#substance use

[androfagus]

Blown pupils (Adderall) with flash on

[thecouncil-aac]

Our alcohol folder! Each button has sub-sections (ie "and [soda]" lists out "and coke" "and sprite" ect, "21+" has "I am an adult, using AAC doesn't change that" "here's my ID" "do you need my ID?", "sobriety" has "we are sober" "we are tipsy" "we are drunk", "alcohol" has "we want a drink" "we don't want a drink" "can we try your drink" ect)

We don't have a folder/buttons for non-alcoholic recreational drug use because we don't use any (whether smoking/cigarettes, edibles/marijuana, ect), so it's not relevent to us... other than a "we don't do/use xyz"... hm, we should add that 🤔

i wanna see more AAC devices with boards for substances. like yes let me see your collection of geekbar flavor buttons

[genderqueerdykes]

i know this won't be available everywhere, but especially if you live in a larger city where a lot of folks are affected by opioid use/addiction, it's a really good idea to ask local pharmacies, and even food banks if they are giving out free narcan (naloxone). this can also be found at certain behavioral health offices as well, my case manager is able to get them for me for free. narcan is a life saving medication that can temporarily halt an opioid (oxycodone, hydrocodone, heroin, fentanyl, codeine, morphine, etc.) overdose while you wait for emergency medical services to arrive.

opioid overdose is distress of the respiratory system, meaning that the person overdosing likely is struggling to, or can't breathe at all. it's very important to watch to see if the person is dealing with labored or shallow breathing.

here the official use guide:

[Image ID start: Two screenshots from the FDA's Narcan (Naloxone HCl) Quick Start Guide infographic. It reads:

"Narcan (Naloxone HCl) Nasal spray quick start guide. Opioid Overdose Response Instructions.

Use NARCAN Nasal Spray (naloxone hydrochloride) for known or suspected opioid overdose in adults and children.

Important: For use in the nose only.

Do not remove or test the NARCAN Nasal Spray until ready to use.

1.) Identify Opioid Overdose and Check for Response Ask the person if they are okay and shout name.

Shake shoulders firmly and rub the middle of their chest.

Check for signs of Opioid Overdose:

Will not wake up or respond to your voice or touch

Breathing is very slow, irregular, or has stopped

Center part of their eye is very small, sometimes called "pinpoint pupils".

Lay the person on their back to receive a dose of NARCAN nasal spray.

2.) Give NARCAN nasal spray

Remove NARCAN nasal spray from the box. Peel back the tab with the circle to open the NARCAN nasal spray.

Hold the NARCAN nasal spray with your thumb at the bottom of the plunger and your first and middle fingers on either side of the nozzle.

Gently insert the tip of the nozzle into either nostril.

Tilt the person's head back and provide support under the neck with your hand. Gently insert the tip of the nozzel into one nostril, until your fingers on either side of the nozzle are against the bottom of the person's nose.

Press the plunger firmly to give the dose of NARCAN nasal spray.

Remove the NARCAN Nasal Spray from the nostril after giving the dose.

3.) Call for emergency medical help, Evaluate, and Support

Get emergency medical help right away.

Move the person on their side (recovery position) after giving NARCAN Nasal Spray

Watch the person closely.

If the person does not respond by waking up, to voice or touch, or breathing normally another dose may be given. NARCAN Nasal Spray may be dosed every 2 - 3 minutes, if available.

Repeat Step 2 using a new NARCAN Nasal Spray to give another dose in the other nostril. If additional NARCAN Nasal Sprays are available, repeat step 2 every 2 to 3 minutes until he person responds or emergency medical help is received.

For more information about NARCAN Nasal Spray go to www.narcannasalspray.com, or call 1-844-4NARCAN (1-844-462-7226)."

End image ID.]

[incognitopolls]

This poll is asking about recreational use only (not medicinal or traditional/religious use). This is asking about psychedelic drugs specifically, not the larger category of hallucinogenic drugs - do not count MDMA, ketamine, PCP, other deliriants or dissociatives, etc.)

–

We ask your questions so you don’t have to! Submit your questions to have them posted anonymously as polls.

