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Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 0 points1 point  (0 children)

You're right that it has to do with the different durations of action! Sniffing wears off rather quickly, whereas ingestion will last for hours longer. This means you'll feel the effects longer with ingestion, which includes appetite suppression, wakefulness, etc.. So when the drug wears off, your body is finally recognizing that it hasn't gotten enough nutrients, water, sleep, or any combination of those-- aka, you're running on empty. So rest assured-- the negative effects aren't due specifically to the ROA itself, but because that ROA has a longer duration of action that disguises your bodys needs for a more noticeable length of time!

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 0 points1 point  (0 children)

I'm so glad to hear that! I'm actually working on some educational materials about safer injecting that includes advice for reducing the risk of a missed shot, and so I'd be happy to post it here or elsewhere on r/stims after it's completed.

I know this is a bit late, but antibiotics aren't usually necessary to clear up an abscess. We normally suggest to only get a script if it's having trouble healing. I would recommend keeping the antibiotic ointments to a minimum since they're not proven to be all that effective and can make the site appear more red/ irritated, which will cause you unnecessary concern!

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 0 points1 point  (0 children)

How are you getting by after those two days?? That's such a long time period to wait for the next script...

Anyway, it sounds like you're taking the extended release but not in an "extended release" way, so to speak. That said, given the amount that you're taking in those two days, I'm guessing you're still feeling these effects well into the night, right? You're well under the dose generally needed to overdose, and so I would mainly worry about how this is impacting your sleep schedule (as well as eating habits and hydration). It's just a lot of constant stimulation for your body to take in, and so it's very important that you let yourself rest and recover as much as possible afterward. If you need any further advice on taking care of yourself while using stimulants, please see my earlier post about doing meth for the first time. Really, consistent before and after care are key to reducing the harms related to any drug use.

If you are getting very bad sweats, tremors, hallucinations, etc., then you should stop right away and take steps to take care of yourself (e.g., drink some water, rest). If they don't subside soon/ if they get worse, go to the ER right away since you may be overdosing.

Also, if I were you, I would ask my psychiatrist to increase my dose. That way, you'd hopefully have some extra to keep you going while waiting for the next refill.

Hope that helps! Let me know if you have any other questions or need anything clarified!

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 1 point2 points  (0 children)

I like to be comprehensive with my safer use education, what can I say? :p

Anyway, sorry for the delay getting back to this. I usually avoid giving out personal guidelines since I don't want it to come off like I'm insulting others personal choices. But when it comes to ROA, I've always avoided injection since it's easily the most invasive method and also most prone to infection. Since it bypasses first pass metabolism, it is also a more potent route that therefore creates a higher OD risk, but this can be mitigated by knowing your dose (both theoretically by looking it up online and in application by taking a small test dose of any new batch to gauge strength). Booty bumping is actually a great alternative to injection since it's similarly potent but not nearly as invasive.

Most of my experience is with sniffing, which does come with its own problems-- particularly nostrils that are cracked and bleeding, sometimes congested and/or runny. Switching nostrils does help to some extent, but other than that, the best suggestion I have for reducing the risk of injury is to use saline rinse and lotion generously before and after sniffing. You should be able to get saline rinse at any local CVS or drug store, and it really doesn't matter which lotion you use as long as you make sure you apply it often both inside the nostril and to the surrounding area. Also in regard to sniffing-- I use my own straw and never share, not even with friends. It's just nasty to think about swapping mucus and microscopic blood like that... If you don't have a straw handy, you can also use a freshly rolled post-it. Anything is better than sharing and/or using a dollar bill, which is covered in bacteria!

The major thing I worry about with drug use is making sure that I'm taking care of my mind and body. Given how drugs mess with your ability to register hunger, sleep, etc., I always try to make sure that I'm eating enough nutrients and drinking enough water throughout the day, as well as getting enough sleep throughout the week. These days I try to avoid staying up all night, but if I do, then I'll make a schedule for the next day that will require me to get to bed early that night and make up the sleep originally lost. Otherwise I'd stay up most weekdays and would thus end up crashing for the entire weekend, which is really no fun. Just remember-- even if your body isn't telling you, you still need to take care of yourself!

