Dance Drugs and Harm Reduction

Dance Drugs & Harm ReductionLisa Campbell Salazarlisa@tripproject.ca
CAMH– October 14th 2011

TRIP! was founded in 1995, by partiers, for partiers!

Our Approach:
We can never stop the use of drugs, but we CAN keep people safe
Drug use is a health issue, not a legal one
Non-judgmental education approach based on facts, not opinions/morals
Providing information (for and by youth drug users) so that users can make their own informed choices

Who We Serve:
The majority of youth respondents (46.2%) are under 19, with triple the rates of drug use of general youth population
44% of TRIP! respondents identified as LGBTQ (33% bi-sexual, 8.8% gay and 3% identifying as transgendered)
9% of TRIP! respondents identifying as homeless, under housed or transient
71.3% identified their use as casual/non-problematic
70% first trying drugs between ages 12-16, with the average age being 13
43% of survey respondents indicated they experience negative health effects from their drug use

What do we do?
Bag and Booth Harm Reduction Outreach
Festivals
Advocacy
Blogging & Social Media
Creation of New Literature
Multimedia Design
Volunteer Trainings & Workshops
Community-Based Research

Social Media Outreach

Creative Workshops
24 creative arts workshops planned in 4 categories: dance, music, visual arts, fashion to build resilience

Cupcakes, Cosplay and Beatz!

Why is TRIP! important?
Research shows that, next to the internet, TRIP! is the most trusted source of information on drugs, sex and high-risk activities; while schools, media and family come in last!

Outcomes for Volunteers
Better knowledge about the safer drug use (98%)
Better knowledge about safer sex (80%)
Access to Safer Use Kits(43%)
Building a sense of community – caring for each other (78%)
Referrals to other supports and services (55%)
Work experience and connections to employment possibilities (35%)

“Alcohol, cannabis, and the medicine cabinet…”
One in four Ontario teens is a binge drinker
One in four Ontario teens have smoked pot in the last year
42% of Ontario students reported use of any drug other than alcohol or tobacco
About 18% of Ontario students report using a prescription opioid pain reliever non-medically in the year

TRIP! Survey Data 2007/08

2010 TRIP! Survey
Drug use rates were significantly higher in TRIP! youth versus all of the results reported in the 2009 Ontario Student Drug Use and Health Survey (OSDUHS).
Alcohol 98% vs. 58%
Cannabis 94% vs. 25%
Salvia 50% vs. 5%
While between 5-7% of OSDUHS reported using hallucinogens and/or stimulants, 84% of TRIP! youth report using MDMA, 79% Magic Mushrooms, 70% Ketamine, 68% LSD and 48% reported using Crystal Meth.

Navigating Risky Behaviours
47% of TRIP! youth surveyed reported having unprotected sex, with 24% reporting having sex with multiple partners.
21% of youth drug users reported sharing straws with 42% saying that it depended on the situation.
9% identified as injection drug users, with 3% saying that they planned to try it in the near future

Emerging Challenges
Rise in Ketamine
Global Rise of Amphetamines
Legal Highs and Research Chemicals

Ketamine
Special K, K, kitty
Price: ~$30 vial (Toronto 2011)
White powder
Looks similar to table salt or a fluffy powder
Typically snorted
Can be smoked or injected (IM or IV)

Harms from Chronic Use
Disturbed sleep (66%) and memory loss (56%) were noted as primary consequences commonly associated with drug use
Common health problems and concerns associated with ketamine use such as bladder problems, ulcers, k-pains, sleep disturbance and memory problems, as well as paranoid / delusional thoughts in longer-term chronic users
Ketamine users were also poly-drug users: MDMA (99%), alcohol (97%), pot (95%), mushrooms (90%), coke (88%), acid (80%), oxies (80%), and 64% crystal meth
80% of k users wanted to know more about mental health
Less than 47% of ketamine users felt comfortable accessing safer sex and drug information from their doctor, and less than 8% from their schools

Ketamine Risk Reduction
Caution with eating before or during using.
Anesthetics often make people throw-up.
Caution should be exercised when measuring doses.
Best to start with small doses, working your way toward the desired levels.
Drinking lots of water to flush out the salts from your system. Users report that this prevents ulcers and scaring.
Mixing with alcohol often results in nausea, vertigo, and "the spins“.
K often “over-powers” the high (but not necessarily the physical effects) of other drugs.
Better to use your own straws and bumpers.
Better to IM than IV. NEVER SHARE EQUIPMENT!

Ketamine Risk Reduction
Be careful using in public environments (e.g., nightclubs) so that you don’t “K-out”.
Tell friends you are doing K and try to have a sober friend that can help if you do too much.
Anaesthesia-levels of ketamine in certain settings could lead to serious accidents, such as falling from balconies or bathtub drownings.
Tolerance builds quickly; take breaks from use to bring it back down.
Long term chronic use can cause serious bladder damage!

