Thinking about drugs: An introduction to harm reduction

The goal of this article is to plainly and openly speak about psychoactive substances (drugs) and considerations to make if you’re using, planning to use, or open to using.

We talk about sex a lot in the queer community but we don’t necessarily talk about substance use with the same openness.

This article cannot cover everything about substances, but hopefully it equips you to feel more confident about choices you make.

Wait – what even are drugs?

Psychoactive substances – which includes pretty much all of the ‘illicit drugs’, some prescription medications, and tobacco, caffeine, and alcohol (although caffeine and alcohol are not typically understood to be ‘drugs’ because they’re licit and normalised) – alter our central nervous system (CNS), which includes the brain.

Some substances slow down our CNS, some increase its activity, and others distort messages occurring in the CNS and alter our sensory perceptions (a few do a combination of these effects on the CNS). Psychoactive substances have been used by people throughout all of conceivable human history, subject to local cultivation, production, and availability. It’s fair to say that we like to shift our mood, our state of mind, and our experience of consciousness.

Gay communities are no strangers to psychoactive substances, and particular substances remain uniquely in trend for decades (such as poppers/amyl for gay men), while others have surfaced and presented their own dilemmas for gay men (such as the recent ‘chemsex’ phenomena). Kane Race, a scholar and activist in Sydney argues that psychoactive substances have presented a method for queer communities to explore the boundaries of sexuality, intimacy, pleasure, and community, along with a means of mourning historical trauma (such as the AIDS epidemic).

This points to a wide field of meaning-making that psychoactive substances can variously enable/disable, and the function of substances therefore depends on a number of interrelated factors, such as social, political, religious/spiritual, and personal contexts.

What the Law says about Drugs

The rhetoric around ‘drugs’, particularly propagated by media, means that psychoactive substances which are criminalised become associated as sinful and/or immoral.

This moralising language makes it difficult to speak about the effects of these substances without being accused of committing some kind of evil. Furthermore, the fact that these substances are illicit contributes to the harms that people experience – criminal records limit people’s opportunities to sustain their own life or seek a different one, lack of regulation and quality control results in substances being ‘cut’ with other (usually more harmful) chemicals, and the social stigma that people face in their personal lives and from healthcare and social services can make life generally difficult.

The legal status of a psychoactive substance can alter the way that people think about their own usage. Given that alcohol usage is legal in most circumstances, and is a cultural norm of almost every facet of adult life, many people can experience numerous harms from alcohol without reflecting on whether or not it is problematic.

Many illicit substances are assumed to be immediately harmful with even the smallest sample. The legal status of psychoactive substances has very little to do with health and harm, and a lot to do with history, economics, culture, and domination – but that is a different topic altogether. In many circumstances, the law is not in place to protect people’s health, and it is vital to suspend the legality of any substance when understanding its effects.

Of course – you should understand that there can be various legal consequences as a result of using, dealing, or possessing substances, dependent on the state or territory you live in. It is helpful to understand your rights!

Do your Research!

Having some knowledge about what’s going into your body, the effect it is likely to have on you, and the safer ways of taking the drug is invaluable. If you’re using different substances at once, it’s also a really good idea to read up on any possible effects – some combinations of substances can be potentially life-threatening.

Even with all of the knowledge, you might not be prepared for some effects that substances can have on your body (everyone reacts to things differently), but you can at least be familiar with some of the risks.

Unfortunately many illicit substances are often ‘cut’ with unknown chemical properties, and many of the harms that people experience from taking these drugs have less to do with the substance itself, and more to do with the lack of quality control that can occur due to the criminalisation of many drugs.

If you have a regular dealer of a substance and you’re familiar with the product you’re getting, it’s advised to stick with the same dealer. If it’s from a new supplier or a different batch, use a smaller quantity to ‘test’ it out (sometimes called ‘tasting’).

Talking to a health professional or educator experienced with alcohol and drug information probably seems a bit strange (especially with illicit substances) – but it’s totally something I would encourage you to do if you’re considering experimenting with new substances or want to talk about a substance you’ve been using before.

