Community alcohol and drug services — Auckland

As with any substance no use is the safest option. However, if you are choosing to drink alcohol here are 22 ways you can reduce the potential harm to keep yourself and others’ safe.

1. Eat before you drink alcohol

• Eat a meal that includes protein and carbohydrates, such as chicken or pizza before and when you are drinking. The alcohol will be absorbed more slowly.
• Eating before or while drinking helps to control how fast alcohol enters your bloodstream, but it will not protect you from the effects of excessive drinking.

2. Be well hydrated before you start drinking 

• If you have plenty of water in your system it will keep you from feeling thirsty so you will drink more slowly. This in turn means you can drink less and avoid the harms that come with drinking too much.
• When thirsty drink water or have a non-alcoholic drink before using alcohol.

3. Pace your drinks, put the glass down between each sip; take smaller sips 

• If you hold on to your glass you tend to drink more. Take small sips occasionally rather than gulping your drink. It takes about 1 hour (more for women) for your liver to metabolise 1 standard drink.
• Try using a smaller glass, dilute your alcoholic drinks or switch to a lower alcohol drink.

4. Drink for taste 

• Enjoy the taste and savour each mouthful.

5. Alternate your alcoholic drinks with non-alcoholic drinks 

• Drinking non-alcoholic drinks slows down your alcohol drinking rate. When you have a glass of wine get a glass of water too or alternate plain soft drink, water or fruit juice with spirits, and sip both.
• Be aware of what percentage of alcohol is on the can or bottle before having a drink.

6. Reduce amounts in rounds 

• Avoid drinking in rounds or keeping up with others. Alternatively, buy your own drinks or one round and then go solo — buy your own drinks from then on.

7. Plan your drinking time and for alcohol free days every week 

• Avoid daily drinking by having a plan that includes abstinent days and moderate days each week. Your drinking then follows a reasonable schedule and will not interfere with work or life's commitments.
• Plan your drinking time — begin drinking later and leaving the pub or club earlier. For example, if you normally start drinking at 5pm try starting at 7pm and leaving earlier.
• Not drinking for a couple of days a week can boost your confidence. It shows you can change a habit and feel good without alcohol. You could discuss this or get support from a range of people and resources (refer to point 20).
• Take a look at the Hello Sunday morning website and sign up to commit to a period of time without alcohol.
  Hello Sunday Morning
• Two alcohol free days per week is recommended by the World Health Organisation.
  Alcohol — Health NZ

8. Occupy yourself 

• Try something else you enjoy while drinking to help distract your attention from the glass.

9. Measure your drinks and set a limit 

• Know how many standard drinks you are drinking. At home, pour a standard drink and compare that with what you are drinking. Set yourself a limit about what you will drink when you are out.

10. Count and record your drinks 

• Before you can break a habit you need to know more about it. A drinking diary can help you see your pattern when drinking.
• In it you write down the number of standard drinks you drink every day, with a zero to record your abstinent days.
• Record the day, the time, the number of hours spent drinking, the place and company. Record how you felt when you drank and when you did not, record what you are drinking as soon as you can.
• There are several drink diaries and apps available online. Search 'drink diary' online to find one that works for you. 

 11. Avoid pre-drinking or pre-loading

• Drinking before going out to get 'warmed up', drinking after work or while cooking dinner are all examples of pre-drinking.
• Cutting out pre-drinking helps to reduce your daily alcohol consumption.

12. Manage cravings with food or activities 

• When the craving comes on, delay the decision to drink alcohol for half an hour.
• Distract yourself by having something to eat. Eating when craving a drink can reduce the cravings for alcohol — though avoid salty snacks which make you thirsty.
• Doing exercise or going for walks can be effective in reducing craving too.

13. Avoid mixing alcohol with other drugs 

• It is potentially dangerous to mix alcohol with other drugs that have a sedative effect.
• Do not mix alcohol with benzodiazepines like Diazepam (Valium), Oxazepam, Clonazepam, morphine, oxycodone, tramadol and codeine and other drugs like ketamine.
• Breathing and other central nervous system activity can slow down to a point where a person can slip into a coma and die.
• Never drink alcohol if you are taking GHB, GBL, 14B (slang names 'liquid Ecstasy', 'Fantasy') as it increases the chances of overdosing.
• Check with your doctor about drinking if you have medical conditions such as diabetes, epilepsy or asthma or if you are on medication.

