Smoking drugs using foil: Steps to safer smoking

This resource provides information on safer smoking using foil. Foil can be used as a surface to smoke drugs (sometimes known as “chasing the dragon”). People may use different supplies (such as straws, straight stems or foil tubes) to inhale the vapours. When heated, many different drugs produce vapour that can be smoked with foil. These include heroin, fentanyl, crack cocaine, crystal meth and some pills (which need to be crushed before smoking).

Smoking drugs with foil is an effective way to lower the risk of many harms related to injecting drugs including vein damage, blood-borne infections such as hepatitis C and HIV, and other types of blood, skin and heart infections. However, smoking drugs with foil can lead to overdose or drug poisoning.

Using safer smoking supplies, not sharing, and following other safer smoking practices helps to lower the chance of health issues. Providing education on safer use practices along with a range of free harm reduction supplies can support people to use their drugs as safely as possible.

Getting ready to smoke drugs with foil

Using new safer smoking supplies is the best way to reduce harms. All supplies are for personal use and should not be shared with others. This is because blood can remain on used supplies and can pass infections when shared, even if blood is not visible.

The following harm reduction supplies are recommended for smoking with foil:

• alcohol swabs
• foil sheets from a harm reduction organization
• straw, straight stem or foil rolled into a tube (for inhaling)
• lighter

Safer practices for smoking drugs using foil

Service providers working with people who smoke drugs should offer education on how to smoke drugs with foil by sharing the following steps and information.

How to smoke drugs with foil:

• Wash hands and preparation surface with soap and water before handling harm reduction supplies. This can help prevent infections caused by viruses and bacteria. Hand sanitizer or alcohol swabs can be used if soap and water are not available.
• Cut foil to the preferred size or fold it in half for extra strength, if needed.
• Fold the foil to create a crease in the middle and place the drugs along the crease. Hold the foil between the thumb and pointer finger.
• Heat the bottom of the foil with a lighter. Avoid touching the foil with the flame because it could burn holes in the foil.
• The drug will start producing vapour that can be inhaled. Some drugs turn to liquid before becoming vapour. Tilt the foil and pinch the edges if needed to prevent the liquid from spilling off the foil.
• Inhale the vapour slowly using a straw, a straight stem or another piece of foil rolled into a tube. Exhale immediately. Holding the vapour in the lungs can cause burns and will not lead to a better high.
• When inhaling using a foil tube, drug residue will remain on the inside wall of the tube. The foil tube can be opened and heated to smoke the residue with a new foil pipe, a straight stem or a straw.

Important info about safer smoking with foil

Using safer smoking supplies

Always use safer smoking supplies from a harm reduction program when possible. It is best to use a foil sheet that is made for drug use. They are thicker and create a more stable surface when heated compared with household aluminum foil. Household or hairdressing foil has an oil coating that will burn off and be inhaled if used for smoking drugs.

Using personal smoking supplies and replacing them regularly

Smoking supplies are for personal use and should not be shared with other people. Replace smoking supplies if they have been used by another person. Dispose of safer smoking supplies in a sharps container or other hard plastic bottle. Drop it off at a local harm reduction organization for disposal.

Mixing different substances

There are risks with mixing drugs. Mixing different drugs can cause stronger or different effects than either drug alone. Mixing stimulants like crystal meth with opioids like fentanyl or heroin increases the risk of heart attack, stroke and overdose. Different drugs also stay in the body for different amounts of time. It is important to always start with a small amount, increase slowly and use caution when using multiple doses or mixing drugs.

Overdose/drug poisoning

When someone is using drugs purchased from the illegal or street supply, there is a higher risk of overdose or poisoning. People can try to prevent or prepare for an overdose by:

• using with other people or at a supervised consumption site
• starting with a small amount and increasing slowly
• getting drugs tested, if possible
• carrying naloxone and knowing how to use it

Naloxone reverses an opioid overdose. A person may be having an opioid overdose if they are unresponsive or unconscious, have slow or no breathing, are snoring or making choking or gurgling sounds, have cold or clammy skin, and/or have blue or grey lips and nails.

Stimulant overamping

Signs of overamping from stimulant use may include rapid heart rate or chest pain, rigid or jerking limbs, skin feeling hot or sweaty, anxiety, agitation and hallucinations. If someone is overamping, try to help the person calm down, cool down and rest. Emergency medical attention is required if someone has crushing chest pain or seizures, if they go unconscious or if they are not breathing. Naloxone only works on opioids and does not reverse stimulant overamping, but it is safe to use and may help if an opioid overdose is suspected.

Resources

Safer substance use video series – CATIE

Responding to an opioid overdose, responding to stimulant overuse and overdose – CATIE, Toward the Heart BCCDC Harm Reduction Services

Harm Reduction Fundamentals: A toolkit for service providers – CATIE

Connecting: A guide to using harm reduction supplies as engagement tools – Ontario Harm Reduction Distribution Program

Best Practice Recommendations for Canadian Harm Reduction Programs – Working group on best practice for harm reduction programs in Canada

Acknowledgement

This resource is adapted from CATIE’s Safer Substance Use Video Series and Connecting: A Guide to Using Harm Reduction Supplies as Engagement Tools by the Ontario Harm Reduction Distribution Program (OHRDP). CATIE thanks the reviewers who contributed their expertise to this resource.