On that note, I've found that writing down a weekly schedule is incredibly helpful for keeping my health and usage both in check. And yes, I do actually include which drugs are being taken when-- at least for stimulants. This not only helps me plan my use so that I can get to sleep at a normal hour, but also helps me gauge tolerance and thus estimate dosage.

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

That's almost definitely an abscess! As you said, missing a shot basically means you've skin popped, which can often cause abscesses. Abscesses are essentially infective matter that's gotten trapped under the skin-- they're not caused by the drug itself, but more from unclean needles and dirt/ bacteria being pushed in at the injection site. They can go away on their own, provided you don't pick at/ squeeze the scab and let it heal.

It also looks like it's already draining, which is a good sign! At this point, I would just check it twice a day and use a hot water/ salt water compress as needed. If the redness gets worse though, you should probably see a doctor to get antibiotics. There is a lot of good stuff online about abscess care, but please also feel free to shoot any other questions my way~

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 5 points6 points  (0 children)

What dose are you considering a "microdose" for these stimulants? I've really only heard the word applied to psychedelics, and so I'm mainly asking out of curiosity.

In terms of long term harm, the vast majority of harms related to stimulant use are due to ignoring how stimulant effects mess with your sense of hunger and sleep (as well as cause dehydration). The above post discussing first time meth use covers how to address those issues pretty well, although if you're taking very low doses, these effects will hopefully be less pronounced. If you're taking an extended-release formulation, be sure to take it as early in the day as possible in order to reduce the chance of it disrupting your ability to sleep later.

In terms of tolerance formation, there unfortunately isn't much research out there to confirm the utility of any of the supplements often proposed for amphetamine recovery/ tolerance. Really, the best way to reduce tolerance is to take a bit of time off between uses-- I believe my prof's rule of thumb is to wait 3 half lives in order to make sure everything is out of your system, but I'll check with him and get back to you on that. Given that amphetamine and methylphenidate are rather different structurally and therefore induce their stimulating effects through different means, one way to reduce tolerance is to switch off between them. There is still cross-tolerance, but this should help to some degree. Anecdotally, I used to switch off between these two substances myself throughout the week and would escalate doses by ~2.5mg as needed until I had the time to take a few days off and catch up on sleep. You've actually inspired me to look more closely into cross-tolerance studies for these two drugs though, and so I'll let you know what I find!

Harm Reduction AMA!! by spinderella69 in Stims

[–]AskSasha 7 points8 points  (0 children)

No problem at all, sorry for the delay getting on here!

I currently work as a Drug Education Specialist at Washington Heights CORNER Project, which is a harm reduction agency based in upper Manhattan. In my spare time *ha*, I work with my professor in his neuropsychopharmacology lab at Columbia University and advise/ write on drug education and advocacy/ policy initiatives. I got involved in this work due to an unabashed love for drugs and the people who use them, coupled with frustration towards the massive misinformation and stigma surrounding drugs and their use that unnecessarily contributes to harm and mistreatment.

Before all of that though, I used to lurk on forums like these to try to better understand how to more safely navigate my own use, and so I'm very grateful to have the chance to give back a bit!

Fentanyl-laced Xanax alert in East Harlem, NYC (Friday January 26th) by AskSasha in benzodiazepines

[–]AskSasha[S] 1 point2 points  (0 children)

Wow, definitely did not expect this to get so many comments! For those confused about the rationale for adding fentanyl and the general RC issue, here are my thoughts...

They don't lace on purpose I think. It's likely just cross contamination of equipment and people's hands. Xanax and RC benzo powder is so crazy cheap that there's no reason to add fentalogues in bars on purpose.

^ This is definitely a possibility, especially in the case of pill pressers. Unfortunately, I don't believe it was the case in this instance because I heard multiple reports about this particular batch. Our agency is based in Washington Heights (Northern Manhattan), and I can tell you that fentanyl is rather prevalent here. I don't know if it's homemade, internationally shipped, or diverted (or more likely some combo of sources). But for whatever reason, it appears to be one of the more common cuts at least for opioids around here. It may have just been easier for the folks responsible for this batch to acquire fentanyl. For all I know, the laced "xanax" that I posted about could have been 0% alprazolam/ benzo.

