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Substance Use

This is the section where we talk about drugs and alcohol. We call it “substance use awareness”. So then, what exactly do we mean by “substance”? Basically a substance is anything that we put into our bodies that changes the way we feel, think, or act.

A few examples of some legal substances are:

  • Caffeine (the most used substance in the world!)
  • Tylenol/Aspirin
  • Alcohol (if you’re over 18)

A few examples of some illegal substances are:

  • Cannabis
  • Cocaine
  • Magic Mushrooms

The safest we can be when it comes to substances is to not use them. We also know that not everyone can, or wants to make that choice all the time. If people are using, it’s important to have accurate information to help reduce the amount of harm that could happen. Even if we aren’t using, this is good info to know because you may find yourself in a position where you can help someone else. Most substances can be classified into one of four categories based on how they work in our bodies. Check out each section to learn more: Downers, Uppers, Cannabis, Hallucinogens and Additional Info

Downers

Some examples of downers are alcohol, sleeping pills, heroin, rohypnol, opium, and anti-anxiety prescriptions (benzos). Downers also include pain-killers such as Tylenol, Advil,  oxycodone, fentanyl, codeine, and morphine.

Why might someone use?
Downers are depressants which means they slow down the body. Someone might take these to reduce tension, anxiety or aggression.  They may use downers to have fun, out of curiosity or boredom. Downers may create a feeling of calm or help a person relax. They can also numb physical or emotional pain. In small doses alcohol can make someone feel energetic and happy (as if it were an upper).
What are the risks?
Downers are called depressants because they slow down our central nervous system which means they can sometimes block messages from getting to our brain. Alcohol can change the things we do and what we think of as safe or unsafe by lowering inhibitions and impairing judgement. Often the greatest risks come from the things people do while drunk.

The more alcohol someone consumes, the more they may find themselves feeling  sad or angry, uncoordinated and slowed down. If someone drinks more than their body can handle they get what’s called alcohol poisoning. Signs of alcohol poisoning are vomiting, clammy skin, shallow breathing or passing out. Consuming amounts quickly, like chugging, puts us at a higher risk of alcohol poisoning and overdose. To much of any downer can result in an overdose which can lead to a coma or death. The body can slow down too much and a person’s heartbeat or breathing can stop.

Alcohol use while pregnant may harm a fetus and put it at risk of  Fetal Alcohol Spectrum Disorder (FASD). Project CHOICES is a free program for young women who are sexually active and drink alcohol. They won’t ask you to change your lifestyle; but can give you the information you need to make the best choices for your health.

How can I be safer?

  • Plan a safe way home (designated driver, know the bus route including last bus home, have a secret cab or bus fare stash,  sleep over, or walk with a friend etc.)
  • Find a safe place to pass out (and have someone check on you)
  • Watch your drink at all times and don’t put stuff in other people’s drinks
  • Know your limits and pace yourself (if 6 beers gets your falling down drunk, maybe only bring 2 or 3 beers)
  • Drink water between alcohol drinks
  • Use a buddy system
  • Know the recovery position
  • Carry condoms if you think sex might happen. If not, you can always give them away to friends.
  • Think about using birth control. Talk to your health care provider, or (in Winnipeg) visit Project CHOICES. It’s a free program where you can get non-judgmental support and information about using alcohol and birth control, and making the best choice for you.

 

Understand consent and use it every time. People sometimes make different choices after using drugs or alcohol than they would usually make; we call this being under the influence. This is also means that getting someone’s consent when they are under the influence isn’t truly consent. The only way to know for sure if they are into hooking up is to wait until later when you’re both sober. Getting someone drunk or high in order to have sex with them is assault.

During a pregnancy it is best to avoid drinking or reduce use as much as possible. Alcohol use while pregnant may harm a fetus and put it at risk of  Fetal Alcohol Spectrum Disorder (FASD). Because of addiction, coping/trauma or lack of information people might use during a pregnancy. It’s helpful to support someone during a pregnancy and not shame or judge them for using.

Uppers

Some examples of uppers are cocaine, crack, nicotine, tobacco, amphetamines (speed), crystal meth, Ritalin, caffeine and energy drinks. Ecstasy (E) and MDMA (Molly) can be considered both an upper and a hallucinogen.

