2. Avoiding overdose
You don't have to take a lethal dose of drugs to die of an overdose - it only takes a tablespoonful of saliva or vomit to build up and block your airway if you are on your back, temporarily unconscious and unable to swallow! This has been the cause of many overdose deaths.

Usually overdose deaths are caused by people mixing sedative drugs such as:

• Alcohol
• Benzodiazepines
• Methadone
• Heroin.

These drugs work together, making each other stronger.
With these drugs it’s like 2+2=5.

Remember that drugs you swallow reach peak levels between 1 and 4 hours after you take them, so an injection can push you over the lethal limit hours after taking something by mouth.

Another cause of many overdoses is people giving up for a while and then going back to opiates. If you stop using drugs (especially opiates) for a while your tolerance drops within a few weeks. So, if you go back to injecting as much as you were, it could kill you.

Every year this sort of overdose kills many people. People at higher risk are those coming out of prison and people relapsing after naltrexone treatment.

You can reduce the risk of overdose by:

• Not injecting, but smoking, snorting or swallowing instead
   
• Taking a test dose of drugs to get a feel for the strength before you inject
   
• Only injecting half of the barrel and waiting until you get the first rush - if it knocks you out,
  injecting more would have been at best a waste and at worst could kill you
   
• Not mixing sedative drugs.

You can reduce the risk of overdose being fatal by:

• Learning how to deal with overdoses when you see them happening
   
• Having other people around when you inject.

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