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Myths & Facts, FAQ, Glossary

Myths and Facts

M: Drug users begin using drugs with eyes open about the consequences of addiction. 

F: No one chooses to become a slave to drugs. People’s initial reasoning for experimenting with drugs is varied but it is never done with the intention to become a full blown addict. However, over time continued use of addictive drugs changes your brain, resulting in a compulsive need for the drug.

M: Drug users could quit if they really wanted to.

F: Quitting drugs often takes more than just will power. Because of how addiction affects the brain and the body, quitting drugs can be extremely difficult (many times impossible) without emotional and physical support.

M: The same treatment methods should work for all drug users.

F: No two addicts are the same, so no two approaches to treatment are going to be the same.

M: Addicts cannot recover, so treatment is pointless.

F: Recovery from drug addiction is completely possible and happens everyday. Although it takes a lot of hard work and commitment, with the support of friend’s family and professionals, many former drug users are able to live happy and productive lives free from the compulsion to use drugs.

M: People who continue to use drugs after treatment are a lost cause.

F: No addict is a lost cause. The road to recovery is not a straight path; many times it is filled with bumps and turns along the way. Unfortunately, due to the insidious nature of addiction, relapse is part of many people’s stories. However, it is never hopeless.  Even the worst user has the potential to recover from drug addiction and be a productive member of society

M: Drug users are criminals, so they must be bad people.

F: Drug use does not determine the moral character of an individual. People begin using drugs for various reasons. Many drug users were victims of abuse and trauma and begin using drugs as a way to cope with that pain. By criminalizing addiction these problems are left untreated and often exacerbated. In order to treat the problem of addiction in society, it is important to recognize the complexities of the individual conditions that lead the user to drugs, and not further demonize them.


What is Harm Reduction?

Harm Reduction is a set of principals in public health policy and practices that recognizes that complete abstinence from drugs is not realistic for some users and seeks to minimize the harmful effects of drug use wherever possible. Sankalp practices Harm Reduction in our Needle Syringe Exchange Program (NSEP), offering clean needles and injection equipment to injection drug use in order to prevent the spread of blood borne pathogens such as HIV and Hep C as well as reduce risk of injection related injury. We also use Harm Reduction in or Opioid Substitution Therapy (OST) program, by offering a safer alternative to street drugs.

What are some of the health risks associated with Injecting Drug Use?

Some of the health risks with injection drug use are overdose, addiction, injection site infection (abscess), blood infections, and spread of blood born virus’ such as Hep-C, HIV,.

How does Injecting Drug Use spread HIV?

Blood particles on the needle are syringe are passed from infected user to non-infected user.  HIV can live for several days inside the small amount of blood left in the barrel of the needle. Sharing rinse water and equipment (cottons, cookers etc) can also spread infection.

How is Advocacy an aspect of Harm Reduction?

Advocacy is an aspect of Harm Reduction to insure the rights of the individual drug user are respected. Many times drug users are criminalized and looked down upon in society. A harm reduction approach sees the criminalization of drug use as another obstacle in getting the user clean and drug free. Instead we advocate for lighter drug sentences in favor of integrated drug treatment. Harm Reduction advocates also advocate for the access to cheaper more affordable HIV and Hep C medications.

What is the difference between HIV and AIDS?

HIV stands for Human Immuno Deficiency Virus. It is a virus that attacks the immune system and leave people susceptible to various forms of infection. AIDS which stands for Acquired Immuno Deficiency Syndrome is a condition brought about by HIV. It is a syndrome rather than a disease because it is a complicated condition with lots of different symptoms and complications. A person can have HIV without having AIDS but it is impossible to get AIDS without having acquired HIV first because HIV is the precursor to AIDS. With treatment a person with HIV can live a normal somewhat healthy life without ever acquiring AIDS.

How is HIV spread?

HIV is spread through the exchange of bloodily fluids such as blood, semen, vaginal and rectal fluids and breast milk. Although saliva is a bodily fluid it is not possible to spread HIV through sharing of utensils or water fountain or even casually kissing someone with HIV. To prevent HIV it is important to protect ones self while having intercourse or sharing needles and injection equipment. Condoms, when used correctly, are highly effective in preventing the spread of HIV through sexual contact. Using a clean rig, cooker and cotton every time you shoot up will insure the injection drug user does not contract or spread HIV to another user.


