What is the biggest potential drug-related harm for Australian users?

[spacejunk]

As the title suggests, I'm interested in gauging what the most serious harms members of the bluelight community perceive to be associated with drug use in Australia (as well as New Zealand or anywhere else for that matter - but focusing on Australasia)

I'm going to list what I can think of, in a series of broad categories that may or may not be relevant to one another.
This is out of interest and hopefully to generate stimulating discussion.
I am including all "drugs" in this list, from alcohol, tobacco, traditional illicit drugs, inhalants, pharmaceuticals and so on, as I don't feel a distinction should be made when discussing harm reduction.

Please feel free to add anything I've missed, or question the inclusion of particular points.

Unexpected adverse reaction or overdose

• bad drug interactions (DXM + serotonin releasers ie MDMA) causing serotonin syndrome, convulsions etc
• purer than normal batches causing emergencies (heroin being the classic example)
• dangerous adulteration (ie MDMA and PMA pressed into pills ; cocaine cut with levamisole)
• misrepresentation (such as recent 25xNBOMe tabs being passed off as LSD - just as DOx chemicals have been (particularly in and around Adelaide)
• dangerous non-active cuts (especially for IDUs) - or active cuts that can increase CNS depression, therefore risk of overdose (again, generally specific to the heroin market)

Careless, taught how to do everything wrong (in regard to HR) or generally reckless drug use

• User consuming far more drugs than is necessary for a 'good time' - be it a bottle of bourbon, half a gram of MDMA, excessive amounts of any drug without sufficient tolerance, leading to medical emergencies, psychosis, violent or self destructive behaviour, etc
• sharing of drug paraphernalia (not necessarily for injection) that risks blood-borne disease transmission
• re-using blunt needles or dirty injecting equipment, risking vein damage or serious infection
• driving a motor vehicle or working in a dangerous job (with heavy machinery, etc) under the influence of drugs
• consuming drugs via non-accepted routes of administration (such as IV admin of codeine or non water soluble substances or experiencing adverse effects from consuming a drug with a sharp dose/effect curve through an unorthodox route of administration
• use of highly damaging substances to alter consciousness, such as inhaling volatile solvents.
• injecting drugs without practicing sterile technique, or injecting pills without adequate (micron) filtering
• insufflating pills without attempting to separate active ingredients from binders and inactive ingredients that are harmful to lungs and respiratory tract
• consumption of drugs made poorly in a clandestine lab - containing solvents, impurities, unreacted precursors or having been insufficiently washed prior to distribution.

Use of Novel psychoactive compounds (aka Research Chemicals)

• Consuming compounds without Reagent testing (or at least allergy testing) product to confirm (to the best of one's ability) that the substance in question is what it was sold to be.
• "eyeballing" doses of highly potent chemicals (ie dosing without weighing the dose with scales)
• consuming drugs (especially commercially labelled "legal highs" without any knowledge of their active (or inactive) ingredients
• having an adverse reaction to a drug/class of drugs/combination of drugs that is likely unknown to the medical community (especially in an ER situation, or with long-term use - making treatment either risky or impossible due to unknown substance, its unknown action, and unknown contraindications)

Legal problems associated with (potentially) illicit drug use

• incarceration (especially with charges of intent to sell or supply)
• criminal record for possession/cultivation/manufacture/importation/intent - and the various implications (hindering future employment, international travel, continued police attention and so on)
• state asset seizure of property (in some states) even if said assets were not a result of drug related activity
• potential police surveillance/persecution, should an individual be considered "of interest" to law enforcement
• trauma for individuals (as well as family, friends - even pets) subjected to drug raids. Resulting damage to personal property and local public reputation (in the eyes of neighbours and the community - regardless of guilt or innocence)

Physical Health

• drug use in its countless forms can have serious long and short term health effects. Specifically;
• sudden discontinuation of a number of pharmaceutical medications such as benzodiazepines (with potentially fatal withdrawal symptoms and lingering mental and physical problems)
• side effects of drugs and medications (such as anti-psychotics being linked with diabetes and a range of other serious health conditions)
• issues associated with long periods of sleep deprecation (also applicable to mental health problems)
• cardiovascular problems (stimulant use, smoking, IV complications)
• respiratory problems - most prominently from smoking and IV complications
• high or low blood pressure
• increased risk of circulation problems
• brain damage or disfunction caused by use - or heavy use -neurotoxic substances, or periods of oxygen being cut off from the brain (such as in overdose situations)
• damage to organs involved in metabolism, such as liver, kidneys etc
• potential/perceived/assumed/proven risk of cancer with certain kinds of drug use (proven in both cigarettes and alcohol use)
• damage or mutation of chromosomes (such as the case with amphetamine - as opposed to the urban myth of LSD being responsible for this

