Safer Drug Use

General Safety Tips for All Users

• Know Your Substance: Ensure you are using a substance that is as pure as possible. Test kits can help identify harmful adulterants.
• Use in a Safe Environment: Use substances in a familiar and safe setting and avoid using alone. Being with trusted people can ensure help is available if needed.
• Start Low and Go Slow: Especially with new substances, start with a small amount to test strength and effects.
• Stay Hydrated and Nourished: Many substances can dehydrate you or suppress your appetite. Drink water and eat balanced meals to maintain energy and health.
• Avoid Mixing Substances: Mixing can lead to unpredictable and often dangerous interactions. If you must mix, ensure you understand the potential interactions.
• Use Clean Equipment: Always use sterile equipment and avoid sharing to reduce the risk of infection and disease transmission.
• Seek Help if Needed: Don’t hesitate to seek medical or professional help if you or someone else shows signs of overdose or adverse effects.

Hierarchy of Drug Use Methods: From Safest to Most Risky

Understanding the different methods of substance use and their relative risks can help individuals make informed decisions to minimize harm. Here’s a hierarchy of substance use methods, ordered from the least risky to the most risky:

1. Oral Ingestion

• Safety Profile: Safest among the use methods because it allows the body more time to process the substances, reducing the intensity of the high and minimizing the risk of overdose.
• Examples: Swallowing pills, consuming cannabis edibles, drinking alcohol.
• Key Tips: Start with a low dose, especially with edibles, as effects can be delayed and unpredictable.

2. Sublingual (Under the Tongue)

• Safety Profile: Allows the substance to enter the bloodstream directly without passing through the digestive system, offering a safer alternative to inhalation or injection.
• Examples: Sublingual strips, tablets, or drops.
• Key Tips: Wait for the substance to dissolve completely under the tongue to avoid swallowing it prematurely, which could divert it into the oral ingestion pathway.

3. Inhalation (Vaping)

• Safety Profile: Safer than smoking because it avoids the combustion of materials, thereby reducing the inhalation of many harmful carcinogenic compounds.
• Examples: Vaporizers, vape pens.
• Key Tips: Use temperature-controlled devices to avoid overheating the substance, which can produce harmful byproducts.

4. Topical Application

• Safety Profile: Very low risk of systemic effects as the substance primarily affects the local area of application.
• Examples: Transdermal patches, creams, ointments.
• Key Tips: Ensure the skin is clean and intact before application to avoid infection or irritation.

5. Inhalation (Smoking)

• Safety Profile: More harmful than vaping due to the combustion process, which releases a variety of toxic substances.
• Examples: Smoking cannabis, cigarettes, or using bongs and pipes.
• Key Tips: If smoking, use filters and avoid deep inhalation or holding your breath to reduce tar intake.

6. Rectal (Plugging)

• Safety Profile: Higher absorption rate than oral ingestion but can damage the mucosal lining if not done correctly.
• Examples: Drug solutions administered rectally.
• Key Tips: Use a lubricated applicator and sterile solution; administer in a clean environment to reduce the risk of infection.

7. Intranasal (Snorting)

• Safety Profile: Risky due to the potential for damage to nasal passages and a more rapid onset of effects, increasing overdose risk.
• Examples: Snorting powders like cocaine, crushed pills.
• Key Tips: Alternate nostrils and use a clean, smooth surface to prepare substances. Avoid sharing snorting instruments to prevent disease transmission.

8. Subcutaneous (Skin Popping)

• Safety Profile: Risk of localized infections and slower drug absorption rate than intravenous or intramuscular methods but can cause severe skin and soft tissue infections.
• Examples: Examples: Injecting drugs just under the skin.
• Key Tips: Key Tips: Rotate sites to prevent abscesses and use sterile equipment for each use.

9. Intramuscular (IM)

• Safety Profile: Less risky than IV use but can cause muscle damage and infections. Absorption is faster than subcutaneous but slower than intravenous.
• Examples: Injecting into large muscle groups.
• Key Tips: Use appropriate needle length, sterile equipment, and avoid repeated injections into the same site.

10. Intravenous (IV)

• Safety Profile: Most dangerous due to the risk of direct bloodstream infections, rapid onset of drug effects increasing overdose potential, and damage to veins.
• Examples: Injecting directly into a vein.
• Key Tips: Never share needles, use sterile equipment, rotate injection sites, and use tourniquets correctly to minimize vein damage.

Special Considerations

• Mixing Substances: Increases the risk significantly, especially mixing depressants (like alcohol and opioids) which can lead to respiratory failure.
• Set and Setting: Using any substance in an unsafe environment or when in a negative state of mind increases the risk of harm.
• Education and Support: Utilizing harm reduction services, getting trained in overdose response (like using naloxone), and understanding your substances can decrease risks.

Safer Smoking Practices

Bongs and Pipes

• Filter and Cool Smoke: Bongs help to filter and cool smoke, reducing the harshness on the lungs. However, they don’t eliminate harmful substances.
• Keep It Clean: Regularly clean your bong or pipe to prevent the buildup of harmful residues and bacteria.
• Avoid Plastic: Use glass, silicone, or stainless steel bongs and pipes to avoid inhaling fumes from heated plastics.
• Don't Hold Smoke In: Inhaling deeply and holding it in increases exposure to tar and other harmful substances without increasing the effects.

Vaporizers

• Temperature Control: Use vaporizers that allow you to control the temperature to avoid burning the substance, which can release harmful chemicals.
• Avoid Direct Contact with Coils: Ensure that the substance does not directly touch heating coils in vaporizers to prevent combustion.

Safer Injecting Practices

Preparation

Technique