Drug Harm Reduction

• Keep yourself hydrated, and try to eat if you have some downtime – even better if you’re able to have some food stashed away to help you through your possible comedown. 

• Check your drugs! There are more regular drug checking clinics popping up throughout the country now that it’s been legalised, so if there’s one near you, consider getting your stash tested so you know exactly what you’re taking. A full calendar can be found on The Level. 

• Set some limits for yourself, and try to stick to them – whether that be length of a session, amount you’ll spend, or how much you’ll take. 

• Consent is crucial – if somebody is looking out of it, stop the session and see if they need a hand - it makes for a better time for everybody. 

• If you decide that you’re going to mix drugs, make sure you know what to expect, and be extra careful around the dosing.

• Try to get some breaks in, especially if a session is going on for a long time – your body will need longer to recover and replenish your neurotransmitters/brain chemicals (especially dopamine!) the longer you’re playing for.

• Discussing preferences, boundaries, and other relevant information you’re your partners before playing with them can be useful for shaping the session and establishing good consent practices.

Some HIV drugs, such as ritonavir (Norvir) and possibly other protease inhibitors, may cause dangerous interactions with methamphetamine, MDMA, and other amphetamines. HIV drugs may also slow down the elimination of recreational drugs from your system which can lead to elevated amounts of the drug active in your body. This significantly increases the chance of negative side effects. There have been reports of fatal overdose resulting from combining GHB and some antiretrovirals, in particular protease inhibitors.  

You can check for interactions between recreational drugs and your antiretroviral medication at the University of Liverpool webpage.

The key is to take steps to keep yourself safe and healthy: 

• Check in regularly with your GP, an experienced HIV medical practitioner, or your HIV specialist

• Know your limits, know your body

• Be aware of the impact that other substances may have on your treatment

• It’s really important to continue taking your HIV medicine while you are partying, so have a plan that will help you to remember to take them. A lot of people set alarms to remind them when it's time to take their meds, as it can be easy to lose track of time.

Methamphetamine (aka P, Tina, ice, crystal) is a stimulant drug that can make you feel euphoric, hyperactive, and sexually aroused. In the PnP scene, it’s likely to be the drug you’ll encounter most, and is often used for boosting your energy, sex drive, and the physical sensations of sex while reducing inhibitions.

It’s most commonly smoked or injected (slamming), but can also be shafted/boofed (inserted rectally), swallowed, or snorted. The effects can last from anywhere between 4-12 hours depending on your dose and means of use. 

There are some specific things you can do to keep safer and have a better time if you decide to use meth during a session: 

• Smoking is one of the safer ways to use meth – remember to use a shatter-proof glass pipe, and try to wrap a rubber band around the mouthpiece so that you reduce the chance of burning your lips.

• Shafting is a similarly safe choice, though can increase your HIV risk by damaging the lining of your anus – if you go with this method, dilute your meth in fresh, clean water and use a syringe (without a needle) to insert.

• If you decide to inject, always use sterile equipment (spoon, needle/syringe), and don’t share this between partners – you can get sterile gear from a local needle exchange and some pharmacies.

• Look after yourself during the comedown – the acronym NEST (Nutrition, Exercise, Sleep, and Time) is a handy way to remember some things to focus on during this time.

• Mixing meth with depressants (e.g. alcohol, benzos, GHB/GBL) can amplify the negative side effects and increase your chance of overdosing, so remember to reduce your dosing if you choose to take more.

Sometimes, meth and other drugs can make people paranoid and experience hallucinations, particularly when sessions extend for multiple days with very little sleep. If someone around you is experiencing these things, the following advice may be useful to support them:  

• Avoid touching them without their consent, telling them they are behaving strangely, or criticising their behaviour

• If they are sharing irrational thoughts, avoid dismissing these or trying to rationalise them on their behalf

• Talk to them gently and calmly, listening attentively to what they say, and try to understand the feelings that they share

• Asking them about things you know they enjoy, or making general positive observations, may help to change their headspace

• If there are significant concerns for their safety, call emergency services

If using regularly and for extended periods, familiarising yourself with the following tips might help you to get through a psychotic episode if it happens:

• Recognise potential early-warning signs, such as feeling self-conscious and uncomfortable, worrying excessively about what others may think of you, or having obsessive thoughts

• Where possible, try to leave the space for somewhere that you may feel safe, such as your home or a trusted friend’s place

• Try to distract yourself with things that comfort you (e.g., music, food, hot drinks), or find something to preoccupy yourself with such as household chores

• After the episode has passed, talk to a trusted friend or health professional (e.g., call 0800 METHHELP) about the experience if you feel comfortable doing so, to explore further support options

GHB, GBL, and 1,4-BD are depressant drugs that often come in liquid or gel form. They can make people feel relaxed, drowsy, and sexually aroused. Many people liken the effects of these drugs to being very drunk. These drugs are usually swallowed, with the effects of GHB and GBL generally starting quickly (within 5–30 mins), and usually lasting around 1–3 hours. 1,4-BD has similar effects, but a notable delay in onset (20–60 mins), lasting around 3–5 hours on average.  

Because GBL and 1,4-BD metabolise into GHB in the body and the three drugs have similar effects, they are often talked about as if they are one drug. While the following information is relevant for each of them, it’s key to note that they should be dosed differently:

• Dosing G is very dependent on body weight/tolerance and potency varies a lot between batches, so copying a play partner’s dose isn’t always the way to go – if in doubt (especially if you’re unsure if you have GHB or GBL), start small at 0.5-1mL, less is more with this one.

• Doses “stack” over time, so reduce your dose slightly each time if you plan to re-dose (1mL, 0.9mL, 0.8mL, etc.). It’s a good idea to space out your doses by a minimum of 1-1.5hrs to avoid overdosing.

• Measure out your doses in advance if you can, and set timers or make a spreadsheet with everybody’s names/dose times – G can impact your memory significantly, so this helps to stick to your limits. 

• Store G in a non-drinking style bottle, or add food colouring to it to reduce the chance of somebody drinking it accidentally.

• Mixing G with other depressants (ESPECIALLY alcohol) is not a good plan – they amplify the effects of one another, and significantly increase your risk of overdosing or “G Drop,” which can be fatal – call 111 immediately in this situation.

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PnP is an intense experience and, for some, can be harmful. The combination of substances used can makes people really out-of-it and there are reports of people experiencing sexual violence when they were unable to consent. If this has happened, you can contact the police, and seek additional support through places like the Pohutukawa Clinic in Auckland or Mosaic in Wellington. Burnett Foundation have counselling services available for help and support.

If you:

• Are using outside of PnP sessions

• Are using more to get the same effect

• Have had people express concern

• Are spending more time and money on drugs than you want to

• Are using to avoid a comedown

• Are experiencing poor mental health  

GHB/GBL/1,4-BD and methamphetamine have risks of dependence. If you are using more than you want to, comedowns are affecting other parts of your life and the unpleasant effects outweigh the pleasant ones, consider making some changes to your use – we can support with that, whether it’s through our ReWired groups or you’d like to explore another way of doing so.

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