Connecting - A Guide to Using Harm Reduction Supplies as Engagement Tools

SAFER INHALING

Section

Inhaling

SAFER

Supplies

REFERENCE GUIDE

Safer Smoking

Providing sterile smoking

supplies can prevent injuries

and risks from smoking/

inhaling/snorting drugs. These

supplies can reduce cuts and

burns to the lips and mouth.

They also prevent transmission

of HIV and hepatitis C.

Safer smoking

supplies include:

• Bowl pipes • Brass screens

• ¬ƥraiĳĺƥ sƥeŞs • lcoĺol swaċs

• Foil • BZK wipes

• Straws • Push sticks

• Mouthpieces

ProǄiēe saĲer sŞokinĳ supplies in

ċoth kits anē as inēiǄiēual suppliesȦ

Safer crack smoking supplies

KITS

Kits include all supplies needed for safer

smoking/vaping/snorting. The kit will include

items depending on the drugs available in

your community and what individuals share

that they need. Examples of different kits

are: crackȡ crǋstal Şethȡ ĲoilȬchasinĳ the

dragon, and snorting.

Safer crǋsƥal meƥĺ smoking supplies

SAFER INHALING

INDIVIDUAL SAFER SMOKING SUPPLIES

Individual supplies allow a person to choose the type of supply and

amount that best suits their needs.

'ƑƭĳƙŞūƙƥūĲƥĚŠƙŞūŒĚēȬǄîƎĚēîƑĚČƑǋƙƥîŕŞĚƥĺȡČƑîČŒČūČîĿŠĚîŠēĲĚŠƥîŠǋŕȦ

¹ĺĚ ƥƑîŠƙŞĿƙƙĿūŠ ūĲ OT× îŠē ĺĚƎîƥĿƥĿƙ Ŀƙ ƎūƙƙĿċŕĚ ƥĺƑūƭĳĺ ƙŞūŒĿŠĳȬǄîƎĿŠĳȦ ŕūūē

ƑĚƙĿēƭĚ ĲƑūŞ ŕĿƎƙ ūƑ Şūƭƥĺ ČîŠ ƥƑîŠƙĲĚƑ ƥū ƙŞūŒĿŠĳȬǄîƎĿŠĳ ƙƭƎƎŕĿĚƙȦ ¤ĚƙĿēƭĚ Ŀƙ ƥĺĚŠ

ƎîƙƙĚē ƥū ūƥĺĚƑƙ ǅĺĚŠ ƙƭƎƎŕĿĚƙ îƑĚ ƙĺîƑĚēȦ

~ƥĺĚƑ ĺîƑŞƙ ĿŠČŕƭēĚ ēîŞîĳĚ ƥū ŕƭŠĳƙ îŠē ūƥĺĚƑ ūƑĳîŠƙȦ ¹ĺĚƙĚ ĺîƑŞƙ ČîŠ ČūŞĚ ĲƑūŞ

ƭƙĿŠĳ ŞîŒĚƙĺĿĲƥ ƎĿƎĚƙ

ĲƑūŞ ĺîǕîƑēūƭƙ ŞîƥĚƑĿîŕƙȦ qîƥĚƑĿîŕƙ ČîŠ ĿŠČŕƭēĚ ĳŕîƙƙ ĲƑîĳŞĚŠƥƙȡ

ƑĚƥƑūǛƥƥĚē ƎĿƎĚƙ ūƑ ƙƥĚŞƙȡ îŠē îŕƭŞĿŠƭŞ ƎūƎ ČîŠƙȦ qîŒĚƙĺĿĲƥ ƎĿƎĚƙ ČîŠ ĚǊƎŕūēĚ ǅĺĚŠ

ĺĚîƥĚēȡ ūƑ ƭŠēĚƑ ĚǊƥƑĚŞĚ ƥĚŞƎĚƑîƥƭƑĚ ČĺîŠĳĚƙȦ

Safer smoking supplies include:

Straight steŞ – used to inhale vapours such as

crack cocaine. Also called a crack pipe.

Bowl Pipe – used to inhale vapours such as crystal

meth. Also called a meth, bowl, bubble or pipe.

Foil – used to smoke/vape different drugs such

as fentanyl, crack, or crystal meth.

Straw – used for snorting/inhaling drugs.

Brass Screen – placed in a straight stem to keep

drugs in place. Screen(s) also keep hot pieces from

being inhaled into the mouth/throat.

Mouthpiece – placed on the mouth end of a bowl

pipe or straight stem for safety.

Alcohol SwabȶƥūČŕĚîŠǛŠĳĚƑƙîŠēƎƑĚƎîƑîƥĿūŠ

space.

BZK Wipe – to clean hands and preparation space.

Push Stick – used to prepare and position screens

in a straight stem. Can also be used to remove/

scrape drug residue from a pipe or stem.

Other useful harm reduction supplies that could

be inc

luded are: lighters or tea lights, lip balm,

bandages, condoms, lubricant, and resource

cards. Additional items can be added to kits

based on the drugs in the region, frequency of

individuals accessing supplies and knowledge

of the community.

When packaging kits, use a variety of

baggie colour s

to quickly differentiate the different kits.