14. Alcohol and asthma 

• Alcoholic drinks can trigger a range of allergy-like symptoms including asthma.
• Wine is the most commonly reported trigger for allergic responses due mainly to histamines and additives like sulphites. When histamines are released into the bloodstream, sneezing, itching, headaches and flushing reactions can occur. Sulphites can trigger an asthma attack.
• If you have asthma and notice that it gets triggered by certain alcoholic drinks, avoid these drinks in future.

15. Avoid alcohol while pregnant 

• It is not okay to drink while pregnant as there is no known safe level of alcohol consumption during pregnancy. When a pregnant woman drinks the alcohol passes from her bloodstream through the placenta to the unborn baby. The mother’s alcohol level is the same for the unborn baby. Alcohol is also absorbed into the fluid surrounding the unborn baby (amniotic fluid); this fluid is swallowed by the unborn baby. 
• Alcohol is a toxic substance that can cause birth defects in an unborn baby. Foetal Alcohol Syndrome Disorder (FASD) is an umbrella term used to describe a range of development disorders and related birth defects resulting from alcohol use during pregnancy. 

16. Avoid drinking if you are caring for children 

• They need you to respond effectively in emergencies. 

17. Avoid drinking alcohol when you feel bad 

• It is much harder to control drinking when you are feeling angry, depressed, anxious, exhausted or bored.
• Cravings for alcohol are often triggered by physical or psychological discomfort and it is these emotions which are associated with relapse. If you have difficulty managing these emotions seek help. 

18. Organise transport before going out 

• Never drive to a drinking event — leave your car keys at home.
• Do not drink on impulse when your main means to get home is by driving.
• If you are out and have your car with you, keep your drinking to a minimum. If you do end up over the limit get a lift with a sober friend or get a taxi home. Do not drive your car.
• If you are planning to walk or use public transport it is better to travel with a friend for added safety.
• It is safer to pre-plan the quantity of alcohol you need for the night to avoid driving intoxicated to the liquor store.
  

19. To prevent spiking don’t leave your drinks unattended 

• While it has been known for people’s drinks to be ‘spiked’ with sedating drugs, the drug most commonly used to spike drinks is alcohol. More alcohol can be added to drinks without arousing suspicion — if someone else goes to the bar or is hosting they could add double or triple shots of spirits without the drinker realising they are consuming so much.
• A person who spikes a drink may be someone you know, an acquaintance, or a stranger.

20. Be aware of the drinks you have without even noticing 

‘Automatic’ drinks are the drinks you have without thinking — the more automatic drinks you have the less likely you are to stay within the recommended standard drinks guidelines.

21. Try a period of being alcohol-free 

• Some people find it helpful to abstain from drinking for a while — during this time you may become more aware of your triggers, the things that make you want to drink and of course you get to reduce any ‘automatic’ drinks.
• How long you do this for is up to you. Some people try for 30-days alcohol-free, some 90 days or more.
• Although you can do this at any time you might find it helpful to do it with others during things like Dry July or Febfast. The other cool thing about these initiatives is that by going without alcohol, they raise money for charities.
  Dry July
  Febfast
• You might also like to look at Mrs D is Going Without at for inspiration and support.
  Mrs D is Going Without

22. Get support

• Change takes time. Having positive support can increase your ability to manage and reduce feelings of isolation, lack of confidence, shame and guilt.
• We know from experience and research that managing alcohol and other drug use is more successful with the support of friends and family. Getting information can be very helpful.
• CADS can support your decision to change the way you drink.