Mental health

• paranoia (due to the drugs themselves, or the environment [such as a state of legal prohibition] the drugs are consumed in)
• triggering of latent or genetically predisposed mental illness such as bipolar disorders, schizophrenia or causinv anxiety, anhedonia, depression and/or Post Acute Withdrawal Symptoms upon cessation of habitual use of certain drugs.
• physical and mental addiction that can affect a person to the point of extreme desperation to obtain their DOC (property crimes, malnutrition, damaged personal relationships etc)

Now, if this reads like a JUST SAY NO propaganda pamphlet - that is far from my intention.

Instead, I wanted to compile a list of the potential harms we want to reduce in our community - especially with many governments taking harm minimisation less and less seriously in this country.

So my question is;

Which of the above "harms" do you see as the most relevant to you and/or your friends and acquaintances?

Do you see any way you as an individual - or bluelight (AusDD particularly) can act to spread further awareness to reduce these risks - or are they already being addressed by authorities; such as targeting of drink driving, the work of needle exchange programs, street medical clinics etc.

Do you see any pressing need for legislative changes to be made in the name of harm reduction? An example would be allowing for pill/drug tests to be carried out at events (where this is currently illegal in all Australian states and territories - to my knowledge).

Besides generating discussion, I also feel that bluelight's membership has grown so large as to be a force to be reckoned with, in regards to advocacy on certain issues, getting petitions together and pressuring legislators to do more to stop preventable deaths from occurring.

Of course, for this to happen, we'd all have to agree on a few basic principles.
So let's so how it goes; thoughts? Additional points I've missed? Personal abuse (j/k)?

What are the biggest risks of using drugs in Australasia - and what (if anything) can we suggest or work towards to reduce these risks?

 

[Halif]

Great thread idea. First off, I'm gonna agree with you that BlueLight has grown large enough to be, in itself, a force for change. That's why apart from the odd post featuring my goofy sense of humour, I try to make sure my posts here have accurate and relevant content. People read these exchanges, and then make big decisions based of them. How do I know that? Because I've done it plenty of times! It was in the years before I joined - the lurking years - that I was most likely to do a certain substance in a certain way going off advice from this forum. There were reasons why I trusted the info here more than I trusted the 'word on the street', and this still applies. The street - or these days, social networks - can be a good place to find drugs but a terrible place for information about them. Even people who have been using their DOC for years can be frightfully misinformed.

In answer to the thread question, I'd say (of course this is a subjective opinion and I'm only speaking about Australia) that the risks are:

1. Complications (including overdose) from taking a substance due to not knowing what exactly is in it, or how much of what actives are in it. There has probably never been more active cutters/fillers so easily available due to the abundance of RCs. Testing kits are nowhere near sophisticated or up to date enough to really inform someone as to what's in there "ecstasy", "cocaine", "heroin", etc. I put quotation marks because these words are becoming umbrella terms and can no longer be taken as synonymous with what they represent. Ecstasy is the most dangerous of the lot, IMO, as it's likely to be picked up spontaneously (say a music festival) by young and/or impulsive people who won't get it tested at all.

2. Mental issues. For the same reason as above. The War On Drugs has brought about substances of mass destruction which make their original counterparts look almost tame. Some of the incense blends have apparently become extremely dangerous, mentally and physically. The NBOMe series appears to be much more volatile than LSD. COnsidering the low purity of cocaine in Australia and the expense, MDPV has given some people a rude awakening as it was used as a cutter - or simply sold itself as cocaine. Another case of the mimic being more immediately dangerous than its original.

Also, on a much more subtle level yet every bit as damaging (maybe more so because it's so insidious) is the stimga which plauges drug users. There is so much judgement around substance use. Even drug users look down on drug users. Some people think if it's legal it's OK (scripted meds, alcohol, even legal highs). Some people think anything's OK, as long as you don't IV it. There's the natural VS synthetic groups. It's endless.

