5 Drug Safety Tips From A Montreal Harm Reduction Expert To Keep You & The Squad Safe

What is harm reduction?

Harm reduction is an approach to the personal health and public health policy around drug use that "doesn't assume that abstinence is the goal," Singh explained to me over a video call.

Harm reduction takes a "person-centred approach, [where] it's up to the individual what their definition of health and well-being is and what it means to move towards that."

This sets the strategy apart from other approaches to drug use, which often impose a particular idea of healthiness, namely abstinence from drug use, onto everyone universally.

The harm reduction approach, instead, seeks to (get this) reduce the harm caused to people by the substances they consume. This is especially relevant during the ongoing toxic drug supply crisis, which Singh says is often and unhelpfully referred to as the "opioid crisis."

The reason for this is that the actual issue, as Singh and other harm reduction professionals see it, is the number of overdoses caused by unregulated drug supply, which means that "people can't always know what they're getting."

"Somebody buys a substance and it's either much more potent than what they were looking for, or there's something cut into it that makes it more dangerous to take," Singh explained.

Solutions to this include safe supply, which means providing tested, clean drugs to people openly — similar to how government-regulated cannabis and alcohol distribution, but for other drugs, too.

The goal is saving lives, not getting "clean," which can mean something different to every person.​

What counts as a drug?

Part of why abstinence isn't a main goal in the harm reduction framework is that a life in which someone is "getting clean" from stigmatized drugs like heroin or cocaine can still include other substances that affect your body, like caffeine or alcohol.

"In North America, we have this spectrum of psychoactive substances that we use, some of which are much more taboo than others, some of which we don't even think about as psychoactive substances," Singh said.

"I'm thinking about caffeine, which at one point was illegal in large parts of the world and is still a forbidden substance in some cultures, but [has] gained widespread acceptance. There was a time when people thought that like caffeine was a product of the devil."

The process of a drug moving from being taboo to gaining acceptance is "repeated over and over again throughout human history," Singh explained. "So now we have these substances like heroin, cocaine, methamphetamine [or] crack," which retain intense stigma that is often associated with disadvantaged social groups.

"We see that with heroin, and we see that with crack in terms of being associated to Black communities in the 70s, and 80s," Singh said. "Crack and methamphetamine are obviously things that people really associate with poverty and with people using on the street.

"People can often conflate some of the physical ramifications of like homelessness, or extreme poverty or trauma with the ramifications of the drug itself, despite the fact that methamphetamine is something that's actually prescribed [in the United States]."

Stigmatized drugs are not necessarily more dangerous than more socially acceptable substances — think of alcohol, a drug that can cause severe harm but is understood to be acceptable in moderation (and even in excess!).

Test your drugs

Now that we have the basics out of the way, here's the real advice — a rule of thumb you've probably heard before. Test, test, test your drugs!

Regulated substances like government cannabis or standard-issue alcohol and caffeine are often not necessary to test, since it's the job of regulatory bodies to do that legwork for you. For unregulated or "street" drugs, it's always best to test before you use, whether that's using at-home kits or by visiting one of Montreal's drug-checking services.

"There are places [in Montreal where] you can take a sample of your substance and it can be really, really small like it's like the size of a match head. We can even sometimes run tests on 'empty' baggies," Singh said.

"That becomes an example of harm reduction: I'm not going to tell you not to use that substance, but if you want to use it, here's a way that we can help reduce the risks associated [with] consuming."

Carry Naloxone

Naloxone is a substance that can temporarily reverse the effects of an opioid overdose, giving you more time for medical assistance to arrive. It's available for free in Quebec at community organizations and pharmacies (follow the link for a tool that searches for Naloxone-offering places near your postal code).

Using Naloxone is one of the few tools people who use drugs have against opioids like Fentanyl.

"Fentanyl is not the only thing that drugs are being cut with," Singh clarified, "But if your drugs were cut with an opioid, and that wasn't what you were expecting, then the Naloxone will help."

Use clean tools, every time

"If you're smoking crack, or smoking meth, and you're using a pipe to smoke, or if you're injecting drugs, then having access to new gear every time is an example of harm reduction," Singh told me.

Various Montreal services offer safe injection sites as well as brand-new tools that can help people avoid passing infections, including bloodborne infections spread by used needles.

Go slow and be patient

Especially when trying a new substance, taking your time and going slow can be a harm-reduction technique in its own right.

"If you don't know your source really well [or] if you aren't 100% sure of what these drugs are, you can also start out with a smaller dose than you usually take," Singh said.

Starting slow and waiting to feel the effects is an excellent way to monitor your reaction to a new substance, whether it's a pot brownie or a hit of methamphetamine.

Pay attention to mixing substances

This includes more than just smoking more cautiously while you're drunk — mixing prescribed medications with other drugs can cause negative interactions that can be more harmful to your body than you realize.

Stay hydrated and think about what else you're consuming, and it doesn't hurt to do a little research into the possible side effects of combining your medications with other substances.