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Wales Drug and Alcohol Helpline

Freephone: 0808 808 2234
Or text DAN to: 81066
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Reducing Harm - Introduction

'Working Together to Reduce Harm' is the Welsh Government's 10 year strategy for tackling the harms associated with the misuse of alcohol, drugs and other substances in Wales, 2008-2018.

People who misuse drugs, alcohol or other substances cause considerable harm to themselves and to society. This includes harm to their own physical and mental health and well being, and possibly to their ability to support themselves. They may harm their familiesí lives by damaging the health and well being of their children and place a burden of care on other relatives (including their children).

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Reducing Harm

Summary of Harms:

  • Alcoholic liver disease is responsible for around 1,600 hospital admissions per year.
  • Over 54,000 incidents of violent crime in Wales in 2006-07 were linked to the consumption of alcohol.
  • The health service cost in Wales of problem drug use has been estimated at £17.6 million per year.
  • The total economic and social cost of Class A drug use in Wales has been estimated to be around £780 million, and drug related crime accounts for 90 per cent of this.
  • 20 per cent of Welsh adults admit to binge drinking.
  • 30,000 bed days are related to the consequence of alcohol comsumption.
  • As many as 129,000 recorded crimes in Wales in 2006-07 were drug related.
  • The estimated health service cost in Wales of alcohol related chronic disease and alcohol related acute incidents is between £70 million and £85 million each year.
  • The economic and social costs of alcohol and Class A drug misuse in Wales is estimated to be as much as £2 billion each year.

Safer Drug Use

The following information is intended to provide general harm reduction advice. Although a range of drugs are listed not all substances can be included as this would be far too extensive to include on the website.

See the Drugs A-Z for effects and risks of specific substances that are not included in the above list. Always seek advice from support services aimed at helping drug / alcohol users if you feel that you need to talk with someone about your substance use; these agencies are essential to assist and sustain recovery.

Always get help / medical assistance when needed. If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.

Welsh Government's Strategy

Working Together to Reduce Harm is the Welsh Government's 10 year strategy which aims to set out a clear national agenda for reducing the harms associated with substance misuse in Wales. The strategy describes four key aims:

  • Reducing the harm to individuals (particularly children and young people), their families and wider communities from the misuse of drugs and alcohol, whilst not stigmatising substance misuse.
  • Improving the availability and quality of education, prevention and treatment services and related support, with a greater priority given than under the previous strategy to those related to alcohol.
  • Making better use of resources - supporting evidenced based decision making, improving treatment outcomes, developing the skills base of partners and service providers by giving a greater focus to workforce development and joining up agencies and services more effectively in line with 'Making the Connections'.
  • Embedding the core Welsh Government values of sustainability, equality and diversity, support for the Welsh language and developing user focused services and a rights basis for children and young people in both the development and delivery of the strategy.

Alcohol

  • Although alcohol is legal, it is a depressant drug.
  • Drinking on an empty stomach can cause you to become more drunk more quickly because the alcohol will get into your bloodstream and to your brain faster; so always make sure you eat a meal before you start drinking.
  • Try to pace drinking by having water or a soft drink between alcoholic drinks. This will give your liver a bit more time to process the alcohol and you won't feel as dehydrated.
  • If you're out with friends avoid drinking in rounds as it can be easy to lose track of what you're drinking.
  • Don't be pressured by others into drinking too much.
  • Don't be forced into drinking too quickly or get involved in drinking games.
  • Don't mix your drinks. Mixing drinks can make you more drunk and feel ill than if you just stick to one type of drink.
  • Don't leave your drink unattended and always make sure you watch your drink being opened / poured, this will avoid someone spiking it.
  • Make sure you know how you're getting home before you leave the pub / club.
  • When you get home drink some water to help rehydrate your body and dilute the alcohol in your bloodstream; when you go to bed sleep on your side in the Recovery Position to avoid choking if you throw up.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
Alcohol information page

