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Safer Use of Sex & Party Drugs

Note: Over the coming months, in partnership with Fruit Loop, the EMHC will be delivering a range of safer substance use activities. Check back soon for more local data and for an expanded safer substance use section which will include new harm reduction tips and safer substance use information for opioid use. 

Guys in Edmonton are using drugs. Period.

When the 2014/15 Sex Now Survey asked Edmonton participants (n=363) about the substances they used in the last 12 months, here’s what they had to say:

SubstanceUse
Alcohol89.5%
Marijuana43.8%
Cocaine11.8%
Crack2.2%
Crystal5.5%
Poppers30.0%
Viagra24.8%
Ecstasy12.4%
GHB6.3%
Ketamine3.0%
Mephedrone0.6%
Steroids1.7%

Not everyone can have a healthy relationship with substance use. For some people, drugs can have a very damaging impact on their relationships and their wellbeing. Conversely, for some, substance use can actually be the result of existing health or social challenges.

If substance use is disrupting or impacting your life and health negatively, you should speak with your family doctor or a mental health/addictions professional. They can help you lessen or stop your substance use, or help you find a way to use substances in a healthier manner.

For those who are using substances, either because they feel they can or don’t feel like they can stop, it’s important to understand how these substances impact your body and overall health. Substances can lower your inhibitions and potentially place you at a higher risk of contracting various STIs, including HIV and Hepatitis C. Also, there is some risk associated with the use of almost any substance. Some can be very mild while others can be severe – like death. However, by understanding how the drugs you use impact your body and how they interact with other drugs you might be using, you can lessen the harm they may cause you (harm reduction).

The tables below have been compiled based on information obtained from various medical sources in addition to anecdotal evidence from substance-using communities. If you are concerned about the impact a substance might have on your body, always speak with a qualified healthcare or addictions professional first. In the meantime, the following general harm reduction tips and the drug-specific information found in the tables below might provide you with some information which can help you use substances in a safer way.

General Harm Reduction Tips:

If you’re going to use a substance, it’s always a good idea to start with a small dose. You can always put more in your body, but once it’s in there it’s hard (and sometimes impossible) to get it out.

Sometimes when you buy a substance you want, it can be spliced with other substances, some of which can be quite dangerous. If you have second thoughts about the source of a substance or what’s in it, don’t use it. One high is not worth your life. Consider testing your substances to make sure you know what you’re putting into your body. Drug testing kits can be purchased from www.dancesafe.org.

HIV, HCV, and other STIs can be passed through the sharing of substance use equipment (primarily through blood). This includes injection equipment (needles), inhalation equipment (pipes), and snorting equipment (a straw or rolled bill). Whenever possible, access clean, unused substance use equipment and do not share with others. If you are in a situation where you are going to share substance use equipment with someone else, try your best to ensure that the equipment is as clean as possible and free from blood and other bodily fluids to lessen the likelihood of transmission. If you are looking to access clean substance use equipment, contact our partner, Streetworks.

Substance use can also increase the likelihood of HIV, HCV, and STI transmission through sex. This might be because you have rougher sex when high (which is more likely to result in the presence of blood), because you have less inhibitions than when you’re sober, or because it can be more challenging to apply safer sex knowledge and harm reduction strategies while high. If you feel like you’re going to be using substances and that might result in you having “riskier” sex, take a moment while you’re sober to help lessen that risk (i.e. consider using PrEP to prevent HIV or make sure you have condoms with you). Click here to learn more about safer sex strategies or here to learn more about PrEP access in Alberta. 

Carry a Naloxone kit. Currently, Alberta is facing an opioid crisis. A Naloxone kit can be accessed free of charge and is small enough to fit in a backpack. If you’re going to be using substances and think that you might come into contact with opioids (particularly fentanyl), make sure that you or someone you know has access to a kit. Naloxone can “pause” an overdose long enough for you or someone you know to get help. To learn more about getting trained for Naloxone, check out our opioid awareness project.

Finally, never use alone – or make sure someone knows you’re using and is able to check on you. Even if you think you’re prepared, sometimes things can go wrong. By having someone you trust on the lookout for you, they can respond if anything goes wrong and make sure you get the help you need.