Sample of a Bowl Pipe Kit

RECOMMENDED

Bowl pipes

Ǩ ċūǅŕ ƎĿƎĚƙ ɨ Ǩ ƭŠĿƥƙ

Moutĺpieces

Ǫ ŞūƭƥĺƎĿĚČĚƙ ɨ Ǫ ƭŠĿƥƙ

Alcoĺol swaċs

Ǩ îŕČūĺūŕ ƙǅîċƙ ɨ Ǩ ƭŠĿƥƙ

Sample of a Straigĺt Stem Kit

RECOMMENDED

Straigĺt stems

Ǩ ƙƥƑîĿĳĺƥ ƙƥĚŞ ɨ Ǩ ƭŠĿƥƙ

Brass screens

Ǫ ƎîČŒîĳĚƙ ɨ Ǫ ƭŠĿƥƙ

Pusĺ stick ǧ Ǝƭƙĺ ƙƥĿČŒ ɨ ǧ ƭŠĿƥ

Moutĺpieces Ǩ ŞūƭƥĺƎĿĚČĚƙ ɨ Ǩ ƭŠĿƥƙ

Alcoĺol swaċs

Ǩ îŕČūĺūŕ ƙǅîċƙ ɨ Ǩ ƭŠĿƥƙ

Sample of a Foil Kit

RECOMMENDED

ǨȹǪ ƙĺĚĚƥƙ ȳĲūĿŕ ĲūƑ

Foil sĺeets

ƎƭƥƥĿŠĳ ƥĺĚ ēƑƭĳ ūŠ

ƥū ƙŞūŒĚȬǄîƎĚ ĲƑūŞ ɤ

ĲūĿŕ ƥū ŞîŒĚ î ƎĿƎĚȴ

Alcoĺol swaċs

Ǩ îŕČūĺūŕ ƙǅîċƙ

ɨ Ǩ ƭŠĿƥƙ

Sample of a Snorting Kit

RECOMMENDED

Paper straws

Ǩ ƙƥƑîǅƙ ȳēĿĲĲĚƑĚŠƥ

ČūŕūƭƑƙȴ ɨ Ǩ ƭŠĿƥƙ

Foil sĺeets

Ǩ ĲūĿŕ ƙĺĚĚƥƙ

Alcoĺol swaċs

Ǩ îŕČūĺūŕ ƙǅîċƙ

ɨ Ǩ ƭŠĿƥƙ

REFERENCE GUIDE

Str aight

Stems

SAFER INHALING

Straight stems are intended for

smoking drugs in rock form such

as crack cocaine. They are also

used for smoking any other drug

that produces vapour. When

heated, the stem funnels vapour

of the drug to the mouth. Always

use a mouthpiece (to prevent

burned lips), and brass screens.

¹ĺĚ ŞūƭƥĺƎĿĚČĚ Ŀƙ ǛƥƥĚē ƥū ƥĺĚ ĚŠē ūĲ ƥĺĚ

ƙƥƑîĿĳĺƥ ƙƥĚŞ îŠē ƙĺūƭŕē Šūƥ ċĚ ƙĺîƑĚēȦ

Ƒîƙƙ ƙČƑĚĚŠƙ îƑĚ ĲūŕēĚē îŠē ĿŠƙĚƑƥĚē ĿŠƥū

ƥĺĚ ƙƥĚŞ ƥū ŞîŒĚ î ƥĿĳĺƥ ƙĚîŕȦ ¹ĺĿƙ Ŀƙ ƥū ŒĚĚƎ

ƙŞîŕŕȡ ǄĚƑǋ ĺūƥ ƎĿĚČĚƙ ūĲ ēƑƭĳ ĲƑūŞ ċĚĿŠĳ

ĿŠĺîŕĚē ĿŠƥū ƥĺĚ Şūƭƥĺ îŠē ƥĺƑūîƥȦ

Using a moutĺpiece and ċrass screens

witĺ tĺe stem can reduce tĺe risk of

ĺepatitis B and C and otĺer infectionsȦ

Straight stems are made from Pyrex

glass which is resistant to high

temperatures. They are intended

for smoking/vaping.

Saliva and blood from the mouth

can transfer to a mouthpiece.

Always use your own. Never share.

Replace brass screens in the pipe

when they become loose or are

falling apart.

Provide straight stems in both

pre-packaged kits and as individual

items. There should be no limit on

the number of straight stems per

person, per visit.

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before handling harm reduction

supplies or drugs. If soap and water are not available,

use BZK wipes or alcohol swabs. Use a new BZK wipe

or alcohol swab to clean the drug preparation surface.

Avoid Sĺaring

There is evidence that hepatitis B and C, pneumonia

and tuberculosis can be passed to others when

inhalation equipment is shared.

Don’t Modify

Self-made stems are not safe to use. Modifying the

stem in any way increases risk of lip and mouth injury

îŠēċƭƑŠƙȦ¤ĚƥƑūǛƥƥĿŠĳîƙƥƑîĿĳĺƥƙƥĚŞČîŠČūŞƎƑūŞĿƙĚ

the glass. It increases the risk of breaking or blowing-up

in your hand.

Not Scratcĺ Resistant

Always use a wooden push stick for packing screens

or removing them. Other items can scratch or damage

the glass, weakening it. This could make the stem

break or shatter when exposed to heat.

Avoid Damaged Stems

Throw away and do not reuse a stem that is broken,

cracked or has visible blood droplets.

Disposal

Used straight stems should be disposed of

safely. Please see page 90-91 for information

on safe disposal.

Replace a straigĺt stem wĺen:

•

The stem was used by someone else

•

The stem is scratched, chipped or cracked

• The stem is burnt

•

Even the smallest trace of blood is on it

Discourage use of selfȹmade pipes or

retroǛtted straigĺt stemsȦ ¹ĺey can

increase risk of inŏury and ċurnsȦ

Try this line:

ȩIf you canȡ always use a glass stem from

a ĺarm reduction programȦ ¹ĺey are resistant

to ĺigĺ ĺeat and ĺarder to ċreak and cĺipȦȩ

br ass

screens

SAFER INHALING

Brass screens hold drugs in

place in a straight stem. Screens

are folded and positioned in the

stem using a wooden push stick.

