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QUICK LINKS I'M USING AND NEED HELP PROFESSIONAL RESOURCES SOMEONE I KNOW USES TOO MUCH RISK & HARM REDUCTION MY CHILD IS USING SUBSTANCES HANG OVER DOSE There's a fine line between hangover and overdose. One is treatable, the other is preventable. Only one can kill. People who combine Cocaine with alcohol often do so to reduce Cocaine’s negative side-effects, such as anxiety, tension, clenching, or twitching. In some cases, a person who consumes too much alcohol may take Cocaine to increase their physical energy and/or give them the ability to drink more than they usually would be able to. Additionally, when intoxicated from alcohol, the use of Cocaine can reduce some of the negative effects caused by alcohol intoxication, making it easier to handle larger amounts of alcohol. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) found that over half of Cocaine-dependent individuals also suffered from alcohol dependency. POLY DRUG SIDE EFFECTS Above are various side-effects of Poly Drug Use that can occurr depending on the type of susbtances you may be using and combining. Brain damage Coma Heart Issues Liver damage/failure Seizure COCAINE & ALCOHOL COCAINE & ALCOHOL VERY BAD, NOT GOOD AT ALL. COCAETHYLENE. ALCOHOL An alcoholic beverage is a drink that contains ethanol, a type of alcohol that acts as a drug and is produced by fermentation of grains, fruits, or other sources of sugar. The consumption of alcoholic drinks, often referred to as "drinking", plays an important social role in many cultures. POLY DRUG STATISTICS 83% Poly Drug Overdoses ending in hospitalisation in Dyfed 240 Poly Drug Use Fatalities 2020 - 2022, source: WGA 17 Victims of sexual assault as a result of excessive poly drug use leading to vulnerability 7 Under 18's fatalities from poly drug use overdose source: WGA POLY DRUG OVERDOSE AWARENESS CAMPAIGN '23 IMPORTANT INFORMATION FOR PEOPLE WHO USE MULTIPLE SUBSTANCES, INCLUDING PRESCRIPTION MEDICATION AND ILLEGAL SUBSTANCES.

Call the team on 0330 363 9997. WHAT IS TURN BACK is a Poly Drug Overdose Awareness Campaign commencing in 2023. It is designed and implemented by Dyfed Drug and Alcohol Service with support from Hywel Dda Health Board, Service Users and eminent health care and academic professionals. The goal is to raise awareness of the dangers of Poly Drug Use and ultimately instill the notion of being able to "TURN BACK" before it's too late and recognise when someone else needs to do the same.