Chemical Name

  • Gamma-hydroxybutyrate

Other Names

  • G
  • Liquid E
  • Liquid X
  • Liquid Ecstasy
  • Georgia Home Boy
  • Grievous Bodily Harm
  • Scoop

Appearance

  • Liquid in small bottles/capsules with a consistency slightly ticker than water

Route of Administration (the path a drug takes into your body, such as through the mouth or nose)

  • Oral (typically diluted in water/pop or can be swallowed directly)

Commonly Used Dose

  • 1-2 mL (try to stick to < 15-20 mL/day)
  • Use dropper bottle or syringe to measure your doses
  • The strength varies with each bottle, test the dose of a new batch using < 0.5 mL and wait for at least 1 hr before re-dosing

Basic Pharmacokinetics (the way the body absorbs, distributes and gets rid of a drug)

  • Time to onset: 5-10 min
  • Time to peak: 15-30 min
  • Duration of action: 2-4 hr

Drug-drug Interaction

  • Mixing with alcohol can increase the effects and put you at high risk for overdosing, so stick to water or juice for dilution
  • Mixing with other stimulant drugs increases the risk of paranoia, hallucination and aggression
  • Don’t mix with ketamine, pain killers, allergy, or anxiety medications

Sexual Functions

  • Mild euphoria and a sense of well-being
  • Loss of inhibition
  • More talkative
  • Enhance sense of touch
  • Increased confidence and desire for sex
  • Can enhance erection and increase intensity of orgasm

Health Risks

  • Overdose (one in five users report passing out each year)
  • Decreased heart rate, unstable blood pressure, loss of bowel and bladder control, breathing problems, seizures, coma or even death.
  • In some cases, GHB also can cause “anterograde amnesia” (memory loss for the events following ingestion). This means that you may not be able to recall what happened to you while you were under the influence of the drug.

Addiction

  • Take as little as 1 or 2 weeks to become physically dependent
  • Don’t use G for more than 2 days in a row to avoid the risks of dangerous withdrawal Being anxious, sweaty and shaky are the first signs for withdrawal
  • May also experience hypertension, increased heart rate, agitation, confusion, anxiety, panic, hallucinations, delirium, respiratory depression or tremor (can last 5-15 days)

General Tips

  • Start with ½ a tsp, wait an hour before re-dosing
  • Use a pipette/syringe/eyedropper or pre-measured doses to avoid overdose
  • Leave a good gap (at least 1-2 hr) between doses to avoid overdose. Set an alarm (e.g. on phone) to the minimum safe time between doses to reduce your risk of overdosing/coma (Ghas impacts on your memory and perception of time, so the alarm is helpful)
  • People can accidentally drink or intentionally slip G into your drink. Avoid putting drinks down, and toss the drink if it tastes strange (GHB has a salty taste)
  • Be open about your substance use with your partners and have people you trust around you

Chemical Name

  • N-methyl-alpha-methylphenethylamine

Other Names

  • Speed
  • Tina
  • Chalk
  • Ice
  • Crystal
  • Glass

Appearance

  • White to light brown odorless bitter powder (more common)
  • Clear chunky crystals resembling ice

Route of Administration (the path a drug takes into your body, such as through the mouth or nose)

  • Swallow (safest method)
  • Snort
  • Bump
  • Smoke
  • Hoop
  • Inject/slamming (most dangerous with high risks of transmitting HIV and Hepatitis C)

Commonly Used Dose

  • 10 to 40mg for a moderate stimulation
  • Up to 100mg

Basic Pharmacokinetics (the way the body absorbs, distributes, and gets rid of a drug)

Taken orally

  • Time to onset: 20-70 min
  • Time to peak: 3-5 hr
  • Duration of action: 2-6 hr

Taken by injection

  • Time to onset: 0-2 min
  • Time to peak: 5-20 min
  • Duration of action: 4-8 hr

Taken by snorting

  • Time to onset: 5-10 min
  • Duration of action: 2-6 hr

Taken by smoking

  • Time to onset: 0-2 min
  • Duration of action: 1-3 hr

Drug-drug Interaction

  • Mixing with GHB makes you unable to sleep and tired, frequently leading to G overdoses
  • Mixing with Viagra to counter the erectile dysfunction effect of crystal meth can cause heart failure; though it should be noted that meth use on its own can cause heart failure
  • Mixing with marijuana and alcohol places extra strain on the heart
  • Alcohol increases dehydration

