The Meth Booklet

A harm reduction guide for people who use

methamphetamine.

Researched and compiled by ANKORS

in Nelson, BC.
 ABOUT THIS BOOKLET
This booklet is intended for people who use methamphetamine. It
combines scientific research, harm reduction techniques, and ad-
vice provided by meth users themselves to help people make safer
choices around their drug use. Through harm reduction we meet
people where they are at without judgement, providing information
and resources to help reduce the harm associated with inherently
risky activities.

ACKNOWLEDGEMENTS
ANKORS would like to thank the people in our community who
openly shared their experiences and knowledge about the highs
and lows of methamphetamine use. The information contained here
would not be possible without their valuable input.

We would also like to acknowledge the following researchers, or-

ganizations, and online resources whose work we pooled in writing
this booklet: Dr. Carl Hart (Columbia University), CATIE, Waterloo
Region Integrated Drug Strategy, Tweaker.Org, The Drug Classroom,
The Drug Policy Alliance, Toronto Vibe, ACT Toronto, and Erowid.

Finally, ANKORS respectfully acknowledges the Sinixt, Ktunaxa,

and Syilx First Nations on whose traditional territories we work and
reside.

Text: Robert E. Livingood with Chemsex section by Joe Reiner

Illustrations: Rebecca Pauline unless marked * Stephanie Kellett
Layout and Design: Stephanie Kellett

WARNING
Methamphetamine use can pose serious, life threatening
health risks. Even while practicing the harm reduction
techniques outlined in this booklet, one still runs the
risk of contracting or transmitting blood borne infec-
tions such as HIV or Hepatitis C, as well as having a fatal
overdose.
 TABLE of CONTENTS

Meth 101 . . . 1

History in Brief . . . 3

Ways People Use . . . 4

Reducing Meth’s Harm . . . 9

Where Are You At? . . . 14

Meth Psychosis . . . 16

The Crash . . . 19

Overdose . . . 21

Treatment/Taking a Break . . . 22

Sex & Meth . . . 25

Links for Further Reading . . . 29

About ANKORS . . . 30
 METH 101
Methamphetamine is closely related to amphetamine. Amphet-
amines are classified as stimulant drugs. Stimulants amp central
nervous system activity, increasing your heart rate and making your
blood pressure go up. Meth crosses the blood/brain barrier faster
than amphetamine, triggering a massive flood of dopamine, the
brain’s “feel good” chemical. The result is an intense high that can
last up to 8 hours (or more) depending upon a person’s tolerance.

STREET NAMES

Side, Meth, Crystal Meth, Speed, Jib, Ice,

Chris, Crank, Tweek, Glass, Crystal, Crissy, Tina

APPEARANCE

Side usually comes in crystal form but can also be a powder. The
powder is white, beige, orange, pink, and variations in between. As
crystal it is often clear to white, but sometimes blue/green and looks
like pieces of crushed ice.

Meth has a bitter, chemical taste, sometimes a strong smell, but you
can’t depend on smell or taste to determine purity.

*Always get drugs tested at your local harm reduction organization

to find out what’s in them! Carry Naloxone and know how to use it!

INGREDIENTS

Meth is a synthetic drug. Ephedrine and pseudoephedrine are main

ingredients. Common chemicals used in the meth making process
also include: hydroidic acid, red phosphorus, iodine, benzene, ethyl
ether, acetone, and lye.

Some of these are toxic and known carcinogens.

LEGALITY

Meth is a Schedule 1 drug in Canada. It carries a maximum penalty

1
of seven years for possession. The maximum penalty for trafficking,
producing, importing/exporting, or possession for the purpose of
export is life imprisonment.

In the US, meth is a Schedule II drug and is only legal with a doc-
tor’s prescription.

THE HIGH

On meth your pupils open wide, you feel alert, euphoric, and
focused. You have increased energy, can become more talkative, or
sometimes very introspective and self interested. Your temperature
rises, digestion slows, and your appetite lowers. Meth users report
feeling a strong sense of confidence on speed and may become
super sexually aroused.

For certain people, especially with severe ADHD, side can mellow
them out.

RISKS

Doing meth can result in serious health risks that include:

*Death *Overdose *Dependency
*Heart Problems *High Blood Pressure
*Sores (from picking/scratching) *Dental Issues
*Paranoia *Blood Borne Infections
*Anxiety *Psychosis *Insomnia
*HIV (from sharing gear) *Hepatitis C
*Sexually Transmitted Infections (from having unprotected sex)

MOLECULAR STRUCTURE of METHAMPHETAMINE

2
 HISTORY IN BRIEF
Methamphetamine was first
synthesized in Japan during
1893. It was originally derived
from ephedrine-a chemical found
within the plant Ephedra sinica.
Both methamphetamine and
amphetamine were widely dis-
tributed to Japanese, German, and
US troops during World War II
to keep soldiers focused, awake,
and alert for combat. Throughout
the 1930s-60s, methamphetamine
was prescribed around the world
for fatigue, attention deficit,
weight loss, and depression. It
was also widely used by artists
in the 50’s and 60s-most notably
within Jack Kerouac’s Beat writer’s
scene. Ephedra sinica

In 1971 the US government severely tightened regulations around

the drug’s legal production and distribution. Biker gangs controlled
the illegal speed trade throughout the 70s. They called it “crank” in
reference to the crankcases of their motorcycles where the drug was
hidden.

