Coronavirus (COVID-19): Drug use

The coronavirus outbreak and the measures taken have brought unprecedented change to our lives.

You might feel increased worry or stress, particularly if you’re in self-isolation.

It’s important to understand how this may affect your behaviour and how to take steps to look after your health and wellbeing.

Your drug use could become more of a problem.

You may:

• feel tempted to use more drugs than usual
• be in recovery and feel at risk of relapse
• have caring responsibilities or
• have concerns for a family member who uses or has a history of using drugs

Risks for drug users

If you take drugs, this is a particularly risky time.

Many things will have changed: from the support services you use and your access to them to support networks and coping strategies.

There may be an impact on the supply of drugs in some areas, leading to an increase in potentially harmful contamination or cutting agents being used in illegal street drugs.

This means what you buy might not contain what you expect.

Physical distancing may affect access to the drugs you usually take.

Your tolerance may be reduced if:

• there is a break or reduction in your drug use.
• you haven’t been able to access your usual quantity of drugs

This means you will need less to feel the effects.

More vulnerable than usual

You may be using drugs more often than normal or be using them alone without access to services in the usual way.

People in recovery may also be more vulnerable to relapse.

Using different drugs, even where you do not have a significant underlying condition, can lead to a temporarily lowered immune system.

This makes people who use drugs a particular risk group with very specific needs.

Advice for difficult times

Coronavirus and the lockdown have made life difficult for many people and increasing your drug use may be harmful.

But you can reduce the risks, especially with the support of family members and friends.

If you use any drugs, keep an eye on your use.

You might feel lonely, bored or isolated. It can be tempting to use drugs more often or in bigger doses than usual if you’re dealing with any uncomfortable feelings or worries.

Using more drugs than you planned, including drinking more, can have a negative effect on your physical and mental health.

Please visit our drugs and drug use page for general support and information resources available to drug users, their families and friends.

Make your drug use safer

Using drugs alone puts you at high risk of overdose as there is no one around to help or call for medical assistance.

Try to avoid using drugs alone and if you are by yourself arrange for someone to check in with you by text, phone, online or, if possible, in person.

Tell them what you are planning to use, how much and when.

Be cautious

If you are using drugs alone it is important to be extra cautious around amount, mixing substances and frequent dosing.

Start low, go slow - start with a small amount/test dose and wait for at least 2 hours before taking any more as the drugs may not have taken full effect.

Don’t mix and match - avoid using drugs with other substances including alcohol and prescription medicines. Mixing drugs can lead to dangerous, unexpected and unpredictable effects.

If substances don’t take effect as quickly as you’d expect, don’t assume they are poor quality, they may contain another substance that takes longer to kick in.

Taking opioids like heroin and methadone and depressants like benzodiazepines and alcohol is very risky.

They slow down your breathing and heart rate and if you take more of these than you’re used to, the risk of overdose is higher.

Health, hygiene and avoiding infection

General hygiene when you’re preparing drugs is important to help minimise the risk of becoming infected or passing it on.

Regular handwashing with soap and water for at least 20 seconds is the most effective way to prevent infection.

Where handwashing isn’t possible, use alcohol-based hand sanitiser.

Wash your hands before and after preparing or taking drugs.

Precautions you should take

Wipe down any drug packaging, wraps or baggies with alcohol wipes or anti-bacterial spray and a clean cloth as soon as possible after buying.

When preparing drugs, always use a sterile surface, cleaned with an anti-bacterial spray and a clean cloth or alcohol wipes.

If this isn’t possible, use something like clean kitchen roll as a temporary surface and bin it afterwards.

Equipment use and care

Using new equipment each time greatly reduces the risk of all infections.

If fresh equipment isn’t available, don’t share any paraphernalia, including:

• injecting equipment such as needles, water, spoons
• snorting equipment such as straws and keys
• smoking equipment such as foil, pipes and vapes

Also avoid sharing from the same bag of drugs and prepare your own drugs yourself. Avoid preparing drugs in a batch and sharing them out.

Pipes or snorting equipment can be wiped down with alcohol wipes.

