Liam* and his friends had used methamphetamine for ten days straight. When he and his mates started getting paranoid and doubting each other, he bailed and spent another couple of days using meth alone. The Level talks to Liam about his experience and explores some of the reasons people choose to use drugs by themselves.
When we speak to Liam, he talks openly about his history with substances and previous experiences using drugs alone – both positive and negative.
On this particular occasion using drugs alone, he says he started to become increasingly anxious about the world around him.
“When you use with others, there’s normally someone around to say, ‘pull your head in.’ [Alone], I worked myself up into a really paranoid state thinking that people were out to get me.”
Liam went for a walk around the city to try and clear his head. The traffic signals on Wellington’s busy Cuba Mall would normally blend into the background, but as he walked around, high, and alone, the constant beeping and buzzing deepened his sense of paranoia. He became convinced that if he didn’t decide where he was walking to, someone would shoot him. He ducked into a nearby furniture store for refuge.
“I was in such a delusional state, I thought the different lounge suites were representative of some sort of choice I had to make. Eventually, the staff worked out something was wrong and suggested I might like to leave. But I was too scared...I didn’t want to leave. So, they called the police.”
The police offered to take Liam home. But he was living with his mum and dad and didn’t want them to know he’d been using meth. With Liam’s paranoia worsening, the police ended up invoking the Mental Health Act to detain him and put him in a cell to sleep it off. Liam was subsequently charged for having a syringe on him.
Liam may have been using alone that day, but his behaviour is far from unique. Across New Zealand, some people who use drugs choose to take them without other people around. Jason George, Harm Reduction Lead at the Needle Exchange in Christchurch, explains why.
“Some reasons include stigma and discrimination. They have to hide it from their friends and family. People who work professionally might have a bigger risk by being open with their drug use, so that’s a factor for some people.”
Jason explains how being dependent on drugs can also factor into the decision to use alone or with others. “It’s more about using the drugs, rather than a social thing – it might be about making yourself feel well.”
The economic factor also comes into play - “If you use your drugs alone, they’re all for you,” - meaning, if you’re alone, you don’t feel pressure to share the drugs you’ve paid for.
Liam touches on how his personal relationships changed when he started using drugs more heavily, and gradually saw him using drugs alone more often.
“When I started using drugs, it was quite social. But there was a retreat into using drugs alone. After I started using drugs heavily, I sort of really lost touch with anyone I was good friends with pre-drugs. I knew a lot of people, and we might have used socially together a bit, but as time went on, it... [became] apparent that a lot of people I was hanging around with weren’t real friends.”
“It was a gradual thing over a number of years... with harder drugs when you’re using with other people who are possibly also dependent or using a lot more regularly, often I found hanging around with other people started to cause me problems. You’d be with someone using drugs, the next moment the police will show up for someone else and suddenly, I’d be in trouble. That was a bit of a deterrent to using with other people, as well.”
When he started injecting drugs, Liam used alone even more, due to the stigma around injecting – even amongst people who use drugs and their communities.
“There’s various hierarchies of drug use. People who inject get stigmatised by people who don’t – that was probably another element.”
People wouldn’t choose to use drugs alone if it was always a bad experience. Most of the time, Liam says, he’d use drugs alone without issue: using hallucinogens or stimulants to have a bit of a one-person rave at his place, putting on his music, and being in his own world.
“[I’ve had] lots of good times doing that.”
Jason explains that some drugs are riskier to use alone than others. “Opioids are right up there with some of the riskiest drugs to use alone but using benzos can be quite risky too – particularly if you’re combining drugs. Combining any types of depressants increases risk factor significantly.”
He stresses that opioids and benzos have higher risks of overdose, respiratory depression, and death. If something goes wrong with those drugs, and there’s no one else around to help, the consequences can be dire.
Liam agrees. “I know lots of people that use drugs alone. Some of them are dead, overdosed on opioids and were found too late.”
Overdoses are one of the more serious and obvious risks of using drugs alone. However, Jason adds, taking too much or having a bad experience without anyone around to talk you out of a bad trip or put you at ease is also something to consider with all drugs.
Advice for staying safer when using drugs alone
Being aware of the risks – but also knowing many people will still choose to use drugs alone – we asked Jason and Liam what could help keep people safer. Both mention some progressive initiatives introduced overseas, such as safe consumptions spaces.
Jason says there is plenty of evidence for safe consumption spaces, but we don’t yet have them in New Zealand. “[Safe consumption rooms] provide a safe environment with people who aren’t going to be judging you, where you can go and use your drugs safely with supervision, with someone able to intervene if something goes wrong. They do a lot to look after people who might otherwise be using drugs alone.”
Liam mentions the Brave app, which has been introduced in North America. It's a phone service aimed at people who use opioids alone, and is intended to prevent overdoses. The anonymous app connects people who use drugs with community members who can send help, if needed. App users set up an overdose plan, detailing how, when, and who is sent for help; supporters activate the plan if an overdose is detected. Currently, there is no equivalent app in New Zealand – but telling someone your plans and asking them to check in with you by text, phone, or online is an alternative way to minimise risk.
Safer to use with others
In absence of these initiatives, there are some other harm reduction measures people can take individually. Jason says the Needle Exchange often advise, if possible, for people to use with a mate so someone can look after you, and to have some naloxone - a medicine that quickly reverses the effects of opioid overdos - around.
“But if [that’s] not possible – and for a lot of people, it’s not – know your dose, measure your dose, and you really have to know your tolerance.”
Part of this is knowing what you're really taking. That's where drug checking can come in - it's a free, legal and confidential service that helps you find out what's really in your drugs. Once you know what you're actually about to take, you can make more informed decisions about how much you take, where and when you take it, and what to expect. Find a drug checking clinic near you here.
Woven throughout both interviews with Jason and Liam, the topic of stigma and the role it plays in drug harm is often mentioned. If drugs were less taboo, they say, it would be easier for people to talk about.
As Liam puts it: “If drugs weren’t so heavily stigmatised, that would help a lot of people not feel like they had to be so secretive. You’re pushing it all underground and people feel like they have to hide away.”
* Name changed to protect his identity.
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