Backyard meth labs emerged in the mid 80s and 90s. These enabled
“cooks” to make crystal meth with over the counter pharmaceuticals
such as ephedrine and pseudoephedrine, as well as industrial chem-
icals found in hardware stores. Further government crackdowns on
the precursor chemicals necessary to make speed resulted in pro-
duction shifting from the US to Mexico where the raw ingredients
are easier to obtain.

Despite methamphetamine being one of the most widely used drugs

worldwide, the people who use it are some of the most stigmatized.

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 WAYS PEOPLE USE
People use meth in different ways. These are referred to as “routes of
administration.”

Routes include:
1) Swallowing 2) Booty bumping (or hooping)
3) Snorting 4) Smoking
5) Hot railing 6) Injecting

Each route influences the onset, duration, and intensity of the high,
and impacts the body in specific ways. It is a good idea to regularly
switch the route of administration to decrease the harms of repeat-
edly using in the same way. So if you usually inject meth, periodi-
cally give your veins a break and try smoking. If you usually smoke,
change the route and go to swallowing for a while so your lungs can
recover.

*If possible, avoid injecting as this is the most dangerous route.

1) SWALLOWING

Swallowing meth is considered the least harmful way to use. A gel

cap (available at natural food stores) is filled with a dose that has
been crushed into powder. The powder can be mixed with juice,
coffee (trucker coffee), or wrapped in tissue paper (parachute) for
swallowing. The come-on is slower than with snorting, smoking, or
injecting, and the rush isn’t as strong, but the high lasts the longest.
Swallowing is considered a “less addictive” route because the brain
doesn’t make the association of getting an instant reward like it does
with smoking or injecting.

Onset: 20-45 minutes

Risks: Nausea, stomach pain, vomiting. Damage to the stomach

lining may occur with prolonged use. People with ulcers or digestive
issues might experience problems with this route. Some users report
that even though the immediate rush isn’t so intense, the high is very
strong. This can be overwhelming if you aren’t expecting it.
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Harm Reduction: If you experience stomach pain or nausea, consid-
er switching your route, taking a break, or stopping altogether. For
someone new to swallowing, it might be tricky to gauge how high
you will get until it hits you. Start with a lower dose and see how it
affects you.

2) BOOTY BUMPING (Hooping)

Booty bumping is taking meth up the butt. This route comes on fast-
er than swallowing. People do it by mixing meth with water, draw-
ing the liquid up into a 3ml or 5ml syringe barrel without a needle,
then squirting the liquefied dose into the anus. Another way is to
put powdered speed on a finger, insert it, then dab the rectal lining
(dabbing). Others insert a shard of crystal into their anus. The blood
vessels that line the rectum absorb the drug quickly.

Onset: 3-5 minutes

Risks: Crystal meth is abrasive. Inserting it into the anus can cause
tiny cuts in the rectum. This increases the risk of contracting or trans-
mitting HIV, hepatitis C, as well as other blood borne infections,
especially for those having anal sex. Even with a condom, it is still
risky to have anal sex after booty bumping since the abrasive pow-
der or pieces of crystal can tear the condom. Regular booty bump-
ing may also cause hemorrhoids, rectal bleeding, and damage to
the mucous membranes of the rectum. Fecal matter on fingers can
transmit parasites, hepatitis A, and other infections.

Harm Reduction: Use your own syringe barrel (without the needle)
for booty bumping. Don’t share gear. Use lube on syringe or on
finger to reduce the risk of tearing rectal lining. Consider not hav-
ing anal right after booty bumping. If you do, wear a condom but
remember abrasive crystals can rip the condom’s thin latex. Wash
your hands before and after. If you can’t, use hand sanitizer.

3) SNORTING
Speed is crushed into a powder then snorted into nostril through
a straw, a rolled dollar bill ($5, $10, $20), or off the back of your
hand. The come on is fast and the rush is intense.

5
Onset: 3-5 minutes

Risks: Damage to the nasal passages, sinus infections, congestion,

nose bleeds, contracting or transmitting HIV, hepatitis C, and other
blood borne infections from sharing snorting gear. Dollar bills are
covered in germs which can also cause infections.