Injection Drug Use – Injection drug use is a method of very quickly getting high off drugs by injecting the substance directly into the body. There are several ways to inject drugs into the body; “intramuscular” by injecting into the muscle tissue, “subcutaneous” by injecting under the surface of the skin (known also as “skin popping”) and intravenous, directly into the blood veins. Intravenous is typically the most popular injection route for opioid injection drug use. People chose to inject drugs because it gives them an instant rush. However, intravenous drug use carries many dangers. Injecting drugs directly into the bloodstream bypasses the body’s natural filtering mechanisms, leaving it open to infection. Shared and non-sterile needles, and any equipment used to dissolve a powdered form of a drug for injection, carry the risk of blood-borne illnesses, such as HIV and Hepatitis C. Particles that have not properly dissolved can create blockages in the veins. Even superficial damage to skin and veins from repeated use can escalate to major health problems if left untreated, and injecting in some areas of the body may interfere with nerves and arteries. Because it is hard to know the exact contents of Brown Sugar, there is a high risk of overdose.

Brown Sugar-  Brown sugar is a crude form of Heroin popular in India. Its actual heroin content is very low, at about 20% thus making it cheap and easier to aquire. Because of its additives, brown sugar burns slow, thus making it a favourite drug for smoking. But after a while, many users build up a tolerance to smoking and begin injecting. Brown Sugar is not very suitable for injection because it doesn’t break down into a liquid easily. It requires the adding of an acidic agent to get it in liquid form. Vitamin C powder is the preferred breakdown agent, but isn’t unavailable to many living on the street, who instead use lemon or lime juice as an alternative. Lemon or lime put the user at greater risk of abscesses or blood infection because they can easily carry bacteria or mold and damage the vein.

Drop-in Centre (DIC)-Drop in centers are strategically placed locations where clients can receive medical care, nutritional support and referrals to hospitals. DICS are also where OST is administered and needle exchange and condom distribution happens. DICs also run group therapy and NA meetings. The DIC is the point of contact for the rest of Sankalp

Needle and Syringe Exchange Program (NSEP)-NSEP is a harm reduction practice of providing clean needles and syringes to IDUs to prevent the spread of HIV/HVC as well as minimize the risk of injection related injuries caused by dull or dirty needles.

Opioid Substitution Therapy (OST) – OST replaces an illicit substance with an orally-administered opioid that is less addictive, long-lasting, and does not cause euphoria. When clients are not preoccupied with the getting the next dosage, they can manage their addiction, as well as the risks of injecting drugs and using criminal substances, and potentially pursue other goals. This in turn provides an incentive to stay clean, making OST a safe and effective means to ultimately taper off the use of opioids, with counselling to help clients manage withdrawal symptoms.

Outreach Worker (ORW)- Outreach workers go into drug using hot spots distributing needles, injection equipment, and condoms in the community. Outreach workers help users access the services of Sankalp without having to leave their comfort zones.

 Peer Educator (PE)- Peer Educators are former and current users who help counsel active users about safer injection practices and ways to protect themselves from HCV/HIV.  They are the leaders of Sankalp offering support and education to their peers in the community.

Low Threshold –Low threshold refers to a harm reduction approach in which users are allowed to access health services while recognizing the clients autonomy and not trying to control their intake of drugs.

Targeted Intervention (TI) – A TI Program is designed to serve the healthcare needs of a specific high risk group. We use a TI approach through our outreach workers and peer educators. TI is important because  we are able to develop relationships with clients in an enviorment they feel comfortable in and thus are more likely to ask for help when needed.

Opportunistic Infection – opportunistic infections are pathogens like bacteria, viruses and fungi, which can cause serious problems in a person with a weakened immune system, such as someone with HIV/AIDS. While the same pathogen could easily be fought off by someone with a healthy immune system, someone with HIV/AIDS is not able to fight if the infection and can cause major complications in health.

Hepatitis C Virus (HCV) – “Hepatitis” means inflammation of the liver. There are several different forms of Hepatitis, A, B and C. Each one has a different cause. HCV, like HIV, is caused by the exchange of bodily fluids (although it is more difficult to pass sexually than HIV). The virus can attack the liver and cause serious health complications. Many time symptoms of the virus don’t manifest until years after the person is initially infected. In this way it is known as a “silent killer”. Hep C is much more common in people who inject drugs. Many injection users are aware of the dangers of HIV but not of HCV. HCV is easier to catch than HIV through contact of infected blood. This means that it takes a smaller amount of blood to spread the virus. Even a tiny infected particle on a shared spoon or needle can spread infection. This is why it is very important not to share injection equipment or needles

Antiretroviral (ARV) Antiretrovirals (ARV) are a series of drugs used to treat HIV. While the drugs are not a cure for HIV they can diminish the growth of the disease and thus vastly improve the length and quality of life of the patient.