Harm reduction

Below are some tips to reduce harm from alcohol and other drugs. For harm reduction advice about specific drugs please visit the individual drug information pages.

  • Spend at least 2 hours researching a drug you plan to take – know the effects, average dose and what to expect during and after the experience
  • Test the drug. If you don’t have access to a drug testing service, reagent testing kits are available online and can give a greater understanding of what the drug contains, but they may not be suitable for identifying newer compounds or adulterants and can tell you nothing about purity or strength
  • Plan how you are getting home before you start your night
  • Avoid taking drugs alone and have a ‘sober’ friend around if possible
  • Tell someone what you have taken, how much and when
  • Try not to accept/buy drugs from people you don’t know – but remember having a trusted source does not remove risk entirely
  • Plan your doses in advance – your perception of a dose once you are already high will not be accurate and use a watch or timer to keep track of how frequently you are dosing 
  • There is no standard amount of a drug when bought on the illegal market. Purity can vary, even within the same batch. You can’t judge content or purity by appearance
  • Use scales to measure the dose – you can’t judge an accurate dose just by looking. Start with a small dose and go slow! Remember, that the more of a drug you take, the riskier it is and the more likely you are to experience negative effects
  • Only carry what you plan on taking. If you have a couple of grams in your pocket it is easy to take more than you anticipated. Leave what you don’t need at home (in a safe place)
  • Avoid mixing different drugs including alcohol and medicines as this can cause dangerous, unintended or unpredictable effects. Take time to research possible interactions with your medication or health condition. 
  • If you do mix drugs, do your research, ensure you are somewhere safe and take way less of both substances than you would if you were only taking one. 
  • If you can’t avoid alcohol completely, try to limit yourself to only a few drinks, choose drinks with a lower alcohol content and drink water or soft drinks between alcoholic ones.
  • If taking a drug for the first time or taking a new batch/packet take a test dose first and wait two hours to feel the effects or any unexpected reactions
  • Start by taking small amounts – this might be quarter of a pill, one small line or dab, a few puffs of a joint or vape
  • Pace yourself and wait two hours before taking any more
  • Keep hydrated, drink small sips of water (about 1/2-1 pint per hour)
  • If experiencing issues with jaw clenching, chew gum or soft sweets
  • Magnesium supplements can help reduce jaw clenching
  • Take regular breaks when dancing
  • If you start to feel unwell, tell someone and be honest about what has been taken
  • If the effects feel stronger than expected try to relax and take small sips of flat sugary juice
  • If the person taking drugs is sleeping or unconscious place them in the recovery position (on their side) and check them frequently to ensure they are okay
  • People should sleep on their side to avoid choking on vomit in their sleep. 
  • If you experience vomiting this could reduce the effectiveness of the contraceptive pill – use alternative methods to avoid unintended pregnancy.  
  • Think about safe sex – grab condoms, dams and whatever else will help keep you safe depending on how you have sexLike other stimulant drugs, cocaine can increase your feelings of arousal so it’s important to think about consent. Are you really feeling it? Are they? Ensure you have full consent before, and during, any sexual activity.
  • If you start to feel any negative effects, simple things like changing your environment may help. If the effects are too strong, try to stay relaxed, control your breathing and take small sips of water or flat sugary juice. Let someone know how you are feeling – sometimes just sharing that feeling can help ease it. 
  • Look after your pals and seek medical help as soon as possible if needed. Be honest about what has been taken. 
  • Make sure you have time to rest afterwards and chill out.
  • Try to have a few drink/drug free days a week to allow your body to recover
  • Get regular health check-ups and tests for blood borne viruses (e.g. hepatitis B, hepatitis C, HIV) and sexually transmitted infections (STIs, e.g. chlamydia)
  • Think you’re taking too much? Find out how risky your use is with our check it out tool!

In addition the following harm reduction advice can be used when using certain routes of administration but check our drugs A-Z for specific information about individual drugs:

SMOKING

Inhaling drugs can damage the mouth, throat and lungs and can cause breathing difficulties, wheezing, chest pain, shortness of breath and in extreme cases, respiratory failure. It can also impact negatively on oral health and can cause sores, cuts and blisters on the lips and in the mouth. 

  • Grind or break the drug into small pieces  
  • When smoking stimulant drugs, the effects may be intense but short-lived. This may leave you immediately craving more. Use a timer to keep track of use and try to wait as long as possible between doses. 
  • If using rolling papers use as little paper as possible
  • If smoking from foil, use clean foil each time. This is available from injecting equipment providers (IEPs or needle exchanges). 
  • If smoking from a pipe, use a clean glass pipe with a metal gauze. Pipes made from bottles and cans release fumes when heated. Glass pipes are less harmful and more efficient than wood or plastic. They can be purchased cheaply from a headshop, or on online
  • Try to use unprinted card for roaches so you don’t inhale ink chemicals. Using a carbon filter won’t affect high but does block the effects of tobacco more effectively. Better yet – ditch tobacco!
  • Avoid holding smoke in your lungs as this can damage tissue without giving a better ‘hit’
  • Allow the pipe to cool down between uses and hold the pipe as far away from the flame as possible to reduce the chance of burns. Keep all burns clean and dry. If they do not start to heal, and instead become more red, hot or inflamed, please seek medical help. 
  • Stay hydrated. Smoking crack dries out the mouth so it’s important to use lip balm, drink small sips of water regularly and brush your teeth twice a day.
  • Sharing pipes can spread infections and blood borne viruses (e.g. hepatitis C, HIV) – only use your own equipment. Get tested regularly for BBVs.
  • Viruses and bacteria that cause illnesses like the common cold or skin infections can also be passed on by sharing joints, cigarettes or pipes

