Reducing risks if you use drugs

There are always risks if you use drugs. Some people may be more at risk than others.

It is safest not to use drugs.

But if you use drugs, there are things you can do to reduce the risk of harm:

• know the effects and risks of what you take
• think about how you feel before you use
• think about where you use
• start with a small amount and go slow
• avoid mixing drugs
• follow advice to reduce risks if you snort or inject drugs
• have a buddy system for high-risk drugs or ways of using drugs
• know what to do in an emergency
• find ways to cope with comedowns
• get support when you need it

Know about the drugs you take

Different types of drugs have different effects and risks.

But the effects of any individual drug can also vary depending on:

• your size, weight and sex
• if you have any health conditions or mental health difficulties
• how you take the drug
• the strength of the drug
• how much you take
• if you take alcohol, medicines or other drugs at the same time
• where you take the drug and how you feel before you take it
• if you have taken the drug before and how often

Before you decide to take a drug, try to find out the effects and things that may increase the risk of harm.

You can find out about:

• effects of drugs and specific advice in our drugs A to Z
• drugs and sex - protecting your sexual health and wellbeing

Know what to do for unexpected effects

You can never be fully sure of the contents or strength of drugs. The effects of a drug can be different within the same batch and each time you take it.

Drugs can:

• have different strengths
• contain other drugs or chemicals

This means you may get an effect you do not expect. It can help to learn what to do if you have an unexpected reaction.

Coping with bad trips or challenging experiences

Think about how you feel

Drugs can cause mental health difficulties or make existing difficulties worse.

This can happen if you take drugs when you are going through a tough time or feel low. But the risk is higher if you or someone in your family has mental health difficulties.

Before you decide to take a drug, it can help to think about:

• how you feel - for example, if you feel low, anxious or tired
• any physical or mental health difficulties you have
• your tolerance, if you have not used in a while
• why you want to take the drug
• your other priorities that may be affected

You are more at risk if you or someone in your family has a history of:

• mental health difficulties such as depression, psychosis, bipolar disorder or thoughts of suicide
• conditions that put you at risk of serious harm such as heart problems or epilepsy

Think about where you use

Think about where you use and be with people you trust. It is best if at least 1 person does not use alcohol or drugs.

If you are not at home, make sure you:

• are in a safe place away from risks such as roads, heights or water
• stay together - do not leave anyone alone
• have a meeting point in case you get separated from people you know
• have a charged phone - write down important numbers in case you need them
• have a safe way to get home together
• take regular breaks to rest and cool down if you are dancing
• check where the medical tent is if you are at a festival

Do not use alone or in an isolated place.

If you take drugs that cause hallucinations, try to be somewhere calm. Using these drugs in a noisy or busy place can cause an overwhelming experience.

Start low and go slow

Start with a very small amount to see how you react to the drug.

Some drugs or cutting agents can take longer to take effect than others. Wait at least 2 hours before you decide to take any more.

Avoid mixing drugs or other substances

It is always more risky and unpredictable to mix drugs with other drugs, alcohol or medicines.

Mixing drugs with similar effects increases the risk of negative effects, challenging experiences or overdose.

Mixing drugs with different effects puts your body under a lot of strain and increases the risk of overdose. You may find it harder to notice some effects. But they are still happening.

Common risks of mixing drugs include:

• very high or very low heart rate and blood pressure
• overheating
• dehydration
• anxiety or panic
• paranoia
• serotonin syndrome - a life-threatening condition where your body makes too much of a chemical called serotonin
• breathing problems
• vomiting or choking
• frightening or challenging hallucinations - when you see, hear or feel things that are not there
• unconsciousness
• overdose

If you take drugs such as MDMA, drink enough water to stay hydrated. But do not drink more than 1 pint an hour. This is to reduce the risk of having too much water in your system (water intoxication).

Extra risky combinations

Some combinations have a very high risk of dangerous effects. It is also dangerous to mix alcohol with any drug.

Reduce risks related to ways of using drugs

There are higher risks of infections and other damage if you:

• snort drugs
• put drugs up your bum
• use pipes to smoke drugs
• mix drugs with tobacco
• inject drugs - this is sometimes called slamming

The risk is highest if you share equipment to use drugs.

Reducing risks if you snort, smoke or inject drugs

Have a buddy system for high-risk situations

Some drugs or ways of using drugs have a very high risk of overdose.

Consider having a buddy system if you:

• inject drugs
• use opioids
• use G (GHB or GBL)

In a buddy system, you:

• have someone with you when you use - it is best if they do not take any drugs or alcohol
• agree with your buddy on what to do in case of an emergency or overdose
• tell your buddy where you keep your naloxone if you use opioids

Know what to do in an emergency

If you take any kind of drug, it is important to know what to do in case of overdose or other emergencies.

An overdose is a life-threatening condition. It happens when someone has too much of a drug or another substance in their system.

Getting help can prevent serious damage or death. Your wellbeing is the main priority.

Overdose and drug emergencies

Find ways to cope with comedowns

A comedown is how you feel as a drug leaves your system. It can include symptoms such as anxiety, low mood and problems with thinking.

Using drugs or alcohol to cope with comedowns can make you feel worse.

Try to:

• take regular breaks from drugs and alcohol to reduce your risk of dependency
• get enough sleep or rest
• eat well
• talk to someone you trust about how you feel if you had a negative experience or witnessed something that worries you
• do some light activity, such as a walk - it releases chemicals in your brain that improve your mood (endorphins)
• do some exercises to manage stress, anxiety and worry
• get medical advice if you have thoughts or feelings that worry you

Organisations that provide mental health supports and services

Getting help for drug use

If drugs have a negative effect on you, you can get support. For example, if you notice health problems or mental health difficulties.

If you see a GP about any symptoms, it's best to tell them about your drug use. It will help them to recommend the right treatment.

Getting help for drug use

If you are worried about someone else