FAQ's I am using multiple substances most weekends, am I at risk of overdose? Many people use multiple substances at the weekend, particularly young people. There is a risk of overdose when using multiple substances at the same time, whether you are mixing between the same substance groups or not (i.e depressants and depressants, or depressants and stimulants etc). We would always advise against using any substances together, but if you plan to use click here for harm reduction advice for specific drug groups. If you plan to use opiates, ensure you carry a Naloxone kit. I am using with friends, sometimes we buy together and share. Is this ok? Being out with friends creates an atmosphere of safety and trust which is a great protective factor when going out and using substances in a social setting. It is important to remember though that everyone’s tolerance is different, and using in rounds or sharing will often lead to getting more intoxicated than intended. We would advise that you obtain your own substances and keep to your own pace where possible. Its important to remember that sharing with friends can bring about dangerous risks. First time users of a substance my have lowered tolerance and should be discouraged from indulging too much. Comparatively, people with a higher tolerance may be spurred on to use at higher levels and introduce more substance types to “keep the pace”: this should also be discouraged. The key point is to reduce the harm by reducing the amount being used; ultimately reducing risk of overdose. No one knows about my substance use so I use alone. Is this risky? Yes it is risky to use substances alone; if something goes wrong or you accidentally overdose there is no one around to offer help or to phone an ambulance. It’s safer to use substances with someone you trust or to let someone know what you are planning to use substances so that they can offer support. I am using multiple substances most days of the week When using multiple substances throughout the week its important to consider your life around your substance use. Are you working daily and/or driving? Are you caring for children or siblings under the age of 18? Are you a fulltime carer for a vulnerable adult? All of these questions should be considered and answers to each can be reasons to stop or make changes to your current use. I am using multiple substances daily If you find yourself using everyday then maybe it could be time to look at reducing the harm you are doing to yourself. Everyday use usually follows a pattern, whether that be self-medicating trauma, escaping reality, binging, numbing pain, battling ongoing mental health issues, escaping violence. There are innumerable reasons people use multiple substances; reducing the amounts of different substance types can help clarity in identifying and addressing underlying triggers for use. Looking to the future can cement your progress and build up recovery capital to strengthen your resolve against a relapse. My child is using multiple substances, what can I do? This can be very worrying, it’s important to remember that help is available for you and your child. If you discover that your child is using substances, we can provide free harm reduction advice and materials aimed at children and young adults. DDAS can also offer help in the form of concerned other support for you. A concerned other is a person that is affected by a loved one’s substance use and is looking for advice and support. DDAS provide a safe place for you to discuss your concerns, increase your understanding of the effects of substances and receive ongoing support from professionals that are trained to support you and your child. Someone I know/love is using multiple substances, what support is available to them? A concerned other is someone who is affected by a loved one’s substance use. Discovering that your closest friend, relative or partner is using substances can elicit a number of feelings and emotions, fear, anger and confusion. If your loved one is using multiple substances, it’s important for them to have the correct information and ideally seek help and guidance from a support service to reduce the overall risks and potential harm to themselves and others. Many services offer an open access where they can informally call in to talk with a professional. Without judgement, a worker will help to identify goals, plan how to achieve them and maintain through recovery. I am addicted to using one or more substances, what are the long term effects? Using multiple substances increases stress on your organs namely the brain, liver and heart. Long term use can also lead to physical and psychological dependence which may make it harder to reduce or stop using substances in the future. If you are worried about your use or would like some advice about how to reduce/stop safely, contact your local substance use service (For Dyfed residents, please call 0330 363 9997). When I use cocaine and MDMA together, I notice that my heart beats really fast. Is this normal? Cocaine and MDMA are both stimulants which means they speed up the central nervous system (increases blood pressure, heart rate and body temperature) Using these substances together puts significant pressure on your heart which can increase the risk of heart attacks and strokes. To reduce harm, avoid mixing these substances. If you feel unwell when using then seek medical attention. Click here for more harm reduction advice. GET HELP SUPPORT IS AVAILABLE If you feel any of the Harm Reduction here speaks to you and you feel you need help, make your next move a positive one. For Dyfed Residents please contact: Dyfed Drug & Alcohol Service on 0330 363 9997. ​ Learn to Turn Back to safety and if you do Poly Use, tread carefully. GET HELP

While poly drug use is not recommended, many people still choose to use multiple substances together. Harm reduction advice is information that can be given to reduce the harms caused by poly drug use. The information below can help you to make an informed decision about your substance use. POLY DRUG HAR M REDUCTION Much like poly drug use, this section is about discovery. Safely learn about the risks and effects of substance combinations before you embark on your own experiments. REDUCE HARM - EDUCATE - PREVENT OVERDOSE If in doubt: ​ ​ G O LOW AND GO SLOW Use a little and wait for the effects CALL 0330 363 9997 FOR FURTHER INFORMATION/SUPPORT ROLL OVER THE BOXES TO DISCOVER QUICK, EASY TO REMEMBER ADVICE. As a rule: ​ ​ DON'T MIX DRU GS If you do, follow harm reduction advice. Remem ber: ​ ​ ​ ​ A LWAYS CARRY NALOXONE If you are using opiates yourself or with others. Get Naloxone here. Use a service like: ​ ​ WEDINOS To test what's in your drugs. Don't accept drugs from strangers. ​ ​ ​ STAY SAFE Only use drugs that you bought yourself. COCAETHYLENE (COCAINE & ALCOHOL) When you use alcohol and cocaine a separate toxic substance called cocaethylene is formed in the body as they metabolize in the liver. Cocaethylene increases the risk of an individual experiencing strokes and cardiovascular issues and is believed to have been linked to a number of sudden deaths in users. We would advise individuals to either use cocaine or alcohol and avoid using both together to eliminate the risks of cocaethylene poisoning. ​ GET HELP SUPPORT IS AVAILABLE If you feel any of the Harm Reduction here speaks to you and you feel you need help, make your next move a positive one. For Dyfed Residents please contact: Dyfed Drug & Alcohol Service on 0330 363 9997. ​ Learn to Turn Back to safety and if you do Poly Use, tread carefully. GET HELP DON'T GET X'D OUT SMASH THIS FOR EVEN MORE INFO