• No use is the safest choice.
• Eat well beforehand for energy reserves.
• Drink plenty of water (600ml per hour) especially if dancing.
• Avoid alcohol and caffeinated drinks which further dehydrate you. Catch up on fluids, food and sleep the next day to aid recovery.
• Combining ATS with alcohol or other drugs overworks the system — especially the liver — and the effects are unpredictable.
• Avoid using ATS when taking medication like antidepressants.
• If snorting, make sure it is finely chopped with a razor or knife and use alternate nostrils.
• Taking ATS orally is generally safer than smoking, injecting, or snorting because the stomach can handle acidic substances better than your lungs, veins, or nose.
• Putting ATS in empty pill capsules or wrapped in cigarette papers and drinking plenty of water reduces the damage if swallowing.
• IV use carries increased risks of HIV and hepatitis if needles and other equipment are shared, plus potential damage to veins.
• Avoid IV Ritalin use completely as it can cause serious blood vessel damage.
• Sex on ATS can be rough and long with sore bits, broken condoms and a greater chance of sexually transmitted infections (STIs). Using lube with condoms is safest.
• ATS and medications used to treat HIV or AIDS do not go well together. Contact your local New Zealand Aids Foundation branch. If in Auckland visit Body Positive or the Burnett Centre for more information and support.
• Brush and floss teeth regularly and sip water. When using ATS the blood flow to the gums is reduced and the mouth becomes dry. Also chewing gum is a good idea if you grind your teeth when speeding.

• No use is the safest choice.
• Inhale vapours only. Drinking can kill.
• Rush is very dangerous to take with Viagra (impotency treatment drug) because it causes dangerously low blood pressure (hypotension). There have been deaths from this combination.
• Avoid getting on your skin as it irritates.
• Do not smoke at the same time — Rush is very flammable.
• Allow at least 3 minutes between inhalations or insufficient oxygen will not get to your brain and you could pass out (not a good look).
• Avoid mixing drugs, as the combined effects become more unpredictable and often increase health risks.
• It is best not to take Rush with acid (LSD) as it is easy to spin out or with stimulants like E, speed or coke which can put too much strain on the heart.
• Avoid if you have low blood pressure, breathing problems, have heart problems, are anaemic (have a low level of iron), or are suffering from glaucoma (a gradual loss of sight) as it increases pressure within the eyeballs.
• Avoid unprotected penetrative sex.

• Unless prescribed no use is the safest choice.
• Take only as prescribed because the risk of physical dependence increases if benzodiazepines are taken regularly.
• We strongly advise not taking benzos long term as, over the long term, benzo use can result in a person experiencing the very problems for which they sought help in the first place for example, sleep disturbances, depression, anxiety and irritability.
• People who do become dependent or who use benzos for more than a few months should not stop taking them without medical advice and support because they are likely to experience serious withdrawal symptoms. Seek advice from your GP or call CADS.
• Avoid taking benzos with other depressants like alcohol, opioids, other sedatives, barbiturates and antihistamines (such as anti-allergy medications) as this can lead to coma and death.
• Benzos slow reaction times, impair concentration and reduce alertness so do not drive or operate equipment or machinery.
• Avoid injecting crushed tablets or melted down gel capsules — this is extremely dangerous and sometimes fatal. The chalk in tablets causes collapsed veins and can lead to infection and abscess. Injecting gel capsules can also be fatal when the gel solidifies inside the blood vessels.
• Avoid benzos during pregnancy as they may increase the risks of the birth defects. Just as adults taking benzos may experience side effects so too may the unborn baby for example, sedation, decreased muscle tone (floppiness), and breathing problems.
• There are also some reports of benzodiazepine withdrawal occurring in newborns exposed to benzodiazepines in utero. Symptoms of benzodiazepine withdrawal include irritability and sleep disruption.
• Benzos can pass from mother to baby through breast milk which may cause drowsiness and slow response times. When the mother stops using the benzo the baby may also experience withdrawal symptoms.
• The decision to take benzos during pregnancy should be discussed with your prescriber ideally before attempts to conceive.

