Stimulant use is a rising crisis that is often overlooked compared to opioid-related unregulated drug deaths. Approximately 62% of unregulated drug deaths in 2025 also involved a stimulant, which are commonly combined with opioids without the user’s knowledge. Stimulant use itself is associated with increased risk of disease, mental health conditions, overdose, and death. A review by the Canadian Medical Association Journal in 2022 states that prescribing psychostimulants like methylphenidate and dextroamphetamine as an alternative to unregulated stimulants is a promising treatment that decreases fatal risks, citing another study:
“Outcomes observed in these studies include reduced use of illegal stimulants, improvement in physical and mental health, and improved focus and attention for patients with concurrent attention-deficit/hyperactivity disorder.” 1
Thus, prescribed psychostimulants are an evidence-based treatment that could be used along with contingency management to reduce harm associated with continued unregulated stimulant use. One notable pan-Canadian trial investigating this treatment method is the ASCME clinical trial.
Additionally, psychostimulants are often prescribed to treat ADHD. This study found that prescribed psychostimulants treated ADHD along with opioid use disorder, reducing instances of unregulated stimulant and opioid-related harms. Evidence shows that, going forward, health policy must adapt to resilient and flexible black markets in order to curb the unregulated drug supply by way of harm reduction and policy intervention.
Sunshine Labs is committed to supporting essential clinical trials to forward innovative mental health and addiction treatments.
Read more about the link between substance use and ADHD here.