Freebase: lower bp, less soluble, vaporised and inhaled
What are the different types of cannibis and how much active compound do they contain?
Marijuana: up to 10% THC
Hashish: up to 15% THC
Oil: up to 30% THC
What drugs are contained in class A?
Ecstacy
LSD
Heroin
Cocaine
Crack
Magic mushrooms
Amphetamines (if prepped for injection)
What drugs are contained in class B?
Amphetamines
Methamphetamine
Pholcodine
Cannabis
What drugs are contained in class C?
Buprenorphine
Tranquilisers
Some painkillers
GHB
Ketamine
What are the risks of using heroin?
OD
HIV/other infections
Damage to veins
Physical dependence leading to crime
How can we reduce the harm associated with injecting?
Needle exchanges
Education
Provide clean, sterile paraphenalia
Accept return of used equipment for safe disposal
How would you go about preparing freebase heroin into an acid salt to inject?
Mix the freebase with ascorbic or citric acid (vinegar too strong and lemon juice has a risk of fungal infection) with water (ideally wfi but if not possible then clean e.g. bottled)
Heat in a "cooker" (spoon held over a lighter)
Draw through a filter into a syringe to remove particles (ensure the filter will not shed particles into syringe)
Locate the vein (get to know arm to avoid valves), use a tourniquet, insert needle into vein and draw up some blood
Inject the drug
Withdraw the needle
What paraphenalia can and can't be supplied as part of the needle exchange program?
Can:
Sterile "cookers"
Citric acid (100mg sachets)
Ascorbic acid (100mg sachets)
Filters
Alcohol swabs
Water for injections
Can't:
Tourniquets
Lighters
Matches
Night lights
Do's and Don't's of preparation of drugs for injection
Do:
Wash your hands
Use sterile equipment
Prepare on a clean disposible surface
Use your own cooker and filter
Use the smallest amount of acid
Reduce the amount of drug after a period of abstinence
Don't:
Use more than one drug
Use lemon juice or vinegar
Crush tablets
Advice on injecting sites
Peripheral veins are safer than deep veins
It's better to have several injection sites and rotate them
Avoid femoral vein and veins in the breast, neck or penis
Advice on injecting practice
Use the smallest needle
Use a tourniquet to identify vein and release prior to injecting
Inject on the line of the vein towards the heart
Use a shallow angle
Inject slowly
Apply pressure to site
Do not share equipment or inject alone
Steps of the cycle of change
Pre-contemplation
Contemplation
Determination to stop
Action
Maintenance
Relapse
Symptoms of opioid withdrawal
Short term:
Flu like - sweating, chills, piloerection
Muscle twitching
Diarrhoea
Agitation
Insomnia
Long term:
Anorexia
Insomnia
Lethargy
Craving
Stages of drug addiction treatment
Stage I: Maintenance - replace drug with legal alternative on Rx