Don't think this has been discussed before, but apologies if I am wrong and just crap at using a search engine.
Sorry that this is so long a post, but I think I'm stumbling around what is actually a very, very large topic.
So, how this came up (you can skip this bit, if you don't want to read the whole thing)... The other day, I was on a drugs forum (I genuinely do not remember which one) and someone was asking for advice regarding finding a vein for IV drug use, in a fairly overweight person. I myself am an extremely obese person (I don't much want to post my weight, as that would involve finding out myself, but suffice to say, I'm FAT fat, medically problematically fat, not just a bit overweight) and I have used IV and IM drugs, and quickly discovered that they need to be taken differently in overweight people - veins do not pop out, even with tourniquets and tapping and all the tricks in the book, and muscle injections require much longer needles - nurses sometimes use needles in excess of 2" for IM injections in severely obese people, certainly not the tiny needles most recreational users will be familiar with. Needles for IM in overweight people, I also discovered, are generally recommended to be of a chunkier gauge.
One of the responses in the thread I was reading was from someone who got quite cross at the OP and said that at their weight, they simply shouldn't be using drugs. They were too fat. The risks were exponentially increased. When challenged by other forum members, this poster stood his ground and went on to say that being so fat was a risk to the OPs health, a burden on the healthcare services that would have to treat them, and, quite simply, that they were too fat to consider drug use.
Now, as a fat person who uses drugs, I wasn't at all offended by what this guy was saying. A morbidly obese person almost certainly does stand to experience more risks from say, injecting cocaine. Furthermore, if they experience problems, it is harder to treat them in a hospital. There is something to be said, from a harm reduction perspective, to spreading the message that you can be 'too fat to do drugs'. That said, it would only apply to certain drugs, and I don't think a fat guy is at more risk of side-effects from vaping some weed than a skinny guy.
The whole thing has got me thinking.
I take drugs, and I have met a lot of other fat people who take drugs. And once I got to thinking about these things, I quickly realized that the subject of whether or not to take different substances, and the necessary changes to equipment for overweight IDUs, aren't the only issues that come up when fat people use drugs.
As a fat drug user, I know that there are some drugs where I will require double or even triple the dose of a small, skinny person, and with some substances this is definitely related to my weight rather than any issue of tolerance. That said, I have also learned that one cannot automatically assume that an overweight person will need or can handle a higher dose of a drug than their skinny counterparts - it is not this way for all overweight people, or with every drug.
I also note that some of the risks of some drugs, for instance, those associated with balance, walking, falling etc, need to be considered more strongly when the user is a bloody great big lump to fall. I have a friend who, a few years ago, experienced a minor blackout while tripping and fell over. A skinny person would have landed on the solid wooden table and knocked over a glass of water - but this guy was BIG, and he just damn well went THROUGH the table, causing injury and chaos. Similarly, if a very overweight person is on drugs and becomes incapacitated, or needs to be moved to a bed or taken outside to get some air or even, in extremis, lifted on to a stretcher and taken to a hospital, well, it's not always easy, or possible, without getting other people to help. A skinny chick who passes out in a club on molly? Pick her up, chuck her over your shoulder and walk out with her, to get air and water and medical attention. Nice and easy. A fat chick? Well, you might have to settle for a couple folk dragging her into a corner to recuperate.
And, of course, there are physical risks. Overweight people are more likely to have high blood sugar, blood pressure, a fast pulse, asthma, the list goes on and on. Drugs can affect all of these things.
So, in a world that is getting fatter, and where drugs show no sign of fading from use, how should the various communities associated with drug use, harm prevention, medical care etc, approach and discuss the issue of drug use among the overweight? No-one seems to talk about it, and I have to say, as a super-fat woman, no-one in the drug-using community has ever brought up or even subtly seemed to be thinking about additional risks posed by my weight. If anything, it's been viewed broadly as a safety measure - I can take more of many drugs before OD than my skinny counterparts, and if ever I were to pass out in a risky environment, I'm at much less risk of sexual or physical assault than other girls, partly because (and I know you shouldn't say it, but...) when the pickings of collapsed girls are good, the fat chicks are less likely to be raped, and partly because it's very hard to move me or carry me away against my will. I also have a lot more weight to throw around in any physical confrontation. That said, being overweight and using drugs damn well DOES NOT make drug use safer over all!
So, if you were sharing drugs amongst friends, would you ever refuse anything to a very fat person? Do (or should) harm reduction services such as needle exchanges be giving out information differently for fat people? I know first-hand that they should be giving out equipment differently. If you saw a very fat guy dancing and gurning in a club, would you worry more about him than an otherwise-similar skinny dude doing the same? Should the drug-using community at large bite the bullet, risk offending and just start straight-up telling people that when you profile the risk of the drugs you take, your weight changes the profile significantly? Which drugs does it make the most difference to?
Anyway, massively rambling opening post, and doubt I've even thought of all the issues wound up in this subject.
Handing it over to the community - opinions? Experiences?
Sorry that this is so long a post, but I think I'm stumbling around what is actually a very, very large topic.