REDUCE HARM - EDUCATE - PREVENT OVERDOSE POLY DRUG OVERDOSE AWARENESS CAMPAIGN LEARN MORE DOWNLOAD MANUAL WHAT IS POLY DRUG USE? Poly drug use is the act of using multiple substances at the same time, including prescribed or illicit medication and alcohol. Poly drug use is very common and poses a serious risk of harm depending on the substances that are being used together. Much like a game of noughts and crosses, Poly Drug use can put you 1 move away from being crossed out. ​ Learn to Turn Back to safety and if you do Poly Use, tread carefully. WATCH A VIDEO ABOUT POLY DRUG USE OR LEARN ABOUT RISKS OF POLY DRUG USE LET'S GET STUCK IN LEARN MORE ABOUT POLY USE GET SUPPORT

POLY DRUG OVERDOSE AWARENESS CAMPAIGN 22 IMPORTANT INFORMATION FOR PEOPLE WHO USE SUBSTANCES. WHAT IS POLY DRUG USE? Probably the most common polydrug use involves the use of alcohol and other substances, as many people do not think of alcohol as a ‘drug’. Alcohol can, however, have a big impact on the way many substances affect you. Some of the time this involves it enhancing the effects of the other drug, but with many substances alcohol can create a dangerous, potentially fatal, chemical reaction. It’s essential to check whether the substance you’re going to take is known to interact with alcohol. POLY DRUG STATISTICS 83% Poly Drug Overdoses ending in hospitalisation in Dyfed 240 Poly Drug Use Fatalities 2020 - 2022, source: WGA 17 Victims of sexual assault as a result of excessive poly drug use leading to vulnerability 7 Under 18's fatalities from poly drug use overdose source: WGA HANG OVER DOSE There's a fine line between hangover and overdose. One is treatable, the other is preventable. Only one can kill. LET'S GET STUCK IN LEARN MORE GET SUPPORT

BETH YW TROI YN ÔL? Mae Turn Back yn ymgyrch ar gyfer 2022 i godi ymwybyddiaeth, hyfforddiant ac addysg am beryglon marwolaeth wrth ddefnyddio sylweddau lluosog ar yr un pryd. Defnydd Poly Cyffuriau yw'r weithred o ddefnyddio 2 neu fwy o'r un math o sylwedd ar unwaith neu, gymysgu mathau o sylweddau i wella, lleddfu neu negyddu effeithiau pob sylwedd a ddefnyddir. Learn More WHAT IS POLY DRUG USE? Probably the most common polydrug use involves the use of alcohol and other substances, as many people do not think of alcohol as a ‘drug’. Alcohol can, however, have a big impact on the way many substances affect you. Probably the most common polydrug use involves the use of alcohol and other substances, as many people do not think of alcohol as a ‘drug’. Alcohol can, however, have a big impact on the way many substances affect you. Some of the time this involves it enhancing the effects of the other drug, but with many substances alcohol can create a dangerous, potentially fatal, chemical reaction. It’s essential to check whether the substance you’re going to take is known to interact with alcohol. Learn More FICTIONAL STATISTICS 83% Poly Drug Overdoses ending in hospitalisation in Dyfed 240 Poly Drug Use Fatalities 2020 - 2022, source: WGA 17 Victims of sexual assault as a result of excessive poly drug use leading to vulnerability 7 Under 18's fatalities from poly drug use overdose source: WGA

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