Harm Reduction: Don’t share snorting gear. Use your own straw or
put a bump on the back of your hand to snort. If you must share a
straw, clean before using with an alcohol pad. Crush meth into a
fine powder to cut down on abrasive damage to the sinuses. Al-
ternate nostrils to reduce sinus damage. A saline nasal spray can
be used to keep sinuses moisturized if they are dry and scabbing.
Steaming with water and clove oil can help sooth irritated nasal
passages.

4) HOT RAILING
Inhaling vaporized speed through the nose with a bent glass tube.
One end of a bent glass tube is heated red hot; the hot end is placed
over a line of powdered speed. The hot end vaporizes the drug
which is then inhaled into the nostril through the cool end of the
tube. The come on is fast and the high is intense.
Onset: 5-10 Seconds

Risks: Damage to nasal passages and lungs, burns from the hot end
of the tube, transmitting or contracting HIV, hepatitis C, and other
infections from sharing gear.

Harm Reduction: Don’t share hot railing gear. Use your own glass
tube every time. If you must share, clean the tube with an alcohol
swab. Alternate nostrils to reduce damage. Saline nasal spray can be
used to keep sinuses moisturized. Use a hot water steam with clove
oil to help treat dried out or infected sinuses (be careful not to get
clove oil in your eyes).

5) SMOKING
Meth is placed into a bubble pipe, heated with a lighter, then vapor
is inhaled through the mouth. Smokers generally use more meth

6
than people who snort or swallow.
Onset: 5-10 Seconds

Risks: HIV, hepatitis C, and other blood born infections if pipes

are shared. Burns to the lips and fingers from hot pipes. Viruses are
passed through cuts, blisters, burns, or sores on the lips or in the
mouth from one user to another. Smoke of any kind will cause dam-
age to the lungs.

Harm Reduction: Always use your own smoking gear. If you can’t,
use your own rubber mouth-piece. If you don’t have a mouth-piece,
at least use an alcohol swab to clean off smoking gear before plac-
ing it to your lips. If you are a heavy smoker, consider switching to
swallowing for a while, or take a break.

6) INJECTING/SLAMMING
Injecting is he riskiest way to use meth.
A dose is crushed, mixed with sterile water in a spoon, cooker, or
the syringe barrel itself, then injected into a vein. Evidence suggests
shooting meth is more addictive than other routes. The high is very
quick and intense, but it doesn’t last as long as with smoking or
swallowing. People who inject tend to do more speed more often.
Tolerance builds quickly with injecting. The crash after slamming
can be extremely hard.
Onset: 15-30 seconds

Risks: Injecting opens a direct path from the outside into the blood
stream. Viruses like HIV, and hepatitis C can be passed from one
user to the next by sharing needles, ties, filters, and cookers.
Other injection related harms include:
*MSRA (potentially life threatening anti-biotic resistant staph infec-
tion)
*Cellulitis (swollen skin and tissue damage from missing the vein)
*Abscesses (pus filled infection at injection site)
*Blood Clots and Embolisms (free floating blood clot)
*Vein Damage

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*Cotton Fever
*Endocarditis (infection of heart lining)

Injection drug use can result in circulation problems, heart attack,

stroke, loss of limb, and death. Injection drug use poses serious
health risks!

Harm Reduction: Learn safer injection techniques (watch ANKORS

safer injection video in links section on pg. 29). Go to your local
harm reduction organization and get trained!

If you are going to inject, remember:

*Get your drugs tested at a harm reduction organization! Don’t

use alone! If you do, keep door unlocked for rescue! Use overdose
prevent site (OPS) whenever possible. Sometimes meth is tainted
with Fentanyl. Get trained in using naloxone and carry it at all times
(watch ANKORS naloxone video in links section).

*Never share rigs - use your own every time! That means syringes,
needles, ties, cookers, and filters. Always use sterile water. Clean
hands with soap and hot water before injecting. If soap/hot water
isn’t available, use hand sanitizer, a handy wipe, or an alcohol pad.

*Clean injection site with alcohol pad before shooting. Maintain a

clean surface for all injection gear.

*Rotate injection sites. Give veins a break and switch to another

method such as smoking or swallowing for a while.

*Dispose used rigs into a SHARPS container. Your local needle ex-
change/harm reduction organization will supply free slamming gear,
SHARPS containers, and harm reduction info and supplies.

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 REDUCING METH’S HARMS
On side it is easy to forget our bodies basic needs. We often stop
eating and drinking water; we may neglect bathing and brushing our
teeth, and we can stay awake for days without sleep. Our relation-
ships get impacted - especially when we stop seeing family mem-
bers, support workers, and friends. And because speed makes us feel
invincible, we tend to engage in risky behavior like having unpro-
tected sex, and sharing syringes, snorting, or smoking gear.

These facets of meth use can have a big impact on our health and
well being, so it’s important to reduce some of the harms by practic-
ing self care.