Global Rise of Amphetamines

Methamphetamine
Crystal, Meth, Jib, Crank, Ice, Tina
Price = $ 50-60 / bag (0.25 – 0.3 gram)
White to off white powder; crystal shards (like glass)

Methamphetamine
Strong stimulant; “upper”
Releases dopamine, serotonin, norepinephrine (adrenalin)
Can be swallowed, snorted, smoked or injected
Smoking and injecting potentially more addictive
Long half-life (12 hours)
Physical effects:
Increase in heart rate, body temperature; decreased appetite and sleep; dry mouth; loss of erection
Psycho/behavioural effects:
Increase in alertness, confidence, euphoria
Paranoia; anxiety; decreased self control / inhibitions

Methamphetamine
Immediate risks:
Dehydration
Lack of food / sleep
Loss of inhibitions
Paranoia / psychosis
Longer-term risks:
Physical/psychological dependency
Weight loss
Tooth decay
Strains on heart
Depression
Loneliness
Loss of friends, school, job

Methamphetamine Risk Reduction
Plan ahead before partying; you may need a few days to recover.
Limit what you buy.
The longer you party, the rougher you’ll feel after.
Smoking and injecting seem to be more common in people entering addiction treatment.
Try to avoid sharing pipes and injection equipment.
Try to eat something while you're high
Protein shakes or fruit juices with healthy supplements are better than nothing. Feed your body the fuel it needs.
Keep hydrated
Use extra lube if having sex.
Lack of sleep. Lack of food. Physically exhausted.
Accept the comedown
Spread out the partying… not every week.
Dopamine and all those other neurotransmitters take time to be replaced.

Ecstasy
E, X, pills, Molly
Specific pills named based on colour, size, shape, stamp/logo
Can come as powder in a gel cap
$5-$15 a pill (Toronto 2011)
Predominately swallowed
Pills may be crushed in to powder and snorted
Rarely hooped or smoked

Ecstasy
MDMA and/or other chemicals
Main neurotransmitter: Serotonin
Though with adulterated pills others maybe effected (e.g., more dopamine if methamphetamine is in pills)
Primarily stimulant effects; “upper”
Though overwhelming sense of “bliss” may leave you feeling lethargic
Physical effects:
Increases in heart rate, body temperature and energy
Jaw clenching/tightening, dilated pupils, nausea
Psycho/behavioural effects:
+ve: empathy, openness, peace, caring, open-hearted communication
–ve: anxiety, paranoia, “bad mood”

Ecstasy
Immediate risks:
Not knowing what you get
Ecstasy pills are one of the most adulterated illicit substances
Dehydration; overheating; stroke
Particularly when used in hot nightclubs and parties
Say or do something you regret
Tendency to talk openly and “feel connected” may not last the next day
Rough comedown
Can be hard to fall asleep
You may feel sad, blue, and easily irritated for a couple of days after

Ecstasy
Longer-term concerns:
Tolerance
Many longer-term users report taking more to get a similar effect (e.g., “½ a pill used to get me high, now I take 2 in a night”).
Psychological Dependency
If you have always taken ecstasy when going out dancing, it may be hard to not think about using when going out, even though your body isn’t physically needing it.
Depression
What goes up, must come down. Serotonin, one of the neurotransmitters ecstasy effects, is part of your eat/sleep patterns and mood cycles - it may be depleted after use.
Anxiety & panic attacks
Stimulant drugs can create a sense of urgency or paranoia in some people, especially with the more you take or the longer you stay high.
May affect ability to perform complex cognitive tasks and memory in “chronic users”.

Ecstasy Risk Reduction
It’s nearly impossible to know the purity and quality of the pill until after you take it.
Kicks in, 20-60 minutes when swallowed (wait to get high!)
Start with half a pill. Wait about 45 minutes after you’ve dosed before deciding to do more.
Less is more. You will likely feel worse after using if:
You do more at one time (e.g., 2 ½ pills vs. 1 pill)
You stay high longer (e.g., 20 hrs vs. 7 hrs)
Stay hydrated:
YES: water; Gatorade
NO: alcohol; energy drinks
If dancing or having sex, take breaks and chill out for a while.
Fruits (esp. bananas), protein shakes, juices, yogurt, are all good (and easier) to eat.

What goes up, must come down…
Lack of sleep. Lack of food. Physically exhausted.
Accept the comedown; chill out with friends.
Depressed; irritable; cranky
Need time for recovery
Eat! Sleep!
Spread out the partying… not every weekend.
Serotonin takes a few weeks to be replaced.

Ecstasy: Pills vs. MDMA
MDMA = “pure” Ecstasy.
Historically found pressed into a pill form, but now commonly found in caps
Pills are usually “cut” with other drugs.
Never know what you are getting!
Each pill is different, even if it looks the same.
Duration of high: 4-6 hrs (pure MDMA), 2-10 hrs (Ecstasy pills)
MDMA currently waiting approval for Canadian clinical trials for PTSD. (Jan 2011)

Ecstasy Pills
Observations and conversations with partiers and clubbers using E, show a wide variety of experiences.
Toronto, 2004:
7 of 21 Ecstasy users showed methamphetamine in hair samples.
BC Centre for Excellence in HIV/AIDS and UBC Dept. of Health Care and Epidemiology, 2004:
94 pills
44 (47%) contained methamphetamine
Drug analysis report on designer drugs seized in Quebec, June 2007 to July 2008 (Health Canada; RCMP).

