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Michigan OPEN
Michigan OPEN

Harm reduction offers safer strategies for people who use drugs.

Not all people who use drugs (PWUD) are ready to stop or enter into treatment. A harm reduction approach can help you adopt safer strategies until you can take the next step.

OPEN’s harm reduction educational materials are created in collaboration with people with lived experience.

Frequently asked questions about reducing harm when using drugs:

Get the answers you need to the following questions:

“Harm reduction is love in action—meeting people with dignity and honoring survival.”
Ashley

How can I stay safer when using drugs?

Harm reduction focuses on individual well being. Following these practices when possible while using drugs can help keep you safe:

  • Do not mix opioids with other drugs, especially benzodiazepines or anything that can make you sleepy
  • Be aware of body tolerance changes
  • Tell family/friends where you store naloxone and how to use it
  • Go slow, never use drugs alone, and carry naloxone

How can I help someone who is
experiencing an overdose?

Take A.C.T.I.O.N.  Following these steps can help save their life.

Arouse
Shout the person’s name, shake their shoulders vigorously, rub their breastbone with your knuckles.
Check for signs of overdose
  • Slowed or no breathing
  • Blue/gray lips or fingernails
  • Deep snoring/gurgling noises
  • Unresponsive to pain
  • Pinpoint pupils
Telephone 911
Don’t wait. Tell dispatch: “I think it’s an overdose.”
Intranasal Naloxone
Give naloxone. Follow these steps.
Oxygen
Do rescue breaths:
Tilt head back
Pinch nose
Lift chin
Give 1 breath every 5 seconds (begin CPR if you know how or follow dispatch instructions).
Naloxone, again
Repeat naloxone every 2-3 minutes until the person starts to wake up.
If you must leave the person, or vomiting occurs, place them in recovery position seen below.



The recovery position can help keep airways open, reducing the risk of aspiration and encouraging body stabilization.
If it’s safe to do so, stay with the person until help arrives.

What is naloxone and how does it work?

Naloxone (Narcan®) is a lifesaving drug that rapidly and temporarily reverses the dangerous effects of an opioid overdose. It works if you have opioids such as fentanyl, heroin, and prescription opioids in your body.

Some things to know:
  • It can be given every 2-3 minutes until the person breathes again
  • A person cannot get high from or become addicted to naloxone
  • It is effective only for 30 – 120 minutes

3 Simple Steps: How to Use Naloxone Nasal Spray.

What’s next? Don’t delay – call 911 immediately.

Looking for more information about naloxone? Find it here.

How do I use fentanyl test strips?

Fentanyl is an extremely powerful opioid – even a small amount can cause a fatal overdose. You can use test strips to test for the presence of fentanyl and reduce your risk. Watch the video to learn the simple steps:

How do I properly care for a xylazine wound?

Also known as tranq, xylazine is becoming more common in the unregulated opioid supply. Because it’s a drug meant to put large animals to sleep, it is not intended for human use and it can have serious side effects – including wounds that require immediate attention and care.

It’s not clear why xylazine causes wounds. It’s important to know they can pop up anywhere on the body, no matter if you inject, smoke, snort, or boof.

  • Snorting
    Wounds can happen inside the nose and sinuses
  • Smoking
    Coughing up black stuff can be a sign of wounds in the throat or lungs
  • Boofing
    Rectal ulcerations can occur inside and on the outside of the anus
  • Injecting
    Unlike a common abscess near where you inject, tranq wounds can be anywhere

4 steps to proper wound care

1. PREPARE

Clean your hands whenever you are touching any wound, and wear gloves if available.

Best: washing with soap and water
Good: hand sanitizer, body wipes, tap water 

Get supplies together in the cleanest area possible.
Remove old dressing: Soaking the old dressing with water can help if it’s stuck and painful.


2. CLEAN WOUND

Wash with mild soap and rinse with lots of water (sterile/clean water bottle)
If you don’t have soap, use mild shampoo or rinse under running water. 

DIY wound wash:
Mix 1-2 teaspoons of antibiotic soap into a water bottle.
Poke a hole in the top and pour on the wound.
Rinse with clean water.