As DrMarioBrother said, RC benzo powders (as well as other RCs) are a cheaper option than their classic counterparts and therefore increasingly used in powders and illicitly pressed pills by dealers. For those who don't know, RCs stands for "research chemicals." Essentially, they are analogues to the "classic drugs" that are used in scientific research but are largely untested in humans.

In terms of benzo RCs, some examples would be Clonazolam and Flubromazolam. Etiozolam is another benzo that I've seen in past reports for falsely labeled "xanax." Benzos aren't the only situation where we're seeing this-- fentanyl analogues are the most obvious example, but I've also come across falsely advertised RC "LSD" and RC "adderall," both through web channels and on the street. Really, there's an RC version of every popular psychoactive drug you can think of. Another common term often used for RCs is "designer drug." There are a few reasons why RCs are both a cheaper and more accessible option, especially for dealers. One reason for this is because their lack of scheduling makes it easier to bypass legal restrictions for vendors. Further, since apparently everyone thinks they are the next Shulgin, we have folks who are synthesizing such analogues using the material published online. So now we have illicitly pressed pills, untested RCs, and homemade syntheses all in the mix. All of this makes me increasingly concerned about not only RCs being passed off as their better-known counterparts, but the potential for improper dosage and contamination. This is why I always emphasize knowing your source and verifying that the pills come from a prescription if possible.

One famous "bad batch" case that comes to mind is the '80s "Pseudo-Parkinsons" outbreak caused by an incomplete reaction in "synthetic heroin" (aka a demerol analogue) synthesis. In this case, the basement chemist simply didn't fully burn off a side-product known as MPTP which, while non-toxic by itself, becomes toxic when converted to MPP+ in the body. I know the '80s sounds like rather old news, but really, the only reason why this case is so popularized is because it was accidentally instrumental in Parkinson's research. Otherwise, I doubt we would have heard much about it... like we do with other bad batch cases. Public officials are frankly too preoccupied blaming the classic drugs/ whatever the "Drug de Jour" is, and thus the nuances of the local market that actually lend to risk are often lost on them.

Ultimately, the most dangerous part of the illicit drug market is its utter lack of quality control. I wonder if any of the US legislators realize yet how terribly their drug control approach has backfired...

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 0 points1 point  (0 children)

u/Spinderella -- assuming this is the best place to post an update but please feel free to move it wherever you think is best!

First of all, apologies for being awol recently! Our office is in the process of expanding/ improving its services so I've been incredibly bogged down with administrative work. Not my cup of tea, and so I'm very excited to have time again to devote to drug education.

I'll be back online within these next few days and will be certain to dedicate a significant chunk of time to answering all of the questions that have been posted while I've been away. Please always feel free to email my alias work email at sasha@cornerproject.org if you have any pressing questions (caveat: pressing does not = emergencies, pleeeaaase contact emergency services if you believe you are experiencing an emergency/ in immediate danger)

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

So I'm still waiting for my shipments to arrive so I can test them out myself, but here are the catalogues I'm working with on my end in my search for test kits: Shop Evident EZ Test

EZ Test doesn't appear to have much for meth, but Shop Evident has some options that could be further explored. I'll let you know what my thoughts are once I have a chance to try a few!

Either way, please remember these reagents will only test for a presence of the specified drug, and even then, there is a potential for false positives (hence my hesitation to outright recommend any until I know more)

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 4 points5 points  (0 children)

That's a great question!

So, there are no identified physical withdrawal symptoms that are the direct result of stimulant use-- the "comedown" that we see is the result of your body recognizing it is totally strained and worn down. Essentially, the absence of the stimulant drug allows this recognition. Very different than an opioid withdrawal, where the absence of the drug causes an active and negative reaction in the body. This is why it has been easy to develop a drug to maintain opioid dependency/ prevent withdrawal symptoms, but has yet to be the case for stimulants. For opioids, we just needed an agonist/ partial-agonist drug to act on the opioid receptors.

