Harm reduction becomes a lot more complicated when you're using powerful stimulants with powerful depressants, with each having a different respective duration. It's a juggling act and unfortunately, a lot of long-term junkies meet their end at the hands of speedball. This is historically Cocaine and Heroin in a shot, but the mechanism is essentially the same; someone uses too much dope, the stimulant keeps their heart beating for a time, until it wears off and then the user overdoses on Heroin.
There really isn't a roadmap for this sort of thing. Perhaps there could be, but then the fact that drugs are of dubious purity, individuals possess countless biological variables that will alter the way that drugs ultimately effect them and keeping track of time accurately when on a drug binge is pretty difficult.
The only advice that I really feel comfortable giving is this: don't be using the Heroin to "knock yourself out" during the comedown. This is when you are going to be most vulnerable to a respiratory event as the Methamphetamine levels in your body beging to drop and the stimulation wears off. Use small dosages of Heroin spaced out as opposed to using large dosages every several hours or what have you.
You have tar already, which is pretty much in an appropriate form to be smoked from the get go. Vaporizing of "smoking" Heroin is pretty much the fastest way to get it into your system, but it also allows you a level of control that can't be easily matched by any of the other routes which you would call "bolus" dosages. You can take a hit, see how you feel, take another and really evaluate how you are feeling minute by minute. Is this something that you would consider? I understand there is technique involved but it's not like you're painting the Mona Lisa, you're catching Heroin vapor with a straw.
Thank you very much for your input. I have some points and questions I'd like to pose to you:
1.) I have been using for about 1 1/2 to two months.
2.) I used them separately up until now (meth then heroin about at least 5 hours later)
3.) I don't experience any high from snorting. I used heroin because I'm a really bad insomniac and it makes me very sleepy
4.) I have been doing as you mentioned, using small amounts of heroin through the course of later in the day usually
5.) I have tapered down from 2-3 bags of meth a day to 1/3 of a bag a day with the intention to quit but not deal with such harsh withdrawal symptoms
6.) Each bag of heroin I use contains about a third of a teaspoon worth. I usually use half at a time
7.) I've only on a handful of occasions used heroin directly after the meth but it has been the last two days with me feeling some anxiety that may be coming from tapering the heroin
8.) I tried last night heating the heroin from underneath foil (with a bit of distance so as not to burn it) and inhaled through rolled up paper - this had no effect
9.) Is the only adverse health effect the masking of the heroin affect leading to more heroin use and then respiratory arrest after the meth affects on the CNS subside or are there others? If so what are they?
10.) I use 3 bags of heroin a day broken up throughout the day
11.) I want to see a doctor to help with this tapering process. Can doctors prescribe to help with a dual-substance issue like this? I don't have money or time off work for a detox clinic but would like to see a doctor to get help
12.) If I see the doctor, is it correct to request 1-month's worth of Valium to cold turkey the meth? Should I request methadone or suboxone for the heroin?
13.) I may not be able to psychologically just cold turkey the meth as yet but could at least use the Valium for the comedown and sleep in place of the heroin. Would this be better?
14.) How should I use tomorrow or until I can get an appointment? 1/4 bag meth speedballed with a half bag of heroin i.e. reduced portions of both or no meth and a bit more heroin to deal with the withdrawals.
Sorry for such a long message but you really seem able to help me and it could save my life.