Sexual Functions

  • Feelings of euphoria and confidence
  • Loss of inhibition and exceptional increase in sex drive
  • Tend to feel very horny
  • Staying awake for many hours after use
  • For some men, crystal can cause problems in maintaining an erection (“crystal dick”)

Health Risks

  • Increased heart rate, hyperactive, decreased appetite, increased blood pressure and increased temperature
  • Meth can cause you to stay awake for days, potentially leading to hallucinations and psychotic episodes
  • When you’re high on meth it’s easy to forget to take important medications
  • High and repeated meth use can lead to long-term emotional and cognitive problems
  • Tolerance rapidly develops with crystal meth. Chronic tolerated users will need 2-3 times the doses listed above

Addiction

  • You may quickly become addicted to crystal meth and often use it with increasing frequency and dose due to developing tolerance for the drug
  • Withdrawal symptoms are intense and include insomnia, irritable moods and depression. Some experience psychosis, others get a sensation of insects crawling on their skin
  • Acute symptoms last typically for 7-10 days
  • Residual symptoms with neurotoxicity will persist for several months

General Tips

  • Try to set boundaries before you take crystal. How long you want to stay awake, what your sexual limits are and how will you manage your crash
  • Crystal meth has a crash phase of many hours where you are extremely tired. Avoid drinking or making decisions during this time
  • Meth causes overheating and dehydration from hyperactivity. Drink 500mL of water each hour and avoid alcohol
  • Remember to have condoms since crystal can make you forget about safety in the heat of the moment

Chemical Name

  • 4-methyl methcathinone (4-MMC)
  • 4-methyl epherdrone

Other Names

  • Meph
  • Bath Salts
  • Drone
  • M-CAT
  • White Magic
  • Meow Meow
  • Plant Food

Appearance

  • Powder (most common)
  • Tablets or capsules
  • Injection (rare)

Route of Administration (the path a drug takes into your body, such as through the mouth or nose)

  • Bombed (wrapped in paper or put in a capsule and swallowed) (recommended as it can avoid aggravation/irritation to nostrils, veins and throat)
  • Snorting
  • Oral ingestion
  • Dissolved in water
  • Taken rectally diluted in water by using a syringe
  • Booty-bumped (syringed up the anus)
  • Intravenous

Commonly Used Dose

  • 100-200 mg orally
  • 5-125 mg if snorting

Basic Pharmacokinetics (the way the body absorbs, distributes and gets rid of a drug)

Taken orally

  • Time to onset: 15-45 min
  • Duration of action 2-5 hr

Taken by snorting

  • Time to onset: 10-20 min or less
  • Time to peak: 30 min or less
  • Duration of effects: 1-2 hr

Taken by injection

  • Time to onset: immediate
  • Time to peak: immediate
  • Duration of action: 30 min

Drug-drug Interaction

  • Mixing with alcohol, MDMA, and other drugs or stimulants can increase the general risks and the likelihood of negative side effects

Sexual Functions

  • Euphoria, loss of inhibitions and pleasant excitement
  • Sense of intimacy
  • Increased sexual arousal
  • Increased alertness and confidence
  • Increased sociability and communicability (more talkative)
  • Temporary stronger affection to your partner

Health Risks

  • Sweating, headaches, heart palpitations, increased heart rate, nausea and vomiting, chest pain, tingling in arms or legs, teeth grinding, feelings of fear and anxiety, reduced appetite, agitation/aggression, insomnia, loss of short-term memory, vertigo, temperature fluctuations, blue or cold fingers, paranoia, hallucinations, depression and concentration difficulties
  • Snorting and direct ingestion can cause damage to the mucous membrane of the nose and the throat

Addiction

  • Improper use can lead to strong psychological dependence, leading to the user craving and taking increasing amounts
  • Early signs of addictions: mood swings, drowsiness or tiredness, agitation and paranoia
  • Later signs of addictions: depression, distraction, psychosis and a general reduction in the ability to perform normal daily tasks

General Tips

  • Drink moderate amounts of water to avoid dehydration (Meph causes increase in body temperature)
  • Limit dose-start with a small amount and leave at least 1 hr before re-dosing
  • Limit to less than 500 mg in 24 hr
  • Ingest within a capsule/cigarette paper
  • If snorting, clean out nose after uses and use straw (don’t share with anyone else)
  • Avoid Meph if you have any history of heart, circulatory or blood pressure problems