Our bodies essential needs are:

*Eating
*Sleeping
*Hydration (drinking water)
*Hygiene (cleaning ourselves)

Ignoring any of these makes us vulnerable. Our immune systems

fail, we become more susceptible to sickness, and our mental/emo-
tional health gets compromised. No matter where you are at in your
relationship with speed, there are steps you can take toward main-
taining your well being.

If you use meth, the following tips can help you take better care of
yourself:

TRACKING

Keeping track of your use can help you gauge where you are at with
crystal. Tracking enables you to slow down or taper off before you
get in too deep.

*Monitor your meth use - see Where Are You At? section, pg.14

*Moderate your meth use - take a break or quit before you lose
control.
9
EATING

Meth decreases your appetite while simultaneously speeding your

heart rate. This increases your body’s energy needs. If you don’t re-
place the calories meth burns, your body takes it from other places
like your fat reserves, muscle mass, and bones.

Remember:

*Regularly eat nutritious meals: fruit, vegetables, protein.

*Smoothies are a great way to quickly nourish yourself!

*Take multi-vitamins - they will help replenish what drugs take from
your body.

Pro Tip: if you know your going on a run with Crystal, binge on
good food before you get high-this will help your body get through.

HYDRATION

Maybe you don’t feel thirsty, but body functions like digestion, ab-
sorption, saliva creation, circulation, and the transportation of nutri-
ents all depend on you being hydrated to function properly. If you’re
dehydrated you can’t efficiently flush toxins out of your system, your
kidneys get stressed, and you’re more susceptible to tooth decay
caused by dry mouth.
Below are a few hydration tips:

*Drink plenty of water (not sugary soda or alcohol) - eight glasses a

day!

*Fortify water with electrolyte/vitamin packets like Emergen-C. These

boost your immune system and taste good!

*Saliva contains substances that fight cavities - remember - a dry

mouth is more susceptible to tooth decay.

*Chewing sugar-free gum will also help keep your mouth moist.

10
HYGIENE

Side can make us forget to keep clean. Without proper hygiene we

become vulnerable to skin infections. Skin infections can become
serious, life threatening health problems especially if they enter and
infect our blood stream through injection drug use. The risk of de-
veloping an infection greatly increases if you don’t keep your body
clean.

Here are a few ways to practice good hygiene:

*Shower regularly (if you don’t have access to a shower, sponge

bath).
*Wash hands with soap/water, handi-wipes, or hand sanitizer.
,
*Clean injection site with an alcohol pad before you slam.

SLEEP

Your body needs it. Go 24 hours without sleep and your memory
slips and decision making becomes impaired. Go 48 hours or more
without sleep and you will exhibit the signs of psychosis. Sleeping
allows your body to heal itself and gives your brain a reset.

Pro Tip: if you are planning to binge on side, prepare for it by resting
up.

RELATIONSHIPS

Try and maintain at least one supportive relationship with a person

who doesn’t use meth. They can be a friend, family member, or
support worker. Having someone to lean on will help when you are
going through a rough time. Check in with them when you aren’t
sure if you are losing touch with reality. This person can also help
connect you with resources like housing, food, medical care, detox/
treatment, and mental health support.

11
SKIN PICKING

Do enough meth and you may feel like bugs are crawling on or un-
der your skin. These sensations are known scientifically as
formication, a condition which is common for heavy meth users. As
real and as strong as the urge is, try not to scratch or pick!

Picking and scratching makes you vulnerable to contracting or

spreading blood borne infections.

Here are some helpful ideas if you get the urge to pick:

*Drink something with electrolytes - juice, coconut water, Emer-

gen-C. These will help ground you and take your mind off the
creepy sensations.

*Nibble on some food like fruit or nuts.

*Put a thick rubber band around your wrist and snap it when you
get the urge to pick.

*Ask a friend who isn’t high for confirmation - if they can’t see the
bugs you believe are there, trust their eyes!

Pro-Tip: if your sober friend isn’t by your side, take a picture of the
body part you believe is infested and text it to them. If they don’t see
the bugs in the picture, believe them!

*If you have picked, clean your wounds with soap and water, apply
antibiotic ointment, and cover them with band-aids.

*Keeping sores clean and covered will help prevent spreading infec-
tions.

*Sores that are hot, swollen, and oozing with puss should be
checked out by a street nurse or doctor immediately!

ORAL HEALTH
On meth we crave sugary treats and soft drinks. At the same time,
we often forget to brush and floss our teeth. Furthermore, dehydra-
tion gives us dry mouth and shuts our salivary glands down. All of
this can spell disaster for our oral health.
12
Tips to help keep your teeth healthy and in your mouth:

*Remember - dry mouth is dangerous! Saliva contains substances

that fight tooth decay.

*Drink plenty of non-sugary liquids to help maintain oral health.

