Guidelines for Prevention and Management of Complications of Injection Drug Use- A WikiGuidelines Group Consensus Statement.

The WikiGuidelines organization seeks to improve the process of guideline writing. WikiGuideline consensus statements use a dichotomized approach to recommendations, such that recommendations are made only when sufficient randomized controlled data are available. In the absence of such data, a clinical review is provided. After applying this approach to the care of patients who inject drugs (PWID), this consensus statement recommends that patients with opioid use disorder (OUD) be offered treatment in the form of opioid agonist therapies. Patients with stimulant use disorder, specifically amphetamine use disorder, should be offered mirtazapine. Patients with stimulant use disorder, regardless of drug of choice, do best when offered behavioral therapies, such as contingency management. For hospitalized patients admitted with complications of substance use, the addition of substance use care teams has demonstrated improved outcomes. Further, patients who inject drugs with hepatitis C should be offered treatment, which can be completed in a variety of low-barrier settings. Several other questions did not meet the threshold for clear recommendations; and therefore, clinical reviews are offered instead.