Chemical Name

  • Ketamine

Other Names

  • K
  • Special K

Appearance

  • White, crystalline powder (smoother than cocaine) (most common)
  • Tablet
  • Clear liquid

Route of Administration (the path a drug takes into your body, such as through the mouth or nose)

  • Snorting in small lines or as bumps (most common)
  • Oral ingestion
  • Injection (intramuscular)
  • Smoked

Commonly Used Dose

  • 30-75 mg (snorting)
  • 75-300 mg (oral)
  • 25-50 mg (intramuscular)

Basic Pharmacokinetics (how the body absorbs, distributes, and gets rid of a drug)

Taken by snorting

  • Time to onset: within seconds
  • Duration of effect: 45-60 min

Taken orally

  • Time to onset: 15-20 min
  • Duration of effect: 1-2 hr

Taken by injection

  • Time to onset: 1-5 min
  • Duration of effect: 30-45 min

Taken by smoking

  • Time to onset: within seconds
  • Duration of effects: 45-60 min

Drug-drug Interaction

  • Mixing K with G or alcohol can cause respiratory failure and decreased heart rate (K, G and alcohol are all central nervous depressants)

Sexual Functions

  • Decreases social or intimacy anxiety, boredom, loneliness and isolation
  • Feeling of body and mind have been separated and having an out-of-body experience
  • Cause changes in auditory or visual sensations
  • Used for fisting (anesthetic function of ketamine)
  • Trippy feelings with hallucinations
  • Loss of feelings in parts or all of the body

Health Risks

  • Overdose (“K-hole”): hallucinations, feelings of paralysis or partial paralysis, and a state of very limited awareness or altered perception/reality (usually lasting one hour)
  • Can be exposed to dangers from sexual assault or accidental harm during “K-hole”
  • Decreased inhibitions
  • Heavy use of ketamine can cause bladder damage (severe pain and incontinence); need to seek medical assistance because the damage may be irreparable

Addiction

  • Infrequent use of ketamine is not often associated with addiction
  • Tolerance and addiction build quickly when used regularly or on a daily basis
  • The numbing or mindlessness effects can make people become psychologically addictive
  • In most cases, no harm in stopping use of Ketamine immediately and abruptly

General Tips

  • K does not work topically, so putting ketamine on your asshole will not numb it
  • Manage your environment when dealing with a K-hole because you may harm yourself (e.g. falling or needle stabbing)
  • Avoid aspiration: move people who are in K-holes into recovery position so they do not choke on vomit
  • Avoid eating while on K to reduce the possibility of vomiting
  • Start with 1/2 or 1/3 dose and wait 30 min before doing more
  • Have a friend around who keeps an eye on to prevent K-hole
  • Related urinary tract problems is a sign that you body needs a break from K (seek medical assistance if necessary)
  • If want to reduce ketamine use, identify a typical amount used daily and reduce it for a week by a certain amount; choose 1 day or 2 to not use Ketamine at all, and make the day special and do something different with a supportive friend

Chemical Name

  • 3,4-methylenedioxy-methamphetamine

Other Names

  • E
  • Molly
  • Love Drug, Lover’s speed
  • X, XTC
  • Snowball
  • M

Appearance

  • Capsule or tablet (most common) – colour varies
  • Powder (MDMA powder)

Route of Administration (the path a drug takes into your body, such as the nose or mouth)

  • Oral (most common and safest method)
  • Snorted

Commonly Used Dose

  • Average of 120mg in a session
  • Upper limit of 700mg in binge sessions but should be avoided

Basic Pharmacokinetics (how the body absorbs, distributes, and gets rid of a drug)

Taken orally

  • Time to onset: 20–30 min
  • Time to peak: 1 to 2 hr
  • Duration of action: 3-5 hr

Drug-drug Interaction

  • Mixing with alcohol can lead to serious dehydration
  • Mixing with other drugs or stimulants can lead to serious side effects, including strain on the heart
  • If you are on prescription medications, particularly antidepressants, do not take MDMA since severe drug interactions can cause death