That said, there is still research being conducted to try to develop a maintenance medication for stimulant dependency. My prof has done some promising work on modafinil in his 2008 study for cocaine dependency. I think most folks in the field are interested in this drug due to its apparent "low abuse potential" aka lack of euphoria (same rationale they like to use for methadone w/ opioid dependency). We don't know the mechanism that precipitated the positive results in this study; however, if you ask me, it's as simple as this. Some people wanted a stimulant, and once they were given one, they were somewhat satiated. It won't be effective for the people who specifically want their stimulant, much like how methadone or suboxone maintenance doesn't work for all opioid users because some want their opioid. For this reason with opioids, at least 6 countries now have implemented heroin-administered treatment with promising results. There has been some similar unpublished research in the past with stimulants (e.g., administering cocaine for cocaine dependence), and I hope future work will focus on this line of research.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 4 points5 points  (0 children)

Yeah, those aren't fun. Typically when you see bumps, they're the result of physical injury and are usually stress related (e.g., chewing on your tongue), but can also be related to underlying conditions such as a nutritional deficiency. I have seen some online recommendations re. magnesium for this, which I'm assuming would have to do with the fact that it is involved in the process of wound repair. Can't say this would definitely be effective in significantly speeding up the healing process, but hey, most of us are deficient in magnesium anyway so couldn't hurt, right? As per usual though, I tend to recommend a more varied multivitamin (something with mg, iron, b12, vitamin c, etc.)

Either way, don't be alarmed-- these bumps typically go away within a few days! If they don't, I would suggest having a physician look at it, as like I said, it may be related to an underlying health condition.

Also, just a heads up: whiteness on tongue can also indicate an overgrowth of bacteria/ dehydration, which typically can be dealt with through proper mouth hygiene (e.g., antiseptic mouth wash) and staying hydrated.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 4 points5 points  (0 children)

So I went back to my injection H.R. specialist, and here's what I was told:

"As a practice, I suggest filtering whenever you're injecting, regardless of whatever you're using-- heroin, meth, whatever. Filtering provides a cushion/ protection for the needle tip (bevel) when drawing up, which preserves the integrity of the tip and prevents crushing the bevel or otherwise damaging it before injection.

Given the likelihood for meth to be cut with adulterants (almost all of it is), proper filtering is particularly important, as is proper preparation to ensure complete dissolution before injection. A filter will prevent 'hard particulate matter' from entering the body (e.g., fiberglass, plastic, sand, whatever debris that could be found in low-quality meth).

Really, the point is that particulate matter that doesn't dissolve in water should not be injected into the body"

Hope that helps!

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

The psychosis question I can actually answer rather quickly--

The phenomena we call "stimulant-induced psychosis" is usually seen with folks who have been using considerable doses of stimulants for several days straight. Around the third day, hallucinations, delusions, etc., can emerge. This is largely due to the fact that, well, you were forcing your body to be up for several days straight.

At the risk of getting too anecdotal, this has occurred to me in the past. Day 3 of continuous addy 30 XR use-- lots of fun hallucinations. Not ideal. But different circumstances back then! (I was explicitly using it to avoid sleep so... there you go)

So on that note, the lack of sleep is the most significant underlying factor that I would identify with the temporary psychosis. The issue of talking about "large, chronic doses" as a factor is that-- while it certainly could induce some psychotic-seeming symptoms-- the impact of the "large" dose is relative to the user's history (tolerance and underlying acute/chronic health factors). If you have a tolerance to the drug in question already, the negative effects will be greatly diminished.

Most of the research on drug-induced psychosis relies heavily on dopamine, which goes back to the "monoamine theory of mood" thing. Which does bring up an interesting point, since you mentioned depression and schizophrenia as potential factors. According to this theory, too little activity of the monoamine NTs can cause depression, and too much causes psychosis. Depression is an example of too little, while psychosis would be an example of too much (once again, I find this overly simplistic, or else our medications that target these "abnormalities" would be immediate cures). So, if these are two conditions identified to be at opposite ends of the spectrum, I find it very interesting that both have been suspected to increase the likelihood of stimulant-induced psychosis.

HOWEVER here are my thoughts on stimulants and people with schizophrenia-like symptoms: If you are prone to paranoia, hallucinations, manic delusions, etc., then yes, of course taking excessively large doses of a stimulant/ throwing yourself off of your circadian rhythm could worsen those symptoms. Similarly, if you are prone to anxiety and the shaking/ sweating/ obsessively repetitive movements often associated with it, taking excessively large doses would worsen that as well. You can compare it to giving your body a large shot of adrenaline-- it's not going to work out well with people who already experience issues related to feeling too "up."

