By Anthony Munger

12/12/2023

In Kentucky, the LGBTQ community confronts numerous challenges, notably higher rates of substance use disorders. These are often exacerbated by social stigma, discrimination, and the pressures of minority stress. Recognizing these issues, the Louisville Pride Foundation dedicates itself to advancing education, support, and harm reduction strategies. Their goal is to empower LGBTQ individuals in their journey with substance use and to cultivate a safe, supportive community environment.

Harm reduction strategies, a cornerstone of the Foundation’s approach, are vital in addressing the immediate health and safety concerns associated with substance use. These strategies encompass a range of initiatives, from educational programs to practical interventions. Education plays a crucial role, aiming to enhance awareness about the risks associated with different substances and their usage. Such knowledge is pivotal in helping individuals make informed, safer choices and significantly reduces the risk of accidental overdoses.

Another critical tool in harm reduction is the distribution of naloxone, a medication that can reverse the effects of opioid overdoses. By making naloxone readily available, the Foundation ensures that both drug users and the broader community have access to this lifesaving intervention.

Furthermore, harm reduction is instrumental in managing public health issues like the spread of infectious diseases, including HIV and Hepatitis C, particularly among those who inject drugs. Initiatives like needle exchange programs not only benefit the individuals involved but also protect the wider community by curbing the spread of these diseases.

Economically, harm reduction strategies are advantageous, leading to significant savings in healthcare and community welfare by preventing overdoses and reducing drug-related crimes. This cost-effectiveness provides a strong incentive for policymakers and healthcare providers to endorse and implement these strategies.

At its essence, harm reduction respects the dignity and rights of individuals who use drugs. It views them as deserving of empathy, care, and support, shifting away from a stance of judgment and stigma. This empathetic approach not only supports the immediate health needs of individuals but also fosters a more understanding and supportive community ethos. This is crucial in paving the way for more compassionate and effective public health policies, especially within the LGBTQ community.

  • LGBTQ+ populations show higher rates of substance use than heterosexual and cisgender individuals.
  • Unique stressors for that may lead to substance include anti-LGBTQ+ policies, family rejection, internalized homophobia, and healthcare discrimination.
  • Only 20% of all U.S. adults needing treatment for substance abuse obtain it
  • LGBTQ+ individuals face additional barriers, including anticipated stigma from non-affirming healthcare providers.
  • Only 28% of opioid use disorder (OUD) treatment programs claiming to offer LGBTQ+-specific services actually do so.
  • Recent studies and surveys have shown that individuals within the LGBTQ community are at a higher risk for substance use, including the use of club drugs. Club drugs are often associated with nightclubs, parties, and raves, and they can have serious health and safety implications.
  • According to the National Survey on Drug Use and Health, gay, lesbian, and bisexual individuals are more than twice as likely as heterosexual individuals to have used MDMA (ecstasy) in the past year.
  • A study published in the Journal of Substance Abuse Treatment found that gay and bisexual men are at an increased risk for using methamphetamine, a powerful stimulant that is commonly used in club settings.
  • Research has also shown that transgender individuals are at a higher risk for substance use disorders, including the use of club drugs.

To prevent overdoses, the further spread of communicable disease, and deaths, we encourage users to keep the following evidence-based strategies in mind:

  • Utilize test strips to determine the presence of fentanyl in a given substance rapidly. By being aware of the presence of fentanyl, users can make informed decisions about usage.
  • Naloxone, commonly known as Narcan, is a life-saving medication that can reverse opioid overdoses. Individuals at risk of an overdose or those who know someone at risk should carry naloxone and be trained on how to use it.
  • For those struggling with substance use, seeking treatment can provide the support and resources needed to reduce the risk of overdose. Medications for opioid use disorder, have been shown to be effective in reducing the risk of overdose.

Frequent snorting of substances can have several detrimental effects on the nasal passages and overall health. One of the primary concerns is the potential damage to the nasal septum, the cartilage that divides the nostrils. Continuous snorting can cause a hole in this septum, leading to complications like frequent nosebleeds and persistent nasal congestion. Additionally, the chemicals present in these snorted substances can cause irritation and inflammation in the nasal passages, leading to chronic discomfort and the possibility of long-term damage.