*Brush and floss twice a day.

*Chew sugar-free gum to keep your mouth moist.

*Take calcium/magnesium supplements to replace minerals deplet-

ed from teeth and bones.

*Visit a dentist if you can afford it. Some communities have dentists
who offer low income dental care. Ask your harm reduction provid-
er if this service is offered in your town.

13
 WHERE ARE YOU AT?
People use meth for various reasons. Some do it strictly for recre-
ational purposes, to study for exams, to escape from problems, or
just to feel good for a change.

Not everyone who tries meth will become addicted. Still, metham-
phetamine does provide a very powerful high. This fact places some
people at greater risk of dependency.

If you’re doing side, it’s a good idea to keep track of your use. Track-
ing can help you modify your intake before you lose control. Below
are some ways to gauge where you’re at with meth.

Which category do you fall into?

Experimental: You’ve tried speed once or twice; it really isn’t your

thing.

Periodic: You party on meth occasionally and enjoy the high, but
you can take it or leave it. When you use speed, you find it relatively
easy to keep things in check.

To Get Shit Done: You use crystal to study for exams, write a paper,
to drive all night, or complete a project. Students, artists, workers,
and truckers can fall into this category.

If this sounds familiar, be mindful. You may trick yourself into believ-
ing that without Tina you can’t perform.

Sex: You take meth to enhance sex. Do you use a few times a year,
several times a month, every weekend?

If you mix sex and meth often, be careful. This type of use can lead
to dependency, erectile dysfunction in men, loss of interest in sober
sex, as well as contracting or transmitting HIV, hepatitis C, or other
STI’s through unprotected sex.

Regular: You get high several times a week. You’ve binged and
know what it’s like to go for a few days without eating or sleeping.
Sometimes you choose speed over other things you care about. Your
tolerance is growing which means you need to spend more money
14
to get high. If you’re at this stage, you may want to consider getting
things under control before they get totally out of hand.

Habitual: Getting high is your priority. Relationships, school, hous-

ing, job, health, and hygiene takes a back seat to it. When you’re out
of speed you get stressed. Sometimes you tweak from regular binges
where you stay awake for days, hearing voices, seeing shadow peo-
ple, staring into the mirror, and digging or scratching your flesh. You
crash hard. Sleep for 24 hours straight then wake up and start all
over again. Meth has become the only thing that makes you happy;
without it you wonder: what’s the point?

If this is where you’re at and you want to stop doing meth, get-
ting into detox and a treatment center can help. Your local Mental
Health and Substance Use office can connect you with supports.

If you aren’t interested in taking a break or stopping, use harm re-

duction techniques to lessen some of meth’s impacts on your health
(see Reducing Meth’s Harm pg. 9).

*Remember practicing self care is showing love for yourself!

15
 METH PSYCHOSIS // OVER AMPING
Meth psychosis happens when you take too much meth (over amp-
ing). It can be terrifying for the person experiencing it.

Common Symptoms

Paranoia: You feel people are out to get you; that you are being
followed, or under surveillance. Trusted friends, family, or support
workers suddenly seem like enemies conspiring against you. A feel-
ing of distrust takes over. The paranoia can lead to aggressive behav-
ior towards self or others.

Hallucinations/Sensations:
These vary, but commonly appear as:

*Blue lines streaking across your hands

*Bugs crawling on or under your skin

*Black crystals stuck in the back of your mouth

*Bruises that appear from merely touching your flesh

*Shadow people

*Buildings mov-
ing from beneath
you

*Hearing voices
that others can’t

16
Dealing with Psychosis

The symptoms of meth psychosis don’t last forever. They will subside
and eventually go away if you take a break from using or quit entire-
ly. How long this takes depends on the individual, how much meth
they use, and for how long. In the meantime, here are a few things
that can help get you through when you’re tweaking:

*Doing more meth when you are over amped will make psychosis
worse!

*Remember that meth psychosis is temporary - it will pass!

*Try to find a mellow and safe place to ride out the episode in peace
and quiet.

*Sip water or juice (not sugary soft drinks).

*Putting a packet of vitamin C powder like Emergen-C in your water

will help ground you and flush toxins out of your system (remember
to pee often).

*Nibble something nourishing (not junk food) like fruits, vegetables,

or nuts (the thought of eating will seem disgusting but eating helps a
person ground out).

*Practice the 4x4 breathing technique.

(inhale for a count of 4 seconds, hold breath for 4 seconds, exhale
for count of 4 seconds, hold for 4 seconds, repeat).

*Try smudging yourself with sage, cedar, or juniper.

*If you have access to a tub, take an Epsom salts bath (use 1 cup or
more of salts-your skin will absorb the magnesium which helps al-
leviate anxiety and tension); a few drops of essential oil in the water
- like lavender oil - will help calm you.

