• Avoid injecting: Injecting increases the risk of overdose and can damage veins and skin. Other methods, such as smoking or oral use, are less risky

• Use clean needles and equipment: Sharing needles, syringes, spoons, or filters can spread infections like HIV or Hepatitis C. Access free sterile equipment through needle exchange services or participating pharmacies

• Do not use alone: make sure you have Naloxone and someone with you in case you overdose

• Start low, go slow: harmful contaminants can vary within a bag and you may not know what you are taking

• Avoid downers (central nervous system depressants) in combination with opiates: drugs such as benzodiazepines (benzos) or alcohol can be fatal if you take too much together.

What are Nitazenes? 

New opioids have arrived in the UK in the last two years, called "nitazenes". They have recently been found mixed with heroin, with some being sold as Xanax powders or illicit oxycodone pills. Nitazenes pose a substantial risk of overdose, hospitalisation and death.

Nitazenes can be at least as strong as fentanyl and can be hundreds of times more potent than heroin. They are known to have led to accidental overdoses and deaths of people in several areas across the UK recently.

How to avoid overdose 

Considering new information about contaminated drugs, the way you use drugs might need to change to avoid overdose:

• Mixing different drugs is common, but it is more likely to cause an overdose. Try to use one at a time. If you are going to mix drugs, use less of each
• Try not to use drugs alone, and don’t let your mates use them alone either. Watch out for signs of overdose in your friends. The signs include difficulty breathing, blue colouring to the lips or fingertips, unresponsiveness, and limp limbs
• Always carry naloxone. It’s available from all treatment providers. If someone overdoses, give naloxone to them and call an ambulance
• Naloxone only works on opioids. However, if you suspect someone has overdosed give them naloxone even if you’re not sure they have taken an opioid. It will not harm your friend
• If you use opioids every day, i-access can support you and prescribe alternatives such as methadone and buprenorphine. Even if abstinence isn’t your goal, these alternatives can help keep you safe. You will know what you are taking, and your risk of overdose may be reduced
• Use WEDINOS Sample Testing to test your drugs if you can spare a bit, but it takes time to get the results back, so go easy in the meantime.

• Don’t mix with alcohol, benzodiazepines (benzos) or opiates
• Bladder damage comes after sustained use so take breaks - never use every day
• Don’t use alone, stay with your friends and have a safety plan
• Don’t hesitate to get help and be honest with any first responders about what you’ve taken
• Never drive or use heavy machinery
• Start low and go slow
• To reduce infection risk, don’t share snorting tubes
• Wash your nose after a session with salt water to reduce the harm to your nose
• If you or your friend’s movement becomes robotic - sit down and stop using