• No use is the safest choice. If you choose to use cannabis then moderate, occasional use is safer than continual use.
• Taking deep tokes and holding smoke down for a long time is very harmful to the lungs and is not necessary to get the full effects.
• If a friend is spinning out, reassure them and get them to focus on relaxed breathing (refer to safer partying section).
• Avoid using cannabis to deal with bad trips as this often intensifies the unpleasant experience.
• Be aware that mixing cannabis and another depressant like alcohol makes the effect much stronger.
• Avoid mixing tobacco with pot as it increases lung damage and risk of nicotine dependency.
• Cannabis strength varies. Try a small quantity of any new smoke first. Although uncommon, cannabis can trigger psychosis in some individuals. If having delusional thoughts or other distorted sensory experiences when not stoned see your GP or local CADS service.
• Cannabis burns at a much higher temperature than tobacco — ‘spotting’ can be especially harsh. It is safer to use a bong or pipe with cold or iced water to reduce damage from hot unfiltered smoke. Ensure that droplets of water are not inhaled — this is not good for your lungs. Avoid inhaling deeply and holding the smoke in your lungs.
• Replace bong water each time to avoid bugs and bacteria. Adding an antibacterial tablet (available at chemists) helps sterilise bongs. Plastic or rubber equipment can give off toxic fumes — glass is best. A pipe for sucking in smoke is less damaging than a wide opening. A long glass or stainless steel pipe kept cold (in a plastic bag in the freezer) will cool smoke effectively.
• The least harmful way to smoke cannabis is with a vaporiser.

• No use is the safest choice.
• Using a water nasal spray or sniffing up water immediately after snorting dissolves the residual coke and will significantly reduce the potential damage to your nose.
• Injecting coke numbs the injection site so any damage is not felt immediately. Avoid using the same injection site when having several blasts in the same night to reduce vein damage. Getting advice and filters (to remove impurities) from your local needle exchange is also advisable.
• If you use other stimulants then reduce your usual dose of each substance by at least half because the combined effects of coke with other drugs become more unpredictable and can increase health risks. Speedballs (IV coke and opiates) can increase the chance of an overdose.
• Drinking alcohol when using coke can be more dangerous than using either on their own due to effects on the liver.
• Trying to prevent the crash by continually using makes the eventual comedown worse.
• Heavy use increases the chances of psychotic episodes.
• Use lube during sex. Coke can cause shrinkage guys and makes it harder to cum. Also, putting coke on genitals is not good for anyone's bits.
• If you have a sensitivity to other stimulants avoid using coke at all.

These tips are for genuine E — pure MDMA. However, what is sold as E may contain little or no MDMA at all. Pills may also contain ketamine, amphetamine, or other drugs.

• No use is the safe choice.
• If you can, get your pills checked.
• Over an hour — every hour — sip, not gulp, up to 600ml of water especially if you are sweating. You will not need this much fluid if you are not sweating.
• Avoid alcohol, caffeine and sugary drinks which increase dehydration.
• Avoid isotonic sports drinks as the potassium they contain can increase blood pressure to unsafe levels. 
• Remember basic safety issues including safe sex.
• Avoid E if you have heart, liver or kidney problems, epilepsy or asthma.
• Avoid combining with alcohol or mixing drugs because this produces unpredictable effects and is a greater health risk, putting a huge strain on the heart and liver.
• Avoid taking E if you are taking medication such as beta blockers. Consult your doctor about taking E with medication.
• If you are diabetic, insulin levels can be affected and you may need to monitor blood sugar levels more regularly.
• E can cause a bad reaction if you have an anxiety or psychotic disorder or suffer panic attacks.
• Taking a break from E use can help you regain your emotional and physical well-being. using E regularly (such as every weekend) can result in becoming emotionally and physically run down and as your natural immunity weakens you become susceptible to infections like colds and flu.
• For more info on what specific pills may contain go to the DrugsData website.
  DrugsData

• No use is safest.
• Avoid if you have heart or breathing problems, epilepsy, sensitivity to other central nervous system depressants, or general poor health.
• Avoid using drugs that also have a sedative effect, for example benzos, opiates, alcohol or ketamine, with GHB because this significantly increases the chance of an overdose.
• Avoid taking it alone. Be with friends who know what you are using in case medical attention is urgently required.
• If purchasing G, check if it is GHB or GBL, as GBL is usually 2 to 3 times stronger. However individual batches of these drugs will also vary, and caution is advised if acquiring G from new sources.
• Avoid accepting GHB or similar drugs from people you do not fully trust due to the possibility risk of rape, robbery or being left alone if you are too out of it or unconscious.
• Phone an ambulance if anyone falls unconscious after taking GHB or similar drugs.