The amount of baggage surrounding use of substances means that it's virtually impossible not to be judged at some point for using something, and quite frequently it's the user judging themselves.

 

[catching fish]

brain damage or disfunction caused by use - or heavy use -neurotoxic substances, or periods of oxygen being cut off from the brain (such as in overdose situations)

Sounds like me. Unfortunately I don't know for sure if my problems are psychological or physical.

 

[ensta]

I agree that the biggest potential drug-related harm is complications due to lack of education and common sense

When I was younger, we had a buddy system, we would never try anything without learning about it, getting it from someone you trusted and starting out in tiny doses as you can always have more. In contrast, my friend got a pill in a foreign country when she was confronted by a strange guy in the bathrooms and then came back after and complained about her drink no longer being there after leaving it unattended for about 10 minutes. I looked at her in disgust and asked her if she was trying to get date raped and after thinking about it she was shocked at how the thought hadn't even crossed her mind.

As a result of these naive users being more prevalent, a certain kind of supplier has also become more prevalent. People used to take more pride in what they did, understand that they weren't just offering a product but a service. Drugs are a means to an end. This applies to licit drugs as well. Bars are just pumping out as many drinks as they can as this new type of dealer is just pumping out whatever sub-par substance that will pass to maximise profits. Even Australia's health care is starting to get like this. I asked for something to help me sleep on a long flight and the doctor told me to just go to the chemist and get an OTC antihistamine called stilnox... I was speechless.

And so what we've ended up with is people who have no idea and a market riddled with inferior products and services, which is just begging for a lot of the direct harm from drug use above to occur. I am finding it hard to think about a way to reduce these risks as I don't think you can teach common sense. However, more unbiased information available and perhaps more media attention on the dangers and how risk can be minimised will make people more informed and accountable. A crude example would be, 'Its unfortunate they were sent to hospital but they could have easily prevented it by...' In theory, more informed users would not only reduce risk of harm through taking proper precautions but also push suppliers to meet the demands of the more safety conscious user.

I have issues with the legal and health system but that is for another day as for me its not about the harm they're causing but the harm they could be better preventing

 

[Halif]

When I was younger, we had a buddy system, we would never try anything without learning about it, getting it from someone you trusted and starting out in tiny doses as you can always have more.

You might have been the exception rather than the rule. That's so... sensible. I mean it IS common sense, but common sense still has to be taught through experience, trial and error. Actually, your post made me wonder if there's an extra burden on parents these days to communicate openly about drugs before allowing their kids to run off to schoolies week at the Gold Coast.

On another, more disturbing note, I keep trying to remind myself that people have been saying "In my day... things were <generally better>" since forever, but I couldn't help relating to a lot of what Ensta's post said regarding an overall drop in standards. I first noticed it in the industry I was working in and wrote it off as burnout on my behalf. But I notice it too. A lot of people don't seem to even pretend to give half a shit about what they're doing. And I'm not just talking about people in menial jobs.

I'm old enough to have friends who have become GPs, and at a lunch meet up a while ago I was disturbed at how open two of the new doctors joked about their own incompetence, saying that when a patient came in complaining of something they weren't sure about they would quickly Google it making sure the monitor was not in view of the patient.

Maybe this has nothing to do with drugs... or maybe it does... but in any case does it ever seem to others like people in Australia have sort of just given up en masse?

 

[Wilsbag]

Great thread!

I agree that the biggest potential drug-related harm is complications due to lack of education and common sense.

I think this is a big one and could apply to a lot of the harms that have been mentioned. More education could lead to more common sense.
Stupidly I had no sensible buddy system. When I first started experimenting with drugs I was taking "ecstasy" pills just about every weekend and would do things like double/triple drop unknown pills- just because the pills the week before weren't so strong, or take a ridiculous amount to try to get a good roll when they weren't giving the right effect in the first place. Could have been swallowing anything from high quality MDMA to talc powder.
Stupid I know, and lucky that I haven't ended up in hospital or with mental issues or something. With the information I've learnt from experiences, bits of research and the hours of browsing sites like BL, I now have ALOT more common sense due to being more educated and don't go putting unknown/untested substances into my body, let alone abuse them.
Knowledge and common sense is the key to safer drug use and could prevent a lot of the harms and risks to Aussie drug users.