Information on how to do this can be found on this Scottish Drugs Forum leaflet: Do you inject drugs (PDF, 540 KB) or this video about cleaning your equipment.

More health suggestions

Many people will consider avoiding or reducing smoking and vaping as coronavirus is a condition which affects the lungs.

They may also think about cutting down on alcohol.

Sleep and good diet are essential in maintaining a healthy immune system. Many drugs, including alcohol, can affect your ability to sleep and sleep quality.

Knowing the effect drug use can have on your health is important. Find out more in our guide to common drugs.

If you're in recovery or need support

Now might be a difficult time for you if you are in recovery, especially if in early recovery.

Be aware of your triggers, many people find boredom, loneliness, depression and anxiety increase the chances of relapse/taking alcohol and other drugs. You should:

• stay connected and reach out to any support networks, organisations, family members, friends or peers to talk to about how you are feeling
• if you're self-isolating, keep in touch online or over your phone
• be kind to yourself. Remember this is a difficult time for everyone and could be a particularly challenging period for people in early recovery

Build structure into your days and include eating sensibly, physical activity, some quiet reflective time or meditation, some study or reading time and plenty of communication with those you are close to.

There is information about a variety of mutual aid on the support and information page.

Managing your mental health

Drug use can make it difficult to manage your mental health or can make existing conditions worse.

Some people may feel more cravings to use drugs while others may feel their mental health is made worse when they use drugs.

Think too about how drugs may interact with any medication you’re taking and make sure you have a good supply of any medicines you are prescribed to manage your mental health.

More information about managing your mental wellbeing during the coronavirus outbreak.

If you attend mental health services regularly, it is a good idea to link in with your mental health worker and discuss any concerns you may have at this time.

Many mental health services are providing phone and online support instead of face-to-face meetings.

The coronavirus outbreak may affect drug supply in some areas and physical distancing may affect your ability to access your usual drugs.

Your tolerance may be reduced if there is a break or reduction in your drug use for a period of time.

If you haven’t been able to access the same quantity of drugs you would usually use your tolerance may be reduced and you’ll need less to feel the effects.

Mixing depressant and opioid drugs such as alcohol, benzodiazepines (valium) and heroin carry an especially high risk of overdose.

There’s a greater risk of overdose if you use drugs following a break, reduction in your use or you have used low purity drugs followed by higher purity drugs.

Taking drugs alone

Using drugs alone puts you at high risk of overdose as there’s no one around to help or call for medical assistance.

Drugs can affect your perception of time and how intoxicated you think you are.

If possible, try to avoid using drugs alone but if you’re by yourself it’s a good idea to arrange someone to check-in with you by text, phone, online or, if possible, in person.

If you are using drugs alone, it’s important to be extra cautious about the amount, mixing substances and how often you dose. Use scales to measure your dose and take a note of the time between doses.

Tell someone what you are planning to take, how much and when.

Start with a test dose and wait at least 2 hours to feel the effects before using any more. Remember, you can always use more but you can’t take less.

Carry a naloxone kit

Naloxone is a medicine which can temporarily reverse the effect of an overdose.

It should be given to any person suspected of experiencing an overdose where opioids are involved.

Even if it doesn’t help, it’ll do no harm. You can find out more about naloxone and how to get it on our drugs information page.

Plan to stay safe

Plan your doses in advance. Use scales to measure your dose and take a note of the time between doses.

Drugs can affect your perception of time and how intoxicated you think you are.

Treatment services are still open and accepting new individuals at this time. They are offering a flexible approach during the coronavirus lockdown. Many will also dispense naloxone. Remember to check ahead they have naloxone in stock.

Try your  best to space out your medication so it lasts you the full week, taking it as prescribed should prevent you from taking too much and prevent you from running out, ultimately reducing the risk of overdose, or suffering withdrawals later in the week.

Set alarms or take at the same time every day and don’t lend or share your medication with others, encourage them to get their own prescription.

Talk to your prescriber if you are having difficulties.

The coronavirus outbreak is a difficult time and many of us might feel lonely, bored or isolated.

It can be tempting to take drugs more often or in bigger doses than usual when we are dealing with uncomfortable feelings or worries.