¬ČƑĚĚŠƙ ċŕūČŒ ĺūƥ ƎîƑƥĿČŕĚƙ ĲƑūŞ

ċĚĿŠĳ ĿŠĺîŕĚē ĿŠƥū ƥĺĚ Şūƭƥĺ îŠē

ƥĺƑūîƥȦ ¹ĺĚ ŞĚƙĺ îŕŕūǅƙ ēƑƭĳ ǄîƎūƭƑ

ƥū ǜūǅ ƥĺƑūƭĳĺȦ ¹ĺĚ Şūƙƥ ČūŞŞūŠ

ēƑƭĳ ƭƙĚē ĿŠ ƥĺĚ ƙƥƑîĿĳĺƥ ƙƥĚŞ ǅĿƥĺ

ƙČƑĚĚŠƙ Ŀƙ ČƑîČŒ ČūČîĿŠĚȦ

Ƒîƙƙ ƙČƑĚĚŠƙ îƑĚ î ƙîĲĚƑ îŠē ċĚƥƥĚƑ

ƐƭîŕĿƥǋ ČĺūĿČĚ ƥĺîŠ ƭƙĿŠĳ ĺūƭƙĚĺūŕē

ĿƥĚŞƙ ƙƭČĺ îƙ ƑĿŕŕū

Ȧ OūƭƙĚĺūŕē

ĿƥĚŞƙ ČîŠ ĺîǄĚ ČĺĚŞĿČîŕƙ ǅĺĿČĺȡ

ǅĺĚŠ ĺĚîƥĚē ǅĿŕŕ ċĚ ĿŠĺîŕĚēȦ ¹ĺĚǋ

ČîŠ îŕƙū ƙĺƑĿŠŒ îŠē ċƑĚîŒ îƎîƑƥ

ǅĺĚŠ ĺĚîƥĚē îŠē ēîŞîĳĚ ƥĺĚ ĿŠƙĿēĚ

ūĲ ƥĺĚ Şūƭƥĺ ūƑ ƥĺƑūîƥ ĿĲ ĿŠĺîŕĚēȦ

Using Brillo

or other types of steel scouring pads

is a very unsafe and harmful practice. Small bits of

the steel wool can break off and be inhaled while

smoking crack. Deeper inhalation or ingestion of the

steel shards can burn the airways and anywhere

along the route to the stomach.

SoŞe suggestions to oĲĲer indiǄiduals who

Şaǋ not be readǋ to change ĲroŞ using Brillo

Place a brass screen over the mouth end of

ƥĺĚƙƥƑîĿĳĺƥƙƥĚŞȦ¹ĺĚŠǛƥîŞūƭƥĺƎĿĚČĚūǄĚƑ

the top of it making it snug and secure. This is

an added layer of protection from having broken

pieces of Brillo

inhaled into the mouth/throat.

Wrapping a brass screen around the Brillo

Packing brass screens in the pipe.

Then putting Brillo

closest to the drug.

Screens are made of thin, brass metal sheets. They are highly heat resistant,

pliable, and have no chemical coating. They allow for inhalation of drug

vapour. Five screens are in each packet.

Screens are Ĳor personal use and should not be shared.

Provide screen packets in both pre-packaged kits and as individual items.

There should be no limit on the number of screen packets per person, per visit.

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before handling harm reduction

supplies or drugs. If soap and water are not available,

use BZK wipes or alcohol swabs. Use a new BZK wipe

or alcohol swab to clean the drug preparation surface.

New every time

Use new brass screens each time when smoking

drugs. Used screens can shrink or shred allowing them

to become loose in the stem. If loose, they could be

inhaled into the mouth or throat. Always make sure

screens are packed tightly.

Pusĺ Stick

Àse a push stick to helpȠ

• Mold the screens

• Pack the screens

• Remove the screens

The wooden push stick is less likely to scratch or

damage the straight stem than other materials.

Different Methods

There is no ‘one way’ of packing screens. Try different

ƙƥǋŕĚƙūĲƎîČŒĿŠĳƭŠƥĿŕǋūƭǛŠēūŠĚǋūƭƎƑĚĲĚƑȦ

Disposal

Used screens should be disposed of safely. Please

see pages 90-91 for information on safe disposal.

ɁÞou asked wĺy use ċrass screens instead of Brillo

Øellȡ ċrass screens are far safer to useȦ ¹ĺey can ĺelp

preǄent ċurns to tĺe tĺroat and moutĺȦ And tĺey are

not coated witĺ potentially toǊic cĺemicalsȦɂ

Try this line:

Step-by-Step

guide

See next page

SAFER INHALING

br ass

screens

This is one method of folding screens for a stem pipe.

Always wash hands and prep

area with soap and water,

BZK Wipes or alcohol swab.

Remove screens from packet.

Stack screens together and fold in

one side of the stack of screens.

Use thumb to fold in

the other side so the

stack of screens has

a cone shape.

REFERENCE GUIDE

STEP-BY-STEP GUIDE

Roll screens into the middle with

the folded sides facing inward.

Press together tightly.

Insert screens into the stem. Place

the stem on prep work space and

push the screens down with a wooden

stick so they are tightly packed.

Push the screens about 1cm into the

stem to allow room for the drug.

bowl pipes

Bowl pipes are used for smoking crystal methamphetamine.

They are also used for other drugs that produce vapour when heated.

The crystals (or other drug) are placed in the bottom of the bowl.

A lighter is held beneath the bowl to heat the drug to a vapour.

Always use a moutĺpiece on tĺe ċowl pipeȦ ØĺĿŕĚ ƎĿƎĚ ƙĺîƑĿŠĳ Ŀƙ î ČūŞŞūŠ

ƎƑîČƥĿČĚ ǅĿƥĺ ƎĚūƎŕĚ ǅĺū ƙŞūŒĚ ČƑǋƙƥîŕ ŞĚƥĺȡ Ŀƥ Ŀƙ Šūƥ ĚŠČūƭƑîĳĚēȦ ŕūūē

îŠē ƙîŕĿǄî ČîŠ ƑĚŞîĿŠ ūŠ ƥĺĚ ƎĿƎĚ îŠē ċîČƥĚƑĿî ūƑ ǄĿƑƭƙĚƙ Čūƭŕē ċĚ ƙĺîƑĚēȦ

¬ŞūŒĚ ƙîĲĚƑ ċǋ ƭƙĿŠĳ î ƎĚƑƙūŠîŕ ŞūƭƥĺƎĿĚČĚȦ

OîŠēĿŠĳ ūƭƥ ċūǅŕ ƎĿƎĚƙ Ŀƙ î ČĺîŠČĚ ƥū

ĚŠĳîĳĚ ǅĿƥĺ ƎĚūƎŕĚȦ

ǋ ƎƑūǄĿēĿŠĳ ĺîƑŞ ƑĚēƭČƥĿūŠ ƙƭƎƎŕĿĚƙ îŠē ĚēƭČîƥĿūŠ ȳĚȦĳȦ ƙîĲĚƑ ƙĚǊȴȡ

Ŀƥ ūƎĚŠƙ ƥĺĚ ēūūƑ ƥū ċƭĿŕē ƑĚŕîƥĿūŠƙĺĿƎƙȦ

Some people retroǛt tĺe sĺape of tĺe ċowl pipeȦ

¹ĺi

s can increase risk of cracks and ċreakages ċy

compromising tĺe integrity of tĺe productȦ

It is safest to use the pipe as is.

