Using all drugs carries some level of risk. That risk is greater right now because coronavirus is affecting drug supplies. You might find that the drugs you’re picking up have a different purity level, or they could be a different substance to what you were expecting. The advice below will help you to stay as safe as possible while using drugs.
This harm reduction advice doesn’t cover prescription or over the counter medication. Please read our advice for prescription drugs or visit the NHS medicines page.
How can I reduce my risk of overdose?
Go low and slow
Even if your drugs look the same as usual, they might have a different purity level or could be cut with something different.
Test dose any drugs you get. Start with a quarter of what you would normally use and see how you feel. Also do this if you’re switching from one opioid to another.
You might want to snort rather than inject right now, as this is less risky. If you’re injecting, don’t ‘slam’ your hit. Depress the plunger slowly, pausing to allow the familiar dose to take effect. If you feel it is unusually strong or sedating, pull it out.
Don’t mix heroin or pills with alcohol, as this is very dangerous. If you do this, make sure you use the heroin first so you can judge the effects. Alcohol and benzos impair your judgement so you may not remember how much you’ve had.
A dose you took hours ago could still cause a fatal overdose if you take something else as well. This is known as the stacking effect.
If you are on a prescription for methadone or buprenorphine, it is very important you take just the dose you are prescribed for each day. Please measure your dose carefully. Your pharmacist can provide you with a dose cup. Don’t take more than you should as there is a risk you may overdose, especially if you are on methadone. Visit our prescriptions page for more information.
Changes in tolerance
If your tolerance could be lower, perhaps because you’ve just come out of prison, be extra careful and start with a very small amount. Your tolerance can go down even if you’ve only gone a few days without using, or using less.
If you’re unwell, or you’ve been unwell, this is also likely to mean your tolerance is lower because your immune system is weaker.
- Do a tester shot and see how it affects you before using more.
- Make sure you use with another person and that you both have and know how to use prenoxad
- If you are injecting and cant get injecting equipment then contact us and we can send you injecting packs through the post
Always use new equipment for every injection. If you get stuck without clean equipment, cleaning a syringe isn’t guaranteed to protect you from infections, but you can reduce your risks by taking these steps:
- Rinse with cold water.
- Rinse with thin bleach or chlorine disinfection tablets.
- Rinse with cold water again.
How can I reduce the risk of me catching coronavirus?
Wash your hands all over for at least 20 seconds. Use soap and water or hand sanitiser. Do this after going out, coming into contact with anyone or handling money. Wash your hands before you handle, prepare or take drugs.
Always prepare your own drugs. Wipe down drug packages or wraps with alcohol-based cleansers (at least 60% alcohol concentration). If you don’t have an alcohol cleanser, using a household disinfectant cleaner will help.
Keep your surfaces clean – wipe them down before and after use, with a disinfectant cleaner or disinfectant wipes.
Avoid sharing any equipment:
- Snorting: use your own straws or personal tubes – don’t use any other everyday items like banknotes or keys.
- Smoking: use your own pipes and bongs – don’t share cigarettes, roll-ups, vapes or foil, This video shows how to make your own pipe from foil.
- Injecting: use your own clean needles, syringes and other equipment such as spoons for cooking up, filters and water.
I have an addiction to prescription drugs but I can’t get hold of them now, what should I do?
Our services are still running, so please get in touch with your local service to see how they can help.
If you want or need to reduce how much medication you’re taking, please speak to a medical professional first. If you are withdrawing from an opioid medication like morphine, codeine or tramadol, we recommend you:
- Eat little and often.
- Drink plenty of fluids – squash, water or herbal tea.
- Rest and give yourself a break – it isn’t easy so be kind to yourself.
- Get support online and over the phone as much as possible.
Harm reduction advice for people who use benzodiazepines
Keeping yourself safe
If you are using benzodiazepines (benzos) that haven’t been prescribed to you, or using more than you’re supposed to, make sure you have someone you trust nearby so they can get you medical help if you need it.
You should be especially careful if you are buying benzos online, because they can vary in strength.
Always start with a small amount and see how you feel before taking more.
Don’t mix with anything else
If you’re using a benzo like Diazepam, it’s important you don’t use any other substances, or drink alcohol, at the same time.
You should also avoid using more than one type of benzo, or other sedative drug like Xanax, at the same time.
Naloxone or Prnoxad, the opioid overdose reversal drug, does not work on benzos.
Am I at risk of alcohol withdrawal symptoms?
- Do you drink over 15 units of alcohol every day? 15 units is about a ½ bottle of spirits, 1½ bottles of wine, 6 pints of regular strength beer, 3 cans super lager or 2 litres of strong cider.
- Have you had withdrawal symptoms in the past when cutting back or stopping alcohol? (these can sometimes take up to a few days to start)
- Do you regularly drink alcohol soon after you get up to relieve shakes, or sweats?
Why is this advice important during the Coronavirus (COVID-19) pandemic? If you are drinking heavily, you are at increased risk of the health impacts of coronavirus (COVID-19). You may want to cut down or stop drinking to help improve your immunity, or because your supply of alcohol is running out. During the pandemic, there will be less support available from hospitals and GPs. Kaleidoscope will have phone or on-line support and will be able to offer medical support.
What might I notice if I cut down or stop?
People often experience sweating, shaking, and feeling sick and anxious. These typically last around a week. Sometimes people get more serious symptoms, which need medical help, but being organised can help reduce your risks.
What are the more serious symptoms to look out for?
- if your symptoms get worse, such as severe shaking and profuse sweating
- seizures (fits)
- seeing, hearing or feeling things that aren’t there (hallucinations)
- feeling confused about where you are, what time it is, who you are with
- poor coordination and unsteadiness on your feet
If you experience any of these more serious symptoms call 999 immediately
Important advice for people who drink more than 30 units of alcohol a day. During this Coronavirus (COVID-19) pandemic you should not try to stop drinking without medical treatment if:
- You usually drink more than 30 units of alcohol a day – 30 units is about 1 bottle of spirits, 3 bottles of wine, 12 pints of normal strength beer, 7 cans of 9% super lager or 4 litres of strong cider
- You suffer from epilepsy or have had fits or delirium tremens (DTs) in the past If either of these applies to you, you should try and keep your drinking steady, without having heavy binges or days completely without alcohol, until it’s possible to arrange a planned alcohol detox with medical support.
If you do need to cut down, you should contact us first