Substance Use



What is safer injecting?

Everyone has their own reasons for using substances, whether for self-medicating, coping, or having fun. Despite how common it is to use substances, there’s still a lot of stigma around buying, using, and talking about drugs. People often have negative reactions that come from society’s views on certain substances and the people who use them.

Some substances are legal and regulated, while others aren’t, which is why learning about how to use substances in safer ways is so important. At Sexfluent, we believe that you deserve to make choices about your health and body that are free from stigma. 💕 This includes having access to accurate information on how to enjoy substances more safely.

Getting High... or Low

There’s lots of different substances out there, and each one has a unique effect on every individual’s body. Psychoactive substances are any drug, medication, inhalant, or solvent that affects your brain by impacting your mood, thinking, and behaviour.

Our emotional state can play a huge role in how often we use substances, which ones, and how they make us feel. How hard a drug hits and what it feels like can be influenced by many factors, like your current mood, age, weight, tolerance, and family history with substance use or mental health. Your trip might feel different than your friend’s on the same drug, and it might not go the same way as it did last week. Since many substances are illegal and unregulated, how they make you feel can also depend on how pure or potent they are. Supply of street drugs is often diluted or contaminated for cost-saving, dosage correction, or accidental reasons.

It can also depend on how the substance passes through your body – people can inject, swallow, smoke, snort, or plug substances for different effects, but more on that here.
Beer bottle

Most substances can be categorized into three major groups: stimulants, depressants, and hallucinogens.

Stimulants, sometimes called uppers, can make you feel awake, upbeat, and energetic. They tell your central nervous system to release feel-good chemicals, like serotonin, dopamine, and adrenaline, which also make you more alert and increase your heart rate. Some examples of stimulant drugs are cigarettes, amphetamines and methamphetamines, cocaine and crack, and yes – caffeine!
Depressants, sometimes called downers, can make folks feel relaxed, calm, and even euphoric. Depressant substances work on your central nervous system to slow your breathing, heart rate, and make you feel drowsy. Some examples of depressant substances are alcohol, GHB, and opioid family drugs, like heroin.
Hallucinogens, sometimes called psychedelics, are substances that can change your sensation and perception of reality, like the things you think, see, taste, smell, and feel. 🌈 Some examples of hallucinogens are LSD, and psilocybin mushrooms.

Safer Substance Use

Making decisions about using substances is like any other decision you make about your safety, health, and well-being. We’ve all engaged in activities that could have potentially harmful effects on us, like riding your bike on a busy street, driving a motor vehicle, or texting your crush after midnight. But there are things we can do to try and reduce the risks of these activities to make them safer for us and the folks who also engage in them.

Harm reduction is about recognizing that if you’re going to do something that could potentially have a negative impact on your well-being, you’ll try to do it more safely. When it comes to using regulated and legal substances, like medications, cigarettes, alcohol, or weed, we usually know exactly what the substance is, how much of it we could use at a time, and how it could make us feel – all because we can check the label on the packaging! 📝 But this isn’t always possible with substances that are illegal or unregulated. The more you learn about different substances, the more you can make informed decisions about how to use them and prevent bad trips, over-intoxication, blood-borne infections (like HIV and Hepatitis C), or overdose.

