Harm Reduction · Real Help · No Judgment

You deserve to
use more safely,
whatever that looks like.

Practical, evidence-based information for people who use drugs — and for the people who love them. No shame. No pressure. Just tools that help.

🌿

You matter.
Your safety matters.

🔬 Test strips
💊 Naloxone
📍 Find services
🤝 Peer support
🚨
If someone is overdosing — call 911 immediately

Good Samaritan laws protect you in most states. Most important: call for help.

Crisis Line 988 SAMHSA Helpline 1-800-662-4357 Harm Reduction 1-800-627-9396

What is harm
reduction?

Harm reduction is a set of practical strategies and ideas aimed at reducing the negative consequences of drug use. It meets people where they are — without requiring abstinence as a goal.

It's rooted in the belief that people have the right to make their own choices, and that reducing harm is always better than doing nothing.

🤝
Non-Judgmental Support
No shame, no prerequisites. Help is available to everyone regardless of their choices or goals.
📚
Evidence-Based Information
Practical, accurate information about risks and ways to reduce them — not scare tactics.
🏥
Access to Services
Connecting people to sterile supplies, naloxone, testing strips, and healthcare without barriers.
💪
Autonomy and Dignity
People are the experts on their own lives. Harm reduction empowers informed decisions.

Know the risks,
reduce the harm.

This is not medical advice. This is real-world harm reduction information from people who care about you staying alive.