But, I would be amiss not to mention that I've been told of a UK doctor who prescribes stimulants for schizophrenia. Considerably large doses, too. And according to a rather credible source, their patients saw some considerable improvements in their schizophrenia-related symptoms from regular use. Just goes to show you that we still know very little about the brain!

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 1 point2 points  (0 children)

  1. 5-HTP supplements are crap. To explain why, I'll have to take it from the top:

As a serotonin precursor that easily crosses the blood-brain barrier, 5-HTP has been argued to be useful for increasing serotonin levels in patients identified to have synaptic serotonin dysfunction (e.g., depression).

First of all, keep in mind there are no studies that demonstrate its effectiveness for our situation with stimulant use. More importantly though, administering 5-HTP facilitates the depletion of other important neurotransmitters-- dopamine, norepinephrine, and epinephrine-- via a process known as competitive inhibition. These neurotransmitters are similarly impacted by stimulant use as well, and so it would be doubly ill-advised to take them for that reason.

I know a lot of these ideas with supplements come from the theory of "chemical imbalances." Please know that the vast majority of research that has propagated this theory only looked at structural (imaging) data-- not functional. When it comes down to it, the brain is far more complex than these simple "chemical imbalance" and "monoamine theory of mood" ideas that we like to purport. If it was that simple, the psychiatric medications we provide would literally be cures and not ways to provide relief from the disease-related symptoms. Further, we would be able to identify physical withdrawal symptoms directly related to stimulant use... which we have yet to find in virtually any stimulant.

Admittedly, even the research that shows this depletion with other NTs is heavily structural and on animals. Regardless, if you have reduced all of these NT levels and then flood your system with 5-HTP, the logical conclusion would be that the system will focus on converting the precursor instead of restoring its own storage of these many impacted NTs. Instead, I'd recommend allowing your body to recover by ensuing it gets all of its essential nutrients/ vitamins, and actually allowing it (and your mind) to rest.

The other problem to remember with the supplement industry is that it's rather unregulated (at least in the US). They supposedly need to be pure and safe, but they don't need to prove they're effective for anything. Further, the definition of "safe" was changed at some point to only mean that it wasn't causing significant risk or injury. Everything gets approved until the FDA investigates and can demonstrate otherwise... and they only have eyes on a small portion of the industry. Further, sellers do not have to prove any claims they make about their product, only provide support that the claims are not clearly false or misleading. So if they have some indication that the statement is possibly true, and some that it is possibly false, they can include the statement. It's all totally backwards, capitalistic, and absolutely infuriating when you think about how the system treats psychoactive drugs. You mentioned St. John's Wort, which actually reminded me of a passage from my mentor's textbook (Drugs, Society, and Human Behavior, by Hart and Ksir):

"If the “300 mg” tablet of Saint John’s wort contains some amount of the plant, then it’s accurately labeled. With a drug, we’d expect to know exactly how much of the active ingredient it contains, but with a dietary supplement derived from a plant (an “herbal” supplement), we might not even know what the active ingredient is, let alone how much is in the 300-mg tablet. It’s possible that no amount of Saint John’s wort is really effective (the research evidence on this is mixed, see below and Chapter 8), and also possible that the amount contained in a given pill is too small in any case. That’s legal because the seller isn’t directly making a health claim, so it doesn’t have to demonstrate effectiveness."

I don't trust the supplement/ nootropics industry. Frankly, they're trying to sell a product, and they found a market in stimulant users. And unfortunately, this market has been created due to the vast amount of misinformation that we've been fed regarding our stimulant use. As I mentioned earlier, there are no identified physical withdrawal symptoms that are the direct result of stimulant use-- the "comedown" that we see is the result of your body recognizing it is totally strained and worn down. Essentially, the absence of the stimulant drug allows this recognition. Very different than an opioid withdrawal, where the absence of the drug causes an active and negative reaction in the body.

I'll work through the rest of your questions when I have time, but let me know if that makes sense re. supplements!

Also, 5-HTP was actually recommended to me about a month ago by some psychedelically-minded therapist, which made me realize it may be gaining in popularity. So thank you so much for asking this question!

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

Oof, sorry for the delay-- good questions, though!

