safer using
Dawn Chamberlain, team co-ordinator with Camden & Islington Substance Misuse Services, looks at practical ways of reducing the risks of drug use
© stockbyte
It's difficult to give hard-and-fast rules about how to use drugs more safely, because there are so many factors to take into account. As well as the content of a drug, these include your bodyweight, metabolism and temperament, your state of mind when you take the drug, and where you are and who you're with.
All drugs – legal and illegal – have side effects and may involve risks. The risks associated with particular drugs are dealt with in the abc of drugs. But some risks apply across the board, or at least to certain drug groups. If you follow the safety guidelines below, you can reduce these risks.
using alone
Avoid taking drugs on your own. If you're going to take drugs, it's best to take them with people you think you can rely on, and let them know what you've taken, particularly if you're an inexperienced user. If you get into difficulties, or just feel panicky, friends can help. And try to take drugs somewhere you feel safe.
methods of use
Don't inject. Injecting is by far the most dangerous way of taking drugs, especially if you don't know how to do it properly. It's easier to take an overdose if you inject, and there is also a risk of infections and of contracting diseases through sharing equipment.
If you do inject, find out how to do it properly and never share equipment. Your local drug agency or needle exchange (see our feature on problems and services) should be able to advise you about how to inject properly using the right equipment and the safest sites. The rule about not sharing equipment applies to needles, filters, spoons or any other paraphernalia – there is a very high risk of passing on diseases such as hepatitis C or HIV if you share your works. And remember you don't have to be an addict or a regular injector to contract a serious illness through sharing – once can be enough.
In addition, you should never crush tablets and inject them, because this is likely to lead to infections, which can be very serious.
The safest way to take any drug in tablet form is to swallow it. Any drug in powder form is safest snorted, because drugs take a bit longer to get into your system if you snort them, so there is less risk of overdose. Snorting also has drawbacks, though: with heavy use the soft tissue of the inner and upper nostrils rots, leading to a constantly runny nose and frequent nosebleeds.
mixing drugs
Combining drugs can be dangerous. People combine drugs for two reasons: to make the overall effect more intense, or to counteract the unwanted effects of one drug with another – using alcohol to 'moderate' the effects of cocaine, for instance, or tranquillisers to help you sleep after a night out using ecstasy. But if you don't know what you're doing – and even if you do – mixing drugs (including alcohol) increases the health risks and means you generally have less control over your body's reaction and how you feel. This applies to prescribed drugs as well as illegal ones. Some psychiatric drugs and treatments for HIV, for example, can greatly increase the risks of taking other drugs. If in doubt, consult a doctor or drugs organisation (see help and info).
In particular:
- Avoid combining depressants such as alcohol and tranquillisers, or tranquillisers or alcohol with opiates such as heroin. One of the most dangerous effects of depressant drugs is that they slow down your heart-rate and breathing; if you take them in combination the risk of overdose and possible death is significantly increased.
- Avoid mixing alcohol and stimulants such as amphetamines, cocaine or ecstasy. Research has shown that alcohol and stimulant drugs combine to put an increased strain on the heart, increasing the risk of heart attack. Also stimulants tend to make you drink more than you would normally (because they keep you awake and make you feel less drunk) and this leads to increased dehydration, worse hangovers, and a greater risk of liver damage. People often use alcohol to come down from stimulants at the end of a night out, but it's much healthier to drink water, try to sleep off the effects and eat a decent meal when you feel able to.
- Avoid combining stimulants. It may be tempting to take a fast-acting drug while you're waiting for the effects of a another drug to come on (for example it can take the best part of an hour for an ecstasy tablet to take effect, and you might be tempted to have a line or two of cocaine while waiting). But a combination of stimulants can lead to anxiety, paranoia and increased dehydration as well as putting an added strain on the heart.
other risks
Stay cool – and hydrated. If you're going out dancing and you're going to take uppers such as ecstasy or amphetamines, choose a well-ventilated club and make sure you have access to water. Drink about a pint of water per hour at a steady rate. Take rests and cool off regularly. Good clubs provide a first-aider on site in case of problems.