Good to see the variety of pill contents.
Cost prohibitive.
Lots of local reports.
Subjective experiences can vary – be careful!
Similar looking pills can have different ingredients.

Canadian results from ecstasydata.org

Most recent tests from ecstasydata.org
(not all Canadian results)

Home Testing Kits
Home testing kits do NOT demonstrate an accurate picture of what is in pills and capsules. They only serve to indicate the SUSPECTED presence, or non-presence, of certain chemicals. The kits do not show a complete chemical picture and in no way show the quantity (or dose) or any ingredients.
www.dancesafe.org (US)
www.eztest.com (Europe)

MDMA Purity
New substances are being developed all the time – some of these are easier to make than MDMA; some are easy to acquire through the internet; and some are not illegal, though can be quite harmful.
Increased global restrictions on the pre-cursor chemicals used in the synthesis of MDMA are making production more difficult and, therefore, people are turning to new substances as substitutes for MDMA, or mixing them with poor quality MDMA to achieve more potent results.

Pure Pillz
Piperazine class of drugs.
Combination of BZP and TFMPP.
First popularized as “Social Tonics” in New Zealand and marketed as a “harm reduction” alternative to street laced ecstasy pills.
Were available in Canada online and in Toronto store-fronts around 2007/2008.
Did not become too popular as decent quality MDMA was widely available and Pure Pillz only crudely mimiced effects of MDMA.
BZP and TFMPP often show up in lab analysis of current ecstasy pills.

Pure Pillz

Health Canada Advisory – Pure Pillz

Ecstasy takers in hospitalCBC News Posted: Apr 8, 2011 http://www.cbc.ca/news/canada/nova-scotia/story/2011/04/08/ns-ecstasy-halifax.html

Media
Ajax teens hospitalized after buying drugs online
Toronto Star, Published On Tue Nov 30 2010
http://www.thestar.com/news/article/898878--ajax-teens-hospitalized-after-buying-drugs-online
Police warn of rise of club drug 'meow-meow' following GTA bust
The Globe and Mail, February 17 2011
http://www.theglobeandmail.com/news/national/toronto/police-warn-of-rise-of-club-drug-meow-meow-following-gta-bust/article1910877/
Young people treated in Halifax hospital after taking bad ecstasy
Global Maritimes: Thursday, April 7, 2011
http://www.globaltvbc.com/Young+people+treated+Halifax+hospital+after+taking+ecstasy/4578060/story.html

Media
Ecstasy takers in hospital (Halifax)
CBC News Posted: Apr 8, 2011
http://www.cbc.ca/news/canada/nova-scotia/story/2011/04/08/ns-ecstasy-halifax.html
RCMP issue warning about party drug BZP (Edmonton)
Global News: Tuesday, May 3, 2011
http://www.globaltvbc.com/RCMP+issue+warning+about+party+drug/4719466/story.html
Teen relives trip on killer ecstasy (Calgary)
Sun Media: Monday, June 6, 2011
http://www.torontosun.com/2011/06/06/teen-relives-trip-on-killer-ecstasy

Research Chemicals
Popularized by “fringe scientist” and doctor, Alexander Shulgin.
Examples
2CI, 2CB, 2CT2, 2CT7, 5-meo-DiPT, 5-meo-AMT, BZP, TFMPP, mephedrone
Some are legal, many are increasingly scheduled.
Have been easily obtained over the internet the last few years.
Often the ones with psychedelic properties are sought.
Some mimic amphetamine type substances.

Research Chemicals
Scheduling of these substances causes ‘blow-out sales’ by manufacturers.
They are often sold over the internet and marketed “bath salts” or “plant fertilizer” and labeled “not for human consumption”.
Come in ‘waves’ through the dance music scene or drug user networks.

Research Chemicals
Little is known of these substances, their long-term effects, potential contraindications with medications and other drugs.
Not a very high success rate: with several of the substances, only 50% of users will get the desired high, the other 50% will have vomiting and diarrhea.
Some people have suggested they should be referred to as “un-researched chemicals” or “experimental chemicals”.

More Challenges!

Pillars of Safer Nightlife
Info!
Peer Education
Free Water / Fruit
Gum and Earplugs
Medics
Safer Consumption Kits
Sexual Health
Drug Testing

Party Packs

Club Drug Clinic

Safer Consumption

Helpful Resources
www.erowid.org
www.bluelight.ru
www.wikipedia.org
www.dancesafe.org

Keep in touch!
www.tripproject.ca
Purerave.com - tripproject
Facebook.com/tripproject
Twitter.com/tripproject
Email us at info@tripproject.ca

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Dance Drugs and Harm Reduction

by Lisa Campbell

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