¤eplace a bowl pipe whenȠ

• The pipe has been used by someone else

• The pipe is scratched, chipped or cracked

• The pipe is burnt

Bowl pipes haǄe been known to be sold on the street

Ĳor Ǜnancial gain. PrograŞs will need to deterŞine iĲ

that presents a probleŞ in their coŞŞunitǋ and how to

address it.

SAFER INHALING

Bowl pipes from harm reduction

programs are made from

Pyrex glass which is much less

likely to shatter than regular

glass when heated. They are

individually wrapped in a foam

envelope to prevent breakage.

Provide bowl pipes both in

pre-packaged kits and as

individual items. There should

be no limit on the number of

bowl pipes per person, per visit.

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before handling harm

reduction supplies or drugs. If soap and water

are not available, use BZK wipes or alcohol

swabs. Use a new BZK wipe or alcohol swab to

clean the drug preparation surface.

Always Use a Moutĺpiece

Remind people of the importance of using a

personal mouthpiece. For safety and health,

don’t share your mouthpiece.

safer Sex Education

Provide safer sex information with bowl pipes

to reduce the risk of infections and transmission

of blood borne viruses.

safe Use

Àsing bowl pipes ĲroŞ ǋour harŞ

reduction prograŞ can help reduceȠ

• Transmission of hepatitis B and C, pneumonia

and tuberculosis (from sharing pipes)

• Injury and burns from using self-made pipes

Repeated Use

¹he pipe becoŞes unsaĲe to use whenȠ

• It is damaged

• It has been used by someone else

• It is burnt

Avoid Damaged Pipes

A bowl pipe that is cracked, broken or has

visible blood droplets should be thrown away

and never used.

Overdose from Smoking

Overdose is possible when smoking drugs.

Learn to recognize the signs of an overdose.

Don't use alone.

Disposal

Used bowl pipes should be disposed

of safely. Please see pages 90-91 for

information on safe disposal.

Try this line:

ɁIf you notice tĺat tĺe pipe is

cĺipped or crackedȡ donɄt use itȦ

Graċ a new one insteadȦɂ

Mouthpieces

Mouthpieces are for

personal use only. They

should never be shared.

Saliva, phlegm or blood

can remain on the

mouthpiece. Infection can

be transmitted by sharing

mouthpieces.

¹ĺĚ ŞūƭƥĺƎĿĚČĚ Ŀƙ î ƙĺūƑƥ ǄĿŠǋŕ ƥƭċĚ ƥĺîƥ Ǜƥƙ

ƥĿĳĺƥŕǋ ūŠ ƥĺĚ ĚŠē ūĲ î ƙƥƑîĿĳĺƥ ƙƥĚŞ ūƑ ċūǅŕ

ƎĿƎĚȦ Tƥ ƎƑūƥĚČƥƙ ŕĿƎƙ ĲƑūŞ ĺîǄĿŠĳ ēĿƑĚČƥ ČūŠƥîČƥ

ǅĿƥĺ ĺūƥ ĳŕîƙƙȦ TĲ Šūƥ ƙĺîƑĚēȡ ŞūƭƥĺƎĿĚČĚƙ

ČîŠ ƑĚēƭČĚ ƥĺĚ ƑĿƙŒ ūĲ ƥƑîŠƙŞĿƥƥĿŠĳ ċîČƥĚƑĿîŕ

ĿŠĲĚČƥĿūŠƙ îŠē ċŕūūē ċūƑŠĚ ǄĿƑƭƙĚƙȦ

qūƭƥĺƎĿĚČĚƙ îƑĚ ŞîēĚ ĲƑūŞ ĲūūēȹĳƑîēĚ

ǄĿŠǋŕ

ƥƭċĿŠĳȦ ¹ĺĚ ċūǅŕ ƎĿƎĚ îŠē ƥĺĚ ƙƥƑîĿĳĺƥ ƙƥĚŞ

îƑĚ ƙŕĿĳĺƥŕǋ ēĿĲĲĚƑĚŠƥ ĿŠ ƙĿǕĚȦ ĚČîƭƙĚ ūĲ ƥĺĿƙȡ

ƥĺĚƑĚ îƑĚ ƥǅū ƙĿǕĚƙ ūĲ ŞūƭƥĺƎĿĚČĚ ƥƭċĿŠĳ ƥū

ĚŠƙƭƑĚ î ƙĚČƭƑĚ ǛƥȦ

A minimum lengtĺ of ǧȦǫ incĺes is

recommendedȡ

ċut can ċe cut to

preferred siǕeȦ

Moutĺpieces are single useȦ

SAFER INHALING

¡ƑūǄĿēĚ ŞūƭƥĺƎĿĚČĚƙ ċūƥĺ

ĿŠ ƎƑĚȹƎîČŒîĳĚē ŒĿƥƙ îŠē

îƙ ĿŠēĿǄĿēƭîŕ ĿƥĚŞƙȦ ¹ĺĚƑĚ

ƙĺūƭŕē ċĚ Šū ŕĿŞĿƥ ūŠ ƥĺĚ

ŠƭŞċĚƑ ūĲ ŞūƭƥĺƎĿĚČĚƙ ƎĚƑ

ƎĚƑƙūŠȡ ƎĚƑ ǄĿƙĿƥȦ

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before touching harm

reduction supplies or drugs. If soap and water

are not available, use BZK wipes or alcohol

swabs. Use a new BZK Wipe or alcohol swab

to clean the drug preparation surface.

Use New

Use a new mouthpiece every time when

smoking/vaping drugs.

Longer Moutĺpiece =less Risks

The longer the mouthpiece, the less chance

debris will reach the mouth and burn the throat.

A minimum length of 1.5 inches is recommended,

but some might prefer a longer mouthpiece.

Never Share

Using a personal mouthpiece every

time prevents transmission of HIV and

hepatitis B and C.