SNORTING

  • This makes it easier to judge a dose, speeds up absorption into the body and reduces the damage to soft tissue from abrasion. 
  • Avoid using bank notes as a tool to snort drugs, as they aren’t disposable and can cut the inside of your nose — post-its or paper straws are a good alternative to notes. 
  • Sharing tools can spread infections and blood borne viruses (e.g. hepatitis C, HIV) – only use your own equipment. Get tested regularly for BBVs. 
  • Viruses and bacteria that cause illnesses like the common cold or skin infections can also be passed on by the tool you use to snort
  • Position the tool as high up the nostril as possible and use a different nostril for each dose. 
  • Rinse your nose out with clean water at the end of a session, to prevent the powder causing further damage to the inside of your nose. 
  • Apply a thin layer of vitamin E oil to the inside of the nose after rinsing.  

INJECTING

(This route of administration poses the highest risk.)

  • Only use clean needles and supplies. Free, clean needles are available from needle exchange services. Alternatively they can be bought online
  • Use the smallest needle you can without it becoming blocked
  • Follow good hygiene practice and wash injection sites (before and after)
  • Always filter your drugs
  • Use a fresh needle if you fail to find a vein first time; needles become blunt after one use
  • Never share equipment (including needles, filters, containers, spoons and water)
  • Do not use citric acid or heat to dissolve substances if it is not needed. For most drugs (apart from heroin) this is unnecessary and it may cause greater harm to injection sites
  • Rotate injection sites
  • Dispose of needles responsibly. These can be returned to a needle exchange
  • Seek medical assistance if site becomes painful, tender or hot, or there is swelling for more than a few days

SWALLOWING

  • Powder can be put into a capsule, wrapped into a cigarette paper or mixed into a drink and swallowed.  
  • Grind or crush powder down as fine as possible before use. This makes it easier to judge a dose and speeds up absorption into the body. 
  • Dose low — start with quarter or half of a pill. Some pills can be hard to break. For best effect use a pill cutter and break your pills up prior to going out. 
  • Dose low — start with a small amount and wait 2 hours before re-dosing. Some pills will take a while to break down and therefore longer for you to feel the effects.  
  • Use a clean cigarette paper or gel capsule to “bomb” powder. 
  • If mixed into a drink, care should be taken to accurately dose and the bottle/cup marked to ensure no one else accidentally drinks it. Never leave your drink unattended and avoid drinking from bottles/cups if you are unsure of what’s in it.  

DABBING

  • Grind or crush the drug down as fine as possible before use. This makes it easier to judge a dose and speeds up absorption into the body. 
  • Dose low  start by dabbing a small dose of powder on the back of the tongue – make sure your hands are clean and wait at least 2 hours before re-dosing. 
  • Viruses and bacteria that cause illnesses like the common cold or skin infections can also be passed on if you are dabbing drugs from the same bag

BUMPING

Taking drugs ‘up the bum’ is also called shelving, plugging, bumping or rectal administration. This route is efficient at absorbing drugs into the bloodstream (i.e. more cocaine enters your system than when snorting) but regularly shelving drugs can cause soft tissue damage, rectal bleeding and increased sensitivity. 

  • Ensure all equipment is clean and sterile before use – this includes washing your hands. 
  • Dissolve the crushed powder in sterile water (0.5 millilitres is usually more than enough). 
  • Use a clean, needleless syringe (or single use straw or lube launcher) to draw up the water containing the drug. 
  • Add lube to the outside of the syringe to allow for easier entry and to prevent soft tissue damage. 
  • Lie on your side, insert the syringe into the anus and slowly press the plunger all the way in. After a few minutes, gently and slowly pull the syringe out. 
  • You can also insert the drugs in a gel capsule or cigarette paper, but this is more physically damaging than dissolving the drugs in water. Use lube and wash your hands before and after administration.
  • Cocaine and other drugs can make the bum numb and you may not be aware of damage – take care and check the area with clean hands. Be aware that this can make it harder for you to feel when you need to go to the toilet.
  • Some drugs (such as GBL) and adulterants (unexpected contents) might burn or damage tissue, which increases the risk of infection.  
  • If you plan to have anal sex, use a condom and check for any reduced sensation or damage beforehand.
  • Sharing water, mixing cups, syringes, straws, lube launchers and lube can spread infections and blood borne viruses (e.g. hepatitis C, HIV) – only use your own. Get tested regularly for STIs and BBVs.
  • Look out for the signs of haemorrhoids (lumps inside and around your bum) or signs of infection and treat them quickly. 
  • Use a vitamin E capsule or apply a thin layer of vitamin E oil to the inside of the anus after a session.

Join Crew on the Kiltwalk 2020

You can help Crew reduce more drug-related harm by joining us to walk the walk at any of the 4 Kiltwalk 2020 events in Scotland!
Go for it!