 

[Wilsbag]

On another, more disturbing note, I keep trying to remind myself that people have been saying "In my day... things were <generally better>" since forever, but I couldn't help relating to a lot of what Ensta's post said regarding an overall drop in standards. I first noticed it in the industry I was working in and wrote it off as burnout on my behalf. But I notice it too. A lot of people don't seem to even pretend to give half a shit about what they're doing. And I'm not just talking about people in menial jobs.

I agree with this too.

 

[spacejunk]

^ standards in general, or concern for the well-being of self and others?

 

[Wilsbag]

More concern for the welling of self and others, we gotta look after ourselves and each other. Or at least give half a shit. Especially in the drug scene.
Just my view of coarse.

 

[spacejunk]

I absolutely agree -especially with batches of PMA "ecstasy" pills (and all other scary shit) being sold - and killing people- around the world.
It seems an apt time for a 'buddy system' should someone drop at an event or a club or whatever - and an agreed upon course of action (don't be afraid to call an ambulance, kids)

 

[Sweet Jones]

While I'm nowhere near well-versed enough in our drug policy or statistics or even that experienced in any lifestyle implications of various drug use, so I can't really talk too much about what I think are the more dangerous drug related harms, I can think of one thing to add to the opening post

The way that drug users, particularly users/addicts of harder drugs are portrayed in the media, on television, in newspapers, in movies, etc is inaccurate, it prompts people to think and excuses them in thinking that these people are all, as portrayed, the worst of the worst, which makes it infinitely more difficult for 'regular' people to relate to them, or to even view it as a problem that affects or could potentially affect them or people they know. It dehumanises and puts that much distance between the supposed 'drug addict' group and everyone else that people think of them almost like a separate minority ethnicity or something.

 

[spacejunk]

^ the stigma.
It's a very good point - and one that keeps a lot of people from seeking treatment and understanding IME

 

[Wilsbag]

Another point to consider could be the recently discussed Australian drug law reform, "war on drugs" and general political view and fear of the issue/topic.
Are the government doing all they can to minimise harm reduction in drug users?
I dont know, Maybe/maybe not?

 

[One Thousand Words]

I feel that the biggest risk to most drugs users today isn't from over dose but from mental illness. This may be partly due to irresponsible extreme use by some (dangerous poly drugs use ), proliferation of unknown and untested research chemicals (once again when used in conjunction with other drugs and alcohol) and also more people who perhaps shouldn't be using drugs are now exposed to them. From time to time we might get a spike in over doses due to increase in purities (particularly common with heroin) but many more deaths are due to suicide and misadventure (car accidents, fights).

The old saying "You don't find LSD, it finds you" to me never meant that acid was some sort of mystical substance, rather in the past those who controlled the drug were more selective with it's distribution. Today with open internet markets any man and his retarded dog can gain access to a increasing wide range of chemicals, many of which are best avoided by the inexperienced. You then find 17yr olds jumping to their deaths after consuming a super hero dose of RC. Add to this many analogues with subtle but more dangerous profiles and it is little wonder the market is one big lottery. I would feel infinitely safer if I could guarantee what I was buying in purity and dose but many people out there could still hurt them selves with something as benign as pure mdma simply due to their extreme dangerous pattern of use.

I am not egalitarian when it comes to drug use. I believe they should be avoided by anyone with a mental illness and any one under the age of 21. If you need antidepressants to feel "normal", self medicating with recreation drugs is foolish. Even then there even more again who are too idiotic to be given the keys to a car let alone mind altering drugs.

 

[spacejunk]

^ I can't say I disagree with you; but I don't know who could objectively decide who makes the grade regarding (can I/can't I take drugs) - but plenty of people with mental illnesses take drugs responsibly - and "mental illness" encompasses such a broad cross-section of the community - and so many variations.

To shift the onus of drug use onto "only the mentally healthy could put even more stigma and misunderstanding on those suffering a form of mental illness.
But I do agree that the open access to a world of crazy drugs (frequently mixed with little consideration of the risk, if many BL reports are to be believed) is a scary, dangerous thing.
People thought the drug market was dangerously unregulated 20 years ago? It's infinitely worse now.