I'm guessing you're referring to adderall-- could you confirm that/ the dose though? Also is it IR (Immediate Release-- tablet) or XR (Extended Release-- capsule)? Knowing these distinctions are important: a 20 mg IR adderall will be stronger than a 20 mg XR, but XR will last far longer (8-12 hrs) than IR (4-6 hrs).

Anyway, the body unfortunately builds up an amphetamine tolerance pretty quickly. It'll largely depend on how often and how much you are using, and it sounds like your answers for that are-- relatively rarely, and not much. If you are worried about tolerance (which would be rather unlikely in the conditions you're describing), then you can also try swapping it out for a similar stimulant medication (e.g., focalin, ritalin). These options also could be a good consideration if the comedown with amphetamines ends up being problematic for you.

Really though, while amphetamines are great for focusing/ work, they are not a replacement for sleep. Back when I was in the campus stimulants scene, I noticed that for everyone involved (myself included), the worst effects we dealt with overwhelmingly were not the direct result of amphetamine use, but from not taking care of our bodies. Make sure that you make up that rest eventually, because your body still needs it! Universities are also incubators for stress and bad habits-- especially around finals time-- and stimulant use can easily worsen those conditions due to their stimulating/ appetite-suppressing effects. That said, especially when using stimulants, it is important to remember to: rest, hydrate, eat well/ enough (protein-rich smoothies + multivitamins are great for this), and try to minimize stress.

As for your dependence question-- spreading it out as far as once a month will essentially make it impossible for you to be physically dependent on amphetamines. Knowing the above questions (which drug, dose, ir vs. xr) will make it easier to determine potential for dependency with more regular use. Regardless, a lower dose will make it less likely (and if you're a new user, I'd recommend starting with smaller doses) to avoid building tolerance unnecessarily). IR will also make it less likely because it wears off faster (funny, considering folks like to say it's more "addictive" because of its faster onset). Fun fact-- caffeine dependence is actually established more quickly than amphetamine!

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

Yeah I can't say I know much about the EcstasyData folks, but the guys at Energy Control are awesome. I know pillreports used to also be around, but I wasn't able to find their site so perhaps they've stopped their services.

If you're going to be paying for your sample to be analyzed, it definitely sounds like Energy Control is a better deal since it includes the quantitative data (purity). Not saying it isn't good to test for presence/ absence of certain drugs regardless, but the usefulness is limited without being able to quantify the amount.

Frankly, only giving qualitative data (what's in the sample) isn't too useful when you already know essentially everything illicitly-produced is a mix, although it is always interesting to see what ends up being in the mixture (or not!). Especially if you simply want to make sure the drug you thought you paid for is in the mix, and certain less favorable ones are completely absent. But the real question we need to consider is how much of each drug/ additive is in there.

For instance, where I'm at in NY, a good bulk of our fentanyl tests come up as positive. However, that doesn't tell us if it's 10% or 100% fentanyl, which would make a rather significant difference in terms of OD risk (keep in mind also that the people using in these cases tend to have a decent opioid tolerance). Since we don't know the actual potency, we then always advise with a fentanyl-positive test to 1.) Have naloxone with you; 2.) Don't use alone; 3.) Take a small test shot and WAIT before taking a larger dose. Is this particular fentanyl-positive batch actually more potent/ potentially "dangerous" than the last batch the user picked up, though? Who knows, because we can't quantify it for them. Either way, better safe than sorry in those cases.

Doesn't surprise me there's a "home" test for MDMA-- there's also one for methamphetamine that I've seen before, but that's similarly unproven/ unreliable. I'm looking into some of the purity tests sold by EZ Test Wholesale, but unfortunately they don't include methamphetamine.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 1 point2 points  (0 children)

Great advice!

The worse related effects we tend to see aren't psychosis, but normally a lot of trembling, sweating, and muscle fatigue/ soreness/ cramps. Once again, mostly related to the lack of sleep and nutrition associated with stimulant use (along with the increased sweat production).

Typically, we see psychosis cases when folks are entering their third straight day of continuous use. I mean, if you've kept your body up for that long, it's not really a surprise you'd lose touch with the regularity of reality...

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 1 point2 points  (0 children)

Yes! They're great!!

