Harm Reduction Guide

This guide provides essential information for reducing risks associated with psychoactive substance use. Remember: the safest approach is abstinence, but if you choose to use, these practices can help minimize harm.

Core Principles of Harm Reduction

What is Harm Reduction?

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Key Principles:

  • Accept that drug use is part of our world and work to minimize its harmful effects
  • Understand drug use as a complex, multi-faceted phenomenon
  • Establish quality of individual and community life as the criteria for successful interventions
  • Call for the non-judgmental, non-coercive provision of services and resources
  • Ensure that people who use drugs have a real voice in the creation of programs and policies
  • Affirm people who use drugs themselves as the primary agents of reducing the harms of their drug use
  • Recognize that the realities of poverty, class, racism, social isolation, past trauma, and other social inequalities affect both people's vulnerability to and capacity for effectively dealing with drug-related harm

Set and Setting

⚠️ Critical Factor

Your mindset (set) and environment (setting) are crucial determinants of your experience. Poor set and setting can turn even a low dose into a difficult experience.

Set (Mindset)

  • Are you in a stable mental state?
  • Do you have any unresolved emotional issues?
  • Are you feeling anxious, depressed, or stressed?
  • Do you have a clear intention for your experience?
  • Are you prepared for the possibility of challenging experiences?

Setting (Environment)

  • Is your environment safe and comfortable?
  • Do you have access to water, food, and bathroom?
  • Is the temperature comfortable?
  • Are you in a place where you won't be disturbed?
  • Do you have a sober, trusted person present (trip sitter)?
  • Is there a way to contact help if needed?

Dosage Guidelines

🚨 Start Low, Go Slow

Always begin with the lowest possible dose, especially with new substances or if you haven't used in a while. You can always take more later, but you can't take less once consumed.

General Dosage Principles

  • Threshold: The minimum dose to feel any effects
  • Light: Subtle effects, good for beginners
  • Common: Standard recreational dose
  • Strong: Intense effects, experienced users only
  • Heavy: Very intense, high risk

Important Considerations

  • Individual tolerance varies greatly
  • Body weight, metabolism, and genetics affect response
  • Previous use history influences tolerance
  • Route of administration affects onset and intensity
  • Combining substances can be unpredictable and dangerous

Substance Testing

🔬 Test Your Substances

Reagent testing is essential for harm reduction. Many substances are misrepresented or adulterated, which can lead to dangerous situations.

Types of Tests

  • Reagent Tests: Marquis, Mecke, Mandelin, etc.
  • Fentanyl Test Strips: Essential for opioid users
  • Lab Testing: Most accurate but expensive

Testing Protocol

  • Test a small sample of your substance
  • Use multiple reagents for confirmation
  • Compare results to known reaction charts
  • Be aware that tests can't guarantee purity
  • Consider lab testing for high-risk substances

Safer Use Practices

General Safety Guidelines

  • Never use alone - have a sober trip sitter
  • Stay hydrated but don't overhydrate
  • Eat before using (unless fasting is required)
  • Have a plan for the duration of effects
  • Keep emergency contacts readily available
  • Know the signs of overdose for your substance
  • Have naloxone available if using opioids

Substance-Specific Guidelines

Psychedelics

  • Ensure stable mental health before use
  • Have a trusted trip sitter present
  • Prepare for potential challenging experiences
  • Allow time for integration after the experience

Stimulants

  • Monitor heart rate and blood pressure
  • Stay hydrated and eat regularly
  • Take breaks to rest and sleep
  • Be aware of the crash phase

Depressants

  • Never mix with other depressants
  • Start with very low doses
  • Have naloxone available
  • Be aware of respiratory depression risk

Emergency Response

🚨 When to Call Emergency Services

  • Unconsciousness or unresponsiveness
  • Severe breathing problems
  • Chest pain or irregular heartbeat
  • Seizures
  • Severe agitation or aggression
  • Extreme paranoia or psychosis
  • Severe vomiting or dehydration

First Aid Basics

  • Call emergency services immediately if needed
  • Stay with the person
  • Keep them calm and comfortable
  • Monitor breathing and consciousness
  • Don't leave them alone
  • Be honest with medical professionals

Additional Resources

Harm Reduction Organizations

  • DanceSafe - Drug checking and harm reduction
  • Erowid - Psychoactive substance information
  • PsychonautWiki - Comprehensive substance database
  • TripSit - Online harm reduction community

Emergency Resources

  • National Poison Control: 1-800-222-1222
  • Crisis Text Line: Text HOME to 741741
  • National Suicide Prevention: 988
  • Emergency: 911

Narcan (Naloxone) Resources

🚨 Narcan Access

Narcan (naloxone) is a life-saving medication that can reverse opioid overdoses. It's available without a prescription in most states and can be obtained for free from many sources.

  • Narcan.delivery - Find state-by-state Narcan information and free vendors (US only)
  • Local Pharmacies: Many pharmacies now carry Narcan without prescription
  • Harm Reduction Organizations: Often provide free Narcan and training
  • Health Departments: Many state and local health departments offer free Narcan