[neuroticboyfriend]

relapse is not a moral failure. substance use and addiction are not a moral failure. mental illness is not a moral failure. disability is not a moral failure. you have a health condition. you are struggling. recovery is not mean to be perfect, and if you're not in recovery, surviving is good too. i'm glad you're here, and i hope life treats you better soon. please know this is not your fault. you do not need to feel guilty over your own health.

[prokopetz]

I love the euphemism "substance use" because truly, who among us has not used substances?

[cannibalchicken]

[rileylastname]

maybe it’s because it’s “too obvious” but im surprised how few readings I’ve seen of the Substance (2024) that discuss the themes of addiction and substance (ha) use & abuse.

in moderation you can use the substance to become a better, more fun, easier, happier version of yourself. then you realize you no longer want to be who you are when you’re not on the substance. then taking the same dose that used to be enough before isn’t enough anymore, so you want to take more, and just a little bit more couldn’t hurt, right? so you start to take even more. but this is only taking away from sober you, which is painful and difficult and even scarier than what compelled you to take it in the first place, so of course you can’t stop now. now you want to take even more, you NEED to take even more. sober life becomes harder and harder to bear, especially compared to how much easier everything is on the substance. now you’re not only using it to enjoy that feeling anymore, you’re using it to hide from what you’re turning into without it, from what you’ve already turned into.

every minute that you’re sober is spent counting down the days until you can use again, and the ends of being high are spent dreading going back. the sober self is upset and jealous at how irresponsible the high self is. the high self is upset at how much of a buzzkill the sober self is, and wishes they could exist on their own, without requiring their sober tether to existence. but the sober and high selves are the same person, you are one, and you become jealous and angry at yourself for ruining your own life in a vain attempt to become an impossible version of yourself that you most desire to be.

you want so badly to have all—and only all—of the best parts that you milk yourself dry, until you end up with all—and nothing but all—of the bad parts. by the time you truly feel that you have indeed lost everything and know you need to stop, the damage is already done, and there is no going back. you wish you had stopped at the first chance, you wish you had never started to begin with. and even then for many people the only way to deal with this terrifying, painful reality is to use even more, because you have made this terrifying, painful life without your substance feel unliveable, even scarier yet than what had made you use in the first place. there is nothing left to do but to hide from your own life, and the only ways to do this are to stop, to love yourself and take care of the person that you are now… or to keep taking more and more, using until there is truly nothing left, not even yourself.

[reasonsforhope]

"For the first time in decades, public health data shows a sudden and hopeful drop in drug overdose deaths across the U.S.

"This is exciting," said Dr. Nora Volkow, head of the National Institute On Drug Abuse [NIDA], the federal laboratory charged with studying addiction. "This looks real. This looks very, very real."

National surveys compiled by the Centers for Disease Control and Prevention already show an unprecedented decline in drug deaths of roughly 10.6 percent. That's a huge reversal from recent years when fatal overdoses regularly increased by double-digit percentages.

Some researchers believe the data will show an even larger decline in drug deaths when federal surveys are updated to reflect improvements being seen at the state level, especially in the eastern U.S.

"In the states that have the most rapid data collection systems, we’re seeing declines of twenty percent, thirty percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina.

According to Dasgupta's analysis, which has sparked discussion among addiction and drug policy experts, the drop in state-level mortality numbers corresponds with similar steep declines in emergency room visits linked to overdoses.

Dasgupta was one of the first researchers to detect the trend. He believes the national decline in street drug deaths is now at least 15 percent and could mean as many as 20,000 fewer fatalities per year.

"Today, I have so much hope"

After years of wrenching drug deaths that seemed all but unstoppable, some researchers, front-line addiction workers, members of law enforcement, and people using street drugs voiced caution about the apparent trend.

Roughly 100,000 deaths are still occurring per year. Street drug cocktails including fentanyl, methamphetamines, xylazine and other synthetic chemicals are more poisonous than ever.

"I think we have to be careful when we get optimistic and see a slight drop in overdose deaths," said Dan Salter, who heads a federal drug interdiction program in the Atlanta-Carolinas region. "The last thing we want to do is spike the ball."

