29
Injection Drug Use
89. For patients who inject stimulants, clinicians should:
a. provide or refer for harm reduction education on safer injection practices and
include information specific to the patient's stimulant(s) and preparation(s) of
choice (eg, safer acid pairings for crack cocaine injection; L-S), and
b. provide or refer for safe injection supplies and harm reduction services (M-S).
HIV Preexposure Prophylaxis
90. Clinicians should offer HIV preexposure prophylaxis (PrEP)* to
patients who use stimulants and are at increased risk for HIV,
including those who:
a. engage in risky sexual behaviors (H-S),
b. access postexposure prophylaxis (PEP) regularly (H-S), and/or
c. inject drugs (H-S).
* https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prevention-of-
human-immunodeficiency-virus-hiv-infection-pre-exposure-prophylaxis
Oral Health
91. People who use stimulants are at high risk of dental complications,
such as poor dentition, dental carries, abscesses, and subsequent
malnutrition. Clinicians should:
a. encourage patients who use stimulants to maintain good oral hygiene and
receive regular dental care (H-S), and
b. offer referrals to dental care providers if needed (H-S).
Nutrition
92. People who use stimulants may experience appetite suppression and
go for long periods without appropriate nutrition, placing them at
high risk for nutritional deficits such as malnutrition, cachexia, and
sequalae involving specific vitamin deficiencies. Clinicians should:
a. inquire about diet, nutrition, and food security (CC-S); and
b. encourage patients who use stimulants to eat nutritious food (CC-C).