Sexual Functions

  • Incites feelings of passion, love and excitement
  • Intensifies the senses of touch, sound and colour
  • Loss of inhibition and greater likelihood to engage in unsafe sex
  • More of a dance drug but sometimes used for sex. Loosen sexual inhibitions
  • Causes difficulty in getting and maintaining an erection

Health Risks

  • Paranoia and anxiety attacks are common during the high
  • For days or even weeks after a high, you can feel confused, depressed and anxious while your brain works to restore your supply of serotonin that MDMA depleted
  • Long term high dose usage will lead to neuron damage. Prolonged effects from serotonergic neuron damage include poor memory recall, flashbacks, panic attacks and psychosis
  • Blood pressure and heart rate increases, loss of appetite commonly observed
  • Death sometimes occur from nonstop activity leading to overheating and dehydration

Addiction

  • Although MDMA may not cause the same physical dependence as some other drugs, the dopamine surge associated with MDMA – and resulting “reward” – can lead to a reward based addiction
  • Users will develop tolerance for its effects over time and chronic users will have to take increased dosages and at higher frequencies
  • For those addicted, withdrawal symptoms include anxiety, confusion, delusions, fatigue, insomnia, panic attacks, poor concentration and psychosis

General Tips

  • Drink about 500 mL of water each hour to accommodate for your hyperactivity after taking MDMA. Do not drink too much water and avoid alcohol
  • Black market ecstasy tablets often contain other more dangerous drugs. In some cases, taking these pills has resulted in death or other serious complications. Verify the source of your tablets before taking them

Chemical Name

  • Benzoylmethylecgonine

Other Names

  • Coke
  • Blow
  • Snow
  • White
  • Cane
  • Dust
  • Shake
  • Toot
  • Nose candy
  • White lady

Appearance

  • Flaky, white, odorless powder

Route of Administration (the path a drug takes into the body, such as the mouth or nose)

  • Snorting
  • Intravenous when diluted
  • Spread on gums
  • Inhale after heating
  • Put on asshole

Commonly Used Dose

  • 10-120 mg

Basic Pharmacokinetics (how the body absorbs, distributes, and gets rid of a drug)

Taken by snorting

  • Time to onset: almost immediately
  • Duration of effects: 15-30 min

Taken orally

  • Time to onset: about 1 hr
  • Duration of effects: 1-2 hr

Taken by injection

  • Time to onset: 15-30 sec

Drug-drug Interaction

  • Cocaine can “counteract” the effect of alcohol, leading you to think you’re sober/making sober decisions when you’re still impaired
  • Can cause damage to your heart and brain when mixing with other drugs

Sexual Functions

  • Feel wide awake, chatty and confident
  • Make you horny but difficult to stay hard when high on coke
  • Can increase the time of anal sex if put up on asshole

Health Risks

  • Aggression, agitation and anxiety
  • Paranoia, depression and insomnia (especially in the “comedown” period a day or two after consumption)
  • Putting cocaine on your asshole can increase the chance of picking up or passing on HIV and Hepatitis C if you are not using condoms and enough lube
  • Frequent snorting can damage your nasal cavity
  • Some guys complain about making unhealthy choices about condom use and sexual risk taking when high on coke

Addiction

  • Although cocaine may not cause the same physical dependency some other drugs do, regular use can lead to a strong psychological addiction

General Tips

  • For first time user, start with smaller lines at longer intervals and keep track of how much you take
  • Don’t share straws if snorting or needles if injecting to avoid transmission of HIV and Hepatitis C
  • Drink plenty of water and try not to stay up for too long to give more time for recovery

Chemical Name

  • Alkyl nitrates (amyl nitrate, butyl nitrate, isobutyl nitrate)

Other Names

  • Jungle juice
  • Leather-cleaner
  • Liquid gold
  • Rush
  • TNT
  • Amyls

Appearance

  • A clear liquid in small bottles with an odor like paint remover or turpentine
  • In glass phials (rare)

Route of Administration (the path a drug takes into your body, such as the mouth or nose)

  • Inhale the vapor directly from the bottle
  • Inhale from an absorbent material such as cloth

Commonly Used Dose

  • Most people take about 3-4 “doses” during the act (depends on the actual length of the act and your own preference)

Basic Pharmacokinetics (how the body absorbs, distributes, and gets rid of a drug)

