Harm Reduction Advice for Heroin/Opioid Users on Avoiding COVID19

The following guidelines were developed by Russell Newcombe and Cheryl White (of 3D Research: russell.3dresearch@gmail.com) for dissemination among the global community.

1) Wash your hands with soap for at least 20 seconds every time you come into contact with others and after handling money and drugs packages

2) Despite social distancing advice, new users and those who inject should avoid using opiates alone. The risk of overdose is greater than the risk of coronavirus. Try to have naloxone and teach others to use it

3)  Check with your regular services - including treatment provider, pharmacist and drugs programs - to see if they are changing how they operate.  For instance, ask if larger supplies of methadone or drug using equipment are being made available

4)  Ensure that you have up-to-date contact details for drug dealers and for your opioid-using friends

5)  Prepare your own drugs – don’t let others touch your drugs or equipment and vice-versa

6)  Prepare for involuntary withdrawal – stock up on any opioids you can get to help you taper off, as well as products that relieve withdrawal symptoms

7)  Heroin smokers need to be aware COVID19 can make it difficult or painful to inhale smoke or vapour. If you become unable to smoke heroin and you don't inject, this leaves 3 options:

  • snort it:  chop the powder finely and sniff it up your nose slowly using a tube
     
  • UYB: dissolve brown heroin with citric or ascorbic acid, and draw it into a syringe - with no needle - and slowly squirt it Up Your Bum into your rectum
     
  • swallow it:  this means the heroin will go via your liver before it reaches your brain, resulting in a morphine-like effect - but it also stops withdrawals