So, how this came up (you can skip this bit, if you don't want to read the whole thing)... The other day, I was on a drugs forum (I genuinely do not remember which one) and someone was asking for advice regarding finding a vein for IV drug use, in a fairly overweight person. I myself am an extremely obese person (I don't much want to post my weight, as that would involve finding out myself, but suffice to say, I'm FAT fat, medically problematically fat, not just a bit overweight) and I have used IV and IM drugs, and quickly discovered that they need to be taken differently in overweight people - veins do not pop out, even with tourniquets and tapping and all the tricks in the book, and muscle injections require much longer needles - nurses sometimes use needles in excess of 2" for IM injections in severely obese people, certainly not the tiny needles most recreational users will be familiar with. Needles for IM in overweight people, I also discovered, are generally recommended to be of a chunkier gauge.
One of the responses in the thread I was reading was from someone who got quite cross at the OP and said that at their weight, they simply shouldn't be using drugs. They were too fat. The risks were exponentially increased. When challenged by other forum members, this poster stood his ground and went on to say that being so fat was a risk to the OPs health, a burden on the healthcare services that would have to treat them, and, quite simply, that they were too fat to consider drug use.
Now, as a fat person who uses drugs, I wasn't at all offended by what this guy was saying. A morbidly obese person almost certainly does stand to experience more risks from say, injecting cocaine. Furthermore, if they experience problems, it is harder to treat them in a hospital. There is something to be said, from a harm reduction perspective, to spreading the message that you can be 'too fat to do drugs'. That said, it would only apply to certain drugs, and I don't think a fat guy is at more risk of side-effects from vaping some weed than a skinny guy.
The whole thing has got me thinking.
I take drugs, and I have met a lot of other fat people who take drugs. And once I got to thinking about these things, I quickly realized that the subject of whether or not to take different substances, and the necessary changes to equipment for overweight IDUs, aren't the only issues that come up when fat people use drugs.
As a fat drug user, I know that there are some drugs where I will require double or even triple the dose of a small, skinny person, and with some substances this is definitely related to my weight rather than any issue of tolerance. That said, I have also learned that one cannot automatically assume that an overweight person will need or can handle a higher dose of a drug than their skinny counterparts - it is not this way for all overweight people, or with every drug.
I also note that some of the risks of some drugs, for instance, those associated with balance, walking, falling etc, need to be considered more strongly when the user is a bloody great big lump to fall. I have a friend who, a few years ago, experienced a minor blackout while tripping and fell over. A skinny person would have landed on the solid wooden table and knocked over a glass of water - but this guy was BIG, and he just damn well went THROUGH the table, causing injury and chaos. Similarly, if a very overweight person is on drugs and becomes incapacitated, or needs to be moved to a bed or taken outside to get some air or even, in extremis, lifted on to a stretcher and taken to a hospital, well, it's not always easy, or possible, without getting other people to help. A skinny chick who passes out in a club on molly? Pick her up, chuck her over your shoulder and walk out with her, to get air and water and medical attention. Nice and easy. A fat chick? Well, you might have to settle for a couple folk dragging her into a corner to recuperate.
And, of course, there are physical risks. Overweight people are more likely to have high blood sugar, blood pressure, a fast pulse, asthma, the list goes on and on. Drugs can affect all of these things.
So, in a world that is getting fatter, and where drugs show no sign of fading from use, how should the various communities associated with drug use, harm prevention, medical care etc, approach and discuss the issue of drug use among the overweight? No-one seems to talk about it, and I have to say, as a super-fat woman, no-one in the drug-using community has ever brought up or even subtly seemed to be thinking about additional risks posed by my weight. If anything, it's been viewed broadly as a safety measure - I can take more of many drugs before OD than my skinny counterparts, and if ever I were to pass out in a risky environment, I'm at much less risk of sexual or physical assault than other girls, partly because (and I know you shouldn't say it, but...) when the pickings of collapsed girls are good, the fat chicks are less likely to be raped, and partly because it's very hard to move me or carry me away against my will. I also have a lot more weight to throw around in any physical confrontation. That said, being overweight and using drugs damn well DOES NOT make drug use safer over all!
So, if you were sharing drugs amongst friends, would you ever refuse anything to a very fat person? Do (or should) harm reduction services such as needle exchanges be giving out information differently for fat people? I know first-hand that they should be giving out equipment differently. If you saw a very fat guy dancing and gurning in a club, would you worry more about him than an otherwise-similar skinny dude doing the same? Should the drug-using community at large bite the bullet, risk offending and just start straight-up telling people that when you profile the risk of the drugs you take, your weight changes the profile significantly? Which drugs does it make the most difference to?
Anyway, massively rambling opening post, and doubt I've even thought of all the issues wound up in this subject.
Handing it over to the community - opinions? Experiences?
*sighs*.... 
I just mean, bring it... somewhere. I'm not suggesting people talk about weight in every drug discussion, I'm just surprised that it doesn't seem to come up in almost any drug discussions. 
