Hepatitis C: An In-Depth Guide

Information on street drugs

Drug patterns fluctuate considerably across Canada. The popularity of certain drugs and even how drugs are taken varies over time in terms of preference, supply, quality and geography. The following table outlines some drugs that are or have been popular as well as some of the ways in which these drugs have been taken. Local public health units and harm reduction organizations may have early warning systems for drug trends and the I-Track series of studies can provide a macro-level look at drug use in Canada.

Drug

Description

How it is usually taken

High

Risks

Cocaine

White powder

Snorted; injected; smoked; swallowed; inserted/ absorbed

Stimulant – rush of alertness, increased sex drive, feelings of importance, confidence, and energy lasting 30–40 minutes

Some of the risks with these drugs come from the drugs themselves (like overdose and addiction), while other risks come from the way the drug is used (injected, snorted or smoked), and still others by the way people look at drug use (stigma and legal issues)

Crack

Rock form of cocaine

Smoked; injected

Stimulant – same as cocaine, but lasts 2–20 minutes

Heroin

White or brown powder

Injected; smoked; snorted; swallowed; inhaled

Depressant – general well-being; rush of pleasure and gratification; reduced hunger and sex drive; strong painkiller (including physical/emotional pain)

Oxycodone,
Oxycontin

Pills, tablets

Injected; swallowed

Depressant – painkiller

Morphine, Hydro- morphone, Dilaudid

Liquid; pills; supposit- ories

Injected; swallowed; inserted/ absorbed

Depressant – painkiller

Crystal Meth

Rock or crystal; powder

Smoked; injected; swallowed; snorted; inserted/ absorbed

Stimulant – rush of energy; restlessness; feeling excited or agitated

Physiological Risks

Overdose

The street-drug industry is not regulated and drug dealers and drug production operations have full control over the potency of their chemicals. Many drugs are cut with other substances to add bulk or change the high. Drug analysis has shown street drugs to be cut with products like dish detergent, ground glass, more potent drugs (PCP, LSD), rat poison or baking soda. Crack is often cut with crystal meth. Without knowing the purity of a drug, it may be difficult to gauge how much drug to take to reach the desired high. This can lead to accidental overdose.

Overdose is easier when different drugs are used at the same time.

A person's tolerance may be low after taking a break from drug use, either voluntarily, while in jail, or while in drug treatment, or when trying a new drug for the first time. Also, a new dealer or other source might mix the product differently. In cases like this, testing the drug in smaller doses to measure its effect before doing a full hit can reduce the chances of overdose. 

Poly-drug use is common amongst many drug users—either because they are looking for specific effects from the drugs or the drugs have been cut with other substances. The health risk is that overdose is easier when different drugs are used at the same time; the majority of cases where drug users overdose report two or more drugs in their systems. This may happen because the drugs have different effects (uppers vs. downers) and last for different amounts of time in the body. For example, people who died of cocaine overdose often have also been drinking alcohol. Also taking heroin with another drug (like benzodiazepines, alcohol or crack) leads to more overdoses than using one of those drugs alone.

Signs of Overdose

Drugs may have different signs or symptoms of overdose depending on whether they are stimulants (uppers) or depressants (downers). Having one or two of the symptoms below can be dangerous, and more than two is a major warning sign that overdose is imminent. Overdose does not mean the person will die, as long as they access medical care quickly. For example, naloxone is a drug that can be used to counteract heroin or morphine overdose. 

Signs of Overdose
Stimulant Overdose (uppers like cocaine and crack) Depressant Overdose (downers like heroin, oxycontin and morphine)
  • Rapid and pounding heart rate
  • High body temperature 
  • Blue lips 
  • Pale skin 
  • Foaming at the mouth 
  • Puking 
  • Seizures or twitching or body shakes 
  • Chest pain 
  • Loss of consciousness
  • Breathing slows or stops 
  • Heart beat slows or stops 
  • Seizures or twitching or body shakes 
  • Puking 
  • Blue lips or skin 
  • Low body temperature 
  • Mental confusion 
  • Loss of consciousness

Dependence

There are two types of drug dependence or addiction: physical and psycological. Physical dependence occurs when a drug changes chemicals in the brain or body so that a person's body cannot function without the drug. Psychological dependence is a desire for the feelings the drug induces, like boosting confidence or masking emotional pain. Any one drug can cause neither, either or both types of dependence. For example, alcohol dependence can be psychological because it makes a person feel uninhibited, relaxed and free, and it can cause physical dependence because stopping can lead to intense withdrawal symptoms in the body, like the shakes and tremors.

Mental Health

Drug use can sometimes cause changes to mental health. Often, these changes can be temporary side effects of the drugs themselves, like the paranoia sometimes associated with cannabis use. Drug use can also sometimes bring underlying mental health concerns to the surface and cause disorders like anxiety, depression or schizophrenia. People may require help and support to deal with their mental health concerns.

Risks associated with how drugs are taken

The way a drug is taken can create its own set of risks.

  • Ingestion – Ingestion is often the safest way to take drugs, thoughgastrointestinal side effects are possible.
  • Insertion – Inserting drugs in the anus or vagina can irritate the mucosal lining, which makes a person more susceptible to STIs and HIV, and possibly Hep C during sex.
  • Snorting – Snorting drugs can lead to Hep C (through reusing someone else's equipment), erosion of nasal passages, runny or drippy nose, nosebleeds and lung irritation.
  • Smoking – Smoking drugs introduces toxins to the lungs and can cause coughs, emphysema, and cancers, but is generally less risky than injection. Broken or homemade crack pipes can cause burns, splits or cuts on lips and inside the mouth, and lead to Hep C (through reusing someone else's equipment).
  • Injection – Risks associated with injection include blood-borne diseases like HIV and Hep C (from reusing someone else's equipment), skin infections and abscesses, vein damage, heart valve infections (endocarditis), chalk lung, blood clots, cotton fever and track marks.

Social Risks

Drug use has an impact beyond getting high and can affect the relationship a person has with family, friends and community. Drug use is a stigmatized behaviour and can alienate people from their families. Disposing of drug equipment in public places is a public nuisance that can expose people in the community to possible needlestick injuries. Drug possession and drug trafficking are criminal offences and are a leading charge associated with incarcerations today. Incarceration itself comes with a number of possible risks, including lowered employment potential, less access to healthcare, increased isolation and disconnection from community, and exposure to the violence that occurs in prisons. Balancing these risks with the benefits of getting high is a serious challenge for drug users, especially when drug use is a normalized part of their social circle, they are dependent on a substance or if they use drugs as a means to cope with other challenges in their lives. Often stigma is based more in people's negative perceptions of drug users and less in their actual behaviour.