harm reduction options
What To Do When An Overdose Occurs
If you can not wake the person up or keep them awake, their life is in danger.
Lie them in the recovery position as described below and call an ambulance.
- Lie them on their stomach,
- place their right hand next to their face with the right arm next to their body,
- extend their left arm in front of them in line with their body,
- extend their left leg straight in line with their body and
- extend their right hip 90 degrees from their body with the right leg in line with their body.
Vein Care & Safe Injection Suggestions:
Find a place with good light and take the time to do it right. Looking after veins when hitting up really does make for easier using.
- Use a new, fine gauge syringe was each time.
- Filter drug solution through dental cottons, or another clean cotton filter. Avoid cotton wool and cigarette filters - they have sharp, brittle fibers which damage veins. Filtering reduces the risk of infections, vein obstructions and abscess.
- Alternate injection sites - don't go back to the same site until the red is gone there.
- Use an easy to release tourniquet. Any veins that roll should be held lightly with a finger to guide the fit in.
- Let off the tourniquet before pushing the plunger down.
- When a vein is missed, the tourniquet should be released and the fit removed. Missed sites should be held lightly with a finger until the bleeding stops.
- After injection the fit should be pulled out and pressure should be applied to the site with a tissue, some cotton or piece of toilet paper (not an alcohol pad) until bleeding stops.
- About fifteen minutes after injecting vitamin E cream can be rubbed over the veins including any misses. This clears up bruises and helps to soften scarring in the skin and veins. Regular use of this cream helps to keep veins in good condition. Vitamin E cream can be gently massaged into the affected areas once or twice a day during and after a binge or regular using to help veins recover and soften any scarring. Pre-existing scarring can also be softened with regular use.
- To avoid infections, fingers, mixing spoon (cooker) and injection sites can be carefully wiped each time with fresh alcohol pads or washed with soap and water.
- Each person using together having their own cooker, cotton, and water and mixing and sharing your drug without using previously used equipment also helps with safer hits.
Selection of Safer Injection Sites
- Two of the safest areas to inject into are the thigh muscle and veins in the arm.
- Veins in the forearm, if in good condition, are also good injection sites.
- Veins in the legs are also a good location, however the blood flows slowly so one must inject slowly and be wary of the artery that runs along side of the vein.
- Skin popping in the stomach area is OK, however avoid veins and arteries in this area.
- Avoid injection in the neck or groin- veins are deep and have arteries running along side of them.
- Avoid injection in the hands and feet- these veins are fragile and injection will be painful- if you must inject here inject very slowly.
Preparing the Injection- Powders
- Dissolve powders in water- water should be boiled for ten minutes and allowed to cool- this should kill almost all germs in the water.
- If you have to add something to help the powder dissolve - use vitamin C. Lemon juice, however, may contain a fungus which may cause an eye infection.
- Heat the liquid in a clean spoon or cooker with a match or a lighter, the heat will help dissolve the drug(s). Cooking does not sterilize anything...
- Tablets are manufactured to be swallowed, there is no completely safe way of injecting them. The chalk content in tablets and pills is a major cause of vein collapse. When ever possible avoid injecting drugs that come in the form of pills or tablets, swallow them instead.
- To prepare tablets for injection crush them as fine as possible- using two spoons that have been rinsed in boiling water.
- Avoid injecting drugs that don't dissolve well - many people have lost limbs after injecting poorly dissolved drugs and there is also an increased risk of abscess.
- Street drugs are rarely pure and may contain additional substances. Smoking and snorting is a much safer alternative than injection.