Encour age Moutĺpieces

A mouthpiece that is not shared will

protect the mouth from:

•

Burns from a hot pipe or stem

•

Oral lesions (sores in the mouth)

•

Infection

•

Blood borne viruses

Careful Removal

To prevent burns to the hands remove

the mouthpiece carefully from a hot stem.

Disposal

Used mouthpieces should be disposed

of safely. Please see pages 90-91 for

information on safe disposal.

Try this line:

ɁHeyȡ you want a ċowl pipe

or straigĺt stem? DonɄt

forget tĺe moutĺpiece

ȶ it goes witĺ itȦȩ

PUSH STICKS

Push sticks are used to pack and

position screens inside the straight stem.

They can also be used to scrape out

the resin that remains in the stem after

smoking/vaping.

Push sticks are birch wood dowels that

will not scratch, chip glass, or lead to

stem breakage.

SAFER INHALING

Provide push sticks both in pre-packaged

kits and as individual items. There should

be no limit on the number of push sticks

per person, per visit.

Try this line:

ɁItȪs safer to use a wooden pusĺ stick to pack

tĺe screensȦ A plastic syringe plunger can melt

inside tĺe ĺot pipeȦ A metal oċŏect can scratcĺ

or damage tĺe glassȦȩ

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before handling harm

reduction supplies or drugs. If soap and water

are not available, use BZK wipes or alcohol

swabs. Use a new BZK Wipe or alcohol swab

to clean the drug preparation surface.

Avoid Makesĺift Sticks

Self-made or makeshift push sticks may

scratch or introduce bacteria into the stem.

Using a metal object as a push stick can impair

the integrity of the glass leading to chipping,

cracking, or breaking.

Disposal

Used push sticks should be disposed

of safely. Please see pages 90-91 for

information on safe disposal.

Try this line:

ɁHeyȡ if you use tĺese

wooden pusĺ sticks instead

of sometĺing elseȡ tĺe pipe

will deǛnitely last longerȦɂ

str aws

Paper straws are used for snorting

powdered drugs or inhaling vapour from

heating drugs on foil. The paper straws are

for personal use only. They are made from

biodegradable material.

¬ŠūƑƥĿŠĳ ēƑƭĳƙ ČîŠ ēîŞîĳĚ ƥĺĚ ŞĚŞċƑîŠĚƙ ĿŠ ƥĺĚ

ŠūƙĚȦ ¹ĺĿƙ ČîŠ ČîƭƙĚ Ŀƥ ƥū ċŕĚĚē ĚîƙĿŕǋȦ TŠƙĚƑƥĿŠĳ ƥĺĚ

ƙƥƑîǅƙ ĿŠ ƥĺĚ Šîƙîŕ ČîǄĿƥǋ ƥū ƙŠūƑƥ ƎūǅēĚƑĚē ēƑƭĳƙ

ČîŠ ČūŠƥîŞĿŠîƥĚ ƥĺĚŞ ǅĿƥĺ ċŕūūē ēƑūƎŕĚƥƙȦ

Straws sĺould never ċe sĺaredȦ ¹ĺey may

transmit ċacteria and viruses tĺat can ċe passed

on to otĺers if sĺaredȦ

qîŒĚƙĺĿĲƥ ĿƥĚŞƙ ūƑ ƎŕîƙƥĿČ ƙƥƑîǅƙ ČîŠ

ČîƭƙĚ

ƙČƑîƥČĺĚƙ îŠē ƥĚîƑƙ ƥū ƥĺĚ ĿŠƙĿēĚ ūĲ ƥĺĚ ŠūƙĚȦ

ÀƙĿŠĳ ƎîƎĚƑ ƙƥƑîǅƙ ĺĚŕƎƙ ƥū ƑĚēƭČĚ ĺîƑŞƙȦ

¡ĚūƎŕĚ ǅĿƥĺ ǛŠĚ ŞūƥūƑ ĿŞƎîĿƑŞĚŠƥ ŞĿĳĺƥ ǛŠē

ƭƙĿŠĳ ƙƥƑîǅƙ ĚîƙĿĚƑ ƥĺîŠ ƑūŕŕĿŠĳ î ĲūĿŕ ƥƭċĚȦ

SAFER INHALING

¡ƑūǄĿēĚ ƎîƎĚƑ ƙƥƑîǅƙ ċūƥĺ ĿŠ

ƎƑĚȹƎîČŒîĳĚē ŒĿƥƙ îŠē îƙ ĿŠēĿǄĿēƭîŕ

ĿƥĚŞƙȦ ¹ĺĚƑĚ ƙĺūƭŕē ċĚ Šū ŕĿŞĿƥ

ūŠ ƥĺĚ ŠƭŞċĚƑ ūĲ ƎîƎĚƑ ƙƥƑîǅƙ

ƎĚƑ ƎĚƑƙūŠȡ ƎĚƑ ǄĿƙĿƥȦ

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before touching harm

reduction supplies or drugs. If soap and water

are not available, use BZK wipes or alcohol

swabs. Use a new BZK Wipe or alcohol swab

to clean the drug preparation surface.

never share

Always use your own straw to lessen the risk of

infection. It will also decrease the chance of spreading

infection from bacteria and germs from hands.

Single Use

Paper straws are single use.

Overdose

Overdose is possible from inhaling drugs.

Never use alone. Always have a naloxone kit

when using opioid drugs.

Keep Straws Dry

Paper straws will deteriorate with moisture or

humidity. Keep them dry.

Disposal

Used paper straws should be disposed

of safely. Please see pages 90-91 for

information on safe disposal.

Try this line:

ɁÞou know tĺat straws arenɄt for

snorting onlyȦ If you smoke drugsȡ

you can use tĺem to vape as wellȦɂ

Foil

Foil sheets are used to smoke/vape drugs that produce inhalable

vapours when heated. Smoking drugs this way is called “chasing the

dragon.” Many drugs can be consumed by using foil, such as: crack

cocaine, crystal meth, brown heroin and pills like oxycodone and

fentanyl. Drugs in pill form such as prescription opiates are crushed

into a powder before smoking.

