Use of gelatine capsules for application of methamphetamine: a new harm reduction approach.
BACKGROUND
In order to reduce injecting drug use, low-threshold facilities in the Czech Republic have started to distribute empty gelatine capsules as an oral alternative of drug application for those injecting methamphetamine. This report reviews implementation of this intervention and its possible benefits and limitations.


METHODS
Between December 2008 and January 2009, 109 low-threshold facilities were asked to complete a questionnaire about the capsule programmes. Two focus groups were conducted, one with professionals involved in distribution and one with peer outreach workers who were interviewed on their experience of using the capsules.


RESULTS
A total of 50 facilities (46%) responded to the questionnaire; 16 (32%) distributed the capsules regularly and 19 (38%) were planning to introduce this practice. The main target groups were injecting users of methamphetamine whose veins had been damaged, and methamphetamine users wishing to reduce injecting. The advantages of capsules, as perceived by service staff and peer outreach workers, were their easy use and the satisfactory effect of the oral application; health risks related to the oral use of methamphetamine were considered drawbacks.


CONCLUSIONS
Capsule distribution is a promising harm reduction approach for injectors of methamphetamine or other stimulants; nonetheless its benefits and limitations should be further analysed in an in-depth longitudinal study.
The National Monitoring Centre for Drugs and Drug Addictions, Office of the Government of the Czech Republic, Czech Republic. mravcik.viktor@vlada.cz
Viktor
V
Mravčík
Kateřina
K
Skařupová
Barbora
B
Orlíková
Tomáš
T
Zábranský
Krystallia
K
Karachaliou
Bernd
B
Schulte
D000284:Administration, Oral; D019969:Amphetamine-Related Disorders / Q000534:rehabilitation*; D002214:Capsules; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D002626:Chemistry, Pharmaceutical; D018153:Czech Republic; D004339:Drug Compounding; D005079:Excipients / Q000737:chemistry*; D017144:Focus Groups; D005780:Gelatin / Q000737:chemistry*; D040261:Harm Reduction; D006801:Humans; D007275:Injections, Intravenous; D008694:Methamphetamine / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D015397:Program Evaluation; D015819:Substance Abuse, Intravenous / Q000517:prevention & control*; D011795:Surveys and Questionnaires
D002214:Capsules; D000697:Central Nervous System Stimulants; D005079:Excipients; D008694:Methamphetamine; D005780:Gelatin