Background: Occurring against the backdrop of an overdose crisis, stimulant use and stimulant-involved deaths in North America are increasing at an alarming rate. Many of these deaths are being attributed to fentanyl and related analogs, which have been increasingly found within street-level stimulant supplies. Within this, people experiencing socioeconomic marginalization are at the greatest risk of overdose and other harms from adulterated stimulants. Current treatments for stimulant use disorder have limited effectiveness, and even less applicability to the lived realities of marginalized stimulant users. Emerging technologies, such as drug checking, are being implemented to support safer stimulant use, but the accessibility and utility of these technologies to stimulant users are framed by experiences of vulnerability that render them largely ineffective. Stimulant safe supply: Solutions that provide a legal and safe supply of non-adulterated stimulants of known quality, and within a health care framework, are needed to directly address the risk of an increasingly adulterated stimulant supply. Similar innovative opioid-focused interventions are being piloted with medications that have a similar pharmacological effect as their illicit counterparts. While there are currently no approved pharmacotherapies for stimulant use, research has demonstrated a number of stimulant medications that are promising substitutes for cocaine and methamphetamine use. Much like with opioid-focused pharmacotherapies, having a consistent and safe supply of stimulants can lead to improved health outcomes and will drastically reduce overdose risk. However, for a stimulant safe supply intervention to be a success, it must provide the high and performance-enhancing effects that people seek from the illicit market, which requires doses and user agency that trials to date have not provided. Conclusion: Efforts are needed to investigate the feasibility of pharmacological stimulant-based interventions that address safe supply needs. The promise of similar opioid-focused approaches in addressing both overdose-related risks and experiences related to vulnerability underscores the need to advance safe supply approaches targeted towards people who use stimulants. Given the current overdose crisis and rising stimulant use across North America, the implementation and evaluation of such novel stimulant-focused interventions should be a public health priority.

Drug and alcohol use have been associated with increased risk for sexual violence, but there is little research on sexual violence within the context of drug use among young adult opioid users. The current mixed-methods study explores young adult opioid users’ sexual experiences in the context of their drug use. Forty-six New York City young adults (ages 18–32) who reported lifetime nonmedical use of prescription opioids (POs) completed in-depth, semistructured interviews, and 164 (ages 18–29) who reported heroin and/or nonmedical PO use in the past 30 days completed structured assessments that inquired about their drug use and sexual behavior and included questions specific to sexual violence. Participants reported frequent incidents of sexual violence experienced both personally and by their opioid using peers. Participants described sexual violence, including sexual assault, as occurring within a context characterized by victimization of users who were unconscious as a result of substance use, implicit and explicit exchanges of sex for drugs and/or money that increased risk for sexual violence, negative sexual perceptions ascribed to drug users, and participants’ own internalized stigma. Recommendations to reduce sexual violence among young adult opioid users include education for users and service providers on the risk of involvement in sexual violence within drug using contexts and efforts to challenge perceptions of acceptability regarding sexual violence.

Objectives: Accreditation standards and challenges in group work education require competency-based approaches in teaching social work with groups. The Association for the Advancement of Social Work with Groups developed Standards for Social Work Practice with Groups, which serve as foundation competencies for professional practice. However, there has been no empirical publication about using them in teaching. This pilot study tested a microskills teaching approach to improve competency in the Standards. Methods: The mixed-methods study used a preexperimental, pretest-posttest design involving 123 diverse baccalaureate and master's students in introductory group work courses. Student responses about the experience were also collected. Results: There were significant, substantial increases in students' perceived importance of and confidence in using the Standards. Confidence gain scores were significantly associated with performance in role-plays. Comments about the assignments were highly favorable and identified role-plays as contributing most to learning. Conclusions: The teaching approach advanced Standards-based group work education.

Harm reduction has gradually entered social work discourse and is now seen as a promising approach for treating individuals with drug and alcohol problems. However, beyond statements and data supporting the utility of a harm reduction approach, few guidelines for clinical practice have been detailed in the social work literature. This lack of concrete detail regarding how harm reduction is actually practiced limits the potential implementation of the model into day-to-day clinical work. This article reiterates that harm reduction is a viable approach to clinical social work practice with individuals who have drug-and alcohol-related problems and for whom traditional approaches may be inappropriate. It focuses on harm reduction therapy as an emerging treatment model that can be implemented by clinical social workers and mentalhealth and substance use treatment providers. The article identifies and elaborates several basic tenets that can be incorporated into clinical social work. It is hoped that social workers who learn how harm reduction is implemented in clinical practice will be more apt to incorporate its principles into their work.

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In November 2020, Oregon voters approved Measure 110, a ballot initiative that decriminalized possession of small quantities of all drugs and allocated hundreds of millions of dollars annually to health services for people who use drugs. Implementation of Measure 110 is ongoing, but several effects are noticeable in the first two years since the measure passed. Among these are substantial decreases in possession of controlled substances arrests and an infusion of funding into harm reduction services that have not traditionally enjoyed a sustainable funding source. This paper analyzes the provisions of Measure 110, examines its early impacts, successes, and challenges, and outlines lessons that jurisdictions contemplating decriminalizing drug possession in the U.S. and globally should consider.

Objective: The authors examined outcomes of a graduate course on evaluating social work practice that required students to use published research, quantitative measures, and single-system designs in a simulated practice evaluation project. Method: Practice evaluation projects from a typical class were analyzed for the number of research references cited, type of client, goals or problems, measures, interventions, single-system designs, and outcomes. Results: More than half of the students conducted selfimprovement projects monitored with self-report measures, and goals or problems selected and interventions applied varied widely. More than 80% of the projects were evaluated with simple AB designs, over 45% of which were associated with statistically significant improvements and an additional 43% showed gains that did not reach statistical significance. Conclusions: Results suggest that students can be taught techniques and skills needed to formulate interventions derived from published research and to evaluate effects of these interventions using single-system designs.