GūĿŕ Ŀƙ ƭƙĚē ċǋ ƎĚūƎŕĚ ǅĺū ƎƑĚĲĚƑ ƙŞūŒĿŠĳȬǄîƎĿŠĳ ēƑƭĳƙȦ

¬ūŞĚ ƭƙĚ ĲūĿŕ ǅĺĚŠ ǅîŠƥĿŠĳ ƥū ƥîŒĚ î ċƑĚîŒ ĲƑūŞ ĿŠŏĚČƥĿŠĳ ƥū

ĳĿǄĚ ǄĚĿŠƙ î ČĺîŠČĚ ƥū ĺĚîŕȦ ¬ūŞĚ ƎĚūƎŕĚ ƙǅĿƥČĺ ƥū ĲūĿŕ ǅĺĚŠ

ƥĺĚǋ ǅîŠƥ ƥū ƥƑîŠƙĿƥĿūŠ îǅîǋ ĲƑūŞ ĿŠŏĚČƥĿŠĳ ƥū ĿŠĺîŕîƥĿūŠȦ

Switching ĲroŞ inŏecting to

sŞoking drugs Şaǋ haǄe

beneǛtsȠ

•

reduces risk of transmission

of blood borne viruses

•

lessens vein injuries

•

no missed or wasted hits

•

reduces abscesses

•

no needle marks

SŞoking drugs ĲroŞ Ĳoil can

preǄent harŞs associated

with inŏecting. Tt still carries

risks. SŞoking drugs can

causeȠ

•

heat damage to the throat

and lungs from hot vapours

•

asthma-like breathing

ēĿĲǛČƭŕƥĿĚƙĲƑūŞƙŞūŒĿŠĳ

drugs and impurities

SAFER INHALING

Foil for smoking drugs is

stronger and thicker than

general household foil. It is

not coated with oil and not

texturized.

Foil sheets can be cut into

multiple pieces as preferred or

folded for a thicker surface.

Provide the foil in both

pre-packaged kits and as

individual items. There should

be no limit on the number of

foil sheets per person, per visit.

REFERENCE GUIDE

KEY MESSAGES

Wash Hands

Always wash hands before handling harm

reduction supplies or drugs. If soap and water

are not available, use BZK wipes or alcohol

swabs. Use a new BZK wipe or alcohol swab

to clean the drug prep surface.

Keep it Clean

A new, clean piece of foil can be used as a

safer preparation surface.

Avoid Sĺaring

Each foil sheet is single use only.

Give Veins a Break

Switching from injecting to smoking can give

veins a break to heal. It helps reduce the risk of

infections and abscesses.

Make a Foil Pipe

Make your own pipe using foil. Foil pipes are

safer than makeshift devices and can reduce

the chance of cutting lips.

No oil coating

This foil was made for smoking drugs. It has no

oil coating, so no need to burn it before using.

Beware of overdose

Drug overdose is possible when smoking/

vaping drugs.

Tt is iŞportant toȠ

•

not use alone

•

recognize the signs of an overdose

•

respond if an overdose occurs

Disposal

Used foil should be disposed of safely.

Please see pages 90-91 for information

on safe disposal.

FOIL FOLDING TECHNIQUE

Foil

Foil Pipe

Try this line

“Did you know you can make

your own pipe out of foil?ɂ

Smoking

cr ack cocaine

USING A STRAIGHT STEM

Crack is made by mixing powdered

cocaine with water and another

substance, usually baking soda

(sodium bicarbonate).

SAFER INHALING

Solid crystals form after boiling the mixture.

These crystals are known as crack or freebase

cocaine. The rocks are white, cream or light

brown colour.

Crack cocaine is in a crystal form. It needs to be

heated to produce vapours that are inhaled. It has

a low melting point producing crackling sounds

when heated. Cocaine powder has a high melting

point and makes no sound.

Crack is a smokable and stronger form of cocaine.

It causes a greater high with more intense side

effects during use and in the ‘comedown’ or

‘crash’ phase.

Crack is commonly smoked using a straight stem

or from foil. Screens are needed for smoking crack

from a straight stem. The screens keep the drug

in place and also keeps hot pieces from being

inhaled into the mouth.

Crack is usually smoked, but can be injected,

snorted or swallowed.

After smoking crack, some of the drug resin will

ƑĚŞîĿŠūŠƥĺĚǅîŕŕƙūĲƥĺĚƙƥĚŞȦÞūƭČîŠƙĚĚƥĺĚ

resin better when the stem cools down. Crack

resin can be collected by pushing a screen to the

opposite side of the stem or by moving it back

and forth to scrape the built up resin from the wall

of the stem. The screen can be pushed out of the

stem and turned round before being reinserted.

Screens can shrink after being heated. Add more

ƙČƑĚĚŠƙĿĲŠĚĚēĚēĲūƑîƙŠƭĳǛƥĿŠƥĺĚƙƥĚŞȦ

REFERENCE GUIDE

7171

KEY MESSAGES

Types of Glass

Tempered glass (Pyrex) is safer than untempered

glass which can shatter and break when heated.

This can cause injuries to the lips and mouth.

Use Proper Equipment

Using makeshift smoking equipment, such as

plastic bottles or cans should be avoided. The

hot, jagged surface of these items can cause

burns, blisters, cuts and sores. Heating or burning

them can release toxic fumes that are inhaled.

Use Br ass Screen

Always use brass screens. Brillo

or other

steel scouring pads should not be used. These

alternatives are unsafe due to chemicals on

them that will be heated and inhaled. They

can also cause injuries and burns to the lips and

inner mouth.

For those who prefer using Brillo

, a safer method

is to place a brass screen over the mouth end of

the pipe. Fit a mouthpiece over the top to keep it

snug and in place. This will keep pieces of Brillo

and hot drug pieces from being inhaled into the

mouth. Another option is to wrap a brass screen

around the Brillo

and use them together.

Using a Str aight Stem

After taking a hit, the straight stem should be put

on a non-melting surface with the screen end

tilted slightly upwards.

Straight stems can get very hot during heating.

Let the stem cool down before taking the next hit

to prevent burns to lips, mouth and hands.

Use Push Sticks

Use wooden push sticks instead of metal or

needles/syringes to position the screens or scrape

the resin. These makeshift devices can chip the

stem or cause it to break.

Avoid Sĺaring

Never share a personal straight stem. Even small

amounts of blood from cuts or burns on the lips

can remain on the stem. The blood residue can

transmit infections such as hepatitis C.