*Avoid triggering environments like busy streets, shopping malls, or

city centers as much as possible while you’re trying to mellow out.

17
*Try not to pick or scratch your flesh.

*Using Fentanyl (down) to take the edge off puts you at high risk of
fatal overdose. Carry Naloxone and know how to use it!

Calling for Help

If you are tweaking too hard to deal with it on your own, time to call
for help. It is a good idea to plan ahead. Make an agreement with a
trusted friend who doesn’t use meth or a support worker. Create an
emergency plan and commit to it!

If no one is available to help call 911.

Preventing Meth Psychosis

Learn to spot the warming signs of meth psychosis early on, respond
accordingly, and reduce the chances of having an episode.

Take a break from Tina if you experience the following:

*Suddenly become suspicious of friends, family, support workers, or

people on the street.

*See or hear things that other people can’t.

*Feel increasingly anxious, agitated, fidgety, or depressed.

*You’ve been binging on meth for two or more days in a row.

*You have lost more than one full night of sleep.

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 THE CRASH
What goes up must come down. After experiencing that “ultimate
high,” crashing sucks!

Common symptoms include:

*Fatigue
*Depression
*Emotional/Physical Exhaustion
*Mood Swings

Everything is dull; everyone is annoying. You may even feel that

without speed there is no point to life. Biologically speaking, it
makes sense. Your brain’s feel good chemicals are spent. All you can
do now is aim for the softest possible landing.

19
Here are some tips to get you through the rough time:

*Remember the symptoms of a crash are your body’s way of reset-

ting - they will eventually pass.

*Give your body a break and don’t use more speed for a few days,
consider taking a longer break, or quitting.

*Eat nutritious food (not junk food).

*Drink plenty of fluids (juice, water, chamomile tea).

*Take calcium-magnesium supplements (these will ease tension and

anxiety).

*Find a safe place where you can chill out for a while; rest and
sleep.

*Reach out to a trusted friend, family member, or support worker-let

them know what you are going through, and ask for help (food, a
place to rest, a shower).

*Avoid triggering situations and people.

*Find a peaceful place in nature where you can sit and relax.
*Consider talking to a councillor if the depression is overwhelming.
*Maybe now is the time for detox and treatment?

20
 OVERDOSE
Overdose occurs when the body has more drugs in it than it can
deal with. Meth overdose can lead to death. Fatal meth related over-
doses are on the increase in both Canada and the US.

SYMPTOMS of METH OVERDOSE:

*
*Red face *Stroke or heart attack
*Racing or irregular heartbeat
*Extreme paranoia, anxiety, or aggression
*Body shakes/trembling *Fever
*Profuse sweating *Hallucinations
*Rapid breathing and/or eye movement

If you suspect someone is having an overdose:

*Call 911 right away! Remain with person until paramedics arrive.

*Stay calm, don’t argue or try to restrain the person - this can lead to
aggressive behavior.

*Be re-assuring - let the person know help is coming and everything
will be okay.

*Try to create a mellow environment-turn off loud music and bright

lights.

*If they are receptive, a cool cloth to the neck, forehead, or wrists
can decrease temperature and sooth the person.

*If the person has stopped breathing or there is no pulse, get some-
one with training to perform CPR.

*Be especially careful if you’re combining meth with opiates like

down/fentanyl/heroin! The signs of opiate overdose are different
than with stimulants. Learn to identify the signs, make sure to have
a Naloxone kit on hand, and know how to use it. Also, remember
to get your drugs tested by your local harm reduction organization.

21
 TAKING A BREAK // TREATMENT
Unlike treatment for opioid dependency, currently there are no
pharmaceutical substitutes for methamphetamine addiction. Ongo-
ing research does aim to find a replacement drug in the future. In
the meantime, treatment options for meth do exist. Treating meth ad-
diction is similar to treating other stimulant addictions like cocaine,
with similar success rates. Visit your local harm reduction organiza-
tion or Mental Health and Substance Use office for advice on how
to get started with a detox and treatment program.

If you are thinking about taking a break or quitting, this info adapted
from ACT Toronto will give you an idea of what to expect.

Meth withdrawal is more mental than physical. Hard as it is, coming

down from it is the body’s way of resetting.

You’ll probably feel:

*Moody *Sleep a lot *Experience intense cravings
Remember: if you can stick it out, withdrawal symptoms will pass.

Below is a general idea of what the early stages of taking a break or

quitting meth is like:
0-2 Weeks:
Acute Withdrawal Phase.

This is the hardest part to get through.

Some of the symptoms include:

*Exhaustion *Depression *Irritability
*Anxiety *Intense cravings for speed

*Sleeping a lot *Excessive hunger *Paranoia

*Swinging emotions (from anger to hopelessness)
*Scattered thoughts *Inability to concentrate or focus
*Aches, pains, headaches *Hopelessness
22
Coping With It

Your body and mind are resetting. Take it easy on yourself. Getting
through will take some time.
*Sleep as much as you can.
*Minimize stressful situations or people that trigger you.

