Why Is Harm Reduction for Queer Meth Users So Understudied?

    It’s no secret that the US harm reduction movement prioritizes opioids and the people who use them in its research and interventions. Stimulants like crystal methamphetamine (MA) continue to fall to the wayside in public discourse about problematic drug use, even as deaths involving meth use are increasing.

    A recent study brings this disparity into focus: Out of 935 scientific research articles investigating interventions that address meth-related harms among men who have sex with men, only one of them specifically studied queer men, crystal meth and harm reduction.

    Researchers from the British Columbia Centre on Substance Use (BCCSU) found that interventions using pharmacological methods, like Bupropion therapy, and psycho-social strategies, like counseling, are far more commonly studied than those oriented towards harm reduction⁠—”an intervention modality that, to date, is notably absent from the literature,” as they described.

    The one paper that they did identify to be studying harm reduction looked at San Francisco’s Stonewall Project, which aimed to help clients transition to less potent modes of meth consumption (from injection, to smoking, to snorting), practice self-care strategies while using the stimulant, learn about safer injection practices, and utilize sexual risk-reduction tools. Published in Journal of Urban Health, the 2014 study reported that it was “among the first to observe that clients may reduce stimulant use and concomitant sexual risk-taking behavior during harm reduction substance abuse treatment.”

    The BCCSU authors encourage more research into the efficacy of harm reduction interventions for queer men using meth. For example, nutritional interventions—like promoting consistent eating, hydrating and sleeping—are advised by harm reduction organizations like Mainline in the Netherlands, yet due to a lack of research, the exact efficacy and the utilization by people who use meth is unclear.

    The BBSU authors also note that there could be barriers to studying such strategies. The researchers suggested that one obstacle may be the studies’ location—the United States—”where many federal and state laws do not support harm reduction approaches such as syringe exchanges.” Still, the researchers “find the lack of reporting on harm reduction outcomes worrisome—particularly in a medical context.”

    Right now research focuses almost “exclusively on [meth] usage patterns,” an approach that is, for the authors, misguided when “there is no “gold standard” or one-size-fits-all approach for treating [meth] use.”

    Future research, they believe, needs to prioritize identifying and evaluating strategies for addressing problematic meth—particularly, harm reduction.



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