Amphetamines

  • Amphetamines are stimulants.
  • They will keep you awake for long periods of time before the comedown.
  • Using more than one stimulant drug at a time drug can put your heart under significant stress.
  • Don't inject - injecting amphetamine can become compulsive and is very risky.
  • If you do inject, always use clean needles and never share any equipment.
  • Safer ways of using are smoking, snorting, swallowing as there is lower risk of overdose, infection and contraction of blood borne viruses.
  • Swallowing it is by far the safest way to use it. Snorting it is more risky and injecting is the riskiest way to use.
  • Stimulant drugs are caustic so if swallowed they can damage the lining of the throat, oesophagus and stomach; if you are going to take them this way then use a capsule or cigarette paper.
  • Amphetamines can cause the body to dehydrate and over heat; if you choose to use make sure you drink water or soft drinks regularly.
  • Don't forget to eat - amphetamines suppress the appetite so eat before and after using.
  • Amphetamines disrupt sleep patterns so sleep is essential to help your body recover.
  • Try not to use other drugs, such as benzos, to come down; food and sleep are the best way.
  • Make sure you have more days where you don't use, than days that you do.
  • Use in a safe environment with trusted company and tell someone you are with what you are taking.
  • Amphetamines may interact badly with some anti-depressant medicines such as monoamine oxidase inhibitors (MAOIs).
Amphetamines information page

Cocaine

  • Avoid using cocaine and alcohol together in a session; the effects of taking cocaine and alcohol together are far more dangerous than taking either drug alone. Cocaethylene is formed when alcohol and cocaine meet in the liver. This 'metabolite' remains in the body much longer, putting the heart and liver under a prolonged period of stress. The risk of sudden death is 18 times greater when alcohol and cocaine are used together.
  • Avoid using any other drugs in combination with cocaine.
  • Avoid using other drugs to help you deal with the come down. It won't last and the best way to get through it is with food, sleep and relaxation.
  • Snort it rather than inject it. Injecting can cause serious damage to your body and increases your risk of overdose.
  • Take care of your nose; snorting cocaine repeatedly can cause damage to the delicate nasal tissue. Take a break from cocaine if you develop irritation or bleeding in your nose and give your body a chance to recover. A nasal douche of lukewarm salt water can help reduce the risk of infection inside the nose and also help minimise the damage done by snorting.
  • Don't share any equipment you use to take cocaine. There is evidence that Hepatitis C can be transmitted through sharing snorting equipment like notes and straws. Never share any injecting equipment including spoons, water and filters.
  • Don't use bank-notes to snort as there could be blood products on an old bank note. Instead use other pieces of unused paper to make your straw.
  • Take care of yourself physically and mentally; make sure you get enough sleep and eat well daily. The stimulant effects of cocaine can interfere with your sleep patterns, and can suppress your appetite. Eating regular healthy meals, getting enough sleep and good hygiene are all important aspects of staying healthy.
  • Physical health can easily slip if you use cocaine frequently, particularly if you are using every day. If your physical health slips it can lead to more serious problems, affecting work and relationships.
  • Make sure you keep doing things you enjoy without using cocaine.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
Cocaine information page

Ecstasy

  • You never know what is in the tablet or powder you get so be careful - use a small amount first to see what the effects are and wait a while before taking any more.
  • If using ecstasy and dancing take a break to cool down, ecstasy can cause overheating and dehydration.
  • Get your water balance right - if you are dancing and sweating you should drink up to a pint of non-alcoholic drink every hour to help replace fluid lost through sweating. If you are not dancing & sweating then drink a little less water - you need to remember that drinking too much water in one go can be dangerous.
  • Mixing ecstasy with alcohol will increase the risk of dehydration and can make you take more risks; and mixing ecstasy with any other drugs increases the risks even further and can be very dangerous.
  • If you suffer from any kind of heart condition you should avoid stimulant drugs like ecstasy.
  • If you choose to use ecstasy it is safer to use small amounts on an occasional basis, giving your body time to recover.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
Ecstasy information page