*Hydrate and eat plenty of nourishing foods (see Crash section

pg.19)
*Call on supportive people to help you.
*Talk to an addictions councillor.
*Join a support group.

*Remember - as hard as this stage is, it will pass!

3 Weeks-1 Month:

The worst of withdrawal is likely over, but cravings for meth remain.

You are probably still dealing with:

*Depression *Restlessness *Difficulty sleeping
*Anxiety *Boredom

On the flipside, you are starting to put some weight back on and
feel healthier. Mental clarity is coming back and the mood swings
are a bit more manageable.

*Now is a good time to start building a routine. Re-engage with life,

celebrate what you have accomplished so far, and set some new
goals for yourself.

*Get physical - exercise and use your body!

1-3 Months:

Cravings are still there, but they are more manageable. Mood still
fluctuates, but maybe not so extremely. You might be re-establishing
connections with family and friends. Housing and income might
also be getting more secure by now. Sense of confidence in your
23
ability to cope without meth is increasing but be careful: many
people relapse at this point because they believe they have their
addiction under control.

The importance of talking to an addictions councillor/joining a sup-

port group cannot be overstated!

*Contact your local harm reduction organization or Mental Heath

and Substance Use office to get connected with supports.

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 SEX & METH
Meth stimulates sexual activity. It is known to lower inhibitions,
boost sexual confidence, heighten the sense of pleasure, and in-
crease sexual stamina. When we’re high on side it’s easy to make
risky sexual choices we might not make while sober, like having
unprotected sex, or choosing partners we normally wouldn’t. This
makes people who mix sex and meth vulnerable to contracting or
transmitting HIV, hepatitis B and C, sexually transmitted infections
(STIs) like syphilis and gonorrhea, and unwanted pregnancy.
*If you plan on getting laid while high on Tina, do it safely!
*Use condoms and lube

CHEMSEX

Chemsex is a gay, bi-sexual, and men who have sex with other men
(gbMSM) sub-culture. It uses drugs to enhance and sustain sexual
encounters. The scene began in England but is now on both sides of
the Atlantic.

In North America, Chemsex is sometimes called Party and Play

(PnP). Hook-ups between two people, or entire groups, are often
arranged through online dating apps like Grindr. Willing participants
are directed to a private house, apartment, or other discrete location
where they use drugs and have sex, sometimes non-stop, for days.

Some of the key words used in online profiles for Chemsex hook
ups include:
*Chems *HnH (High and Horny)
*PnP (Party & Play) *Favs

While doing drugs and having sex is nothing new, in the past
decade, drug use trends among men who have sex with men have
shifted. “Club drugs,” such as cocaine and ecstasy, appear to be less
popular than drugs associated with Chemsex, which include meth-
amphetamine, mephedrone, gamma-hydroxybutyrate (GHB), and
gamma-butyrolactone (GBL). Crystal meth is one of the primary PnP
drugs because it kicks sexual desire into overdrive and increases
sexual stamina. But using meth for sex has its risks.
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RISKS

*Research shows gbMSM who PnP are more likely to have condom-
less anal sex with multiple partners (even if they are HIV positive).

*The chance of contracting sexually transmitted infections such as

syphilis, gonorrhoea, and chlamydia are higher for men who engage
in Chemsex than for those who don’t.

*Sexually transmitted infections such as syphilis, gonorrhea, and

chlamydia are higher for gbMSM who engage in Chemsex than
gbMSM who don’t do Chemsex.

Interactions between different drugs used in Chemsex can also be

problematic. For example, mixing GHB and alcohol is a dangerous
combination that can be fatal.

Sharing injection, smoking, snorting, booty bumping, or hot railing

gear increases the risk of spreading or contracting:
*HIV *Hepatitis B, C *Blood borne infections

*Used syringes left laying around can cause needlestick injuries and
spread disease.

26
Slamming also increases chances of vein damage, blood born in-
fections and addiction (see WAYS PEOPLE USE - INJECTION/SLAM-
MING section pg. 7).

Repeated crystal meth use in Chemsex can lead to:

*Impotency for some men (crystal dick).
*Loss of interest in sober sex
*Dependency.

There is also the issue of consent. With so many drugs and sleep
deprivation influencing a person’s behavior, the lines of consent
can get blurry. At certain PnP gatherings, just being there can imply
consent.
*Get clear on the rules of the party before you play.

*Reports of rape and robbery have occurred within certain PnP

circles.

HARM REDUCTION for CHEMSEX

(Written by Joe Reiner)

For harm reduction tips on safer injection, smoking, snorting, hot

railing, swallowing, and booty bumping see Ways People Use sec-
tion of this guide (pgs.4-8).