But most public health experts and some people living with addiction told NPR they believe catastrophic increases in drug deaths, which began in 2019, have ended, at least for now. Many said a widespread, meaningful shift appears underway.

"Some of us have learned to deal with the overdoses a lot better," said Kevin Donaldson, who uses fentanyl and xylazine on the street in Burlington, Vermont.

According to Donaldson, many people using fentanyl now carry naloxone, a medication that reverses most opioid overdoses. He said his friends also use street drugs with others nearby, ready to offer aid and support when overdoses occur.

He believes these changes - a response to the increasingly toxic street drug supply - mean more people like himself are surviving.

"For a while we were hearing about [drug deaths] every other day. When was the last one we heard about? Maybe two weeks ago? That's pretty few and far between," he said.

His experience is reflected in data from the Vermont Department of Health, which shows a 22 percent decline in drug deaths in 2024.

"The trends are definitely positive," said Dr. Keith Humphreys, a nationally respected drug policy researcher at Stanford University. "This is going to be the best year we've had since all of this started."

"A year ago when overdose deaths continued to rise, I was really struggling with hope," said Brad Finegood, who directs the overdose crisis response in Seattle.

Deaths in King County, Washington, linked to all drugs have dropped by 15 percent in the first half of 2024. Fatal overdoses caused by street fentanyl have dropped by 20 percent.

"Today, I have so much hope," Finegood said.

-via NPR, September 18, 2024. Article continues below with an exploration of the whys (mostly unknown) and some absolutely fucking incredible statistics.

Why the sudden and hopeful shift? Most experts say it's a mystery

While many people offered theories about why the drop in deaths is happening at unprecedented speed, most experts agreed that the data doesn't yet provide clear answers.

Some pointed to rapid improvements in the availability and affordability of medical treatments for fentanyl addiction. "Expansion of naloxone and medications for opioid use disorder — these strategies worked," said Dr. Volkow at NIDA.

"We've almost tripled the amount of naloxone out in the community," said Finegood. He noted that one survey in the Seattle area found 85 percent of high-risk drug users now carry the overdose-reversal medication.

Dr. Rahul Gupta, the White House drug czar, said the drop in drug deaths shows a path forward.

"This is the largest decrease on record and the fifth consecutive month of recorded decreases," he said.

Gupta called for more funding for addiction treatment and healthcare services, especially in Black and Native American communities where overdose deaths remain catastrophically high.

"There is no way we're going to beat this epidemic by not focusing on communities that are often marginalized, underserved and communities of color," Gupta said.

"Overdose deaths in Ohio are down 31 percent"

Indeed, in many states in the eastern and central U.S. where improvements are largest, the sudden drop in drug deaths stunned some observers who lived through the darkest days of the fentanyl overdose crisis.

"This year overdose deaths [in Ohio] are down 31 percent," said Dennis Couchon, a harm reduction activist. "The deaths were just plummeting. The data has never moved like this."

"While the mortality data for 2024 is incomplete and subject to change, Ohio is now in the ninth consecutive month of a historic and unexpected drop in overdose deaths," said the organization Harm Reduction Ohio in a statement.

Missouri is seeing a similar trend that appears to be accelerating. After dropping by 10 percent last year, preliminary data shows drug deaths in the state have now fallen roughly 34 percent in the second quarter of 2024.

"It absolutely seems things are going in the right direction, and it's something we should feel pleased about," said Dr. Rachel Winograd, director of addiction science at the University of Missouri St. Louis, who also noted that drug deaths remain too high.

"It feels wonderful and great," said Dr. Mark Levine, head of the Vermont Health Department. "We need encouraging data like this and it will help sustain all of us who are actively involved in trying to have an impact here."

Levine, too, said there's still "plenty of work left to do."" ...

Dasgupta, the researcher at the University of North Carolina, agreed more needs to be done to help people in addiction recover when they're ready.

But he said keeping more people alive is a crucial first step that seemed impossible only a year ago.

"A fifteen or twenty percent [drop in deaths] is a really big number, an enormous impact," he said, calling for more research to determine how to keep the trend going.

"If interventions are what's driving this decline, then let's double down on those interventions."

-article via NPR, September 18, 2024

[catastrothy]

[chronicallycouchbound]

People who use drugs deserve love and kindness.

