Prospects for Stimulant Maintenance in Vancouver, Canada

Abstract

Medical provision of orally-administered stimulants is a harm reduction technique that could reduce suffering and slow the spread of AIDS among cocaine misusers in Vancouver, B.C., Canada. However, experimentation with stimulant maintenance will be difficult to carry out until the public's exaggerated fears of cocaine and other stimulants, engendered by a prolonged “War on Drugs”, have subsided. This article explores the prospects for stimulant maintenance by (1) reviewing the actual dangers and benefits arising from use of cocaine and other stimulants, (2) describing small scale stimulant maintenance programs that already exist in various countries, and (3) drawing from Vancouver's experience with methadone maintenance to propose first steps towards stimulant maintenance. Although we focus our analysis on Vancouver, we believe it has wider applicability.

Key Words:

• Harm reduction
• AIDS
• stimulant maintenance
• agonist replacement
• cocaine
• methylphenidate
• amphetamines