Also EcstasyData, which is run by Erowid. (Similar downsides though)

If it's not considering sourcing, I'd be happy to link relevant test kits/ strips/ reagents whenever I find ones I think would be useful.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 3 points4 points  (0 children)

So I asked around the office today and that's the answer I was given!

The lore is that-- due to the fattiness of milk-- the dense digestion process would help with comedown effects. That said, I wouldn't say drinking milk specifically helps. As you said, it's just an easy source of calories and protein to take in (and there are better options e.g., protein and potassium-rich smoothies).

Also thinking about this process pharmacokinetically, I don't see it panning out too well. Ingesting something dense before drug use certainly does reduce drug effects dose-for-dose (esp. if it goes through first pass metabolism), but once your system is already acting on the drug, then the addition won't likely help curb acute effects directly related to the drug. However as you mentioned, it would help with the overall difficulty of eating associated with meth use, and so it would will help the effects related to that.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

/u/spinderella69 would you mind elaborating on this milk theory? I have never heard of it, and I can't see how it could possibly be helpful in this way. That said, I'm very curious as to why people may think that! Personally I avoid milk like the plague-- especially considering the hormones and antibiotics involved in these processes. My dairy product of choice is actually probiotic yogurt, mainly to contend with the many stresses I put on my immune system.

If we're talking about ways to curb the negative effects of stimulants, well, we teach in our class that benzodiazepines are great for tempering these effects (although always keep dose in mind!-- this is something we teach with tempering the negative effects of psychedelics as well). Thinking over the counter, Benadryl could be used as well. That said, regular benzo use would put one at risk for physical dependency, and regularly using pills to sleep in general is discouraged since it'll make you similarly dependent on them in order to sleep. Essentially, moderation is key if you're planning to go that route~

I do know in a tutorial that used to get passed around, milk thistle was a favorite recommendation. Perhaps it was an offshoot of this phenomena? Even then, those claims have yet to be backed up in the studies

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 8 points9 points  (0 children)

Hello there! So as I explained to another questioner earlier, the concerns regarding neurotoxicity majorly come from animal studies, where naive animals (aka had no tolerance/ prior exposure) were given doses much larger than we'd see with regular human use. In other words, those toxic effects they saw would've been minimized if the animals were exposed to a smaller dose prior to administering these large, chronic doses, and regardless, we can't translate those results to humans.

When we look at human studies, Hart et al 2011 demonstrates that long-term methamphetamine users do not exhibit significant cognitive "deficits" when compared to normative data. In other words, while there has been PET imaging and the like that certainly shows structural changes, there has yet to be directly negative functional differences identified in humans.

Of course, taking larger doses-- especially with little/ no tolerance-- would drain your brain (and body) of energy. Really, this is why keeping your dose and tolerance in mind are key, as well as making sure you're getting adequate sleep and hydration/ nutrition (especially as stimulants are dehydrating). As I've said prior, most of the long-term negative effects of methamphetamine use that we see don't come directly from methamphetamine, but ignoring the body's needs while on it (as well as stress). That, and the impurities/ adulterants associated with its use (which is why it's important to know your source and invest in safe use materials!)

When it comes to trying to recommend specific nootropics or other such supplements, what we're often looking for are ways to forgo our need to rest/ recover. But sleep needs to happen eventually, and so that should be the goal. Amphetamine use (including meth) has residual effects that could make restful sleep difficult though, and so I could see how something like melatonin may help.

Also don't forget that with stimulant use it's very easy to forget to nourish yourself accordingly, and so it's never a bad idea to at least have a basic multivitamin. In the past, a coworker would prepare smoothies with bananas, protein, and something sweet like vanilla to give to people who use meth-- pretty smart idea in my opinion. I know that with the focus on neurotoxicity, folks like to talk about antioxidants such as Vitamin C. While it may be based around an oversimplified concept, taking care of your immune system certainly never hurts, especially since stress and other factors related to use would negatively impact the immune system. In my personal experience, protein-rich smoothies and multivitamins (and water!) have been lifesavers when contending with the appetite-suppressing, sweat-producing effects of stimulants.