Abstinence is not the only form of recovery. AA/NA doesn’t work for everyone. Sometimes people choose to use instead of meeting other needs, which is valid. Some people use for recreational purposes. Some people use for medicinal purposes. Some people who use have substance abuse disorder. Treatment looks different for everyone. Not everyone needs or wants treatment, for various reasons. The only thing Naloxone enables is breathing. Active use is not shameful. People who use drugs often also deal drugs. People in recovery should not shame active users. Active users deserve love. Active users deserve someone to check in on them, get them safer use supplies, and get them pizza. Active users deserve to be listened to. They deserve better than to have that be the first time anyone ever treated them as human since they began using.

Let’s care for each other.

[lastcatghost]

[bioethicists]

beer killed my father . he had a disease which destroyed his body and strained his relationships with his wife, his friends, and his children. Alcohol destroys everything it touches, theres a reason you see so many liquor stores in poor neighborhoods. don’t be fucking obtuse. Prohibition obviously doesn’t work, but I wish alcohol was taxed higher. And i want the CEO of Heineken on the guillotine right after Jeff Bezos.

before anything, i want to let you know that i am incredibly sorry about your father. alcohol has decimated entire generations of my family, played a crucial role in the neglectful family structure i spent the first 19 years of my life suffering under, + played a minor but not insignificant role in my brother's death. i would never undermine or dismiss that in anyone.

i used to feel very similarly to you, in large part because my mother is a recovering alcoholic who raised me to believe that alcohol is a magic poison which turns people into monsters + i, being her child, probably inherited a disease which would also turn me into a monster if i chose to drink. it's a deeply painful + understandable response to the pain that alcohol can cause.

my first question is, does alcohol really "destroy everything it touches"? are there not millions of people who engage with alcohol, in varying degrees of recreational use, who experience minimal or no negative impacts? or do you believe that everyone who drinks alcohol in any capacity is experiencing severe destruction in their lives as a result? does the existence of people for whom alcohol enriches their lives (or is a neutral presence) at all invalidate your experience, or your father's?

my second question is, you've identified that there are 'so many liquor stores in poor neighborhoods' (i would add there is a lot of alcohol in rich neighborhoods, just distributed in less stigmatized ways, like boutique wineries + fancy bars), do you think that companies are strategically attempting to create alcohol dependencies among poor people, or do you think that poverty creates the pain, hopelessness, + desperation which can fuel an alcohol habit (which is then exacerbated by intergenerational trauma + community alcohol culture).

i feel no allegiance to liquor companies- they absolutely do make the bulk of their profits off of people who are drinking in a way that is destroying their lives (unsure if i trust the exact scope of the research in that link but i trust the gist). however, liquor companies love the disease model, because it exempts them from responsibility. if alcoholism is truly a genetic disease, then liquor companies, bars, package stores hold no fault in the development of destructive drinking habits + community norms (natasha Schüll discusses this in her book about gambling addiction)- the people were already sick + would be getting it somewhere else, anyway, right? but as you have correctly identified, liquor companies help create the structures which turn alcohol use into an accessible + normalized mode of self-destruction.

my third question is, will taxing liquor help the real problem? yes, it reduces alcohol consumption, but does it reduce addiction? or does it make cheapskates like me say "i'm not fucking paying for that" while individuals who consume alcohol compulsively either eat the cost or turn to more illicit ways of obtaining alcohol. or, rephrased, is the problem that alcohol is too accessible? is alcohol a magical poison which turns 'normal' people into 'alcoholics'? alternatively, is alcoholism a genetic condition, unrelated to any outside circumstances, which is triggered by drinking?

or: is alcoholism one of many ways in which people who are experiencing hopelessness, pain, grief, poverty, trauma, etc use to numb themselves, harm themselves, + make life feel more bearable? at this point, i do believe there is at least a temperament factor which makes people more likely to use substances over other forms of escape (hence why my brother used substances while i turned to anorexia + do not struggle with substance use). are we actually addressing the problem if we make it more expensive (thus, mind you, further impoverishing people with alcohol addictions!)? or are we shifting the pain these people are experiencing to either other avenues (opioids, other drugs, totally different ways of coping which are often just as destructive) or an unregulated, underground alcohol market.