Reusing Screens

If you are reusing screens, add more so that the

ǛƥĿƙƙŠƭĳĿŠƥĺĚƙƥĚŞȦ

Always Use a Moutĺpiece

If people are sharing their stem with others,

remind them to always use their own mouthpiece.

A personal mouthpiece can protect lips from

burns and cuts.

Always Clean

If reusing your own straight stem, bowl pipe or

mouthpiece, always clean with an alcohol swab.

This does not make it safe for sharing.

Fentanyl

Remind individuals that sometimes fentanyl or

fentanyl-analogs (similar drugs) are found in crack

cocaine. There is no way to tell by colour, taste or

smell if the crack cocaine batch contains fentanyl.

Carry Naloxone

Encourage everyone to carry a naloxone kit.

It is used to reverse opioid overdose only. It has

no effect on overdoses caused by other drugs.

Avoid Using Alone

Overdose is possible when smoking drugs.

Learn to recognize the signs of an overdose.

Don't use alone.

Smoking drugs

using foil

Smoking drugs using foil

is also known as ‘Chasing

the Dragon’. Many drugs

can be used this way such

as: brown/black tar heroin,

crack cocaine, crystal

meth, fentanyl and some

pills. Drugs in tablet form

are often crushed into a

ƎūǅēĚƑǛƑƙƥċĚĲūƑĚƎƭƥƥĿŠĳ

them on foil.

Exposing lungs and mouth to any kind of smoke or

heated vapour can be harmful. Providing foil may

prevent or divert people from injecting.

Foil may help reduce the risks associated with

injecting, such as:

• transmission of HIV, hepatitis B and C

• bacterial or fungal infections

• vein damage

SAFER INHALING

A Metĺod of Using Foil for Chasing the Dr agon

Cut or fold the foil to preferred length.

Place the drug on the foil.

Heat the bottom of the foil with a lighter

(do not touch the foil as it will burn holes).

The drug will start producing vapour.

Inhale the vapour using a straw or

foil pipe.

USING FOIL TO

SMOKE CRACK

COCAINE

REFERENCE GUIDE

A Metĺod of Using Foil to

smoke cr ack cocaine

Always wash hands before handling

harm reduction supplies. Use soap and

water, BZK Wipe or alcohol swab to

clean hands and preparation area.

Fold foil in half to provide strength or

cut to desired length.

Place rocks in the middle of the foil

while holding the foil between thumb

îŠēƎūĿŠƥĚƑǛŠĳĚƑȦ

Apply heat from below foil using a

lighter. Take care not to touch the foil

ǅĿƥĺƥĺĚǜîŞĚȦTƥČūƭŕēċƭƑŠĺūŕĚƙĿŠƥĺĚ

foil, and evaporate the drug too quickly.

Tilt the foil so the liquid runs or slides

when the rocks melt to a liquid form.

Pinch the edges of the foil to prevent

liquid crack from spilling over. Crack

can slide fast on the foil surface when

it becomes liquid.

The straw or foil pipe is used to follow

the vapours as crack slides up and

down the foil.

When using a foil pipe, drug residue will

remain on the inside wall of the pipe.

Open the foil pipe to use as the next

surface using the residue. Make a new

foil pipe out of a new piece of foil.

Smoking

crystal meth

USING A BOWL PIPE

Bowl Pipes are used primarily

for smoking crystal meth. When

smoked, crystal meth is absorbed

in the bloodstream through the

lungs. The effects are usually felt

within 2 minutes.

Using safer smoking supplies from ĺarm

reduction programs can decrease tĺe

amount of cutsȡ ċurnsȡ ċlisters and sores

inside tĺe moutĺ and on tĺe lipsȦ These

ūČČƭƑ ŞūƑe ǅheŠ ƭsĿŠĳ ŞîŒeshĿĲƥ eƐƭĿƎŞeŠƥ

ƥhîƥ ČîŠ ĿŠČƑeîse ƑĿsŒ ūĲ OT× îŠē heƎîƥĿƥĿs

ƥƑîŠsŞĿssĿūŠȦ ŕūūē ƥū ċŕūūē ČūŠƥîČƥ ČîŠ

ūČČƭƑ ǅheŠ ƥhese ĿƥeŞs îƑe shîƑe

ēȦ

A metĺod for

smoking crystal meth

ŕǅîǋs ČŕeîŠ hîŠēs ċeĲūƑe hîŠēŕĿŠĳ

hîƑŞ ƑeēƭČƥĿūŠ sƭƎƎŕĿesȦ Àse sūîƎ îŠē

ǅîƥeƑȡ èe ØĿƎes ūƑ îŕČūhūŕ sǅîċsȦ

ƥƥîČh ƥhe ŞūƭƥhƎĿeČe ƥū ƥhe eŠē ūĲ

ƥhe ƎĿƎeȦ

ēē ČƑǋsƥîŕ Şeƥh ĿŠƥū ƥhe ċūǅŕ ƎĿƎeȦ

TîƎ ƥhe ƎĿƎe ĳeŠƥŕǋ

ƥū seƥƥŕe ƥhe ƑūČŒs

ĿŠ ƥhe ċūǅŕȦ

Oūŕē ƥhe ƎĿƎe hîŕĲǅîǋ ēūǅŠ ƥhe sƥeŞ îŠē

îƎƎŕǋ heîƥ ȳŕĿĳhƥeƑȴ sŕūǅŕǋ ƥū ƥhe ċūǅŕȦ

gĿĳhƥeƑ Ŀs sŕūǅŕǋ ŞūǄeē ċîČŒ îŠē ĲūƑƥh ƥū

ēĿsƥƑĿċƭƥe ƥhe heîƥ eǄeŠŕǋȦ

¤ūČŒs sŕūǅŕǋ ČhîŠĳe ƥū ŕĿƐƭĿē ČƑeîƥĿŠĳ î ǄîƎūƭƑȦ

TŠhîŕe ƥhe ǄîƎūƭƑ sŕūǅŕǋ îŠē eǊ

hîŕe ĿŞŞeēĿîƥeŕǋȦ

'ū Šūƥ hūŕē ƥhe ǄîƎūƭƑ ĿŠ ƥhe ŕƭŠĳsȦ ThĿs ČîŠ ċƭƑŠ

ǋūƭƑ ŕƭŠĳs îŠē ǅĿŕŕ Šūƥ ĳĿǄe ǋūƭ î ċeƥƥeƑ hĿĳhȦ

SAFER INHALING

KEY MESSAGES

REFERENCE GUIDE

Inhale and Exhale

Inhale slowly and exhale immediately to

prevent burning the lungs. Holding the smoke

in the lungs can be very damaging. It makes no

difference to the intensity of the drug effect.