GHB

  • Overdose, coma and death are real risks with GHB and GBL.
  • GHB, when sold as a solution varies in concentration, so it is very difficult to judge how strong it is, and you can't rely on what you may have been told. So you can't be sure how much will give the desired effect and the amount which leads to overdose and coma.
  • Always start with a very small amount; people have ended up coming round in hospital after swigging from the bottle directly.
  • Use small amounts and do not mix with other drugs especially alcohol; GHB & GBL are both depressants so a very little alcohol combined with them can have powerful negative effects.
  • GHB and GBL can have a significant effect on our senses, coordination and thinking which means that you can also be vulnerable to accidents or assaults.
  • Stay with friends to avoid being in a vulnerable position on your own.
  • Do not take drinks from strangers, or leave glasses unattended because someone might spike your drink; GHB and GBL have been linked to drug assisted sexual assault.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
GHB information page

Heroin

  • You can never be sure of the purity of heroin or what it is cut with.
  • Smoking heroin is safer than injecting intravenously; chasing heroin gives the user a hit like injecting as it gets into the bloodstream quickly, and it is far safer.
  • If you do inject, always use clean needles and injecting equipment (spoons, swabs, water etc). You can access these from needle exchanges, drug agencies and pharmacies; this can protect you from blood borne viruses like Hepatitis B & C and HIV.
  • Never share your needles or works with anyone else, no matter how well you know them.
  • If you inject, learn how to inject yourself using the safest technique. Injecting with poor technique is one of the riskiest things you could ever do and can be extremely damaging to your body causing problems such as abscesses, infections, blood clots & deep vein thrombosis (DVT), or hitting an artery. You can contact drug services and needle exchanges for advice on safer injecting.
  • If you are going to inject, use sterile citric acid or ascorbic acid rather than lemon juice or vinegar as these are particularly risky acids and can cause even more damage to veins and other health problems.
  • Mixing heroin with other drugs can increase the risk of overdose, especially drugs like alcohol, benzo's and methadone.
  • Speedballing (using heroin and crack together) can lead to an extreme decline in your health and lifestyle.
  • Avoid using alone or in unfamiliar or locked places. More overdoses happen in these environments than anywhere else.
  • If you have had a break from using, your tolerance will be significantly lower and you are at a greater risk of overdose.
  • If you suspect someone has overdosed, put them in the Recovery Position and call for emergency help immediately.
  • Know about Naloxone. Naloxone is a short acting opiate antagonist that reverses the effects of heroin and other opiates like morphine - it can save lives.
Heroin information page

Ketamine

  • Ketamine is a dissociative psychedelic used medically as a veterinary and human anaesthetic.
  • Ketamine impairs coordination, so minor accidents like bumping into things are common; it can make you forgetful as well.
  • If you take ketamine when you are out and about you risk losing coordination very suddenly; this could be potentially very dangerous and can make you very vulnerable. And as an anaesthetic, Ketamine means you won't feel pain so you are at more risk of injuring yourself.
  • Although it is fairly short acting, stick to small doses. You are safer on a small dose than if you take a large amount in one go.
  • Avoid swallowing ketamine - ketamine in the stomach makes cramps worse. Don't sit in the bath to soothe the pain as there is a risk you may become unconsciousness and drown. Seek medical advice and mention your ketamine use to the doctor.
  • If snorting alternate nostrils, and clean your nostrils after each session to minimise damage.
  • Injecting ketamine brings the additional risk of damage to your veins, skin infections and contracting blood bourne viruses such as Hepatitis or HIV. If you choose to use this way, get safer injecting advice from your nearest needle exchange.
  • There is a risk of bladder problems and kidney damage with regular use. Long-term ketamine use has been shown to damage the bladder and urinary tract, causing 'ketamine bladder'.
  • If you experience pain in your bladder seek medical help, tell your GP that that you use ketamine. Try to stop or reduce your use if you notice any symptoms.
  • Try to keep your use as low as possible. Give yourself breaks from using if you can to avoid developing tolerance and dependency.
  • If you feel depressed and anxious when stopping ketamine use or reducing the amount you use, get some professional help to do this. Gradual reduction may help. Try to distract yourself with purposeful and enjoyable activities.
  • If you experience ongoing panic and anxiety attacks get support from your nearest drug agency.
  • Don't use ketamine with alcohol or other depressant drugs as the effects can be unpredictable and may lead to overdose.
  • Make sure you have more days where you don't use, than days where you use.
  • If you choose to use ketamine use in a safe environment especially if you are an inexperienced user.
  • Tell someone you are with what you are taking and have a person you trust with you in case things go wrong.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
Ketamine information page