Why might someone use?
Uppers are stimulants that work by increasing dopamine levels in the brain. This can make someone feel alert, happy, excited or “high”. Because of this someone might use uppers for fun, to stay awake or for coping.  Uppers can also increase pain tolerance.
What are the risks?
With all uppers there’s a crash at some point. When someone crashes they may feel depressed. upset, mad or really tired. This might make someone take more however they will not reach the same level of “high”. It’s this crash/use cycle that can make uppers so addictive. If someone uses too much of an upper (especially cocaine or amphetamines) they can overdose by having a heart attack. With uppers there is also a risk of nausea, headaches, racing heart, anxiety, mood swings, paranoia, severe depression or violent behaviour.
How Can I Be Safer?

  • Start with a low dose to see how your body responds
  • Take a break between uses to avoid dependence and to give your brain chemistry time to recover
  • Try to buy from someone you know
  • Use a buddy system
  • Don’t share equipment such as straws, bills, water, needles etc. HIV and Hepatise C can be transmitted through sharing equipment.
  • If injecting drugs
    • Rotate injection sites
    • Use new needles every time
    • Get new needles from Street Connections
    • Safely dispose of used needles

Cannabis/Marijuana

Marijuana is the dried buds of the Cannabis plant. It can be smoked, eaten or vaporized and has many nicknames including weed, pot or kush. It can also be processed into a paste (Hash) or an oil (Hash Oil).

Why might someone use?
Cannabis can make someone feel relaxed, confident, have a sense of well-being or a slowed sense of time. Some people may use cannabis for medical purposes, however in Canada it is only legal with a prescription from a doctor.
What are the risks?
Cannabis includes chemicals called cannabinoids. The most prominent cannabinoid is called THC (tetrahydrocannabinol). It can be hard to predict what the effect of a particular batch of cannabis will be because the levels of THC and other cannabinoids will vary. Some people may experience panic, paranoia, anxiety or memory problems. Someone might “Green out” which is when someone feels sick after using cannabis. Greening out is not fatal, but someone may feel sweaty, dizzy (the spins), nauseous, go pale and may even start vomiting. Smoking cannabis can increase the risk of lung damage.

Cannabis distorts thinking. People may think they are driving fine when they are high even though they are not due to effects like slower reaction time, distorted perceptions of time and distance, decreased alertness and increased drowsiness.    

How Can I Be Safer?

  • Eating or vaporizing cannabis instead of smoking it may help to prevent the negative effects on lungs
  • If smoking, use a water pipe instead of a dry pipe or joint to reduce the risk of lung damage
  • Wait to feel the full effects. The dosage can make a big difference between getting the desired effects and getting anxious
  • The effects or eating cannabis can be stronger than smoking and will take a longer time to kick in so it’s important to pace yourself and allow more time for the high to get going before eating more
  • If using an unfamiliar batch start with a smaller amount to know the effects

Hallucinogens

Includes Magic Mushrooms, LSD (acid), peyote, mescaline and salvia. Ecstasy (E) and MDMA (Molly) are both a hallucinogen and an upper. Inhalants are in this category because of their mind-altering (psychoactive) effects.

Why might someone use?
Hallucinogens change the way people think, see or hear things; we call these sensory changes. Someone might have feelings of openness, euphoria or increased energy. With inhalants someone might also feel light-headed, dizzy and lose inhibitions. A person may use hallucinogens for the experience, for fun or for coping. Some cultures use hallucinogens for ceremonial purposes to obtain information, knowledge or purpose and this is typically guided by a medicine person in a controlled manner.  
What are the risks?
With hallucinogens bad trips can happen. A bad trip is when someone may feel fear, panic or even terror. Other effects may include an upset stomach, big pupils and confusion which has led to accidental injuries and death. Hallucinogens may cause lasting perception changes (streaking/tracers) or flashbacks. Flashbacks are spontaneous recurrences of some of the sensory changes that originally took place when the hallucinogen was used. These effects may last for years. There is also a risk of Persistent Psychosis which may include lasting mood changes ranging from mania to severe depression as well as ongoing hallucinations.

The effects of inhalants can be unpredictable and it is possible to die from a chemical overdose the first time using. This can happen from someone passing out or from sudden sniffing death where the heart stops. Using inhalants may cause permanent brain damage. Other side effects may include feeling irritable, memory loss, loss of hearing and sense of smell or permanent changes in personality. People using inhalants are often judged negatively compared to people using other substances. This can make it harder for someone to get help if they feel their use is becoming problematic.  

