk (M-S);
i. consider providing information about local STI testing services where
patients can obtain free or low-cost testing (M-S);
b. consider offering a referral to a local psychosocial sex education program or
harm reduction program that addresses risky sexual behavior for additional or
continuing harm reduction intervention (L-S); and
c. offer condoms and lubrication or advice about where to obtain them (CC-S).