Hepatitis B - (HBV)
HBV Can Live For Months On A Surface. HBV is carried in blood, semen, vaginal fluids and discharges. It is easily passed on by sharing needles and having vaginal or anal sex without a condom. You can catch it from: sharing needles, tooth brushes, razors and by equipment used in tattooing, acupuncture, electrolysis and ear/body piercing that has not been properly sterilized and from breast milk from an HBV infected individual. You can't catch it from: shaking hands, coughing, sneezing, sharing knives and forks, or toilet seats. Some people with HBV feel sick for months. Others never feel sick at all. Those who get sick may have the following symptoms: general weakness, headaches, fever, upset stomach, stiff or sore joints, yellow coloration of the skin, dark urine and a pain in the right side. Many people with HBV think they have the flu. Most people recover from HBV, but those who do not may end up with lasting liver problems or cancer of the liver. If the liver stops working the person may die. You can catch it easier than HIV, however unlike HIV or Hepatitis C, there is a vaccine you can have for Hepatitis B. It's three shots over a six month period that you can get at most any clinic
Hepatitis C - (HCV)
HCV Can Live For Months On A Surface. HCV prevention is making sure everything is clean, freshly washed with soap and water or, ideally, new and sterile. HCV transmission is different from HIV and HBV because it is chiefly environmentally transmitted. What that means is that you can get HCV by contact with dried and old blood. If your finger, picks up some HCV from a used syringe or cooker and you touch a fresh injection site, you are at risk of HCV. Syringes, cookers/spoons, cotton, old tissues, even the plastic bag you carry your works in, or anything that has been in contact with blood, can carry HCV. The incubation period, from infection to the development of acute HCV, is about one to three months and is generally a mild illness, with nausea and abdominal pain, and fever. Around the time these symptoms disappear jaundice may occur. (jaundice is a build up of bile, a digestive fluid, which discloses itself as a yellowing of the skin and eyes, and sometimes a discoloration or darkening of urine)
TB is a airborne infection that come from contact with an individual with active TB. (coughing, sneezing can introduce large amounts of TB in the air). TB can be detected in early stages by a skin test called PPD, which inserts sterilized, neutralized TB under the skin to check for reaction. The test is usually done on the underside of the forearm, and is checked for reaction in three days. Symptoms of TB include fatigue, dry unproductive cough, cough increases during night time hours, low grade fever and night sweats. These symptoms are common to many illnesses therefore testing is necessary to determine TB infection. If untreated TB is life threatening. Also failure to complete medication as prescribed can cause of development of a multi-drug resistant strain of TB which reduces the ability of current medications to treat this illness. TB primarily effects the lungs, however it can be found in other organs. A positive reaction to a test does not necessarily mean the individual is infected. It means the individual has been exposed to TB and their bodies have produced antibodies to TB. If a person has been found to be exposed to TB a chest x-ray can determine if the TB is active or if the individual has just been exposed. If active TB is found, treatment begins with a short isolation period, then daily medication which is taken over an extended period of time, minimally six months.
Buprenorphine is a new medication to treat addiction to heroin or other opiates. It is a pill that dissolves under the tongue. Unlike methadone, buprenorphine can be prescribed by doctors in an office setting. You can fill your prescription at a pharmacy, like other medication. You do not have to go to a clinic every day to get it.
Buprenorphine does different things depending on when you last used heroin:
Buprenorphine treats heroin addiction by preventing withdrawal symptoms, stopping cravings and blocking the heroin high. Side effects are usually mild and might include constipation, nausea, and vomiting.
- If you are high or straight on heroin, buprenorphine may put you into withdrawal.
- If you are in withdrawal, it makes you straight.
Methadone is an opioid drug which can be prescribed as a substitute for opiates such as heroin as part of a treatment program. Methadone is itself addictive; however, it has a number of positive attributes.
By receiving a controlled amount of methadone each day, clients can stabilize their drug intake. Methadone is usually given as an oral mixture, thus avoiding the risks associated with injection. It is a long acting drug and needs to be administered only once a day. Clients no longer need to find a substantial amount of money on a daily basis to support their drug habit and can thus avoid criminal behavior and imprisonment. Once stable on methadone it is much easier for clients to make positive changes in their lifestyle.
Do It Yourself Detox Information
Heroin and other opiates-
Things to try:
- Yoga or meditation
- Relaxation sessions, listening to relaxation tapes
- Warm baths, bubble baths, lavender oil helps
- Rescue Remedy, Bach Flower concoction available from health food shops
- Tincture of oats, available from food shops and said to help stop craving
- Valerian tablets, available from health food shops, help with mild and moderate hanging out but may not be enough for a full on detox.
- Multi-vitamin tablets, even vitamin B injections. B12 and B3 deficiencies are common in detox and you really notice the lack of energy and depression. B6, Vitamin C and zinc will also help.
- Don't make any life altering decisions because you are depressed.
- Avoid high anxiety, high energy situations.
- Benzodiazepines, if you can get a doctor to give you some use only as long as you are detoxing. The last thing you want is a benzodiazepine habit, withdrawal from this can be worse than withdrawal from heroin.
Methadone detox can be more difficult. It takes more than twice as long as heroin and the effects can be harder. The general advice for methadone is to come off gradually. Don't try to detox off on anything more than 20 mls if you have been on it for over a month. Get your clinic to manage your dose to 20 or less before trying complete withdrawal.
Withdrawal from heroin and methadone is not without suffering it will not be pleasant. Following the above suggestions are certainly not a definite guide to detoxing, however it will certainly minimize the level of discomfort.
Infections and Abscess Care
Symptoms of Infection Are:
- Swelling or redness near an injection site
- A hard lump located near an injection site, otherwise known as an abscess
- Feeling warm or hot- all over, in one limb or one vein, or an injection site
- Pain - in a vein, or a limb, or near an injection site
- A general feeling of unwell for any length of time
Left unattended infections nearly always get worse and can lead to loss of a limb and death. If symptoms exist, professional care should be sought as soon a possible. Seek out a sympathetic doctor or visit the hospital and GET IT TREATED