Always Use a Moutĺpiece

Always use a mouthpiece to avoid burning lips

and mouth.

Avoid Sĺaring

A bowl pipe is for personal use only. Never

share. Blood particles with the hepatitis C

virus can be passed on from cracked lips.

Prevent Side Effects

Smoking crystal meth can damage lungs and

dry out the mouth and lips. Using lip balm after

smoking can help prevent lip sores.

Single Use

All harm reduction supplies are single use.

If pipes are being used again, be sure to clean

ǅĚŕŕǛƑƙƥǅĿƥĺîŠîŕČūĺūŕƙǅîċȦ

Use Proper Equipment

Using makeshift equipment can cause

cuts, burns, blisters and open sores

on the mouth, lips and gums.

Encourage Eating

Encourage people who smoke crystal meth to

take vitamins and eat something before they

smoke. Crystal meth is an appetite suppressant

and most people will not feel hunger after

smoking. When coming down, eating will help

with sleep.

Stay Protected

Crystal meth is associated with more risky sex.

Encourage people to carry condoms to avoid

having unprotected sex while being high.

Avoid Using Alone

If possible, smoke in a safe place with trusted

people.

Overdose Risk

Overdose from smoking crystal meth is possible.

Individuals should know how to recognize signs

of overdose and how to respond.

Disposal

Used safer smoking supplies should

be disposed of safely. Please see

pages 90-91 for information

on safe disposal.

Using foil to

smoke fentanyl

Smoking is a common way of using fentanyl. Fentanyl comes in many

forms: rock, pills, powder, and transdermal patches. Fentanyl can be

mixed with drugs such as heroin, crystal meth, or cocaine. The high from

injecting or smoking fentanyl is felt almost instantly. Depending on the

form, different methods may be needed to prepare it for smoking.

ȟ ¡ĿŕŕsȠ ČƑƭsh ƥhe ƎĿŕŕs ĿŠƥū î ƎūǅēeƑ îŠē heîƥ

ƥhe ĲeŠƥîŠǋŕ ūŠ ĲūĿŕȦ TŠhîŕe ƥhe ǄîƎūƭƑsȦ

ȟ ¡ūǅēeƑȠ heîƥ ƥhe ĲeŠƥîŠǋŕ ƎūǅēeƑ ūŠ ĲūĿŕȦ

TŠhîŕe ƥhe ǄîƎūƭƑsȦ

ȟ ¤ūČŒȠ ċƑeîŒ sūŞe ūĲ ƥhe ČhîŕŒǋ ƎĿeČes ūĲĲ

îŠē

heîƥ Ŀƥ ūŠ ĲūĿŕȦ TŠhîŕe ƥhe ǄîƎūƭƑsȦ

Some common metĺods of smoking fentanyl include:

•

¡îƥČhȠ sƥĿČŒ ƥhe ƎîƥČh ūŠ ƥhe ĲūĿŕ îŠē heîƥ

Ŀƥ ƥū ƥƑîŠsĲeƑ ĲeŠƥîŠǋŕ ƥū ƥhe ĲūĿŕȦ ¤eŞūǄe

ƥhe ƎîƥČhȡ heîƥ ƥhe ƑesĿēƭe îŠē ĿŠhîŕe

ƥhe ǄîƎūƭƑsȦ

SAFER INHALING

7676

KEY MESSAGES

Cutting

Fentanyl in powder form comes in different

colours. These variations in colour typically

comes from substances used to dilute it, also

known as “cutting.” This form is incredibly

dangerous because there is no way to

determine its true potency.

Uncertain Dose

Cutting fentanyl patches and smoking smaller

pieces can lead to very uncertain and fast

release of fentanyl. Fast release of fentanyl

leads to fast increase in fentanyl levels in the

blood. It makes it hard to control the dose and

can cause an overdose if the dose is too high.

Fentanyl acts Fast

Using slowly allows time for the body to adjust.

This can prevent taking too much at once.

Re-dosing

The initial very intense high is typically followed by a

more lucid feeling. That doesn’t mean the fentanyl has

left the system. “Re-dosing” right away could lead to

an overdose.

Overdose Risk

Fentanyl and its analogues are much stronger than

any other opioid. Because of its almost instant effect

when smoked, margin for error is low. Very small

doses can lead to an overdose.

Recognize Signs of Overdose

Learn how to recognize and respond to an overdose.

Carry Naloxone

Encourage everyone to carry a naloxone kit. It is

used to reverse opioid overdose only. It has no effect

on overdoses caused by other drugs.

Avoid Using Alone

Remind people to avoid using alone and always have

naloxone on hand. If possible, suggest they have a

plan for a friend to check in on them.

A Metĺod of Using Foil to

smoke fentanyl

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¡ŕîČe ƥhe ĲeŠƥîŠǋŕ ȳƎūǅēeƑȡ ƑūČŒ ūƑ ƎîƥČhȴ

ūŠ ƥhe ĲūĿŕȦ

Oeîƥ ƥhe ċūƥƥūŞ ūĲ ƥhe ĲūĿŕ ǅĿƥh î ŕĿĳhƥeƑ

ȳēū Šūƥ ƥūƭČh ƥhe ĲūĿŕ îs Ŀƥ ǅĿŕŕ ċƭƑŠ hūŕesȴȦ

GeŠƥîŠǋŕ ǅĿŕŕ sƥîƑƥ ƎƑūēƭČĿŠĳ ǄîƎūƭƑȦ

TŠhîŕe ƥhe ǄîƎūƭƑ ƭsĿŠĳ î sƥƑîǅ ūƑ

ĲūĿŕ ƎĿƎeȦ

REFERENCE GUIDE