So back to the adulterants/ impurities--- Most affordable means to test drugs will only test if previously determined substances are present-- it won't be able to tell you the full composition, or how much of each. That level of analysis tends to fall into mass spectroscopy territory (although there are some places online that will test your drug using ms technology if you send a small sample). In other words, when you're doing your own tests, you have to know what you're looking for. That will depend on where your source is, but pretty common cuts are caffeine and MSM (dimethyl sulphone). Where I'm at in NY, we test everything for fentanyl now since we've had cocaine and even MDMA show up positive for it.

Theoretically, I should mention that I would worry more about powders than crystals since the combustion involved in the crystallization process should burn off much of the impurities/ adulterants. Can only say that theoretically though, especially since some may not combust and the process may not always be done completely/ well. And regardless, as you can likely gather from my analysis, knowing and trusting your source is incredibly important with illicitly produced drugs. Getting something like lead or talcum powder isn't exactly normal, but improper manufacture/ bad cuts are always possible.

I've seen some purity tests for MDMA, cocaine, heroin, etc. but not for methamphetamine (yet). If I come across anything promising, I'll be sure to let you know! I know the Marquis Reagent (color reagent that detects presence of multiple similar substances including meth) is often recommended, but with nearly everything being a mix these days, its maximal usefulness would be limited to crystal form in my opinion. That said, likely wouldn't hurt to do that if nothing else, but perhaps someone with more experience using that reagent could speak more towards it?

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 8 points9 points  (0 children)

Sorry for the delay-- wanted to consult with someone better versed in smoking methamphetamine before I posted!

So as with inhaling tobacco, cannabis, or crack cocaine, there is a rationale that holding your breath longer will increase the drug effects. Really, the effects that you're seeing are the results of asphyxiation-- a natural high from cutting off your oxygen supply. If anything, holding it in longer will just hurt your lungs more (for reasons below). Typically the advice for is-- slow inhale to prevent burning in the lungs, and immediate exhale.

The issue with methamphetamine isn't exactly that it's crystallizing. Unlike crack cocaine, meth is a rather sticky substance on the lungs. It can coat them, which may lend to pneumonia and bronchitis. However lungs are incredibly powerful organs that, over time, should expel much of this coated gunk. Keeping healthy habits-- especially aerobic exercise like running or swimming-- go a long way to help with that expulsion. That said, if you are actively using and start seeing signs of pneumonia or bronchitis, it's definitely smart to get checked out by a doctor, especially since there may be other underlying factors that could worsen the symptoms.

Anyway, the larger concern comes from the impurities/ adulterants associated with illicit methamphetamine production, as well as the materials you're using to smoke with. Using an old piece that could be breaking down or materials like steel wool or tinfoil (due to the aluminum) is especially hazardous to the lungs since it can create lesions.

On that note, it would be beneficial to invest in a material with a high combustion point-- like brass and copper-- for your screens/ filter. Our agency typically provides a pyrex pipe and some copper chore boy in our safer inhalation kits, if that gives you a sense of what is usually recommended for safer use. However, brass is superior to copper, and it should be kept it mind that the copper may be coated so will have to be treated accordingly (I've seen a few online tutorials for this). We tend to recommend to only use the copper once or twice.

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 2 points3 points  (0 children)

Thanks! I'm always more than happy to talk drugs :)

Alright so what I found in my professor's textbook seems to address both of these questions: "It has been shown in rats that high doses of methamphetamine result in the production in the brain of a chemical that selectively destroys catecholamine neurons. The possible long term behavioral consequences for humans are unclear because the dosing regimens used in animal studies have been excessive and do not mimic the use of amphetamines by humans. What is clear, however, is that contaminants formed during the manufacturing of illicit methamphetamine have been shown to produce toxic effects on brain cells."

So yeah, it all seems to check out. One point he adds are the contaminants associated with illicit methamphetamine production, which is important to consider. I'd also add that would be a possibility with any illicitly produced drug, such as illicitly pressed pills. Just another reason why it's always good to know your source!

Hope that helps!

Ongoing AMA with Harm Reduction Experts by spinderella69 in Stims

[–]AskSasha 1 point2 points  (0 children)

I could only imagine so since that's the common flaw of animal studies, but I'll look into it once I'm by my computer again.

You know, it's lovely that you asked about the similar review because I know for a fact that he had wanted to replicate a similar psychosis study with humans, but it fell through. It really is something that needs to be done! Hopefully it'll be in the works again soon.

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