Safer drug use

Drug use means taking any drug that has an effect on the way a person's brain and body work. Some drugs are legal, like caffeine and alcohol. Some are illegal, like crack or crystal meth. Some are legal but used illegally like taking oxycontin without a prescription. The way people use drugs varies a lot because of where they live, what's available, and what kind of high they are looking for.

Uppers and downers

Drugs have different effects on the brain and body such as:

• Uppers are stimulants that can make you hyper and give you energy. They can make your heart race and may crank up your sex drive. Some examples of uppers are crack, cocaine, meth, caffeine and nicotine.
• Downers, or depressants, are usually painkillers, like heroin or oxycontin, and make you feel relaxed, chill or even sleepy. Alcohol is also a depressant because it slows down your heartbeat and breathing rate.

Things to watch out for

Drug warnings

Some needle exchange programs try to keep track of changes to the quality of drugs in the area. Dealers who make the drugs can change what drugs are cut with, which can mean there is “bad crack” or “nasty heroin” going around that's making people sick or causing people to overdose. Pay attention to warnings or reports about drug quality so you don't get stuck with a bad hit and share your information with others.

Overdose (OD)

Taking more of a drug than your body can handle can cause an overdose. This happens when you take too much of the drug (or drugs), or you've been on a break—either from being in jail, or in treatment, or because you just wanted a break—and your tolerance is low, or you're trying a new drug or new dealer and don't quite know what you're getting. It's a good idea to mix up a smaller dose (like half a hit) of the drug the first time before taking a full hit to make sure you know how strong it is.

Drug users don't always stick to one drug and often use more than one drug at the same time—either by choice (because they're looking for a particular high or to balance out some of the crash) or because the drug they are using has been cut with some other drug. The health risk is that it's easier to overdose when using more than one type of drug at the same time. This may happen because the drugs have different effects (uppers vs. downers) and last for different amounts of time in the body. Now, lots of people who use more than one drug don't OD, but most people who OD have two or more drugs in their system. For example, people who die of cocaine overdose often have also been drinking alcohol. Also taking heroin with another drug (like benzos, alcohol or crack) leads to more overdoses than using one of those drugs alone.

Signs of overdose

Even if you take precautions, you or someone you know might OD some day. But how do you know if a person is OD'ing? The signs of an OD can be different based on which drug the person took. The table below shows signs for overdose with both uppers and downers.

The more of these signs a person has, the more likely it is that they could be overdosing. It doesn't mean they'll die, but they do need medical attention. Call 911 or go to the hospital, especially if the person has passed out and stopped breathing. Stay with them if you can, or at least leave a note for the paramedics to know which drug the person took so they can give them the best help.

Problematic Drug Use

Many drug users are able to keep a balance between their drug use and other things in their lives. But getting and using the drug can sometimes become your main focus. You use even if it means losing friends, doing something illegal or “crossing the line” to a point where things you used to like to do no longer matter and things you don't really like to do become routine. Answering “yes” to some of the following questions may be a sign that drug use is hurting your life:

• Do you go through withdrawal if you don't use for a while?
• Do you have to use more and more of the drug to get the same high?
• Are a lot or all of your activities happening around getting and using drugs? Are a lot or all of your friendships based on getting and using?
• Do you use even when you didn't plan to?
• Have you tried to cut back but had trouble doing so?
• Do you think you use too much and want to cut back?

These can be hard questions to deal with, especially if the answer is “yes.” If you feel drugs or alcohol are affecting your life, you can talk to a healthcare worker or someone at a needle exchange program  to learn about your options and ways to cut back. 

Risks associated with how drugs are taken

The way you take drugs affects the risks you face:

• Swallowing – popping pills or eating the drug is safer than other ways of using
• Inserting – inserting drugs in your vagina or anus can make them raw or irritated, which makes it easier for HIV, Hep C, and STIs to enter your body
• Snorting – snorting drugs can damage your nose and cause a runny nose or nosebleed; sharing straws can pass on Hep C
• Smoking – smoking is safer than injecting but you can hurt your lungs with smoke or burn your mouth if you use homemade pipes. You can also get Hep C if you share your smoking equipment, including pipes and mouthpieces.
• Shooting or injecting – when you prepare and shoot drugs and share your needles and works, you can get infections like HIV and Hep C from reusing someone else's equipment or infections like abscesses and cotton fever from using used equipment or not properly cleaning your skin before shooting up. Using a needle you found lying around and don't know whether someone else has used it is also risky.

Stigma

Using drugs doesn't only present health risks like overdose or Hep C infection. Some people look down on people who use drugs and this can create challenges for you as a drug user. For example:

• people might judge you for using and think you're unpredictable or dangerous if they see you when you're high
• it might be hard to get good service at places like hospitals, welfare offices, or even grocery stores, which means you have to work harder to get food, rent money, or healthcare
• if you've been in jail or been arrested for having or selling drugs, a criminal record makes it harder to find a job.

Use safely to protect yourself and others.

Mental health

Because drugs change the way the brain and the body work, using them can sometimes cause changes to your mental health. Sometimes they are temporary, like feeling paranoid when using pot or crack. Some people use drugs to help deal with mental health issues that they already face. Other times there can be permanent changes when mental health issues, like depression, anxiety or schizophrenia, are uncovered or brought to the surface. Talk to your healthcare provider or a worker you trust such as a needle exchange worker if you experience changes that you don't like or for other information on coping with mental health issues.