There are several ways to practice harm reduction while using methamphetamine. 

How to Avoid Overamping

Sometimes, people take more methamphetamine than they intend or can tolerate. This can lead to what is known as “overamping” - troubling psychological effects like anxiety or paranoia, or physical effects like overheating, increased blood pressure, or rapid heartbeat. This is more likely when the person has not slept, eaten enough food, or is dehydrated. Overamping can make someone feel nervous or disoriented, or even feel sick. 

To avoid overamping, drink plenty of water, get adequate sleep, and eat proper foods. It’s also important to follow the “start low, go slow” approach to avoid overamping. This means start with a small dose, and wait to feel the effects before using again, as the methamphetamine might be more potent than thought initially. This is especially important for those who inject, swallow, or booty bump methamphetamine since it is easy to take more than anticipated. Avoiding smoking before injecting can also help prevent overamping.

Being mindful of setting is important to consider when practicing harm reduction for methamphetamine and for all drugs. One should avoid using alone and try to around known and trusted people, so they can help manage any potential feelings of overamping, including anxiety or paranoia. They can also be available to call for help if someone experiences a medical emergency. Other ways to reduce harm are to avoid mixing with other classes of drugs or reduce the number of drugs taken at the same time.

Strategies for Safer Injecting

It is important to reduce the risks associated with different methods of use and to use sterile equipment. Sharing or reusing syringes when injecting methamphetamine, also known as “slamming,” can put people at higher risk of contracting blood-borne infections (i.e. HIV, Hepatitis C, etc.) or skin and soft tissue infections. Only new syringes should be used to inject methamphetamine, obtained from either pharmacies or – in some states – syringe exchange programs

If someone is injecting methamphetamine, they should make sure to clean their skin with alcohol first, use a tourniquet, and use a sterile cooker. Rotating injection sites, drinking lots of water, and not smoking before injecting are other ways to practice harm reduction while injecting methamphetamine. Rotating sites is important because it gives previously used injection sites and veins a chance to heal, thus preventing infections and abscesses. Injecting into a vein is preferable to injecting into an artery, because injecting an artery causes pain and the substance is pushed right into the tissue.

Strategies for Safer Snorting

In some cases, it is helpful consider changing the route of use to a less risky method. If one regularly injects methamphetamine, it might be helpful to switch to snorting, “boofing,” or smoking methamphetamine instead of injecting. These are lower-risk for blood-borne and skin and soft tissue infections. 

People who snort methamphetamine should avoid sharing bumpers or straws used for snorting and instead use their own supplies. Using bills to snort can spread bacteria, so it is advisable to use post-it notes or other clean paper. Smoking methamphetamine can dry out the mouth and lips; use lip balm and avoid sharing pipes if possible.

Strategies for Safer “Booty-bumping”

People may also take methamphetamine rectally, a practice referred to as “booty-bumping” or “boofing.” Booty-bumping is another good alternative to injecting methamphetamine, if done correctly. To properly administer this way, dissolve the methamphetamine in sterile water and squirt the solution rectally with a needle-less, unshared syringe. Avoid sharing syringe barrels or cups used to prepare the solution as well.

Strategies for Safer Chemsex

Some people use methamphetamine because it enhances sexual experiences; this practice is called chemsex. If a person is engaging in sexual activity while using methamphetamine, one way to practice harm reduction is to carry condoms, or to get tested after a sexual encounter. 

Engaging in sexual activity immediately after booty-bumping methamphetamine particular can put someone at higher risk for acquiring or transmitting an infection because booty bumping can induce small tears in the fragile rectal tissue, leading to hemorrhoids, rectal pain, or bleeding. Therefore, it’s always important to use condoms, but especially after administering methamphetamine rectally. 

Drug Checking

When people purchase illicit drugs, they cannot always be sure that the drug they intended to buy is actually the drug they received. Therefore, an important practice when using drugs is to check the drugs in order to detect what is present, to help identify the substance they intend on taking and prevent harms associated with consuming an unknown substance. 

To test if a sample of methamphetamine is really methamphetamine, one can use reagent testing, which involves liquid drops that are applied to a small sample of a substance. The presence of certain substances in the sample can be identified by color changes and corresponding codes. These results take about 30 seconds and can identify methamphetamine, among other substances.

Fentanyl, a powerful opioid, has sometimes been detected in illicit stimulant supplies around the country, which puts users at higher risk for opioid overdose. People who use methamphetamine should try to have fentanyl test strips available to test their supply before using. It has been found that methamphetamine residue must be diluted with slightly more water than other drugs when testing for fentanyl. 

Test strips used to detect the presence of fentanyl.
Test strips used to detect the presence of fentanyl.

A half cup of water is enough to properly dilute methamphetamine for accurate fentanyl testing. Many local harm reduction organizations have test strips for free, and even people who use stimulants should have naloxone on hand just in case.

See the fact sheet for more information and sources.