How Can I Be Safer?

Mushrooms and LSD

  • Know your mood before using because it may effect whether you have a bad trip or not. If you’re not feeling good or are having a bad day it may not be the right time to use
  • Try to use with people and a in space that is comfortable for you
  • If having a bad trip, try and go to a place that is quiet and ideally with a person who can “talk you down”

Ecstasy and MDMA/Molly

  • Drink water to avoid dehydration
  • Be aware that molly doesn’t necessarily mean you are getting pure MDMA even if it is powdered and not pressed
  • Start with a lower dose
  • If dancing, take breaks to reduce your heart rate

Inhalants

Overdose with inhalants can be random and harder to prevent than with other substances. To try and reduce your risk with inhalants:

  • Avoid spraying directly into your mouth
  • Try not to light a match or lighter because inhalants are highly flammable
  • Use in an open space rather than in a confined space

Additional Info

Mixing Substances
Mixing substances is the number one cause of an overdose. This is because downers and uppers have opposite effects on the body which could lead to someone taking a lot more then their body can handle. The body’s default response to too much of a downer is to pass out, however an upper may prevent this from happening. If someone consumes more of a downer without passing out it may lead to an overdose.  If choosing to mix substances it is important to have someone with you in case you need help.
Prescription Drugs
Prescription drugs may be harmful when they are not being used for their intended purpose or not yours in the first place. It can be a lot more complicated to stay safe with prescription drugs because it is hard to know what class of drug (upper, downer or both) you are taking and what dosage the pill is. Pill size does not tell us the pill’s strength so we may not know how much to take for a desired effect versus a harmful effect. Starting with a small dose and not mixing with other substances may help reduce your risks and don’t be afraid to ask questions and get information before using.

If taking medication prescribed to you, talk to your health care provider about the effects of using other substance while on the meds. No matter what the substance is you have the right to accurate information and support.

The Recovery Position
If someone is passed out at a party, it is important to put them into the recovery position. This can help keep them safe and stop them from choking on their own vomit (puke). Check out this picture that shows how it works:

recover position website

 

These steps break it down for you, but it’s important to use your own judgment and make sure to keep the person safe. You might think there’s a chance you’ll get in trouble if you call 911, but if your friend is passed out and not responding, then they could be in trouble. The paramedics don’t care about the party, they only care about keeping your friend safe. And what’s more important in the end? Not getting in trouble or possibly saving your friend’s life?

 

Problematic Use
When it comes to substances there can be varying levels of use ranging from not using at all to someone who is using to the point where it is a problem for them. Problematic use is essentially where someone continues to use a substance even though it is negatively impacting their life. Some of the warning signs that someone’s use has become a problem could be:

  • Conflicts in relationships
  • Missing school or maybe getting kicked out
  • Other people are concerned about their use
  • Using when they’d rather not be
  • Hiding their use from other people or feeling embarrassed
  • Trying to cut down unsuccessfully several times
  • Stealing money to buy substances
  • Giving up activities they used to like
  • Hanging out with people who are also using

 

It can be difficult to have a friend or family member who is using substances, but ultimately they need to decide for themselves if they have a problem or need help. When people are judged for using substances they are less likely to get help. If we want to support someone who may have a problem the helpful thing to do are to not judge them and let them know we are there for them.

If you are concerned about your use it’s important to find support. You could talk with a guidance counsellor, teacher, family member, elder, etc.; essentially someone you trust. Addictions Foundation of Manitoba is a great resource that people can call if they need to talk. They are free to call from anywhere in Manitoba. Their phone number is 1-888-383-2776 or 204-944-6235. You can also check out our Resources page for more supports and info.