This irritation can further develop into chronic sinusitis, a condition where the sinuses become swollen and inflamed over an extended period. Individuals with chronic sinusitis often experience symptoms such as facial pain, nasal discharge, and a diminished sense of smell. Moreover, the damage to the nasal passages from snorting increases their vulnerability to infections, heightening the risk of sinus infections.

Another significant risk associated with snorting is the potential transmission of blood-borne viruses. Sharing snorting devices can lead to the spread of serious viruses like HIV and Hepatitis C. Additionally, the risk of transmitting other types of infections, including bacterial infections, is also heightened with the shared use of snorting apparatus. These health risks underscore the importance of understanding and addressing the potential harms associated with the practice of snorting substances.

  • Always use personal, disposable equipment for snorting. This reduces the risk of transmitting blood-borne viruses and other infections.
  • Sharing snorting devices can lead to the transmission of various diseases, including Hepatitis C, HIV, and other bacterial infections.
  • Rinsing your nostrils can help to remove drug residue, reduce irritation, and prevent damage to the nasal passages.
  • Using softer materials reduces the risk of causing cuts or abrasions inside the nostrils, which can lead to infections and other complications. Never use hard or sharp objects as snorting devices, as they can cause significant damage to the nasal passages.

With recreational drugs, it’s crucial to understand both their effects and associated risks. MDMA, commonly known as Ecstasy or Molly, is known for inducing feelings of euphoria, heightened energy, emotional warmth, and altered sensory and time perceptions. However, its use is not without risks, which include dehydration, hyperthermia, serotonin syndrome, and the potential for addiction.

Methamphetamine, often referred to as Meth or Crystal, offers a different set of effects, including increased energy, an enhanced mood, and a boost in libido. The risks associated with methamphetamine are particularly severe, including the notorious “meth mouth” characterized by severe dental problems, skin sores, addiction, and cognitive deficits.

GHB, another drug used recreationally, is sought for its euphoric effects, increased libido, and ability to lower inhibitions. However, it carries serious risks, such as the possibility of unconsciousness, seizures, and a high potential for overdose, especially when combined with alcohol.

Ketamine, also known as Special K, creates an experience marked by disassociation, altered perceptions, and a sense of detachment from reality. While these effects might appeal to some users, the risks include confusion, impaired motor function, and a potential for addiction. Understanding these effects and risks is vital for anyone considering the use of these substances or for those seeking to inform themselves about the realities of drug use.

  • Educate yourself and others about the effects, risks, and safer use practices of club drugs.
  • Use drug checking services or kits to ensure that what you are taking is what you think it is.
  • Drink water to stay hydrated, but avoid excessive water intake, especially when using MDMA.
  • Stay with trusted friends and look out for signs of overdose or adverse reactions.
  • Be aware of your own limits, and don’t feel pressured to use substances if you don’t want to.

Methamphetamine abuse has become a significant concern within the gay community, particularly among gay men, where there has been a notable rise in meth-related arrests in areas with substantial gay populations. Often, meth is used in combination with other substances such as Special K, Poppers, Viagra, GHB, and Ecstasy, a practice referred to as “speedballing.” This combination can be extremely dangerous, sometimes even life-threatening, due to the conflicting effects of these drugs.

The advent and spread of social media platforms have further complicated this issue by facilitating the organization of sex/meth parties. These events typically combine meth use with anonymous sexual encounters, often unprotected, thereby heightening the risk of transmitting HIV and other sexually transmitted infections. Particularly worrying is the impact of meth use among HIV-positive gay men, as it can lead to a decrease in immune resilience, evidenced by a lower ratio of CD4/CD8 cells. Additionally, there is an increase in the concentration of HIV in their semen, which may contribute to the development of more virulent HIV strains and diminish the effectiveness of HIV medications.

Young gay men, especially those under the age of 40, are at an increased risk of both meth addiction and contracting HIV. The highest usage is reported among those aged 17 to 29. Alarmingly, there has been a significant uptick in the number of gay men who inject meth, known as “slamming.” This method of ingestion is associated with an intense high and has been linked to a surge in HIV infection rates, further exacerbating the health challenges faced by this community.

  • If you’re using a new batch of amphetamines, start with a smaller dose to gauge its strength and reduce the risk of overdose.
  • Mixing amphetamines with other drugs, can increase the risk of adverse reactions and overdose. Try to use one substance at a time.
  • Amphetamines can suppress appetite and lead to dehydration. Remember to drink water and eat balanced meals.
  • Amphetamines can increase libido and lead to risky sexual behavior. Always use condoms to reduce the risk of STIs and HIV transmission.
  • Ensure you have a safe space to rest and recover, and reach out to friends or support networks if you’re feeling low.

