SUBSTANCE USE HEALTH

Substances and Safer Use Strategies

Below you will find some information and tips for safer use for some of the more commonly used substances in Canada.

  • Alcohol is a depressant and it slows down parts of the brain, including the part that controls breathing; it changes how you act, feel and think.
  • Alcohol affects people differently. Some people may find alcohol makes them feel calmer and more relaxed, while others may find it makes them depressed or aggressive.
  • Drinking excessive amounts of alcohol quickly is harmful to your health and is known as binge drinking. The most common short-term risk of binge drinking is a hangover, including fatigue, nausea, vomiting and headaches.
  • Binge drinking can also lead to alcohol poisoning, violent behaviour and poor decision making.

Safer use

Tips for drinking safely:

  1. Keep track of how much you’re drinking
    • Eat before you drink and avoid chugging your drinks or playing drinking games.
    • Decide how much alcohol you plan on drinking for the week and try to stick to it.
    • Have non-drinking days every week so that you can reduce your risk of developing a tolerance or dependence to alcohol.
  2. Stay Hydrated
    • Have water, juice or a soft drink in between your drinks. Having a glass of water for every glass of alcohol you drink can help ensure that you stay hydrated
  3. Snack
    • Make sure you eat before, and while you are drinking alcohol. This will lessen the side effects and nausea you may feel from drinking excessively.
  4. Plan for a safe way home or stay where you are
    • Driving while intoxicated is dangerous and punishable by law. An impaired driving offence can affect your potential for jobs and competitive academic opportunities.
  5. Avoid mixing alcohol with presciption medication, other drugs or energy drinks
    • Alcohol and other drugs contain many different chemicals and compounds that may interact negatively if combined.
  6. Stay in the company of trusted friends
    • That way, you won’t have to cope alone if something goes wrong.
  7. Drink slowly
    • Alternate drinks with water or other non-alcoholic beverages to avoid drinking too fast.
  8. Sex it smart
    • Alcohol lowers inhibitions making it easier to engage in potentially harmful actions such as unprotected sex. Consent is not possible if someone is intoxicated, so avoid hooking up if you or the person you are interested in have been drinking.

You can reduce your risk for developing long term health consequences by following Canada’s Lower-risk Alcohol Drinking Guidelines. This means drinking no more than 10 drinks a week for women, and 15 drinks a week for men. When counting your drinks, remember that a standard drink is different depending on what you are drinking. You can use the lines on a standard Red Solo cup to help you measure! Generally, one standard drink will be 1 ounce of liquor, 5 ounces of wine and 12 ounces of beer.

Cannabis

  • Cannabis is a plant that contains chemicals called cannabinoids, and the two main cannabinoids are THC and CBD.
  • THC is the psychoactive component of cannabis, it causes cognitive impairment. CBD is a non-psychoactive component in cannabis.
  • It is important to remember that reactions to cannabis differ for everyone.
  • Some of the possible short-term effects include sleepiness, impaired ability to remember, lack of concentration, anxiety, fear, panic, reduced coordination, reaction time, or decision-making abilities, and psychotic episodes.

Safer Use

Much like alcohol, researches have determined Canada’s Lower-risk Cannabis Use Guidelines that will help to minimize the risk of harms when using cannabis.

  1. Pace yourself, start low, and go slow
    • It takes seconds to minutes to feel the effects of smoking or vaping and 30 minutes to 2 hours to feel the effects of edibles. Start with a small amount and wait 30 minutes or more to feel the effects. Consider using strains that are lower in THC and contain CBD.
  2. Do not use synthetic Cannabinoids.
  3. Go easy on your lungs
    • Cannabis smoke has many of the same chemicals as tobacco smoke. Don’t hold the smoke in your lungs after you inhale; it only takes a few seconds for the smoke to reach your lungs to absorb the THC.
  4. Delay taking up Cannabis use until later in life
    • Using cannabis before the age of 25 is associated with changes to the developing brain’s structure and function, which leads to difficulty with memory concentration, intelligence, judgement, and decision making.
  5. Secure your stash
    • Keep cannabis products in their original packaging, somewhere out of reach and with a lock.
  6. Stick to one drug at a time
    • Using more than one drug at a time can lead to unpredictable changes in how you think, feel, and act. Leave tobacco out of the mix, too; tobacco contains nicotine that is also addictive.
  7. Plan a safe ride home
    • Cannabis impairs coordination, attention, judgement, and reaction times. Calling #TAXI in the Ottawa area connects you to the first available taxi service. If you have to drive, plan ahead. It is safest to wait 3-4 hours before driving.
  8. Share with care
    • Sharing joints, bongs or vapes means you may also be sharing germs and infections from your mouth and saliva. Avoid sharing or find ways to use without direct contact to your lips.
  9. Prevent burns on your lips or fingers
    • Use a small piece of rolled unbleached cardboard as a filter. Filters are often included with rolling papers now.
  10. Limit and reduce how often you use Cannabis
  11. When you use Cannabis, try to use safer consumption methods
    • Smoking from bongs, joints and pipes is the most harmful way to consume cannabis, consider using edibles or a dry herb vaporizor.