Avoid peroxide, alcohol, bleach, or other chemicals, which dry out the area and prevent healing.

3. APPLY DRESSING

First Layer (Nonstick)
Put ointment (like antibiotic ointment or Medihoney*) on a non-stick dressing or gauze.
If you have Adaptic or Xeroform, cut it to fit the wound.
Place this directly on the wound.

*Do not use Medihoney if allergic to bees or honey 

Second Layer (Absorbent)
Apply soft cushion dressing to protect from injury (ABD pad, dry gauze, or menstrual pads).
Gravity and drainage don’t mix – make sure the dressing goes BELOW/BEYOND the border of the wound to catch drainage when you stand or walk.


4. PROTECT WOUND

Secure the dressings using rolled gauze with tape, ACE, or Coban wrapped loosely.
Change dressings daily or at least every other day.
Change dressing if drainage soaks through.
Covering wounds keeps out bacteria and lets them heal.

Some things to keep in mind as you treat wounds:

  • It’s important to treat wounds immediately, keeping them clean, moist, and covered
  • Wounds with yellow, crusty layers of dead skin and fluid built up (slough), or wounds with black inside (necrosis, eschar) cannot heal; the yellow, top pale layer or black stuff needs to be removed (debrided)
  • Worsening wounds can develop dead tissue and eschar, which block healing
  • Keep the skin around wounds as healthy as possible
  • Make sure skin doesn’t get too wet/wrinkly/white (macerated)
  • Petroleum jelly on the skin and absorptive pads/wrapping to soak up drainage can help this

Wound care supplies

Cleansers

  • Woven Gauze
  • Potable Tap Water
  • Normal Saline
  • Wound Cleansers
  • Vashe
  • Quarter-strength Dakins Solution

Topicals

  • A&D, Vaseline
  • Medihoney
  • Polyhexamethylene Biguanide
  • Silver Hydrogel
  • Silver Sulfadiazine
  • Mupirocin
  • Callagenase

Periwound Barriers

  • A&D
  • Dimethicone
  • Zinc Barrier Ointment
  • No Sting Skin Prep

Contact Dressings

  • Non-Occlusive Oil Emulsion
  • Nonadherent Pads
  • Occlusive Petrolatum
  • Alginate, CMC

Absorbent Dressings

  • Foam
  • ABD Pad
  • Super Absorb Pad

Supportive Dressings

  • Rolled Gauze
  • Self-Adhesive Wrap
  • Elastic Bandage (Ace Wrap)
  • Netting, Sleeve

When to get medical care

Get medical care as soon as possible if you have wounds along with any of these symptoms:

  • Chills
  • Skin turns dark or black
  • Pieces of skin are falling off
  • Thick, smelly, yellow or green drainage is present

When to get emergency care

Go to the emergency room immediately if you have wounds along with any of these symptoms:

  • Fever
  • Fast heart rate
  • Skin is red, hard, and hot to touch
  • Severe or worsening pain at wound site
  • Can’t feel or move body part where the wound is located
  • Bone and/or tendons are showing

To learn more about xylazine, wound identification, and wound care, download our Xylazine Wound Care resource guide.


Download

How do I access clean needles and syringes?

Access to clean needles and syringes is important to prevent infections and other complications such as HIV and hepatitis. Syringe Services Programs are community based and provide services such as linkage to substance use treatment, vaccination, testing, and education about overdose prevention and safer injection practices while also screening and testing for HIV and hepatitis.

Find a Syringe Services Program near you.

How do I get support?

Harm reduction can help keep you safe and sometimes be the bridge to the path to recovery. If you’re looking for support, call the SAMHSA National Helpline, a free, confidential, 24/7, 365 day-a-year treatment referral and information service for anyone facing mental or substance use disorders.

CALL: 1-800-662-HELP (4357)

The Overdose Prevention Engagement Network (OPEN) is dedicated to improving lives and reducing harms of substance use. We share education and resources to strengthen person-centered prevention, treatment, and recovery.

"People can improve their lives even while they're still using drugs."
Monica