Alcohol and Drugs

Heroin Overdose


Injection poses the greatest risk of lethal overdose by enabling large amounts of heroin (and additional contaminants if any) into the bloodstream at once.

Smoking and snorting heroin can also result in overdose, especially if a non-tolerant user ingests a large amount of potent heroin and/or combines it with other depressant drugs, such as alcohol.

Symptoms of a heroin overdose include slow and shallow breathing, convulsions, coma and possibly death. To avoid fatal overdose, it is strongly recommended that people who use heroin (and their peers and loved ones) be trained to administer naloxone, an overdose reversal drug that has been approved by the FDA since 1971.

Street heroin is rarely pure and may range from a white to dark brown powder of varying consistency. Such differences typically reflect the impurities remaining from the manufacturing process and/or the presence of additional substances. These "cuts" are often sugar, starch, powdered milk and occasionally other drugs, which are added to provide filler.


Clean syringe access

  • pharmacies
  • physician prescription
  • syringe exchange programs

The best way to avoid contracting hepatitis C and other blood borne viruses such as HIV and hepatitis B is not to inject.

How to Clean a used syringe
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Introduction to Needle Exchange
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Needle Exchange Program PSA
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 Disinfected Syringe Facts
 A Guide to Cleaning Used Syringes


A Disinfected Syringe is NOT a Sterile Syringe If it is done carefully and thoroughly, disinfection can reduce the amount of live HIV, HBV, and HCV in a syringe.

However, even the best disinfection procedure cannot guarantee that all viruses have been killed. The plastic syringes usually used by IDUs are designed for one-time use. They are not designed to be cleaned and used again.

Disinfected syringes do NOT meet the standards that are applied in all other settings in which people use syringes (such as hospitals, other health care settings, and insulin injections by people with diabetes). In these settings, people must use a new, sterile syringe for every injection.

For these reasons, a disinfected syringe is NOT as safe as a new, sterile syringe. Recommendations about disinfecting syringes with bleach or others agents apply ONLY to situations in which IDUs do not have sterile syringes.

Substance abuse treatment and access to sterile syringes through pharmacies, physician prescription, and syringe exchange programs are essential components of HIV prevention efforts among injection drug users. 


US Syringe Exchange Program Database

NASEN is dedicated to the creation, expansion and continued existence of syringe exchange programs as a proven method of stopping the transmission of blood-borne pathogens in the injecting drug using community.

The following is a list by state/province/territory of those syringe exchange programs in North America that have given us permission to make their contact information public. This is not a definitive list of all syringe exchange programs.

AK | AZ | CA | CO | CT | DC | DE | FL | GA | HI | IL | IN | LA | MA | MD | ME | MI | MN | MO | MT | NC | NE | NJ | NM | NY | OH | OR | PA | PR | RI | VT | WA | WI

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