Core Harm Reduction Principles
Know What You're Taking

    Test your substances using drug testing kits (fentanyl test strips, reagent tests) before consuming. Many overdoses occur because people don't know what they've actually taken.
    Understand that street drugs are often contaminated or mislabeled. Fentanyl, a powerful synthetic opioid, is commonly found in heroin, cocaine, and counterfeit pills.
    Start with a small amount (test dose) if trying something new or from a new source.

Use Safer Consumption Methods

    Inhalation/smoking is generally lower-risk than injection for overdose, as you can titrate (use small amounts gradually).
    If injecting: use sterile needles and equipment (never share), clean injection sites with alcohol swabs, rotate injection sites, and use proper technique to avoid infections.
    Avoid mixing substances, as combining drugs (especially with alcohol or depressants) dramatically increases overdose risk.

Overdose Prevention & Response
Reduce Overdose Risk

    Never use alone when possible. Have someone nearby who can call for help.
    Use naloxone (Narcan) — an opioid antagonist that reverses overdose. It's free or low-cost at pharmacies and harm reduction programs in most areas.
    Avoid using after periods of abstinence (tolerance drops significantly).
    Be cautious with tolerance — if you've been abstinent, even your "usual dose" can be fatal.

If an Overdose Occurs

    Call emergency services immediately 911. Many areas have Good Samaritan laws protecting callers from legal consequences.
    Administer naloxone if available: intranasal spray (2–4 mg) or intramuscular injection. You cannot overdose on naloxone itself.
    Place the person in recovery position (on their side) to prevent choking if they vomit.
    Stay with them until emergency responders arrive.
    Note that naloxone wears off in 30–90 minutes; the overdose may return, so medical attention is essential.

Infection Prevention
For Injection Use

    Use new, sterile equipment every time: needles, syringes, cookers, filters, tourniquets, and cotton.
    Wash your hands before preparing and injecting.
    Clean the injection site with alcohol or soap and water.
    Rotate injection sites to avoid abscesses, infections, and vein damage. Avoid groin, neck, and under the arm when possible.
    Watch for signs of infection: redness, warmth, swelling, pus, or fever. Seek medical care early.

General Hygiene

    Share water, cookers, and filters is risky — bacteria and viruses can spread even if needles are clean.
    Don't share straws or pipes when snorting or smoking.
    Practice good oral hygiene if using drugs that affect teeth.

Mental Health & Substance Use
Recognize Co-occurring Conditions

    Depression, anxiety, PTSD, and trauma are common alongside substance use. Treating underlying mental health issues reduces drug use severity.
    Seek support from counselors, therapists, or peer support groups (Narcotics Anonymous, SMART Recovery, harm reduction groups).

Reduce Isolation

    Connect with harm reduction services, community health centers, or peer support networks.
    Many harm reduction programs offer free supplies, testing, counseling, and connection to treatment when you're ready.

Access to Healthcare & Treatment
Know Your Options

    Medication-assisted treatment (MAT): Methadone and buprenorphine reduce cravings and withdrawal, decreasing illicit use and overdose risk.
    Counseling and behavioral therapy address underlying triggers and build coping skills.
    Harm reduction programs offer free needles, naloxone, testing, and referrals — no judgment, no legal consequences.