Harm Reduction Tips

Here are a few tips to reduce the potential harms when using different substances and to prevent overdose:
  • Learn as much as you can about the substance you’re interested in before trying it. Look into how it's supposed to make you feel, how long its effects last, how you might feel afterwards, and how it could interact with any existing health conditions or medications you’re on.  This resource is great for that, as well as talking to folks you know who also use substances!
  • Know who and where you’re getting your substances from. Ask questions, and vet your supply.
  • Check 👏 your 👏 drugs! 👏 In Canada, many substances (especially powder drugs, cocaine, crack, and opioid family drugs) are cut or contaminated with other substances, like fentanyl and benzodiazepines, which can increase your chance of overdose. Even if fentanyl or benzos are what you’re using, it can be hard to know how potent, or strong, the substance is. Consider bringing your substances to a local drug checking service before using – these can be found at local community centres, harm reduction organizations, or supervised consumption sites!
  • If you can, use your drugs at a supervised consumption site. These are public health sites that have nurses and harm reduction workers on standby in case you overdose. Not a single person has died from an overdose at a supervised consumption site. Click here to check out a map of different harm reduction sites across Canada.
  • In general, try not to use substances alone. Having a friend, family member, or community member check-in with you after a certain amount of time has passed can make the experience safer in the event of an overdose.
  • If possible, use substances in an environment that feels good for you and during a time where you’re in a neutral or positive emotional state. Your experience of the substance is more likely to be positive if you’re already feeling that way!
  • Start low and slow. You can always increase your dose, but you can’t go back. Don’t forget to review how long it should take before you start feeling the effects of the substance!
  • If you can, measure your own dose every time – only you will know how much you’ve used in the past and what your body can handle.
  • Use your own supplies to reduce the likelihood of getting or passing HIV or Hepatitis C – this includes any needles, cookers, pipes, or straws you might use to take a hit. Remember our golden rule: everything new, every single time!
  • Avoid mixing substances, as this can increase your chance of overdose. For example, mixing downers can slow or stop your breathing – but more on that here.
  • Plan your night out in advance if you can, and to try to stick to it. What substances are you going to use? How much, where, and with whom? You're not obligated to stick to the plan but thinking in advance can help with decision-making when faced with unexpected activities.
  • If you’re going to use substances before having sex, use forms of protection! This can be difficult to remember in the heat of the moment, so try to prepare for 🔥 spicy encounters 🔥 by having forms of protection, like condoms or dental dams, ready in advance. Some folks may also take PrEP or PEP to prevent or reduce their chances of getting or passing HIV while using substances. Learning more about U=U and your sexual partner(s)’ status(es) can also help keep you and your partner(s) safer, too. 😍
  • Lastly, stay hydrated! Try to eat beforehand and get a good night’s sleep! 😴 These can help make your experience more comfortable. ✨
For more harm reduction tips specific to different types of substances, check out our blog post here!

Safer Injecting

Some folks like to inject their substances because it can give them a faster, more intense high or experience of the substance. Other ways of consuming substances, like smoking or snorting, are usually safer than injecting because the puncture made on your skin with a needle can cause injuries (like abscesses) and open a pathway for bacteria, viruses (like HIV and Hepatitis C), and other infections to potentially enter your body. Click here to read more on how to inject more safely and take care of your veins.

Folks who are beginning hormone replacement therapy, or HRT, may also inject hormones to affirm their gender identity. Learning how to inject more safely is important for everyone who uses injection drugs, regardless of your reason.

Safer injecting means using your own tools to inject your substances! This includes not sharing or reusing tourniquets, needles, syringes, filters, cookers, or straws. Since both HIV and Hepatitis C are common viral infections that are passed through blood-to-blood contact, sharing or reusing needles and other tools have a much higher chance of passing these on, as well as causing skin and heart infections. HIV and Hepatitis C are common viral infections passed through blood-to-blood contact. Sharing used needles and other tools increases your chances of passing these viruses on, as well as infections in the skin and heart.

HIV is a virus that weakens the body's immune system, while HCV (Hepatitis C) attacks your liver. The only way to know your HIV or HCV status is by getting tested! HCV can be treated with a medication routine that lasts between 8 to 24 weeks. While there is no cure for HIV, highly effective treatment in the form of a daily pill exists, and people living with HIV are living healthy and full lives. 💪 The sooner you get tested, the sooner you can begin treatment. (P.S. It's also possible to get a co-infection of HIV and HCV, meaning you can have both viruses at the same time – which is why getting tested regularly is so important!)

When it comes to needles and other tools, just remember: ✍✍ everything new, every single time! ✍✍ Not sure where to get new needles? Syringe distribution programs can provide you with unused needles and are available across Canada at various harm reduction sites. Click here to find one near you.