* One of the best resources we have to keep one’s self and others
safe in a Chemsex environment is EACH OTHER. Knowing the signs
and symptoms of overdose is critical (See overdose section pg. 21).
In case of opioid overdose, know the signs, have Naloxone on hand,
and know how to use it.

* Use of traditional condoms or initial condoms with personal lubri-

cant and/or PrEP are still some of the most effective barrier methods
to prevent the transmission of HIV, Hepatitis and other STI’s such as
chlamydia, gonorrhea and syphilis.

* Although it may seem basic, remaining hydrated is critical. Rule of

thumb should be to have a glass of water or sports drink every hour.
27
* If you have a Prince Albert piercing, consider removing it while
having Chemsex as to avoid injury and hence bleeding. The same
thing goes for rings, bracelets and long fingernails.  

* If possible, use your own rectal douche. Otherwise, wipe any that
you use clean of oil or grease and disinfect it in a bleach solution
before use.  

* Take breaks often and especially between partners if in group sit-

uations. Have a chat or take a nap. Start a conversation about your
HIV status and viral load.

* Keep used and unused sex toys separated. It’s advisable for every-
one to bring their own sex toys. Otherwise, make sure all toys are
properly disinfected in bleach and water for at least 5 minutes.  

* Do not share syringes, needles or snorting equipment. Invisible

particles of blood can transmit Hepatitis C which can survive for up
to six weeks outside the body on materials such as plastic, rubber,
steel, etc.

* Wash your cock, balls, ass and groin with a mild soap and rinse
with lots of water. Wash your pubic hair too; lubricant residue con-
taining blood particles can stick to your pubic hair quite easily.

* Party and Play form. Keep a record of what you are taking, when
and how much. This is handy for knowing when it’s okay to take
more, but it’s also useful to know what you’ve taken in case some-
thing goes wrong.

A Word about PrEP (Pre Exposure Prophylaxis)

For men who have sex with other men, PrEP can help prevent the
transmission of HIV. PrEP is used by people who are HIV negative
to help prevent acquiring HIV. PrEP stands for pre-exposure prophy-
laxis; and is a once daily oral pill (or taken as prescribed by your
doctor) that enhances the immune system to inhibit the virus from
replicating or establishing a permanent infection within the blood-
stream.

28
Taking PrEP involves seeing a doctor or nurse practitioner every
three months for HIV testing and screening for other sexually trans-
mitted infections (STI’s), monitoring for possible side effects, and
on-going support to remain well informed around ones sexual
health.
  
PrEP only helps to prevent HIV - it does not protect against other
STI’s (such as chlamydia, gonorrhea and syphilis) or other infections
such as hepatitis A, B and C. Nor does PrEP protect against pregnan-
cy. PrEP is now publicly funded for individuals identified at high risk
of contracting HIV. If you feel that getting on PrEP might be a good
option in protecting your health, talk to your doctor or nurse practi-
tioner. More information on PrEP can be found at:
www.catie.ca/en/prep

LINKS FOR FURTHER READING

ANKORS Safer Injection Video Series:

www.youtube.com/channel/UCWTISYQM58JKm9R5q3ZVnvQ/fea-
tured

ANKORS Naloxone Training:

www.youtube.com/watch?v=JyfFq4aZzdM

Tweaker (dot) Org is a San Francisco based source of info on meth

and the gay party scene:
www.tweaker.org

The Drug Policy Alliance is a US based resource on the Four Pillars

Approach to Methamphetamine:
www.drugpolicy.org/resource/four-pillars-approach-methamphet-
amine

CATIE is Canada’s leading source for harm reduction information:

www.catie.ca/en/home

AIDS Committee of Toronto published the guide, Staying Off Crys-

tal For a Day or Longer:
www.actoronto.org
29
 ABOUT ANKORS
ANKORS provides a multitude of services, with offices in Nelson and
Cranbrook BC as well as rural outreach and education throughout
the Kootenay region. ANKORS programs are based on the belief that
services are provided in a non-judgmental manner without prejudice
that ensures individuals’ right to anonymity and confidential access.
We serve those living with and at the greatest risk of acquiring HIV /
AIDS and/or HCV, who have difficulty obtaining services elsewhere,
especially due to substance use, mental illness, sexual orientation,
gender identity, race and ethnicity, and/or other social barriers. AN-
KORS was established in 1992 as a non-profit society.

Please feel free to email us with any comments or suggestions on

what we are presenting here.

West Kootenay Office:

101 Baker St., Nelson, BC Canada V1L 2J7

Phone: 250-505-5506
Email: [email protected]

East Kootenay Office:

# 209A- 16th Ave. North, Cranbrook, BC V1C 5S8

Phone: 250-426-3383
Email: [email protected]