Cocaine and Other Stimulants

  • Cocaine is a psychoactive (mind-altering) drug that affects how we think and behave; it is a stimulant that speeds up our breathing, heart rate, thoughts and actions.
  • When cocaine is ingested, it travels to the brain, triggering an increase in naturally occurring chemicals associated with pleasure. Some people may experience intense pleasure, and others may also feel anxious or restless.
  • There are both short and long-term dangers of cocaine use, ranging from an overdose to organ failure.
  • Cocaine abuse constricts blood vessels, which causes an increase in unhealthy blood pressure.
  • Snorting cocaine can also cause severe damage to the nasal cavity and septum.
  • Other common stimulants include caffine, nicotine and amphetamines (meth, adderall, and vyvance).

Some factors that can influence how stimulants will affect us include:

  • Past experiences with the drug
  • Present mood and surroundings
  • Mental and physical health conditions

Safer Use

  1. Be prepared
    •  if you’re planning on snorting, have a clean straw to use and don’t share with others. Snorting warm water between bumps could also decrease the risk of nosebleed.
  2. Stay hydrated
    • Drink lots of water and take breaks in between bumps.
    • Your temperature can increase while on MDMA, leading to overheating and dehydration.
  3. Bring your own equipment
    • Such as a straw or post-it notes; this will help limit the spread of infection.
  4. Finely grind substance before use
    • To avoid damage to your nasal passage.
  5. Buy less so you use less
    • If you’re a first-time user, only take a quarter of the amount suggested. Test how you react to the drug by using a smaller dose. Since everyone’s body tolerates drugs differently, it is important to test how your body handles its effects.
  6. Be clear about why you want to use
    • It is important to not use these drugs as a way to avoid or cope with problems.
  7. Know your dealer
    • Since cocaine and other stimulants are illegal, it is hard to ensure you are getting the safest product, so make sure you choose someone you know and trust.
  8. Plan a safer environment
    •  Tell friends if you are planning on using to have people look out for you and make sure that your whole group has a safe way to get home.
  9. Only use in safe context
    • Making informed decisions about where and with whom we use MDMA helps minimize harms. Choose a safe, peaceful spot to hang out, knowing your trip will last several hours. Talk to your friend about things you can do if you have a bad trip.
  10. Start low, go slow
    • Start with half a pill. Swallow MDMA instead of snorting, and avoid using alcohol and other drugs.
  11. If you are having a bad trip
    • Go to a safe environment (if you’re not already in one) and play calming music
    • Surrender to the experience (rather than trying to control it
    • Try to relax
  12. If someone else is having a bad trip
    • Take them to a calm, safe environment.
    • Reassure them that you are their friend and that in time the experience will pass.
    • Help them relax.
    • Avoid combination drug use.

Hallucinogens

  • A Hallucinogen is a drug or chemical capable of producing hallucinations. A hallucination is a false perception through one of the senses (for example, seeing or hearing something that is not there).
  • Some examples of hallucinogens include DMT, LSD, MDMA, psilocybin (magic mushrooms) and THC.
  • Hallucinogens can also alter mood and perception amongst other brain processes.
  • Research suggests that hallucinogens work at least partially by temporarily disrupting communication between brain chemical systems throughout the brain and spinal cord. Some hallucinogens interfere with the action of the brain chemical serotonin, which regulates:
    • mood
    • sensory perception
    • sleep
    • hunger
    • body temperature
    • sexual behaviour
    • intestinal muscle control
    • pain perception
    • responses to the environment
    • emotion
    • learning and memory

Safer Use

Before you start

  1. Think about why you want to use
    • It is best not to use hallucinogens as a way of avoiding or coping with stressors.
  2. Know your dealer
    • It is best to choose a dealer you feel safe with and who knows about the substances they sell.
  3. Find a buddy
    • Using alone can mean coping by yourself if you get injured or have a bad trip.
  4. Plan your trip
    • Choose a safe, peaceful place to hang out, most trips last 8-12 hours. Talk to your friend about things you could do if you have a bad trip.