Recognize Signs of and Overdose

  1. Changes in Vital Signs: Unusual heart rate, blood pressure, temperature, or respiratory rate.
  2. Altered Mental State: Confusion, delirium, paranoia, or agitation.
  3. Loss of Consciousness: Unresponsiveness or inability to wake up.
  4. Seizures or Convulsions.
  5. Difficulty Breathing: Shallow, slow, or labored breathing.
  6. Chest Pain.
  7. Nausea and Vomiting.
  8. Abdominal Pain.
  9. Diarrhea.
  10. Drowsiness or Dizziness.
  11. Bluish Lips or Fingernails: Indicating a lack of oxygen.
  12. Skin Changes: Sweating, cool or clammy skin.

How to Administer Intranasal Naloxone / Narcan (Nasal Spray):

  1. Check for Signs of Opioid Overdose: Look for symptoms like unresponsiveness, slow or no breathing, blue or gray skin, especially on lips and nails.
  2. Call for Emergency Help: Before administering Narcan, call emergency services.
  3. Prepare the Narcan Nasal Spray:
    • Remove Narcan from the box.
    • Peel back the package to remove the device.
    • Hold the spray with your thumb on the bottom of the plunger and two fingers on the nozzle.
  4. Administer the Dose:
    • Tilt the person’s head back and provide support under the neck with your hand.
    • Insert the tip of the nozzle into one nostril.
    • Press the plunger firmly to release the dose.
  5. After Administration:
    • Move the person on their back.
    • If the person does not respond or wake up in 2-3 minutes, administer a second dose in the other nostril.
    • Continue to monitor the person’s breathing and heart rate.
    • Perform rescue breathing or CPR if necessary.
  6. Stay with the Person: Remain with the person until emergency services arrive. Narcan can wear off in 30-90 minutes, and the person may need another dose.

 

How to Use Fentanyl Test Strips

  1. Gather Materials: You’ll need the fentanyl test strip, a small container (like a cooker or spoon), water, and the substance to be tested.
  2. Prepare the Substance: If testing a pill or powder, you need to dissolve a small amount in water. If testing a liquid, you can use it directly.

Testing Process:

  1. Dissolve the Sample:
    • Place a tiny amount of the drug (equivalent to a match head or a small pinch) into the container.
    • Add a few drops of water to the container and mix it with the drug to create a solution.
  2. Use the Test Strip:
    • Open the fentanyl test strip package.
    • Hold the strip by the blue end and insert the other end (without the blue lines) into the solution.
    • Allow the strip to absorb the liquid for about 15 seconds, then remove it from the solution.
  3. Wait for Results:
    • Lay the strip on a flat, clean surface.
    • Wait for about 2 minutes for the test to develop.

Reading the Results:

  • Two Lines: If two lines appear on the strip (even faint lines), this indicates a negative result (no fentanyl detected).
  • One Line: If only one line appears (next to the “C” on the strip), this indicates a positive result (fentanyl is present).
  • No Lines or One Line by the “T”: This indicates an invalid test.

Important Considerations:

  • Accuracy: While fentanyl test strips can be a helpful tool, they are not 100% accurate. Some analogs of fentanyl may not be detected.
  • Safety: Always handle drugs and test strips with care. Avoid direct contact with the substance.
  • Disposal: Safely dispose of the used test strip and any remaining solution.
  • Limitations: A negative result does not guarantee the substance is safe. Other potent substances may be present.
  • Emergency Response: If you suspect an overdose, call emergency services immediately. Fentanyl overdoses require prompt medical attention.

Additional Tips:

  • Practice Harm Reduction: Use these strips as part of a broader harm reduction strategy.
  • Seek Information: If available, get training or additional information from a harm reduction organization on how to use the strips effectively.

Remember, the presence of fentanyl significantly increases the risk of overdose. If you’re using substances, consider reaching out for support from local harm reduction organizations or health professionals.

Resources: 

https://neverusealone.com

https://nasen.org

https://findhelpnow.org/

https://kyhrc.org/

Kentucky Opioid Assistance and Resource Hotline, 1-800-854-6813

Always call 911 during an overdose emergency