⚠ High Priority
Never use alone
Opioid overdose can happen in minutes. Always have someone nearby. If you must use alone, call the Never Use Alone hotline: 1-800-484-3731 — a live person stays on the line.
⚠ High Priority
Test for fentanyl every time
Fentanyl is in virtually every supply. A small amount can cause overdose. Use fentanyl test strips before every use, even on substances you've used before.
⚡ Important
Start low, go slow
Tolerance drops fast — after even a few days. After any break (release from jail, hospital, or treatment), use much less than you used before. Overdose risk is highest here.
⚡ Important
Avoid mixing
Mixing opioids with alcohol, benzodiazepines (Xanax, Valium, Klonopin), or other depressants dramatically increases overdose risk. Each drug slows breathing — together they can stop it.
✓ Safer Practice
Use sterile supplies
Never share syringes, cookers, cotton, or water. Syringe service programs (SSPs) provide free sterile supplies and are confidential.
✓ Safer Practice
Carry naloxone
Naloxone (Narcan) reverses opioid overdose. Get it free at many pharmacies, SSPs, and harm reduction organizations. Tell people you use with where it is.
⚠ High Priority
Cardiovascular risks
Stimulants raise heart rate and blood pressure significantly. If you have any heart conditions, be extra cautious. Chest pain or irregular heartbeat requires immediate medical attention.
⚡ Important
Sleep and nutrition
Stimulants suppress appetite and sleep drive. Long use without eating or sleeping can lead to dangerous crashes, psychosis, and immune suppression. Build in rest days.
⚡ Important
Mental health watch
Stimulant psychosis can resemble schizophrenia and can develop rapidly with heavy use or lack of sleep. Paranoia, racing thoughts, and hallucinations are signs to slow down or stop.
✓ Safer Practice
Hydrate — but not too much
Stay hydrated, especially if active or in heat. Electrolyte drinks can help. Avoid excessive water intake which can cause dangerous sodium imbalance.
⚠ High Priority
Don't quit cold turkey if dependent
Unlike most substances, alcohol withdrawal can be fatal. If you drink heavily every day and want to stop, talk to a doctor first. Symptoms include seizures and can begin within 8 hours of last drink.
⚡ Important
Eat before and during
Food slows alcohol absorption and reduces harm. Avoid drinking on an empty stomach. B vitamins (especially thiamine) help protect the brain during heavy drinking periods.
✓ Safer Practice
Alternate with water
Matching each alcoholic drink with water slows consumption, reduces dehydration, and helps you pace yourself. Designate a trusted sober person when going out.
✓ Safer Practice
Plan for getting home safe
Arrange transport before drinking. Alcohol impairs judgment about impairment. Have a designated driver or rideshare plan in place ahead of time.
⚡ Important
High-potency products
Modern cannabis (especially concentrates and edibles) can be far more potent than expected. Start with a very small amount. Edibles can take 1–2 hours to feel effects — don't redose too early.
⚡ Important
Mental health considerations
Cannabis can trigger or worsen anxiety, paranoia, and in rare cases psychosis — especially in people with a personal or family history of psychotic disorders. High-THC products carry more risk.
✓ Safer Practice
Reduce smoking harms
Vaporizing at lower temperatures or using edibles avoids many combustion-related respiratory harms. If you smoke, avoid holding smoke in — it doesn't increase effect but does increase harm.
✓ Safer Practice
Avoid driving
Cannabis impairs reaction time and judgment. Avoid driving for at least several hours after use. Impairment can be subtle and underestimated, especially with regular use.
⚠ High Priority
Dangerous to stop suddenly
Like alcohol, benzodiazepine withdrawal can cause fatal seizures. If you use regularly, never stop abruptly. Taper slowly, ideally with medical guidance. This is serious.
⚠ High Priority
Never mix with opioids or alcohol
The combination of benzos with opioids or alcohol is responsible for a huge percentage of overdose deaths. Both suppress the nervous system — together they can stop your breathing while you sleep.
⚡ Important
Street benzos are unpredictable
Illicit benzos (like pressed bars or powders) often contain novel designer benzodiazepines that are much more potent and longer-acting. Use fentanyl test strips — some also detect benzo adulterants.
✓ Safer Practice
Use in a safe environment
Benzos impair coordination and memory. Avoid using alone, near traffic, water, or at heights. Falls and accidents are a major risk.
⚡ Important
Set and setting matter enormously
Your mental state and physical environment profoundly shape psychedelic experiences. Choose a safe, comfortable environment with people you trust. Having a sober trip-sitter is strongly advised.
⚡ Important
Mental health contraindications
People with personal or family history of psychosis, schizophrenia, or bipolar disorder face elevated risks. Psychedelics can trigger latent conditions. Approach with extra caution or avoid.
✓ Safer Practice
Test your substances
Use reagent test kits to verify what you have. Many substances are misrepresented. Fentanyl-laced psychedelics are rare but have been reported — use test strips as an extra precaution.
✓ Safer Practice
Avoid combining and plan for duration
Psychedelics can last 4–12+ hours. Clear your schedule, don't mix with other substances, and have benzodiazepines available as an emergency "exit ramp" if needed.
Save a Life

Naloxone: the overdose
antidote that works.

Naloxone (brand name Narcan) rapidly reverses opioid overdose. It's safe, effective, free in many places, and legal in all 50 states without a prescription.

01
Recognize an overdose
Signs include: unresponsive, slow or no breathing, blue or gray lips, pinpoint pupils, gurgling or snoring sounds. If you can't wake them up with a sternal rub — act now.
02
Call 911 first
Call for emergency help immediately. Good Samaritan laws protect you from prosecution in most states when you call 911 for an overdose. Don't wait to call.
03
Administer naloxone
For nasal spray (Narcan): tilt head back, spray one dose in one nostril. For injectable: inject 0.4mg into muscle. Repeat every 2–3 minutes if no response (up to 3 doses).
04
Recovery position
Place them on their side (recovery position) to prevent choking. If not breathing, perform rescue breathing (one breath every 5 seconds) until they breathe on their own.
05
Stay with them
Naloxone wears off in 30–90 minutes — less time than most opioids last. They may need more doses. Stay until EMS arrives. They may wake up in withdrawal — keep them calm and still.
06
Get naloxone for free
NEXT Distro mails naloxone to all 50 states for free. Local pharmacies dispense without prescription. Syringe service programs, health departments, and harm reduction orgs carry it.
Get Free Naloxone Mailed to You → No ID required. Available in all 50 states via mail.