the way you are viewing alcohol, alcohol is a unique substance which is manufacturing or feeding illness in people in order to make them behave in ways which destroy their lives + the lives of others. the way i am viewing it, alcohol is a presence which can fill a void that is being created in people's lives as a response to structural, communal, or social suffering. when alcohol is painted as the cause of this pain, we are able to look the other way from a which world is structured to cause an immense amount of people to suffer needlessly. at the same time, the common sense observation that many of us engage with alcohol in ways which do not destroy our lives, as well as the knowledge that prohibition does not work, prevents the erasure of alcohol from public or private life.

who benefits from the belief that alcohol is a uniquely corrupting substance? what lessons did we actually learn from prohibition- is trying to do it to a lesser degree (make alcohol less accessible) actually going to do anything? when the price of opioids went up due to dea crackdowns, did people stop buying opioids or did the market flood with cheap + deadly fentanyl? is the problem that people are drinking or that they are suffering?

[nv-alexander]

PSA: HARM REDUCTION

This term has been getting thrown around quite a bit this year and I want to clear some things up because this is a very important topic.

What does harm reduction mean?

Harm reduction is the practice of reducing Harm or risk associated with activities such as substance use, self injury, or sex.

For an everyday example: a parent who says, "If you're going to drink, drink at my house," is actually promoting harm reduction strategies. If you are going to do it, do it safely.

Having a DD or using a taxi is harm reduction. Practicing safe sex is also harm reduction.

Harm reduction strategies for substance use:

- education on substances and associated risk

- creating safe use sites

- education on overdose and first aid

- providing new, sterile supplies for use--find out if your town has a needle exchange, never know when you or someone you know will need one

- providing test kits for fentanyl, xylazine, GHB

- public education on administering narcan

- legalization of recreational use of substances to ensure regulation of ingredients

- providing narcan

- creating crisis response units comprised of social workers and paramedics for people experiencing OD or substance related crises.

Harm reduction for self harm:

- using sterile blades

- cutting in places that are not potentially lethal

- using shallow cuts

- properly cleaning and treating of wounds

- education on first aid

- having a crisis plan

- having a safe, clean space for engaging in self harm

- social worker/paramedic crisis response units for mental health crises

Harm reduction for sex:

- condoms and contraceptives

- plan b

- engaging in sex in a safe space (swinger clubs actually fulfill this)

- getting tested for STDs & HIV (also many swinger clubs check this)

- taking PreP

- reproductive education

- decriminalized sex work (provides protections for sex workers and can help limit spread of STDs)

Harm reduction is a very specific concept and does not apply to politics unless you are promoting the implementation of harm reduction practices

Harm reduction is a public health issue. It is not "well person A will be worse than person B so we will vote for person B"

Harm reduction does not present alternative actions but ways to engage in high-risk actions safely. Using it to describe a choice between A and B is a gross misunderstanding of the basic concept.

Harm reduction is "if you are going to do it, do it safely"

[incognitopolls]

We ask your questions so you don’t have to! Submit your questions to have them posted anonymously as polls.

[neuroticboyfriend]

a lot of the time, abusers are just regular people. abuse is something we're all capable of - it's a pattern of harmful behavior in which there's power imbalance. we all hold various privileges, connections, and knowledge that can be turned into the power to abuse others. we can all exert our will, thoughts, feelings, etc. onto others in a way that hurts them and takes power away from them.

abusive people have done something horrible and inexcusable, yet they aren't... inherently special. they're people, capable of choosing between right and wrong, capable of change, just as much as others are. i say this in part because i think a lot of people have this lofty idea of abusers that leads them to think they couldn't possibly be a victim of abuse. but abuse can be incredibly mundane - and this also means we all have to watch out for abusive behaviors in ourselves.

abuse isn't just something Obviously Bad People (TM) are capable of... and abuse isn't caused by mental illness, substance use/addiction, gender, etc. etc., even if these things impact what happens. idk. there's no real end point to this post. i just wish people didn't mystify abuse, and realized how (deeply unfortunately) normal and subtle it can be... and often is.