Needles & Vein Care

When it comes to injecting drugs, there are a few things you may want to consider so the experience is safer for you and the folks you’re using with.

You can inject drugs into muscles, veins, or right underneath the skin.  Different parts of the body work best for different ways of injecting substances. Hover over the diagram below to explore where you might inject substances, and where you want to avoid!

If you’re doing an intramuscular injection (this also applies to hormone therapy!), you want to go for the ✨ thickest ✨ parts of your body. For some folks, these are your thighs, butt, and upper arms. 🍑💪

If you’re injecting just under the skin (or skin-popping) for a slow-release of the substance, you want to go for your upper and lower arms, or legs.

It's recommended to rotate between different veins or areas of your body when injecting substances – this gives your veins some time to heal, and reduces the chances for infection, scarring and blood clots. Try to keep one vein for medical purposes only, like if you’re in an emergency and need an IV inserted!

***Remember to dispose of used needles at your nearest sharps container to prevent passing on bacteria and viruses, like HIV and HCV! These can be found at local community centres, harm reduction sites, public health clinics, and some public restrooms. ***
If you’re injecting intravenous substances (into your veins), check out our handy interactive diagram:
  1. Arms are the best area to inject - the veins are more visible and have good circulation. Make sure to rotate vein sites so they’ll have a chance to heal.
  2. The hands and feet are also good places to inject, though not as ideal – the veins are easily visible, but they’re more delicate, closer to nerves and can take longer to heal. Veins in the legs can be prone to clotting.
  3. The groin and neck are the least ideal places to inject because they’re close to arteries, so use these sites as a last resort, if you can.
A tourniquet can help you find a vein because it constricts blood flow to an area and makes your veins stand out. These can be made of socks, stockings, or even a condom - the softer the material, the better, because it will be gentler on your skin. Other ways of finding a vein include drinking water, clenching then relaxing your fist, or putting a warm cloth over the area you want to take a hit from. In general, you want to avoid injecting where you feel a pulse, as it could mean there’s an artery nearby.

Why We Use

Substances play a big role in many of our lives and can be an enjoyable experience for lots of people. But the relationship you have with yourself, as well as the circumstances you’re in can have a huge impact on why you use substances, how often, and how you feel while you’re using the substance(s).

For example, using substances can be fun and pleasurable – they can teach us about ourselves, enhance our experiences, and help us connect with friends and partners!  Substances can also be a tool to help cope with hard feelings. This can be the case for many people going through different experiences, like those who are street-involved or unhoused, those coming into their gender identity and sexuality, or those who may be managing feelings of grief, loss or abandonment. Folks with mental health conditions may use substances to help loosen tension in their bodies, or take their mind off things. Sometimes, folks also use substances as a way of boosting self-esteem and confidence before having sexbefore having sex. Some folks may have experienced or witnessed substance use in their homes or communities, which made substance use more familiar to them.

Regardless of your reasons, your decision to use substances is valid. That's why it’s important to check-in with yourself before, during and after you’re done using, and as time goes on. You might ask yourself:
  • Is the substance giving you the effect or experience you hoped it would?
  • How is it fulfilling your needs?
  • What’s missing?
You may also want to think about the types of decisions you make when using substances – these can be social, sexual, financial, and more.
  • How do you feel about yourself when you use substances?
  • How do substances play a role in your romantic and sexual life?
  • What are your spending habits like when you’re using?
Checking in with
yourself can be a way of monitoring if and how your substance use is affecting any deeper emotions you might be dealing with.

For example, some folks who use substances when in a really low place with their mental health may experience more intense feelings of self-harm or suicide – which is another reason why it's so important not to use substances alone! Building a network of trustworthy people to talk to about your substance use is a good way to make sure support is there when you need it. If you find that things tend to get worse or more challenging when you're using, it could be worth considering what other outlets you can turn to, in addition to substances. 💞

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