Risk Reduction

This information has been produced to help those people who use any substance to do so more safely (by ‘substance‘ we mean any drug, legal (like alcohol) or illegal (like E), prescribed or not). Any substance use carries risk; by establishing what risks you are engaging in (through self-assessment) and finding areas where risk can be reduced, you can minimise the likelihood of harm. The only way to ensure that you engage in no risk at all is of course not to use any substance. If you are not currently using any substance, these pages hold valuable information that you may be able to pass on to friends who do.

Risk reduction

What are the risks?

The idea that the main risk involved in substance use is a ‘long slippery slope.’ inevitably leading to addiction and death is mistaken and misleading. This fear can obscure many of the real risks involved when we use substances. Cannabis by itself does not kill people, but this does not mean that using it is a risk-free activity. Risks might be physical, psychological, short-term or long-term (or a combination of all of these). Risks may relate to the substance itself, or how, where and why it is being used. Risks are clearly increased when a variety of substances are being used together, or when a substance is used regularly over a prolonged period of time. Safer substance use starts with assessing the risks you are engaging in.

Risk assessment

How much do you know about the substance (or substances) you are using? One of the most obvious risks is using a substance you know nothing about. Information about risks relating to specific substances is available from a variety of sources (more on this later). Even if you know the specific risks for the substance you are using, this information will not help you unless you act on it, or if the substance you have acquired is not what you think it is (a particular risk when taking illegally-sold pills, capsules and powders). How you get the substance into your body dramatically affects the risks you engage in. The method that carries the most risk of harm is injection. Injecting might be seen as a cost effective way of taking a substance, but this is a false economy. There are a whole range of issues that are presented to any person who uses a substance in this way. There are a range of viruses (including HIV and Hepatitis) that are carried in the body fluids of infected people (who may themselves appear perfectly healthy).

These viruses can be passed on if you share any injecting equipment (including water, filters, citric/lemon juice, spoons, needles and barrels). Infections can also come from dirty (i.e…. non-sterile) equipment, and unsafe injecting practices. Pills and powders that have been produced in illicit laboratories (like E, speed, heroin and cocaine) won’t be sterile, and will contain adulterants – other substances that add bulk to what you buy.

Sometimes the adulterants will be toxic, and this can lead to damage. Generally, the least risk will come from swallowing a substance – our bodies are able to recognise a range of toxins which can be filtered by the gut (or expelled). Sniffing (or snorting) powders can lead to immediate damage, especially if the powder is severely adulterated (for example with a cleaning agent like vim or harpic). Regularly smoking any substance is likely to lead to respiratory problems.

Once a powder has been cut (or adulterated) there is no indication of how concentrated it is. Recent confiscations of street ‘speed’ have contained as little as 4% of amphetamine sulphate in the powder. Occasionally a powder with an unusually high purity (maybe as high as 80%) will be sold, usually by an inexperienced dealer. This may sound like a bonus, but taking a substance that is so pure is likely to lead to an overdose – effectively you could be doubling or even tripling the quantity you would normally use. We take drugs to affect how we feel, our behavior and our perception of the world.

Some risks come from these changes – our behavior may become less inhibited; we may be more likely to engage in unsafe sex, react violently to situations or make decisions which we later regret. All substance use changes our perception to some extent. This can affect our ability to react quickly – for example when driving or cycling – or can make a ‘normal‘ activity more dangerous (like crossing roads, swimming, dancing and climbing stairs).

There is a big difference between taking a drug to change how you feel and taking a drug to enhance how you feel. If you use a substance to lift you out of a depression or relieve yourself from stress, the result will only ever be short term.

DRUGS DON’T TAKE PROBLEMS AWAY

They can mask problems, or make them seem less important, but they don’t resolve them. The danger is that someone who uses a substance to deal with an unchanging situation has to continually use the substance. Most substances (especially hallucinogens) enhance and amplify our feelings – taking LSD when you’re in a bad mood is unlikely to result in a ‘good‘ experience. A good way to assess your own substance use is to ask yourself a few questions…

How much do you really know about the substance you are using? Do you use everyday? Do you mix with people who don’t use? Can you afford your substance use? Do you have good times without using drugs? Does your substance use adversely affect other aspects of your life (like employment, studies or relationships)? Any patterns or aspects of your use that concern you can be checked out with others (see ‘who can I talk to’ at the end of this page).

Risk reduction

So, you’ve explored your substance use, become aware of the risks you are engaging in – now what? Reducing risks is not difficult. When you are planning to use a substance, think ahead and make the experience as safe as you can. Seek information about the substance; if you are buying it illegally then be aware that the substance has not been through any ‘quality control‘ – if you’ve decided to buy, then buy from someone you trust rather than a complete stranger. If you are injecting, use sterile equipment (available from needle exchanges).

Think (honestly) about how you feel – are you taking the substance to have a ‘good‘ time or to escape a ‘bad‘ time? Plan ahead – make sure that you are as unlikely as possible to encounter a stressful or dangerous environment. Will you feel safe? Will you feel comfortable (or threatened)? Will someone you know be there to look after you if you do get into difficulty? It’s far better to think all of this through before you take a substance rather than panicking whilst you’re using.