  • Time to onset: immediate
  • Duration of effects: 30 sec to 2 min

Drug-drug Interaction

  • Mixing with alcohol can cause extra stress to your body
  • Mixing with ED drugs like Viagra or Cialis can add extra strain to your heart, causing headaches, dizziness, nausea or even stroke
  • Mixing with crystal can cause heart stress, sudden shifts in blood pressure, chest pains, heart attack or stroke

Sexual Functions

  • A might burst of dizzy energy
  • Feeling of a sudden rush of blood to the head (poppers dilate your veins and arteries)
  • Temporary perception of having larger penis
  • Relax the sphincter muscle, making anal sex easier and more pleasurable
  • Increase sensation to the penis and other extremities and heighten sexual intensity
  • Better orgasms, improved anal sex and a bigger erection for a few minutes
  • Normal for some users to temporarily loose erection (poppers decrease blood pressure throughout the body, including penis)

Health Risks

  • Some people may suffer pounding headaches or poor concentration, dizziness and a flushed face
  • Can experience headaches in the morning
  • Popper burns: highly acidic poppers can burn surfaces including your skin, especially around your nostrils if sniff too close
  • Can weaken your immune system
  • Sudden high can cause you to make unhealthy choices about condom use and sexual risk
  • Can lead to rougher anal sex and fisting, which increase the chance of tearing or bleeding and makes it easier to contract HIV or Hepatitis C
  • Using poppers can be a serious health risk for those with heart conditions, breathing problems, or anemia and glaucoma

Addiction

  • Not reported to be addictive but many people have cravings when out clubbing or during sex after frequent use
  • Can develop tolerance

General Tips

  • Never drink poppers (highly poisonous and potentially fatal)
  • Avoid flame if also smoking because it is a highly volatile flammable liquid
  • Sit down or recline when using poppers as some people may experience headaches or dizziness
  • Remember to put the cap back on so as not to spill during movements from sex

Generic Name

  • Sildenafil, Vardenafil, Tadalafil

Other Names

  • Hard-ons
  • Blue diamond (Viagra)

Appearance

  • Viagra is a blue diamond shaped tablet
  • Levitra comes in round orange tablets
  • Cialis are yellow, film coated and almond shaped

Route of Administration (the path a drug takes into the body, such as the mouth or nose)

  • All comes in pill form and are taken orally

Commonly Used Dose

  • Viagra: every 48 hours 50mg for most men, 25mg if on HIV drugs
  • Levitra: every 72 hours, 5mg for most, no more than 2.5mg if on HIV drugs
  • Cialis: every 72 hours average dose is usually 10mg, 10mg if on HIV meds

Basic Pharmacokinetics (how the body absorbs, distributes, and gets rid of a drug)

Viagra

  • Time to onset: 30-60 min
  • Duration of action: 4 hr

Levitra

  • Time to onset: 25 min
  • Duration of action: 4-5 hr

Cialis

  • Time to onset: 30 min
  • Duration of action: up to 36 hr

Drug-drug Interaction

  • Viagra and Ecstasy are often mixed together. This causes a lot of strain on the heart and can cause and persistent erection
  • Avoid mixing with any other drug that changes blood pressure, especially poppers, as this can complicate heart health

Sexual Functions

  • Does not cause libido or horniness. Does not instantly cause hard-ons
  • Allows erections to last longer and shortens the time between erections

Health Risks

  • Common side effects are redness in the upper body, stuffy noses, headaches, upset stomachs or back pain
  • If you experience vision loss, ringing in ears, chest pain, fainting or dizziness, contact emergency services and stop taking it
  • Possible long term effects include heart problems and hearing loss
  • The three medications should not be combined as the combined effects can cause cardiovascular problems
  • Can cause serious prolonged erections. If it goes on longer than 4 hours (priapism), seek emergency medical care to avoid permanent damage

Addiction

  • Physical addiction to these drugs is unlikely
  • Some psychological addiction has been observed. Some men report that they continue to take Viagra even though they did not need it physically – out of fear of losing an erection during sex

General Tips

  • All the erectile dysfunction medications work less well after eating a fatty meal or taking alcohol
  • Start and try to use the lowest dose (often the ½ pill). Higher dose doesn’t improve erections but simply increase the chance of side effects