When you’re using

  1. Be sure you’re in the right frame of mind
    • Using hallucinogens can be fun, spiritual, or educational if you embrace the experience. It can also be scary, especially if you try to control the experience.
  2. Avoid bad experiences
    • Steer clear of climbing up on things, looking in the mirror, or having sex with anyone other than a comfortable, familiar partner. These activities can have unpleasant or unexpected results.
  3. Stick to one substance at a time
    • Using cannabis and alcohol while on hallucinogens can change your experience in unpredictable ways.
  4. Stay away from the steering wheel
    • Your judgement and coordination may be significantly impaired.
  5. Test it before you ingest it

Opioids

Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Examples of opioids include Morphine, Codeine, Oxycodone, and Fentanyl.

When opioids travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure.

What makes opioid medications effective for treating pain can also make them dangerous.

At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death. The feelings of pleasure that result from taking opioids and the rapid pace that a tolerance is developed combine to increase the risk of dependence and accidental overdose.

Across Canada, including Ottawa, there has been an increase in overdoses and overdose deaths related to opioids. Locally,there have been examples of fentanyl being added to counterfeit prescription medications, and to other drugs such as cocaine, speed, and ecstasy/MDMA.

If you choose to use illicit drugs or counterfeit prescription medication, inform yourself of the risks and learn how to reduce your risk. This information could save your life, or the life of someone you know.

It’s important to know:

  • Fentanyl is 50 to 100 times more toxic than the basic opioid, morphine.
    It only takes an extremely small amount of the powder form to kill someone (as little as the equivalent of 2 grains of salt).
  • Fentanyl is in counterfeit pills that look identical to prescription opioids (OxyContin, Percocet).
  • You can’t see, smell, or taste fentanyl.
  • Carry Naloxone – it’s a medication that can reverse an overdose for a few minutes. For more information about how to sign up for Naloxone training or Carleton’s overdose prevention strategy, please visit our Supports and Resources page, under the Naloxone tab.

Safer Use

Injecting is the riskiest way to use drugs. Some of the risks are related to using needles. Other risks are associated with the type of drugs that go in the needles. There are things you can do to reduce those risks.

Before you start

  1. Know your dealer
    • It’s best to choose someone you feel safe with and who knows about the drugs they sell.
  2. Find a buddy
    • Using alone means no one will be there to help you if you overdose.
  3. Find a safe, quiet place
    • Being relaxed and not in a hurry can make injecting easier and, therefore, safer.
  4. Clean your hands and the injection site for intravenous use
    • Use soap and water to wash your hands and wipe the injection site with an alcohol swab; this will help prevent germs from going into your blood.

If you’re curshing and adding water to your substance

  1. Use a sterile, disposable cooker or spoon to mix and heat the drug
    • Avoid re-using and sharing cookers since this can lead to contamination and infection.
  2. Use as small an amount as possible of acidic solution
    • It is best to use vitamin C packs (VIT-C), avoid using lemon juice and vinegar because they damage veins.
  3. Use a clean, capped needle for mixing and dissolving
    • Uncapped needle tips can be damaged if used for mixing.

If you’re injecting

  1. Plump up the vien with a warm compress
    • Heat makes it easier to see and use a vein.
  2. Use a tie that you can undo quickly and easily
    • Use a non-latex tourniquet. Pump up the vein by opening and closing a fist.
  3. Use a clean filter
    • Dental cotton is best. Avoid using cigarette filters. Use one per needle and do not share it with others.
  4. Use a new sterile needle each time
    • Used needles may be dull, making them hard and painful to use. Avoid infection and disease by not sharing needles.
  5. Start with a small amount if you’re not sure how strong it is
    • This can help reduce your risk of overdose.
  6. Start with viens closest to the wrist and work your way up
    • This way, if the bottom part of the vein collapses, you can still use the upper part.
  7. Insert the needle with bevel (hole) pointing up
    • This helps with flow and reduces the risk of vein damage.
  8. Aim in the direction of blood flow
    • Go towards the heart.
  9. Flag the needle
    • Push plunger in a little and then pull back until you see blood in the needle. This way, you know your needle is in the vein correctly.
  10. Release tie and inject slowly
    • This allows easy flow into the body.
  11. Add pressure to the injection site.
    • This prevents bleeding and bruising.
  12. Dispose of needles safely
    • It is best to put it in a container with a lid.

