Resource: Harm Reduction & Overdose Prevention: Safer Use

When you’re using drugs with other people, be sure to be as clear as possible about who is taking what. This can help avoid dangerous drug mix-ups that could lead to accidental overdose.
Slow down. Don’t use too quickly. You can always do more, but you can’t do less.
Pay attention to what’s going on around you when using and watch out for your personal safety.
Don’t take the risk of using alone! If possible, use with others who can help if an overdose happens. If you don’t have anyone to use with, open the door to your room a bit so someone can find and help if you need it. Alternatively, try to arrange for someone to come and check on you during your session.
Always carry naloxone (Narcan), which is a medication you can use to prevent overdose. Ensure that everyone in your circle has Narcan too.
Be aware of the signs of an overdose, so you can act quickly if necessary. A person might have grayish skin, be unresponsive, limp, or rigid, and not be breathing. Knowing these signs can help you respond in time.
If you want to test your supply for fentanyl, you can use a fentanyl test strip. They’re available at harm reduction centers and syringe access sites, and the people there can give you info on how to use them.

Use your own pipe to prevent overdose. We’ve seen people overdose, and have overdosed ourselves, after using someone else’s pipe. Drug residue can stay in a pipe and affect the next person who uses it.
Try to use pipes that aren’t cracked or broken.
Always have multiple pipes on hand so that you never have to use a broken pipe.
Use pipes with longer stems – they’ll be less likely to burn you. Thicker pipes are less likely to break.
Use a rubber pipe cover to prevent burns.
Wear chapstick and keep your lips healthy. Making sure you don’t have cracked lips can help with prevention of infections like hep C if you ever end up sharing pipes.
Smoke a small amount first, especially if you’re smoking fentanyl. Wait a few minutes after your first hit.
Pick up new pipes and covers at harm reduction centers and syringe access sites.

Negotiate what you’re willing to do and use ahead of time. Party and play may be part of the job, but remember you can always walk away if you need to.
Using drugs while you’re working can make you less able to respond in case of a bad date or violence. If possible, share your location with a friend ahead of time, and use your best judgment if you feel bad about a situation.
Be in control when you meet up. If you’re getting a hotel room, ask them for cash and put the room in your name.
Have a route home and a way to get there.
Bring condoms and lube with you. Have a bag of supplies that you can get to easily

Try to crush pills up on surfaces that are clean and sterile.
If you’re injecting, dissolve your drugs using sterile water (you can get ampules from harm reduction centers and syringe access services), and use sterile and new injection supplies.
Keep in mind that pills oftentimes have coatings and ingredients in them that can cause problems like infections if you inject.
Steri-filters or wheel filters are highly recommended for pill injection.

Wash your hands and the place you’ll inject thoroughly. Use hand sanitizer if you don’t have access to soap & water.
Use new, sterile supplies each and every time you inject.
Use sterile water or saline to mix your drugs. You can get ampules from harm reduction centers and syringe access sites.
Filter your shots with clean, sterile cottons and filters.
Change the spot on your body where you insect – it can take a couple of days to heal.
Take as many precautions as possible, especially with Intramuscular injections which have a higher risk of abscess than IV.
Go see a medical provider for help with an abscess or wound if it keeps getting bigger, if you see red streaks coming from the infection, or if it’s not healing. It’s a good idea to go right away to an ER if you develop a fever, have chest pain/chills, if the skin around your infection gets really dark in color, or you have other serious or unusual symptoms.
Do not lance or pop the abscess yourself.