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Methamphetamine Use:
Harm Reduction Strategies
Facilitated by: Neva Chauppette, Psy.D.
CA License PSY14524
P.O. Box 6234, Woodland Hills, CA 91365
(818) 439-7080
www.drchauppette.com
Application of Harm Reduction
 Stage of Change
 Precontemplation
 Contemplation
 Relapse – Lapse
 Recovery vs. Abstinence
 The components of addiction
Provider Competence
and Comfort
 Uniqueness of methamphetamine requires
provider’s to:
 Accept harm reduction as treatment
 Develop competence and comfort discussing
sexual behavior
 Recognize time sensitivity issues
 Post Exposure Prophylaxis (PEP)
 Plan B
Two Pathways:
Mode of Administration and
Sexual Risk-Taking Behaviors
 Harm Reduction strategies specific to mode of
administration of the methamphetamine
 PEP (within 72 hours for 28 days – 80% reduction)
 Friends La Brea – AHF – 323-463-1601
 AHF Men’s Wellness Centers
 Hollywood 866-339-2525
 Westside 888-836-5943
 West Adams 888-836-5946
 Harm Reduction strategies specific to client’s sexual
behaviors under the influence of methamphetamine
 PEP and Plan B
Modes of Administration:
Swallowing
 20-30 minutes to feel effects to “get off”
 This method of administration has the least risks.
The body has a safety mechanism for dangerous
substances that are swallowed, called vomiting!
 Meth can be put in a drink, like water, soda or
juice, or put in gel caps and taken orally.
“Parachuting” is placing meth in a piece of toilet
paper and swallowing it.
Modes of Administration:
Swallowing
 Harm Reduction Techniques: Drugs are absorbed
more slowly through the gut therefore the effects of the
drugs tend to be less extreme.
 Madonna and Child: A bath bead is hollowed and
cleaned out, meth is placed in the center of the bead
surrounded by pulverized ecstasy in a clear gelatin
capsule then swallowed. The “X” is released first
followed by the meth, and the combination of the two
drugs is quite a high.
Modes of Administration:
Smoking
 7-10 seconds to feel effects.
 Drug enters blood stream through the lungs.
 Smoke irritates the lungs, which can lead to breathing
difficulties, coughing and possibly can be carcinogenic.
 Harm Reduction Techniques: Remember the time to
get off from smoking is quicker and more intense and
the tendency is to become addicted quicker.
Modes of Administration:
Shooting Up
 15-30 seconds to feel effects.
 Meth is injected directly into the veins, commonly known as the
“slamming”.
 Abscesses and skin infection can develop at the injection site.
 Injecting into the vein bypasses all of the body’s defenses to
protect the blood stream.
 Sharing needles can transmit HIV, Hepatitis B and C.
 If air bubbles are in the needle they can travel through the veins to
the heart and cause the heart to stop.
Modes of Administration:
Snorting
 3-5 minutes to feel effects.
 Most common method of use.
 Snorting tends to destroy the tissue in the nose. The lining of the
nasal passages is fairly delicate and can be injured leading to
nose bleeds, sinus trouble, and in some cases permanent damage
to the nasal structure.
 Sharing inhaling instruments transmits all types of germs from the
common cold or flu to Hepatitis C and HIV.
 Harm Reduction Techniques: Don’t share snorting equipment. If
sharing, clean off inhaling instruments between uses.

Modes of Administration:
“Booty Bump”
 10-15 minutes to feel effects.
 A syringe without a needle is used to pump a liquid
solution of meth into the rectum. The drug is absorbed
by the blood vessels in the lining of the rectum. In
some places the lining of the rectum is only 1 cell thick.
 Meth can act as an analgesic and when placed in the
rectum anal sex becomes less painful. Therefore sex
can be more aggressive, last longer and increase the
risk of ripping or tearing of the lining.
Modes of Administration:
“Booty Bump”
 High Risk - possible damage to the mucous
membranes, burning or tearing of the tissue in the
rectum, which increases risk of HIV transmission.
 Harm Reduction Techniques: If you booty bump
and have receptive anal sex (bottom) make sure
he is wearing a condom. Increasing the amount of
lube you use will decrease friction and reduce
ripping and tearing of the rectal lining.
Modes of Administration:
“Hot Railing”
 7-10 seconds to feel effects.
 A glass tube (stem) is heated until the tip is red hot, and
then placed over a bump (small pile of the drug / similar to a
line) and the vapor is inhaled through the nose.
 Risk factors similar to smoking, vapor can be carcinogenic.
 Tube used for railing can transmit Hepatitis C or HIV
assuming blood is present.
 Harm Reduction Techniques:. Don’t share your stem and
if you have to wash the stem between uses.
Sex
 It can often lead to uninhibited, disconnected,
sometimes violent, and often unprotected sex that
meth abusers (“tweakers”) obsess about, hunting for
orgasms as they would a gram of meth. For men who
are meth addicts, their desire is increased for sex, but
their ability to perform is often reduced.
 “Crystal dick” is the inability to maintain or achieve an
erection as a result of meth use. For women, there may
be an increase in pregnancies and/or STDs, obstetric
complications due to poor prenatal care, involvement
with abusive partners, and domestic violence due to
paranoia and sexual preoccupation.
HARM REDUCTION STRATEGIES:
Sexual Risk-Taking
 Time sensitive: PEP and Plan B
 See Sexual Risk-Taking Form
 Screen and treat STIs and vaccinate for HPV, HAV,
HBV
 Avoid douching or enemas
 Timing of sex (i.e., menses, illness, etc.)
HARM REDUCTION STRATEGIES:
Sexual
 Ejaculation outside the body
 Don’t use ejaculation as lubrication - “felching” and
“snowballing”
 Avoid felching/rimming w/o barriers
 “Sounding” – equipment cleaning, no sharing
 “Natural Harvest” – no abrasions, no cuts, gum
disease, etc.
 “Serosorting” – positive with positive