Try not to use drugs if you're feeling under the weather, anxious or depressed. In the short term they may make you feel worse, either as part of their immediate effects or when your body is recovering. Also, if you're using drugs as a way of escaping from problems, you're more likely to become dependent.
Try to buy drugs from a reliable source. Most street drugs (those bought illegally on the black market) have been mixed with other substances. If you're unsure about a drug's content or strength, take a small amount first to check its effects.
Don't go over the top. Be aware of your limits and don't get carried away. If you do, there's an increased risk that you'll get anxious or paranoid, have an accident, overdose, or at best make an idiot of yourself. Again, if you're unsure about the content or strength of what you're taking, try a small amount first.
Don't have unprotected sex. Alcohol and other drugs can make you more relaxed about having sex – not only about who you have sex with but how you have it. Always use condoms to reduce the risks of unwanted pregnancy and getting sexually transmitted diseases, including hepatitis and HIV. See the sex section for more on safer sex.
If you're pregnant, get advice on any drugs you are taking. Both legal and illegal drugs can affect unborn babies. See women's issues.
Don't drive or carry out tasks that may put you or others at risk. If a drug affects your body and state of mind, it also affects your performance. Don't kid yourself. Also, driving under the influence of drugs is illegal.
Try to look after yourself. Using drugs can affect your health in many ways so it's important that you eat well, keep up your fluid intake, get enough sleep, and get regular health checks.
help and info
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organisations
Alcohol Concern
32-36 Loman Street
London SE1 0EE
Telephone: 020 7928 7377 (Mon-Fri 9am-5pm)
E-mail: contact@alcoholconcern.org.uk
Website: www.alcoholconcern.org.uk
Alcohol Concern acts as the national umbrella body for 500 local agencies tackling alcohol-related harm and offering help to the families and friends of those with alcohol-related problems.
Drinkline
PO Box 4000
Glasgow G3 8XX
Helpline: 0800 917 8282 (24 hours)
Minicom: 0800 027 4114
A free national helpline offering advice and information for people with alcohol problems or anyone concerned about alcohol misuse. Provide advice on sensible drinking and information on local support services to help people cut down on their drinking.
DrugScope
32-36 Loman Street
London SE1 0EE
Tel: 020 7928 1211 (Mon-Fri 9am-5.30pm)
E-mail: info@drugscope.org.uk
Website: www.drugscope.org.uk
National drugs information agency with services that include a library, a wide range of publications, policy research and consultancy.
FRANK
Helpline: 0800 77 66 00 (24 hours)
Textphone: 0800 917 8765
E-mail: frank@talktofrank.com
Website: www.talktofrank.com
Provides free confidential drugs information and advice 24 hours a day. All calls are confidential. Use the website's search facility to get the contact details of organisations offering practical help and support in your area.
HIT
Hanover House
Hanover Street
Liverpool L1 3DZ
Tel: 0870 990 9702
Website: www.hit.org.uk
HIT, formerly the Mersey Drug Training and Information Centre (MDTIC), was established in 1985 to reduce drug-related harm. Based in Liverpool, the organisation has gained an international reputation for developing, advocating and implementing a pragmatic and effective approach to the use of drugs. The website has an extensive collection of information on drug use which is available to download or buy, including a guide to safer injecting.
Release
388 Old Street
London EC1V 9LT
Legal Helpline: 0845 4500 215 (Mon-Fri 10am-5.30pm)
Heroin Helpline: 0845 4500 215 (Mon-Fri 10am-5.30pm)
E-mail: ask@release.org.uk
Website: www.release.org.uk
Offers confidential and professional legal, health and welfare advice for those who come into contact with drugs. Can refer you to local drug agencies and specialist lawyers. The website features drug facts, information on the law, and advice for dealing with the police.
websites
AVERT.org
www.avert.org/druguse.htm
Information on HIV prevention and reducing the risks of injecting.
Transform
www.tdpf.org.uk/AboutUs_MissionAndActivities.htm
Site outlining the Transform Drug Policy Foundation's aims and objectives as it seeks to minimise drug-related harm to individuals and communities.
www.urban75.com/Drugs/druguse.html
Information on safe drug use including a guide to cleaning needles as a last resort if new ones cannot be obtained.
(revised February 2003, resources updated February 2005)