Risky Behaviours

Some non-substance use related behaviors can stimulate the dopamine reward pathway in our brain and cause unhealthy attachment or dependance.

Social Media

Social media is any digital platform that allows users to create and share content with the public quickly. Social media encompasses a wide range of websites and apps.

Some popular social media sites like Twitter and Facebook specialize in sharing links and short written messages, while other social media platforms like Instagram, TikTok, and Snapchat are built to optimize the sharing of photos and videos.

Social Media can impact our mental health, and 96% of post-secondary students are on some form of social media.

How does using social media affect us?

  • By being constantly distracted & losing productivity (leading frustration seen with social media users)
  • Sedentary
    • We are not typically moving around when on social media; instead, we are displacing things that we know will lead to better mental health, i.e. being out in nature, engaging with communities, exercising).
  • Lonely
    • As a society, we are supposed to be more connected than we have ever been, but we are reporting higher levels of loneliness than we’ve ever felt (before COVID), and these feelings of loneliness are amplified under COVID restrictions that have created a whole new layer of loneliness.
  • Anxiety & depression
  • Fear of missing out (FOMO)
  • Addiction (psychological-dopamine & physical-habitual)

Safer Use #SAFESOCIAL

  1. Building awareness and understanding
  2. Modify your consumption
  3. Build offline soft skills
    • Self-awareness
    • Self-confidence
    • Resilience
    • Time management
    • Mindfulness
  4. Model good behaviour and lead by example
  5. Hold responsible parties accountable for what they share

Sex

By way of a definition, a “sex disorder” is described as a compulsive need to perform sexual acts to stimulate the brain’s reward system, much like substances can, leading to addiction.

A person may have a sex addiction if they show some or all of the following signs:

  • chronic, obsessive sexual thoughts and fantasies
  • compulsive relations with multiple partners, including strangers
  • lying to cover behaviours
  • preoccupation with having sex, even when it interferes with daily life, productivity, work performance, and so on
  • inability to stop or control the behaviours
  • putting onself or others in danger due to sexual behaviour
  • feeling remorse or guilt after sex
  • experiencing other negative personal or professional consequences

It’s important to remember that enjoying sexual activity is not a sign of sex addiction. Sex is a healthy human activity and enjoying it is normal. For more information on health sexual relationship, please visit our Sexual Health page.

Gaming

A gaming disorder is defined as the compulsive use of video games that significantly impair an individual’s ability to function, despite the toll it may take.

People with gaming disorder have trouble controlling the amount of time they spend playing digital games. They also prioritize gaming over other activities and experience negative effects from their gaming behaviours.

A person who has gaming disorder will show the following characteristics for at least 12 months:

  • lacking control over their gaming habits
  • prioritizing gaming over other interests and activities
  • continuing gaming despite its negative consequences to:
    • family life
    • social life
    • personal life
    • education
    • work

Gambling

Compulsive gambling, also called gambling disorder, is the uncontrollable urge to keep gambling despite the toll it takes on your life. Gambling means that you’re willing to risk something you value in the hope of attaining something of even greater value.

Gambling can stimulate the brain’s reward system, much like substances can, leading to addiction.

Signs and Symptoms of Compulsive Gambling (Gambling Disorder)

  • Procupation with gambling, such as always planning how to get more gambling money
  • Needing to gamble with increasing amounts of money to get the same thrill
  • trying to control, cut back or stop gambling without success
  • Feeling restless or irritable when you try to cut down on gambling
  • Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or depression
  • Trying to get back lost money by gambling more (chasing losses)
  • Lying to family memebers or others to hide the extent of your gambling
  • Jeopardizing or losing meaningful relationships, a job, or school or work opportunities because of gambling
  • Resorting to theft or fraud to get gambling money

For more information on gambling risks and how to gamble responsibly, please visit the Responsible Gaming Council.

Risk Factors Associated with Compulsive Gambling

  • Mental health disorders
    • People who gamble compulsively often have substance use disorders, personality disorders, depression or anxiety. Compulsive gambling may also be associated with bipolar disorder, obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD).
  • Age
    • Compulsive gambling is more common in younger and middle-aged people.
  • Family or friend influence
    • If your family members or friends have a gambling problem, the chances are greater that you will, too.

If you are looking for additional information please visit the Ottawa Public Health, The Link webpage.

To answer questions or assist you further, please contact the Manager of Student Conduct and Harm Reduction, Dillon Brady.