How to reduce harm when using substances
Harm reduction advice
Think ahead
- The only way to avoid all the risks is to not take any drugs which are not prescribed for you. Think carefully about the risks before you start.
- Make sure someone else is with you, ideally someone you can trust to look after you if things go wrong.
- Try to eat well, rest and drink plenty of liquid before you start using drugs. You’ll feel better after the session. Avoid alcohol or energy drinks if at all possible.
- Make sure you know what you are buying. Describe what you want, including the effects you are seeking from the drug, and see if this matches what the seller is offering. If going to a new seller, be particularly cautious and ask questions about the product especially if it looks, smells or tastes different to what you are used to.
- Carry condoms so that you don’t have unprotected sex. Drugs and alcohol raise the desire for sex but decrease performance, making orgasm for both sexes harder to achieve. This can lead to more vigorous sex, especially with stimulant use, which can cause a condom to rip. So have spare condoms and a water-based lubricant available.
Mixing drugs
- Mixing any drug with another drug increases the risk of dangerous side effects. This includes alcohol.
- Some drugs are especially risky to mix. This includes:
- cocaine and alcohol;
- opioids (such as heroin or morphine) and downers /depressants (such as benzos), alcohol or other opioids such as tramadol.
- Prescription drugs which are highly likely to cause serious side effects when taken along with an illegal drug or drugs include:
- painkillers (such as morphine, oxycodone, co-codamol, tramadol);
- antidepressants (fluoxetine/Prozac, amitriptyline);
- tranquilisers and sleepers (diazepam, nitrazepam, phenazepam);
- drugs normally used for epilepsy and nerve pain such as Lyrica/pregabalin
Taking drugs
- Start low and go slow, especially if you are taking a drug you have never used before. Take a small amount at first and let it reach its peak effect to test how strong it is. Remember, you can always take more later on – you can never go back and take less.
- Remember that different drugs act at different speeds, and a slow response does not necessarily mean that the drug is weak – it may mean you have taken a slow-acting drug which could in fact be strong. Redosing could lead to overdose.
- Bear in mind that drugs that look the same as each other may not be the same. A pill or powder that looks like one you took last week may in fact have entirely different drugs in it.
- It is important to keep hydrated. Aim to drink about a pint of fluid per hour during the session. Avoid alcohol as this causes dehydration. Energy drinks contain lots of caffeine which can increase the strain on the heart. Keeping hydrated is especially important in warm, sunny weather.
- Look after your friends. It’s ok to tell each other to take it easy; that’s what good friends do. Don’t let anyone go off by themselves. If anyone becomes unwell stay with them. Some people can become aggressive. This can be a sign of someone having taken too much and may be an indicator of overdose.
- If you or a friend have any worrying symptoms, call an ambulance. Try to remain calm, keep the noise down in the area and reassure the person that you are there to help. If they are breathing normally encourage them to put themselves into the recovery position or at least to keep still.
Coming down
- Try to avoid taking other drugs to help you come down as these could prolong the come down or even cause overdose.
- Go somewhere you feel safe to relax and keep numbers of people you can talk to in your phone if you start to feel depressed, frightened or unwell.
- Some people experience suicidal thoughts and feelings after taking drugs, especially after a binge. If you are concerned about yourself or another user, make sure you talk to someone like a GP, Substance misuse service or mental health service immediately.
Page last reviewed: 01/07/2025
Next review due: 31/07/2025