I don't know how 'benign' MDMA is - but compared to "street pills", regulated MDMA would be infinitely safer and less risky - agreed.

 

[One Thousand Words]

It's benign if you accept that you can't redose after 4-5 hours. Yet how many here still fiend a whole night redosing multiple times until dawn and then wonder why they feel so shit 3 days later?

If you take prescription drugs for depression, you have suicidal thoughts or you spend most of the night lost in paranoid thoughts after smoking a joint then you should really avoid most if not all recreational drugs. Might sound harsh but its not really that difficult to understand why. i'm not going to stop you but by the same token I won't give you any sympathy if you ignore my warnings.

 

[Christ!]

I'd say Mental Illness. It's so broad but has got to be the biggest risk factor. You can get down to [what is mental illness,] [what makes someone mentally ill compared to "normal"] etc." - where I'm coming from is people who have trouble coping anyway, especially the young with poor self-esteem who are lacking effective strategies (an outlet) to deal "normally" on a day to day basis. Huge risk for future drug abuse/addiction and the harm that comes from that.

I'm getting this backwards I think. The main harms I see are people destroying their lives by abusing drugs, along with the direct and indirect effect it has on everyone who knows them (spouses/siblings/friends/relatives/children/neighbours) These users are the most visible in the public eye - teaching them HR is great but it's a tiny step overall.

Would be interesting to find out what percentage of drug users are the mentally ill/massively drug abusing/addicted kind. Maybe 1-2%?

 

[spacejunk]

Yeah, 1KW- I think you're more or less right. And Christ! Is on the money too.

I think people are entitled to learn from their mistakes - and there is no cut-and-dry determination of who "should" and who "shouldn't" be allowed to take drugs (in my opinion, anyway.
In a perfect world, violent meat heads would be barred from drinking alcohol).

Anyway, I think what you're talking about comes down to proper drug education (such as easily accessible information telling people the threshold/medium/strong/dangerous dosage ranges - as opposed to the "drug aware" kinda bullishit campaigns the federal govt has pushed in the last few decades).
If people knew what was safe, they'd be fools not to follow that information.
All we have currently is classic "boy who cried wolf" nonsense that does more harm than good.
Spend a few generations telling people that weed will make you a crazy killer; of course people ignore the warnings about meth...or MDPV.

What they do need, is qualiy control, proper manufacture safeguards - and for the production to come out of the shadows and be open to scrutiny, purity testing, improvement (where necessary).

As for people having bad reactions to weed - that seems pretty self regulating. I love me some nice strong bud/edibles/honey oil etc - but some folks aren't cut out for it.
I'd even go as far as to say that most of my friends don't smoke pot - because it doesn't give them pleasurable effects.

Lots of these drugs don't need regulation (in terms of who can use them) - as they are effectively self-regulating.
If you have a total bummer every time you smoke, you don't need anyone to tell you not to do it.


In the same regard, I smoke moderately these days, because experience taught me that with cannabis, less is often more. If I smoke from dawn til dusk, it never gets me high; whereas if I keep my use down, I get all the desirable effects I look for.
Obviously plenty of drugs don't have this quality (stims can be very much the opposite) - but I think overall, the mental health aspect of drug use is greatly overlooked by users and prohibitionists alike; especially when the drug use is symptomatic of other psychological issues, or sub/semi conscious self medication.

 

[One Thousand Words]

The guys and girls I know who have had problems with cannabis were never the "have a toke only on the weekend" types. I can't think of any who didn't start the day with breaky cones then smoke all day before they finally lost their shit. Even one or two who smoked at the end of everyday eventually reach a staged when they weren't really enjoying the high. You can argue that most if not all has some undiagnosed predisposition to psychosis but they never really followed the moderation route to begin with so who is to really say?

No amount of clever marketing posters over the top of pub urinals are going to prevent some people from getting into trouble when weed is finally legalised. I guess we just have to hope it is only a small percentage

 

[spacejunk]

It's just like booze.
Some can do moderation; some can't.
I don't think cannabis is the biggest risk, personally - but my observed experience is different from yours.
Serious stoners I know have very often smoked heavily for decades.
The people I know that don't dig it, simply don't smoke it .