Contacting these services to talk about your substance usage will not result in getting in trouble with the law. The Drug & Alcohol Information Line, the WA Substance Users Association, and specific to gay/bi men, M Clinic’s Drug & Alcohol Clinic are all friendly and reputable places to discuss these things.

What am I hoping to Experience?

It’s important to consider – what am I hoping to experience from using this substance? Whether it’s a night of drinking wine with your besties or experimenting with crystal meth with your regular fuck buddy, it’s a good idea to consider what you’re expecting to happen, what state of mind you’re already in, and how the substance might alter that (of course if it’s the first time using it, you might not really know!)

Part of the thrill of taking some substances is unveiling the unknown and pushing the limits of your conscious experience. Others are more predictable – I drink my cappuccino because I love the taste of coffee and because the caffeine in it stimulates me to be more productive and alert.

Of course, planning your substance usage doesn’t always fit in with the reality of actually using (possibly because of peer pressure, experimenting, and opportunistic usage).

Setting Limitations

Once you’ve figured out what kind of experience you’re hoping to get, it can be helpful to set some boundaries and limitations for yourself. Many people do this with alcohol – Spacing out drinks and the total amount of standard drinks because you know you need to drive home, having a back-up plan to crash at a friend’s place because you might end up drinking more than you plan to, abstaining from drinking at a particular event because you’re the designated driver, or limiting the amount of drinks you have because you have work or some other commitment in the morning.

Most substance use occurs in a social setting and it may be helpful to discuss these things with your peers – although not everyone you’re around may support the limitations you’re trying to set for yourself.

Figure out who respects your boundaries and plan a contingency if you know that Sandra is going to coax you to do some shots of vodka (classic Sandra!)

Won’t I get ‘Hooked’?

There is a prevailing myth that a single encounter with a substance is enough to condemn a person to a lifetime of ‘addiction’; the impetus behind the detestable Nancy Reagan’s ‘just say no’ campaign in the 1980s.

While some people may report repeatedly chasing an original positive experience they once had with a particular substance and therefore develop a pattern of dependency with that substance, most people may use a substance once or more and never really form any kind of dependency with that substance.

The function of a substance within our life is more complicated than simply becoming immediately ‘hooked’ on a substance from enjoying it once. It really depends on a whole suite of factors. If you’re worried about a substance’s impact on your life, it can be helpful to speak to someone.

What if it goes wrong?

If you think you or your peer’s life is in danger, you need to call 000 and go to an emergency department. You will not get in trouble with the law for having used substances when accessing a health service – hospitals and healthcare workers are only (and should only be) interested in making sure you are OK.

If you and your peers are using opioids (such as heroin), you can attend Naloxone-training with WASUA for free and acquire Naloxone to have on hand in case of potential overdose.

If you believe you are at risk of HIV due to sexual activity you’ve engaged in, or because you shared needles, you can access post-exposure prophylaxis (PEP) within 72 hours of the incident in order to prevent HIV for yourself. If this has happened more than once or you are worried about your HIV risk, consider accessing pre-exposure prophylaxis (PrEP) to take all of the time.

Reducing harms

There are numerous ways of reducing harms of substance usage, but they are typically dependent on the substance being used, the mode of using (how the substance gets into your body), and possibly dependent on geographical context (in terms of local ‘batches’ of substances). Check out TouchBase.org.au for information specific to different substances.

If you’re injecting any substances (intramuscular or intravenous) it is best to use all of your own needles, syringes, and other equipment, and not to share any of it with anyone else.

Sharing any products may put you at risk of HIV, Hepatitis B virus, and/or Hepatitis C virus. Free needle/syringe programs are available across Australia, and cheap fitpacks can be purchased at many pharmacies.

There are many other considerations when injecting to maintain your veincare and health – check out the Australian Injecting & Illicit Drug Users League.

Substance usage involving snorting/sniffing may damage your nasal cavity, smoking/inhaling may damage your lungs, and booty-bumping/shafting (up your bum!) may damage your rectum/colon.

Familiarise yourself with any potential harms of a particular mode of using and monitor yourself!

Anthony K J Smith

Useful Links

Touchbase – queer drug & alcohol information: www.touchbase.org.au

WA Substance Users Association: www.wasua.com.au

Chemsex Care Plan: http://www.davidstuart.org/care-plan


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