Harm reduction

• Decreases the transmission of blood-borne infections including HIV, hepatitis B, and hepatitis C.
• Reduces skin and other bacterial infections associated with substance use.
• Decreases high-risk behaviours associated with accessing and using substances.
• Reduces the number of used needles discarded in the community.
• Does not encourage initiation of substance use.
• Does not increase the duration or frequency of substance use.
• Provides the motivation to decrease substance use.
• Often the only contact people who use substances will have with health or social service providers.
• Provides education and connects individuals with services and resources when they are ready.

• Try to eat beforehand.
• Stay hydrated with water.
• Take a break to get some sleep.
• Use lip balm to reduce cracks and blisters.
• Have condoms and lubricant available.
• Keep the injection site clean with an alcohol swab before you inject.
• Seek medical care for treatment of abscesses or wounds.

Benzodiazepines are a family of drugs that function as central nervous system depressants.

Benzodiazepines are used to treat anxiety disorders, panic attacks, sleep disorders, and seizure disorders.

When used as prescribed by a physician, benzodiazepines are safe; however, combining benzodiazepines with other depressant drugs can be dangerous. Powerful benzodiazepines such as etizolam have been found in the unregulated opioid drug supply. This can complicate an opioid poisoning response, as naloxone will not reverse a benzodiazepine poisoning.

Etizolam poisoning can present with signs and symptoms like those of an opioid poisoning and can include:

• Central nervous system and respiratory depression
• Dizziness
• Sedation
• Slurred speech
• Lethargy

Cocaine is a stimulant drug that makes people feel energetic, talkative, alert, and euphoric. The white crystalline powder form of cocaine can be snorted or injected while the base form of cocaine (also known as crack) can be smoked and looks like crystals or rocks.

Cocaine on its own causes blood vessels to thicken and constrict which reduces the flow of oxygen to the heart, causes the heart to work harder, increasing the risk of a heart attack, and raises blood pressure. Regular use may result in tolerance to the euphoric effects of cocaine, meaning a person may need to take more of the drug to get the same desired effect.

Cocaine can also be mixed with other drugs such as fentanyl. There is no way to tell by the colour, taste, or smell, whether fentanyl is in cocaine. Always carry a naloxone kit (even if you don’t plan on consuming opioids), avoid using alone, and use new supplies when using cocaine.

For more information on cocaine, visit the Centre for Addiction and Mental Health.

Crystal methamphetamine is a stimulant drug that speeds up the body’s central nervous system and provides an intense sense of euphoria. The white, crystalline substance can come in powder or crystal form that can be smoked, swallowed, snorted, or injected. Effects can last up to 12 hours.

In addition to an intense euphoria, methamphetamine use may cause racing of the heart, chest pain, dryness of mouth, nausea, vomiting, diarrhea, restlessness, physical tension, irritability, paranoid delusions, hallucinations, aggressive behaviour, and impulsive violence.

Crystal methamphetamine may also be mixed with fentanyl. Always carry a naloxone kit (even if you don’t intend on consuming opioids), avoid using alone, and use new supplies when smoking or injecting crystal methamphetamine.

For more information on methamphetamine, visit the Centre for Addiction and Mental Health.

Opioids are a class of depressant drugs that reduce experiences of pain. Common opioids include morphine, codeine, oxycodone (e.g., Percocet), hydromorphone (e.g., Dilaudid), heroin, and fentanyl.

Opioids can cause dangerously slow breathing that may lead to drug poisoning and death. Certain opioids, such as fentanyl, are very powerful so even a small amount can cause drug poisoning and death.

Opioid overdoses and fatalities have risen dramatically since 2016 in the Southeast Public Health area due to the introduction of fentanyl into the unregulated drug supply. The unregulated drug supply contains unknown amounts of fentanyl, benzodiazepines, and other fillers that increase the risk of drug poisoning and death.

An opioid overdose happens when there is more of the opioid in your body than it can handle. An opioid overdose is a medical emergency. Always call 911 and give naloxone, if available.

Signs of an opioid poisoning can include:

• Tiny pupils
• No or slow breathing
• Not responding
• Snoring
• Gurgling sounds
• Vomiting
• Cold or clammy skin
• Blue or purplish lips or fingernails