The right tools
save lives.

These supplies are available free or low-cost at syringe service programs, harm reduction orgs, and many pharmacies.

💉
Sterile Syringes
Prevents HIV, Hepatitis C, and bacterial infections. Available free at SSPs nationwide, no questions asked.
🧪
Fentanyl Test Strips
Detect fentanyl in any substance before use. Results in 2–5 minutes. Now legal in all 50 states.
💊
Naloxone (Narcan)
Reverses opioid overdose. Available free without a prescription. OTC at most pharmacies.
🩺
Wound Care Supplies
Bandages, antiseptics, and guidance for wound care. Abscesses are common and treatable — don't wait.
🔬
Drug Checking Services
Some orgs offer spectrometry testing to identify what's really in your supply. Growing in availability.
🛡️
Condoms & Sexual Health
Free at most harm reduction sites and health departments. PrEP for HIV prevention is also available.
🌡️
Xylazine (Tranq) Strips
Test for xylazine, now found in much of the opioid supply. Naloxone won't reverse xylazine — wound care is critical.
🧴
Smoking Supplies
Pipes, foil, and mouthpieces reduce sharing-related disease transmission. A safer alternative to injection.
Testing Guide

How to use
fentanyl test strips.

1
Prepare a small residue sample
Use a tiny residue (about a match head) from your supply. Put it in a clean cup or spoon. For pills, crush a small amount. For powders, use residue from the bag.
2
Add water
Add about 1 teaspoon (5ml) of clean water. Stir to dissolve. For meth or MDMA testing, use more water (about ¼ teaspoon of substance per 1 teaspoon water).
3
Dip the strip wavy-end down
Dip the wavy end of the test strip into the water for 15 seconds. Then lay it flat on a clean surface and wait 2–5 minutes.
4
Read the result
Look for lines in the C (Control) and T (Test) windows. The result is ready when the control line appears. Read within 10 minutes.
5
Important: a negative result isn't certainty
Even a negative result doesn't mean your supply is fentanyl-free. Fentanyl can be unevenly mixed ("hot spots"). Always start with a test dose regardless of results.
Reading Your Strip Results
C
T
Two lines = NEGATIVE Fentanyl not detected. Still start with a small test dose.
C
T
One line (C only) = POSITIVE Fentanyl detected. Use much less, have naloxone ready, don't use alone.
C
T
No lines = Invalid Test failed. Try again with a fresh strip.
⚠ Test strips cannot detect xylazine (tranq), benzodiazepines, or other adulterants. A negative fentanyl result doesn't mean your supply is safe from all substances.
Get Help Near You

Find services in
your community.

Syringe service programs, harm reduction orgs, treatment on demand, and peer support — all without judgment.

Mail-Order
NEXT Distro
Free naloxone, test strips, and safer use supplies mailed anywhere in the US. No ID required.
nextdistro.org →
Syringe Programs
NASEN Locator
Find syringe service programs near you. Free sterile supplies, wound care, and more.
nasen.org →
SAMHSA
Treatment Locator
Find local substance use treatment facilities, including low-barrier and same-day programs.
findtreatment.gov →
Policy & Advocacy
Drug Policy Alliance
Know your rights. Legal resources and advocacy for people who use drugs.
drugpolicy.org →
Hepatitis C
HCV & HIV Testing
Free, confidential Hep C and HIV testing at thousands of locations nationwide. Cure exists for Hep C.
gettested.cdc.gov →
If You Use Alone
Never Use Alone Hotline
Call 1-800-484-3731 before using alone. A live person stays on the line and calls 911 if you stop responding.
neverusealone.com →

Your mental health
matters too.

Drug use and mental health are deeply connected. Whether you're looking for support, therapy, or just want to talk to someone who gets it — help is here.

You don't have to be in crisis to reach out. Peer support workers have often lived experience with drug use and can help navigate systems without judgment.