Name the stages of drug abuse
Stage I: experimentation
Stage II: recreational use
Stage III: problematic use
Stage IV: addiction
What are the two forms of cocaine?
Hydrochloride: soluble, injected
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?
- Magic mushrooms
- Amphetamines (if prepped for injection)
What drugs are contained in class B?
What drugs are contained in class C?
- Some painkillers
What are the risks of using heroin?
- HIV/other infections
- Damage to veins
- Physical dependence leading to crime
How can we reduce the harm associated with injecting?
- Needle exchanges
- 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?
- Sterile "cookers"
- Citric acid (100mg sachets)
- Ascorbic acid (100mg sachets)
- Alcohol swabs
- Water for injections
- Night lights
Do's and Don't's of preparation of drugs for injection
- 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
- 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
- Determination to stop
Symptoms of opioid withdrawal
- Short term:
- Flu like - sweating, chills, piloerection
- Muscle twitching
- Long term:
Stages of drug addiction treatment
Stage I: Maintenance - replace drug with legal alternative on Rx
Stage II: Withdrawal - aim to become drug free