• No use is the safest option. Low doses work best and are safer.
• Avoid mixing drugs as the combined effects become more unpredictable and often increase risks.
• Especially avoid using other depressant drugs, such as benzos, opiates, alcohol, as the combined sedative effect increases the risk of overdose, choking or losing consciousness.
• Combining with speed or other stimulants puts extra strain on your system or heart and increases the risk of psychotic reactions similar to PCP.
• If you have freaked out on acid (LSD) or other hallucinogens, it would be safest to avoid K.
• Watch out for each other as it is easy to injure yourself if you are numb, uncoordinated and 'off the planet'. The chill room (if you can find one) can be a good place to blob out for a while. Or stay home.
• Avoid K if you have heart or breathing problems or are feeling emotionally fragile.
• IV use is very dangerous and likely to produce unconsciousness. It is safest to avoid injecting K completely but if you are going to inject, do it intramuscularly not intravenously.
• Do not share straws or other snorting devices as these may have traces of blood on them and put you at risk of contracting HIV or hepatitis.
• You should avoid food for at least 1.5 hours before taking ketamine. Nausea and vomiting can occur when it is coming on. Staying still can help with this feeling.
• It is not advisable to use alone. Tell friends if you are taking K and keep an eye on friends who are.
• It is very important to avoid driving while on ketamine.

• No use is the safest choice. People with heart problems should never use LSD.
• It is best to trip only if you are in a positive mood and with friends.
• First time users — take less than a whole trip and make sure you are in a safe environment with people you trust including an experienced tripper or tripsitter.
• The strength tends to vary between tabs so it is advisable to take a small amount at first each time you go tripping.
• Mixing with drugs and alcohol can increase health risks. Mixing LSD with stimulants, such as speed, increases the chance of a bad trip — sensory overload can lead to panic.
• Combining LSD with Ketamine can be extremely disorientating and should be avoided.
• Taking large doses of LSD can bring back suppressed memories.
• If you are having a bad trip use your supports or change the scene or music. Avoid dwelling on personal problems. If you start to panic, reduce breathing to a steady rate and rationalise things. And remember — you will eventually come down.

• No use is the safest choice.
• It is best to take mushies if you are in a positive mood and with friends in a safe environment.
• If you are new to it start slow — take 3 to 5 mushies only.
• Dropping a shroom trip while out clubbing could end up in disaster. Wait until the effects have peaked before deciding if you can deal with going out.
• It is best to go mushroom hunting with someone who knows what they are doing. Do not pick anything you cannot positively identify. There are very poisonous mushrooms that may be mistaken for psilocybin shrooms.
• The strength of magic mushrooms varies considerably depending on the type, age, recent rain and soil conditions. Mushrooms from the same batch vary and some are toxic. It is safer to take a small dose and wait 2 hours before having more (if required).
• Many people eat magic mushrooms in the forest as they find them. It is safest to stay in a group and plan to have water and other essentials available including a straight driver to get you home.
• Avoid binging during the shroom season as this could put your mental health at risk.
• Driving on mushies is not recommended.

• No use is safest — especially around pēpi and tamariki. If using make arrangements for tamariki to be cared for by someone who is not using.
• Keep all drugs and equipment including pain relief medications (prescribed or purchased over-the-counter from a pharmacy) away from tamariki.
• Avoid using opioids with alcohol and other sedatives (downers) such as benzos, tranquilisers, barbiturates. They all depress the central nervous system and together significantly increase the risk of sedation and overdose.
• Always use clean equipment if injecting.
• Take note of the dosage instructions on any pain relief medications and do not exceed the recommended dose.
• Unless it has been prescribed for you avoid using fentanyl. It is incredibly strong meaning it is very easy to accidentally overdose.