Harm reduction
Reducing risk, whatever stage you're at
Harm reduction means taking practical steps to stay safer and healthier. You do not have to stop using, or plan to stop, to deserve accurate information and good care.
Core principles
Six principles that reduce risk
These apply across substances and are drawn from established UK harm-reduction practice.
Never use alone where you can avoid it
If someone is with you, they can call 999 and respond if something goes wrong. If you are alone, tell someone what you are doing and when to check on you, and leave the door unlocked.
Start low, go slow
Potency of illicit substances is unpredictable and varies between batches. Using a smaller amount first and waiting gives you information about strength before you take more.
Avoid mixing
Combining substances — especially opioids, alcohol, benzodiazepines, gabapentinoids or other sedatives — greatly increases the risk of stopped breathing and death.
Tolerance drops fast
After a break — prison, hospital, detox, treatment or simply a pause — the same amount you used before can be dangerous. Restart much lower.
Carry naloxone if opioids may be involved
Naloxone temporarily reverses opioid overdose. It is free in the UK and can be supplied to people likely to witness an overdose. Always call 999 as well.
Look after the basics
Hydration, food, sleep, wound care and dental care all affect how well your body copes. Blood-borne virus testing and vaccination are free and confidential.
Naloxone
Naloxone saves lives — and it's free
Naloxone temporarily reverses the effects of an opioid overdose, giving time for an ambulance to arrive. In the UK it can be supplied without a prescription to people likely to need it, including family members, friends and peers.
- Ask a drug and alcohol service, needle and syringe programme, or participating pharmacy about a free kit and training.
- Naloxone only works on opioids — but it is safe to give if you are unsure and opioids may be involved.
- It wears off before many opioids do, so the person can deteriorate again. Always call 999.
- Stay with the person, keep their airway clear, and follow the call handler's instructions.
Safer injecting
- Use sterile, single-use injecting equipment every time — needle and syringe programmes are free and confidential.
- Never share needles, syringes, filters, spoons, water or swabs; hepatitis C can be passed on through shared equipment.
- Wash your hands, use a clean surface and rotate injection sites where possible.
- Dispose of used equipment in a sharps bin — services provide these free.
- Get free, confidential testing for hepatitis B, hepatitis C and HIV. Hepatitis C treatment is available and highly effective.
- Seek medical help promptly for redness, swelling, heat, pain or an abscess — infections can become serious quickly.
Alcohol and sedatives
Two situations where stopping suddenly can be dangerous
With alcohol and with benzodiazepines, abrupt withdrawal after heavy, regular use can cause seizures and other serious medical problems.
Alcohol
If you drink heavily every day, do not stop abruptly without medical advice. Speak to a GP, pharmacist or alcohol service about a safe plan — medically supported withdrawal is available and is often provided in the community.
Benzodiazepines and similar
Reductions should be planned and gradual with a prescriber. Illicit "benzos" are often stronger or different from what they are sold as, and are frequently involved in UK drug deaths when combined with opioids.