Questions About Substance Use

What's the most dangerous drug?
We can’t really say what the most dangerous drug is because it really depends on the person. There can be a lot of different things that influence if a substance is higher risk or lower risk for someone. Family history, access to healthcare, coping skills and supports in our life are just some of the things that influence our personal levels of risk.  For example, if alcoholism is in a person’s family then this might make getting wasted every weekend more risky. If someone is using meth but has a good support system and knows where to get new drug gear then it may be less risky for them. This also means that if a friend says they had a great time with a substance it does not automatically mean we are going to have a good time too. It’s important to have accurate information on substances, but also important to know ourselves and what the risks may be to us in particular.
How can I cut down on my use?
The more interesting and fun things you have in your life, the easier it will be to cut down on substance use. When choosing other activities to do make sure they are things you enjoy or find stimulating (for a natural high). For some people this could be exercise (like riding your bike or going for a run) as it stimulates and releases adrenaline in our bodies and give us that natural high. For others, instead of using to relax they could pick another chill activity like listening to music, a hot bath or watching TV. Just remember to do something that will replace using, not make you want to use. For instance if you only play video games when you’re smoking weed, choosing a different activity might work better. It is also worth remembering that if you’ve have been using for a while, it can take some time to adjust to being sober.

It can be hard to cut down use on our own. Getting support from someone you trust can help you adjust to being sober. This could be an addictions counsellor, teacher, family member, elder, etc.. Addictions Foundation of Manitoba is a great resource that people can call if they need to talk. They are free to call from anywhere in Manitoba. Their phone number is 1-888-383-2776 or 204-944-6235. You can also check out our Resources page for more supports and info.

Where can someone get new gear in Winnipeg?
 If someone is choosing to use substances that use drug gear, such as needles, it is important that they use new equipment and do not share.  This is because of the risk of infection including HIV and Hepatitis C. In Winnipeg there is a mobile van service called Street Connections ( 204-981-0742) that offers free, safe needle and glass pipe exchanges.  It’s staffed by nurses and outreach workers who also provide free condoms, and on the spot STI tests and the HIV rapid test. The Street Connections van drives around the city every evening except Sunday. You can also find them during the day from Monday to Friday on the main floor of 496 Hargrave St.
I want to hang out with my friends, but they want me to drink. What can I do?
It’s not always easy to be around other people who are drinking when we don’t want to. A lot of times there can be pressure to join in or we may feel singled out.  Some ways you can respond to others trying to pressure you are:

  • No thanks, I’m driving
  • I’ve got a big test/game tomorrow
  • I just don’t want to
  • I’m hung over from yesterday
  • Nah, I’m cutting down, thanks though!
  • I’m working early tomorrow morning
  • Whatever! Someone needs to stay sober to watch out for you!

We know sometimes words are not enough. Sometimes it’s easier to appear to be drinking instead. You could walk around with a beer bottle filled with water, or drink a pop but tell people that it’s mixed with alcohol.

I'm pregnant. What happens to my baby if I drink?

Drinking alcohol while pregnant may cause Fetal Alcohol Spectrum Disorder (FASD). There is no known safe amount of alcohol that can be used while pregnant. The more alcohol someone who is pregnant drinks, and the more often they drink, the greater the chance of harm to the fetus. If you are pregnant the safest thing for the fetus is to stop drinking. For some people giving up drinking when they find out they are pregnant is simple. But quitting or cutting down may not be as easy for everyone. Even if you can’t quit, drinking less can help reduce your risk for FASD.

If you are deciding to continue a pregnancy and are struggling with drinking you can get help and support to have the healthiest pregnancy possible. Talk with someone you trust like a family member, counsellor, someone at a health centre, elder or the Teen Clinic.

If you are in Winnipeg, check out the Mothering Project at Mount Carmel Clinic. They offer non-judgmental prenatal care and support for people who are pregnant and drinking.

From anywhere in Canada you can call the Motherrisk Alcohol and Substance phone line for more information and support during a pregnancy, 1-877-327-4636.

I'm worried about how much my friend/partner/family member is using?
Having someone in our life who is struggling with substance use can be pretty tough.  If we want to support someone who may have a problem it’s important to not judge them. By judging that person you won’t stop the behavior because when someone feels judged for using a substance they are less likely to get help. Ultimately it is up to them to decide if their use is a problem or if they need help. A helpful thing to do is to let them know you care about them and that you are there for them. You can also hook them up with good information to stay safer or an addictions counselor if they are ready to take that step.

The other thing that is really important is to get your own help, because supporting someone with problematic use can be pretty stressful and upsetting at times.  The Klinic Crisis Line is available 24/7  and is free to call from anywhere in Manitoba. Their number is  1-888-322-3019 or (204) 786-8686.