Methadone

  • Methadone is prescribed as a substitute to street heroin when users have become dependent. It is used to reduce from opiates and helps to stabilise a users lifestyle.
  • You should take methadone orally at the dosage it has been prescribed - is the safest way to take it.
  • It is recommended that methadone is taken once daily, at the same time each day.
  • If you take methadone with other substances, especially alcohol, heroin and benzos, it increases the risk of overdose.
  • Getting additional support like counselling or CBT to tackle other aspects of your addiction will increase the chances of making changes to your life and improving your recovery capital.
  • Get involved in diversionary activities that are meaningful to you; discovering healthier things to occupy your time - feeling bored will leave you thinking about using; spend time with non-using friends.
  • If you suspect someone has overdosed, put them in the Recovery Position and call for emergency help immediately.
  • Know about Naloxone. Naloxone is a short acting opiate antagonist that reverses the effects of heroin and other opiates like morphine - it can save lives.
Methadone information page

Solvents

  • Do not spray aerosols directly into your mouth; this is highly dangerous and may freeze your throat or cause your throat to swell up; this can cause breathing to become irregular or stop and can put a strain on your heart.
  • Do not inhale by putting plastic bags over your head as this can cause suffocation. Inhaling through a cloth is less risky.
  • Do not mix with other drugs - particularly alcohol as this can lead to unconsciousness and death.
  • Use only small amounts especially if you are an inexperienced user, and try not to use repeatedly.
  • If you choose to use solvents use in a safe environment i.e. not by a railway, motorway or industrial areas etc.
  • Use when other people are present and have a person you trust with you in case things go wrong.
  • Many of these products are highly flammable and if used at the same time as smoking, or using a naked flame, can harm you or others around you, cause fires or may even explode.
  • Do not drive while under the influence as they can affect coordination and the ability to judge speed and distance.
  • Do not use inhalants when in a negative state of mind; or to cloud negative feelings because they could make those negative feelings worse. Also you are more likely to become aggressive and engage in risky behaviours that may harm yourself and/or others.
  • Death and overdose is a very real risk with solvents and it can happen at any time, no matter how experienced you think you are.
  • If someone is suffering bad effects like vomiting, convulsions, unconsciousness - put them in the Recovery Position and call for medical assistance immediately.
Solvents information page

Steroids

  • Steroids can be toxic to your liver. If you notice a yellowing of your eyes (jaundice) it can indicate a serious liver problem. Seek medical advice immediately.
  • If injecting steroids ensure that needles are clean and have not been used; get clean needles and safer injecting information from a needle exchange or drug agency.
  • Injectable steroids always are injected into the muscle; there is no anabolic steroid designed for intravenous use.
  • Before using steroids seek advice from a drugs worker. They can give you safer injecting advice and direct you to information about steroids.
  • Taking steroids orally will reduce the risks and problems with injecting. However, taking steroids orally can do more damage to your liver and may be more toxic to your kidneys.
  • It is advised to stop using steroids periodically. Always reduce dosages gradually, don't stop suddenly.
Steroids information page

More Information

If you have a question about drugs or alcohol use that isn't answered on our website then you can call DAN 24/7 confidentially on 0808 808 2234 at any time and ask an advisor for help.

 
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